An orthopedic chiropractor is a chiropractor who has completed additional postgraduate training in diagnosing and managing musculoskeletal conditions, particularly complex bone, joint, and nerve problems that go beyond routine back pain. They hold a standard chiropractic license plus a specialty certification, most commonly the Diplomate in Chiropractic Orthopedics (DACO) or the Diplomate of the International Academy of Neuromusculoskeletal Medicine (DIANM). This is not the same thing as an orthopedic surgeon or orthopedic physician, which is a common point of confusion.
How They Differ From General Chiropractors
All chiropractors complete a doctoral program in chiropractic and pass national board exams to earn their license. An orthopedic chiropractor goes further, completing a minimum of 300 hours of additional postgraduate education focused on orthopedic diagnosis, musculoskeletal pathology, and advanced clinical decision-making. This training covers how to identify conditions that may not respond to standard chiropractic adjustments, or cases where a referral to a surgeon or other specialist is the better path.
In practice, this extra training means an orthopedic chiropractor is more likely to use detailed physical examination procedures, order or interpret advanced imaging like MRI or CT scans, and recognize when a problem such as spinal stenosis, nerve root compression, or inflammatory arthritis needs care beyond manual therapy. A general chiropractor may focus primarily on spinal adjustments and soft tissue work. An orthopedic chiropractor still uses those tools but layers in a broader diagnostic framework to sort out what’s actually causing the problem before deciding on treatment.
How They Differ From Orthopedic Doctors
This is where the naming gets confusing. An orthopedic physician (sometimes spelled “orthopaedic”) is a medical doctor who completed four years of medical school, a one-year internship, and four years of residency in orthopedics, often followed by an additional fellowship year in a subspecialty like spine surgery or pain management. They can prescribe medication, administer injections, and perform surgery.
An orthopedic chiropractor cannot do any of those things. They are not medical doctors. Their scope of practice centers on manual therapies, rehabilitative exercises, bracing, and other non-surgical, non-pharmaceutical interventions. The word “orthopedic” in their title refers to their area of advanced study, not to a medical degree. If your condition ultimately requires surgery, injections, or prescription pain management, an orthopedic chiropractor would refer you to a medical orthopedist or other appropriate specialist.
Credentials and Board Certification
The specialty was historically overseen by the American Board of Chiropractic Orthopedists, which has since been reorganized under the International Academy of Neuromusculoskeletal Medicine (IANM). The American Board of Chiropractic Specialties, an arm of the American Chiropractic Association, provides third-party recognition that the certification program meets national credentialing standards.
To earn the diplomate credential, a chiropractor must complete at least 300 hours of postgraduate coursework or a formal residency program, then pass a board examination. Some residency programs run 12 months, others up to 36 months, depending on the institution and specialty track. After certification, practitioners may list the credential DACO or DIANM after their name. A now-discontinued fellowship designation (FACO) was reclassified as fraternal rather than academic, so the diplomate remains the meaningful clinical credential.
If you want to verify that a provider actually holds this certification, the IANM maintains two online directories: one for certified doctors and one for those who have completed Maintenance of Certification requirements, which ensure the provider’s training stays current.
Conditions They Commonly Manage
Orthopedic chiropractors typically see patients with problems that are more complicated or persistent than a simple muscle strain. These include radiculopathy (nerve pain radiating into an arm or leg from a compressed spinal nerve root), disc herniations, spinal stenosis, chronic joint pain from osteoarthritis, and post-injury rehabilitation. They also evaluate conditions that might mimic musculoskeletal problems but actually stem from something else entirely, like inflammatory or autoimmune disorders, which would need referral to a rheumatologist or other medical specialist.
Their diagnostic training is oriented toward figuring out not just where you hurt, but why. For someone with chronic low back pain, for instance, that might mean distinguishing between a disc problem, a joint problem, a nerve problem, or a combination, and then deciding whether chiropractic care is appropriate or whether you need imaging, a surgical consultation, or a different type of specialist altogether.
What Treatment Looks Like
Treatment from an orthopedic chiropractor stays within the non-surgical, drug-free lane but tends to be more structured than a standard chiropractic visit. You can expect a thorough initial examination that may include orthopedic and neurological testing, review of any existing imaging, and a detailed health history. Based on that assessment, a treatment plan might combine spinal or joint manipulation, soft tissue techniques, customized rehabilitative exercises, bracing, and ergonomic or lifestyle recommendations.
For chronic low back pain specifically, research on patients referred from spine surgery divisions to chiropractic care offers a useful picture of what to expect. In one study tracking 67 patients with chronic low back pain (most lasting over a year), chiropractic treatment reduced pain scores by about 25% and overall biopsychosocial impairment by 27% over 12 months. Roughly half of the patients reported meaningful overall improvement, with gains becoming noticeable within the first month and stabilizing around three to six months. Notably, the improvements patients reported weren’t just about pain reduction. They also reflected better function, sleep, and quality of life.
These results won’t apply to every patient or every condition, but they illustrate the kind of incremental, sustained improvement that conservative musculoskeletal care can produce, particularly for people whose pain hasn’t responded to other approaches and who want to avoid or delay surgery.
Working Alongside Other Providers
Orthopedic chiropractors increasingly work in settings where they coordinate directly with medical doctors, physical therapists, and other specialists. In multidisciplinary clinics, this can look like shared electronic medical records, where the chiropractor can review lab work, imaging reports, specialist notes, and medication lists. It also involves informal consultations between providers to align on a consistent treatment plan for a shared patient.
This kind of collaboration matters most for complex cases. A patient with chronic neck pain and concurrent anxiety, for example, might have a treatment plan developed jointly between a chiropractor, a mental health counselor, and a nurse practitioner, combining spinal manipulation, stress management strategies, and home stretching routines. When a chiropractor identifies something on examination that falls outside their scope, such as a suspected fracture, tumor, or systemic inflammatory condition, they can immediately recommend imaging or a referral to the appropriate medical provider.
While many chiropractors still practice independently, the trend toward integrated care is growing. If coordinated treatment across multiple providers matters to you, look for orthopedic chiropractors who practice within or alongside medical groups, hospital systems, or multidisciplinary pain clinics rather than in solo practices.
How to Find One
Start with the IANM’s certified doctor directory, which lists providers who hold the current diplomate credential and those maintaining active certification. You can also check with your state chiropractic licensing board to confirm that a provider’s license is in good standing. When evaluating a potential provider, look for the DACO or DIANM designation and ask directly about their postgraduate training, how long they’ve held the certification, and whether they coordinate with medical providers for cases that may need imaging, injections, or surgical evaluation.