Is Chiropractic Medicine Safe & Effective For Pain Relief? All You Need To Know

woman sitting at a desk holding her neck and back in pain for which chiropractic medicine can help

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This Article was originally published on Rupa Health. *

Prescription opioids are commonly prescribed to treat moderate-to-severe pain. But significant risks come with these pain medications. Not only are prescription opioid medications highly addictive, they have caused more than 263,000 overdose deaths since 1999. In 2021 alone, there were 16,706 deaths involving prescription opioids, which is almost five times as many prescription opioid deaths as there were in 1999. When it comes to pain, we need better options.

Chiropractic medicine is an excellent solution. Initially presenting to a chiropractic physician instead of another primary care physician for low back pain is associated with substantially reduced short and long-term use of opioid medications. Regarding musculoskeletal pain relief, chiropractic medicine offers an effective non-drug approach to support the body’s natural healing process.

How Does Chiropractic Medicine Work?

Chiropractic medicine is a form of care provided by chiropractic physicians to support the body’s healing process using natural therapies such as spinal manipulation, manual therapy, stretching, exercise, and nutrition. Chiropractic physicians routinely provide treatment for conditions related to the musculoskeletal system.

Chiropractic medicine approaches patient care similarly to other forms of medicine. When you see a chiropractor, a thorough health history, physical examination, and additional testing are performed to determine an underlying root cause for your health issue. In addition, a personalized, comprehensive treatment plan is created for you.

Treatment methods that chiropractic medicine utilizes often involve manual therapies, such as trigger point therapy, stretching, joint mobilization, and joint manipulation. Chiropractors also use therapeutic exercises and nutrition therapy and often recommend stress-management techniques and mind-body therapies to support their patients on their healing journeys.

Joint manipulations, which chiropractic medicine is well known for, are performed by hand or with an instrument to apply a quick, controlled force to a joint to improve joint motion and body function. Chiropractic physicians often perform joint manipulations on spinal joints, referred to as spinal manipulations. Spinal manipulations impact the nervous system and surrounding tissues, resulting in reduced stiffness, enhanced muscle recruitment, less pain, and improved function.

chiropractic medicine for pain relief

Is Chiropractic Medicine Safe?

When considering a treatment or therapy option, safety is a valid concern. A common question surrounding chiropractic care is whether or not chiropractic medicine is safe. Overwhelmingly, chiropractic medicine is proven to be a safe form of therapy for many complaints, including pain management.

As with any therapy, however, there is potential for side effects and adverse events. Most adverse events reported with chiropractic care are mild, transient, and related to the musculoskeletal system. A 2017 systematic review and meta-analysis on spinal manipulation for acute low back pain reported mild and brief adverse events, including increased pain, muscle stiffness, and headache. Although many of these side affects subside within a few hours after treatment.

Cervical spinal manipulations are a common treatment offered by chiropractors to treat neck discomfort, stiffness, impaired cervical spine range of motion, and headaches. The safety of these manipulations has been questioned due to observational studies linking this procedure to vertebral artery dissection and resulting vertebrobasilar stroke (VBS). The data, however, fails to show conclusive evidence of this claim.

A study published in 2015 sought to identify the risk for stroke following chiropractic manipulation and concluded that the incidence of vertebrobasilar stroke was extremely low. In patients that saw a chiropractor, their risk for stroke at 7 days after care was significantly lower than those who saw a primary care physician. The study also cited reviews from 2009, 2010, and 2012 that could not show a significant association between stroke and cervical manipulations.

Estimates of serious adverse events, such as stroke, are extremely low. They are 0.05 to 1.46 per 10 million manipulations. For perspective, opioids have a total event rate of 7.5% for serious adverse events, which is 7.5 out of 100.

Chiropractic care is shown to be a safe solution for pain management.

Efficacy of Chiropractic Care and Pain Relief

The most common reasons people seek chiropractic care include low back pain, neck pain, and headaches. Let’s look at the evidence for how effective chiropractic care is in relieving pain from these complaints.

A systematic review and meta-analysis published in 2017 examined the effectiveness of chiropractic care for acute low back pain. The study concluded that spinal manipulation was associated with statistically significant modest improvements in pain and function.  

A randomized controlled trial published in 2021 evaluated the effectiveness of spinal manipulation in patients with tension-type headaches and neck pain. There were three treatment groups: manipulation plus exercise, myofascial release, and exercise only. The results indicated that cervical spinal manipulation plus exercise effectively reduced headache severity, frequency, and duration, as well as neck pain and disability.

Another randomized controlled trial examined the effectiveness of chiropractic care along with standard medical care for acute low back pain versus just standard medical care alone. The group receiving chiropractic care showed significantly reduced pain and improved physical function versus the group receiving only standard medical care.

As stated earlier, chiropractic medicine incorporates many therapies, with spinal adjustment being the most common. The evidence confirms what doctors of chiropractic and patients receiving this type of care already know: chiropractic care offers effective pain relief.

chiropractic medicine for pain relief

Possible Causes of Pain a Chiropractor Can Help With

A wide variety of insults can cause pain, but common causes of pain that chiropractors can help with include musculoskeletal injuries, such as sprains and strains, muscle tension or spasms, herniated or bulging discs, spinal stenosis (narrowing of the spinal canal), arthritis, headaches, and poor posture.

Genetic Causes of Pain

Many environmental and lifestyle factors can increase the risk of experiencing pain. Genetics plays a role in how you experience pain. Variations in your genes determine your sensitivity to pain, how likely you are to develop chronic pain, and whether certain therapies will help reduce your pain. Females have a higher prevalence of chronic pain than men, experience higher pain levels from certain conditions, and are at greater risk of developing many pain conditions.

Inflammatory Causes of Pain

Inflammation plays a major role in causing pain. Inflammatory mediators, pro-inflammatory cytokines, and chemokines bind to pain receptors to trigger pain. Neuroinflammation is inflammation that occurs in the central and peripheral nervous system and is thought to mediate human pain conditions and contribute to the development of chronic pain. Inflammation is triggered by the immune, somatosensory, nervous, autonomic, and circulatory systems’ response to pathogens, irritants, or tissue damage.

Lifestyle Causes of Pain

Lifestyle factors including stress, lack of sleep, skipping meals, and alcohol consumption are common causes of headaches. Risk factors for experiencing osteoarthritis type of pain include being overweight, obesity, muscular weakness, and lack of physical activity.

Nutritional Causes of Pain

Nutrition also has an impact on pain. A systematic review found Western diets and diets with high inflammatory potential were associated with increased osteoarthritis symptoms, and this diet is also more prevalent in people with rheumatoid arthritis. Inadequate levels of micronutrients, such as Vitamin D, omega-3 fatty acids, B vitamins, magnesium, zinc, selenium, and iron, are associated with chronic pain.

Gut Dysbiosis Causes of Pain

Evidence continues to emerge, showing the importance of gut health in every facet of human health. When gut health is impaired, it can lead to many issues, including increased pain. Gut dysbiosis is shown to trigger neuroinflammation, which we just discussed as being intricately involved in mediating pain.

Functional Medicine Labs Commonly Used in Chiropractic Pain Management

In addition to diagnostic imaging to identify structural causes of pain and comprehensive blood testing to evaluate for immune abnormalities and dehydration, other functional labs are commonly ordered to identify the root cause of pain.

Genetic Testing

Some individuals have a certain genetic predisposition to experience negative effects of pain. Some genetic mutations can even indicate that an individual will not likely tolerate pain medication well. This Genetic Test: Pain Management by Ayumetrix assesses specific genes related to pain and pain management. This could give individuals a better idea of how they can approach their pain management.

Inflammation Testing

In addition to the foundational blood tests to evaluate overall health, various inflammatory markers help identify an inflammatory cause for pain. Inflammatory markers, such as CRP and ESR, can be beneficial in delivering appropriate individualized care for patients with pain.

Micronutrient Testing

Given nutrients’ role in developing and improving pain, a Micronutrients Panel can be valuable in providing a targeted nutritional approach for patients with pain. This panel from Vibrant America is a blood test that measures 40 different vitamins, minerals, antioxidants, fatty acids, and amino acids, including Vitamin DOmega-3 fatty acids, magnesium, B vitamins, iron, zinc, and selenium, nutrients known to be associated with pain.

Comprehensive Stool Analysis

Various factors impact gastrointestinal health and can lead to dysbiosis and inflammation. Gut health is essential for many aspects of overall health, making a comprehensive stool test helpful in identifying a root cause for pain and formulating an effective treatment plan. Stool tests provide information about the gut microbiome, inflammation, digestion, absorption, and immune responses in the gut.

chiropractic medicine for pain relief

Complementary and Integrative Medicine for the Treatment of Pain

In this article, we’ve covered the effectiveness of chiropractic medicine for treating pain conditions. In addition to the foundational aspects of a healthy lifestyle, such as stress management, sleep optimization, physical activity, a healthy diet, and proper hydration, chiropractic physicians often utilize additional complementary and integrative medicine treatments to support their patients in healing.

Nutritional supplements: that are shown to reduce pain include Vitamin DOmega-3 fatty acids, magnesium, B vitamins, vitamin E, probiotics to support gut health, and curcumin to reduce inflammation.

NOTE: always consult your healthcare practitioner before beginning any new supplement to ensure it is right for you.

Yoga: is often utilized as a form of exercise and stress management. Evidence indicates yoga can assist in reducing pain and may also help reduce the use of opioid medications in people with low back pain.

Acupuncture: Chiropractors usually work in conjunction with Acupuncture Physicians and refer out for other pain management options. Traditional Chinese Medicine treatment approach utilizing fine needles at various points on the body to bring balance to the body and improve health. Acupuncture is shown to be effective for pain control.

Massage Therapy: Chiropractors often incorporate massage therapy into the treatment plan when treating pain conditions. Evidence indicates massage therapy reduces pain and improves function and range of motion, making it an excellent adjunct to chiropractic care for pain control.

Physical Therapy: Chiropractic physicians often recommend physical therapy for patients with pain conditions. Physical therapists incorporate strengthening exercises, stretching, exercises to improve range of motion, and manual therapies to help reduce pain and improve function.

Tai chi :is a therapeutic mind-body exercise involving slow movements, breathwork, and a meditative state of mind. Chiropractors often recommend this form of therapy, especially for elderly patients, as it is gentle and is shown to be effective in reducing pain, particularly for osteoarthritis, low back pain, and osteoporosis.

yoga for pain relief


Pain can be debilitating; unfortunately, conventional pain medications are often addictive and dangerous. Chiropractic medicine provides a safe and effective drug-free approach to treating pain.

Chiropractors utilize various natural therapies, such as spinal manipulation, manual therapy, stretching, exercise, and nutrition, to support patients with pain.

Chiropractic medicine can be utilized in conjunction with standard medical care, and chiropractors also often recommend other complementary and integrative therapies to help patients with pain.

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