In chiropractic, a manipulative and body-based practice, the relationship between the structure of the spine and the function of the nervous system is seen as key to maintaining or restoring health. The main method for correcting this relationship is spinal manipulation. Chiropractors may also provide physical therapies (such as heat and cold, electrical stimulation, and rehabilitation strategies), massage, or acupressure or recommend exercises or lifestyle changes. They may recommend ways that people can rearrange things in their work environment to make them easier and safer to use (ergonomic changes). Such changes can help prevent problems such as back pain. (See also Overview of Integrative, Complementary, and Alternative Medicine.)
Some chiropractors use spinal manipulation to correct suggested misalignments in the backbones (vertebrae) in an attempt to restore the flow of vital energy. These chiropractors practice a hybrid of energy therapy and manipulation. Other chiropractors reject this belief.
Chiropractic is being actively studied. Problems most commonly treated by chiropractic include low back pain, headaches, neck pain, and nerve pain due to nerve compression.
Past clinical trials (studies to determine the safety and effectiveness of treatments in people) have shown chiropractic to be effective for short-term relief of low back pain. Conventional medical practice guidelines include chiropractic as a treatment option for sudden low back pain that persists despite measures people take on their own. Treatments continued beyond 3 months may not provide added benefit.
The usefulness of manipulation for conditions not directly related to the musculoskeletal system (such as asthma, colic, and ear infections in children) has not been established. The few studies that have been done suggest that manipulation is not effective for these disorders.
Serious complications resulting from spinal manipulation, such as low back pain, damage to cervical nerves, and damage to arteries in the neck, are rare. Other side effects may include discomfort, headache, and fatigue, which usually disappear within 24 hours. Spinal manipulation is not recommended for people who have any of the following: