CurrentDC, Chiropractor
Chiropractor
What it is
Commonly works on
- Spinal and joint pain
- Headache of neck origin
- Movement and function
- Sport and work injury
Typical settings
- Private practice
- Multidisciplinary clinics
- Sport teams
- Hospitals and the VA
Chiropractic dates its start to September 18, 1895, when D.D. Palmer performed what the profession counts as the first chiropractic adjustment, in Davenport, Iowa; he founded the school that became Palmer College of Chiropractic there in 1897. The profession has since grown into one licensed in every state, and federal survey data show that 11.0 percent of US adults saw a chiropractor in 2022, up from 7.4 percent in 2002.
A chiropractic visit follows the pattern of conventional medicine: the chiropractor takes a history, examines the patient, may order tests, reaches a working diagnosis and then sets out and monitors a management plan. Most patients come with musculoskeletal problems, especially of the spine. Treatment ranges from stretching and sustained pressure to joint manipulation, usually a quick thrust delivered by hand, which chiropractors call an adjustment.
Chiropractic is a drug-free profession by law in most states. Washington's chiropractic act, for example, excludes prescribing or dispensing any medicine and any form of venipuncture, and California's rules exclude using drugs from the materia medica while allowing vitamins and food supplements.
Entry runs through college study (a bachelor's degree in some states), graduation from an accredited chiropractic college, the national board examinations and the state's own licensing requirements. Licensed chiropractors may use the titles Doctor of Chiropractic, D.C. or chiropractic physician.
Sources
- The Palmer Family (official site)
- Spinal Manipulation: What You Need To Know (official site)
- Chiropractic: In Depth (official site)
- RCW 18.25.005, Chiropractic defined (official site)
- Board of Chiropractic Examiners Rules and Regulations, 16 CCR Section 302 (official site)
- Becoming a Chiropractor (official site)
A general description of the profession. It does not say what you may do under your license; for that, see the scope statuses below and your state board.
How it is regulated
State license
A license from a state board is what authorizes practice. Each state sets its own requirements, and a national exam, where there is one, is a step toward the license rather than a substitute for it. There is no national license.
- DC
- State license
- Around 7–8 years from starting undergraduate study
Licensure
A state license is required in every state, and it is the credential that authorizes practice. There is no national chiropractic license.
Chiropractic
No compactNo interstate compact exists for chiropractic. Practicing in a second state means a second license.
Scope at a glance
- Within scopeSpinal adjustment is the core procedure named in chiropractic practice acts.
- Within scopeChiropractic laws authorize manual treatment of the spine and other joints, which covers non-thrust mobilization.
- Varies by stateChiropractic acts rarely name instrument-assisted soft tissue work; Oregon's board treats it as part of chiropractic, but whether it is allowed depends on your state board.
- Varies by stateChiropractic acts rarely name cupping; boards that have ruled, such as Oregon's, Nevada's and West Virginia's, treat it as part of chiropractic, but whether it is allowed depends on your state board.
- Varies by stateSome states let chiropractors dry needle with added training, while courts or rules in other states have found it outside chiropractic.
- Within scopeChiropractic practice acts commonly authorize chiropractors to take or order diagnostic X-rays; ordering advanced imaging such as MRI is allowed in some states and limited in others. Medicare does not pay for imaging a chiropractor orders, which is a payment rule rather than a limit on scope.
- Within scopeChiropractic laws commonly list exercise and rehabilitation among chiropractic treatments.
- Varies by stateChiropractic laws often allow exercise-based rehabilitation but none we found names blood flow restriction, and some are much narrower, so whether it is allowed depends on your state board.
- Varies by stateSome states let chiropractors assess concussion and clear young athletes to return to play, sometimes only with extra credentials or physician involvement; others do not.
- Varies by stateChiropractic laws rarely name elastic taping; some state rules allow supports and similar add-on measures while narrower laws say nothing about them, so whether it is allowed depends on your state board.
- Varies by stateChiropractors may use electrical stimulation in many states, but at least one state excludes it and others add training requirements.
- Varies by stateChiropractors may use therapeutic ultrasound in many states, but at least one state excludes it and others require added training.
- Varies by stateChiropractic laws do not name vestibular rehabilitation; Texas's highest court upheld a board rule letting specially trained chiropractors perform vestibular eye-movement testing, and some states allow whatever procedures chiropractic colleges teach, but no board was found to address repositioning maneuvers, so the answer depends on the state.
- Varies by stateChiropractic laws commonly allow exercise, and those that name water, hydrotherapy or physiotherapy clearly reach exercise in water, but narrower laws mention neither, so whether aquatic therapy fits depends on the state board's reading.
- Within scopeChiropractic laws commonly include massage or treatment of muscle and connective tissue, though narrower laws describe it only in general terms.
- Within scopeTraction is a common chiropractic procedure and some chiropractic laws name it, though many describe it only through general terms such as mechanical measures.
- Within scopeChiropractic boards we read allow therapeutic (non-surgical) lasers within chiropractic scope, usually on conditions such as FDA clearance, training and no cosmetic use.
- Varies by stateChiropractic acts do not name shockwave therapy; some boards treat it as chiropractic physiotherapy, while at least one state's law excludes treatments that apply sound.
- Varies by stateSome states expressly let chiropractors use diagnostic ultrasound for musculoskeletal diagnosis, sometimes only after certification, while at least one state's courts have held it falls outside chiropractic scope.
- Varies by stateA few states let chiropractors clear young athletes after concussion, sometimes only with a physician's involvement or added credentials, while others reserve clearance for physicians and other listed providers.
- Within scopeChiropractors are first-contact providers: chiropractic laws let them examine, diagnose and treat patients who come to them directly, and require referral elsewhere when chiropractic care is not appropriate.
- Varies by stateGeneral state telehealth laws, such as Arizona's, cover chiropractors, but chiropractic care is largely hands-on and states differ on what a chiropractor may do remotely, so it depends on the state.
- Not typicalChiropractic laws generally exclude prescribing, dispensing and administering drugs.
- Varies by stateSome states let chiropractors order laboratory tests such as blood and urine work as part of diagnosis, while others limit related procedures such as drawing blood, so it depends on the state.
Bodies and guidance
Bodies
- ACAProfessional associationAmerican Chiropractic AssociationThe largest professional association for chiropractors in the United States.
- Clinical CompassProfessional associationClinical Compass (formerly the Council on Chiropractic Guidelines and Practice Parameters)Develops clinical practice guidelines for the chiropractic profession; known as CCGPP until 2018.
- WHOInternational organizationWorld Health OrganizationThe United Nations agency for global public health; issues evidence-based guidelines, including on low back pain.
- FCLBFederation of state boardsFederation of Chiropractic Licensing BoardsThe federation of state chiropractic licensing boards.
- NBCEExam bodyNational Board of Chiropractic ExaminersWrites and administers the national chiropractic examinations.
- CCEProgram accreditorCouncil on Chiropractic EducationAccredits Doctor of Chiropractic programs.
- CISGConsensus groupConcussion in Sport GroupInternational expert group behind the consensus statements on concussion in sport.
- WFCInternational organizationWorld Federation of ChiropracticA global not-for-profit organization of national chiropractic associations in more than 90 countries, and a non-governmental organization in official relations with the WHO.
Guidance
CurrentAT, Athletic trainerPT, Physical therapistOT, Occupational therapistDC, Chiropractor
Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022
CurrentDC, ChiropractorPT, Physical therapistOT, Occupational therapist
WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings
CurrentDC, Chiropractor
Best practices for chiropractic management of adult patients with mechanical low back pain: a clinical practice guideline for chiropractors in the United States
SupersededDC, Chiropractor
Practice Analysis of Chiropractic 2020
CurrentAT, Athletic trainerPT, Physical therapistDC, Chiropractor
International Olympic Committee consensus statement on pain management in elite athletes
SupersededDC, Chiropractor
Clinical practice guideline: chiropractic care for low back pain
Overlap with other professions
- DC, ChiropractorPT, Physical therapistCompare with physical therapistsEducation, exams, regulation and scope side by side
- DC, ChiropractorAT, Athletic trainerCompare with athletic trainersEducation, exams, regulation and scope side by side
- DC, ChiropractorLMT, Massage therapistCompare with massage therapistsEducation, exams, regulation and scope side by side
How to become a chiropractor
- Step 1
Complete the undergraduate prerequisite
- Step 2
Earn a Doctor of Chiropractic from a CCE-accredited program
- Step 3
Pass the NBCE examinations
- Step 4
Apply to the board of the state you will practice in
Where to get licensed
Each step in full, with the board for every state and the compacts that apply.
Get licensed as a chiropractorCareer path
Education routes, settings and how the profession is changing.