Myth 3: Chiropractic Isn’t Evidence-Based

This one makes us laugh

This is one of the most common claims made about Chiropractic care, and it’s usually repeated with confidence.

The problem is, it’s no longer true.

In fact, modern Chiropractic care is supported by a substantial and growing body of peer-reviewed research, particularly in the management of spinal pain, movement dysfunction, and nervous system regulation.



So where does this myth come from?

Where the Myth Started

The idea that Chiropractic “isn’t evidence-based” largely comes from three sources:

• Outdated education that hasn’t kept up with modern research
• Confusion between poorly delivered Chiropractic and Chiropractic as a profession
• Research studies that misclassify or dilute Chiropractic care

Many older studies grouped together:

• Mobilisation
• General manipulation
• Exercise-only care
• Low-frequency treatment

…and then labelled all of it “spinal manipulation”.

This made Chiropractic appear ineffective when, in reality, the intervention being studied was
not representative of real Chiropractic care (Bronfort et al., 2008).

What the Evidence Actually Shows

When Chiropractic care is delivered as it is intended to be delivered - with:

• Specific spinal assessment
• High-velocity, low-amplitude (HVLA) adjustments
• Appropriate frequency and duration of care

…the outcomes are consistently positive.

Randomized controlled trials and large cohort studies show that Chiropractic care is:



• More effective than usual medical care for many cases of low back pain (Bishop et al., 2010; Goertz et al., 2018)
• Associated with reduced opioid use and fewer surgeries (Cifuentes et al., 2011)
• Cost-effective compared to medical and physiotherapy care (Manga et al., 1993)

These are not fringe studies. They are published in respected, peer-reviewed journals.

Dose Matters (And This Is Often Ignored)

One of the biggest reasons Chiropractic is occasionally labelled “ineffective” in some reviews is because of underdosing.

Many studies evaluate:

• 2–6 visits in total
• Over only a few weeks
• Often with no maintenance or follow-up visits

This would be equivalent to:

• Going to the gym twice
• Saying exercise doesn’t work
• And publishing that conclusion

High-quality dose-response studies show that around 12 visits over 4–6 weeks produces significantly better outcomes than low-dose care (Haas et al., 2014). When care is stopped too early, improvements regress, a finding that has been repeatedly demonstrated in long-term follow-up studies (Senna & Machaly, 2011).

Chiropractic and the Nervous System: Not Theory Anymore

Modern research has moved beyond pain scores alone.



Neuroimaging and neurophysiology studies now show that Chiropractic adjustments can influence:

• Brain processing of sensory input
• Sensorimotor integration
• Central pain modulation
• Mood and stress regulation

Randomized trials have demonstrated measurable changes in brain metabolites and EEG patterns following a structured course of Chiropractic care (Didehdar et al., 2020; Niazi et al., 2024).

This directly challenges the idea that Chiropractic is “just mechanical” or placebo-based

Why Some Still Say “There’s No Evidence”

In many cases, the statement “there’s no evidence” actually means:



• “I haven’t read the research”
• “I don't care enough to investigate”
• “I’m unfamiliar with evidence-based Chiropractic protocols”

Importantly, lack of familiarity is not the same as lack of evidence.

Chiropractic care is now included in multiple international clinical guidelines for low back pain and is recognised as a first-line conservative option before medication or surgery (Bronfort et al., 2011).

Evidence-Based Does Not Mean Pharmaceutical

Another reason this myth persists is cultural.

In modern healthcare, “evidence-based” is often wrongly equated with:

• Medication
• Surgery
• Pharmaceutical intervention

Yet systematic reviews repeatedly show that:

• Paracetamol is ineffective for low back pain (Davies et al., 2008; Enthoven et al., 2016)
• NSAIDs offer minimal benefit with meaningful risk (Chou et al., 2017)
• Surgery for non-specific back pain has poor long-term outcomes (Nguyen et al., 2011)

Meanwhile, Chiropractic care demonstrates benefit with lower risk and better functional outcomes when applied correctly.



The Bottom Line



Chiropractic is not lacking evidence.

What it has lacked historically, is accurate representation.

When Chiropractic care is:

• Properly assessed
• Specifically delivered
• Appropriately dosed

…the evidence supporting its effectiveness is strong, growing, and difficult to ignore.

At Adjusting to Health, this research forms the foundation of our Health Blueprint™ Process,
ensuring care is not only effective, but appropriate, measurable, and safe.

References

Bishop, P.B. et al. (2010). The chiropractic hospital-based interventions research outcomes (CHIRO) study. The Spine Journal, 10(12), pp.1055–1064.

Bronfort, G. et al. (2008). Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. The Spine Journal, 8(1), pp.213–225.

Chou, R. et al. (2017). Systemic pharmacologic therapies for low back pain. Annals of Internal Medicine, 166(7), pp.480–492.

Cifuentes, M. et al. (2011). Health maintenance care with chiropractic and disability recurrence. Journal of Occupational and Environmental Medicine, 53(2), pp.190–198.

Davies, R.A. et al. (2008). Paracetamol for non-specific low back pain. European Spine Journal, 17(11), pp.1423–1430.

Didehdar, K. et al. (2020). The effect of spinal manipulation on brain neurometabolites. Irish Journal of Medical Science, 189, pp.543–550.



Goertz, C.M. et al. (2018). Effect of usual medical care plus chiropractic care vs usual medical care alone. JAMA Network Open, 1(1), e180105.

Haas, M. et al. (2014). Dose-response and efficacy of spinal manipulation. The Spine Journal, 14(7), pp.1106–1116.

Manga, P. et al. (1993). The effectiveness and cost-effectiveness of chiropractic management of low back pain. Ontario Ministry of Health.

Nguyen, T.H. et al. (2011). Long-term outcomes of lumbar fusion. Spine, 36(4), pp.320–331.

Niazi, I.K. et al. (2024). Neuroplastic responses of chiropractic care. Scientific Reports, 14, 1159.

Senna, M.K. and Machaly, S.A. (2011). Maintained spinal manipulation therapy for chronic low back pain. Spine, 36(18), pp.1427–1437.