Chiropractic

Chiropractic () is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. The main chiropractic treatment technique involves manual therapy but may also include exercises and health and lifestyle counseling. Most who seek chiropractic care do so for low back pain. Chiropractic is well established in the United States, Canada, and Australia, along with other manual-therapy professions such as osteopathy and physical therapy. Many chiropractors (often known informally as chiros), especially those in the field's early history, have proposed that mechanical disorders affect general health, and that regular manipulation of the spine (spinal adjustment) improves general health. A chiropractor may have a Doctor of Chiropractic (D.C.) degree and be referred to as "doctor" but is not a Doctor of Medicine (M.D.) or a Doctor of Osteopathic Medicine (D.O.). While many chiropractors view themselves as primary care providers, chiropractic clinical training does not meet the requirements for that designation. There is no compelling evidence that either primary or maintenance chiropractic adjustment is effective for any symptoms or diseases, including low back pain. A 2011 critical evaluation of 45 systematic reviews concluded that the data included in the study "fail[ed] to demonstrate convincingly that spinal manipulation is an effective intervention for any condition." Conclusions about cost-effectiveness are limited by low-quality studies, uncertainty about efficacy, and insufficient evidence. There are not sufficient data to establish the safety of chiropractic manipulations. It is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases. There is controversy regarding the degree of risk of vertebral artery dissection, which can lead to stroke and death, from cervical manipulation. Several deaths have been associated with this technique and it has been suggested that the relationship is causative, a...