What Is Chiropractic and What Does a Chiropractor Do?

By Benjamin McCay, DC, CCSP

Published August 6, 2026

Many people first consider chiropractic care because something is interfering with their life. Perhaps back pain makes it difficult to work, sleep, exercise, or sit comfortably. Neck stiffness may make it harder to turn your head while driving. A headache may keep returning. An injury may have left you feeling sore, restricted, or unsure about how active you should be. Chiropractic care is designed to help people with these types of problems move more comfortably, function better, and return to the activities that matter to them.

Many people still think chiropractic is simply “cracking backs” or putting bones back into place. Those descriptions miss most of what modern chiropractic care involves.

Although chiropractors are best known for performing spinal adjustments, chiropractic care involves much more than the adjustment itself. A chiropractor is a licensed health care provider trained to examine, diagnose, and conservatively treat conditions involving the joints, muscles, connective tissues, and related nerves.

Treatment may include chiropractic adjustments, joint mobilization, soft-tissue therapy, rehabilitative exercise, posture and movement advice, and strategies that patients can use at home. When a condition requires imaging, medical treatment, or evaluation by another specialist, the chiropractor can make an appropriate referral.

For many people, chiropractic offers a practical first step: a personalized, nonsurgical approach intended to reduce pain, restore movement, and improve everyday function.

What Is Chiropractic?

Chiropractic is a health profession focused primarily on musculoskeletal conditions and related nerve symptoms. Chiropractic care aims to improve mobility in joints that are stiff or painful and to help different areas of the body move together more comfortably, efficiently, and with less strain.

The musculoskeletal system includes:

• Spine
• Joints
• Muscles
• Tendons
• Ligaments
• Fascia
• Discs

These structures work together. When a joint becomes stiff, a muscle is strained, or movement becomes painful, the body may begin to compensate. A person may move differently, avoid certain activities, become weaker, or develop tension in nearby areas.

For example, back pain may involve more than one structure. Joint irritation, muscle guarding, reduced mobility, nerve sensitivity, poor endurance, and altered movement patterns may all contribute. Effective treatment therefore requires more than simply identifying where it hurts.

A chiropractor evaluates how the body is moving, which tissues may be involved, whether neurological function is affected, and whether there are signs that another type of evaluation is needed.

The goal is not merely to produce a temporary sensation or a popping sound. The goal is to help the patient:

• Move with less pain
• Restore comfortable joint motion
• Reduce muscle tension
• Improve strength and stability
• Resume work, exercise, sleep, and normal activities
• Lower the likelihood of recurring problems

The treatment plan should be based on the patient’s condition, health history, examination findings, and personal goals.

A Brief History of Chiropractic

Hands-on treatment for painful muscles and joints has existed for thousands of years. Various forms of massage, stretching, joint mobilization, and bone setting appeared in many cultures long before chiropractic became an organized profession.

Chiropractic developed in the United States during the late nineteenth century, when health care was undergoing major change. Many medical treatments available at that time were ineffective, poorly regulated, or dangerous. This created interest in approaches that emphasized the relationship between body structure, movement, and health.

Andrew Taylor Still began developing osteopathy during the 1870s and founded the American School of Osteopathy in Kirksville, Missouri, in 1892.

Only three years later, Daniel David “D.D.” Palmer performed what the chiropractic profession recognizes as its first adjustment in Davenport, Iowa, in 1895. Palmer established a chiropractic school in 1897, which later became Palmer College of Chiropractic. Because chiropractic emerged soon after osteopathy and in relatively close geographic proximity to Andrew Still’s school in Kirksville, Missouri, some historians have suggested that Palmer may have been influenced by Still or by early osteopathic ideas. However, direct evidence that Palmer formally studied under Still remains incomplete.

Although the two professions shared similar origins in their dissatisfaction with the medical practices of the era, they eventually followed different paths. Osteopathic medicine became incorporated into the broader medical system in the United States, while chiropractic remained a separate profession with a strong emphasis on hands-on, conservative care.

Early chiropractic explanations often centered on the idea of the vertebral “subluxation.” D.D. Palmer believed that altered spinal relationships could interfere with nerve function and contribute to disease throughout the body. Some early chiropractors made claims that extended far beyond what later scientific research could support. Modern chiropractic practice has evolved considerably.

Chiropractic education now includes anatomy, physiology, pathology, neurology, diagnostic imaging, physical examination, clinical diagnosis, manual treatment, rehabilitation, and supervised patient care. Chiropractors must graduate from an accredited Doctor of Chiropractic program, pass national board examinations, and meet state licensing requirements.

The profession remains diverse. Some chiropractors retain a traditional philosophical approach, while others focus primarily on modern musculoskeletal diagnosis, evidence-based treatment, exercise, and rehabilitation.

Like medicine and osteopathy, chiropractic has changed substantially since the nineteenth century. Modern chiropractic should not be judged solely by what its founders believed. Its treatments and health claims should be evaluated according to current anatomy, physiology, clinical evidence, patient outcomes, and the benefits and risks of care.

Patients benefit from choosing a chiropractor whose approach is based on a careful examination, clear explanations, measurable goals, and treatment appropriate for the condition being treated.

What Training Does a Chiropractor Receive?

A chiropractor earns a Doctor of Chiropractic degree and must meet the licensing requirements of the state in which the chiropractor practices.

Accredited Doctor of Chiropractic programs in the United States require at least 4,200 instructional hours, including substantial supervised patient care. Chiropractic students study many of the same foundational biomedical and clinical subjects taught in medical education, including anatomy, physiology, biochemistry, pathology, microbiology, neurology, embryology, cardiopulmonary, dermatology, rheumatology, obstetrics and gynecology, diagnostic imaging, and physical, orthopedic, and neurological examination. Chiropractic training also emphasizes differential diagnosis, manual treatment, rehabilitation, and recognition of conditions requiring medical referral.

This training prepares chiropractors to do more than locate a painful or stiff joint. They must determine whether a musculoskeletal condition is appropriate for chiropractic care, whether additional testing is needed, and whether the patient should be referred to another provider.

Chiropractors do not prescribe medication nor perform surgery in most states. Their primary role is to provide conservative care and help patients improve without more invasive treatment.

What Happens During a Chiropractic Examination?

An initial chiropractic visit should begin with a conversation and examination—not an automatic adjustment.

The purpose of the evaluation is to determine:

1. What may be causing the symptoms
2. Whether chiropractic treatment is appropriate
3. Which type of treatment is most likely to help
4. Whether imaging, medical evaluation, or referral is needed

The chiropractor first needs to understand what is happening, how it is affecting you, and what you want to regain or achieve through treatment.

Health History

The chiropractor will usually ask questions such as:

• When did the problem begin?
• Was there an injury?
• Where is the pain located?
• Does it travel into an arm or leg?
• What movements make it better or worse?
• Does it affect sleep, work, exercise, or daily activities?
• Have you experienced numbness, tingling, or weakness?
• What treatment have you already tried?
• Have you had similar problems before?

A patient's broader medical history also matters. Previous injuries, surgeries, medications, medical conditions, work demands, and exercise habits can influence both diagnosis and treatment.

This discussion helps the chiropractor understand not only the pain itself, but what a patient wants to regain. One patient may want to return to work without restriction. Another may want to sleep through the night, lift a child, exercise again, or turn the head comfortably while driving.

Physical Examination

The examination is tailored to the area of concern. It may include an assessment of:

• Posture
• Walking and balance
• Spinal movement
• Shoulder, hip, or other joint motion
• Muscle tension and tenderness
• Strength
• Reflexes
• Sensation
• Coordination
• Orthopedic tests
• Neurological function

Chiropractors are trained to examine the actual problem rather than assume that every symptom comes from the same spinal issue. For example, pain extending into the leg may require tests for nerve irritation. Shoulder pain might include examination of the shoulder (as opposed to merely the neck). Headaches may require evaluation of neck motion, muscles, joints, neurological findings, and other possible causes.

The examination also helps identify warning signs that may require medical evaluation. Chiropractors are trained to recognize when symptoms may indicate a fracture, serious neurological problem, infection, vascular condition, or another disorder that should not be managed solely with chiropractic treatment.

Will You Need X-Rays or an MRI?

Many patients do not need imaging before beginning care. X-rays and MRI scans can be valuable when the results are likely to affect diagnosis or treatment. They may be appropriate after significant trauma, when a fracture is suspected, when neurological symptoms are worsening, when the history or examination raises concern about another condition, or when a patient does not respond as expected to treatment.

For uncomplicated back or neck pain, however, a careful clinical examination often provides enough information to begin conservative treatment safely. Imaging should be ordered because it is medically useful, and not merely because a patient walked through the door.

Diagnosis and Treatment Plan

After the examination, the chiropractor should explain:

• What appears to be causing the symptoms
• Whether chiropractic care is appropriate
• What treatment is recommended
• How often treatment may initially be needed
• What improvement should look like
• What can/should be done at home
• When progress will be reassessed

A good treatment plan has a purpose. The purpose may be to improve range of motion, decrease pain during sitting, restore walking tolerance, improve sleep, or help the patient return to work or exercise.

Treatment should not continue indefinitely without evaluating whether it is helping. Many patients begin with a short trial of care. As symptoms and function improve, visits are commonly reduced while the patient becomes more independent with exercise and normal activity.

What Types of Treatment Do Chiropractors Use?

Chiropractic treatment should be individualized. Not every patient receives the same technique, and not every condition requires spinal manipulation.

Chiropractic Adjustments

A chiropractic adjustment is a controlled movement applied to a joint that is painful, stiff, or not moving normally. During a manual adjustment, the joint may move slightly beyond its usual active range while remaining within its normal anatomical limits.

Adjustments are commonly used to:

• Improve joint motion
• Reduce stiffness
• Decrease pain
• Reduce protective muscle tension
• Make movement feel easier
• Help restore normal physical activity

Some adjustments involve a quick manual movement. Others use a handheld instrument, a specialized table, or a lower-force technique.

The familiar popping sound that sometimes accompanies an adjustment is called joint cavitation. It results from a rapid pressure change within the joint. It does not mean that bones were rubbing together or that a dangerously displaced vertebra was forced back into place.

A louder adjustment is not necessarily more effective, and an effective treatment does not always produce a sound. The clinical effects may involve changes in joint motion, muscle activity, pain sensitivity, and sensory information from the treated area.

Treatment should also be adapted to the individual. Age, comfort, bone health, medications, diagnosis, previous injuries, and personal preference all influence which techniques are appropriate.

Patients may decline any treatment technique. Someone who does not want the neck adjusted, for example, may still receive mobilization, soft-tissue treatment, exercise, and care directed toward other areas.

Joint Mobilization

Joint mobilization uses slower, repeated movements rather than a quick thrust. It may be used to gradually improve motion, reduce stiffness, or provide a gentler alternative for patients who prefer lower-force treatment.

Soft-Tissue Treatment

Muscles and fascia frequently tighten around painful or injured areas. This may contribute to stiffness, tenderness, and restricted movement.

Soft-tissue treatment may include:

• Myofascial techniques
• Trigger-point therapy
• Massage
• Stretching
• Manual resistance techniques
• Instrument-assisted treatment

These techniques can help reduce muscle guarding and make it easier to move and exercise.

Exercise and Rehabilitation

Exercise is one of the most valuable components of modern chiropractic care.

Manual treatment may help reduce pain and improve motion, creating an opportunity for the patient to move more comfortably. Exercise then helps build the strength, control, endurance, and confidence needed for longer-term recovery.

Depending on the condition, rehabilitation may include:

• Mobility exercises
• Core strengthening
• Balance training
• Postural endurance
• Shoulder or hip strengthening
• Spinal stabilization
• Nerve-mobility exercises
• Gradual return to work or exercise

The exercises should be manageable and relevant to the patient’s goals. A person recovering from a car accident may need a different program than someone preparing to return to golf, construction work, or prolonged computer use.

Education and Activity Guidance

Pain can make people afraid that normal movement will cause damage. In many cases, avoiding movement for too long can increase stiffness, weakness, and sensitivity.

A chiropractor can help patients understand:

• Which activities are safe
• Which movements should temporarily be modified
• How to gradually resume normal activity
• How to improve lifting or workstation habits
• How to manage temporary flare-ups
• What exercises to perform between visits

The purpose is to help patients become more capable and confident—not dependent on treatment.

Additional Therapies

Depending on the office and the patient’s needs, care may also include:

• Heat or ice
• Traction
• Supportive taping
• Bracing
• Soft tissue therapy
• Exercises
• Workstation or ergonomic recommendations

These therapies may complement the main treatment plan but should be used for a clear reason.

What Conditions Do Chiropractors Commonly Treat?

People most often visit chiropractors for problems involving pain, stiffness, injury, or limited movement.

Common reasons for seeking chiropractic care include:

• Low back pain
• Neck pain
• Mid-back pain
• Joint stiffness
• Muscle strains
• Ligament sprains
• Headaches associated with the neck
• Whiplash and motor-vehicle injuries
• Work-related injuries
• Sports injuries
• Shoulder pain
• Hip pain
• Rib and chest-wall pain
• Selected cases of arm or leg pain
• Certain symptoms involving nerve irritation

Some patients seek care after a specific event, such as lifting an object, falling, playing sports, or being involved in a collision.

Others develop symptoms gradually from repetitive work, prolonged sitting, physical strain, reduced activity, or age-related changes.

Chiropractic treatment is not limited to the spine. Chiropractors commonly evaluate and treat joints and soft tissues throughout the body, although individual training and practice emphasis vary.

Not every person with one of these symptoms will need the same care. The value of the examination is determining what is likely causing the problem and which treatments are most appropriate.

Why Do Millions of People Choose Chiropractic?

Millions of Americans visit chiropractors each year, most commonly for back pain, neck pain, joint problems, headaches, and injuries.

People often choose chiropractic because they want:

• A nonsurgical approach
• Treatment that does not begin with medication
• Hands-on care
• Help improving movement as well as pain
• A personalized treatment plan
• Guidance about exercise and activity
• Conservative care before considering injections or surgery

Chiropractic can also provide something many patients value: active participation in recovery.

Rather than simply receiving a prescription and waiting, patients can learn what is contributing to the problem, receive treatment directed at the painful or restricted area, and begin taking practical steps to restore function.

Many people also appreciate that chiropractors focus on how symptoms affect daily life. The important question is not only, “How much does it hurt?” It is also:

• Can you sleep comfortably?
• Can you turn your head?
• Can you sit through the workday?
• Can you exercise?
• Can you lift safely?
• Can you care for your family?
• Can you return to the activities you enjoy?

For patients with musculoskeletal pain, chiropractic care often offers a sensible place to begin.

What Does the Evidence Say?

Research supports spinal manipulation and related chiropractic treatments as effective conservative options for many patients with musculoskeletal pain.

Clinical guidelines recognize spinal manipulation as an established non-drug treatment for low back pain, and research also supports chiropractic treatment for selected patients with neck pain and headaches associated with the cervical spine.

An adjustment may help decrease pain and restore movement, while exercise, activity, and self-management help the patient build on that improvement.

How We Apply This Evidence in Practice

Many uncomplicated musculoskeletal problems respond relatively quickly to appropriate treatment. At Advanced Chiropractic, we generally begin with a short, goal-directed trial of care rather than an automatic long-term treatment plan.

Based on our clinical experience, many patients achieve substantial, stable improvement within approximately four to six visits, while some reach their goals within only two or three visits.

Recovery time varies according to the nature and duration of the condition, whether a significant injury is present, and the individual patient’s response. Progress is reassessed throughout care, and treatment frequency is reduced as improvement becomes stable.

Our objective is not to keep patients in treatment indefinitely. It is to help them regain comfortable movement and normal function as efficiently as reasonably possible. We do not routinely recommend ongoing maintenance care once a patient has reached stable improvement.

No treatment works equally well for every person. Some patients respond rapidly, while others improve more gradually. The purpose of a trial of care is to determine whether meaningful improvement is occurring.

Signs that treatment is helping may include:

• Less pain
• Easier movement
• Better sleep
• Fewer headaches
• Increased sitting or walking tolerance
• Improved ability to work
• Reduced need to avoid activities
• Greater confidence in movement

When improvement does not occur as expected, the diagnosis and treatment plan should be reconsidered. Treatment may need to be modified, discontinued, or coordinated with another health care provider.

Chiropractic care does not depend on guaranteeing that every patient will respond. It provides a reasonable conservative treatment option, measures progress, and adjusts the plan according to the patient’s response.

Is Chiropractic Care Safe?

Chiropractic treatment is generally considered safe when it is appropriately selected and performed by a licensed provider. The most common reactions are temporary soreness, stiffness, or a brief increase in discomfort, near the beginning of care. This is often similar to the soreness a person may experience after beginning a new exercise program.

Serious complications are rare, but no health care treatment is entirely without risk. Fractures have occasionally been reported, particularly when reduced bone strength, a recent injury, or an existing fracture was not recognized before treatment. For this reason, the chiropractor should review the patient’s health history, assess relevant risk factors, and use gentler techniques—or avoid manipulation—when appropriate.

The safety concern most commonly associated with neck manipulation is cervical artery dissection and stroke. Individual cases have been reported, although establishing cause can be difficult because an arterial dissection may initially produce neck pain or headache, which are the same symptoms that may lead someone to seek either chiropractic or medical care.

Neck manipulation is not required for every patient. Mobilization, lower-force techniques, exercise, and other forms of treatment may be used according to the patient’s condition and preferences.

Safe chiropractic care involves more than performing an adjustment correctly. It requires an appropriate examination, recognition of warning signs, informed consent, individualized technique selection, and prompt referral when a condition may require medical evaluation.

What Should You Expect From a Good Chiropractor?

A good chiropractor should:

• Listen carefully to your concerns
• Perform an appropriate examination
• Explain the likely cause of your symptoms
• Discuss treatment options
• Adapt care to your comfort and condition
• Provide practical advice and exercises
• Determine whether you are improving
• Reduce treatment frequency as you improve
• Change or discontinue treatment that is not helping
• Refer you when another type of care is needed

You should understand why a treatment is being recommended and what it is intended to accomplish.

You should not feel pressured into a long treatment plan before the chiropractor has determined how you respond. Not every patient needs manipulation, and not every painful joint needs to crack.

The best chiropractic care is collaborative. The chiropractor provides evaluation, treatment, guidance, and clinical judgment; while the patient provides feedback, follows appropriate recommendations, and gradually resumes normal activity. Collaboration may also involve other health care providers. At Advanced Chiropractic, we regularly coordinate care with primary-care providers, physiatrists, orthopedic and spine surgeons, podiatrists, physical therapists, massage therapists, and other specialists when a patient’s condition requires additional expertise.

This may include sharing examination findings, reviewing imaging or specialist recommendations, modifying treatment around another provider’s plan, or referring a patient when medication, injections, surgery, advanced imaging, or another form of rehabilitation may be appropriate.

Good chiropractic care does not require treating every problem alone. It requires recognizing when chiropractic treatment is appropriate, when another provider should be involved, and how different forms of care can work together to help the patient recover.

Conclusion

Chiropractic is a licensed health profession focused on helping people with pain, stiffness, impaired movement, and injuries involving the muscles, joints, connective tissues, and related nerves.

A chiropractor does more than adjust the spine. Chiropractic care may include a detailed examination, diagnosis, joint treatment, soft-tissue therapy, exercise, rehabilitation, activity guidance, and referral when necessary.

For people with back pain, neck pain, headaches related to the neck, joint stiffness, or many common injuries, chiropractic care can provide an effective and practical path toward recovery.

The objective is not simply to make a joint pop. The objective is to help you move more comfortably, function more normally, and return to the work, exercise, family responsibilities, and activities that are important to you.