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What is Chiropractic?

Chiropractors, also known as doctors of chiropractic or chiropractic physicians, diagnose and treat patients with health problems of the musculoskeletal system and treat the effects of those problems on the nervous system and on general health. Many chiropractic treatments deal specifically with the spine and the manipulation of the spine. Chiropractic medicine is based on the principle that spinal joint misalignments interfere with the nervous system and can result in lower resistance to disease and many different conditions of diminished health.

The chiropractic approach to health care stresses the patient's overall health. Chiropractors provide natural, drugless, nonsurgical health treatments, relying on the body's inherent recuperative abilities. They also recognize that many factors affect health, including exercise, diet, rest, environment, and heredity. Chiropractors recommend changes in lifestyle that affect those factors. In some situations, chiropractors refer patients to or consult with other health practitioners.

Like other health practitioners, chiropractors follow a standard routine to get information needed to diagnose and treat patients. They take the patient's medical history; conduct physical, neurological, and orthopedic examinations; and may order laboratory tests. X rays and other diagnostic images are important tools because of the chiropractor's emphasis on the spine and its proper function. Chiropractors also analyze the patient's posture and spine using a specialized technique. For patients whose health problems can be traced to the musculoskeletal system, chiropractors manually adjust the spinal column.

Some chiropractors use other alternative medicines in their practices, including therapies using water, light, massage, ultrasound, electric, acupuncture, and heat. They also may apply supports such as straps, tapes, and braces to manually adjust the spine. Chiropractors counsel patients about health concepts such as nutrition, exercise, changes in lifestyle, and stress management, but chiropractors do not prescribe drugs or perform surgery.

In addition to general chiropractic practice, some chiropractors specialize in sports injuries, neurology, orthopedics, pediatrics, nutrition, internal disorders, or diagnostic imaging.

Training and Other Qualifications. Chiropractors must be licensed, which requires 2 to 4 years of undergraduate education, the completion of a 4-year chiropractic college course, and passing scores on national and State examinations.

Education and training. In 2007, 16 chiropractic programs and 2 chiropractic institutions in the United States were accredited by the Council on Chiropractic Education. Applicants must have at least 90 semester hours of undergraduate study leading toward a bachelor's degree, including courses in English, the social sciences or humanities, organic and inorganic chemistry, biology, physics, and psychology. Many applicants have a bachelor's degree, which may eventually become the minimum entry requirement.

Chiropractic programs require a minimum of 4,200 hours of combined classroom, laboratory, and clinical experience. During the first 2 years, most chiropractic programs emphasize classroom and laboratory work in sciences such as anatomy, physiology, public health, microbiology, pathology, and biochemistry. The last 2 years focus on courses in manipulation and spinal adjustment and provide clinical experience in physical and laboratory diagnosis, neurology, orthopedics, geriatrics, physiotherapy, and nutrition. Chiropractic programs and institutions grant the degree of Doctor of Chiropractic.

Chiropractic colleges also offer postdoctoral training in orthopedics, neurology, sports injuries, nutrition, rehabilitation, radiology, industrial consulting, family practice, pediatrics, and applied chiropractic sciences. Once such training is complete, chiropractors may take specialty exams leading to "diplomate" status in a given specialty. Exams are administered by specialty chiropractic associations.

Licensure. All States and the District of Columbia regulate the practice of chiropractic and grant licenses to chiropractors who meet the educational and examination requirements established by the State. Chiropractors can practice only in States where they are licensed. Some States have agreements permitting chiropractors licensed in one State to obtain a license in another without further examination, provided that their educational, examination, and practice credentials meet State specifications.
For licensure, most State boards recognize either all or part of the four-part test administered by the National Board of Chiropractic Examiners. State examinations may supplement the National Board tests, depending on State requirements. All States except New Jersey require the completion of a specified number of hours of continuing education each year in order to maintain licensure. Chiropractic associations and accredited chiropractic programs and institutions offer continuing education programs.

Other qualifications. Chiropractic requires keen observation to detect physical abnormalities. It also takes considerable manual dexterity, but not unusual strength or endurance, to perform adjustments. As in other health-related occupations, empathy, understanding, and the desire to help others are good qualities for dealing effectively with patients.