Chiropractic Care: What the Science Really Says — and Why Caution Matters

Chiropractic care, especially spinal manipulation, has become a common choice for people seeking relief from back and neck pain. But while some patients swear by it, others wonder: Does it actually work? And more importantly — is it safe?

The honest answer lies somewhere between hype and skepticism. Scientific evidence shows some benefits for certain conditions, but also important limitations and potential risks that every patient should understand before making a decision.

What the Research Actually Shows

Most research on chiropractic care focuses on spinal manipulative therapy (SMT) — the primary technique used by chiropractors.

1. Low Back Pain — Modest but Real Benefits

A major 2019 systematic review published in the BMJ analyzed 47 clinical trials involving more than 9,000 participants.

• SMT led to small but statistically significant improvements in physical function for people with chronic low back pain.

• Pain reduction was minimal and often below what researchers consider “clinically meaningful.”

• Results were similar to other recommended non-drug treatments like exercise or physical therapy.

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In other words, spinal manipulation can help some people with back pain, but it’s not a miracle cure.

2. Cochrane Review — No Major Superiority

The Cochrane Collaboration, known for its rigorous evidence reviews, came to a similar conclusion in 2011:

“High-quality evidence suggests there is no clinically relevant difference between spinal manipulative therapy and other interventions for reducing pain and improving function in patients with chronic low-back pain.”

This means chiropractic care is about as effective as other conservative options — not better, not worse.

3. Global Guidelines Emphasize Conservative Care

The The Lancet Low Back Pain Series (2018) emphasized the need to prioritize non-pharmacologic, evidence-based approaches like education, exercise, and manual therapy.

Spinal manipulation can be one option among many — but it shouldn’t replace self-management, physical activity, or medical oversight.

🚫 What Chiropractic Care Doesn’t Treat

Despite marketing claims, there’s no strong scientific evidence that chiropractic adjustments help with non-musculoskeletal conditions, such as:

• Asthma

• Hypertension

• Gastrointestinal issues

• Menstrual problems

Choosing chiropractic care for these conditions can delay appropriate medical treatment — a risk not worth taking.

⚠️ Understanding the Risks

Most people experience only mild, short-term side effects like temporary soreness, fatigue, or mild headache. But rare serious complications have been reported, including:

• Cervical artery dissection (a tear in the artery of the neck)

• Stroke (associated with some high-velocity neck manipulations)

  
  

While the absolute risk appears low, these complications can be life-altering or fatal. That’s why informed consent and practitioner training matter.

Warning signs before treatment:

• Sudden, severe neck pain or headache

• Dizziness or vision changes

• History of vascular problems or connective tissue disorders

  
  

If any of these apply, consult your primary care provider or a neurologist before undergoing neck manipulation.

A Safer, Relaxing Alternative: Float Therapy

When it comes to muscle relaxation, pain reduction, and stress relief, many people turn to float therapy as a gentler, lower-risk option.

Research on Floatation-REST (Reduced Environmental Stimulation Therapy) suggests that floating in warm, buoyant salt water can help:

• Decrease muscle tension and support full-body relaxation

• Reduce nerve-related discomfort by removing pressure from the spine and joints

• Lower stress hormones like cortisol, promoting overall nervous system calm

Because the body is fully supported in the water, floating allows tight muscles to relax naturally — without any forceful manipulation. This can be especially beneficial for people managing chronic pain, stress, or post-workout soreness.

(Read more about how magnesium in the water actively relaxes muscles and decreases pain signals in our blog posts about Float Therapy).

👉 And if you have a favorite massage therapist, scheduling a float session before your massage can help loosen tissues and make hands-on work even more effective.

How to Choose Chiropractic Care Wisely

If you’re still considering chiropractic care, keep these evidence-based guidelines in mind:

1. Know what it’s good for: Chiropractic manipulation is most supported for certain types of low back pain, some mechanical neck pain, and possibly cervicogenic headaches.

2. Use it as part of a broader wellness plan: Consider integrating gentle therapies like floatation or physical therapy.

3. Be cautious with neck adjustments: Ask about technique, risks, and alternatives.

4. Ask about credentials: Choose a licensed chiropractor who practices evidence-based care and doesn’t promise to “cure” unrelated health problems.

5. Keep your primary care provider in the loop: Especially if you have underlying health conditions.

Bottom Line

Chiropractic care isn’t a magic bullet — but for some people, it can be a helpful piece of a larger pain management strategy. Evidence supports its use for some types of back and neck pain, but not for unrelated health issues. And like any medical intervention, it comes with real risks that deserve respect.

Float therapy, on the other hand, offers a low-risk, deeply relaxing way to ease muscle tension and nerve pain — and it can easily be combined with other recovery tools like massage or physical therapy for even better results.

When it comes to your body, informed decisions are always the best decisions.

References:

• Buchbinder, R., van Tulder, M., Öberg, B., Costa, L. M., Woolf, A., Schoene, M., Croft, P., & Lancet Low Back Pain Series Working Group. (2018). Low back pain: A call for action. The Lancet, 391(10137), 2384–2388. https://doi.org/10.1016/S0140-6736(18)30488-4

• Feinstein, J. S., Khalsa, S. S., Yeh, H., Wohlrab, C., Simmons, W. K., Stein, M. B., & Paulus, M. P. (2018). Examining the short-term anxiolytic and antidepressant effect of Floatation-REST (Reduced Environmental Stimulation Therapy). PLOS ONE, 13(2), e0190292. https://doi.org/10.1371/journal.pone.0190292

• Kjellgren, A., & Westman, J. (2014). Beneficial effects of treatment with sensory isolation in flotation tank as a preventive health-care intervention – a randomized controlled pilot trial. BMC Complementary and Alternative Medicine, 14, 417. https://doi.org/10.1186/1472-6882-14-417

• Rubinstein, S. M., Terwee, C. B., Assendelft, W. J., de Boer, M. R., & van Tulder, M. W. (2011). Spinal manipulative therapy for chronic low-back pain. Cochrane Database of Systematic Reviews, (2), CD008880. https://doi.org/10.1002/14651858.CD008880.pub2

• Rubinstein, S. M., de Zoete, A., van Middelkoop, M., Assendelft, W. J., de Boer, M. R., & van Tulder, M. W. (2019). Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: Systematic review and meta-analysis of randomized controlled trials. BMJ, 364, l689. https://doi.org/10.1136/bmj.l689