Chiropractic Management of Musculoskeletal Pain

Chiropractic care encompasses a range of conservative, non-pharmacological interventions aimed at the diagnosis, treatment and prevention of disorders of the musculoskeletal system, particularly of the spine. Central to chiropractic practice is manual therapy, including spinal manipulative therapy (SMT), which seeks to restore joint mobility, alleviate pain and improve function. Chiropractors employ a biopsychosocial approach, integrating patient history, physical examination and functional assessment to tailor multimodal care that may include mobilisation, soft-tissue techniques, rehabilitative exercise and advice on ergonomics and lifestyle modification. The global burden of musculoskeletal pain, notably low back and neck pain, has driven the inclusion of chiropractic services in multidisciplinary settings, from community practices to military and geriatric care. Clinical guidelines increasingly recommend manual therapies alongside exercise and psychosocial support, reflecting evidence of moderate improvements in pain intensity, functional outcomes and patient satisfaction. Efforts to refine interprofessional collaboration and standardise outcome measures have improved the integration of chiropractic management within broader healthcare frameworks, underscoring its role in reducing reliance on pharmacotherapy and invasive procedures.

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Chiropractic Management of Musculoskeletal Pain publication trend

The graph below shows the total number of articles in chiropractic management of musculoskeletal pain across all publications each year (not limited to Nature Index journals).

Technical terms

Spinal manipulative therapy (SMT): A manual technique involving high-velocity, low-amplitude force applied to spinal joints to improve mobility and alleviate pain.

Comparative effectiveness trial: A study design that directly compares two or more active interventions to determine which works best for specific patient outcomes.

Numerical Rating Scale (NRS): A patient-reported measure of pain intensity, typically ranging from 0 (no pain) to 10 (worst imaginable pain).

Roland-Morris Disability Questionnaire (RMDQ): A self-report instrument assessing functional impairment due to low back pain, with higher scores indicating greater disability.

References

1. Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial. JAMA Network Open (2018).
2. The effect of spinal manipulative therapy on pain relief and function in patients with chronic low back pain: an individual participant data meta-analysis. Physiotherapy (2021).
3. Patient-centered professional practice models for managing low back pain in older adults: a pilot randomized controlled trial. BMC Geriatrics (2017).