​​3 Times a Chiropractor Can Make You Feel Better—and 9 Things He Should Never Even Attempt

The research is there to back up adjustments as a treatment for back pain. A 2016 research review in the journal PLoS One, for instance, concluded that chiropractic care works as well as physical therapy—a staple treatment medical doctors would prescribe for low back pain, with few negative side effects.

Related: This Is the Best Workout to Prevent Back Pain

In fact, recently released guidelines from the American College of Physicians—a national organization of internists—recommend spinal manipulation as one of several first-line options for patients with low back pain. Starting there might provide relief while helping you avoid heavy-duty pain meds or surgery, the group points out.

And though the evidence isn’t quite as strong, adjustments often ease neck pain too, according to a review of 41 previous studies published in the Journal of Manipulative and Physiological Therapeutics

The underlying mechanism behind why chiropractic care helps isn’t totally clear, but many believe the adjustments work by increasing the mobility of the joint, which can restore function and allow damaged tissues to heal, relieving pain. Or, it may simply change the way your central nervous system processes pain.

Whether your aches have been with you for years or just started yesterday, the adjustments and other treatments chiropractors provide might provide relief, says Ralph Gay, M.D., D.C., a physiatrist at Mayo Clinic in Rochester, Minnesota. (He earned his chiropractic degree first, then went back to medical school.)

Spinal manipulations address some problems that occur from the neck up, too.

In an Australian study, two months of spinal manipulation nearly cut in the half the number of migraines participants had monthly, from nearly eight to about four. Some experienced even more dramatic improvements: 22 percent of patients had a 90 percent reduction in their migraines, while another 50 percent experienced significant relief.

Since doctors aren’t completely sure what causes migraines in the first place, they don’t know for sure why chiropractic care helps. One theory holds that manipulating the spine changes the way the brain perceives pain. Others believe signals from the nerves in the cervical spine contribute to migraines, and that adjustments can calm them.

The same doesn’t hold for regular old tension headaches, though—that dull ache in your head brought on by stress and similar conditions. (That’s per a review by Canadian researchers, which found chiropractic wasn’t effective for these.) Medications, massage, or acupuncture are probably better bets to relieve those. (Here are 4 weird types of headaches you never knew existed.)

Sports injuries also fall within a chiropractor’s purview, says Hayden, who treats runners, golfers, and dancers, among others.

The approach depends on the exact injury. For instance, if you sprain your ankle, a chiropractor can realign the bones in your foot with an adjustment, and use athletic tape to stabilize and keep it there. That’ll correct the issue causing tissue damage, so the problem doesn’t continue to worsen.

In the meantime, the swelling—the result of inflammation, and the actual source of your pain—surrounding the sprain can be addressed with tools like ultrasound, laser, and electrotherapy. These boost blood flow and break down inflammatory compounds.

“Most of the time, we can greatly accelerate the healing,” Hayden says.

For serious injuries, a chiropractor can order imaging—such as an X-ray or MRI—to check for things like fractures. If he or she sees a break, it’s time for a referral to an orthopedist or other specialist, Hayden says.

With the exception of certain degenerative spinal fractures, broken bones are one of the few neuromuscular problems chiropractors probably can’t fix, Hayden says. That’s because they might require surgery or other invasive options—or else the removal of pressure through tools like crutches or casts.

Researchers have also explored whether spinal manipulation works for other types of farther-reaching health problems, since some proponents believe alignment issues can contribute to even more systemic health problems in your other organs and tissues. But evidence has fallen short. So far, research suggests it’s ineffective for treating asthma or hypertension, Mudd says.

It’s also been shown unlikely to aid colic in babies, ear infections, or allergies, Dr. Gay points out. (These 6 everyday habits may be making your allergies even worse.)

Some chiropractic offices make even wilder claims, from addressing prostate problems to treating irritable bowel disease to curing cancer. But those types of marketing messages should serve as red flags, Dr. Gay says.

“Serious diseases such as cancer should not be treated with chiropractic care,” Mudd says. “While people with cancer may look to chiropractic care to relieve symptoms associated with the disease, it is not a treatment for the disease.”

Hayden, for instance, has a wide network of specialists—ranging from family doctors to oncologists—where he sends his patients who show up with problems he can’t treat. (For instance, a patient may have back or side pain that turns out to be a kidney infection—which a primary care doctor can treat with antibiotics.) Some chiropractors might order tests like blood work or urinalysis to get to the bottom of the issue, while others might refer you to another physician for those assessments.

Good candidates for chiropractic care include people with lower back pain, since conventional medicine doesn’t always offer many effective options for it, Dr. Gay says. (In fact, acetaminophen, which people often pop when aches hit, has proven unhelpful, as we reported.)

Hayden says his ideal patients are people with the patience and life circumstances to invest in their health and well-being. That might mean spending time (both on regular appointments and at-home exercises) or cash—since insurance doesn’t always cover chiropractic, Mudd says.

Decide you’d like to give chiropractic care a try? Consider asking your primary care doctor for a referral and choose a licensed practitioner—you can check in with your state board here. Beware any who make over-the-top marketing claims.

Once you’ve picked your chiropractor, know that your first visit may take a while. Dr. Hayden often spends between 45 minutes and an hour and a half with new patients. Expect a thorough history—where you’ll answer questions about your symptoms and your family and health history—and a complete physical exam.

Then, the doctor will typically sit you down, explain the probable cause of your problems, and propose a treatment plan—or a referral, if he or she believes you have a problem that requires another provider’s expertise.

If he or she determines that spinal manipulation or another hands-on therapy will help, you might get your first treatment right away, Hayden says. Sometimes, they bring near-instant relief—while in other cases, it might take a few treatments to address your issue.

Still, be wary of doctors who require you to buy a package of treatments in advance. Research suggests if you have to go more than 12 to 15 times, chiropractic care probably isn’t going to work for you.