Key Facts About the Chiropractic Profession

By the Numbers

More than 96,000 chiropractic physicians, or Doctors of Chiropractic (DCs) are state licensed and nationally certified.  There are 5,847 actively practicing DCs in Texas and an additional 686 DCs holding an inactive license. [1][2][3]  

Chiropractors are designated as physician-level providers in the vast majority of states and federal Medicare program. The essential services provided by chiropractors are also available in federal health delivery systems, including those administered by Medicaid, the U.S. Departments of Veterans Affairs and Defense, Federal Employees Health Benefits Program, Federal Workers’ Compensation, and all state workers’ compensation programs. [4]

Chiropractors are educated in nationally accredited, four-year doctoral graduate school programs through a curriculum that includes a minimum of 4,200 hours of classroom, laboratory and clinical internship, with the average DC program equivalent in classroom hours to allopathic (MD) and osteopathic (DO) medical schools. There are approximately 10,000 chiropractic students in 18 nationally accredited, chiropractic doctoral graduate education programs across the United States with 2,500 chiropractors entering the workforce every year.  Enrollment at the two chiropractic colleges in Texas approximates 1,400 chiropractic students. [4][5]

An estimated 40,000 chiropractic assistants (CAs)  are in clinical  and business management roles for chiropractic practices across the United States.  It is estimated that chiropractors treat more than 35 million Americans (adults and children) annually. [4][6]

A First Line of Defense

The essential services provided by chiropractors represent a primary approach for the prevention, diagnosis and conservative management of back pain and spinal disorders that can often enable patients to reduce or avoid the need for riskier treatments, such as prescription opioid pain medications and surgery. [4]

In 2017, the American College of Physicians released an update to its low back pain treatment guideline that recommends first using non-drug treatments, such as spinal manipulation (a centerpiece of chiropractic care), for acute and chronic low back pain.[7]

A systematic review/meta-analysis published in the Journal of the American Medical Associationin 2017 supports the use of spinal manipulative therapy as a first-line treatment for acute low back pain. [8]

Chiropractic Satisfaction

Chiropractors are the highest-rated healthcare practitioner for low-back pain treatments above physical therapists (PTs), specialist physician/MD (i.e., neurosurgeons, neurologists, orthopaedic surgeons), and primary care physician/MD (i.e., family or internal medicine). [6]

Three in four people who saw a chiropractor in the last year (77%) described chiropractic care as “very effective.” [6]

In a consumer survey, chiropractic outperformed all other back pain treatments, including prescription medication, deep-tissue massage, yoga, pilates, and over-the-counter medication therapies. [10]

Chiropractors’ collaborative, whole person-centered approach reflects the changing realities of health care delivery and fits well into Accountable Care Organization (ACO) and patient-centered, medical home (PCMH) models bringing greater clinical efficiency, patient satisfaction and cost savings. [10]

In 2015, the Joint Commission, the organization that accredits more than 20,000 health care systems in the U.S. (including every major hospital), recognized the value of non-drug approaches by adding chiropractic to its pain management standard. [11]

A clinical comparative trial conducted at three military medical centers found that chiropractic care combined with usual medical care for low back pain provides greater pain relief and a greater reduction in disability than medical care alone. [12]

In another comparative-effectiveness trial, 94% of manual-thrust manipulation (chiropractic) recipients experienced a 30% reduction in their pain.  Only 54% of medical care recipients received comparable results. [13]

[1] Federation of Chiropractic Licensing Boards 
[2] National Board of Chiropractic Examiners 
[3] Texas Board of Chiropractic Examiners 
[5] and
[6] “One in Four Americans Sought Care for Neck and Back Pain Last Year,”, accessed March 2019:
[7] Qaseem, A., Wilt, T. J., McLean, R. M., Forciea, M. A., & for the Clinical Guidelines Committee of the American College of Physicians. (2017). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine, 166(7), 514. 
[8] Paige, N. M., Miake-Lye, I. M., Booth, M. S., Beroes, J. M., Mardian, A. S., Dougherty, P., … Shekelle, P. G. (2017). Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain: Systematic Review and Meta-analysis. JAMA, 317(14), 1451–1460.
[9] Consumer Reports Health Ratings Center. Back-Pain; July 2011.
[10]  Accountable Care Organizations Optimize Outcomes, Cost Savings and Patient Satisfaction with Chiropractic Care. Foundation for Chiropractic Progress. May 2013.
[11] Clarification of the Pain Management Standard. Joint Commission.
[12] Goertz CM et al. 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;1(1):e180105.
[13] Schneider M et. al. Comparison of spinal manipulation methods and usual medical care for acute and subacute low back pain. Spine2015; 40(4):209-217.