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 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 healthcare focuses on 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 health 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 additional procedures in their practices, including therapies using heat, water, light, massage, ultrasound, electric currents, and acupuncture . They may apply supports such as straps, tape, braces, or shoe inserts. Chiropractors often 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.
Many chiropractors are solo or group practitioners who also have the administrative responsibilities of running a practice. In larger offices, chiropractors delegate these tasks to office managers and chiropractic assistants. Chiropractors in private practice are responsible for developing a patient base, hiring employees, and keeping records.
Work Environment
Chiropractors held about 51,400 jobs in 2020. The largest employers of chiropractors were as follows:
- Offices of chiropractors - 64%
- Self-employed workers - 30%
- Offices of physicians - 2%
Chiropractors typically work in office settings. They may be on their feet for long periods when examining and treating patients.
Work Schedules
Most chiropractors work full time. Chiropractors may work in the evenings or on weekends to accommodate patients. Some chiropractors travel to patients’ homes to give treatment. Self-employed chiropractors set their own hours.
Education & Training Required
In 2009, 16 chiropractic programs 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. Several chiropractic colleges offer prechiropractic study, as well as a bachelor's degree program. Recognition of prechiropractic education offered by chiropractic colleges varies among the States.
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 (D.C.).
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 chiropractic specialty boards.
Certifications Needed
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.
Most State licensing boards require at least 2 years of undergraduate education, but an increasing number are requiring a 4-year bachelor's degree. All boards require the completion of a 4-year program at an accredited chiropractic college leading to the Doctor of Chiropractic degree.
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 Skills Required
Chiropractic requires keen observation to detect physical abnormalities. It also takes considerable manual dexterity, but not unusual strength or endurance, to perform adjustments. Chiropractors should be able to work independently and handle responsibility. As in other health-related occupations, empathy, understanding, and the desire to help others are good qualities for dealing effectively with patients.
How to Advance
Newly licensed chiropractors can set up a new practice, purchase an established one, or enter into partnership with an established practitioner. They also may take a salaried position with an established chiropractor, a group practice, or a healthcare facility.
Job Outlook
Employment of chiropractors is projected to grow 11 percent from 2020 to 2030, faster than the average for all occupations.
About 1,800 openings for chiropractors are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment
Demand is expected to increase for chiropractic services as a nonsurgical, drug-free way to treat pain and improve overall wellness. Rising interest in integrative or complementary healthcare has led to more acceptance of chiropractic treatment of the back, neck, limbs, and involved joints. As a result, chiropractors are increasingly working with other healthcare workers, such as physicians and physical therapists, through referrals and complementary care.
Opportunities for chiropractors also will be created by the continued aging of the large baby-boom generation. Older adults are more likely than younger people to have neuromusculoskeletal and joint problems, and they will continue to seek treatment for these conditions as they lead longer, more active lives.
Earnings
The median annual wage for chiropractors was $75,000 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $37,400, and the highest 10 percent earned more than $128,750.
In May 2021, the median annual wages for chiropractors in the top industries in which they worked were as follows:
- Offices of physicians - $79,810
- Offices of chiropractors - $73,990
Earnings vary with the chiropractor’s number of years in practice, geographic region of practice, and hours worked. Chiropractors tend to earn more as they build a client base and become owners of, or partners in, a practice.
Most chiropractors work full time. Chiropractors may work in the evenings or on weekends to accommodate patients. Some chiropractors travel to patients’ homes to give treatment. Self-employed chiropractors set their own hours.
