Chiropractic Research & Facts — The Evidence Behind Your Care
What Is Chiropractic?
“Chiropractic is a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery. The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health. In addition, Doctors of Chiropractic recognize the value and responsibility of working in cooperation with other health care practitioners when in the best interest of the patient.”
The practice of chiropractic includes establishing a diagnosis; facilitating neurological and biomechanical integrity through appropriate chiropractic case management; and advising and educating patients on spinal hygiene, rehabilitative exercise, nutrition, and healthful living practices.
“A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health. A subluxation is evaluated, diagnosed, and managed through the use of chiropractic procedures based on the best available rational and empirical evidence.”
— The Association of Chiropractic Colleges, Position Paper
At West Los Angeles Chiropractic®, this is exactly how Dr. Karr practices: thorough diagnosis first (with in-office digital X-rays when needed), hands-on treatment, and honest guidance on exercise, nutrition, and long-term spinal health — in cooperation with your other health care providers whenever it serves you best.
Chiropractic Facts
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Chiropractic Education & Professional Facts
To earn a Doctor of Chiropractic (D.C.) degree, a candidate must complete a rigorous four-year doctoral program consisting of approximately 4,800 hours of classroom, laboratory, and clinical study — including anatomy, physiology, radiology, biochemistry, toxicology, biomechanics, nutrition, diagnosis, and physical examination — plus a hands-on clinical internship in a professional setting. Chiropractic colleges are accredited by the Council on Chiropractic Education (CCE), which is officially recognized by the U.S. Department of Education.
Did you know?
- Every D.C. must pass national board examinations and obtain a state license before earning the privilege to practice.
- All 50 states, the District of Columbia, U.S. Virgin Islands, and Puerto Rico license doctors of chiropractic — and all include chiropractic care in their workers’ compensation statutes.
- Chiropractic services are included in Medicare, Federal Workers’ Compensation, most Federal Employees’ Benefits programs, the Railroad Retirement Act, and the Longshoremen’s & Harbor Workers’ Compensation Act.
- Virtually all commercial insurance carriers include chiropractic services in their health plans.
- The Department of Health and Human Services classifies doctors of chiropractic as Category 1 providers — the same category as medical doctors, osteopaths, and dentists.
- Chiropractic is the third largest health care profession in the Western world after medicine and dentistry.
- The vast majority of spinal manipulation performed in the United States is delivered by doctors of chiropractic.
At West Los Angeles Chiropractic®, Dr. Michael C. Karr — a UCLA graduate with postgraduate honors in radiology — has brought this standard of training and care to West LA patients for over 35 years.
Chiropractic Effectiveness
- One of Chicago’s leading medical orthopedists testified about the results he had noticed between two competing hospitals in Chicago, one which was using doctors of Chiropractic and one which was not. Since he was on the staff of both hospitals he could evaluate the results of each. He found that the hospital using Chiropractic care was sending patients home 7 to 9 days sooner and that the reason was entirely due to the Chiropractic care that they were receiving.
Per Freitag, MD,PhD, US Federal Court Testimony, Chicago, IL., May, 1987. Comparing JFK Hospital with Lutheran General Hospital, which does not use Chiropractic. - AV MED, the largest HMO in the southeastern U.S., tried an experiment with 100 of its medically unresponsive patients by sending them to a local doctor of Chiropractic. Within 3 weeks 86% of them had their ailments corrected. 12 of these cases were medically diagnosed as needing disc surgery. All 12 of these cases ere corrected and none needed surgery. Just these 12 cases saved the HMO $250,000 in surgical/hospital bills. Later re-evaluation of these cases showed that the results were permanent Herbert Davis, MD, AVMED Health Maintenance Organization, Miami, FL. 1982
- In 1979, the Royal Commission of Inquiry on Chiropractic in New Zealand, after an 18 month study in five nations, including the U.S., concluded, “The Commission has found it established beyond any reasonable degree of doubt that chiropractors have a more thorough training in spinal mechanics and spinal manual therapy than any other health professional.” It found that Chiropractic was a scientifically based, valid, safe and very effective treatment that should be in the mainstream of health care and should be used in hospitals.
Chiropractic in New Zealand-Report of the Commission of Inquiry, 1979 - In 1971, the Oregon Workers’ Compensation Study showed that people under Chiropractic care were able to return to work in half the time as those receiving medical care. Also that chiropractic costs were less than 25% of medical costs.
- In 1972, the California Workers’ Compensation Study comparing Chiropractic to medical care for back ailments on 1000 patients showed that Chiropractic was twice as effective and the patients lost half as many days as of work.
Richard Wolf, MD, California Workers Compensation Records, 1972 - In 1986 the Florida Workers’ Compensation Study the duration of disability was 51.3% shorter for chiropractic patients. The cost of chiropractic care was 58.8% less than medical care.
- The recent Utah Workers’ Compensation Study followed 3062 cases. The record shows that Chiropractic care outperformed medicine by 10:1 margin in compensation costs.
Kelly Jarivs, DC. Red Philips, DC, Elliot Morris, JD MBA Workers Compensation Fund of Utah, 1991.
- A two year study conducted by the Italian government followed 17,000 patients. The dramatic results showed that patients under chiropractic care had their hospitalization for back ailments reduced by 87.6% and work loss by 75.5% Prof.F.Splendori, Chiropractic Therapeutic Effectiveness-Social Importance. Incidence on Absence from Work and Hospitalization. Italy
- A ten year government study in Great Britain showed that among all patients with severe and chronic pain, chiropractic patients improved 13% more than medical patients. “If all the patients were referred for chiropractic instead of hospital treatments…there might be a reduction of some 290,000 days in sickness absence during two years saving about $21,580,000 in output and $4,814,000 in social security payments.”
T.W. Mead, FRCP, British Medical Research Council, 1990 - In 1991, the RAND study from UCLA found Chiropractic care to be an “appropriate” treatment for low back disorders.
Shekelle PG, Adams et el. The Appropriateness of Spinal Manipulation for Low Back Pain:Indications and Ratings by a Multidisciplinary Expert Panel. RAND Corporation, Santa Monica, California - Kirkaldy-Willis, M.D., world renowned medical orthopedist, joined David Cassidy, D.C., PhD. to do an evaluation of the clinical results of Chiropractic care on evaluation of the clinical results of Chiropractic care on 171 chronic medically unresponsive low back sufferers for a period of 7 years. Within 3 weeks, Dr. Cassidy eliminated 87% of the ailments. It is significant to note that a reevaluation of these patients one y ear later showed that they remained pain free!
David Cassidy, DC, Kirkaldy Willis, MD, University of Saskatchewan, 1985 - A study conducted during WWII by a former AMA (American Medical Association) trustee reported to the AMA the impressive results a doctor of Chiropractic had in the Army medical ward and that his over-all results compared with the best that the department had to offer. The study was suppressed for over 40 years until the Wilk, et. al. v. AMA trial.
- There are more controlled studies showing the effectiveness of manipulation for low back pain compared to any other type of treatment for low back pain.
- In 1991 a Gallop Poll revealed that 90% of Chiropractic users felt their treatment was effective. A report in the Western Journal Of Medicine (March, 1989) stated that patients of Chiropractors were 3 times more satisfied with their care than patients of family practice medical doctors.
- The Ontario government commissioned a study on Chiropractic that analyzed all available clinical studies, statistics and other pertinent data and found that there was an “overwhelming body of evidence” that Chiropractic was superior, more therapeutically effective, cost efficient, safer, more scientifically based and had a much higher level of patient satisfaction than Medical care. It cautioned the Ontario government against many of the “untested, questionable or harmful medical treatments” and urged the government to prefer Chiropractic care over Medical care for some ailments. It also recommended that Chiropractors be “gate keepers” in hospitals when admitting back ailments. Manga Report to the Ontario Ministry of Health, August, 1993.
Why Wait for Pain? The Science of Joint Movement
Tooth decay begins well before the first warning sign of pain — which is why dentistry recommends regular check-ups, not just emergency visits. Your spine works the same way.
According to chiropractic theory and practice, loss of normal movement in a spinal joint can lead to degenerative changes (osteoarthritis) — changes that may be prevented or even halted with timely care, but that often progress silently before pain ever appears.
Research bears this out. In published joint immobilization studies, animal joints that were splinted began showing degenerative changes within one week, and were completely fused by week twelve. Remarkably, in follow-up studies, joints remobilized after five weeks and returned to regular activity showed no further increase in arthritis. The lesson: restoring and maintaining joint movement — through chiropractic adjustment and regular exercise — helps prevent and halt degenerative change. (The Chiropractic Report, May 2004)
A Profession That Earned Its Place
Chiropractic’s legitimacy was confirmed in federal court. In Wilk v. American Medical Association, the U.S. Court of Appeals found that the AMA had engaged in a decades-long effort to “destroy a competitor,” motivated by economic concerns. The ruling ended organized efforts to marginalize chiropractic and opened the door to the cooperation between chiropractors and medical physicians that exists today — including hospital privileges, joint research, and the integrated referral relationships Dr. Karr maintains with physicians and specialists throughout Los Angeles.
Chiropractic Safety
Chiropractic care is drug-free and non-surgical — eliminating two of the most significant risk factors in health care. Serious adverse events associated with chiropractic adjustment are extremely rare; published estimates place them at a few cases per million treatments. By comparison, the 2017 American College of Physicians guidelines specifically recommend conservative care like spinal manipulation first, in part to help patients avoid the well-documented risks of long-term medication use and surgery.
Safety at our office starts with proper diagnosis: Dr. Karr — a UCLA graduate with postgraduate honors in radiology — reviews every patient’s history, with in-office digital X-rays when needed, before any treatment begins.
“Researchers studying health-care quality have concluded that medical injuries caused during hospital stays kill tens of thousands of American patients annually, requireing at least 2.4 million extra hospital days resulting in potential medical charges of $9.3 billion.” Wall Street Journal 10/08/03 p. A3
Is Chiropractic Care Safe?
Chiropractic care is widely recognized as one of the safest drug-free, non-invasive treatment options available for back pain, neck pain, and headaches.
Modern research supports starting with conservative care first:
The 2017 American College of Physicians guidelines recommend spinal manipulation as a first-line treatment for low back pain — before turning to medication.
The Lancet (2018) called for a global shift away from medications, injections, and surgery as initial treatments for low back pain, and toward non-pharmacologic care including spinal manipulation.
A 2019 BMJ Open study found that patients who saw a chiropractor first for new low back pain were significantly less likely to ever receive an opioid prescription.
Choosing conservative care first means avoiding the documented risks associated with long-term NSAID use, opioid medications, and unnecessary surgery — while keeping every option open if your condition requires referral.
At West Los Angeles Chiropractic®, safety starts with proper diagnosis. Dr. Karr reviews every patient’s history — with in-office digital X-rays when needed — to confirm chiropractic care is appropriate for your specific condition. If your case requires a different specialist, we’ll tell you honestly and help you get there.
The Case for Conservative Care First
Modern medicine increasingly agrees: start with the least invasive option. The 2017 American College of Physicians guidelines recommend non-drug treatments — including spinal manipulation — as the first-line approach for low back pain. The Lancet (2018) urged a global shift away from medications, injections, and surgery as starting points. Choosing conservative chiropractic care first keeps every option open, while avoiding the documented risks of long-term NSAID use, opioids, and unnecessary procedures.
When a case genuinely requires a specialist, Dr. Karr will tell you honestly — and refer you to the right physician. That’s what over 35 years of cooperative, evidence-based practice in West Los Angeles looks like.
Chiropractic Research
The Scientific Evidence Behind Chiropractic Care
For decades, independent researchers, government agencies, and major medical journals have studied chiropractic care — and the evidence consistently supports spinal manipulation as a safe, effective, and cost-effective treatment for back pain and related conditions. Below is a summary of key research, from today’s leading guidelines to the landmark studies that built the foundation.
Recent Research & Current Guidelines
American College of Physicians Clinical Practice Guideline (2017) The ACP — the largest medical specialty organization in the United States — recommends that patients with acute or chronic low back pain receive non-drug treatment FIRST, including spinal manipulation, before turning to medication. This guideline was published in the Annals of Internal Medicine and remains the current standard of care. Qaseem A, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain. Annals of Internal Medicine, 2017;166(7):514-530.
JAMA Systematic Review (2017) A systematic review published in the Journal of the American Medical Association analyzed 26 randomized clinical trials and found that spinal manipulative therapy was associated with statistically significant improvements in both pain and function for patients with acute low back pain. Paige NM, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain. JAMA, 2017;317(14):1451-1460.
The Lancet Low Back Pain Series (2018) The Lancet, one of the world’s most respected medical journals, published a landmark three-paper series on low back pain calling for a global shift away from medications, injections, and surgery as first-line treatments — and toward evidence-based non-pharmacologic care, including spinal manipulation, exercise, and active rehabilitation. Foster NE, et al. Prevention and Treatment of Low Back Pain: Evidence, Challenges, and Promising Directions. The Lancet, 2018;391(10137):2368-2383.
Spinal Manipulation and Opioid Reduction Multiple studies have found that patients who see a chiropractor first for low back pain are significantly less likely to receive an opioid prescription — an increasingly important finding amid the opioid crisis. Kazis LE, et al. Observational Retrospective Study of the Association of Initial Healthcare Provider for New-Onset Low Back Pain with Early and Long-Term Opioid Use. BMJ Open, 2019;9:e028633.
Foundational Research
These landmark studies established the evidence base for chiropractic care and remain historically significant.
U.S. Department of Health and Human Services (1994) Chiropractic manipulation was recommended as a treatment of choice for acute low back pain by the Agency for Health Care Policy and Research, a division of the U.S. Department of Health and Human Services.
The RAND Corporation Study (1991-1992) Independent research authority RAND Corporation reported that spinal manipulation was proven to be an appropriate treatment for most back pain patients. Shekelle PG, Adams A, et al. The Appropriateness of Spinal Manipulation for Low-Back Pain. RAND Corporation, Santa Monica, CA, 1992.
The Meade Study — British Medical Journal (1990 & 1995) A ten-year government study in Great Britain found that among patients with severe and chronic pain, chiropractic patients improved more than medical patients. The three-year follow-up concluded: “Those treated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals” — with a 29% greater improvement in patients treated with chiropractic compared with hospital care. Meade TW, et al. British Medical Journal, 1990;300:1431-1437 and 1995;311.
The Manga Report — Government of Ontario (1993) This government-commissioned report concluded that chiropractic management of low back pain is superior to medical management in safety, scientific evidence of effectiveness, cost-effectiveness, and patient satisfaction — stating there is “an overwhelming body of evidence indicating that chiropractic management of low-back pain is more cost-effective than medical management.” Manga P, Angus D, et al. University of Ottawa, Canada, 1993.
The Duke University Study (2001) A panel of 19 multidisciplinary experts concluded that spinal manipulation resulted in almost immediate improvement for cervicogenic headaches, with significantly fewer side effects and longer-lasting relief of tension-type headache than commonly prescribed medication. McCrory DC, et al. Duke University Evidence-Based Practice Center, 2001.
Workers’ Compensation Studies (1972-1991) Multiple state studies — California, Wisconsin, Florida, and Utah — consistently found chiropractic care resulted in roughly half the lost work days and substantially lower costs compared to medical management for work-related back injuries. The Utah study found compensation costs under medical care were nearly 10 times higher than chiropractic care. Jarvis KB, et al. Journal of Occupational Medicine, 1991;33(8):847-852.
Patient Satisfaction Research A 1991 Gallup Poll found 90% of chiropractic patients felt their treatment was effective. The Western Journal of Medicine reported that chiropractic patients were three times more satisfied with their care than patients of family practice medical doctors. Western Journal of Medicine, 1989;150:351-355.
What This Means for You
The research is clear and consistent across five decades: for most patients with back pain, neck pain, and headaches, chiropractic care offers effective relief — safely, without drugs or surgery, and at lower overall cost.
At West Los Angeles Chiropractic®, Dr. Michael C. Karr has applied this evidence-based approach for over 35 years, combining chiropractic care with FDA-cleared spinal decompression (DRX9000), in-office digital X-rays, cold laser therapy, and MedX rehabilitation.
Schedule your evaluation: Call Betty at 310-914-9400 West Los Angeles Chiropractic® | 11340 W. Olympic Blvd., Suite 165, Los Angeles, CA 90064
Page last updated: June 2026
