You’ve seen videos on social media or experienced it IRL: The loud crack that can happen during a chiropractic adjustment.
For some people, the thought of the spinal adjustment is jarring to say the least. For others, the crack or popping noise is the sweet sound of pain relief.
Most people who turn to chiropractic care are looking to ease pain in the body. And chiropractic has been gaining popularity in recent years in part because of the rising interest in alternative therapies for pain that do not involve surgery or drugs.
“People are now looking for and recognizing that if they can treat pain without a pill perhaps they can take better control of their life because when you mask a problem, it tends to come back and you end up with chronic pain,” said Sherry McAllister, DC, M.S., CCSP, president of the Foundation for Chiropractic Progress.
Today, more than 1 in 4 people in the U.S. are living with chronic pain — and more women experience chronic pain compared to men.
Given the high rates of chronic pain and the rising interest in chiropractic care, is chiropractic effective for managing chronic pain?
What is chiropractic?
Chiropractic care is a licensed healthcare profession that involves using non-surgical, drug-free methods to help evaluate, diagnose and manage musculoskeletal conditions — the most common being headache, neck and back pain.
“But chiropractic addresses more than just your neck and back — it’s really about whole-being care,” McAllister said.
During the first visit with a licensed chiropractor, they will give you a physical exam, take your medical history and work to diagnose the problem and form a treatment plan.
Treatments usually involve manual therapy such as spinal manipulation, which realigns joints to decrease pain and increase range of motion (aka the back crack), stretching and exercise and may include nutrition guidance as part of a whole-being approach to health.
McAllister said chiropractic is also preventive. “There are certain things we can do to alleviate pain, but at the end of the day — much like a dentist — the chiropractor's best role is to prevent pain before it even happens.”
Preventive practices can include routine adjustments, addressing spinal misalignments, posture correction and long-term wellness practices to help stop injuries and chronic issues before they start.
Chiropractic and chronic pain
Chronic pain — pain that lasts more than three to six months — is complex and can affect all aspects of everyday life.
Although research shows chiropractic can help with some issues of acute pain, there are limited studies addressing the effectiveness of chiropractic on chronic pain.
“Chiropractic care, particularly spinal manipulative therapy, has shown some short-term benefit for adults with acute low back pain, including women, though the overall effect tends to be modest and temporary,” said Jessica Oswald, M.D., MPH, a
pain management specialist at UC San Diego. “The American College of Physicians includes spinal manipulation among its recommended non-pharmacologic options for acute low back pain.”
Additionally, a 2025 review published in the Journal of Bone & Joint Surgery supported spinal manipulation therapy as a conservative treatment for lower back pain — including chronic cases. However, research on spinal manipulation showed little or conflicting evidence regarding its efficacy for pain relief for headache, neck pain and extremity disorders.
Oswald noted that chiropractic manipulation is typically safe to try, but if you’re thinking about doing it, it’s important to note that the long-term benefits can be limited and the cost of chiropractic care, which may or may not be covered under insurance, can be high.
Also, people with certain conditions such as connective tissue disease and vascular disorders should not try chiropractic, so it’s important to discuss your medical history before any manual therapies.
Chiropractic care and chronic pain in women
Research shows women are more likely to report higher pain intensity compared to men. And the risk for both chronic pain and high impact chronic pain, which is pain that impacts your daily life, is higher for women.
Women tend to have greater sensory awareness and emotional connection to physical touch, which Oswald noted may enhance the benefit of manual therapies used in chiropractic care.
“Although few studies have analyzed outcomes by gender, it is plausible that the therapeutic context, patient-provider interaction and tactile component of chiropractic care could contribute to a more positive treatment experience for some women,” Oswald said.
One very small study of 15 women with chronic lower back pain found that joint bracing/taping, also called kinesiology taping, as part of chiropractic care showed reduced pain and improved function.
McAllister noted the personalized approach of chiropractic care means women have more individually tailored treatment options for pain. “Early intervention can be critical in preventing acute pain from progressing into chronic pain, particularly for women who may be more prone to prolonged discomfort due to hormonal, emotional and social factors,” she said.
If you’re living in pain, you have options
McAllister’s personal experience with chiropractic care as a young woman helped shape her desire to be part of the healthcare profession. She was in college when she was in a car accident that left her with debilitating headaches and neck pain.
After six months of physical therapy and medications, chiropractic was what finally worked for her. “I think people get put into these places where they start losing hope … and I would never want anybody else in chronic pain to ever lose hope because chiropractic changed my life,” she said.
No two people with chronic pain are the same. What works for one person may not work for another, but there are options to consider outside of prescription medications and surgery for some people living with chronic pain.
