Chiropractic

Chiropractic is faith healing through bone manipulation, invented by D. D. Palmer, Sep 18, 1895. He claims that he adjusted the spine of a deaf man and allegedly restored his hearing. From what we know of from modern medicine, this is a very implausible claim.

Part of the Pseudoscience Therapies Series

  • Pseudoscience: a system of beliefs, theories, or practices that are presented as scientific but do not use the real scientific method. (‘pseudo‘ = ‘false‘).

Red Flags

Chiropractic’s pseudoscience Ref Flags:

  • Alternative Medicine
  • Buzzwords
  • Panacea: Claims that homeopathy cures or treats everything.
  • Spirit Energy [Innate Force / Life Force]
  • Purple Hat Therapy
  • Mechanism: is nonsense
  • Quality Research: shows “core Chiropractic doesn’t work”

Origins

Daniel David Palmer performed a spinal adjustment on a partially deaf janitor, Harvey Lillard in 1895. Palmer alleges that he noticed that when Lillard bent over to empty a trash can (without his shirt on), Palmer noticed that a vertebra was out of position. Palmer queried Lillard on this, and Lillard allegedly stated “I moved the wrong way, and I heard a ‘pop’ in my back, and that’s when I lost my hearing” (History of Chiropractic, Wikipedia). Palmer was involved with many “natural” healing philosophies, asked Lillard to lie face down on the floor and adjusted the vertebra back into place. Allegedly Lillard informed Palmer the following day that he “can hear that rackets on the streets”. This led to Palmer to open a school of chiropractic 2 years later. The term Chiropractic was coined by Samuel H. Weed, from a portmanteau of the ancient Greek words cheiro (hand) and praktikos (action, to do). (Chiropractic: A Critical Evaluation)

Palmer explained his method as part of vitalism (life energy), naturalism, magnetism and spiritualism. As science improved and showed that none of these health ideas were valid, Palmer did try to merge the new science with metaphysics with a key phrase “a science of healing without drugs”. The original Principles of Chiropractic mimicked Andrew Still’s Principles of Osteopathy (established a decade earlier). Palmer’s Chiropractic was mostly a copy of Osteopathy, with Still referring to chiropractic as a “bastardized form of osteopathy”. Still succeeded in passing a law for licensure, which resulted in Palmer and other chiropractors being jailed for practicing medicine without a license (Chiropractic: A Critical Evaluation).

The modern Principles of Chiropractic have 33 statements, most of which are nonsense and still rely on vitalism, which was shown to be medically and scientifically invalid even in Palmer’s era.

Does it work? (Mostly no)

Options: No / Mostly no / Purple hat (usual practice, but pretending to be more), Yes.

When studying the efficacy of chiropractic, the chiropractors that show consistent positive results are in the third category, those who mix in physiotherapy treatments (Purple Hat Physiotherapy).

Chiropractic can work when Chiropractors provide Physiotherapy

  • Chiropractors rarely have a degree in Physiotherapy and so are not qualified to do provide Physiotherapy treatments.

When studying the efficacy of the pure chiropractic interventions, no reliable positive results occur, indicating that it is an ineffective treatment.

TLDR: Effectively, all of the unique Chiropractic technique doesn’t work, and Chiropractors who have shown consistent positive results are doing Physiotherapy instead, often without a license – Hence, mostly no.

Mechanism

How Chiropractic Says it Works

Chiropractic (that is the right grammar) relies on the 33 Principles of Chiropractic. These are nonsensical statements that approximately equate to faith healing, attempting to reverse the interreferences of life forces by adjusting dislocated bones along the spine.

Chiropractic is founded on the ‘33 Principles of Chiropractic‘, reproduced below.

None of this is medicine, or makes scientific sense. Many scientists have tested the claims of ‘energy channels‘ (see above Magic Energy), and none have been found. The dot points under each entry is commentary on why this principle is either meaningless, nonsensical, or faulty.

TLDR: The 33 Principles of Chiropractic

  • These are the 33 Principles of Chiropractic.
  • They are all about defining the world in a very weird, often self contradicting, way.
  • The only part of the principles that refer to ‘healing‘ are in clauses 28, 29, 30 and 31.
    • Effectively these say that “disease is caused by an interference in the transmission of innate force [chi type energy] from subluxation [dislocation] of the spinal column”.
  • Zero evidence exists to demonstrate:
    • any form of Magic Energy, let alone that altering this thing that has never been shown to exist somehow heals anyone beyond a placebo.
    • that any bones along the spinal column for the vast majority of people who receive a spinal adjustment from a chiropractor are dislocated

The 33 Principles of Chiropractic

The statements next to the number is from Chiropractic, the dot points are my comments it.

  1. The Major Premise – A Universal Intelligence is in all matter and continually gives to it all its properties and actions, thus maintaining it in existence.
    • This appeals to panpsychism, which is an interesting philosophical concept with zero evidence of truth.
  2. The Chiropractic Meaning of Life – The expression of this intelligence through matter is the Chiropractic meaning of life.
    • This makes no actual sense. How does all things having a mind (if true) give Chiropractic Meaning of Life? Do Chiropractic’s treat rocks?
  3. The Union of Intelligence and Matter – Life is necessarily the union of intelligence and matter.
    • This also makes no sense. If The Major Premise above it true (regardless of lack of evidence), then this statement makes no sense, as all matter is intelligent, so all matter is alive.
  4. The Triune of Life – Life is a triunity having three necessary united factors, namely: Intelligence, Force and Matter.
    • First all matter is intelligent, then life is any matter that is intelligent (so all matter is life), and now life is matter, intelligence and force. Pick one?
  5. The Perfection of the Triune – In order to have 100% Life, there must be 100% Intelligence, 100% Force, 100% Matter.
    • 100% Life is 300%? This is not how math works. 100 % Life can’t be made of 100% intelligence and 100% force and 100% matter.
  6. The Principle of Time – There is no process that does not require time.
    • This is actually accurate.
  7. The Amount of Intelligence in Matter – The amount of intelligence for any given amount of matter is 100% and is always proportional to its requirements.
    • This doesn’t make sense.
    • According to the Major Premise, all matter is intelligent. All of it.
    • So how can any matter have less than 100% intelligence?
    • If that is the case, and any amount of intelligence is 100%, then how can it now be proportional to its requirements?
    • This is not how math works.
  8. The Function of Intelligence – The function of intelligence is to create force.
    • This is a hypothesis and while I think it is wrong, let us let it stand.
    • By “force”, they mean “spirit energy”, but they never actually state that.
  9. The Amount of Force Created by Intelligence – The amount of force created by intelligence is always 100%.
    • This is another nonsense.
    • The amount of force is always 100%, so that means that all matter, which is intelligent, is always 100% intelligent, and always creates 100% force.
    • Which force, in what direction, with what effect?
    • This proposes that intelligence can not have no force effect.
  10. The Function of Force – The function of force is to unite intelligence and matter.
    • The force is to unite intelligence and matter, in contradiction to the Major Premise which states the universal intelligence is in all matter.
  11. The Character of Universal Forces – The forces of Universal Intelligence are manifested by physical laws; are unswerving and unadapted and have no solicitude for the structures in which they work.
    • This is just non sensical. It uses many fancy words which mean nothing when combined like this.
  12. Interference with Transmission of Universal Forces – There can be interference with transmission of universal forces.
    • This contradicts the little meaning of 11, the Charact of Universal Forces. If the Universal Intelligence is manifested by unswerving and unadapted physical laws, then these unswerving and unadapted physical laws cannot be interfered with.
  13. The Function of Matter – The function of matter is to express force.
    • This makes no real sense in relation to the rest.
  14. Universal Life – Force is manifested by motion in matter; all matter has motion, therefore there is universal life in all matter.
    • This is non sense again.
    • All matter has intelligence. Some matter has innate intelligence. All matter has motion, so all matter has force. Therefore all matter has life. If all matter has intelligence, force and life, then why have a differentiation between matter, intelligence, force and life?
    • Which contradicts innate intelligence, the purpose of life, the purpose of matter etc.
  15. No Motion without the Effort of Force – Matter can have no motion without the application of force by intelligence.
    • Physics would like to disagree with this statement. The four forces are all without the application of intelligence.
    • However, this is where we get a hint that they mean “spirit”.
  16. Intelligence in both Organic and Inorganic Matter – Universal Intelligence gives force to both organic and inorganic matter.
    • This is the same as the first statement, the Major Premise.
  17. Cause and Effect – Every effect has a cause, and every cause has effects.
    • This is a tautology. A = B because B = A.
  18. Evidence of Life – The signs of life are evidence of the intelligence of life.
    • This is a misleading statement, and is in conflict with the statement 1 and statement 14.
  19. Organic Matter – The material of the body of a “living thing” is organized matter.
    • Ok, and?
    • As stated in 18 and 14, all matter is life, so organic matter is all matter.
  20. Innate Intelligence – A “living thing” has an inborn intelligence within its body, called Innate Intelligence.
    • This makes no sense if statement 1, the Major Premise is true – all things have intelligence, all matter has intelligence.
    • Why would a “living thing” have innate intelligence, and how is that different to the intelligence that all things have?
    • It seems that with the statements that all matter is life, intelligent and contains force, the principles have left no way to differentiate humans from everything else, so now they have added innate intelligence and organic matter to try to separate out humans.
  21. The Mission of Innate Intelligence – The mission of Innate Intelligence is to maintain the material of the body of a “living thing” in active organization.
    • That makes no sense without assuming spirit and human difference in intelligence.
  22. The Amount of Innate intelligence – There is 100% of Innate Intelligence in every “living thing,” the requisite amount, proportional to its organization.
    • We still don’t know what innate intelligence is compared to intelligence
    • Based on previous statements, all matter has intelligence, which is always 100%.
    • So why is it proportional?
  23. The Function of Innate Intelligence – The function of Innate Intelligence is to adapt universal forces and matter for use in the body, so that all parts of the body will have coordinated action for mutual benefit.
    • This makes no sense.
    • It seems to be trying to imply that “being an alive human means biology”, but doesn’t say that.
  24. The Limits of Adaptation – Innate Intelligence adapts forces and matter for the body as long as it can do so without breaking a universal law, or Innate Intelligence is limited by the limitations of matter.
    • Innate Intelligence, still not defined, adapts forces and matter so long as it doesn’t break the physics laws.
    • If the Universal Law is the “laws of physics”, then most matter has no intelligence, and force exists outside of intelligence, contradicting earlier statements.
    • If the Universal Law is something else, Chiropractic never states what it is.
  25. The Character of Innate Forces – The forces of Innate Intelligence never injure or destroy the structures in which they work.
    • This is in contradiction to excellent evidence of cancer, viruses and bacteria.
  26. Comparison of Universal and Innate Forces – In order to carry on the universal cycle of life, Universal forces are destructive, and Innate forces constructive, as regards structural matter.
    • This seems contradictory.
    • What is structural matter?
  27. The Normality of Innate Intelligence – Innate Intelligence is always normal, and its function is always normal.
    • This contradicts conditions such as psychosis
    • There is a lot of evidence that psychosis is real, and therefore this is wrong.
  28. The Conductors of Innate Forces – The forces of Innate Intelligence operate through or over the nerve system in animal bodies.
    • Ok, sure. That is compatible with the idea of medicine, where signals from the brain travel over the nerve system.
    • Chiropractic is trying to imply that the signal is spiritual in nature, via the “force” rather than biochemical.
  29. Interference with Transmission of Innate Forces – There can be interference with the transmission of Innate forces.
    • This contradicts point 11.
  30. The Causes of Dis-ease – Interference with the transmission of Innate forces causes incoordination or dis-ease.
    • This contradicts point 11, 25 and 27.
    • Since Innate forces haven’t been defined, we don’t know how that is different to any force.
  31. Subluxations – Interference with transmission in the body is always directly or indirectly due to subluxations in the spinal column.
    • There is zero evidence that this is true.
    • Since all matter has life, intelligence and force, then why is the [human] body different? If it is not different, then where is the spinal column of an intelligent rock whose force transmission has been interfered with? How is that spinal column subluxed?
    • A subluxation is chiropractic speak for a dislocation, which can easily be seen in various scans and are still defined as diseased by chiropractors.
    • People who have clearly no dislocations of any bones in the spinal column still seem to get “adjustments” made by chiropractors to fix their disease.
  32. The Principle of Coordination – Coordination is the principle of harmonious action of all the parts of an organism, in fulfilling their offices and purposes.
    • This can be defined like this, but what does it mean, and how do they know it to be true? This statement is a nothing burger.
  33. The Law of Demand and Supply – The Law of Demand and Supply is existent in the body in its ideal state; wherein the “clearing house,” is the brain, Innate the virtuous “banker,” brain cells “clerks,” and nerve cells “messenger”.
    • Ok? Just like in statement 32, you can define anything as anything I guess, but what does that mean?

Source: International Chiropractors Association, (copied here in 2025)

The Actual Science

Science Based Medicine reports that there is no credible evidence to support the claims of the above principles for their practice, and no evidence that adjusting the bones of the spine, or anywhere else, give any reliable medical therapeutic treatment to the vast majority of the diseases that Chiropractors claim to treat.

We can divide Chiropractic practitioners into 3 categories:

  1. Straight practitioners, who only adjust the spine
  2. Mixed alternative medicine practitioners, who include other pseudoscience treatments like acupuncture, kinesiology etc
  3. Mixed with physiotherapy (and probably the pseudoscience treatments)

Chiropractic Practitioner Type 1: Zero evidence of consistent positive results for any of the large number of conditions they claim to address.
Chiropractic Practitioner Type 2: Zero evidence of consistent positive results for any of the large number of conditions they claim to address.
Chiropractic Practitioner Type 3: Some evidence of treating conditions that a physiotherapist would typically treat.

There is some positive evidence that Chiropractic can relieve some forms of back pain for a short amount of time. There is poor evidence that it lasts for long.

Quality Research

Quality Research that Chiropractic works reliably.

TLDR: There isn’t much, and it is terrible.

  • Most of the Chiropractic Research (affirming positive results) that was considered for this article should not have passed peer review. I was unable to find research that should.
  • No quality evidence shows that Chiropractic consistently works in the absences of physiotherapy or some other legitimate treatment.

I went into some research hell trying to find some actual positive data that Chiropractic consistently works. Mostly I found assurances or assumptions that it does – and that isn’t evidence or reassuring.

For example:

  • Conservative Approaches for the Management of Temporomandibular Disorders: A Narrative Review, by Tiwari, Aakanksha; Dangore-Khasbage, Suwarna
    • Why it is bad:
      • This document offers to be an introduction to a type of pain in people’s jaws called Temporomandibular disorders, and a summary of treatments for it.
      • The article does a non critical review of “Chiropractic Technique“:
        • “It has been demonstrated that chiropractic therapy is an effective noninvasive way to treat TMD symptoms.”
          • Has it?
        • “Moreover, manual mandibular therapy and spinal manipulation were the most successful chiropractic methods for treating TMD”.
        • I followed the rabbit hole of references.
          • TLDR: no, it is not been demonstrated to any level of trust.
          • Conservative management of temporomandibular dysfunction: A literature review with implications for clinical practice guidelines (Narrative review part 2), Raymond Butts, James Dunning, et al. [source (pdf)]
            • “High-velocity low-amplitude (HVLA) thrust manipulation has been shown to increase afferent discharge rates of mechanoreceptors” p3 … HVLA is a stealth way of saying ‘chiropractic’. That is, this paper didn’t want to admit to including chiropractic techniques.
            • However, “the ‘most recent systematic review of only 2 medium quality studies‘ on HVLA thrust manipulation of the TMJ by Alves et al. ‘found insufficient evidence to support using the technique‘ for patients with TMD (Alves et al., 2013).” p3.
            • Mandibular manipulation for the treatment of temporomandibular disorder, Betania Mara Franco Alves, Cristiane Rufino Macedo, et al. [source].
              • “research question: Is the mandibular manipulation technique an effective and safe technique for the treatment of the temporomandibular joint disk displacement without reduction?”
                • 7 major generally high quality research repositories were searched, language not a barrier (very open).
                • Only randomized and controlled clinical studies were included.
                  • To calculate effectiveness, “randomized” and “controlled clinical studies” are a good base line.
                • “Two studies of medium quality fulfilled all the inclusion criteria.”
                  • Only 2?
                • “There is no sufficient evidence to support the effectiveness of the mandibular manipulation therapy, and therefore its use remains questionable”.
          • The article that is referenced quickly pivots and tries to make this all about the spine.
            • “Interestingly, there is considerably more evidence for manipulating the cervical spine (i.e. HVLA thrust manipulation) to treat symptoms associated with TMD.”
              • If this is true, then this is very important information.
              • Yet, each time I followed a statement like this down to its source, I would end up with a blatant contradiction.
                • For example:
                  • “… manual therapy, including manipulation and/or mobilization to the orofacial and C-spine, was effective when administered alone or in combination with exercise (Armijo Olivo et al., 2016).”
                  • Here is the article referenced: Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic review and Meta-Analysis, Susan Armijo-Olivo 1, Laurent Pitance et al, [source], which says:
                    • Data synthesis: “The overall evidence for this systematic review was considered low. The trials included in this review had unclear or high risk of bias.“
                    • Conclusion: “No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and MT for treatment of TMD.”
    • The article did not check to see if the claims were backed by evidence. When you follow the links to see what the evidence says, it says “no evidence was found” or “no sufficient evidence to support”.
    • Thus the Peer Review should have stopped this from being published.

How did these papers pass Peer Review?

The fundamental problem here is, you don’t ask dentists to review the quality of an astrophysics paper on black holes. You ask black hole astrophysicists to do that. The journals therefore ask chiropractors to review the papers on chiropractic, and as the one of the misquoted sources * states “The trials included in this review had unclear or high risk of bias“. Thus, if you don’t know how to check the quality of a meta review or paper, you will assume that the writer has done their diligent work, is being honest, and that the peer reviewer will maintain the quality of the journal. Unfortunately, because chiropractic has been ‘assumed to be science‘ (Logical fallacy: Begging the Question), the peer review is left to the same ‘experts‘ that are either ‘in on it‘, or have been conned into thinking it is true.

* misquoted, because the article I began to review, simplified an article that reluctantly and passingly admitted that evidence was a bit light, but assumed it is there, and when I looked at that source, effectively said “no evidence here.”

Where is the Harm?

The risk is high for very little reward.

There is a slight chance that with a spinal adjustment you can be paralysed or have a stroke. Far too many people have had strokes after a spinal adjustment who weren’t in any standard risk category. As many countries now allow chiropractic as a health treatment, the investigation and punishment of malpractice is generally handled by that country or states chiropractic board of chiropractors. When someone is concerned that some malpractice has occurred, the chiropractic board of chiropractors investigate and find that there is no evidence to support the higher than average number of spontaneous stroke victims has anything to do with chiropractic. Apparently, they were all due to pre-existing problems, or from some incident that occurred after that adjustment. (Source)

This is a serious risk of injury for no consistent proven benefit for the adjustment – all risk with no gain.

Summary

  • This risk analysis effectively says “pay money for a treatment that can kill you with zero reliable evidence that this treatment will help you”.
    • Purely chiropractic treatment is faith healing with zero evidence that it works.
    • The only reliable treatment that Chiropractors give is physiotherapy, which most are not qualified to give. If you want physiotherapy, go and see a physiotherapist.
    • There is a risk of paralysis or stroke, which is a serious consequence, without any evidence of reliable positive results.

References

History of chiropractic. (2020, November 8). Wikipedia. https://en.wikipedia.org/wiki/History_of_chiropractic

Edzard Ernst, MD, PhD, FRCP, FRCPEd, Chiropractic: A Critical Evaluation, (February 15, 2008). Journal of Pain and Symptom Management (JPSM), https://www.jpsmjournal.com/article/S0885-3924(07)00783-X/fulltext

Panpsychism. (2022, May 7). Wikipedia. https://en.wikipedia.org/wiki/Panpsychism

33 Principles of Chiropractic The 33 Principles of Chiropractic. (n.d.). Retrieved October 4, 2026, from https://www.chiropractic.org/wp-content/uploads/2024/09/33-Principles.pdf

Fulgham, J. (2013, June 13). Chiropractic | Science-Based Medicine. Sciencebasedmedicine.Org. https://sciencebasedmedicine.org/reference/chiropractic/

Tiwari, A., & Dangore-Khasbage, S. (2025). Conservative Approaches for the Management of Temporomandibular Disorders: A Narrative Review. Journal of Datta Meghe Institute of Medical Sciences University, 20(3), 495–502. https://doi.org/10.4103/jdmimsu.jdmimsu_221_25

Butts, R., Dunning, J., Pavkovich, R., Mettille, J., & Mourad, F. (2017). Conservative management of temporomandibular dysfunction: A literature review with implications for clinical practice guidelines (Narrative review part 2). Journal of Bodywork and Movement Therapies, 21(3), 541–548. https://doi.org/10.1016/j.jbmt.2017.05.021

Alves, B. M. F., Macedo, C. R., Januzzi, E., Grossmann, E., Atallah, Á. N., & Peccin, S. (2013). Mandibular manipulation for the treatment of temporomandibular disorder. In The Journal of craniofacial surgery (Vol. 24, Issue 2, pp. 488–493). PubMed. https://doi.org/10.1097/SCS.0b013e31827c81b3

Armijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A. (2015). Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Physical Therapy, 96(1), 9–25. https://doi.org/10.2522/ptj.20140548

Jones, J. (2002). Neurologists warn about link between chiropractic, stroke. CMAJ: Canadian Medical Association Journal, 166(6), 794. https://pmc.ncbi.nlm.nih.gov/articles/PMC99474/