A recent comparison of medicine, acupuncture, and chiropractic care Comparing, in a randomized trial, medication (Celebrex, Vioxx, or paracetamol) to acupuncture and spinal manipulation over the course of 9 weeks in persons with chronic spinal pain (neck to low back pain included), the authors demonstrated a rather profound superiority in chiropractic spinal manipulation. The exception was for neck pain in which acupuncture was found to be superior on the basis of Neck Disability Scores. The average period of chronicity was 4.5 years in the medicine group; 6.4 years in the acupuncture group; and 8.3 years in the chiropractic group. After 9 weeks of care, spinal manipulation had achieved asymptomatic status in 27%, compared to 9.4% for acupuncture and only 5% for medicine. Patients were allowed to change therapy groups if they perceived a lack of effectiveness in their current treatment group. Over the course of the 9 weeks, nine from the medical group, five from the acupuncture group, and two from the chiropractic group changed treatment types.

The primary tool of modern chiropractors is spinal manipulation or, in the parlance of the profession, spinal adjusting. Chiropractors also utilize a variety of physical medicine and rehabilitation approaches, along with nutritional advice to strengthen and balance the body. They may utilize traditional modalities such as ultrasound, diathermy, microcurrent stimulation, laser therapy, traction, and heat and cold applications in addition to spinal manipulation.