Major Research Findings: Choose Chiropractic First, Lower Healthcare Costs

Major Research Findings: Choose Chiropractic First

 
 
A systematic review published in March 2024 analyzed 44 studies and found that patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management.

The review examined over 2,200 research papers, including economic studies, randomized controlled trials, and observational studies, from inception through October 2022.
 
 

Specific Downstream Cost Reductions

When chiropractors serve as the first provider, research shows significant reductions in:

Opioid Prescriptions: Ten studies published since 2017 found reduced dispensing of opioid prescriptions when chiropractors were the first provider. Patients who saw a chiropractor as their initial provider for low back pain had 90% decreased odds of both early and long-term opioid use.

Surgeries and Hospitalizations: Spinal pain patients who consulted chiropractors as first providers needed fewer opioid prescriptions, surgeries, hospitalizations, emergency department visits, specialist referrals and injection procedures.

Care Escalation: For neck pain patients, initial spinal manipulative therapy was associated with a 64% lower rate for long-term care escalation encounters compared to primary care without analgesics.
 
 

Recent 2025 Research

A February 2025 study in Archives of Physical Medicine and Rehabilitation found that for older adults with new neck pain episodes, initial spinal manipulative therapy is associated with lower healthcare costs, particularly for Medicare Part A total and neck pain-related claims.
 
 

Patient Outcomes

The research consistently shows that clinical outcomes are comparable or better with chiropractic care:

• In a study of 272 participants with neck pain, about 57% of those who saw chiropractors and 48% of those who exercised reported at least a 75% reduction in pain after 12 weeks, compared with 33% in the medication group.
• Medicare patients with chronic low back pain who received spinal manipulation from a chiropractor had lower costs of care and shorter episodes of back pain than patients in other treatment groups.

Cost Implications

Given that spine-related pain in the United States costs an estimated $134.5 billion annually, researchers suggest that healthcare organizations should consider reducing barriers to chiropractic access by modifying pre-authorization requirements, eliminating gatekeepers, and reducing arbitrary visit limits.

The research consistently suggests that starting with chiropractic care leads to less invasive downstream interventions and lower overall healthcare system costs, while maintaining comparable or superior clinical outcomes.