Recommended Reading

Chiropractic coverage and costs

  1. Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain. Davis MA, Yakusheva O, Gottlieb DJ, Bynum JP. J Am Board Fam Med. 2015
  2. Coverage of Nonpharmacologic Treatments for Low Back Pain Among US Public and Private Insurers. Heyward J, Jones CM, Compton WM, Lin DH, Losby JL, Murimi IB, Baldwin GT, Ballreich JM, Thomas DA, Bicket MC, Porter L, Tierce JC, Alexander GC. JAMA Netw Open. 2018
  3. The association between use of chiropractic care and costs of care among older Medicare patients with chronic low back pain and multiple comorbidities. William B Weeks, Brent Leininger, James M Whedon, Jon D Lurie, Tor D Tosteson, Rand Swenson, Alistair J O’Malley, Christine M Goertz. J Manipulative Physiol Ther. (2016)
  4. Visit Frequency and Outcomes for Patients Using Ongoing Chiropractic Care for Chronic Low-Back and Neck Pain. Coulter ID, Goertz CM, Hurwitz EL, Sorbero ME, Herman PM, Edgington SE. Pain Physician. 2021
  5. Trends in Insurance Coverage for Complementary Health Care Services. Whedon JM, Bezdjian S, Goehl JH, and Kazal LA. J Altern Complement Med. 2020

  6. Insurance Reimbursement for Complementary Healthcare Services. Whedon JM, Tosteson TD, Kizhakkeveettil A, Nagare Kimura M. J Altern Complement Med. 2017

Nonpharmacologic pain management / Opioid reduction

  1. Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis. Corcoran KL, Bastian LA, Gunderson CG, Steffens C, Brackett A, Lisi AJ. Pain Medicine. 2020
  2. Initial Provider Specialty Is Associated With Long-term Opiate Use in Patients With Newly Diagnosed Low Back and Lower Extremity Pain. Azad TD, Vail D, Bentley J, Han SS, Suarez P, Varshneya K, Mittal V, Veeravagu A, Desai M, Bhattacharya J, Ratliff JK. Spine. 2019
  3. Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries. Weeks WB et al. J Manipulative Physiol Ther. 2016
  4. Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care. Lisi AJ et al. Pain Med. 2018
  5. Ineffective Policies to Address the Opioid Epidemic. Weeks WB, Goertz CM. JAMA Psychiatry. 2017
  6. Association Among Opioid Use, Treatment Preferences, and Perceptions of Physician Treatment Recommendations in Patients With Neck and Back Pain. Weeks WB, Goertz CM, Long CR, Meeker WC, Marchiori DM. J Manipulative Physiol Ther. 2018
  7. Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids. Whedon JM, Toler AWJ, Goehl JM, Kazal LA. J Altern Complement Med. 2018
  8. Chiropractic Management of a Patient With Chronic Pain in a Federally Qualified Health Center: A Case Report. Mann DJ, Mattox R. J Chiropr Med. 2018
  9. CAM therapies among primary care patients using opioid therapy for chronic pain. Fleming S, Rabago DP, Mundt MP, Fleming MF. BMC Complement Altern Med. 2007
  10. Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain, an RCT. Eklund A, Jensen I, Lohela-Karlsson M, Hagberg J, Leboeuf-Yde C, Kongsted A, Bodin L, Axén I. PLOS ONE. 2018
  11. Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain. Whedon JM, Toler AWJ, Kazal LA, Bezdjian S, Goehl JM, Greenstein J. Pain Med. 2020
  12. Observational retrospective study of the association of initial healthcare provider for new-onset low back pain with early and long-term opioid use. Kazis LE, Ameli O, Rothendler J, Garrity B, Cabral H, McDonough C, Carey K, Stein M, Sanghavi D, Elton D, Fritz J, Saper R. BMJ Open. 2019


  1. Implementation of the Primary Spine Care Model in a Multi-Clinician Primary Care Setting: An Observational Cohort Study. Whedon JM, Toler AWJ, Bezdjian S, Goehl JM, Russell R, Kazal LA, Nagare M. J Manipulative Physiol Ther. 2020

Standards of care prioritizing manipulation

  1. Joint Commission, which accredits hospitals, requires non-pharmacologic pain management options: (policy) (press release) (Safety Guide)
  2. American College of Physicians includes spinal manipulation in guideline on low back pain: (Annals of Internal Medicine)
Local note:

Papers authored by James Whedon, DC, MS, are based on data collected in the state of New Hampshire. Among the authors listed above, Justin Goehl, DC, MS, and Louis Kazal, MD, practice in New Hampshire at Dartmouth-Hitchcock in Lebanon.

Citations assembled with assistance from:

James Whedon, DC, MS, Professor of Research at Southern California University of Health Sciences; Christine Goertz, DC, PhD, Director of System Development for Spine Health at Duke University; and Michael Schneider, DC, PhD, Associate Professor in the Department of Physical Therapy at the University of Pittsburgh.