How do spine doctors feel about chiropractors?

September 29, 2025 •

4 min read

According to a 2009 survey, North American orthopedic surgeons hold widely diverse attitudes towards chiropractic care, with views ranging from favorable to skeptical. Understanding how do spine doctors feel about chiropractors? is key for patients navigating spinal health and seeking collaborative treatment options. It is not a simple consensus but a nuanced spectrum of professional opinions that informs patient care.

Quick Summary

The opinions of spine doctors regarding chiropractors are varied, influenced by differences in medical philosophy, education, and patient safety concerns, yet an increasing number recognize the value of chiropractic care, especially for non-surgical musculoskeletal issues. Collaborative and integrated care models, where both professionals work together, are becoming more common to achieve optimal patient outcomes.

Key Points

Diverse Opinions: Spine doctors' views on chiropractors range from favorable and collaborative to neutral or skeptical, influenced by different medical philosophies and experiences.
Collaboration is Growing: Despite past friction, many spine doctors and chiropractors increasingly collaborate through referrals and co-management to provide comprehensive patient care, especially for musculoskeletal issues.
Differences in Approach: Core differences lie in their training and scope of practice, with spine doctors trained in evidence-based medicine, medication, and surgery, while chiropractors focus on non-invasive manual adjustments.
Patient-Centered Care: For optimal results, an integrated, team-based approach is often best, where both professionals communicate and coordinate care based on the patient's specific needs.
Key Concerns: Some skepticism among spine doctors stems from concerns about limited scientific evidence for certain chiropractic claims, patient safety issues, and aggressive marketing by some practitioners.

A Spectrum of Professional Opinions

Professional attitudes are far from monolithic; research and anecdotal evidence reveal a wide range of opinions among spine doctors, including orthopedic surgeons and neurosurgeons. A significant portion of surgeons hold a negative impression, while others maintain a neutral stance or express favorable views. This variability is often influenced by factors like personal experience with a specific chiropractor, exposure to formal education on the topic, and the type of evidence they prioritize. Some spine doctors may find chiropractic care an excellent non-operative option, particularly for general musculoskeletal complaints, and actively refer patients. For these doctors, they see a valuable resource that can delay or prevent the need for more invasive treatments like surgery. Conversely, another segment of the medical community expresses strong skepticism, viewing some chiropractic practices as unproven or even bordering on quackery. These differing viewpoints highlight the importance of communication and collaboration to ensure the best interests of the patient are always at the forefront.

The Philosophical and Educational Divide

A fundamental difference in approach and training often underpins the professional tension. Spine doctors, as medical doctors (MDs) or doctors of osteopathic medicine (DOs), are trained within the framework of evidence-based medicine, focusing on diagnosis, pharmacology, and surgical interventions. Their rigorous educational path includes medical school, years of residency, and often specialized fellowships. In contrast, chiropractors earn a Doctor of Chiropractic (DC) degree, with their training centered on the musculoskeletal system, spinal manipulation, and a more holistic view of the body's natural healing capabilities. Chiropractors are not licensed to prescribe medications or perform surgery.

Key Concerns Cited by Skeptics

While many modern chiropractors operate within a medically accepted scope of practice, some spine doctors express concern over historical or fringe practices. Common reservations include:

Lack of Evidence: Skepticism arises from a lack of robust scientific evidence supporting certain chiropractic claims, particularly regarding non-musculoskeletal conditions.
Patient Safety: Although rare, reported cases of serious complications like vertebral artery dissection from cervical manipulation are a significant concern for some neurosurgeons.
Overly Aggressive Marketing: Some spine doctors perceive that certain chiropractors engage in aggressive marketing tactics or promote dependency on frequent adjustments, especially when there is no medical necessity.
Scope of Practice: Concerns arise when chiropractors provide advice or attempt to treat conditions that fall outside their scope of training and expertise.

Collaborative and Integrated Care

Despite the historical and philosophical friction, a growing number of practitioners are embracing collaborative, integrated care models. This approach recognizes that the patient's best outcome often involves combining different therapeutic modalities. For example, a spine doctor might refer a patient for chiropractic care for conservative management of lower back pain, while a chiropractor may refer a patient to a spine surgeon when non-invasive treatment is unsuccessful or a more serious issue like a herniated disc is identified. Many modern clinics are adopting an interdisciplinary approach, with teams of chiropractors, physical therapists, and medical doctors working together seamlessly.

This collaborative effort ensures that patients receive conservative care when appropriate, but have a clear pathway to advanced medical or surgical interventions if needed. Studies support the effectiveness of this approach in managing complex musculoskeletal issues, improving patient outcomes, and potentially reducing reliance on medication and surgery. For more on the benefits of integrated care, refer to resources on modern spine care approaches and collaborative treatment plans, such as those found on the National Institutes of Health (NIH) website.

Comparison: Spine Doctor vs. Chiropractor


Aspect	Spine Doctor (Orthopedic Surgeon)	Chiropractor
Education	Bachelor's degree, medical school (MD/DO), 5-year residency, and fellowship.	Bachelor's degree, 4+ years chiropractic college (DC), certification.
Scope	Diagnosis, medication, injections, physical therapy, surgery.	Non-invasive manual therapies, spinal adjustments, lifestyle advice.
Focus	Treats a broad range of spinal conditions from mild to severe.	Focuses on musculoskeletal and nervous system health, especially spinal alignment.
Treatment	Conservative methods first, progressing to injections and surgery if needed.	Manual adjustments, massage, heat, therapeutic exercises.
Medication	Can prescribe medication.	Cannot prescribe medication.
Imaging	Uses advanced diagnostics like MRIs and CT scans.	Primarily uses physical exams and basic imaging like X-rays.

Tips for Patients Navigating Integrated Care

To ensure the best outcome, patients can take proactive steps when receiving care from multiple providers:

Communicate Honestly: Inform both your spine doctor and your chiropractor about all treatments you are receiving. This ensures your care is coordinated effectively.
Share Records: Request that your chiropractor and spine doctor share medical records, test results (like X-rays or MRIs), and treatment plans.
Start with Conservative Care: For many musculoskeletal issues, starting with a conservative, non-invasive approach like chiropractic care can be a beneficial first step, with a clear plan to escalate to specialist care if necessary.
Ask for Credentials: Understand your chiropractor's credentials, experience, and specific techniques to ensure they align with your needs and comfort level.

Conclusion: Finding the Right Path

Ultimately, the varied opinions among spine doctors regarding chiropractors underscore the importance of finding a comprehensive, patient-centered approach. While historical and philosophical differences exist, the modern trend toward interprofessional collaboration shows a promising path forward. For most patients, the choice is not an either/or situation, but rather about building a team of professionals who can address their unique spinal health needs with a coordinated and cooperative strategy. By understanding the differing perspectives and fostering open communication, patients can navigate the healthcare landscape effectively and work towards achieving optimal spinal health and well-being.

Frequently Asked Questions

Yes, many spine doctors and chiropractors work together in a collaborative care model. They may refer patients to each other, especially for low back pain, to ensure the patient receives the most appropriate blend of conservative and medical treatments.

In most cases, you do not need a referral to see a chiropractor, as they are often considered primary-contact healthcare providers for musculoskeletal issues. However, some insurance plans or worker's compensation policies may require one for coverage.

Skepticism can arise from several factors, including differing medical philosophies, a focus on evidence-based medicine, concerns about patient safety (e.g., cervical manipulation), and reservations about unproven claims made by some chiropractors.

Commonly treated conditions include low back pain, neck pain, sciatica, herniated discs, and osteoarthritis. Collaboration can be particularly effective when a patient initially seeks non-invasive care before considering more aggressive medical treatments.

The primary difference is their core treatment methods. A chiropractor focuses on manual adjustments and non-invasive therapies, while a spine doctor can provide medication, injections, and surgical options when necessary.

Yes, it is always a good idea to inform all your healthcare providers about your treatment plan. This ensures everyone is on the same page, allowing for better-coordinated care and helping to avoid potential conflicts or unnecessary tests.

Look for a chiropractor who practices evidence-based care and emphasizes clear communication and collaboration with other medical professionals. You can also ask your spine doctor or primary care physician for a recommendation or check with integrated clinics.