Chiropractic massage is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromuscular skeletal system and the effects of these disorders on general health. It is generally categorized as complementary and alternative medicine. Although chiropractors have many attributes of primary care providers, chiropractic massage has more of the attributes of a medical specialty like dentistry or podiatry.
The main chiropractic massage treatment technique involves manual therapy, including manipulation of the spine, other joints, and soft tissues; treatment also includes exercises and health and lifestyle counseling. Traditional chiropractic massage assumes that a vertebral subluxation interferes with the body's innate intelligence, a vitalistic notion ridiculed by the scientific and healthcare communities. A large number of chiropractors want to separate themselves from the traditional vitalistic concept of innate intelligence.
D.D. Palmer founded chiropractic massage in the 1890s, and his son B.J. Palmer helped to expand it in the early 20th century. It has two main groups: "straights", now the minority, emphasize vitalism, innate intelligence and spinal adjustments, and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.
Chiropractic massage is well established in the U.S., Canada and Australia and is the "third largest of the doctored health professions". It overlaps with other manual-therapy professions, including massage therapy, osteopathy, and physical therapy. Most who seek chiropractic care do so for low back pain.
Throughout its history, chiropractic massage has been controversial. For most of its existence it has battled with mainstream medicine, sustained by pseudoscientific ideas such as subluxation and innate intelligence that are not based on solid science. Despite the consensus of public health professionals regarding the benefits of vaccination, among chiropractors there are significant disagreements over the subject, which has led to negative impacts on both public vaccination and mainstream acceptance of chiropractic. The American Medical Association called chiropractic an "unscientific cult" and boycotted it until losing an antitrust case in 1987. Chiropractic has developed a strong political base and sustained demand for services; in recent decades, it has gained more legitimacy and greater acceptance among medical physicians and health plans in the U.S., and the principles of evidence-based medicine have been used to review research studies and generate practice guidelines.
Manual therapies commonly used by chiropractors are effective for the treatment of low back pain, and might also be effective for the treatment of lumbar disc herniation with radiculopathy, neck pain, some forms of headache, and some extremity joint conditions. The efficacy and cost-effectiveness of maintenance chiropractic care are unknown. Chiropractic massage is generally safe when employed skillfully and appropriately. Spinal manipulation is frequently associated with mild to moderate adverse effects, with serious or fatal complications in rare cases.