Advanced Practice Nursing
Chiropractor Career Guide
$75,380/year
Bachelor's degree + 4 years chiropractic school
Certification
State licensure
Job Growth
10% (2022-2032)
Entry Level
No
Work Setting
Private practices (majority), group practices
Last Updated
January 2025
Reviewed by:Sarah Mitchell, PA-C, MPAS – Emergency Medicine Physician Assistant
What is a Chiropractor?
Chiropractors (Doctors of Chiropractic, DC) are healthcare professionals who diagnose and treat neuromuscular disorders primarily through manual adjustment and manipulation of the spine. Chiropractors focus on the relationship between the body’s structure (primarily the spine) and function, emphasizing the body’s inherent ability to heal itself. There are approximately 77,000 chiropractors practicing in the United States, with most operating private practices or working in multidisciplinary healthcare settings.
Chiropractic care emphasizes non-invasive, drug-free treatment approaches for musculoskeletal conditions, particularly back pain, neck pain, headaches, and joint problems. Chiropractors use spinal manipulation (adjustments), soft tissue therapy, exercise rehabilitation, lifestyle counseling, and nutritional advice to help patients achieve optimal health. The profession is based on the principle that proper alignment of the body’s musculoskeletal structure, particularly the spine, enables the body to heal without surgery or medication.
Chiropractors complete four years of chiropractic college following undergraduate education, studying anatomy, physiology, diagnostic techniques, spinal adjustment methods, radiography, and clinical patient care. Unlike medical doctors, chiropractors do not prescribe medications or perform surgery. Their scope of practice focuses on conservative, manual therapies for musculoskeletal conditions.
Why Become a Chiropractor?
Practice Autonomy and Ownership:
Over 60% of chiropractors own their practices, one of the highest ownership rates in healthcare. Practice ownership provides scheduling control, clinical autonomy, and potential for substantial income.
Drug-Free, Non-Invasive Care:
Chiropractors help patients avoid medications and surgery, appealing to those preferring natural, conservative treatment approaches. Many patients seek chiropractic care specifically to avoid pharmaceutical interventions.
Strong Job Growth:
The Bureau of Labor Statistics projects 10% job growth for chiropractors from 2022-2032, faster than average for all occupations. Growing interest in alternative medicine and conservative pain management drives demand.
Work-Life Balance:
Most chiropractors work regular office hours (Monday-Friday, 8 AM-6 PM) with minimal or no call responsibilities. Flexible scheduling allows time for family and personal interests.
Helping People Naturally:
Chiropractors provide hands-on care, building strong therapeutic relationships with patients. The satisfaction of relieving pain and improving function without drugs or surgery appeals to many practitioners.
Entrepreneurial Opportunities:
Chiropractic practice offers business ownership opportunities with relatively lower overhead than medical practices. Many chiropractors build successful multi-location practices or specialized wellness centers.
Shorter Training Than Physicians:
Chiropractors enter practice after 8 years (4 undergraduate + 4 chiropractic school) versus 11-15+ years for physicians, allowing earlier career start with less educational debt.
Three Spheres of PHN Influence
What Chiropractors Do?
In the next section, you’ll learn about the core responsibilities, daily activities, and areas of impact that define a Chiropractor—across patient care, nursing practice, and healthcare systems.
Daily Responsibilities and Tasks
Patient Assessment and Diagnosis
Chiropractors conduct comprehensive patient evaluations including detailed health histories, physical examinations, orthopedic and neurological testing, and postural analysis. They assess spinal alignment, joint mobility, muscle strength, reflexes, and range of motion. Many chiropractors take and interpret X-rays identifying structural abnormalities, fractures, or degenerative changes.
Diagnostic focus centers on identifying spinal subluxations (misalignments), joint dysfunction, muscle imbalances, and biomechanical problems contributing to pain or decreased function. Chiropractors develop differential diagnoses and determine if conditions are appropriate for chiropractic care or require referral to other healthcare providers.
Spinal Manipulation and Adjustments
The hallmark of chiropractic care is spinal manipulation (adjustment), using controlled force applied to joints that have become restricted in movement. Chiropractors use hands or specialized instruments to deliver quick, controlled thrusts to specific vertebrae, restoring proper joint motion and alignment.
Adjustment techniques vary widely. Diversified technique uses high-velocity, low-amplitude thrusts with audible joint cavitation. Activator technique employs a small handheld instrument delivering gentle impulses. Gonstead, Thompson, and Cox flexion-distraction represent other specialized approaches. Chiropractors typically master multiple techniques adapting treatment to individual patient needs.
Beyond the spine, chiropractors adjust extremity joints including shoulders, elbows, wrists, hips, knees, ankles, and jaw (TMJ), treating sports injuries, repetitive strain injuries, and joint dysfunction throughout the body.
Soft Tissue Therapy
Chiropractors perform various soft tissue techniques complementing spinal adjustments. Myofascial release addresses muscle tension and fascial restrictions. Trigger point therapy targets localized muscle knots causing referred pain. Instrument-assisted soft tissue mobilization (IASTM) uses specialized tools breaking down scar tissue and adhesions.
Many chiropractors incorporate massage therapy, stretching, and muscle energy techniques releasing tension and improving tissue flexibility before or after adjustments.
Therapeutic Exercise and Rehabilitation
Chiropractors prescribe therapeutic exercises strengthening weak muscles, improving flexibility, enhancing core stability, and correcting postural imbalances. Exercise programs may include stretching routines, strengthening protocols, balance training, and functional movement patterns preventing injury recurrence.
Rehabilitation focuses on restoring optimal function after injury, improving work ergonomics, and teaching proper body mechanics for daily activities.
Lifestyle and Nutritional Counseling
Many chiropractors provide lifestyle advice addressing factors affecting musculoskeletal health. This includes ergonomic assessments for workstations, sleep position recommendations, stress management techniques, and activity modification strategies.
Some chiropractors incorporate nutritional counseling, recommending dietary changes, supplements, or anti-inflammatory protocols supporting healing and overall wellness. Scope varies by state regulations and individual practitioner focus.
Physical Modalities
Chiropractors may use various therapeutic modalities including electrical muscle stimulation (reducing muscle spasm), ultrasound therapy (promoting tissue healing), cold laser therapy, heat/ice applications, and mechanical traction. These modalities complement manual therapies enhancing treatment outcomes.
Patient Education and Prevention
Chiropractors educate patients about spinal health, injury prevention, proper posture, ergonomics, and self-care strategies. Preventive care emphasis includes regular maintenance adjustments, lifestyle modifications, and proactive health management.
Practice Management
Practice-owning chiropractors manage business operations including staff supervision, scheduling, billing, insurance processing, marketing, and regulatory compliance. Successful practices require both clinical expertise and business acumen.
What’s Next?
Work Environment and Lifestyle
This section covers hospitals, specialty clinics, academic environments, and leadership roles—helping you visualize your future workplace.
Work Environment and Lifestyle
Where Chiropractors Work
Approximately 60% of chiropractors are self-employed, owning solo or group practices. Private practice chiropractors operate outpatient offices providing scheduled appointments with dedicated treatment rooms for adjustments and therapies.
About 25% work in group practices with multiple chiropractors or multidisciplinary clinics integrating chiropractic with physical therapy, massage therapy, acupuncture, or medical care. These settings offer collaboration, shared overhead, and guaranteed salaries.
Some chiropractors work in hospitals, especially Veterans Affairs facilities increasingly incorporating chiropractic services. Sports medicine clinics employ chiropractors treating athletes at professional, collegiate, or high school levels. Corporate wellness programs utilize chiropractors providing on-site employee care.
Mobile chiropractors travel to patients’ homes, workplaces, or events providing convenient care. This model reduces overhead but requires efficient scheduling and travel management.
Work Schedule and Lifestyle
Most chiropractors work 35-45 hours weekly with flexible scheduling. Office-based chiropractors typically work Monday-Friday with some offering evening or Saturday hours accommodating working patients. Call responsibilities are essentially non-existent.
New practice owners may work longer hours building patient bases and managing business operations. Established practitioners often reduce hours while maintaining income through efficient practice management.
Work-life balance is generally excellent compared to other healthcare professions. Predictable schedules, no emergency calls, and practice ownership flexibility allow time for family, hobbies, and personal interests.
Pros
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Practice Ownership - 60%+ ownership rate, autonomy, control
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Excellent Work-Life Balance - Regular hours, no call, flexible scheduling
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Growing Demand - 10% job growth, increasing acceptance
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Drug-Free Care Philosophy - Natural, conservative treatment approach
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Strong Patient Relationships - Hands-on care, repeat visits
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Entrepreneurial Opportunities - Build multi-location or specialized practices
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Physical Activity - Active work versus sedentary office jobs
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Shorter Training - 8 years versus 11-15+ for physicians
Cons
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Lower Income Than Physicians - Median $75,380 versus $200,000+ for MDs
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Limited Scope - No prescribing, no surgery, primarily musculoskeletal
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Insurance Reimbursement Issues - Declining payments, coverage limitations
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Professional Skepticism - Some medical providers question effectiveness
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Physical Demands - Repetitive movements, standing, manual therapy strain
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Student Debt - $120,000-$180,000 average with modest starting salaries
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Competition - Saturated markets in some areas, physical therapists overlap
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Marketing Required - Practice growth depends on marketing and referrals
What’s Next?
Salary and Compensation
Learn about average salaries, factors that influence compensation, and projected demand for Chiropractor Career Guide.
Salary and Compensation
National Salary Overview
According to Bureau of Labor Statistics May 2023 data, chiropractors earn median annual salaries of $75,380 with hourly rates of $36.24. Salary varies significantly based on practice ownership, location, and patient volume.
Salary by Experience and Practice Type
Experience/Type
Annual Salary
Notes
New Graduate (0-2 years)
$45,000-$65,000
Associate positions, building practice
Early Career (3-5 years)
$65,000-$85,000
Establishing patient base
Mid-Career (6-15 years)
$80,000-$120,000
Established practice
Practice Owner
$90,000-$150,000+
Varies widely by location, volume
Employed Associate
$60,000-$80,000
Guaranteed salary, no overhead
Multi-Location Owner
$150,000-$250,000+
Successful business expansion
Practice owners earn more than employed associates but assume business risks, overhead costs, and management responsibilities. Income depends heavily on patient volume, payer mix (cash versus insurance), location, and business management skills.
Salary by State
State
Annual Salary
Hourly Rate
Rhode Island
$101,140
$48.63
Tennessee
$95,310
$45.82
Connecticut
$87,150
$41.90
Delaware
$84,530
$40.64
Alaska
$83,060
$39.93
Illinois
$81,770
$39.31
Kansas
$80,190
$38.55
Massachusetts
$78,470
$37.73
California
$77,640
$37.33
Texas
$71,320
$34.29
Florida
$69,950
$33.63
Geographic variation reflects cost of living, competition density, insurance reimbursement rates, and cultural acceptance of chiropractic care. Rural areas often offer less competition but smaller patient populations.
Additional Income Sources
Many chiropractors supplement income through:
- Cash-Based Services: Wellness care, sports performance, corporate wellness
- Product Sales: Supplements, orthotics, pillows, ergonomic products
- Insurance Personal Injury: Higher reimbursement for auto accident cases
- Speaking/Teaching: Seminars, workshops, teaching at chiropractic colleges
- Multiple Locations: Expanding to additional offices increases revenue substantially
What’s Next?
How to Become a Chiropractor
This section outlines education requirements, licensure, certification, and experience needed to become a Chiropractor.
Educational Path
Step 1
Complete Bachelor's Degree (4 years)
Earn bachelor’s degree completing chiropractic college prerequisites:
- Biology (1 year with lab)
- Chemistry (1 year with lab including organic)
- Physics (1 year with lab)
- Psychology (1 semester)
- English/Communications (varies)
- Social sciences/humanities (varies)
Maintain strong GPA (3.5+ competitive, 3.0+ minimum). Shadow chiropractors understanding practice realities and philosophy. Volunteer demonstrating commitment to healthcare and service.
Step 2
Take Required Entrance Exams
Most chiropractic colleges accept multiple entrance exams including GRE, MCAT, or chiropractic-specific tests. Some schools admit based solely on GPA and prerequisites without standardized testing.
Step 3
Complete Chiropractic College (4 years, 10 trimesters)
Apply through individual schools or association services. Eighteen accredited chiropractic colleges exist in the United States. Most programs require 4,200+ instructional hours over 10 trimesters (3.3 years to 4 years depending on summer breaks).
First Two Years (Basic Sciences): Intensive study of anatomy (extensive cadaver dissection), physiology, biochemistry, pathology, microbiology, public health, and diagnostic procedures. Chiropractic principles, philosophy, and technique training begin first year.
Last Two Years (Clinical Sciences): Diagnostic imaging (X-ray interpretation), clinical diagnosis, chiropractic technique (multiple adjustment methods), nutrition, physical therapy modalities, and practice management. Clinical internship provides supervised patient care in college clinics treating hundreds of patients.
Students develop proficiency in various adjustment techniques, learn when to adjust versus refer, interpret diagnostic imaging, and manage business aspects of practice.
Tuition and Costs: Chiropractic college tuition ranges $30,000-$40,000 annually. Total program costs including living expenses average $120,000-$180,000. Total debt is typically lower than medical or dental school but significant relative to starting salaries.
Step 4
Pass National Board Examinations
Chiropractors must pass four-part National Board of Chiropractic Examiners (NBCE) examination:
- Part I: Basic sciences (anatomy, physiology, chemistry, pathology)
- Part II: Clinical sciences (diagnostic imaging, principles of chiropractic)
- Part III: Clinical competency (case management, diagnostic imaging interpretation)
- Part IV: Practical examination (demonstrating adjustment techniques, physical examination skills)
Most students take Parts I-III during school and Part IV after graduation.
Step 5
Obtain State Licensure
Each state has specific licensure requirements typically including:
- Graduation from accredited chiropractic college
- Passing NBCE examinations
- State jurisprudence exam
- Background check
- Application fees ($300-$800)
Some states have additional requirements including state-specific practical examinations or continuing education before licensure.
Scope of practice varies significantly by state. Some states allow chiropractors to perform minor surgery, acupuncture, or order advanced imaging, while others restrict practice more narrowly.
Step 6
Optional Specialization
After licensure, chiropractors can pursue diplomate certification in specialties including:
- Sports chiropractic (CCSP, DACBSP)
- Pediatrics (DICCP, CACCP)
- Neurology (DACNB)
- Rehabilitation (DACRB)
- Diagnostic imaging (DACBR)
Specialty certification requires additional coursework, examinations, and clinical experience, enhancing expertise and marketability.
Total Timeline
High school to licensed chiropractor: 8 years (4 years undergraduate + 4 years chiropractic college).
What’s Next?
Career Advancement
Understand advancement opportunities and long-term growth potential.
Practice Growth
Solo to Group Practice: Expand from single-doctor practice to multi-doctor group, increasing patient capacity and revenue while sharing overhead.
Multi-Location Expansion: Open additional office locations in different geographic areas, hiring associate chiropractors to manage satellite offices.
Specialized Services: Develop niche practices in sports chiropractic, pediatrics, prenatal care, rehabilitation, or wellness, differentiating from competitors.
Multidisciplinary Integration: Partner with massage therapists, physical therapists, acupuncturists, or medical providers creating comprehensive care centers.
Academic and Leadership
Chiropractic College Faculty: Teach at chiropractic colleges in technique, diagnosis, business, or basic sciences. Faculty positions combine teaching with practice.
Residency Preceptor: Supervise post-graduate residents pursuing specialty certification.
Professional Organization Leadership: Serve on state or national chiropractic association boards, advocacy committees, or examination boards.
Alternative Paths
Sports Team Chiropractor: Work with professional, collegiate, or Olympic sports teams traveling with athletes and providing event coverage.
Corporate Wellness: Contract with corporations providing on-site employee care, ergonomic consultations, and injury prevention programs.
Research: Conduct research investigating chiropractic effectiveness, technique outcomes, or practice patterns at academic institutions.
Product Development: Consult for companies developing chiropractic tables, instruments, software, or related products.
Expert Witness: Provide testimony in personal injury or malpractice litigation.
What’s Next?
Career Path and Advancement
Understand advancement opportunities and long-term growth potential.
Similar Careers
Physical Therapist
DPT degree (3 years)
$97,960/year median
Rehabilitation specialists using exercise, manual therapy, and modalities treating movement dysfunction. Broader scope than chiropractors including post-surgical rehabilitation.
Osteopathic Physician (DO)
4 years osteopathic medical school + residency
$229,300/year median
Full physicians with prescribing and surgical privileges plus osteopathic manipulative treatment training. Much broader scope than chiropractors.
Massage Therapist
Certificate/diploma (6-12 months)
$49,860/year median
Soft tissue specialists using manual manipulation for relaxation, pain relief, and wellness. More limited scope than chiropractors.
Acupuncturist
Master's degree (3-4 years)
$77,190/year median
Traditional Chinese medicine practitioners using needle insertion at specific points treating various conditions.
What’s Next?
Frequently Asked Questions
Still have questions? The final section addresses common concerns and practical questions about becoming and working as a Chiropractor Career Guide.
Frequently Asked Questions
What is the difference between a chiropractor and a physical therapist?
Both treat musculoskeletal conditions but with different approaches. Chiropractors focus on spinal manipulation and joint adjustments believing proper alignment facilitates healing. Physical therapists emphasize exercise, stretching, and rehabilitation restoring function after injury or surgery. Chiropractors cannot prescribe medications; PTs work more closely with physicians in medical settings. Both are effective for many musculoskeletal conditions with overlapping patient populations.
Do chiropractors go to medical school?
No. Chiropractors attend chiropractic colleges, not medical schools, earning Doctor of Chiropractic (DC) degrees. Both programs are four years post-undergraduate, but curricula differ significantly. Medical school emphasizes pharmacology, surgery, and disease management. Chiropractic college focuses on spinal manipulation, diagnostic imaging, musculoskeletal assessment, and natural therapeutics. Chiropractors cannot prescribe medications or perform surgery.
Is chiropractic care safe?
When performed by licensed chiropractors, spinal manipulation is generally safe for appropriate conditions. Serious complications are rare (estimated 1 in 2 million cervical adjustments). Common side effects include temporary soreness or stiffness. Chiropractors screen for contraindications (fractures, severe osteoporosis, spinal infections, vascular disease) before treating. Certain high-risk populations (severe osteoporosis, anticoagulation therapy) require extra caution.
How much does chiropractic school cost?
Tuition ranges $30,000-$40,000 annually for four years. Total costs including living expenses average $120,000-$180,000, less than medical or dental school but significant relative to starting chiropractor salaries. Most students finance education through federal loans and private loans.
Can chiropractors diagnose conditions?
Yes, within their scope of practice. Chiropractors are trained to diagnose musculoskeletal conditions through physical examination, patient history, and diagnostic imaging. They identify spinal subluxations, joint dysfunction, muscle strains, ligament sprains, and other biomechanical problems. However, chiropractors must recognize conditions outside their scope (fractures, infections, tumors, systemic diseases) requiring referral to medical providers.
Do insurance companies cover chiropractic care?
Most health insurance plans provide some chiropractic coverage, though often with limitations (visit caps, copayments, pre-authorization requirements). Medicare covers chiropractic manipulation for spine-related conditions. Coverage varies significantly by insurance plan. Many chiropractors accept cash payments or payment plans for uninsured patients.
How long does it take to become a chiropractor?
Eight years after high school: 4 years undergraduate earning bachelor’s degree plus 4 years chiropractic college. This is shorter than physicians (11-15+ years including residency) but longer than physical therapists (7 years: 4 undergraduate + 3-year DPT).
What is the job outlook for chiropractors?
Good. The BLS projects 10% job growth from 2022-2032, faster than average. Growth driven by increasing acceptance of alternative medicine, aging populations needing musculoskeletal care, and preference for non-pharmaceutical pain management. However, some markets are saturated requiring careful location selection.
What’s Next?
Overview
The overview brings together key highlights, role impact, and career context—making it a helpful starting point whether you’re just beginning or refining your decision.
Nurse Educator
Career Guide
Overview
What Chiropractor do
Work Environment
Salary & Outlook
How to Become
Similar Careers
Career Path
FAQ
Free Downloadable Resources
Get comprehensive guides to help you on your CNS career journey
Chiropractic College Directory
Complete list of accredited DC programs
Chiropractic Technique Guide
Overview of major adjustment methods
Practice Startup Checklist
Business planning for new chiropractors
State Licensing Requirements
Comprehensive state-by-state licensure guide
References and Sources
- Bureau of Labor Statistics. (May 2023). Occupational Employment and Wage Statistics: Chiropractors. https://www.bls.gov/oes/current/oes291011.htm
- Council on Chiropractic Education (CCE). (2024). Accredited Doctor of Chiropractic Programs. https://www.cce-usa.org
- National Board of Chiropractic Examiners (NBCE). (2024). Examination Information. https://www.nbce.org
- American Chiropractic Association (ACA). (2024). Chiropractic Statistics and Facts. https://www.acatoday.org
- Federation of Chiropractic Licensing Boards (FCLB). (2024). State Board Requirements. https://www.fclb.org
Medical Disclaimer: This content is for informational purposes only. Consult official sources including CCE, NBCE, and individual chiropractic colleges for current information.