{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T18:51:42Z","timestamp":1783968702591,"version":"3.55.0"},"reference-count":89,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Chiropractors diagnose and manage musculoskeletal disorders, commonly using spinal manipulative therapy (SMT). Over the past half-century, the chiropractic profession has seen increased utilization in the United States following Medicare authorization for payment of chiropractic SMT in 1972. We reviewed chiropractic research trends since that year and recent clinical practice guideline (CPG) recommendations regarding SMT. We searched Scopus for articles associated with chiropractic (spanning 1972\u20132024), analyzing publication trends and keywords, and searched PubMed, Scopus, and Web of Science for CPGs addressing SMT use (spanning 2013\u20132024). We identified 6286 articles on chiropractic. The rate of publication trended upward. Keywords initially related to historical evolution, scope of practice, medicolegal, and regulatory aspects evolved to include randomized controlled trials and systematic reviews. We identified 33 CPGs, providing a total of 59 SMT-related recommendations. The recommendations primarily targeted low back pain (n = 21) and neck pain (n = 14); of these, 90% favored SMT for low back pain while 100% favored SMT for neck pain. Recent CPG recommendations favored SMT for tension-type and cervicogenic headaches. There has been substantial growth in the number and quality of chiropractic research articles over the past 50 years, resulting in multiple CPG recommendations favoring SMT. These findings reinforce the utility of SMT for spine-related disorders.<\/jats:p>","DOI":"10.3390\/jcm13195668","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T08:56:06Z","timestamp":1727168166000},"page":"5668","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4714-1076","authenticated-orcid":false,"given":"Robert J.","family":"Trager","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA"},{"name":"Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"},{"name":"Connor Whole Health, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-4132","authenticated-orcid":false,"given":"Geronimo","family":"Bejarano","sequence":"additional","affiliation":[{"name":"Department of Health Services, Policy and Practice, Brown University, Providence, RI 02912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romeo-Paolo T.","family":"Perfecto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4863-8674","authenticated-orcid":false,"given":"Elizabeth R.","family":"Blackwood","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Library & Archives, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Goertz","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, USA"},{"name":"Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27701, USA"},{"name":"Robert J. Margolis, MD, Center for Health Policy, Duke University, Durham, NC 27705, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.7326\/0003-4819-136-3-200202050-00010","article-title":"Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine","volume":"136","author":"Meeker","year":"2002","journal-title":"Ann. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Harwood, K.J., Pines, J.M., Andrilla, C.H.A., and Frogner, B.K. (2022). Where to Start? A Two Stage Residual Inclusion Approach to Estimating Influence of the Initial Provider on Health Care Utilization and Costs for Low Back Pain in the US. BMC Health Serv. 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