A Failed Scientific Quest
I was a chiropractor from 1983 to 2010. I started at Palmer College of Chiropractic-West just as a small group of researchers began a push to treat chiropractic as a serious subject for scientific evidence. We wanted to validate the practice and secure its place in mainstream medicine. I wrote to the college president before I enrolled to confirm the school’s commitment to this work. He told me that research was vital for the field to survive. Many of us expected evidence to transform the profession and push it beyond its nineteenth-century roots in vitalism.
Today the success of that effort is thin. The most striking fact is that over a decade of rigorous study in North America, Europe, and Australia has effectively vanished from professional memory. Current students and practitioners act as if these questions were never asked. Since the answers were not what the leadership wanted, the results were discarded. We believed we could treat back pain safer than drugs or surgery, but we had to prove it first.
The Era of Opening Doors
PCCW became an early hub for this work. The timing was good because the Wilk antitrust case against the American Medical Association was moving through the courts. Judge Susan Getzendanner ruled in 1987 that organized medicine had illegally restrained competition by trying to isolate our field. While she did not declare chiropractic scientifically valid, the ruling removed the legal barriers to fair competition. This opened the door for collaboration with physicians.
Congress funded the Office of Alternative Medicine in 1991, which marked a shift toward legitimacy. By the mid-1990s, integrative medicine gained academic standing at institutions like the University of Arizona. Organizations such as the Foundation for Chiropractic Education and Research built programs unlike anything the field had previously seen. If we possessed a unique clinical contribution, we finally had the chance to demonstrate it. Failure could no longer be blamed on exclusion.
Research Findings and The Null Result
I served as the research statistician for a $350,000 trial at PCCW. We compared chiropractic care, physical therapy, and medical management for low back pain. My ambition grew as I connected with experts at Stanford University. I taught manual medicine in Andrew Weil’s Program in Integrative Medicine and participated in research at the Arizona Cancer Center. Despite these opportunities, chiropractic leadership showed no interest in integration or serious scientific rigor. They wanted the benefits of medical status without the obligations of scientific proof.
As the studies grew more sophisticated, the clinical picture softened. Patients improved, but we could not attribute the results specifically to spinal manipulation. Natural history and the simple benefit of attention kept blurring the data. Manipulation performed as well as other conservative care but rarely outperformed a placebo. I eventually led a meta-analysis of 120 randomized trials and 19,000 patients. The results showed that when you account for natural history, the effect of manipulation for chronic pain is nonexistent.
The Lingering Status Quo
A trial published in 2026 involving 1,000 patients reinforced these findings. Manipulation was statistically indistinguishable from medical care, while a biopsychosocial self-management program outperformed both. I came to the conclusion that manipulation works best when it is part of a broad human encounter rather than an isolated mechanical input. The core issue is that the average chiropractic office has not changed in thirty years.
Technique systems still proliferate and the focus on subluxation remains. The profession learned more about itself, but it did not change its practice. Palmer West closed its doors in 2025. I am writing this to leave a marker. We performed the work, and the results were equivocal. A body of literature that does not resolve after hundreds of well-powered attempts is not unfinished. It is null.