Functional Limitations in Adults Who Utilize Chiropractic or Osteopathic Manipulation in the United States: Analysis of the 2012 National Health Interview Survey

J Manipulative Physiol Ther. 2017 Nov-Dec;40(9):668-675. doi: 10.1016/j.jmpt.2017.07.015.


Objectives: The goals of this study were to identify self-reported differences in function, comorbidities, and medical service utilization among adults who reported using chiropractic and/or osteopathic manipulation in the 2012 National Health Interview Survey, and to compare these between older and younger adults.

Methods: We conducted a descriptive study of adults aged 18 or older who were included in the 2012 National Health Interview Survey and the Alternative Medicine Questionnaire. We included those who reported using chiropractic and/or osteopathic manipulation in the past 12 months. Responses were analyzed using SAS software. Weighted estimates were reported as percentages of chiropractic/osteopathic users overall and by age group (<65 years vs ≥65 years).

Results: Among the 8.5% of US adults who reported receiving manipulation, 97.6% saw chiropractors. Most adults were under age 65 (83.7%), female (56.6%), and white (85.1%). Except for sitting tolerance, functional limitations were significantly higher among older manipulation users compared with younger manipulation users (all P < .001). Older (vs younger) chiropractic/osteopathic users more often reported functional limitations (65.7% vs 37.2%), had difficulty walking without equipment (14.7% vs 2.8%), found it very difficult or were unable to walk one-quarter mile (15.7% vs 3.8%) or climb 10 steps (11.4% vs 2.5%), and needed help with instrumental activities of daily living (6.9% vs 2.0%). Comorbidities differed by age: cardiovascular events/conditions, cancer, diabetes, and arthritis were more common among older adults, and headaches, neck pain, and depression were more frequent in younger adults. Similar proportions of older and younger adults had emergency room visits (23.0% vs 21.7%); older adults reported more surgeries (26.1% vs 15.4%).

Conclusions: Notable differences exist in functional limitations and comorbidities between older and younger chiropractic and osteopathic manipulation users. This information could inform clinical practice, education, and policy.

Keywords: Chiropractic; Manipulation; Osteopathic.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Back Pain / diagnosis
  • Back Pain / therapy*
  • Disability Evaluation
  • Female
  • Health Care Surveys
  • Humans
  • Incidence
  • Interviews as Topic
  • Male
  • Manipulation, Chiropractic / statistics & numerical data*
  • Manipulation, Osteopathic / statistics & numerical data*
  • Middle Aged
  • Musculoskeletal Pain / diagnosis
  • Musculoskeletal Pain / therapy*
  • Pain Measurement*
  • Sex Factors
  • Treatment Outcome
  • United States
  • Young Adult