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Chiropractic’s Next Big Challenge

By Frank M. Painter|July 21, 2026|Announcement|

Chiropractic’s Next Big Challenge

Chiropractic’s Next Big Challenge

It’s time for us to lead the charge to help NIH see the need to fund Musculoskeletal research based on how much low-quality management of MSK care has cost our economy. It won’t last forever, just long enough to change the thinking on the ground, with Insurers and at the State and Federal levels.

READ THIS ARTICLE NOW!

Musculoskeletal Health: An Ecological Study Assessing Disease Burden and Research Funding
Lancet Reg Health Am 2024 (Jan 8): 29: 100661

Before undertaking this study, we conducted an extensive literature review to identify existing evidence related to the relationship between disease burden and research funding, particularly focusing on the National Institutes of Health (NIH) and the Global Burden of Disease (GBD) data.

Disease Burden is measured by 3 characteristics:

• Disability-Adjusted Life Years (DALYs),
• Years Lived with Disability (YLDs),
• Years of Life Lost (YLLs)

The goal was to gather insights into the existing body of knowledge surrounding disease burden and research funding disparities to inform our ecological study design and analysis methodology.

Implications of all the available evidence

Global health morbidity has shifted in recent decades from
communicable, maternal, neonatal, and nutritional (CMNN) diseases to non-communicable diseases (NCDs). [1]

As death rates have declined, non-fatal injuries and NCDs have become a significant concern for health systems.

When rerviewing the 2019 disease burden (measured in DALYs) and 2021
NIH funding levels, 23.4% of funding variation were driven by DALYs.

A DALY (Disability-Adjusted Life Year) is a measure of health burden, including both reduction in life expectancy and diminished quality of life. More specifically, the DALY burden for a particular condition is the sum of YLL (years of life lost due to premature mortality) and YLD (years lost to disability).

However, in the 2021 NIH funding, all musculoskeletal diseases were underfunded, compared to their societal/economic burden, with low back pain receiving the least relative funding, at $496.4 million less funding than was predicted.

Predicted funding levels were derived to assess the adequacy of funding for various diseases. Subsequently, the ratios of actual to predicted 2021 NIH funding for diseases characterized as underfunded (where the ratio <1) were determined. Musculoskeletal diseases were underfunded relative to their disease burden, with neck pain receiving the least funding at 0.83% of the predicted amount.

Low back pain, osteoarthritis, and rheumatoid arthritis were underfunded at 13.88%, 35.08%, and 66.26% of predicted amounts, respectively. To be commensurate with their actual total burden, funding for neck pain, low back pain, and osteoarthritis would need to increase 120–fold, 7–fold, and 3–fold, respectively.

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Spinal Pain Management Section

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Integrated Health Care and Chiropractic

By Frank M. Painter|July 19, 2026|History|

Integrated Health Care and Chiropractic

The Chiro.Org Blog

SOURCE: Integrated Health Care and Chiropractic

I never imagined that, when I first started volunteer-working @ Chiro.Org back in 1996, that I would be here 30 years later, connecting-the-dots, to detail chiropractic’s progress. When I graduated Palmer in 1993, our Profession was self-considered as an ‘Alternative” to ‘Conventional Medicine’. I still think of it that way.

In 1993, few medical Journals would publish articles penned by a chiropractor. This was a hold-over from the insidious plot the AMA and related medical societies created in the 1960s (when I was only 12) to isolate and destroy the Profession of Chiropractic, as detailed in our Wilk, et. al. vs. the AMA, et. al. section.

So, there I was, at the age of 45 in my last 2 trimesters @ PCC, walking through the David D. Palmer Health Sciences Library, when I noticed the new copy of the New England Journal of Medicine. Although I don’t recall the particulars of what drew my attention, that issue contained the first unconventional (?) article by David M. Eisenberg, MD titled Unconventional Medicine in the United States [NEJM 1993 (Jan 28); 328 (4): 246–252].

I started reading it, and before long I was standing at the copy machine, so I could add it to my collection of favored articles. And like Alice, I found myself looking at the ‘rabbit hole’, and deciding to take the plunge. This article was also WHY I decided to name my practice Alternative Care Chiropractic.

After retiring as a ‘Field Doc’ in late 2020, I started remodeling the Chiro.Org website. My first assignment had been to flesh out our non-existent LINKS Section. At that time it was just a long collection of links TO materials on the web. It wasn’t long before I noticed that materials I had linked to had already disappeared (thanks to a link-checking software called Xenu’s Link Sleuth).

In the late 90s, as the WWW expanded exponentially, it was also very expensive to maintain a website, especially if you didn’t know HOW to write your own HTML (the language of the web) and had to hire a ‘webmaster’ to render your materials for you. So many budding websites that contained interesting materials disappeared every month, under that crushing expense.

So, whenever I found cool materials, I would LINK to them, BUT I would also make a copy of them, in the event that website evaporated. In fact, Chiro.Org is now the largest Archive of chiropractic materials on the web, outside of PubMed. That’s because we are archival in nature. It’s very rare that any materials are removed.

As I continued to collect materials, many of them seemed focused on Low Back Pain. Not the most interesting topic for a DC, but LBP is the most common complaint that presents to our offices, so our researchers were wise to focus on that topic, and Low Back Pain and Chiropractic became one of my first break-out pages in the LINKS. I refer to the pages in the LINKS as ‘topical’, and to date there are 86 of them, covering all the various topics I was interested in (from A-Z) from Acupuncture to Chiropractic and Workers’ Compensation.

If you check our Home Page it details all of our ‘active’ topical pages, which are regularly updated (as new materials are published) and the “Archival Sections” that are occasionally updated.

Those topical pages are the easiest way to find the materials that YOU may be interested in. The LINKS Section and our Chiropractic Research Section both display the spectrum of topics that might interest either a patient or a doctor, but all the other Active sections mentioned on our Home Page also contain numerous other mini-topical-sections that may also interest you.

I encourage you to snoop about the site, because after 31 years online, we have collected a spectrum of materials way beyond what you’ll find on any other chiropractic-related website.

The Association of First Provider Seen With Time Loss From Work Among Workers With Back Injury: A Cohort Study

By Frank M. Painter|May 27, 2026|Unnecessary Surgery, Workers' Compensation|

The Association of First Provider Seen With Time Loss From Work Among Workers With Back Injury: A Cohort Study

The Chiro.Org Blog

SOURCE: Am J Ind Med 2026 (May 26) [EPUB]
Brian Chin PhC, MSPH • Sean D. Rundell PT, DPT, PhD • Jeanne M. Sears PhD, RN • Deborah Fulton-Kehoe PhD, MPH • June T. Spector MD, MPH • Gary M. Franklin MD, MPH

Washington State Department of Labor and Industries,
Tumwater, Washington, USA.

FROM: Weeks ~ JMPT 2016 (Feb) Hurwitz ~ JMPT 2016 (May)

Background: Prior evidence suggests that seeking initial care from a chiropractor for back pain, compared to seeing a primary care provider first, is associated with better clinical outcomes. However, prior studies have not comprehensively adjusted for potential confounders and few studies have focused on work-related outcomes.

Methods: This population-based prospective cohort study analyzed data from workers’ compensation claimants with a work-related back injury who initiated care with either a chiropractor or a primary care physician. We evaluated the association of seeing a chiropractor first, compared to seeing a primary care physician first, with receipt of wage replacement benefits for temporary total disability (time loss) at 1 year after claim initiation. Association was estimated using logistic regression adjusting for potential confounders including patient sociodemographic characteristics, employment details, self-reported pain and physical function, injury severity, healthcare factors, and psychological factors. The E-value was used to assess unmeasured confounding.

Results: Of 1,219 participants (mean age = 39, 67.5% male, 72.1% non-Hispanic White), 541 (44.4%) initiated care with a chiropractor. Participants who saw a chiropractor first, compared to a primary care physician first, were less likely to be on time-loss at 1 year as estimated by adjusted multivariate logistic regression (4.8% vs. 11.8%; adjusted odds ratio [OR]: 0.45, 95% CI: 0.24-0.86; E-value: 3.8).

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Return to WORKERS’ COMPENSATION Section and the

Return to INITIAL PROVIDER/FIRST CONTACT Section

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Prior Authorization to be dropped by UnitedHealthcare

By Frank M. Painter|May 7, 2026|Announcement|

Prior Authorization to be dropped by UnitedHealthcare

The Chiro.Org Blog

SOURCE:
American Chiropractic Association
Thu, May 7 at 9:39 AM

Media Contact:
Annette Bernat
abernat@acatoday.org
(703) 812-0226

FOR IMMEDIATE RELEASE: May 7, 2026

American Chiropractic Association Comments on UnitedHealthcare Policy Change for Chiropractic Care

Arlington, Va. — American Chiropractic Association (ACA) President Kris Anderson, DC, released the following statement in response to UnitedHealthcare’s announcement this week that it would eliminate prior authorization for chiropractic care by the end of 2026:

“UnitedHealthcare’s decision to remove prior authorization for chiropractic services aligns well with ongoing efforts to reduce reliance on prescription opioid pain medications, especially for common musculoskeletal conditions. When used at the onset of an episode of spine-related pain, chiropractic services offer an evidence-based, non-drug approach for pain management that research has shown not only to alleviate pain and improve function but also to reduce costly downstream healthcare services such as surgery, hospitalization and ER visits.”

About the American Chiropractic Association

The American Chiropractic Association (ACA) is the largest professional chiropractic organization in the United States. ACA attracts the most principled and accomplished chiropractors, who understand that it takes more to be called an ACA chiropractor. We are leading our profession in the most constructive and far-reaching ways — by working hand in hand with other health care professionals, by lobbying for pro-chiropractic legislation and policies, by supporting meaningful research, and by using that research to inform our treatment practices. We also provide professional and educational opportunities for all our members and are committed to being a positive and unifying force for the practice of modern chiropractic. To learn more, visit acatoday.org

A Randomized Clinical Trial of Low-dose Cannabis Extract in Alzheimer’s Disease

By Frank M. Painter|December 20, 2025|Alzheimer's Disease|

A Randomized Clinical Trial of Low-dose Cannabis Extract in Alzheimer’s Disease

The Chiro.Org Blog

SOURCE: J Alzheimers Dis 2025 (Dec); 108 (4): 1602–1613

Rafael de Morais Cury • Taynara da Silva • Fernando Cezar-Dos-Santos • Yasmin Rafaela Correia Fakih • Karlin Andrea Ramírez Narvaez • Murilo Chaves Gouvea • Carlos Espínola • Charles Francisco Ferreira • Wagner Antonio Chiba de Castro • Fabrício Alano Pamplona • Elton Gomes da Silva • Maíra Assunção Bicca • Francisney Pinto Nascimento

Laboratório de Cannabis e Psicodélicos,
School of Medicine,
Universidade Federal da Integração Latino-Americana,
Foz do Iguaçu, PR, Brazil.

SOURCE: The Conversation

Background: Preclinical and clinical evidence suggest that low-dose cannabinoids could ameliorate Alzheimer’s disease (AD) signs and symptoms. We designed this trial to evaluate the safety and efficacy of low-dose THC-CBD balanced cannabinoid extract in the treatment of patients with AD-associated dementia.

Objective: The objective of this phase 2 trial was to evaluate the safety and efficacy of a balanced THC-CBD cannabinoid extract for symptomatic patients with AD.

Methods: A Phase 2, randomized, double-blind, placebo-controlled, clinical trial including patients between 60 and 80 years-old diagnosed with AD-associated dementia. For 26 weeks, participants orally received either placebo or THC-CBD extract (0.350 mg/THC and 0.245 mg/CBD), daily.

Results: At week 26, Mini-Mental State Exam total score was significantly higher in cannabis- when compared to placebo-treated patients, which was assessed using the mixed model analysis. No significant difference was detected between placebo and cannabis groups in terms of secondary outcomes and adverse events incidence.

Conclusions: To this date, this is the longest clinical trial evaluating cannabinoids effects on AD patients. We initially demonstrate that low-dose THC-CBD potentially can be an effective and safe therapeutic option for AD-related dementia. Nonetheless, larger and longer trials are necessary to confirm this finding and establish cannabinoid administration as therapy for AD dementia.

Keywords: Trial RegistrationThe Brazilian Registry of Clinical Trials (ReBEC) registration #U1111-1258-2058 – REBEC (ensaiosclinicos.gov.br).

Keywords: Alzheimer’s disease; Mini-Mental State Examination; cannabinoids; dementia; memory.

ACA Applauds Congress for Initial Step to Restore Chiropractic at Select Military Bases

By Frank M. Painter|December 19, 2025|Veterans|

ACA Applauds Congress for Initial Step to Restore Chiropractic at Select Military Bases

The Chiro.Org Blog

FOR IMMEDIATE RELEASE: Dec. 18, 2025

Arlington, Va. — The U.S. House of Representatives and Senate have passed the final version of the Fiscal Year 2026 National Defense Department Authorization Act, which includes a plan to restore chiropractic services at six U.S. military bases where services have been arbitrarily discontinued. The six clinics that will be reopened include those seeing 400 or more patients per month.

The final provision also calls on the Defense Health Agency (DHA) to develop a plan to reopen closed clinics and to explore the feasibility of putting doctors of chiropractic stationed at military facilities in the federal General Schedule (GS) system. Further, the amendment directs DHA to report back to the House and Senate on its progress by March 31, 2026.

The move to restore chiropractic services is consistent with the DHA’s ongoing concern over the use of opioids by active-duty members of the military and calls to make non-addictive alternatives for pain management more readily available to military personnel. The final language was first adopted in September as an amendment by Rep. Greg Steube (R-Fla.) to the House version of the bill. It reflects upon the Floyd D. Spence National Defense Authorization Act (Public Law 106-398), which in 2001 established the original chiropractic benefit in the Department of Defense healthcare system.

We thank Rep. Steube for his foresight to tackle this issue, and we also acknowledge House and Senate negotiators who kept the bulk of his amendment in the final package,” said John Falardeau, American Chiropractic Association (ACA) senior vice president of public policy and advocacy.

The Steube amendment was drafted in response to chiropractic clinic closures over the past year caused by contracts with participating chiropractors being allowed to lapse, even though surveys indicate chiropractic services are highly valued at U.S. military facilities. Reports show that these clinics provide proven, cost-effective care to hundreds of patients monthly, offering a range of non-drug services to address painful musculoskeletal conditions commonly experienced by members of the military, enabling them to return to service. The results of a four-year clinical trial conducted at several military sites—the largest chiropractic clinical trial on record—provided further evidence that chiropractic care, when added to usual medical care, resulted in moderate short-term improvements in low back pain intensity in active-duty personnel.

The Fiscal Year 2026 National Defense Department Authorization Act now heads to the president’s desk for his signature. ACA will continue to work with Congress to ensure all military clinics that were recently closed reopen and to expand access at additional bases across the country and overseas.

About the American Chiropractic Association

The American Chiropractic Association (ACA) is the largest professional chiropractic organization in the United States. ACA attracts the most principled and accomplished chiropractors, who understand that it takes more to be called an ACA chiropractor. We are leading our profession in the most constructive and far-reaching ways—by working hand in hand with other health care professionals, by lobbying for pro-chiropractic legislation and policies, by supporting meaningful research and by using that research to inform our treatment practices. We also provide professional and educational opportunities for all our members and are committed to being a positive and unifying force for the practice of modern chiropractic. To learn more, visit acatoday.org.

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