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

By |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.

Identifying Patient-Reported Outcome Measure Documentation in Veterans Health Administration Chiropractic Clinic Notes: Natural Language Processing Analysis

By |April 13, 2025|Outcome Assessment, Patient Satisfaction, Veterans|

Identifying Patient-Reported Outcome Measure Documentation in Veterans Health Administration Chiropractic Clinic Notes: Natural Language Processing Analysis

The Chiro.Org Blog


SOURCE:   JMIR Medical Informatics 2025 (Apr 2): 13: e66466


Brian C Coleman • Kelsey L Corcoran • Cynthia A Brandt
Joseph L Goulet • Stephen L Luther • Anthony J Lisi

Pain Research, Informatics, Multimorbidities, and Education Center,
VA Connecticut Healthcare System,
950 Campbell Ave,
West Haven, CT, 06516



Background:   The use of patient-reported outcome measures (PROMs) is an expected component of high-quality, measurement-based chiropractic care. The largest health care system offering integrated chiropractic care is the Veterans Health Administration (VHA). Challenges limit monitoring PROM use as a care quality metric at a national scale in the VHA. Structured data are unavailable, with PROMs often embedded within clinic text notes as unstructured data requiring time-intensive, peer-conducted chart review for evaluation. Natural language processing (NLP) of clinic text notes is one promising solution to extracting care quality data from unstructured text.

Objective:   This study aims to test NLP approaches to identify PROMs documented in VHA chiropractic text notes.

Methods:   VHA chiropractic notes from October 1, 2017, to September 30, 2020, were obtained from the VHA Musculoskeletal Diagnosis/Complementary and Integrative Health Cohort. A rule-based NLP model built using medspaCy and spaCy was evaluated on text matching and note categorization tasks. SpaCy was used to build bag-of-words, convoluted neural networks, and ensemble models for note categorization. Performance metrics for each model and task included precision, recall, and F-measure. Cross-validation was used to validate performance metric estimates for the statistical and machine-learning models.

Results:   Our sample included 377,213 visit notes from 56,628 patients. The rule-based model performance was good for soft-boundary text-matching (precision=81.1%, recall=96.7%, and F-measure=88.2%) and excellent for note categorization (precision=90.3%, recall=99.5%, and F-measure=94.7%). Cross-validation performance of the statistical and machine learning models for the note categorization task was very good overall, but lower than rule-based model performance. The overall prevalence of PROM documentation was low (17.0%).

Conclusions:   We evaluated multiple NLP methods across a series of tasks, with optimal performance achieved using a rule-based method. By leveraging NLP approaches, we can overcome the challenges posed by unstructured clinical text notes to track documented PROM use. Overall documented use of PROMs in chiropractic notes was low and highlights a potential for quality improvement. This work represents a methodological advancement in the identification and monitoring of documented use of PROMs to ensure consistent, high-quality chiropractic care for veterans.

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CHIROPRACTIC CARE FOR VETERANS Section

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A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis

By |December 28, 2023|Chiropractic Management, Veterans|

A Systems Approach for Assessing Low Back Pain Care Quality in Veterans Health Administration Chiropractic Visits: A Cross-Sectional Analysis

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther 2023 (Dec 22) [EPUB]

  OPEN ACCESS   

Ryan D. Muller, DC, MS • Sarah E. Graham, DC • Xiwen Zhao, MSPH • Anna R. Sites, MSN, RN • Kelsey L. Corcoran, DC • Anthony J. Lisi, DC

VA Connecticut Healthcare System,
West Haven, Connecticut;
Yale School of Medicine,
Yale University,
New Haven, Connecticut.



Objective:   The purpose of this study was to explore a systemwide process for assessing components of low back pain (LBP) care quality in Veterans Health Administration (VHA) chiropractic visits using electronic health record (EHR) data.

thods:   MeWe performed a cross-sectional quality improvement project. We randomly sampled 1000 on-station VHA chiropractic initial visits occurring from October 1, 2017, to September 30, 2018, for patients with no such visits within the prior 12 months. Characteristics of LBP visits were extracted from VHA national EHR data via structured data queries and manual chart review. We developed quality indicators for history and/or examination and treatment procedures using previously published literature and calculated frequencies of visits meeting these indicators.

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Chiropractic Care of a Female Veteran After Cervical Total Disk Replacement: A Case Report

By |May 7, 2023|Chiropractic Care, Chronic Neck Pain, Radiculopathy, Veterans|

Chiropractic Care of a Female Veteran After Cervical Total Disk Replacement: A Case Report

The Chiro.Org Blog


SOURCE:   J Chiropractic Medicine 2022 (Mar); 21 (1): 60–65

  OPEN ACCESS   

Michael Mortenson DC, Anna Montgomery MPH, Glenn Buttermann MD

Whole Health Department,
Fargo VA Healthcare System,
Fargo, North Dakota.



Objective:   The purpose of this case study is to describe chiropractic care of the cervical spine for a patient who previously underwent cervical total disk replacement (CTDR) of the C5–6 and C6–7 disks.

Clinical features:   A 42–year-old female veteran of the U.S. Army presented to a Veterans Affairs chiropractic clinic with chronic cervical pain and radiculopathy. She had previously undergone CTDR surgery of the C5–6 disk 9 years earlier, but the pain had become severe and radicular symptoms had returned in the upper left extremity. Imaging taken before the chiropractic referral demonstrated significant joint space narrowing and disk herniation of the C6–7 disk with protrusion to the left side.

Intervention and outcome:   The patient received spinal manipulative therapy, trigger-point therapy, and manual traction to the cervical spine. However, these treatments were not effective in reducing her cervical pain and radiculopathy. She then opted for CTDR of the C6–7 disk. After surgery, the patient reported that radicular symptoms were mostly relieved and cervical pain had decreased by 50%. After 6 additional spinal manipulative therapy treatments, she reported having no neurologic symptoms and that her pain had decreased more than 70% from presurgery levels.

Conclusion:   This case report is the first reported example of chiropractic care after cervical total disk replacement (CTDR) within an integrated health care environment. The patient’s cervical pain and radiculopathy improved with CTDR along with postsurgical chiropractic care.

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CHRONIC NECK PAIN Section and the:

NON-PHARMACOLOGIC THERAPY Section and the:

CHIROPRACTIC CARE FOR VETERANS Section

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Chiropractic in the United States Military Health System: A 25th-Anniversary Celebration of the Early Years

By |February 5, 2022|Nonpharmacologic Therapies, Veterans|

Chiropractic in the United States Military Health System: A 25th-Anniversary Celebration of the Early Years

The Chiro.Org Blog


SOURCE:   J Chiropractic Humanities 2020 (Dec); 27: 37-58

Bart N.Green DC, MSEd, PhD, Scott R.Gilford DC, Richard F.Beacham DC

Employer Based Integrated Primary Care Health Centers,
Stanford Health Care,
San Diego, California



Objective   The purpose of this report is to record noteworthy events that occurred during the early years of chiropractic in the United States Military Health System (MHS).

Methods   We used mixed methods to create this historical account, including documents, artifacts, research papers, and reports from personal experiences.

Results   Chiropractic care was first included in the MHS in 1995, after years of legislative activity. The initial program was a 3-year study of the feasibility and advisability of integrating chiropractic in the MHS. This period was called the Chiropractic Health Care Demonstration Project; 20 pioneering chiropractors began their MHS journeys at 10 military bases in fiscal year 1995. The Demonstration Project was extended for 2 more years to gather research data, and 3 additional military facilities were added during those years to accomplish that purpose. The Demonstration Project concluded in 1999. In 2000, Congress approved the development of permanent chiropractic services and benefits for members of the uniformed services. These new clinics opened in 2002.

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Health-related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care plus Chiropractic Care plus Usual Care vs Usual Care Alone

By |January 29, 2022|Nonpharmacologic Therapies, Veterans|

Health-related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care plus Chiropractic Care plus Usual Care vs Usual Care Alone

The Chiro.Org Blog


SOURCE:   Pain Medicine 2022 (Jan 21); pnac009 [EPUB]

UCLA Department of Medicine,
Los Angeles, CA.

Department of Epidemiology,
University of Iowa,
Iowa City, IA.



Objective:   This study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to: 1) worst pain intensity from a numerical pain rating 0-10 scale, 2) 24-item Roland-Morris Disability Questionnaire (RMDQ); and 3) global improvement (modified visual analog scale).


Design:   A pragmatic, prospective, multisite, parallel-group comparative effectiveness clinical trial comparing usual medical care (UMC) with UMC plus chiropractic care (UMC+CC).

Setting:   3 military treatment facilities.

Subjects:   750 active-duty military personnel with low back pain.

Methods:   Linear mixed effects regression models estimated the treatment group differences. Coefficient of repeatability to estimate significant individual change.

Results:   We found statistically significant mean group differences favoring UMC+CC for all PROMIS®-29 scales and the RMDQ score. Area under the curve estimates for global improvement for the PROMIS®-29 scales and the RMDQ, ranged from 0.79 to 0.83.

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LOW BACK PAIN Section and the:

NON-PHARMACOLOGIC THERAPY Section and the:

CHIROPRACTIC CARE FOR VETERANS Section

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