A chiropractor works on how your joints move and line up, using hands-on adjustments guided by an exam. An acupuncturist places thin needles at specific points on the body. Both are reasonable first options for low back pain, and you can use them side by side as long as each provider knows about the other.
Patients bring this up with us often, usually worded as “Is it okay if I see an acupuncturist too?” Usually, yes. Which one to lean on depends on what is actually behind your pain.
What is the difference between a chiropractor and an acupuncturist?
A chiropractor evaluates the spine and joints and uses adjustments to change how they move. An acupuncturist, trained in a tradition that grew out of Chinese medicine, inserts fine needles at mapped points on the body. Chiropractic works on joint mechanics you can see and measure on an x-ray. Acupuncture works through mapped points rather than joint movement.
| Chiropractic at CORE | Acupuncture | |
|---|---|---|
| What the visit focuses on | How your spine and joints move and where they sit | Points on the body chosen by the acupuncturist |
| How it is delivered | Hands-on adjustments, sometimes paired with spinal decompression | Thin, sterile needles, usually left in while you rest |
| What guides the treatment | Measurements taken from your x-ray plus an in-office exam | The acupuncturist’s assessment and point selection |
| Why people usually come | Back pain, neck pain, sciatica and headaches with a mechanical source | Pain, and also many concerns that have nothing to do with the spine |
| Training | Doctor of Chiropractic degree and a state license | Separate acupuncture training and a state license |
The philosophies behind the two are very different. For most people with back or neck pain, that difference is useful, because the two are not competing for the same job.
Which is better for back pain, a chiropractor or acupuncture?
Neither chiropractic nor acupuncture wins across the board. The American College of Physicians’ 2017 low back pain guideline lists both spinal manipulation and acupuncture among the nondrug treatments to try first, for recent pain and for chronic pain. What decides between them is what is driving your pain, because that tells you which one has something to work on.
If the pain comes from how a joint moves, or from a pelvis that has shifted, chiropractic has a direct target. That is what we look for first when someone comes in for chiropractic care for back pain.
That same guideline notes that most new low back pain improves over time regardless of which treatment someone picks. In our office, measuring the spine matters most when pain keeps coming back, because a pattern that shows up on an x-ray is something we can build a plan around.
When leg pain travels from a disc, we may add spinal decompression to the adjustments. You sit upright in a Back On Trac chair, fully clothed, and nothing straps you in. Decompression creates space at the disc, and most people who are candidates notice the leg pain settling before the back pain does.
Is chiropractic or acupuncture better for neck pain?
For neck pain tied to posture, chiropractic has the most to work with. We measure the cervical curve and the amount of forward head posture on your x-ray, then adjust to what we find. Acupuncture can still be a reasonable addition when muscle tension is a big part of how the pain feels day to day.
If you spend eight hours a day angled toward a monitor, the measurements tend to show it.
How do we decide whether chiropractic is the right fit for you?
We start with a standing x-ray and take measurements from it before anyone adjusts you. Those measurements show whether there is a mechanical problem for chiropractic to work on. If there is not one, we tell you, and that is often the point where acupuncture or another provider makes more sense.
We take seven measurements, from the cervical curve and forward head posture down to pelvis position and the tilt and rotation of each vertebra. Those numbers become the x-ray notes your doctor pulls up before every adjustment, on every visit. It does not matter which of our nine doctors you see or which office you walk into. You can read more about chiropractic x-rays and how chiropractors know where to adjust.
A pelvis shift that does not make mechanical sense, for example, can point to a leg that is anatomically shorter. That finding changes the whole plan, and it only shows up because someone measured.
If your spine does not need adjusting, I would rather send you to an acupuncturist. The x-ray is how we know which situation we are in.
When does acupuncture make more sense?
Acupuncture makes more sense when your concern is not mechanical, or when a thorough spinal workup shows the joints are moving and sitting well. People also see acupuncturists for plenty of reasons that have nothing to do with the spine, such as sleep or quitting smoking, and those sit outside what a chiropractor treats.
I have had acupuncture myself. We try to experience any treatment we recommend to patients when we can, and I found it comfortable and helpful. When I asked the acupuncturist what brings most people in, pain was not the top answer. That surprised me, since pain is why nearly everyone walks into our office.
We refer patients to acupuncturists regularly when their concern calls for it.
Can you do acupuncture and chiropractic on the same day?
Yes, most people can have acupuncture and a chiropractic adjustment on the same day. Let both providers know about the other visit, and mention any soreness from either one, so each of them can plan that day’s session around it. Booking them back to back is fine.
Should acupuncture come before or after a chiropractic adjustment?
No study we know of has tested which order works better. Pick whatever fits your schedule. If one of the two leaves you feeling loose and ready for a nap, put that one second so you can head home afterward.
Frequently asked questions
Do chiropractors do acupuncture?
Acupuncture takes its own training and its own license. At CORE, we focus on chiropractic care and refer patients to licensed acupuncturists when acupuncture fits their plan. If you already have an acupuncturist you like, keep seeing them and let us know.
How can I tell which one is helping if I do both?
Start one at a time when you can, and give it a few weeks before adding the second, so you can tell what changed. If you are already doing both, jot down how you feel the day after each visit. A simple note on your phone is enough. For the chiropractic side, we cover typical visit ranges in our guide on how often to see a chiropractor.
The first step
If you are weighing chiropractic and acupuncture for back or neck pain, a chiropractic exam with x-ray measurements is a good place to start, because it tells you whether there is something mechanical to work on. Book a visit at the office closest to you. If acupuncture belongs in your plan, we will tell you that too.
Where this recommendation comes from: The treatment guidance cited on this page comes from the American College of Physicians, published in Annals of Internal Medicine in 2017: Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.