Key points from this video
- Manual care may be one part of a broader plan for selected mechanical pain, but it is not a universal treatment.
- A short trial with clear goals is different from an open-ended package of visits without reassessment.
- Pain accompanied by weakness, numbness that is progressing, hand clumsiness, balance trouble, or bowel or bladder changes needs a different level of evaluation.
- The safest plan depends on the diagnosis, not on loyalty to one treatment category.
What this video can—and cannot—tell you
“Back pain” and “neck pain” describe locations, not diagnoses. Before committing to a long treatment plan, ask what problem is being treated, how progress will be measured, what evidence supports the recommendation, and what would trigger imaging or referral.
This is general educational information, not medical advice. Symptoms vary by person — a clinical evaluation is the only way to know what’s right for you.
Full video transcript
Dr. Greenberg speaks to the camera. Overlays show research articles, a diagram labeled normal and subluxation, a spine X-ray, a prepaid visit plan, and images of manual treatment as he discusses each claim.
I'm a minimally invasive spine surgeon, and I'm about to defend chiropractors, at least partially.
You'd probably expect someone who operates on spines for a living to tell you to avoid chiropractors entirely. But, 35 million Americans see one every year. So, instead of joining the turf war, let me walk you through what the evidence actually shows.
In 2019, researchers combined 47 clinical trials covering more than 9,000 patients with chronic back pain. And they found that spinal manipulation relieves pain about as well as physical therapy does, no better, no worse, with a benefit that's modest and short-term, somewhere around 10 points on a 100-point pain scale.
What's more surprising is that in 2025, uh there was an analysis that found the specific technique they used made no measurable difference. Whether a chiropractor pushes on one spot or another, or in one direction, patients improved by the same amount. And that tells us that the benefit comes from skilled hands-on care and massage, rather than precisely correcting anything in your spine. For the right problem, that's still a perfect, perfectly reasonable option.
But, the value of that care depends entirely on who's providing it. So, here are the warning signs that tell you you're probably in the wrong office. The first is the diagnosis of subluxations that supposedly only they can detect. That has never been validated as a real medical finding, and two chiropractors examining the same spine can't even agree on where the subluxation is.
The second is a full set of spinal x-rays on your first visit, which exposes you to radiation without likely changing your treatment in any way.
The third is being asked to pre-pay for like a 30- or 40-visit care plan, when the evidence supports about four to six visits. Because if you haven't improved by then, more of the same treatment isn't going to fix you.
And the last is any claim that adjustments can treat asthma, colic, or your immune system. Because in 2021, an international research team reviewed every study ever published and found no evidence that manipulation helps any condition outside of the musculoskeletal system.
So, if those are the warning signs, what does a good chiropractor actually look like? A good chiropractor sticks to the back and combines manipulation with exercise and other therapies and give you a short trial with a clear endpoint and refers you to the right surgeon or physician when their work stops working.
And the reason I'm telling you all of this is that I'm the surgeon who operates last. If a few weeks of conservative care solves your problem, then I've done my job without ever picking up a scalpel. But, if your leg is getting weaker, or you're noticing numbness, or nothing you've tried is working, that's a totally different conversation and it's exactly the one I'm here for because I'm here ultimately for you.
