Best Practices & Practice Guidelines


These Best Practices and Practice Guidelines, written for and by International Chiropractors Association members, contained herein, are evidence-based suggestions for appropriate care of patients seeking chiropractic care.

While no guideline can replace the clinical decisions made by a chiropractic practitioner in the course of caring for an individual patient’s health problem, the suggestions contain herein, are based on the best available published evidence.  Any approach, by a practitioner, that is different from these ICA-BPPG Guidelines, does not necessarily mean that the approach in question was below the standard of care.  However, any chiropractic practitioner, who adopts a course of action different from these ICA-BPPG Guidelines, is advised to keep sufficient patient records to explain why such an action was undertaken.

Chiropractic is a philosophy, a science, and an art.  The nature of a science is that it is constantly evolving.  Due to the variety, complexity, severity, and intricacy of human health conditions it is impossible to always determine the appropriate examination, appropriate diagnostic analyses, and to predict with absolute certainty the patient’s response to chiropractic spinal care.  Therefore, adherence to these ICA-BPPG Guidelines will not always ensure that an accurate assessment and care of the patient’s spinal health has occurred, but adherence to these ICA-BPPG Guidelines will assist the practitioner by allowing him to practice based on the most current scientific data available.  However, to do so without also combining it with all the knowledge and skills of a doctor of chiropractic may result in an inaccurate assessment and care of the patient.

By following the ICA-BPPG Guidelines, it is expected that the chiropractic practitioner will follow a reasonable course of action based on the best available knowledge.  It is expected that with the assistance of the ICA-BPPG Guidelines, the chiropractic practitioner will use the assessment and care of spinal subluxation suggested herein to deliver safe and effective chiropractic care.


Section I:  Preliminaries
Preface: Background
Chapter 1: Introduction
Chapter 2: Legal Authorities, Definitions, Responsibilities
Chapter 3: Choice of Chiropractic Technique: Doctor’s Right Under State Laws
Chapter 4: Risk of Chiropractic Care
Chapter 5: Cost of Chiropractic Compared to Family
Chapter 6: Routine Plain Film Radiography is the Standard of Practice in Chiropractic

Section II:

ICA Best Practices
Chapter 7: Outcome Assessment Measures in Chiropractic
Chapter 8: Methods: The Search for, Levels of, Ratings of, and Grading of  Evidence
Chapter 9: Pysiotherapy Modalities: Ancillary and Preparatory to the Chiropractic
Chapter 10: Best Practices: Organizing the Chiropractic Clinical Evidence

Section III:

ICA’s Practice Guidelines
Chapter 11: Frequency & Duration Recommendations
Chapter 12: Presentation, Implementation, Future Updates
Appendix 1: Definitions from 2000 ICA Practice Guidelines
Appendix 2: References for Tables 1-4 in Chapter 10

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