Chiropractic is now the third largest primary health care profession in the western world, after medicine and dentistry. There are approximately 50,000 chiropractors in the United States, 10,000 in Japan, 5,000 in Canada, 2,500 in Australia, 1,000 in the United Kingdom and 100-500 each in Belgium, Denmark, France, Italy, Norway, Sweden, Switzerland, New Zealand, South Africa and The Netherlands. The profession is established, though in smaller numbers, in other European countries, Asia, Africa, the Middle East and South America.
The profession has always presented itself as a natural based and conservative health care discipline, offering a primary step in health care either before, after or in conjunction with medication and surgery. Accordingly chiropractic makes no use of drugs or surgery and, unlike osteopathy in the United States, has no aspirations to do so. Medical reservations on this point are quickly put to rest upon first-hand experience of chiropractic doctors and offices.
The main focus of chiropractic practice is the relationship between the function of joints, muscles and the nervous system (neuromusculoskeletal disorders) and the effects of these disorders on health. The spine is of central importance.
The principle treatment is joint adjustment or manipulation. Management also includes the use of physiologic therapeutics, exercise programs, nutritional counseling, patient education, activities of daily living, industrial consulting, lifestyle modification, and the use of braces, supports and orthotics. There is also an emphasis on health promotion and early return to activities for injured patients. The focus on education and patient empowerment, as research now shows, is an important factor in the success of chiropractic management and the high level of patient satisfaction reported.
The practice of chiropractic is now recognized in all world regions. Regulation by legislation exists, for example, in Canada and the United states (North America), Mexico, Panama and Venezuela (Latin America), Denmark, Norway, Sweden, Switzerland, and the UK (Europe), Australia, Hong Kong and New Zealand, (Asia/Pacific), Cyprus, Jordan and Saudia Arabia (Eastern Mediterranean) and Nigeria, South Africa and Zimbabwe (Africa). In many other countries where the profession is established, practice is recognized and legal under general law. Common features in all jurisdictions are: primary care (direct contact with the patient and responsibility to diagnose), and the right, competence and duty to diagnose, including the right to use diagnostic x-ray laboratory and other diagnostic procedures.
Common international standards of education have been achieved through a network of accrediting agencies that began with the US Council on Chiropractic Education (CCE) recognized by the US Office of Education since 1974.
Entrance requirements vary according to country, but are a minimum of two years university credits in qualifying subjects in North America. The chiropractic college undergraduate program has a minimum of 4 full-time academic years and is followed by postgraduate clinical training and/or licensing exams in many countries. Postgraduate specialties include chiropractic sciences, family practice, neurology, nutrition, orthopedics, pediatrics, radiology, rehabilitation and sports medicine.
In former times most chiropractors graduated from North American Colleges. There are now colleges in Australia, Brazil, Canada, Denmark, England, France, Japan, Korea, Mexico, New Zealand and South Africa as well as the United States. Depending upon the country chiropractic education is either within the University System (e.g. Australia, Brazil, Canada, Denmark, England, South Africa and the United States) or in private colleges (e.g. France, Japan and the United States).