Check your advertising: Chiropractic examples

Resources

This information outlines examples of advertising claims that don’t meet the legal requirements and how to make them compliant. The Australian Health Practitioner Regulation Agency (Ahpra) and the Chiropractic Board of Australia (the Board) are sharing these examples to help you check your own advertising to ensure you comply with your obligations under the National Law.

Why the advertising is non-compliant and how the specific examples could be corrected is based on our assessment of advertising complaints we have received for the chiropractic profession. To do this we apply the National Law and any further guidance that National Boards and Ahpra publish, including the Guidelines for advertising a regulated health service and resources on our websites.

The examples are specific to chiropractors and are some of the most common mistakes we see. We have also published common examples which highlight advertising from various regulated health professions but are still important to help you make your advertising compliant.

Check your advertising: Chiropractic examples PDF

Types of non-compliance

This document comprises examples of advertising considered false, misleading or deceptive, because:

The advertising is not supported by acceptable evidence
The advertising includes claims about specialising
The advertising uses titles such as ‘doctor’ or ‘Dr’ incorrectly or in a way that is misleading
The advertising includes a testimonial
The advertising encourages the unnecessary use of regulated health services

Important information

Check if your advertising complies with legal requirements

There are many ways advertisements can be false, misleading or deceptive.
Always be clear about the level of evidence to support a claim. You should not make claims about the effectiveness of the treatment or services you provide if those claims cannot be substantiated with acceptable evidence.
We have published a Summary of advertising requirements to help explain the legal requirements for advertising a regulated health service.
You should also refer to the full Guidelines for advertising a regulated health service.

Is your advertising about non-musculoskeletal conditions? Be particularly careful

The limited research evidence across manual therapies is not supportive of practitioners making advertising claims that they can effectively treat non-musculoskeletal conditions. However, sometimes chiropractic care may benefit aspects of some non-musculoskeletal conditions and syndromes. For example, manual therapy may help with musculoskeletal aspects of a non-musculoskeletal condition such as muscular tension often associated with asthma, and in these circumstances chiropractic care could be helpful in managing the condition alongside care from other practitioners.

If advertising refers to a specific non-musculoskeletal condition, it should be clear that the practitioner is treating the aspects of the condition amenable to manual therapy and the role of the treatment should not be overstated.

Key

These examples highlight non-compliant advertising by chiropractors and/or chiropractic related websites, Facebook pages, print advertisements and/or advertising by chiropractors or chiropractic clinics on third party websites.

Text in green means this is okay and is unlikely to mislead consumers.

Text in orange means it can depend. If you have qualified your advertising by providing the appropriate context and clarification, it is unlikely to be misleading to consumers.

Text in red means this advertising is in breach of the legal requirements, and you should remove it from your advertising.

Examples of non-compliant advertising and how to correct it

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A1. This advertising is not supported by acceptable evidence

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This advertising is considered false misleading and deceptive. Parts of this advertising are unqualified and/ or are not supported by acceptable evidence and therefore may mislead consumers.

Example chiropractors inc.

Statement 1

Chiropractic has been proven to be a very safe and effective healthcare modality in Australia

Statement 2

Chiropractic treatment can help with:

back pain
neck pain
joint and muscle stiffness
asthma
indigestion
ear infections
behaviour disorders
boosting immune functions

To resolve the issues with this advertising, we suggest the following changes.

Example chiropractors inc.

Statement 1 could be corrected to read:

Chiropractic treatment may help patients to manage a range of musculoskeletal conditions, as well as musculoskeletal aspects of non-musculoskeletal conditions

See Note 1 for more information

Statement 2 could be corrected to read:

Chiropractic treatment can help with:

Back pain
Neck pain
Joint and muscle stiffness
Managing symptoms such as muscular tension often associated with asthma

See Note 2 for more information

Notes

It is potentially misleading to state or imply that chiropractic treatment or a particular approach is safe without also acknowledging that individuals respond differently and all forms of treatment have the potential for adverse events. Advertising about chiropractic treatment should not imply that a treatment or service cannot cause harm or have no adverse effects.

Generalisations about chiropractic being effective are also often misleading and risk implying an unreasonable expectation of benefit.
The limited research evidence across manual therapies is not supportive of practitioners making advertising claims that they can effectively treat non-musculoskeletal conditions. However, sometimes chiropractic care may benefit aspects of some non-musculoskeletal conditions and syndromes.

Where chiropractic can assist with musculoskeletal aspects of a non-musculoskeletal condition (such as assisting with the muscular tension associated with asthma), this needs to be made clear (qualified) in your advertising, otherwise your advertising may be misleading. Ear infections, indigestion, behaviour disorders, immune functions are non-musculoskeletal conditions and have no clear musculoskeletal symptoms. They do not justify a reference to these conditions in advertising by a chiropractor.

The use of a list of health conditions in advertising is often misleading because a list does not include enough information on how chiropractic treatment can assist the listed conditions.

If there is no or insufficient acceptable evidence to support treatment claims, such as non-musculoskeletal conditions, they must not be included in advertising.

The Board is particularly concerned about treatment claims that suggest there is a relationship between manual therapy (e.g. manipulation) for spinal problems and treating various organic diseases and infections, such as ear infections.

A2. This advertising is not supported by acceptable evidence

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This advertising is considered false misleading and deceptive. Parts of this advertising are unqualified and/ or are not supported by acceptable evidence and therefore may mislead consumers.

Example chiropractors inc.

Do you have a young child?

Statement 1

Chiropractic care can assist infants and children with:

developmental and behavioural disorders
ADHD
autistic spectrum disorders
infantile colic
bedwetting
ear infections
digestive problems
improving brain development
boosting immune systems
reducing illness and infection
improved sleep cycles
improved behaviour, concentration and mood, and
improving growth and development.

Chiropractic offers natural, drug-free solutions to keep your children developing at full potential.

Statement 2

A recent study has shown that spinal adjustments/chiropractic care is effective in the management of children with hyperactivity.

The results of this study show that chiropractic is an important non-drug intervention for children with hyperactivity.

Statement 1 These statements cannot be corrected and must be removed

See Note 1 for more information

Statement 2 These statements cannot be corrected and must be removed

See Note 2 for more information

Notes

The Board is concerned about claims in advertising that there is a relationship between manual therapy (e.g. spinal adjustments and/or manipulation) for spinal problems and achieving general wellness or treating various organic diseases and infections; or that spinal problems may have a direct role in various organic diseases and infections. There is insufficient acceptable evidence to support these claims.

Of particular concern is the number of treatment claims in advertising relating to infants and children. Claims suggesting that manual therapy for spinal problems can assist with general wellness and development, and/or benefit a variety of paediatric syndromes and organic conditions are not supported by acceptable evidence.
If the results of a study do not sufficiently support the claims in your advertising, or the research is of lower quality that would not be considered acceptable evidence. Further information on acceptable evidence in health advertising can be found on the Ahpra website.

For example, if the study concluded: The results of this study are not conclusive and require further investigation, but they do suggest that chiropractic manipulation has the potential to become an important non-drug intervention for children with hyperactivity. Then the statement made in the advertising would be false and misleading, as the advertising has misrepresented the findings of the study.

There are factors to consider when assessing whether evidence is acceptable to support advertising:
- Source: Is the evidence supporting my claim from a publicly accessible and reliable source?
- Relevance: Does the evidence directly support my advertising claim? Is it about the patient population targeted by my claim?
- Inclusion: Have I considered relevant studies on this topic, including negative and neutral findings?
- Level: Was the study well-designed and appropriately selected to answer the research question/s?
- Quality: How was the study conducted? How much uncertainty is there? Have chance, bias and confounding factors been considered?
- Strength: Does the evidence show a meaningful effect that supports my advertising claim?

A3. This advertising is not supported by acceptable evidence

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This advertising is considered false, misleading or deceptive. Parts of this advertising are not supported by acceptable evidence so may not be included in advertising.

If there is not acceptable evidence to support a claim it may not be in included in advertising

Example chiropractors inc.

Are you pregnant?

Statement 1

Chiropractic treatment can help pregnant women with:

back pain and spinal pain
other pregnancy related musculoskeletal pains
reducing pain medication
stabilising hormone levels
morning sickness and nausea
shorter labour times
a more comfortable delivery
increased chance of a natural birth
optimal foetal positioning/malpositioned foetus/ breech baby
improving your overall health and wellbeing giving the baby a healthier environment to grow.

Statement 2

Chiropractic treatment can help clear your nervous system of interferences, which in turn can improve fertility, and aid in conception to become pregnant.

To resolve the issues with this advertising, we suggest the following changes.

Example chiropractors inc.

Statement 1 could be corrected to read:

Chiropractic treatment can help pregnant women with:

back and spinal pain
other pregnancy related musculoskeletal pains
reducing the need for pain medication for musculoskeletal conditions

See Note 1 for more information

Statement 2 This statement cannot be corrected and must be removed

See Note 2 for more information

Notes

In this advertising there are no clear links between chiropractic treatment and the causes of the non-musculoskeletal conditions listed in red.

There is no acceptable evidence that chiropractic could effectively treat the conditions listed relating to pregnancy or an unborn child, therefore it’s not appropriate to make claims about them in advertising.

The Board is particularly concerned about chiropractors representing that they provide treatment to the unborn child. Chiropractors are not trained to and should not deliver any treatment to the unborn child.

The use of a list of health conditions in advertising is often misleading because a list does not include enough information on how chiropractic treatment can assist the listed conditions.

The claim that chiropractic can assist pregnant women to reduce pain medication would need to be clarified (qualified), as chiropractic may be able to reduce the need for pain medication for musculoskeletal conditions, but not for other non-musculoskeletal sources of pain. If this is made clear in your advertising, it is unlikely to mislead consumers.
If there is no acceptable evidence to support treatment claims, such as non-musculoskeletal conditions, they must not be included in advertising.

B. This advertising includes claims about specialising

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This advertising is considered false, misleading or deceptive. Under the National Law there is no specialist registration for chiropractic. When a practitioner does not hold specialist registration, advertising that uses words or titles related to specialty is likely to mislead the public to believe the practitioner holds a type of specialist registration.

Advertising that uses the words, or variations of the words or phrases ‘specialist’, ‘specialises in’, ‘specialty’, or ‘specialised’ is likely to mislead the public to believe the practitioner holds a type of specialist registration approved under the National Law.

Example chiropractors inc.

Statement 1

Did you know Chiropractors are spine specialists!

Statement 2

We use specialised chiropractic techniques in our practice.

Statement 3

Our practice specialises in chiropractic care for children.

Statement 4

Our practice includes Dr McKenzie (chiropractor) Our practice specialises in chiropractic care for children.

To resolve the issues with this advertising, we suggest the following changes.

Example chiropractors inc.

Statement 1 could be corrected to read:

Chiropractors are spine experts.

See Note 1 for more information

Statement 2 could be corrected to read:

We use several specific chiropractic techniques in our practice.

See Note 1 for more information

Statement 3 could be corrected to read:

Our practice has a specific interest in chiropractic care for children.

See Note 1 for more information

Statement4 could be corrected to read:

... who says “I have a particular interest in musculoskeletal issues in children.”

See Note 2 for more information

Notes

Chiropractors cannot use the term ‘specialist’ when referring to their practice or registration in their advertising or any other materials. There are no recognised specialist registration categories for the chiropractic profession under the National Law. Even if you have the appropriate training and experience, you cannot give the impression or advertise that you specialise or are a specialist.

This advertising would need to be corrected by removing the references to ‘specialists’, ‘specialised’ and ‘specialises’.
Removing the reference to the practitioner being a ‘specialist’ would correct this advertising as it now describes the area that Dr McKenzie works in without inferring that they are a specialist. Using a descriptive job title can help to inform the public that the practitioner works with a specific group, in an area of practice or in a specific setting, as long as the title does not infer the practitioner holds specialist registration.

Please see the guidance on the use of titles published on the Ahpra website

C. This advertising uses titles such as ‘doctor’ or ‘Dr’ in a way that is misleading

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This advertising is considered false, misleading or deceptive. There is no provision in the National Law that prohibits a practitioner from using titles such as ‘doctor’ or ‘Dr’ but there is potential to mislead or deceive if the title is not applied clearly.

If practitioners choose to adopt the title ‘Dr’ in their advertising and they are not registered medical practitioners, then (whether or not they hold a Doctorate degree or PhD) they should clearly state their profession.

Example chiropractors inc.

Statement 1

Dr McKenzie has spent the last 10 years as a health practitioner practising in the field of musculoskeletal sports injuries

To resolve the issues with this advertising, we suggest the following changes.

Example chiropractors inc.

Statement 1 could be corrected to read:

Dr McKenzie (chiropractor) has spent the last 10 years as a health practitioner practising the field of musculoskeletal sports injuries.

Dr McKenzie has spent the last 10 years as a chiropractor practising in the field of musculoskeletal sports injuries.

See Note 1 for more information

Notes

As this advertising uses the title ‘Dr’, it needs to clearly state that the practitioner is a registered chiropractor under the National Law. Otherwise there is the potential for a consumer to be misled into thinking Dr McKenzie is a medical practitioner.

Both these suggested changes in green are examples that make it clear to the public that Dr McKenzie is a chiropractor.

D. Advertising that includes testimonial

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This advertising is clearly a testimonial.

Testimonials or purported testimonials, that is, recommendations or positive statements about clinical aspects of a regulated health service are prohibited under the National Law when advertising regulated health services.

Pay particular attention to testimonials (real or fake) which can be misleading for consumers, particularly about a clinical aspect. If you’re unsure about whether or not the feedback relates to a clinical aspect of a regulated health service, it’s best to seek legal advice or leave it out.

Example chiropractors inc.

Statement 1

Jac, 47, is one of our many patients who experienced great results with chiropractic treatment. Jac says: ‘As a patient who has received this treatment, I confirm that it really does work and my chronic back pain is much improved after only five sessions’.

To resolve the issues with this advertising, we suggest the following changes.

Example chiropractors inc.

Statement 1 An example of a recommendation that could be used in advertising:

Alex, 35, says: ‘The practice is in a great spot so parking isn’t a problem. The staff are lovely and I have been going there for many years’.

S ee Note 1 for more information

Notes

The testimonial in red is about a clinical aspect and is prohibited in advertising, so it will need to be removed. The statement in green can be used because it doesn’t refer to a clinical aspect.
A clinical aspect exists if one of the following is expressed:

Symptom – the specific symptom or the reason for seeking treatment.

Diagnosis or treatment – the specific diagnosis or treatment provided by the practitioner.

Outcome – the specific outcome or the skills or experience of the practitioner either directly or via comparison.

E. This advertising encourages the unnecessary use of regulated health services

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This advertising is considered to encourage the unnecessary use of regulated health services. The advertising is also considered to be false, misleading and deceptive as it includes claims that are not supported by acceptable evidence.

Example chiropractors inc.

Statement 1

Did you know that regular checking of newborns, toddler and children’s spines by a chiropractor for subluxations are essential to help deal with trauma in gestation/birth/childhood and prevent illness later in life? Book a visit for your child now.

Statement 2

The birth process can, and often does, cause your baby’s first subluxation, especially if forceps or suction is used. During birth the shape of the baby’s head can be altered and it can also place unnecessary pressure on parts of the brain which if not corrected can lead to subtle changes in development.

The sooner a baby can be checked following birth the sooner the bone structure of the baby can be accessed and corrected if needed.

Having your child’s spine carefully assessed for spinal problems after birth gives them a good foundation for healthy growth and development later in life. Many parents are amazed at how such gentle and non-invasive care can make such a positive impact on the health of their child.

Statement 1 These statements cannot be corrected and must be removed

See Note 1 for more information

Statement 2 These statements cannot be corrected and must be removed

See Note 2 for more information

Notes

This advertising is considered to encourage the unnecessary use of regulated health services. This statement is not acceptable in advertising, so it will need to be removed.

This statement claims that a check-up with a chiropractor can prevent illness later in life. This claim is not supported by acceptable evidence and therefore may mislead consumers.

This statement also encourages patients to seek regular treatment when it is not clinically indicated (i.e. in the absence of any particular symptoms).

This claim goes further than just recommending a check-up, and links a check-up with a chiropractor to a therapeutic benefit for the consumer for which there is no acceptable evidence. In this case indicating the actual prevention of disease.

The Board is particularly concerned about claims in advertising that there is a relationship between manual therapy (e.g. spinal adjustments and/or manipulation) for spinal problems and achieving general wellness or treating various organic diseases and infections.
This advertising claims that a baby should receive chiropractic care after birth with no link to a specific condition or symptom. This claim is not supported by acceptable evidence and therefore may mislead consumers. This statement is not acceptable in advertising, so it will need to be removed.

Be careful not to include advertising that encourages consumers to use a regulated health service when there is no clinical indication to do so as it is likely to encourage the unnecessary use of regulated health services.

If your advertising includes information about providing general wellness advice (such as dietary, exercise, or child developmental advice) as part of chiropractic services, you need to be careful of the language you use to ensure that it does not encourage patients to seek treatment when there is no clinical indication to do so. Advertising should not encourage a patient to seek chiropractic care in the absence of a link to a specific condition or symptom and any claims need to be supported by acceptable evidence.