The NBCE’s “Pain” Problem: When the Gatekeepers of Chiropractic Miss the Point
Originally published: 2025-10-06
The National Board of Chiropractic Examiners (NBCE) recently posted an infographic to its Facebook page in recognition of National Chiropractic Health Month. With its blue and white palette, medicalized design, and central image of a man clutching his lower back in pain, the message was clear: chiropractic equals pain relief.
The post, funded by the very student fees the NBCE collects, read like a pharmaceutical ad. It featured a 2014 citation on low back pain as the “single leading cause of disability worldwide,” a red arrow pointing to the word “PAIN,” and a summary on the “aging population” and “sedentary lifestyles.” Nowhere did it mention the nervous system, vertebral subluxation, wellness, or the distinct philosophical and scientific foundation of chiropractic.
The backlash was immediate and intense.
Chiropractors Speak Out
Within hours, dozens of practicing chiropractors and thought leaders condemned the NBCE post. Their reactions ranged from disbelief to outrage. Comments called it “a sad post,” “an embarrassment,” and “a sellout.” Others questioned why a testing agency, not a membership organization, was spending student-derived funds on public advertising at all.
“How can this be the testing organization for Chiropractic?”
“A licensing body should not be advertising, is this even legal?”
“Chronic musculoskeletal pain, really? That’s what National Chiropractic Month has come to?”
One chiropractor summed it up: “How and why does a licensing body advertise? This is wrong on so many levels.”
Another pointed out the deeper issue. The NBCE isn’t an accrediting body, but a private corporation with a monopoly on chiropractic licensure testing. Its leadership is not accountable to the profession, to students, or to the public. Yet it continues to shape the image and trajectory of chiropractic, often in ways that undermine its foundational principles.
“Chiropractic is NOT about low back pain! NBCE is a sellout organization.”
The Cartel Connection: Centralization and Control
The controversy arrives at a pivotal moment. The NBCE is moving forward with centralization of the Part IV exam, a decision that has drawn widespread opposition from schools, students, and professional organizations alike.
By consolidating control over clinical competency testing into a single, for-profit entity, the NBCE is tightening its grip on the profession. This move, enabled by the Council on Chiropractic Education (CCE) through Policy 56, forces every accredited college to tie student progression and graduation to NBCE exam participation, regardless of whether the exams actually measure the program’s stated competencies.
Critics have called it what it is: a cartel mechanism designed to maintain financial and political dominance under the guise of “standards.”
“Exactly the type of chiropractor they want to be able to pass their tests.”
Advertising “Pain” While Causing It
Beyond the philosophical insult, many see the NBCE’s “back pain” campaign as an affront to students already burdened by debt and disillusionment. Each exam costs hundreds to thousands of dollars, generating tens of millions annually for the NBCE. Now, that money is being spent on ads that diminish the scope and identity of the very profession students are paying to enter.
“They should be giving that wasted ad money back to students.”
“They charge ignorant prices for a terribly outdated testing rubric, still spewing pain and modalities.”
As one practitioner noted, “Adding insult to injury, student loan money was used to create and distribute this.”
This sentiment resonates widely in a profession increasingly divided between those who see chiropractic as a vitalistic, subluxation-centered discipline and those who have aligned it with a narrow, mechanistic pain model. The NBCE’s ad didn’t just miss the mark, it revealed it.
The Larger Question: Who Speaks for Chiropractic?
When a testing monopoly with no mandate for public education positions itself as the voice of the profession, it’s not just overreach, it’s occupation.
“Shows how out of touch they are with their role, as a result of cartel leadership giving them the power they do.”
The NBCE’s post and the outrage it provoked should serve as a wake-up call. The future of chiropractic cannot be determined by private corporations unaccountable to the profession. The conversation must shift back to where it belongs, in the hands of chiropractors, educators, and institutions committed to chiropractic’s true purpose, the detection, analysis, and correction of vertebral subluxation to restore and maintain health.
Until then, expect more tone-deaf PR, more misuse of student funds, and more pain, just not the kind they’re advertising.
