Education and Research

WHO Guidelines documents

WHO Guidelines on Basic Training and Safety in Chiropractic

Nowadays Chiropractic is international healthcare recognized by WHO (World Health Organization), one of organizations of UN (United Nations). Though it spreads to about 90 countries with legislation over 40 countries, it is not still legalized in Japan. On November 2005, WHO published the official document comprising guidelines on basic training and safety in chiropractic. As the Japanese Ministry of Health, Labour and Welfare affiliates with WHO, it is inevitable for them to refer this WHO documents for future legislation. The objectives of this document are; to provide minimum requirements for chiropractic education; to serve as a reference for national authorities in establishing an examination and licensing system for the qualified practice of chiropractic; to review contraindications in order to minimize the risk of accidents and to advise on the management of complications occurring during treatment and to promote the safe practice of chiropractic. Currently there are about 800 chiropractic practitioners who completed this standard of education in Japan.

WHO standard Chiropractors List

Japan Chiropractic Register (JCR) is a self-regulated registration body releasing the list of qualified chiropractors who meet the WHO standard education such as the international standard college graduates and CSC program graduates in Japan. The purpose of releasing the list is notifying the Japanese Ministry of Health, Labour and Welfare, and media the accurate total numbers of qualified chiropractors in Japan. JCR provides the registration exam provided by the International Board of Chiropractic Examiners (IBCE) once a year.

WHO health profession's Guidelines

WHO published health profession’s guidelines, including traditional and complementary medicine services, education, system, practices and practitioners.


Chiropractic Situation in Japan

Chiropractic was first introduced to Japan by Saburo Kawaguchi who studied at Palmer school of US in 1916. Precedence by the Supreme Court decision in 1960 allows anyone to practice spinal manipulations including chiropractic if it is not harmful to people. In 1991 “Medical research on manipulative therapy for diseases of spinal origin” so called Miura Report was published by then the Japanese Ministry of Health. This report was purposely compiled to condemn chiropractic profession by to a group of orthopedic surgeons without referring any scientific literatures or articles.

Today’s laissez faire situation created numerous entrepreneurs and proprietary schools. Under this circumstance, ceasing the local standard programs and starting the new international standard colleges in the country will be the key for the future direction of the Japanese profession. The Japanese Ministry of Health, Labour and Welfare (MHLW) sees chiropractic profession as “non licensed quasi medical practice” from the following reasons. However the Employment Security Bureau of the MHLW recognizes the occupation of chiropractor while the Health Policy Bureau of the MHLW indicates that chiropractic therapy is different from other regulated health care.

  1. It is difficult to define the manipulative therapy
  2. It is impossible to prove chiropractic’s identity, safety and effectiveness
  3. A large number of oppositions from medical profession and other established professional groups such as masseur, Shiatsu practitioners, acupuncturists and bonesetters, exist.

🔹JAC claims meaningful purposes of legislation against Miura Report

  1. Adequate chiropractic care contributes a large benefit to Japanese society and patients
    (Benefits and choices for Nation)
  2. Chiropractic has its own identity which differs from other health care
    (Separation from vested interests)
  3. Practitioners are required to obtain degrees at chiropractic education institutions
    (Establishment of Identity, Safety, Effectiveness)

🔹Classifications of 'Chiropractic' and 'Chiropractor' by the Japanese government



Name of ReportYearCountryCommiteeResult
Chiropractic in NZ The Report of the Commission of Inquiry1979New ZealandB.D. Inglis (chaireman), Betty Fraser, B.R. Penfold, et al.Effective
The Austaralian Ministry of Health Report1984AustraliaMedicare Benefits Review CommitteeEffective
The Report of a commission on alternative medicine in Sweden1987SwedenA commission on alt. medicine including goverment officer, educator, MD, DC, et al.Effective
The Report of Japanese Ministry of Health: Miura Report1991JapanYukio Miura (chairman), Hajime Ishida and
7 other MDs.
Not Effective
Appropriateness of Spinal Manipulation for Low-Back Pain
1991USShekelle, P.G. (chairman: university) , 6 MDs, 3 DCs, et al.Effective
Canadian governments
The Manga Report
1993CanadaPran Manga (chairman: university professor)and AssociatesEffective
The Report of a Working Party on Chiropractic1993UKSir Thomas Bingham and 10 member-group including journalists, MDs and DCsEffective
US Department of Health and Human Services AHCPR1994USBigos S., et al. (23 commissioners and 2 DCs)Effective
Report of Back Pain
1994UKClinical Standards Advisory group: 10 members inc. 1 DCEffective
UK BEAM randomised trial: effectiveness of physical treatments for back pain in primary care2004UKUK Beam (back pain and exercise and manipulation) Trial TeamEffective
WHO guidelines on basic training and safety in chiropractic2005WHOWHO consultation on chiropracticEffective
European guidelines for the management of chronic non-specific low back pain2004European Commissionworking groups on European guidelines for acute/chronic low back painEffective