Co-written with Jai Liester.
In recent years, research has illuminated the intricate connection between our gut and brain, revealing how this relationship significantly impacts mental health. Now, a growing body of evidence suggests a third player in this system—the spine—creating what researchers call the “gut-brain-spine axis.” With mental health disorders affecting nearly one in five American adults, exploring innovative approaches to supporting mental well-being has never been more important. Chiropractic care, with its focus on spinal health and nervous system function, presents an intriguing avenue for influencing this complex neurological highway.
The Gut-Brain-Spine Axis and Mental Health
The bidirectional communication network between our central nervous system and enteric nervous system (often called our “second brain”) occurs through neural, endocrine, immune, and metabolic pathways. The spine serves as a critical conduit in this network, transmitting signals between the brain and the rest of the body, including the gut.
Research suggests that the spine functions as a critical communication pathway for the body, with spinal health potentially influencing how the brain and gut communicate, which may affect mood, anxiety, and cognitive function.
The vagus nerve, extending from the brainstem to the abdomen, transmits signals related to stress, mood regulation, and inflammatory responses—all key factors in mental health. Sympathetic nerve fibers originating from the spinal cord similarly influence gut function, affecting everything from digestion to microbiome composition, which emerging research links to mental health conditions including depression and anxiety.
Research on Chiropractic Care and Mental Health Pathways
Several promising research avenues demonstrate how chiropractic adjustments may positively influence mental health through the gut-brain-spine axis.
Autonomic Nervous System Regulation
Multiple clinical studies demonstrate that spinal manipulation influences autonomic nervous system function. Kingston et al. (2014) found significant evidence that spinal adjustments alter heart rate variability—a key marker of autonomic function and stress resilience. Since autonomic dysregulation features prominently in anxiety disorders, depression, and trauma responses, these findings suggest a neurophysiological mechanism through which chiropractic care may support mental well-being.
Stress Response Improvement
Chronic stress wreaks havoc on both gut health and mental well-being. Encouragingly, research by Jamison (2011) found that patients receiving regular chiropractic care reported significantly lower stress levels compared to control groups. This stress reduction creates a positive downstream effect on both gut function and mental health through neuroendocrine pathways.
The impact of chiropractic care on stress reduction represents one of the more established connections to potential mental health outcomes. By potentially modulating the body’s stress response, spinal adjustments may help interrupt the cycle of stress that exacerbates both digestive issues and mental health symptoms.
Inflammation Reduction
Neuroinflammation plays a significant role in depression, anxiety, and other mental health disorders. A pioneering study by Song et al. (2016) demonstrated that spinal manipulation reduces pro-inflammatory cytokines in participants with back pain. This anti-inflammatory effect could potentially benefit both gut integrity and brain function, supporting mental health through multiple pathways.
Mechanisms Supporting Mental Health Benefits
Several evidence-based mechanisms explain how chiropractic care influences the gut-brain-spine axis and mental health:
- Vagal tone improvement: Research by Driscoll & Hall (2000) shows spinal adjustment positively influences vagal tone—critical for stress resilience and emotional regulation. The vagus nerve’s role in the gut-brain axis makes this finding particularly relevant for mental health applications.
- Neuroplasticity enhancement: Neuroimaging research suggests spinal manipulation alters activity in brain regions involved in pain processing, emotional regulation, and autonomic control. These central effects could improve mood regulation and cognitive function.
- HPA axis modulation: Chiropractic adjustments appear to influence hypothalamic-pituitary-adrenal axis function, potentially normalizing cortisol patterns often disrupted in depression and anxiety disorders.
- Microbiome influence: Preliminary research suggests improved nervous system function following chiropractic care may positively affect gut microbiome composition—increasingly recognized as a key factor in mental health.
Mental Health Applications in Clinical Practice
For those experiencing mental health challenges, these research findings suggest several practical applications:
- Integrated approach: Consider chiropractic care as a complementary approach alongside traditional mental health treatments. Research indicates that chiropractic care and spinal manipulation regulate the autonomic nervous system. In particular, they may activate the parasympathetic system. Vagal parasympathetic stimulation is also considered an effective therapy for major depression as it releases neurotrophins, including brain-derived neurotrophic factor and nerve growth factor.
- Stress reduction strategy: Regular chiropractic adjustments may serve as an effective stress management technique, particularly for those whose mental health symptoms worsen during periods of high stress.
- Gut health support: For individuals experiencing both digestive issues and mental health symptoms (common in conditions like irritable bowel syndrome), chiropractic care may help address the nervous system component of these interconnected systems.
- Body awareness practice: The mindful attention to physical sensation during chiropractic sessions can enhance interoceptive awareness—a skill increasingly recommended for anxiety management and trauma recovery.
Future Directions
The intersection of chiropractic care, gut health, and mental well-being represents an exciting frontier in integrative health research. Future developments will likely include the following:
- Larger clinical trials examining chiropractic adjustments’ effects on specific mental health outcomes
- Research on how different adjustment techniques influence autonomic balance and stress resilience
- Investigation of chiropractic care as an adjunctive treatment for specific mental health conditions
The evidence base for potential chiropractic influence on mental health through the gut-brain-spine axis continues to develop. As research in this area advances, more targeted approaches to potentially support mental well-being through spinal health may emerge.
Conclusion
The emerging understanding of the gut-brain-spine axis opens new possibilities for supporting mental health through approaches like chiropractic care. By recognizing the body as an interconnected system where spinal function influences both gut health and brain function, we move toward truly integrative approaches to mental well-being—approaches that honor the profound connections between physical and psychological health.
Jai Liester has a Bachelor of Science degree in exercise science. Jai has conducted and published research in cardiovascular physiology. He is currently a student at Palmer Chiropractic College in Davenport, Iowa.