As a physician and principal of NIMM - Nordic Institute for Manual Medicine, with many years of clinical experience treating patients with pain, it is clear that there is a significant need for more entry points into the healthcare system for people with chronic back and neck pain. Naprapaths and chiropractors possess unique expertise that can relieve pressure on primary care, shorten waiting times, and help prevent fewer patients from developing long-term issues.
At NIMM, we develop educational programs in both naprapathy and chiropractic. Through early clinical patient contact, external quality assurance, and an interprofessional environment, we create the conditions for future therapists to provide high-quality care and patient safety. NIMM shares the position recently highlighted in Dagens Medicin: that naprapathy and chiropractic need to become a clearer part of primary care, for the benefit of both patients and the sustainability of the healthcare system.
In an op-ed in Dagens Medicin on August 31, 2025, Magnus Johansson (Företagarna), together with Jakob Petersen-Klingberg and Gunnar Arnarson (LKR), as well as Sofie Svahn and Anders Mattsson-Coll (Sveriges Naprapater), argue for allowing licensed naprapaths and chiropractors to serve as the first point of contact for common musculoskeletal issues. The point is straightforward: let the right expertise meet back and neck patients directly to make care faster and more accurate, while relieving pressure on primary care. The authors also point out that approximately 2,800 licensed professionals currently working outside the public healthcare system could contribute immediately.
The authors refer to reviews showing clinically meaningful improvements following chiropractic and naprapathic treatment, with a very low risk of serious side effects. They emphasize that this approach—early assessment, manual treatment, individualized exercise, and patient education—is in line with recommended practices for back and neck care. At the same time, they remind us of the societal cost: back pain costs around 44 billion SEK per year in Sweden, primarily due to loss of productivity.
The proposals are concrete: launch pilot clinics where naprapaths and chiropractors perform initial assessments for uncomplicated issues, open up procurement for more healthcare providers, and define clear roles within publicly funded care. At the School of Naprapathy, students are trained daily in exactly this—clinical reasoning, safe triage, effective manual treatment, and sustainable exercise advice—in close collaboration with other healthcare sectors. This makes us ready to contribute where the needs are greatest.
Helene Schulte
MD, PhD
Principal at NIMM - Nordic Institute for Manual Medicine
Links:
Företagarna: https://www.foretagarna.se/nyheter/riks/2025/september/oppna-upp-primarvarden-for-kiropraktorer-och-naprapater/
Dagens Medicin: https://www.dagensmedicin.se/opinion/debatt/lat-kiropraktik-och-naprapati-avlasta-i-primarvarden/
