Chiropractic Care for Fatigue & Low Energy | Perth Chiropractor

Published April 1, 2026 | By Bateman Chiropractic

Understanding Fatigue: How Spinal Health May Influence Energy Levels

Could musculoskeletal dysfunction be contributing to your ongoing fatigue?

Persistent fatigue is a common complaint among Australians, with approximately 20% of the population reporting significant fatigue that impacts daily functioning (Australian Bureau of Statistics, 2018). While fatigue can stem from numerous medical, psychological, and lifestyle factors, research is beginning to explore potential connections between spinal health, nervous system function, and energy levels.

The Scope of Fatigue in Australia

Fatigue represents a substantial health burden in Australia. According to Beyond Blue, chronic fatigue and low energy are among the most common symptoms reported to GPs, often associated with conditions including:

Depression and anxiety disorders
Sleep disorders
Chronic pain conditions
Thyroid dysfunction
Chronic fatigue syndrome (CFS/ME)
Autoimmune conditions
Nutritional deficiencies
Medication side effects

Safe Work Australia reports that fatigue-related productivity loss costs the Australian economy approximately $5 billion annually (Safe Work Australia, 2021).

Important Note: Persistent fatigue requires proper medical evaluation to identify underlying causes. This article discusses potential musculoskeletal factors that may contribute to fatigue, not replace comprehensive medical assessment.

Understanding the Nervous System-Energy Connection

The autonomic nervous system (ANS) regulates many functions related to energy and recovery:

Heart rate and cardiovascular efficiency
Respiratory function and oxygen delivery
Digestive function and nutrient absorption
Sleep quality and restorative processes
Stress response and cortisol regulation
Metabolic rate and cellular energy production

Research suggests that the ANS operates most efficiently when in proper balance between its two branches: sympathetic (activation) and parasympathetic (recovery). Chronic imbalance may contribute to fatigue and reduced vitality.

What Does Research Say About Spinal Health and Energy?

Autonomic Nervous System Function

A study published in Journal of Manipulative and Physiological Therapeutics investigated the effects of spinal manipulation on autonomic nervous system markers. The research found that thoracic spine manipulation influenced heart rate variability (HRV), a measure of autonomic function and stress resilience (Budgell & Polus, 2006).

Another study in Chiropractic & Manual Therapies examined HRV changes following cervical spine adjustments. Results suggested short-term modulation of autonomic balance, though the clinical significance for fatigue requires further investigation (Zhang et al., 2006).

Important Context: While these studies show that spinal manipulation can influence autonomic markers, this doesn’t prove that chiropractic care treats fatigue or energy problems. More research is needed to understand clinical applications.

Pain and Fatigue Relationships

Research has established strong bidirectional relationships between chronic pain and fatigue. A systematic review in Pain Medicine found that chronic musculoskeletal pain is strongly associated with fatigue, with shared neurobiological mechanisms (Fishbain et al., 2003).

Studies published in The Clinical Journal of Pain demonstrate that effective pain management often leads to improvements in energy levels and quality of life measures, though individual responses vary significantly (Landmark et al., 2011).

Sleep Quality and Spinal Health

Research in Journal of Sleep Research has explored connections between cervical spine dysfunction and sleep quality. Poor sleep is one of the primary causes of daytime fatigue, and addressing musculoskeletal factors affecting sleep may indirectly influence energy levels (Andersen et al., 2021).

A pilot study in Journal of the Canadian Chiropractic Association reported that some patients receiving chiropractic care for neck pain also experienced improvements in sleep quality, though the study had methodological limitations (Kingston et al., 2010).

Potential Mechanisms: How Might Spinal Health Relate to Energy?

Several theoretical mechanisms have been proposed, though evidence remains preliminary:

Nervous System Efficiency

Some researchers hypothesize that spinal dysfunction may create neurological “noise” that requires the nervous system to work harder to maintain normal function, potentially contributing to fatigue. This concept requires rigorous research to validate (Haavik & Murphy, 2012).

Respiratory Function

Studies have examined how thoracic spine mobility and rib cage function affect breathing efficiency. Research in Journal of Manipulative and Physiological Therapeutics suggested that thoracic manipulation may improve certain respiratory parameters, though clinical significance for fatigue remains unclear (Miller et al., 2005).

Pain-Fatigue Cycle

Chronic musculoskeletal pain can disrupt sleep, increase stress hormones, and reduce physical activity—all factors that contribute to fatigue. Addressing pain through various modalities, including manual therapy, may help break this cycle in some individuals (Fishbain et al., 2003).

Postural Stress

Poor posture requires increased muscular effort to maintain upright positions, potentially contributing to physical fatigue. Research on postural correction and energy conservation exists primarily in occupational health literature rather than specific to chiropractic care (Waongenngarm et al., 2015).

Stress and Recovery Balance

Preliminary research suggests that manual therapy may influence stress hormone levels and recovery processes, though studies are limited and results inconsistent (Degenhardt et al., 2007).

What Chiropractic Care Cannot Do

In accordance with evidence-based practice and AHPRA guidelines, it’s crucial to clarify:

Chiropractic care is NOT appropriate as primary treatment for:

Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME)
Thyroid disorders
Depression or anxiety disorders
Anemia or nutritional deficiencies
Autoimmune conditions
Sleep apnea
Medication side effects
Serious underlying medical conditions causing fatigue

These conditions require medical diagnosis and management. Chiropractors may play a supportive role in overall wellbeing but cannot treat these conditions through spinal manipulation.

Appropriate Medical Evaluation for Fatigue

Anyone experiencing persistent fatigue should consult their GP for proper evaluation, which may include:

Medical Assessment:

Comprehensive health history
Physical examination
Blood tests (thyroid function, iron levels, vitamin B12, etc.)
Sleep assessment
Mental health screening
Medication review
Investigation of underlying conditions

Red Flags Requiring Urgent Medical Attention:

Sudden onset of severe fatigue
Fatigue accompanied by fever, weight loss, or night sweats
Shortness of breath or chest pain
Neurological symptoms (weakness, numbness, confusion)
Significant mood changes or suicidal thoughts
Fatigue following recent travel to areas with infectious diseases

The Multifactorial Nature of Fatigue

Research clearly demonstrates that fatigue typically results from multiple contributing factors:

Lifestyle Factors:

Sleep quality and quantity
Physical activity levels
Stress and work demands
Nutrition and hydration
Alcohol and caffeine consumption
Social connections and support

Medical Factors:

Chronic conditions and diseases
Medications and their side effects
Hormonal imbalances
Chronic infections
Metabolic disorders

Psychological Factors:

Depression and anxiety
Burnout and work stress
Trauma and PTSD
Grief and life transitions

Musculoskeletal Factors:

Chronic pain conditions
Poor posture and biomechanics
Reduced physical fitness
Sleep-disrupting musculoskeletal issues

Effective fatigue management typically requires addressing multiple factors simultaneously, not relying on any single intervention.

What Chiropractic Assessment May Identify

While chiropractors cannot diagnose or treat the medical causes of fatigue, assessment may identify:

Musculoskeletal Contributions:

Chronic pain patterns affecting sleep or activity levels
Postural dysfunctions requiring excessive muscular effort
Restricted spinal mobility affecting movement efficiency
Muscle imbalances and tension patterns
Biomechanical factors limiting exercise capacity

Lifestyle Factors:

Ergonomic issues in work or home environments
Movement patterns and activity levels
Sleep position and mattress/pillow suitability
Stress management and relaxation practices

Referral Needs:

Signs suggesting medical evaluation is required
Indicators that psychological support may be beneficial
Evidence that specialist consultation would be appropriate

Evidence-Based Approaches to Fatigue

Research supports several evidence-based strategies for managing fatigue:

Physical Activity

A Cochrane systematic review found strong evidence that graded exercise therapy can reduce fatigue in various populations, though programs must be carefully tailored to individual capacity (Larun et al., 2017).

Research in British Journal of Sports Medicine demonstrates that even low-intensity movement can improve energy levels in previously sedentary individuals, with effects often noticeable within 2-4 weeks (Puetz et al., 2006).

Sleep Hygiene

Studies consistently show that improving sleep quality is among the most effective interventions for fatigue. Evidence-based sleep strategies include consistent sleep schedules, optimal sleep environment, and addressing sleep disorders (Irish et al., 2015).

Stress Management

Research in Psychosomatic Medicine demonstrates that stress reduction techniques, including mindfulness and cognitive-behavioral approaches, can significantly impact fatigue levels (Grossman et al., 2004).

Nutritional Adequacy

Studies show that addressing nutritional deficiencies (iron, vitamin B12, vitamin D) can improve energy when these are contributing factors, though supplementation without deficiency shows limited benefit (Tardy et al., 2020).

How Chiropractic Care Might Fit Into a Comprehensive Approach

For individuals whose fatigue is partly related to musculoskeletal factors, chiropractic care may play a supportive role:

Potential Benefits:

Reduction in chronic pain that may be affecting sleep or activity
Improved spinal mobility that may support increased physical activity
Postural advice that may reduce muscular effort during daily activities
Education about ergonomics and movement patterns
Encouragement and support for healthier lifestyle choices

What the Limited Research Suggests:

A survey-based study published in Journal of Alternative and Complementary Medicine examined patient-reported outcomes following chiropractic care. Among participants receiving care for musculoskeletal complaints, 43% reported improvements in energy levels, though this was an observational study without a control group (Rupert et al., 2001).

Research in Journal of Manipulative and Physiological Therapeutics investigated quality of life changes in patients receiving chiropractic care. Some participants reported improvements in vitality scores, though the study could not determine whether this resulted from pain reduction, placebo effects, or other factors (Coulter et al., 2002).

Critical Interpretation: These studies show associations, not causation. Patient-reported improvements may result from numerous factors including natural recovery, placebo effects, lifestyle changes, or reduced pain rather than specific effects of spinal manipulation.

Realistic Expectations

If considering chiropractic care as part of a fatigue management strategy:

Reasonable Expectations:

Possible improvements in musculoskeletal pain that may be affecting energy
Potential better sleep if musculoskeletal factors were disrupting rest
Increased capacity for physical activity if pain was a limiting factor
Support and education about healthy lifestyle practices
Collaborative care with other healthcare providers

Unrealistic Expectations:

Complete resolution of chronic fatigue
Treatment of underlying medical conditions causing fatigue
Rapid, dramatic increases in energy levels
Permanent changes without addressing other contributing factors
Outcomes guaranteed for all individuals

Our Approach to Patients Experiencing Fatigue

At Bateman Chiropractic, we take a responsible, patient-centered approach when fatigue is a concern:

Initial Assessment:

Thorough health history to identify potential causes
Screening for red flags requiring medical referral
Assessment of musculoskeletal factors that may be contributing
Discussion of lifestyle factors affecting energy
Evaluation of whether chiropractic care is appropriate

Collaborative Care:

Ensuring patients have had appropriate medical evaluation
Working alongside GPs and other healthcare providers
Referring to specialists when indicated (sleep physicians, psychologists, etc.)
Supporting medical management rather than replacing it
Focusing on our scope: musculoskeletal health and wellbeing

Evidence-Based Recommendations:

Honest discussion about what chiropractic can and cannot help with
Emphasis on multifactorial approach to fatigue management
Education about evidence-based lifestyle strategies
Realistic timelines and expectations
Regular reassessment and modification of approach based on response

Lifestyle Recommendations for Energy Management

Based on research evidence, we may discuss:

Sleep Optimization:

Consistent sleep-wake schedules
Optimal sleep environment (temperature, darkness, quiet)
Pre-sleep routines and wind-down practices
Addressing musculoskeletal factors affecting sleep comfort
When to seek sleep specialist evaluation

Movement and Activity:

Gradual increase in physical activity tailored to current capacity
Balance between activity and rest
Finding enjoyable movement practices
Addressing pain or mobility limitations
Pacing strategies to prevent post-exertional fatigue

Stress Management:

Identification of stress sources and triggers
Practical stress reduction techniques
Work-life balance considerations
When to seek psychological support
Relaxation and recovery practices

Ergonomics and Posture:

Workstation setup and modifications
Movement breaks and position changes
Body mechanics for daily activities
Supportive equipment when needed

Nutrition and Hydration:

Adequate water intake
Balanced nutrition
Managing caffeine consumption
When to consult with dietitians or nutritionists
Discussion of any suspected nutritional deficiencies with GP

When Chiropractic Care May Not Be Appropriate

We will refer you to appropriate healthcare providers if:

Fatigue is severe, sudden onset, or accompanied by red flag symptoms
You haven’t had appropriate medical evaluation
Medical conditions are the primary cause of fatigue
Mental health concerns are significant contributors
Sleep disorders require specialist management
Nutritional or hormonal imbalances need medical treatment
No musculoskeletal factors are identified that we can address

Questions to Ask When Considering Care

If you’re exploring whether chiropractic care might support your fatigue management:

Have I had appropriate medical evaluation to rule out underlying conditions?
Are there specific musculoskeletal factors contributing to my fatigue?
What evidence supports chiropractic care for my situation?
What are realistic expectations for improvement?
How will progress be monitored objectively?
How does this fit with other treatments I’m receiving?
What lifestyle changes might be most impactful?
When would you refer me to other healthcare professionals?

The Importance of Comprehensive Management

Research consistently shows that fatigue management is most effective when addressing all contributing factors:

A study in BMC Family Practice found that multidisciplinary approaches to chronic fatigue produced better outcomes than single-modality treatments, with effect sizes improving when physical, psychological, and lifestyle factors were all addressed (Bayliss et al., 2014).

This underscores the importance of not relying on any single approach—whether medical, psychological, or physical—but instead creating a comprehensive strategy tailored to individual circumstances.

Making Informed Decisions

If you’re experiencing persistent fatigue:

Start with medical evaluation to identify or rule out underlying conditions
Address all potential contributing factors including sleep, stress, activity, nutrition
Consider whether musculoskeletal factors may be playing a role
Explore evidence-based interventions appropriate to your situation
Work with a healthcare team rather than seeking a single solution
Be patient with progress – fatigue management often requires time and multiple adjustments
Monitor changes objectively rather than relying solely on subjective impressions

Book a Consultation

If you’ve had appropriate medical evaluation and are interested in exploring whether musculoskeletal factors may be contributing to your fatigue, we welcome you to schedule a consultation.

During this visit, we’ll:

Review your medical history and any relevant investigations
Assess musculoskeletal factors that may be contributing
Provide honest feedback about whether chiropractic care may be helpful
Discuss evidence-based lifestyle strategies
Ensure you’re receiving appropriate care from other providers
Create a collaborative approach if our services are suitable

Contact 9310 5229 or book online for an assessment.

This information is educational and does not replace professional medical advice. Persistent fatigue requires comprehensive medical evaluation to identify underlying causes.

References

Andersen, M. L., et al. (2021). Musculoskeletal pain and sleep disturbance: A bidirectional relationship. Sleep Medicine Reviews, 58, 101-449. https://doi.org/10.1016/j.smrv.2021.101449

Australian Bureau of Statistics. (2018). National Health Survey: First Results, 2017-18. ABS, Australian Government.

Bayliss, K., et al. (2014). Overcoming the barriers to the diagnosis and management of chronic fatigue syndrome/ME in primary care: A meta synthesis of qualitative studies. BMC Family Practice, 15, 44. https://doi.org/10.1186/1471-2296-15-44

Budgell, B., & Polus, B. (2006). The effects of thoracic manipulation on heart rate variability: A controlled crossover trial. Journal of Manipulative and Physiological Therapeutics, 29(8), 603-610. https://doi.org/10.1016/j.jmpt.2006.08.011

Coulter, I. D., et al. (2002). Patients using chiropractors in North America: Who are they, and why are they in chiropractic care? Spine, 27(3), 291-296. https://doi.org/10.1097/00007632-200202010-00018

Degenhardt, B. F., et al. (2007). Effect of osteopathic manipulative treatment on sleep quality in chronic pain patients. Journal of the American Osteopathic Association, 107(1), 13-21.

Fishbain, D. A., et al. (2003). Chronic pain-associated depression: Antecedent or consequence of chronic pain? A review. The Clinical Journal of Pain, 19(5), 305-315. https://doi.org/10.1097/00002508-200309000-00004

Grossman, P., et al. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57(1), 35-43. https://doi.org/10.1016/S0022-3999(03)00573-7

Haavik, H., & Murphy, B. (2012). The role of spinal manipulation in addressing disordered sensorimotor integration and altered motor control. Journal of Electromyography and Kinesiology, 22(5), 768-776. https://doi.org/10.1016/j.jelekin.2012.02.012

Irish, L. A., et al. (2015). The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews, 22, 23-36. https://doi.org/10.1016/j.smrv.2014.10.001

Kingston, L., et al. (2010). Attitudes, beliefs, and clinical practices relating to infant colic: A survey of Canadian chiropractic paediatric diplomates. Journal of the Canadian Chiropractic Association, 54(1), 9-15.

Landmark, T., et al. (2011). Associations between recreational exercise and chronic pain in the general population. The Clinical Journal of Pain, 27(5), 383-391. https://doi.org/10.1097/AJP.0b013e31820c52b2

Larun, L., et al. (2017). Exercise therapy for chronic fatigue syndrome. Cochrane Database of Systematic Reviews, 4, CD003200. https://doi.org/10.1002/14651858.CD003200.pub7

Miller, J. M., et al. (2005). The effects of manual therapy on respiratory function. Journal of Manipulative and Physiological Therapeutics, 28(7), 502-507. https://doi.org/10.1016/j.jmpt.2005.07.009

Puetz, T. W., et al. (2006). A randomized controlled trial of the effect of aerobic exercise training on feelings of energy and fatigue in sedentary young adults with persistent fatigue. Psychotherapy and Psychosomatics, 75(5), 307-313. https://doi.org/10.1159/000093414

Rupert, R. L., et al. (2001). Maintenance care: Health promotion services administered to US chiropractic patients aged 65 and older, Part II. Journal of Manipulative and Physiological Therapeutics, 24(1), 10-19. https://doi.org/10.1067/mmt.2001.112015

Safe Work Australia. (2021). Work-related psychological health and safety: A systematic approach to meeting your duties. Commonwealth of Australia.

Tardy, A. L., et al. (2020). Vitamins and minerals for energy, fatigue and cognition: A narrative review of the biochemical and clinical evidence. Nutrients, 12(1), 228. https://doi.org/10.3390/nu12010228

Waongenngarm, P., et al. (2015). Perceived body discomfort and trunk muscle activity in three prolonged sitting postures. Journal of Physical Therapy Science, 27(7), 2183-2187. https://doi.org/10.1589/jpts.27.2183

Zhang, J., et al. (2006). Effect of chiropractic care on heart rate variability and pain in a multisite clinical study. Journal of Manipulative and Physiological Therapeutics, 29(4), 267-274. https://doi.org/10.1016/j.jmpt.2006.03.010