What Texas Chiropractors Need to Know About the TBCE’s Latest Warning on Neuropathy, Scope, and PI Clinics (December 2025 Report)
The Texas Board of Chiropractic Examiners (TBCE) has released its December 2025 Board Report, and this one carries some of the most important regulatory clarifications we’ve seen all year. If you’re a Texas chiropractor, this update directly affects how you advertise, how you describe neuropathy and nerve-related issues, and what risks you take when working in non-chiropractor-owned clinics.
Here’s a clear breakdown of what the Board said, in plain English, and how it should guide your marketing and practice decisions going into 2026.
1. Neuropathy Advertising & Scope of Practice: TBCE Issues a Major Clarification
The TBCE opened with a long President’s Message explaining a growing concern: chiropractors advertising or treating “neuropathy” without proper scope awareness.
According to the report, neuropathy (especially diabetic peripheral neuropathy) is generally considered a disease of the nervous system, not the musculoskeletal system chiropractors are authorized to treat.
The Board emphasizes:
- The musculoskeletal system does include muscles, tendons, ligaments, bones, joints, associated tissues, and nerves, but only in the context of biomechanical structure.
- Chiropractors may treat neuromusculoskeletal conditions, including the effects these conditions have on health through the nervous system.
- BUT diagnosing or treating diseases of the nervous system is outside chiropractic scope.
This distinction matters because “neuropathy treatment” programs have exploded in recent years, and the TBCE has received complaints from patients who felt misled by promotional claims.
Why This Matters for Your Marketing
If a clinic promotes:
❌ “We treat neuropathy”
❌ “Neuropathy reversal programs”
❌ “We fix diabetic neuropathy”
…it risks violating §77.4 (misleading claims) and §201.502(9) (false advertising).
Compliant alternatives:
✔ “We support patients experiencing nerve-related discomfort through chiropractic care focused on improving biomechanics and musculoskeletal function.”
✔ “We address neuromusculoskeletal contributors to nerve irritation.”
Safe, simple phrasing options
✔ “Support for nerve-related discomfort through chiropractic care.” ✔ “Helping address musculoskeletal factors that may affect nerve function.” ✔ “Chiropractic care for nerve-related tension and irritation.” ✔ “Care focused on improving alignment and reducing pressure on surrounding tissues.” ✔ “Natural support for musculoskeletal contributors to nerve symptoms.” ✔ “Helping improve mobility and reduce strain on nerves through gentle chiropractic care.” ✔ “Addressing posture and alignment issues that may influence nerve irritation.” ✔ “Chiropractic care for musculoskeletal issues that can impact nerve comfort.” ✔ “Supporting overall nerve health by optimizing spinal and joint mechanics.” ✔ “Focused musculoskeletal care for patients experiencing nerve-related sensations.”
Ultra-short versions (GBP-friendly)
✔ “Chiropractic support for nerve-related discomfort.” ✔ “Care for musculoskeletal contributors to nerve symptoms.” ✔ “Gentle chiropractic care for nerve-related tension.” ✔ “Alignment-focused care to reduce nerve strain.” ✔ “Chiropractic support for posture and nerve comfort.”
Variations tailored for different pages
Homepage:
✔ “Helping families find relief from nerve-related tension through musculoskeletal care.”
Services page:
✔ “Chiropractic support for musculoskeletal issues that can influence nerve irritation.”
Blog/educational:
✔ “How chiropractic care can support nerve comfort by improving biomechanics.”
Video/social:
✔ “Safe, natural support for nerve-related discomfort.”
***It’s truly unfortunate that we must go to these lengths to underpromise the miracle of chiropractic, but that’s the world we live in. Mitigating legal issues becomes of utmost importance to preserve and further the profession. We aren’t “hiding” the true benefits of chiropractic, as much as it may seem that way. We’re simply easing people into learning those benefits for themselves. We don’t need to overpromise because in many cases, treatment will speak for itself and become part of the personal referral conversation your patients have in their circle of influence.
2. TBCE Re-Emphasizes Informed Consent & Evidence-Based Expectations
The Board reminds all chiropractors that informed consent must reflect:
- Evidence-based expectations
- Your actual clinical experience
- Your scope of practice
- When referral or co-management is needed
Rule §75.1 requires chiropractors to “promote public health, illness prevention, and the alleviation of suffering,” but in a way that is truthful and grounded in evidence.
This is a direct response to:
- Exaggerated claims
- High-pressure sales tactics
- Contracts for expensive neuropathy programs
- Promotions that suggest unrealistic results
Marketing takeaway:
Avoid any language that promises symptom reversal or guaranteed neurologic improvement. Keep your educational tone strong and compliant.
3. Use of “Dr.” in Advertising: TBCE Reminder
On page 3, the TBCE again stresses a rule many forget:
If you use “Dr.” or “Doctor” in ANY medium, you must clearly state you are a Doctor of Chiropractic. Not every utterance of your title and name, but it must be easily deduced from reading your content that you are a chiropractor. Again, there’s no need to puff your chest. Being a chiropractor is one of the most amazing of the healing arts. It’s been an uphill battle to help the public gain understanding and appreciation for what we do, particularly when there are those who try to undermine it and call us names. But, make no mistake, being a chiropractor is the closest thing to the true meaning of the word “doctor.” Try to treat naysayers with empathy instead of anger and frustration. You are true healers.
This issue applies to content in:
- Websites
- Social media bios
- Business cards
- Email signatures
- Videos
- Blog posts
4. The TBCE Warns New Chiropractors: Beware of Non-Chiropractor-Owned Clinics (Especially PI)
A full article (“The Hidden Dangers of Working for Non-Chiropractor-Owned Clinics”) warns that many PI clinics are run by attorneys or investors, not doctors.
The Board explains:
Why these clinics hire chiropractors:
- Not for your clinical skills
- But for your NPI number to bill insurance and support lawsuit settlements
Risks to your license:
- You’re responsible for all documentation
- Fraudulent billing falls on YOU
- You can’t blame staff or the clinic owner
- You can’t be told what to diagnose, how many visits to prescribe, or what to write in notes
If anything unethical happens, backdated notes, unauthorized therapy codes, inflated treatment plans, the TBCE and OIG will come after the chiropractor, not the owner.
Marketing takeaway:
If you ever create content targeting new chiropractors or offering career advice, you should guide them away from PI mills and toward ethical, compliant practice models.
5. TBCE Encourages Ethical Promotions & Evidence-Based Patient Communication
The Board is very clear:
- No overpromising
- No misleading language
- No exaggerated results
- No deceptive financial arrangements
- No high-pressure sales tactics disguised as “wellness programs”
Marketing must reflect:
- Actual scope
- Realistic expectations
- Evidence-based chiropractic care
- A clear path for co-management when necessary
This matches perfectly with your “compliant content” brand.
What This Means for Texas Chiropractors
The December 2025 TBCE Report makes one thing undeniable:
Compliance isn’t optional; it’s strategic.
Whether you’re addressing neuropathy, nerve-related discomfort, posture, headaches, pregnancy, or wellness, your messaging must stay firmly inside:
- Texas Administrative Code §77.1 & §77.4
- Texas Occupations Code §201.502(9)
- TBCE’s clarified stance on nerve-related issues
Most chiropractors want to do the right thing; they just need clarity. That’s where compliant, educational marketing makes all the difference.
If you want help rewriting marketing materials, updating your website, or auditing your messaging for compliance, I can guide you through every step.
📞 (817) 382-1902 📧 bi**@************on.com
