Zacariah Shannon, D.C., M.S., Ph.D.

Chiropractic and nonpharmacological management of musculoskeletal and low back pain; clinical trial epidemiology; causal mediation and moderation analysis; pain trajectories and longer-term outcomes; veteran and active-duty military populations; and public health and quality measurement.

Research Keywords

Epidemiology; chiropractic; musculoskeletal and low back pain; pragmatic clinical trials; causal-mediation and moderation analysis; pain trajectories; biopsychosocial outcomes; secondary data analysis; veteran and military health; implementation; public health; quality measurement.

• Ph.D., Epidemiology — University of Iowa
• M.S., Clinical Research — Palmer College of Chiropractic
• D.C. — Palmer College of Chiropractic
• B.S., Biological Sciences — Illinois State University

• • VERDICT — Chiropractic Care for Veterans (Administrative Supplement)
  • Moderation, Mediation, and Pain Trajectories of Chiropractic Care for U.S. Veterans with Chronic Low Back Pain (Principal Investigator)
  • Longer-Term Effectiveness, Mechanisms, and Pain Trajectories of Chiropractic Care for LBP (Principal Investigator)
  • IMPACt-LBP — Implementation of the ACP Guideline for Low Back Pain (Co-Investigator)

• Moderation, Mediation, and Pain Trajectories of Chiropractic Care for U.S. Veterans with Chronic Low Back Pain (NIH Loan Repayment Program, competing renewal, L30AT013015). Principal Investigator; primary mentor, C. Long. 7/2026–6/2028.
• Longer-Term Effectiveness, Mechanisms, and Pain Trajectories of Chiropractic Care for LBP (NIH Loan Repayment Program, L30AT013015). Principal Investigator; primary mentor, C. Long. 7/2024–6/2026.
• IMPACt-LBP — Implementation of the ACP Guideline for Low Back Pain (NIH UH3AT011187). Palmer Center for Chiropractic Research (PCCR) Co-Investigator. 7/2021–6/2026.

View all publications on PubMed →

• Shannon ZK, Long CR, Vining RD, Walter JA, Coulter ID, Goertz CM. Mediators of the effect of chiropractic care on 12- and 52-week outcomes for U.S. active-duty military personnel with low back pain: secondary analysis of a clinical trial. Chiropr Man Therap. 2026 Apr 16;34(1):12. doi: 10.1186/s12998-026-00628-0. PMID: 41992252; PMCID: PMC13088719.
• Shannon ZK, Long CR, Vining RD, McCarey J, Walter JA, Coulter ID, Goertz CM. Longer-term chiropractic care outcomes for US active-duty military personnel with low back pain: secondary analysis of a pragmatic clinical trial. BMC Complement Med Ther. 2026 Apr 7;26(1):185. doi: 10.1186/s12906-026-05347-w. PMID: 41947115; PMCID: PMC13188315.
• Goode AP, Goertz C, Chakraborty H, Salsbury SA, Broderick S, Levy BT, Ryan K, Settles S, Hort S, Dolor RJ, Chrischilles EA, Kasper S, Stahl JE, Almond C, Reed SD, Shannon Z, Harris D, Daly J, Winokur P, Lurie JD. Implementation of the American College of Physicians Guideline for Low Back Pain (IMPACt-LBP): protocol for a healthcare systems embedded multisite pragmatic cluster-randomised trial. BMJ Open. 2025 Mar 26;15(3):e097133. doi: 10.1136/bmjopen-2024-097133. PMID: 40139699; PMCID: PMC11950946.
• Shannon ZK, Long CR, Chrischilles E, Goertz C, Wallace R, Casteel C, Carnahan RM. Secondary causal mediation analysis of a pragmatic clinical trial to evaluate the effect of chiropractic care for US active-duty military on biopsychosocial outcomes occurring through effects on low back pain interference and intensity. BMJ Open. 2024 Nov 19;14(11):e083509. doi: 10.1136/bmjopen-2023-083509. PMID: 39566948; PMCID: PMC11580239.
• Shannon ZK, Long CR, Chrischilles EA, Goertz CM, Wallace RB, Casteel C, Carnahan RM. Effect of chiropractic care on low back pain for active-duty military members: Mediation through biopsychosocial factors. PLoS One. 2024 Oct 1;19(10):e0310642. doi: 10.1371/journal.pone.0310642. PMID: 39352877; PMCID: PMC11444394.
• Hays RD, Shannon ZK, Long CR, Spritzer KL, Vining RD, Coulter ID, Pohlman KA, Walter JA, Goertz CM. Health-Related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care Plus Chiropractic Care vs Usual Care Alone: Secondary Outcomes of a Pragmatic Clinical Trial. Pain Med. 2022 Aug 31;23(9):1550-1559. doi: 10.1093/pm/pnac009. Erratum in: Pain Med. 2022 May 30;23(6):1198. doi: 10.1093/pm/pnac054. PMID: 35060609; PMCID: PMC9434322.
• Ziegler AL, Shannon Z, Long CR, Vining RD, Walter JA, Coulter ID, Goertz CM. Chiropractic Services and Diagnoses for Low Back Pain in 3 U.S. Department of Defense Military Treatment Facilities: A Secondary Analysis of a Pragmatic Clinical Trial. J Manipulative Physiol Ther. 2021 Nov-Dec;44(9):690-698. doi: 10.1016/j.jmpt.2022.03.009. Epub 2022 Jun 23. PMID: 35752500.
• Long CR, Lisi AJ, Vining RD, Wallace RB, Salsbury SA, Shannon ZK, Halloran S, Minkalis AL, Corber L, Shekelle PG, Krebs EE, Abrams TE, Lurie JD, Goertz CM. Veteran Response to Dosage in Chiropractic Therapy (VERDICT): Study Protocol of a Pragmatic Randomized Trial for Chronic Low Back Pain. Pain Med. 2020 Dec 12;21(Suppl 2):S37-S44. doi: 10.1093/pm/pnaa289. PMID: 33313732; PMCID: PMC7734654.
• Shannon ZK, Vining RD, Gudavalli MR, Boesch RJ. High-velocity, low-amplitude spinal manipulation training of prescribed forces and thrust duration: A pilot study. J Chiropr Educ. 2020 Oct 1;34(2):107-115. doi: 10.7899/JCE-18-19. PMID: 30951380; PMCID: PMC7682642.
• Vining RD, Shannon ZK, Minkalis AL, Twist EJ. Current Evidence for Diagnosis of Common Conditions Causing Low Back Pain: Systematic Review and Standardized Terminology Recommendations. J Manipulative Physiol Ther. 2019 Nov;42(9):651-664. doi: 10.1016/j.jmpt.2019.08.002. Epub 2019 Dec 20. PMID: 31870637.
• Vining RD, Minkalis AL, Shannon ZK, Twist EJ. Development of an Evidence-Based Practical Diagnostic Checklist and Corresponding Clinical Exam for Low Back Pain. J Manipulative Physiol Ther. 2019 Nov;42(9):665-676. doi: 10.1016/j.jmpt.2019.08.003. Epub 2019 Dec 19. PMID: 31864770.
• Vining RD, Shannon ZK, Salsbury SA, Corber L, Minkalis AL, Goertz CM. Development of a Clinical Decision Aid for Chiropractic Management of Common Conditions Causing Low Back Pain in Veterans: Results of a Consensus Process. J Manipulative Physiol Ther. 2019 Nov;42(9):677-693. doi: 10.1016/j.jmpt.2019.03.009. Epub 2019 Dec 19. PMID: 31864769; PMCID: PMC7183425.
• Shannon ZK, Salsbury SA, Gosselin D, Vining RD. Stakeholder expectations from the integration of chiropractic care into a rehabilitation setting: a qualitative study. BMC Complement Altern Med. 2018 Dec 4;18(1):316. doi: 10.1186/s12906-018-2386-3. PMID: 30514271; PMCID: PMC6278071.

• Chair, Public Health Advisory Committee, American Chiropractic Association (ACA) — 2026
• Honorable Mention, National Chiropractic Mutual Insurance Company (NCMIC)-Journal of Manipulative and Physiological Therapeutics (JMPT) Louis Sportelli Research Award, World Federation of Chiropractic (WFC) 18th Biennial Congress — 2025
• Representative, Faculty Senate, Palmer College — 2025
• 10-Under-10 Alumni Award, Palmer College of Chiropractic — 2024
• Appointed Member, National Quality Forum Research, Development and Solutions Stakeholder Council — 2024
• National Chiropractic Mutual Insurance Company (NCMIC) Early Career Research Award, World Federation of Chiropractic (WFC) 17th Biennial Congress — 2023
• Research Chair, Chiropractic Health Care Section, American Public Health Association (APHA) — 2023–present
• Member, Patient-Centered Outcomes Core Workgroup, National Institutes of Health (NIH) Pragmatic Trials Collaboratory — 2024–present
• National Board of Chiropractic Examiners (NBCE) Top Paper Award (second author), Association of Chiropractic Colleges and Research Agenda Conference (ACC-RAC) Conference — 2021
• Student & Trainee Travel Award, 2020 International Congress on Integrative Medicine and Health (ICIMH)
• National Center for Complementary and Integrative Health (NCCIH) Fellow/Trainee — 2018–2020
• Best Regional Poster, North America (second author), World Federation of Chiropractic (WFC) Biennial Congress —2018
• National Chiropractic Mutual Insurance Company (NCMIC) Foundation Educational Fellowship Award — 2018–2022
• Thelma Fordyce-Mack Award — 2018