Most chiropractors build a first keyword list the same way: they sit down and guess. "Chiropractor." "Back pain." "Spine adjustment." It feels thorough. Then the account runs for a month and the search terms report fills up with phrasings nobody thought of, and a few nobody wanted.
There's a better starting point, and it's sitting in plain view. The practice down the road has a website full of service pages, condition pages and location pages, written for the same patients you want. Google will read that site and turn it into a list of real searches with real volumes. This chapter walks through doing exactly that, then cleaning the list until only patient searches are left.
Google's Ad Preview Tool Shows Which Chiropractors Advertise Near You Without Costing Anyone a Click
Before building a list from a rival's site, find out which rivals are worth reading.
The obvious move, searching Google on your phone and tapping the ads you see, is the wrong one. Every tap costs that practice money and puts a fake click in their data. The better route is Google's Ad Preview and Diagnosis tool, found in the Tools menu of your Google Ads account. Enter a search like "chiropractor near me" and it draws the results page, ads included, the way a searcher would see it. Google says previews like this don't count as impressions, so no practice pays for your curiosity.
Run a handful of searches through it for your own town: "chiropractor near me," "chiropractor [your town]," and two or three conditions you treat. Note which practices show up in the ads repeatedly. Those are the sites to read next. Pick two or three that keep appearing, ideally practices that treat the same conditions you do and serve a similar mix of patients. A sports-and-rehab clinic's site will hand back different searches than a family wellness office's, so choose the rivals whose patients you'd actually want. In our experience, national chains' sites are built around their brand and membership plans more than condition pages, so local practices usually make better seeds.
Keyword Planner Turns a Rival Chiropractor's Website Into Hundreds of Real Searches
Keyword Planner is Google's research tool inside Google Ads, and one of its starting options is a website. Type in the address of a practice you saw in Ad Preview, narrow the location to the towns your patients drive from, and the tool scans that site's pages. What you get back reads like that practice's menu translated into patient language: hundreds of searches, how often each one happens, and roughly what advertisers paid to show for it.
We did this for twelve chiropractic practices that advertise in our example market, Baltimore. Each site came back with hundreds of ideas. Your own market will produce different searches and volumes, but the shape of the results is likely to look similar.
A note on the bid ranges. In our experience, they're a rough guide rather than a forecast, and we treat them as plus or minus about 30%. They're good for telling a $3 search from a $15 one, not for promising the bookkeeper an exact monthly spend; Chapter 3 handles the budget.
Keyword Planner Reads Your Own Chiropractic Site and Shows What Google Thinks You Treat
Then feed Keyword Planner your own practice's address. What comes back is Google's read on what your website says you do, and it can be humbling.
The results vary a lot by how a site is written. For six of the twelve example sites, between 86.6% and 91.7% of the ideas Keyword Planner returned were chiropractic searches. For three others, the share was much lower, from 4.2% to 34.7%, because the tool filled their lists with general symptom searches like "sciatic nerve pain" and "carpal tunnel symptoms." Those sites had plenty of content about conditions and much less that tied the conditions to chiropractic care.
If your own site comes back looking like the second group, it's a sign your condition pages talk about the problem without saying clearly what your practice does about it. That matters for keywords, and it matters for the landing pages from Chapter 4.
Four in Ten Keyword Ideas Are Symptom Lookups, Not Patients Looking for Care
Across all twelve pulls, Keyword Planner returned 6,380 unique ideas. Of those, 2,548, about 40%, were bare symptom lookups: "sciatic nerve pain," "sciatic nerve tenderness," variations on carpal tunnel. A few have large volumes, nearly all have tiny bids, and the people typing them want to understand what's wrong, not book an appointment (Chapter 2 explains why that matters for a new account).
Keep the line clear between two kinds of condition search:
- Condition plus care: "chiropractor for pinched nerve," "back pain chiropractor," "chiropractor near me for sciatica." These belong in your ad groups.
- Condition alone: "sciatic nerve pain," "lower back pain." These stay out at launch.
Exact match, which every launch ad group uses, already keeps most condition-alone searches from triggering your ads. Sorting them out of the list keeps your ad groups clean when broad match arrives later (Chapter 6).
Chiropractic School and Salary Searches Draw 27,510 a Month. They Belong on the Negative List.
The word "chiropractor" has a second audience: people who want to become one. Keyword Planner's US figures for those searches are large:
- "chiropractic school": 8,100 searches a month
- "how much do chiropractors make": 6,600, with top-of-page bids reaching $26.44
- "how to become a chiropractor": 4,400
Counting the strict job, salary, school and board-exam searches together, it adds up to 27,510 a month in the US. None of those people need an adjustment, and some of their searches carry higher bids than your patient searches do.
Build a negative keyword list from day one with words like school, salary, make, become, jobs, career, degree and board exam. Negatives are fairly literal. Google says they automatically handle capital letters and misspellings, but not synonyms or singular and plural forms, so add each version you want blocked.
Keyword Planner Hands Back More Than 100 Rival Chiropractors' Names, and Every One Is a Wasted Click at Launch
Seed a tool with a competitor's website and it hands you their name. Across the twelve pulls, more than 100 ideas were the names of specific practices, chains and doctors: local clinics, national franchises, hospital systems and individual chiropractors. The most searched of those names in the twelve pulls was "the joint chiropractic near me" at 320 a month.
Someone searching a specific practice's name is looking for that practice. Paying for their click at launch, when every dollar should go to people still choosing, is a poor trade. Add rival names to your negative list as they appear.
Bidding on a competitor's name on purpose is a different decision. A practice that ever tries it should give it a separate campaign and budget, and should think hard first. It isn't part of building the first account.
A Chiropractor Who Takes Insurance Wants the Insurance Searches. A Cash Practice Doesn't.
Some words look like junk and aren't. Insurance is the clearest case. Searches like "chiropractor that accepts medicaid" (2,900 a month in the US) and "chiropractor that takes insurance" (1,300) are people trying to find a practice their plan covers. A practice that takes their plan should want those searches. A cash-only practice should exclude them.
"Free" works the same way. Searches for a free chiropractic consultation are tiny in Keyword Planner, 10 a month or less for each phrasing. But five of the twelve example practices offer a free consultation on their websites, and for them, someone searching for one is a fair lead. A practice that doesn't offer one should block the word.
The rule is to decide on purpose. "Cheap" goes on the negative list by default. Insurance, Medicare and Medicaid go on it only if your practice doesn't take them, and "free" only if you don't offer a free consultation.
Twenty Keywords in One Ad Group Hide Which Chiropractic Search Brings the Patients
With the list cleaned, sort what's left into ad groups by condition and service, the structure from Chapter 4. A back pain group. A sciatica group. A neck pain group. A "chiropractor near me" group for the general searches. Five or six closely related searches in each is enough.
Every keyword goes live on exact match at launch, inside the Isolation campaign (our name for the first campaign: exact match only, bids set by hand). Exact match means each keyword reports its own clicks, cost and patients, so after a few weeks you can see which searches book and which don't. Stuff twenty keywords into one group and that answer disappears into an average.
Two more pieces finish the build:
- Your own name goes in its own campaign. In our experience, searches for your practice and doctors' names are cheap, and they come from people who already know you. Keep them separate so they don't flatter the numbers for everything else.
- The negative list starts now and never stops. Career words, rival names and any payer you don't serve go in on day one. Once Exploration starts, with broad match finding new phrasings every day, reviewing search terms and adding negatives becomes a daily job for the first month (Chapter 6).
If you'd like a hand building the first list, our Google Ads agency team does this research for every new account.
Next: A Quarter of Chiropractic Searches Name the Pain, Not the Chiropractor
Exact match covers the searches you can list. Chapter 6 picks up the searches nobody could list in advance, the endless phrasings of a sore back or a stiff neck that never mention a chiropractor, and the broad match campaign that goes after them once tracking has data. Every chapter so far, from Ad Rank back to tracking, is on the Google Ads for Chiropractors guide home.
