Clinic Ad Index, October 2026: What 231 PT and Chiro Clinics Are Advertising

Data collected October 25, 2026 from the Meta Ad Library. Sample: 231 clinic advertisers and 949 active ads. 199 of those advertisers (838 ads) could be placed in one of 18 US metros. Every figure below comes from that one collection run, and every count is a minimum, because the Ad Library only shows what a search can find on one day.

What does the Clinic Ad Index measure?

The Clinic Ad Index tracks what physical therapy and chiropractic clinics actually put in front of patients on Meta: how many lead with a price, what that price is, how many offer something free, which conditions and devices they name, and how long their ads stay live. It is collected monthly with a fixed method so the numbers can be compared edition to edition. This is the October 2026 edition, the first.

National numbers

Most common conditions named in headlines (number of advertisers): back pain 20, disc/spine/decompression 19, neck/headache/migraine 12, shoulder/arm 11, sciatica 11, knee 10, sports/running 9, pelvic/prenatal/women's health 9, neuropathy 8.

How does it break down by metro?

"Priced intro" counts advertisers with at least one priced first-visit offer. The price columns use each advertiser's lowest stated price. "Top advertiser share" is the share of a metro's ads that came from its single biggest advertiser; a high value means one clinic's ad volume skews that metro's counts.

The other 32 advertisers (111 ads) are US clinics we could not place in a metro. They count toward the national numbers only.

PT is under-represented in every metro. Searches pairing a city name with "physical therapy" mostly returned unrelated ads. The PT rows above come mainly from chiropractic-term searches and a few national PT searches.

Which clinic ads have run the longest?

One ad per advertiser, ranked by delivery start date. Days running are counted to October 25, 2026.

Just outside the top 10: Nokomis Chiropractic Community (Minneapolis), live since mid-July 2026. 21 of its ads have run 90+ days, all with the same bundled $39 exam, massage and adjustment offer.

Read this list with care. The Ad Library returns the newest ads first and caps each search at 50. Older ads only show up when a search returns fewer than 50 results. All 10 of these came from such searches (Seattle, Tampa Bay PT, Brooklyn). Longer-running ads certainly exist in the other metros; the October 1 study found a Dallas ad live since 2024. Treat this list as a floor, not a ranking of the oldest ads on Meta.

What are the findings?

1. A $49 first visit is the norm. 102 of 231 clinic advertisers (44%) led with a priced intro offer. Of the 101 that stated a price, 36 asked exactly $49 and 47 were between $47 and $49. Prices ran from $17 (a Charlotte chiropractor's full new-patient visit) to $149 (a Tampa Bay neck and headache evaluation).

2. Free offers have nearly disappeared from clinic headlines. Only 15 advertisers (6%) led with a free consult, screen, visit or discovery call. Priced intros outnumbered them about 7 to 1 (102 vs 15). Where "free" did appear, it was usually an add-on to a paid visit, such as "$47 exam + free adjustment."

3. PT clinics charge about twice as much for the first visit. The 10 PT clinics with a stated price had a median of $97. The 84 chiropractic clinics had a median of $49. PT offers were usually framed as an "analysis" or "assessment" for a body part or sport (runners, shoulders, hips). Chiropractic offers were usually a bundled exam, X-ray and adjustment. The PT sample is small, so treat this as directional.

4. About 1 in 14 clinics advertises in Spanish. 16 advertisers (7%) ran Spanish-language headlines, often alongside English versions of the same offer. Miami had the most (3), then Los Angeles (2) and New York (2). 11 of the 16 put a price or a free consult in the Spanish headline, for example a $29 special against a "regular" $75, or a $27 complete exam.

5. Devices are becoming the hook. 26 advertisers (11%) led with a machine or technique rather than a condition: shockwave or SoftWave, spinal decompression, laser, red light. 5 clinics used their ad budget on non-pain aesthetic packages (body contouring, LED fat reduction, facials) in Raleigh, Houston, Charlotte, Denver and San Francisco.

Also notable: most ads in this sample are new. The median active ad was 5 days old, and only 35 of 949 (4%) had run 90 days or more. That fits clinics constantly re-launching the same offer as fresh ads, but the newest-first sort inflates it (see Limits).

How was the Index collected?

Source. Meta Ad Library, queried through the Meta Ads connector's ad library search. Filters: country US, active ads only, up to 50 results per search. Collected October 25, 2026, 38 searches in total.

Searches. For each metro we searched the city name in quotes plus "chiropractic," e.g. "Austin" chiropractic. New York used "Brooklyn" and "Manhattan". We also searched the quoted city plus "physical therapy," along with three national PT searches: "dry needling", "pelvic floor" "physical therapy" and "cash-based physical therapy". Unquoted searches were tried first and dropped because they matched any word.

Identifying clinics. We kept a result only if the page was clearly a PT, chiropractic or closely related pain/neuropathy/spine clinic. We excluded product sellers and advertorial pages styled as news or a personal story; schools, staffing and hiring ads; equipment vendors and practice-marketing companies; med spas and IV clinics; animal chiropractors; and pages named after an individual person.

Placing clinics in metros. We assigned a metro when the page name or headline named the metro or a town in it, or when a quoted-city search matched the ad text. Clinics whose page name placed them elsewhere, and clinics with no location evidence, count toward national figures only. Franchise ads with generic headlines across many local pages were left unassigned.

Counting. Ads were deduplicated by Ad Library ID. Advertisers were counted by page name, with all The Joint Chiropractic franchise pages counted as one advertiser.

Classifying. Offer type, price and condition were classified from the ad headline (the link title), which is the only creative text the tool returns. "Save $X," "normally $X" and "$X value" figures were treated as anchors, not prices.

Limits.

• The tool does not return ad body text, images, video, format, platform, targeting, spend or results. Format mix and platform split could not be measured.
• Classification uses headlines only. An ad whose offer appears only in its body text is counted as "no offer in headline."
• Each search returns at most 50 ads, newest first. Busy metros are under-counted and long-running ads are under-sampled. All counts are minimums.
• Ad counts are skewed by clinics that run dozens of near-identical variants. One Miami clinic ran 47 ads and one Minneapolis clinic 39. That is why the headline figures use advertisers, not ads.
• PT is under-sampled: 29 of 231 advertisers. City-plus-"physical therapy" searches failed for Phoenix, Minneapolis and Seattle, so their PT coverage is effectively zero.
• "Cash-pay" positioning could not be measured. No headline used cash-pay language, and only 4 mentioned insurance.
• These figures are not directly comparable to the October 1 State of Clinic Advertising study, which used a different collection method and date.

Cite this

Clinic MarketingOS, Clinic Ad Index, October 2026. Analysis of 949 active Meta ads from 231 US physical therapy and chiropractic clinic advertisers across 18 metros, collected from the Meta Ad Library on October 25, 2026. clinicmarketingos.com/benchmarks/clinic-ad-index

Short form: Source: Clinic MarketingOS Clinic Ad Index, October 2026 (clinicmarketingos.com/benchmarks/clinic-ad-index).

The next edition is collected in early November 2026 with the same 38 searches.