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I have a website that is much better optimized than its competitors, but the competitors rank much higher for the keywords I'm going for!

This site: https://carlsbadchiropractic.com/ Has errors and all sorts of issues but it ranks in the top 10 for all the keywords I'm trying to rank for in Carlsbad, CA. chiropractor, chiropractic, carlsbad chiropractor, and chiropractor near me. My site: https://www.gohlclinic.com is much better optimized for a year now and it still ranks extremely low for these keywords. Not to mention, I was #1 for chiropractic and then it suddenly dropped to #97 and all I did was optimize some images. It's now back up to #17 but I'm seriously confused.

Does anyone have any thoughts on this? I'd really appreciate it.

Thanks for your response.

1. I was ranking #1 for "chiropractic" in Carlsbad CA. I made some simple updates, optimized images etc... and it dropped to 97 and then back up to 3 and then down to 17. I'm also trying to rank for carlsbad chiopractor, chiropractor near me, and chiropractor.

2. There are no other chiropractic clinics very close to me but it's a small town and there are quite a few competitors.

3. No, I haven't built any duplicate listings or paid anyone for reviews. I also started a PPC campaign. Oh, and I published a blog entry.

4. I updated some plugins and optimized images...and I changed the layout of a few pages but that's it. The drop was in organic rankings.

Question: Does traffic to my blog posts help my rankings on my homepage seeing as it's a different page even though it's on the same domain?

Question: Is it realistic to try to rank for 4-5 keywords for my homepage? I should I be happy if I just rank for one?

Thanks again, I appreciate your input.

Thank you Miriam for your response. A couple of follow up questions. What would you recommend I do about the high spam score? Disavow links with a score over a certain %?