More often than not it’s an episode of severe pain which brings patients to the Chiropractor for the first time. While we see many patients with persistent pain, such as low back pain – nine times out of ten our first job is to take care of sudden back, neck or shoulder pain which is getting in the way of everyday life. Because of this, most patients forget that chiropractic care is much more than just a way to deal with initial pain – in fact it is a comprehensive suite of methods which, when used correctly, are also a great way to maintain health and ward off pain going forward. This week, we look at the importance of maintenance care.
Why is maintenance care important?
Ask any chiropractor and they will tell you that treating the condition which brings a patient to their clinic is only half the battle. From the patient’s perspective, relieving the pain they are experiencing in the here and now is often the only thing on their mind – and with so many of us suffering from chronic and often severe pain, that’s no surprise… but there’s a problem with this view! It’s important to realise that usually it’s not actually a sudden injury which brings people to the chiropractor – instead that sudden event is just the latest symptom in a long line of problems. Common issues such as untreated injury, poor posture, muscle imbalance or just overdoing it at work or in the gym all eventually catch up with us, usually in the form of pain or discomfort.
No matter what the problem is, it’s no good to simply treat the pain and carry on with the destructive behaviors which caused it in the first place – instead you need to swap your old routine for a healthier new one – and that’s where maintenance care comes in.
What is maintenance care?
At Complete Chiropractic we like to think about our course of care as a “pathway to health” – in the initial stages, patients are very often in severe pain which is having a significant impact upon their daily life. The first objective is therefore to treat the immediate condition and reduce the pain. How long this process takes will depend upon the cause of the issue and the severity of the problem, but eventually the initial problem will have been reduced enough that normal life is once again possible. While initial treatment might be every few days, after your condition is under control treatment might be just once or twice a week.
Once you are well on the road to a full recovery it’s time to think about maintenance care. Whereas your initial care aims primarily to reduce pain and improve quality of life, maintenance care is aimed at addressing the underlying problems which led you to the chiropractor in the first instance and stopping them from reoccurring. Maintenance care will certainly include your usual chiropractic treatment, but might also involve an individual exercise program, postural improvement, chiropractic biophysics mirror image treatment and any relevant lifestyle advice. At Complete Chiropractic we also offer complementary services, such as sports therapy and massage which may be of considerable benefits to clients who are at risk of injury, such as sportsmen or those involved in physical jobs.
How effective is maintenance care?
Compared with primary care, the effectiveness of maintenance care can be more difficult to establish – after all, the objective of maintenance care is to prevent injury and pain from reoccurring, so if maintenance care is successful a patient will have nothing of interest to report in the first place!
This point notwithstanding , an alternative way of looking at the outcome of maintenance care is to look at patients suffering from long term conditions, such as low back pain, which can often take longer to resolve. A recent study did just this and tried to establish how effective maintenance care was for reducing chronic lower back pain after initial treatment.
During the study, 328 patients with recurrent and persistent Low back pain who responded well to an initial course of chiropractic treatment, were provided with ongoing maintenance care. The results showed that the maintenance care provided a reduction in number of days with bothersome low back pain per week. In total, the maintenance care group had on average 12.8 fewer days with bothersome LBP over 12 months, when compared to a control group. What’s more, the number of visits to the chiropractor in this study was quite low – an average of just 1.7 over the 12-month period. Imagine how many days of pain might have been avoided with a weekly or bi-weekly visit!
 Rupert RL. A survey of practice patterns and the health promotion and prevention attitudes of US chiropractors. Maintenance care: part I. J Manipulative Physiol Ther. 2000;23(1):1–9. pmid:10658870
 Bringsli M, Berntzen A, Olsen DB, Leboeuf-Yde C, Hestbaek L. The Nordic Maintenance Care Program: Maintenance care—what happens during the consultation? Observations an
 Rupert RL, Manello D, Sandefur R. Maintenance care: health promotion services administered to US chiropractic patients aged 65 and older, part II. J Manipulative Physiol Ther. 2000;23(1):10–9. pmid:10658871
 Andreas Eklund et al. The Nordic Maintenance Care program: Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain—A pragmatic randomized controlled trial. PLoS ONE 13(9)