A peer-reviewed study was published by PLOS ONE on September 12, 2018, documenting that chiropractic maintenance care was more effective for reducing the total number of episodes of non-specific lower back pain (LBP) over a 52 week period than chiropractic symptom-guided treatment.
When it comes to chiropractic adjustments, patients have usually taken one of two approaches. One approach is known as corrective or symptom care. In this approach, the patient begins care with the purpose of decreasing or eliminating pain. Once the pain has been corrected, the care is discontinued until another episode of pain occurs and the patient seeks chiropractic care again.
The second approach involves the patient remaining under chiropractic care after the alleviation of pain. This approach is usually known as either wellness or maintenance care. Most chiropractors promote the continuation of care after symptoms have gone to either help prevent future episodes of pain, or to promote overall wellness.
This study specifically looked at the comparison of what researchers called “symptom-guided treatment” verses chiropractic maintenance care. The narrow criterion chosen for this comparison was to see if patients with “recurrent or persistent non-specific low back pain” had less future episode of their problem if they continued chiropractic care beyond the correction of their symptoms while under chiropractic care for their initial episode of lower back pain.
This study was a randomized controlled trial which included 328 patients between the ages of 18 and 65 who sought chiropractic for non-specific lower back pain and had a favorable response to the initial chiropractic care. The study was conducted between the years 2012 and 2016 from the offices of 40 participating Swedish chiropractors with clinics across Sweden.
After the initial chiropractic care, the patients were randomly selected be in one of two groups. One group would continue to receive chiropractic care on a maintenance basis, while the second group, known as the control group, would not receive any additional chiropractic care.
Each week for one year after the initial chiropractic care was completed, the patients in both the maintenance chiropractic group and the control group would send text messages to researchers about any “bothersome days” of lower back pain they may have experienced. The results of the study showed that the patients who continued to receive chiropractic care on a maintenance basis experienced statistically fewer days of bothersome lower back pain over the next year than did the patients in the control group. As expected and reported by the researchers, those patients under chiropractic maintenance care received more chiropractic visits than those in the control group.
In their conclusion the researchers reported, “MC (maintenance care) was more effective than symptom-guided treatment in reducing the total number of days over 52 weeks with bothersome non-specific LBP but it resulted in a higher number of treatments. For selected patients with recurrent or persistent non-specific LBP who respond well to an initial course of chiropractic care, MC should be considered an option for tertiary prevention.”