Maintenance Care

People go to see a chiropractor for many different reasons.1 Some go because they want help with back pain, or neck pain, or headaches…some go because they want to perform better on the sporting field or athletics track… some want to sleep better or be better able to deal with stress… but you might be surprised to know that almost 50% of chiropractic patients go to see their chiropractor because they simply want to maintain their health and well-being! This is what chiropractors call maintenance care. The idea with maintenance care is that regular adjustments will help maintain your spine and nervous system function at its optimal level and help you to be your best and to prevent new episodes of pain developing.2

So, what does the research tell us about maintenance care? Well, it tells us that maintenance care makes perfect sense if you want to function at your best. We know that if your brain doesn’t send appropriate protective messages to your core trunk muscles you will have a higher risk of developing low back injuries.3This makes sense because a lack of core stability means you’re basically creating mini whiplash injuries to your spine each time you move around or lift your arm or leg. So, if you end up in pain after bending down to tie your shoelaces your pain has not just come out of the blue, it has usually been developing for some time without you knowing about it. It’s often the thousandth straw that break the camel’s back. All of life’s stressors can build up and impact the way your brain is communicating with your trunk muscles and then all that is needed is one last minor thing to go wrong and you end up with pain or other symptoms. The goal of maintenance care is to help take the straws off your camel’s back before they cause symptoms or have a big impact on your life.

A study published by researchers from Sweden in 20184 showed the benefits of maintenance care in a group of people who suffered from low back pain. In this study the researchers followed 328 patients with low back pain who went to 40 different Swedish chiropractic clinics. If the patients responded well when they were first adjusted they joined the study and either received chiropractic maintenance care over the next year or symptom-guided care. The maintenance care patients were seen every 1 to 3 months with the intention being that they were checked before substantial pain reoccurred. Patients in the control group were told to call if and when pain recurred. They were then adjusted until they got better, and they were told to call again if the pain returned. What the researchers were most interested in was the number of days of bothersome back pain suffered by each group throughout the 1-year trial period.

What they found was that the maintenance care group experienced 13 fewer days of pain over the course of the study on average compared to the symptom guided group. The amazing thing from this study was that the maintenance care group needed less than 2 extra visits to their chiropractor over the course of a year to have 13 fewer days of pain. This suggests that patients who have had low back pain, who respond well to care, should see their chiropractor regularly, irrespective of whether their symptoms have returned or not. This study did have some limitations of course. One limitation was that chiropractors were told not to schedule their maintenance care patients more frequently than once a month. So some patients in this group may have benefitted even more if the chiropractors had been able to schedule their visits more frequently if they thought that was a good idea.

This study shows that it’s really important to keep your spine working well, even if you don’t have pain or symptoms. So if you want to function at your optimal potential consider chiropractic maintenance care because the research suggests your spine will love you for it!

1. Adams J, Peng W, Cramer H, et al. The Prevalence, Patterns, and Predictors of Chiropractic Use Among US Adults: Results From the 2012 National Health Interview Survey. Spine (Phila Pa 1976) 2017;42(23):1810-16.

2. Leboeuf-Yde C, Hestbæk L. Maintenance care in chiropractic – what do we know? Chiropractic & Osteopathy 2008;16:3-3.

3. Cholewicki J, Silfies SP, Shah RA, et al. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine (Phila Pa 1976) 2005;30(23):2614-20.

4. Eklund A, Jensen I, Lohela-Karlsson M, 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 2018;13(9):e0203029.