Maintenance Chiropractic for Chronic Low Back Pain


When people think of chiropractic, they immediately think of low back pain and are often surprised to find out that chiropractic can benefit many conditions such as carpal tunnel syndrome, tennis elbow, headaches, rotator cuff tears, as well as hip, knee, and ankle conditions. There is also research support for manipulation (a key component of chiropractic) and its role in managing “somatovisceral” related conditions such as pneumonia, dizziness, stage 1 hypertension, PMS, asthma, colic, and bed wetting.


Research clearly shows that chiropractic manipulation outperforms other forms of treatment for acute, subacute and chronic low back pain. But, the question remains, can “maintenance chiropractic” PREVENT problems down the road? In August of 2011 , two medical doctors published an article in a leading medical journal (SPINE) entitled, “Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?” The study’s objective was to determine if treating chronic low back pain patients (pain > six months) after a course of twelve treatments in the first month would do better, the same, or worse if treatments were continued at two-week intervals for an additional nine months. They compared three groups of patients: 1.) Twelve treatments of “sham” (placebo) manipulation over a one-month period. 2.) Twelve treatment of “real” spinal manipulative therapy (SMT) for one month but no treatments for the subsequent nine months. 3.) The same as #2 but with treatments every two weeks over the next nine months. To determine the differences between these three groups, the authors measured pain and disability scores (using questionnaires), generic health status (questionnaire), and back-specific patient satisfaction (questionnaire) at 1, 4, 7 and 10-month intervals.


The results showed that groups 2 (SMT for one month only) and 3 (SMT for one month + every two weeks for nine months) had significantly lower pain and disability scores than the 1st group (sham/placebo group) at the end of the 1st month or 12 visits. However, only group 3 (treatments were continued for nine months at two-week intervals) showed more improvement in pain and disability scores at ten months. Equally important, the scores for the non-maintained group 2 patients returned to near their pre-treatment levels by month 10!


The authors concluded that not only is spinal manipulative therapy effective for chronic low back pain, but more importantly, REGULAR ADJUSTMENTS EVERY TWO WEEKS after the initial course of concentrated care (3x/week for 4 weeks) were needed, “…to obtain long-term benefit,” suggesting that, “…maintenance SM after the initial intensive manipulative therapy,” is appropriate care to obtain long-term results.


This study FINALLY supports the recommendations made by chiropractors for many years that regular adjustments are beneficial to obtain a higher quality of life, less pain, and less disability!

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