By Dr. David Graber
A systematic review of the studies on chiropractic maintenance care came out this month in the journal Chiropractic and Manual Therapies. While there have been a few previous reviews, this latest one was able to better describe more fully the concept of maintenance care in the research literature and to report on its clinical usefulness.
Some of the findings:
- Maintenance care was defined as a type of prolonged care delivered at regular intervals. It was described by chiropractors as a preventive approach, aimed at preventing new episodes and maintaining improvement of a patient’s condition.
- Patients surveyed stated that the purpose of maintenance care was to prevent recurrences (78%), to remain pain-free (68%), with a few patients (17%) taking the holistic view of wellness and general disease prevention.
- Across the Nordic countries, around 30% of chiropractic patients are maintenance care patients. When it is provided, visits are usually scheduled between one and three months.
- Among the studies reviewed, the results were mixed on outcomes. Some showed patients on maintenance care had better outcomes and less “bothersome days” of back pain than those who received short-term treatment, short-term sham treatment, or “call as needed” management. Neck pain patients reported better outcomes with long-term maintenance care than back pain patients.
- Maintenance care can clearly be said to be used as a preventive therapy and chiropractors in the role of “back pain coaches.”
- Back pain is a chronic disease for most, with episodes at short or long intervals. As such, it makes sense to use a preventive approach such as maintenance care.
References: Iben, A., Lise, H. & Charlotte, L. Chiropractic maintenance care – what’s new? A systematic review of the literature. Chiropr Man Therap 27, 63 (2019) doi:10.1186/s12998-019-0283-6
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