Maintenance chiropractic care, does the research support it or does it vilify it?

We all want to have healthy backs. They allow us to perform various physical activities, as well as engage in various fun, social tasks, such as lifting and playing with our children and grandchildren. When we get acute or chronic back pain, this could literally put a hamper in our mood and severely limit our activities of daily living.

Most people are aware that a chiropractor can assist with acute low back pain, and greatly reduce or eliminate such pain with one or a few spinal manipulations. Yet how do we ensure that the pain does not return and that we are able to live a fulfilling lifestyle in short, as well as in the long run?

At PRI clinic, we are all about evidence-based medicine.

Recently, a Spine scientific journal has published an interesting research, which described a single blinded placebo study that specifically wanted to assess whether spinal manipulation therapy for chronic nonspecific low back pain could result in better long-term outcome.

The researchers wanted to assess the effectiveness of spinal manipulation therapy (SMT) for the management of chronic nonspecific low back pain (LBP) and to determine the effectiveness of maintenance SMT in long-term reduction of pain and disability levels associated with chronic low back conditions after an initial phase of treatments.

Sixty patients, with chronic, nonspecific LBP lasting at least 6 months, were randomized into 3 groups:

First group received 12 treatments of sham SMT over a 1-month period.

Second group received 12 treatments, consisting of real SMT over a 1-month period, but no treatments for the subsequent 9 months

Third group received 12 treatments over a 1-month period, along with “maintenance spinal manipulation” every 2 weeks for the following 9 months.

To determine any difference among therapies, pain and disability scores, generic health status, and back-specific patient satisfaction were measured at the initial assessment and at 1-, 4-, 7-, and 10-month intervals.

Patients in second and third groups experienced significantly lower pain and disability scores than first group at the end of 1-month period. However, only the third group that was given spinal manipulations (SM) during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation. In the non-maintained (2^nd) SMT group, however, the mean pain and disability scores returned back near to their pretreatment level after 2 months of non-treatment.

This showed that SMT is effective for the treatment of chronic nonspecific LBP. However to obtain long-term benefit, this study suggests spinal manipulation maintenance after the initial intensive manipulative therapy.