“Patients in the second and third groups [that received spinal manipulation therapy] experienced significantly lower pain and disability scores than the first group [placebo 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 SMT group, however, the mean pain and disability scores returned back near to their pretreatment level.”

Conclusions: “Spinal Manipulation Therapy is effective for the treatment of chronic low back pain. To obtain long-term benefit, this study suggests maintenance spinal manipulation after the initial intensive manipulative therapy.”

CLINICAL IMPORTANCE

After one month of acute care (3x/wk for 4 weeks) spinal manipulative therapy elicited significant improvements in pain, functional ability, and quality of life compared to placebo.

However, only the group that received maintenance care (1x/2wk) not only maintained, but increased mobility, comfort, function, and quality of life as time under maintenance care progressed over the 10 months.

The group that did not receive maintenance care not only failed to see any increased benefits, they lost the improvements they had made during the first month of acute care; they lost their investment of time and money!

CLINICAL IMPLEMENTATION FOR PATIENT RESULTS

A maintenance chiropractic care program consisting of care every 2 weeks not only prevented relapse and a waste of initial investment, but paid huge dividends in continued improvements!

Every patient deserves this information so that they can make an informed decision regarding their care. Maintenance care should be seen by both patient and clinician as much more of an investment than a cost.

The real cost is seen when maintenance care is not invested in and the benefits of acute care, and the increased benefits of maintenance care, are lost.