Traditionally, chiropractic care is most commonly rendered for a finite amount of time, usually until the symptoms that initially drove the patient to seek out care resolve. However, some patients find that periodic chiropractic treatments make them feel better and improve their sense of well-being.
Three basic methods of chiropractic care exist: 1) acute care, 2) supportive care, and 3) maintenance care.
Acute care is considered “medically necessary” as the patient is typically in a lot of pain and unable to self-manage it. Although most patients choose short-term pain relief care, other types of care focus on functional improvement and the prevention of future episodes. By the conclusion of the first month, the patient can frequently get along independently and is released. Some may need additional care, perhaps once a week to every two weeks for a few visits (depending on the case). The patient may also receive nutritional counseling to help reduce inflammation and education regarding proper bending, lifting, pulling, and pushing methods. At discharge, many of these patients are typically treated on an “as needed” basis when they cannot properly manage their condition with what they’ve learned.
Supportive care is treatment rendered periodically, usually at similar time intervals (such as every 2, 3, 4, 6, etc. weeks) when the patient's prior experience proves that waiting longer results in an acute exacerbation. This type of care is not for most patients as it's primarily used for chronic, permanent conditions.
Maintenance care is elective and rendered as a preventative measure, “…to keep a healthy individual healthy.” Typically, insurance policy language excludes payment for supportive and maintenance care.
In a recent study, patients with chronic low back pain (LBP) who received regular treatments every two weeks for a total of ten months scored the best in regards to pain and disability after ten months when compared with two other treatment groups that did not receive “maintenance care.” For patients in the groups that did NOT receive chiropractic care every two weeks, the researchers reported their pain and disability scores gradually worsened back to pre-treatment levels during the course of the study. Another study searched the literature to develop a framework for future research on maintenance chiropractic care (MCC) purposing the following benefits: MCC optimizes the levels of function and provides a process for achieving the best possible health, which is accomplished through spinal manipulation, exercise training, diet and nutritional counseling, and lifestyle coaching. By improving joint motion, spinal manipulation may retard the degeneration arthritic process, stimulate neuronal changes improving muscle strength and recruitment patterns (which may result in improved function), decreased injury episodes, and improve a patient's sense of well-being.
