Chiropractic Treatment Program Guidelines

Depending on the nature and extent of the specific back problem, a few visits to the chiropractor should help the patient feel noticeably better.

    As a general rule, within 1 to 4 weeks of starting a chiropractic treatment program for non-complex musculoskeletal conditions, the patient should typically feel a 40% to 80% reduction in pain.

The frequency of visits to the chiropractor should decrease as the patient's pain and function improve.

Common Chiropractic Program Plans

Good chiropractors do everything in their power to help their patients feel better as fast as possible with as few chiropractic treatments as necessary, ultimately reducing care to an as-needed follow-up plan.

They also give advice on how to avoid future problems by evaluating lifestyle activities, ergonomics, posture, orthotics, and/or diet. Proactive recommendations include exercises and stretches; ergonomic tools like back supports, belts, or pillows; home rehabilitation tools like foam roller, elastic bands; orthotics; and/or dietary support.

    In general, in the absence of progressive worsening of a condition during chiropractic care, a common chiropractic program is 3 times per week for 2 to 4 weeks, followed by a re-evaluation.

If improvement is noted, a tapering of treatment frequency is appropriate while introducing self-help, home-based recommendations as noted above. With an absence or plateau in improvement, treatment should be changed or other therapy options introduced.

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Chiropractic Treatment Program Questions

Questions to ask about the specific chiropractic treatment for back pain or other symptoms may include the following:

  • What is the chiropractor's typical practice pattern or treatment program?
  • What chiropractic services does the chiropractor offer? Some chiropractors offer additional services, such as massage, exercise instruction, rehabilitation and strength training, and nutritional counseling.
  • What is the chiropractor's recommendation if the treatment program doesn't seem to help? A good chiropractor will recommend that the patient consult another practitioner, particularly if other methods of treatment (such as medications or surgery) are indicated.
  • Has the chiropractor ever referred any patients to other health professionals? If yes, under what circumstances? Ask for case examples.

Potential Red Flags about Chiropractic Treatment Programs

There are a few elements of chiropractic treatment programs that most chiropractors agree are questionable. Examples include:

  • Manipulation of symptom-free areas of the spine. As a general rule, a chiropractor should not manipulate areas that do not have symptoms. For example, a chiropractor will not manipulate the patient's neck if the patient has a lower back problem.
  • Pressure to purchase nutritional supplements exclusively at their clinic. Patients should not feel obligated to purchase supplements from their chiropractors. A reputable chiropractor who recommends nutritional supplements will first give their patients information to review and the option to purchase them from a variety of sources.
  • Treating all patients the same. It is advisable for patients to avoid practitioners who tend to find the same thing wrong with every patient and treat every patient with the same treatment program.
  • Continued treatments after symptoms have resolved. Most chiropractors have the goal of decreasing their patient's pain level with as few visits as possible. Patients should be aware that the chiropractic standard of care is to discontinue treatment after the patient's symptoms have been addressed.
  • Long-term treatment programs. Patients should be cautious if a chiropractor recommends a lengthy (e.g., a 3-, 6-, or 12-month) chiropractic program after just 1 or 2 consultations. The majority of patients will find pain relief within several weeks of treatment, and if not, then another treatment approach - possibly by a different health provider - is likely warranted.

The bottom line for patients is to exercise their judgment in choosing a good chiropractor, as they should when choosing any type of health care practitioner.

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