If the patient's symptoms do not improve within 2 to 4 weeks of chiropractic manipulation, then other treatment possibilities beyond a chiropractic program should be explored.

For example, there may be:

  • Another mechanical problem that has been overlooked and the chiropractor should try treating a different spinal area
  • Repeated ergonomic stress that reproduces the patient's pain. Ergonomic suggestions should be addressed
  • A complicating condition that may need further diagnostic evaluation or may benefit from another form of treatment besides the current chiropractic program

It is not uncommon to note mild discomfort after the initial manipulation treatment for the first 24 hours (similar to starting a new exercise). Beyond that, if the patient has pain during spinal manipulation and/or increased pain following the manipulation, then the chiropractor should stop doing that kind of manipulation and re-evaluate the treatment plan immediately.


Changes to Chiropractic Treatment Approaches

If the patient is not getting pain relief after the first 2 to 4 weeks of chiropractic manipulation, then a good chiropractor will typically consider other alternatives.

Typical changes that may be made to the chiropractic treatment plan include:

  • Treating a different spinal area
  • Changing the therapeutic/treatment technique for an additional 2 to 4 week trial period, followed by a re-evaluation
  • Co-managing the patient with other allied healthcare providers, such as a medical doctor, osteopathic physician, and/or physical therapist, or with a complementary medicine practitioner such as acupuncturist, massage therapist, or naturopath
  • Referring to another practitioner - either another chiropractor or other healthcare provider, or to an integrated spine clinic

A good chiropractor will usually have strong working relationships with other health professionals in their area, including spine surgeons, physical therapists, massage therapists, physiatrists, and pain management specialists.

Patients are well advised to look for a chiropractor who routinely coordinates patient care with these types of health professionals, either as part of an informal network - referring patients to other doctors and health professionals that they trust - or as a part of an integrated network or spine clinic.