The Element of Time

There's a brand-new study, due to be published in the prestigious journal Spine, entitled Does maintained spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome? It has been repeatedly demonstrated that chiropractic adjustments positively impact injuries in the short run, but there has been a lack of research regarding long-term care. Many chiropractic patients continue to visit their chiropractor once a month, even after the acute phase of their injury is over, but do those infrequent visits do any good?

The answer is a resounding yes. This particular study used three groups of patients: a placebo group, another group which received 12 visits during four weeks of care, and a third group which received those same 12 visits plus additional follow-up care on a biweekly basis.

As expected, the two groups who received adjustments noted marked improvement over the placebo group. But, interestingly, over a ten-month period of time, the group which only received initial acute care failed to maintain their gains in function and reduced pain. In fact, by the end of the study, that group had backslid to their initial pre-treatment pains! In other words, they would have had to undergo a whole new course of acute treatment in order to gain relief again.

In contrast, the "maintenance care" group which continued to receive biweekly adjustments not only maintained their post-acute treatment status regarding pain, they continued to improve over time. To quote the article abstract directly: "To obtain long-term benefit, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy."

There is a wise adage regarding health and wellness: "If you're not moving, you're dying." Your body is going to continue to improve, or it's going to decline. The body, being a dynamic being full of life and vitality, never remains static. Just as the best exercise is regular exercise, so the path to health is marked by regular intervals. The study participants who failed to continue their adjustments also failed to continue their health improvements. This is a very important study, and I hope that further studies are pursued on this issue to confirm these findings. Time is sometimes a cruel mistress, but at least she's a predictable one.

The good news for patients is two-fold: 1) it is much easier to maintain or improve an already healthy nervous system than to attempt to repair or restore an injured one; 2) maintenance or wellness care is usually much less expensive in the long run than recurrent episodes of aggressive care for the acute patient.