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Phase 4: Maintenance Care

I want to prevent future problems from occurring and old ones from returning.

Maintenance is Key to Healthy Living

Once your body has fully healed, routine chiropractic care can help ensure that your physical problems do not return, and keep your body in optimal condition. Just like continuing an exercise program and eating well in order to sustain the benefits of exercise and proper diet, you can decide for continuation of chiropractic care to ensure the health of your musculoskeletal system.

Chiropractic maintenance care is treatment received in order to prevent future pain or health problems, prevent a relapse, and to improve quality of life.  Maintenance care is elective, so that means that the choice is yours!!  When it comes to receiving maintenance care, chiropractic patients can be divided into three groups.

The first group of patients see the benefit of preventative care early on, and elect to receive maintenance care after they are helped through their first episode of pain.  These patients take a proactive stance on their health.

The next group of patients may decide that after experiencing three or four flare-ups of pain that they would rather not let their body get to that point again! They realize that they do not experience as much pain (or as many health problems) when they receive chiropractic care every 4-6 weeks (for example); regardless if they are experiencing pain at that point or not.

The third group of patients never elect to receive maintenance care, and typically stop care once they are feeling better.  They usually reserve going to the chiropractor only when they are in severe pain or when they are experiencing a crisis.  These patients take a reactive stance on health care.  While there is nothing wrong about this approach, it does limit the number of benefits that chiropractic care can provide them.  They use chiropractic for pain relief only. 

With all this being said, it is still the patient's decision to receive maintenance care.  We cannot, nor do we desire to force anyone into receiving treatment that they do not want.  We let our patients benefit from chiropractic as long as they want to.  However, our job is educate patients on all their treatment options so that they can make an informed decision about their health care.

Research shows that more regular chiropractic treatment can prevent degenerative changes ("arthritis") from developing.  There are many other benefits that patients report (anecdotal evidence) from receiving chiropractic care on an occasional basis, even if they are experiencing little to no pain. They are as follows:

  • Better sleep quality - many patients sleep longer and more soundly after an adjustment.
  • Better digestive health- many patients report less indigestion, heartburn, and bowel irregularity after a chiropractic adjustment.
  • Less colds, flus, and infections - chiropractic adjustments "heighten" the function of the immune system.
  • Less muscle spasms and numbness - normal moving spinal joints do not irritate muscles, or nerves as much.
  • Better athletic performance- symmetrical joint movement ensures that muscles do not have to strain in order to move a joint.  Ever wonder why Tiger Woods, Barry Bonds, Jerry Rice, Michael Jordan, or Lance Armstrong have a chiropractor?
  • Less anxiety- adjustments quiet down our body's "fight or flight" response to stress (attenuates the sympathetic nervous system).
  • Less headaches- many report less frequent headaches and migraines, and if one is experienced they are usually less severe.
  • Less severe allergies -many patients report increased sinus drainage after an adjustment and a lessening of allergy symptoms.
  • Less need for medication- Many chiropractic patients report using less medication after starting care. (Especially pain medication!).
  • Less medical doctor & hospital visits- many of our maintenance patients consider us as their primary care provider because they realize that chiropractic physicians can manage many common ailments.  If more care is needed, then a referral can be made when necessary. This has been researched and documented by many health insurance companies.
  • Better mental clarity- many report being able to "think better" after an adjustment.
  • Better circulation- Older patients or sedentary patients report feeling like they have better circulation after receiving treatment.
  • Easier to Breathe- patients often report that after an adjustment they can take a deep breath again.  Asthmatic patients often find that they have fewer attacks and use less medication when under chiropractic care.

Two research studies generated by the medical profession add evidence in support of the value of chiropractic maintenance care. 

The first study published in January 2011 in Spine concluded that “SMT is effective for the treatment of chronic non specific LBP. To obtain long-term benefit, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy.” 

The second study in April 2011, published in the Journal of Occupational and Environmental Medicine, provides additional support for the value of chiropractic maintenance care for post injury low back pain patients.  The study followed 894 injured workers for a period of one year.  During that year there were four different types of therapy available to the workers:  medical management, physical therapy, chiropractic, and no therapy.  Episodes of repeat disability were recorded during the year following the initial injury.  Physical therapy had the highest percentage of reinjured workers followed by those receiving medical management or no treatment at all.  The lowest incidence of repeat injury was found among those workers who had received chiropractic maintenance care. 


1. Does maintained Spinal manipulation therapy for chronic non-specific low back pain result in better long term outcome? Spine (Phila Pa 1976). 2011 Jan 17. Senna MK, Machaly SA. Rheumatology and Rehabilitation Department,Mansoura Faculty of Medicine, Mansoura University.

2. Health maintenance care in work-related low back pain and its association with disability recurrence. J Occup Environ Med. 2011 Apr;53(4):396-404. Cifuentes M, Willetts J, Wasiak R. From the Center for Disability Research at the Liberty Mutual Research Institute for Safety (Dr Cifuentes and Ms Willetts) and University of Massachusetts Lowell (Dr Cifuentes), Hopkinton, Mass; and Center for Health Economics & Science Policy at United BioSource Corporation, London, United Kingdom (Dr Wasiak).

3. Efficacy of Preventive Spinal Manipulation for Chronic Low-Back Pain and Related Disabilities: A Preliminary Study. J Manipulative Physiol. Ther. 2004 Oct; 27(8) pp. 509-15.Descarreaux M, Blouin J-S, Drolet M, Papadimitriou S, Teasdale N.