Low back pain (LBP) is one of the most common and costly problems in the world today [1]. While it is not the sole reason people choose to seek Chiropractic care, it is the most common [2, 3]. Most Chiropractors recommend maintenance care (MC) after the resolution of a patient’s primary complaint [4] and is generally offered as a secondary or tertiary prevention strategy.
Until recently, empirical evidence investigating the effectiveness of MC was scarce. The alternative to MC is to discontinue care and instruct the patient to schedule a new visit when they experience a new episode of pain or when the patient perceives a need (symptom- guided treatment). In other words: one is controlled by the doctor (maintenance care), the other is controlled by the patient (symptom-guided treatment). So, which is more appropriate? Let’s look at the evidence!
This article examines the outcomes of a pragmatic randomized controlled trial that investigated the effectiveness of MC for patients with recurrent or persistent low back pain. The study compared MC to symptom-guided treatment with regard to the total number of days with bothersome LBP over 52 weeks, the prevalence of days with pain per week over time, and the total number of treatments.