Today we want to discuss how often should you see a chiropractor. The problem is that Singapore chiropractors are telling people they need to come for 40 or 80 sessions. But is this true?
What is in a chiropractic treatment?
The first thing to understand is what is in a chiropractic treatment.
Most people think chiropractic treatment is all about adjustments. This is not true.
Chiropractors are trained in a variety of techniques and treatment modalities from chiropractic adjustments (also known as spinal manipulation), dry needling, soft tissue therapy, clinical rehabilitation, and other forms or physiotherapy or physical therapy such as ultrasound, electrotherapy, etc.
So, remember … chiropractors are not all crack-and-go.
Does chiropractic adjustments work?
I supposed if chiropractic adjustments do not work, it doesn’t matter if you were to get adjusted three times a week for the rest of your life. You won’t be getting any better.
We blogged about this at the seven hard truths behind a chiropractic adjustment so we won’t go into the details again.
TL;DR chiropractic adjustments provide SHORT-TERM improvement in pain and function. It works but just for the short-term.
What is the recommended “dose” of chiropractic adjustments?
Now if you want to know how often should you get a chiropractic adjustment, we can’t be absolutely sure because there isn’t much research looking specifically at the recommended dosage for spinal manipulation. Nonetheless, there are two trials that had looked into this.
The first study looking at how often should you get a adjusted found that low back pain sufferer who saw a chiropractor three to four times over a 3-week period experienced more pain relief than those who only went once or twice. In short, patients who went to the chiropractor nine or 12 times fared better than those who went only three or six times.
A second trial looking at the recommended dose for spinal adjustment was published in 2014. It compared four doses of care – no treatment, 6, 12, or 18 sessions of chiropractic adjustments. The paper found that 12 sessions over a six week period yielded the best improvement for both pain and functional impairment.
From what we know (as of today), 12 sessions seems like the magic number – way less than the 40-session packages Singapore chiropractors seem to be peddling!
Read: How Much Does It Cost To See A Chiropractor In Singapore
It should be noted that these studies did not offer a combination treatment group. Perhaps exercise WITH chiropractic adjustments could lead to shorter recovery times? After all, we do know exercise is first-line treatment when it comes to low back pain.
There IS Research to Support Regular Chiropractic Adjustments
Contrary to what most of us would think, there is hard science behind regular chiropractic treatment.
A 2011 study published in Spine (one of the world’s most prestigious journals) looking at the benefits of regular spinal adjustments separated sixty patients into three groups. First group received 12 sham spinal manipulation (think placebo) over 1 month, the second group received 12 treatments of spinal manipulation over 1 month, and the third group received 12 spinal manipulations over a month followed by maintenance spinal manipulation every two weeks for nine months.
Results? The third group (12 sessions of spinal manipulation plus maintenance spinal manipulation every two weeks) had more improvement in pain and disability scores at the end of ten months.
A bigger, higher quality paper (328 patients) published just this year found that patients who have undergone maintenance chiropractic care experienced 13 fewer days of bothersome low back pain compared to the control group. The average total number of chiropractic visits (over a year) in the maintenance group patients was just under nine! Pretty neat huh?
It should be note that in this study, patients received predominantly chiropractic adjustments but also other therapies including soft tissue therapy and exercise advice!
So if you are thinking you need regular chiropractic sessions to help with your lower back pain, there is some research to say that it does. Based on the 12 chiropractic session plus maintenance care every two weeks, a 40 session chiropractic page should be able to last you over a year!
What is the difference between symptomatic and maintenance care?
In symptomatic care, patients are treated based on their symptoms. This means you come in with pain somewhere in your body, your chiropractor uses chiropractic adjustments or a variety of treatment options to get you out of pain. Once your symptoms are gone, you are discharged from care. It is also referred to as sick care (i.e. the care you get when you are sick).
In maintenance care, however, patients are usually committed to a long-term care plan. This means patients regularly receives chiropractic adjustments, soft tissue therapy, stretching, and exercises even after their symptoms have resolved. The interval between visits can be as short as one week to a month. The treatment you received will largely based on what the chiropractor finds. For example, the chiropractor may decide you have some joint restrictions and proceed to perform a chiropractic adjustment. Maybe they think you have “tight” muscles and will use soft tissue techniques to “release” them. Maintenance care is also referred to as wellness care. Because you are still under care despite being well.
p.s. chiropractors (or physiotherapists or massage therapists) CANNOT accurately determined if your vertebra is out of place. We briefly mentioned this in Four Things Your Chiropractor Doesn’t Want You To Know.
Most chiropractors believe maintenance care visits can prevent future pain episodes through optimisation of spinal function. However, there is no agreement on the frequency of treatments required to achieve this.
How Often Should I See A Chiropractor?
Seeing a chiropractor regularly for as little as once every month (1.5 months to be exact) can significantly improve your long-term pain outcomes. While there is some research to support higher frequency of chiropractic treatments, more research needs to done to determine their cost-effectiveness.
How often should you see a chiropractor? We can’t be entirely sure. For now.
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