How often should you visit a chiropractor?

When you first see your chiropractor, you may be among the many people who ask, "How often do I need to come?" Often, the answer people want to hear is "once," but chiropractic care, like most things that are really good for us, rarely makes a long-term difference to your health and wellness after just one visit.

One reason a single visit to the chiropractor may not make a long-term change is that it usually takes years for the problem to develop, which motivates someone to first see a chiropractor, and it can take many visits to the chiropractor to correct that problem.

One way of looking at it is that it can be like the thousandth straw that breaks the camel’s back. A problem can build up day after day as you sit hunched over your desk, or bend and twist as you lift, or tense up as you deal with your daily stress, and then one day, you bend to tie your shoelaces, and all of a sudden, something hurts! You can rest assured that tying your shoelaces isn’t what caused the problem. It’s simply the thousandth straw that broke the camel’s back (or was too much for your back), and that’s why you’re in pain.

There will usually be changes to how the supporting muscles in your spine work that build up over time until your muscles can’t cope anymore and symptoms appear.1-2 So, seeing a chiropractor can be a little like going to the gym. It takes time, frequency, and follow-up. Work with you to correct the problem and help your brain and the muscles in your spine communicate or ‘talk’ with each other again to regain the stability you need to function properly and resolve your aches and pains.3

But how long will this take, and how often do you need to be checked by your chiropractor? Everybody is different, so your chiropractor will be guided by their clinical experience and your goals when they recommend a care plan for you.

A new research study was recently published that suggests, in the early stages of chiropractic care, the more often you get adjusted, the better the results you enjoy, and this can also be better for you in the long term as well.4

In this study, they looked at 256 people who had chronic, regular headaches and divided them into groups who either received chiropractic care once a week, twice a week, or three times a week, for up to six weeks, or they received no chiropractic care at all and instead were given light massages over the same 6-week period. Previous studies have shown that people with this kind of headache often respond well to chiropractic care.

The scientists in this study were most interested in how many visits per week to the chiropractor showed the best results. They looked at how many days a week a patient suffered from headaches at the end of the study and whether any changes in headache frequency between the groups were still there up to one year later. What they found was that the patients who were seen by their chiropractor most regularly, so up to three times a week (total of 18 adjustments), had fewer headaches than those who were seen once or twice a week, and they were much better than the patients who received no chiropractic care at all.

In fact, after one year, the patients who had been seen three times a week (up to 18 adjustments) had over three fewer headaches per month compared to the patients who only received a light massage. So, these effects obviously lasted. A similar study in patients with chronic low back pain also showed that people who were adjusted more often had the best results5.

"The more you get adjusted, the better the results that you will enjoy"

Maintenance Care

The idea with maintenance care is that regular adjustments will help maintain your spine and nervous system function at their optimal level and help you to be your best, and prevent new episodes of pain from developing6.

"Maintenance care makes perfect sense if you want to function at your best."

We know that if your brain doesn’t send appropriate protective messages to your core trunk muscles, you will have a higher risk of developing low back injuries7. This makes sense because a lack of core stability means you’re basically creating mini whiplash injuries to your spine each time you move around or lift your arm or leg.

All of life’s stressors can build up and impact the way your brain is communicating with your trunk muscles, and then all that is needed is one last minor thing to go wrong, and you end up with pain or other symptoms. The goal of maintenance care is to prevent building up stresses on your body before they cause symptoms or have a significant impact on your life.

A study published by researchers from Sweden in 20188 showed the benefits of maintenance care in a group of people who suffered from low back pain. In this study the researchers followed 328 patients with low back pain who went to 40 different Swedish chiropractic clinics. If the patients responded well when they were first adjusted (treated), they joined the study and either received chiropractic maintenance care over the next year or symptom-guided care.

Maintenance care patients were seen every 1 to 3 months with the intention of being checked before substantial pain reoccurred. Patients in the control group were told to call if and when pain recurred. They were then adjusted until they got better, and they were told to call again if the pain returned. The researchers were most interested in the number of days of bothersome back pain suffered by each group throughout the 1-year trial period.

They found that the maintenance care group experienced 13 fewer days of pain over the course of the study (1 year) on average compared to the symptom-guided group. The amazing thing from this study was that the maintenance care group needed less than 2 extra visits to their chiropractor over the course of a year to have 13 fewer days of pain than the control group (symptom-guided group).

This suggests that patients who have had low back pain, who respond well to care, should see their chiropractor regularly, irrespective of whether their symptoms have returned or not. This study did have some limitations of course. One limitation was that chiropractors were told not to schedule their maintenance care patients more frequently than once a month. So some patients in this group may have benefitted even more if the chiropractors had been able to schedule their visits more frequently if they thought that was a good idea.

This study shows that it’s really important to keep your spine working well, even if you don’t have pain or symptoms. So if you want to function at your optimal potential consider chiropractic maintenance care because the research suggests your spine will love you for it!

References

Hodges & Moseley. J Electromyogr Kinesiol 2003;13(4):361-70.
MacDonald et al. Pain 2009;142(3):183-8.
Ferreira et al. Manual Therapy 2007;12(3):240-48.
Haas et al. Spine J 2018. 18(10): 1741-1754.
Haas et al. Spine J 2014;14(7):1106-16.
Leboeuf-Yde C, Hestbæk L. Maintenance care in chiropractic – what do we know? Chiropractic & Osteopathy 2008;16:3-3.
Cholewicki J, Silfies SP, Shah RA, et al. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine (Phila Pa 1976) 2005;30(23):2614-20.
Eklund A, Jensen I, Lohela-Karlsson M, et al. The Nordic Maintenance Care program: Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain- A pragmatic randomized controlled trial. PLoS One 2018;13(9):e0203029.