Great strategies exist to manage an acute episode of low back pain – if ever you’ve sought help from our North York clinic you’ve likely received some combination of manual therapy, exercise recommendations, and behavior modification advice that was tailored to your specific needs. This strategy is known as ‘multimodal care’, and is considered a gold standard for many common low back complaints.
For some people, low back pain can persist. In other people it can return periodically. Chiropractors are commonly asked about ‘maintenance care’ – accessing these multimodal strategies in regularly spaced visits over longer periods of time, with the hope that it may reduce the impact of persistent or recurrent episodes. A new high-quality study finally sheds some useful light on this topic.
328 patients who responded well to chiropractic care for an initial acute low back episode were split in to two groups and then studied for a year. The first group received symptom-guided care – when things hurt they came for treatment. The second group received maintenance care.
The results… The maintenance care group had less total low back pain days over the course of a year – and not by a little bit. The difference was almost two weeks less of back pain! Now, the maintenance care group did receive more adjustments than the symptom-guided care group. And that does carry an additional expense. But in this study the average difference was less than two visits. Two visits! Two weeks less pain.
Low back pain is one of the most common, and most costly, healthcare problems today – it is also the leading cause of disability and of work absence in the world! So you do have two great options. 1) You can use evidence backed great strategies to effectively deal with your low back pain episodes as they come. Or,
2) You can invest a little more time, a little more attention, a little more exercise, and yes… a little more money. The expected dividend on your investment? Almost two extra pain-free weeks to continue working without modifications or leave. Almost two extra weeks to enjoy family and leisure time without the same limiting pains.
The idea of Patient Centered Care holds that your preferences are important, and need to be a part of the decision. Whether a patient chooses symptom-guided care or maintenance care, the hope is that studies like this increase a patient’s confidence in their decisions. Care. That makes the difference ™.
Eklund A, Jensen I, Lohela-Karlsson M, Hagberg J, Leboeuf-Yde C, Kongsted A, et al. (2018) 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 13(9): e0203029. https://doi.org/10.1371/journal.pone.0203029