Prevention of spinal pain and related disability at the secondary (preventing chronicity and recurrence) and tertiary (preventing progression of a condition) levels is an important issue in musculoskeletal health, particularly when considering the worldwide burden of spinal conditions.Maintenance care (MC) is an approach to chronic and recurrent spinal pain that is often utilized by chiropractors.  MC involves appointments typically scheduled on a regular basis and most often includes the provision of manual therapy (like spinal manipulation), exercise prescription and other ancillary treatments and/or lifestyle advice. Much of the research on MC has been observational and qualitative, although a few RCTs have been produced in the past decade.  The majority of the highest quality research on MC has come from the Nordic Maintenance Care Program, which has done an admirable job of characterizing what maintenance care is and looking at its effectiveness (we have reviewed this work – check the “Maintenance Care” section of the RRS Education database).

To further our understanding of the nature of how patients may benefit from MC (specifically whether it is a matter of treatment dose or timing), the authors conducted this further secondary analysis of their original trial, focusing on pain trajectories of patients before and after visits or the first visit in a new treatment period; time to/risk of a new episode following the first recovery period; and the length of pain-free periods and total number of pain-free weeks…critical information to better our understanding.

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THIS WEEK'S RESEARCH REVIEW: “Chiropractic Maintenance Care – Selecting the Right Patients” 

This paper was published in Chiropractic & Manual Therapies (2020) and this Review is posted in Recent Reviews, Low Back Pain, Maintenance Care and the 2020 Archive.

Dr. Eklund presenting this paper and the Nordic MC line of research at Parker Vegas in February 2020...

Nordic MC Eklund