Maintenance Care: Medical Study Applauds but Misses Point

[originally published in KCN, November 2011]

Every once in a while a health care study comes out that makes you stop and say…

“Now why didn’t someone think of doing that earlier?”

Well, such a study recently hit the pages of the prestigious medical journal Spine.

The study, conducted by two medical doctors in Egypt, acknowledged the body of research that shows lower back suffers do very well with spinal manipulation (or what we chiropractors refer to as adjustments).  That’s not breaking news, and it certainly is not why I’m writing this article.

What makes their study interesting is an observation they made in the studies that went before them:  all the studies were short-term.  None of them looked beyond the initial symptomatic relief that spinal manipulation brought to patients.  None of them asked the question: “What would happen if we continued adjusting patients after the pain went away?”  Or in their words (and the title of their research), “Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in a better long term outcome?”

Well, of course it does!  We chiropractors witness it everyday in our practices.  I’m just stunned that no one thought of challenging this everyday observation through the rigors of “science.”   In hindsight though, even if it is a bit odd, it’s probably good that a couple medical doctors conducted the research, because had the chiropractic profession done this one, it would have reeked of bias.

Listen to Dr. Lamar's Podcast on this subject!

So here’s what happened:  Nearly 100 patients with lower back pain lasting at least six months were brought together.  They were broken out into three groups.  One of them was a control.  The other two received twelve spinal manipulation treatments over a period of one month.  Both of them showed significant, and near equal, improvement versus the control group.  At this point, treatment was halted for one of the groups, and the other continued to receive treatment every two weeks for the next nine months.

The result:  those in the “maintained group” saw continued improvement with their condition, above and beyond where they were after the one month mark.  The patients who stopped treatment after one month, found themselves to have regressed to a level that was nearly equivalent to where they were before they started.

This led the researchers to conclude: “Spinal manipulative therapy is effective for the treatment of chronic nonspecific low back pain. To obtain long-term benefit, this study suggests maintenance spinal manipulation after the initial intensive manipulative therapy.”

Amazing!  I know, I had to pinch myself.  I couldn’t believe that this actually made it to print in a medical research journal.

So has a new day dawned for chiropractic?  Will patients be able to receive chiropractic maintenance care and have their insurance company pay the bill?  Probably not.  Because maintenance care is contrary to the business model of insurance, and this study when applied to chiropractic views it from a medical perspective.

When we view chiropractic as a “treatment,” we miss the point.   The chiropractic adjustment — or spinal manipulation as they like to call it — is really not a treatment for anything.  It merely serves to remove mechanical interference in the body’s electrical system — an interference that hinders the body’s natural ability to self-heal and self-regulate.  Lower back pain, in this case, is really just a symptom — a sign — that the body’s ability to function in this capacity has been failing.  The adjustment really just removes the barriers that are preventing the body from functioning properly.  It allows the body to express life.

True health is more than being pain-free, it’s about functioning at the most optimum level possible.  When the spine is adjusted, and maintained as such, the nervous system which controls and regulates every cell, tissue, and organ in the body is able to communicate more effectively… and when that’s in place, pain just isn’t an option.


Sources used for this article:
Senna and Machaly. Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long term outcome?  Spine. 36(18): 1427-1437.  August 15, 2011.
Explore posts in the same categories: adjustment, chiropractic 101, chronic, healthy living, low back pain, maintenance care, whole body health

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