This is one of the most common questions patients ask me. The answer is: it depends. Things like age, fitness level, and the severity and chronicity of the problem all influence what a patient’s treatment plan looks like. Here are a couple examples:
1. An active, fit twenty-five year old woman presents with acute lower back pain after lifting a heavy box. She has no history of lower back pain and no other health problems. Examination reveals a simple lumbar sprain/strain. She is treated four times with ultrasound to decrease inflammation, chiropractic adjustments to improve joint motion, and massage to decrease muscle spasm. By the fifth visit, she is no longer experiencing any back pain or restriction of motion. She is shown how to do lumbar stability exercises and told to check in every few months for a “tune-up”.
2. An overweight sedentary forty-nine year old woman presents with a long history of intermittent back pain. X-rays show moderate degeneration of the lumbosacral area. Examination reveals poor core strength, tight hip flexors, and multiple areas of restriction in the lumbosacral area. She is treated with chiropractic adjustments and hip flexor release three times per week for two weeks. At this point, she reports that the pain is much less frequent and less severe, but she still feels very stiff in the morning. She continues to come in weekly for the next four weeks in order to be adjusted and stretched. During these appointments, she is also taught how to do a series of stretches and exercises to improve flexibility and core strength, and encouraged to do them daily at home. By this time her condition has stabilized and she rarely has back discomfort. It is recommended that she comes in once per month for maintenance care.
As you can see, there are many variables in determining the proper treatment plan. If you are young, in shape, generally healthy, and have a simple problem, you might only need a few treatments. If you are older, out-of-shape, work at a demanding job, have a chronic problem, or do not comply with exercise advice, your treatment plan will be longer. Once you are feeling better, it is your decision whether or not to come in for “maintenance”. Some of my patients come in regularly in order to take care of simple misalignments, joint restrictions and tight muscles that inevitably arise during our hectic lives. Others wait until they can barely walk before they call me. In these cases, we usually have to go back to square one, treating three times per week for a couple weeks in order to “put out the fire”. Personally, I believe that old adage, “an ounce of prevention is worth a pound of cure.” I try to get adjusted at least once per month so that I can be at the top of my game.