How often should a Patient be treated with manipulation?

We do not know the answer but early evidence from a small study suggests that high-frequency care initially may have some short-term benefit.

Patients were randomly allocated to visits (1, 2, 3 or 4 visits/week for 3 weeks) and to treatment regimen (spinal manipulation only or spinal manipulation with PM). All patients received high-velocity low-amplitude spinal manipulation. Half received one or two of the following PM at each visit: soft tissue therapy, hot packs, electrotherapy or ultrasound. Pain intensity: At 4 weeks, there was a substantial linear effect of visits favoring a larger number of visits: 5.7 points per 3 visits (SE=2.3, p=.014). At 4 weeks, a visits effect was noted (p=.018); the slope for group means was approximately 5 points per 3 visits. There were no group differences at 12 weeks. CONCLUSIONS: There was a positive, clinically important effect of the number of chiropractic treatments for chronic low back pain on pain intensity and disability at 4 weeks. Relief was substantial for patients receiving care 3 to 4 times per week for 3 weeks.

A similar study was performed with patients diagnosed with cervicogenic headache demonstrating similar results.

Haas, M, Groupp, E, Kraemer, D. F. Dose-response for chiropractic care of chronic low back pain. Spine J 2004;4:574-583.

Is Chiropractic Effective?

Spinal Manipulation

Some people are still skeptical of Chiropractic and wonder if it really works or if its just "all in your head". Below are some great research articles to help show just how much Chiropractic can help all sorts of different problems.

"An Actuarial Analysis of the Impact of Chiropractic Care on the Costs of Medical Care for Patients with Common Spinal Diagnoses" indicates "that spinal patients who seek chiropractic coverage have materially lower health care costs than those who do not. The difference is consistent in all years and in between the two data sets. The difference range from 10% to 23% lower costs for those patients who sought [chiropractic] care." Milliman USA, September, 2009.

"Conclusion: Spinal manipulation provided better short and long-term functional improvement, and more pain relief in the follow-up than either back school or individual physiotherapy." Clinical Rehabilitation, January, 2010.

"...best evidence synthesis suggests that therapies involving manual therapy (manipulation) and exercise are more effective than alternative strategies for patients with neck pain..." Spine, 2008.
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"For chronic spinal pain in general, when compared to acupuncture and traditional medical approaches, chiropractic has generally been shown to be more effective." Journal of Manipulative and Physiologic Therapeutics, 2005.

"Low back pain patients with chiropractic coverage in their insurance plan needed less surgery and fewer x-rays than patients on the same insurance plan without chiropractic coverage." Archives of Internal Medicine, 2004.

Listed under Mayo Clinic's Top 10 Complementary Therapies is spinal manipulation. One of the criteria used at the world-renowned Clinic is"...Does it meet a need that cannot be met by conventional medicine?" Listed under BEST TREATMENTS is "Spinal Manipulation. Practiced by chiropractors,...this hands-on technique adjusts the spine to properly align the vertebrae with muscles, joints and nerves. Standout scientific evidence. At the University of California, Los Angeles, School of Public Health, a study of 681 patients with low back pain showed that chiropractic care was as effective as medical care, including painkilling drugs, in relieving discomfort." Mayo Clinic's Top 10 Complementary Therapies, Mayo Clinic College of Medicine, Amit Sood, M.D., 2008.