The scientific periodical Chiropractic & Manual Therapies published an open access article in their November 21,2019, journal that reviewed scientific evidence of the benefits of chiropractic maintenance care and the reasons that patients receive this care. The authors of the study explain chiropractic maintenance care by stating, “Maintenance Care is a well-known concept in the chiropractic profession, describing continued care beyond that of reducing symptoms.”
The study reports that generally chiropractors describe two scenarios that are both referred to as maintenance care. “Some chiropractors appear to have recommended Maintenance Care as a form of precaution to keep the patient healthy, regardless of symptoms and patient history. Others though, seem to have used it to ‘keep patients going’, when they had chronic or recurring problems.” The first of the two descriptions is also known as “wellness care” in many chiropractic offices.
This study noted that in the past, there was a lack of consensus or clear research evidence on the concept of chiropractic maintenance care. To help do more research on the subject and possibly add more clarity, the Nordic Maintenance Care Program was started. This research program explored maintenance care among chiropractors in Denmark, Sweden, Finland, and Norway.
The study authors performed a search for all studies on chiropractic with the terms chiropractic or manual therapy and maintenance care or prevention included. However, the term wellness was specifically excluded. The study identified 14 articles that were published between 2008 and 2018 on the subject of maintenance chiropractic, including four from Canada, the U.S. and Egypt.
One of the studies looked at the patient’s rationale for receiving chiropractic maintenance care. In this study, it was reported that “…patients stated that the purpose was to prevent recurrences (78%) and to remain pain-free (68%). A few patients (17%) echoed the holistic view expressed by some chiropractors, i.e. that maintenance care was used to prevent disease in general, a wellness approach.”
Another study included in this paper showed that maintenance chiropractic was more prevalent in the practices of experienced chiropractors and those who were graduates of chiropractic schools in the United States. In the Nordic countries, it was reported that about 30% of chiropractic patients are receiving maintenance care.
In their conclusion, the authors wrote, “Knowledge of chiropractic Maintenance Care has advanced. There is reasonable consensus among chiropractors on what Maintenance Care is, how it should be used, and its indications. Presently, Maintenance Care can be considered an evidence-based method to perform secondary or tertiary prevention in patients with previous episodes of low back pain, who report a good outcome from the initial treatments.” They go on to state, “Back pain is a chronic disease for most, with episodes at short or long intervals. A preventive approach such as Maintenance Care, therefore, makes sense.”