Maintenance Chiropractic

Maintenance Chiropractic: Does the research support or vilify it?

Non-specific low back pain represents about 85 percent of low back pain (LBP) patients seen in a primary care centre and about 10 percent will go on to develop chronic disabling low back pain”



Maintaining spinal health with regular Chiropractic Spinal Manipulative Therapy (SMT)


Does it actually help in reducing future episodes of back pain?

Is there a reason for continued Chiropractic care even while out of pain?

Most importantly, is there research that supports the value of it?


A study by SPINE journal assessed the effectiveness of spinal manipulation therapy (SMT) for the management of chronic non-specific lower back pain and whether continued treatment helped prevent further episodes of pain and re-injury.


Study Link:

Senna MK, Machala SA. Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in a better long-term outcome? August (2011;  15:36 (18):1427-37





Sixty patients with non-specific low back pain for at least 6 months were divided into 3 groups.


Group 1:

12 treatments of sham (fake) SMT over a 1-month period


Group 2:

12 treatments of SMT over a 1-month period with no follow up treatments for following 9 months


Group 3:

12 treatments of SMT over 1-month period along with “maintenance spinal manipulation” every 2 weeks for the following 9 months


  • Each group was re-assessed at baseline and at 1-, 4-, 7-, and 10-month intervals.
  • Differences among therapies were measured with pain and disability scores, generic health status, and back-specific patient satisfaction





  • Patients in second and third groups experienced significantly lower pain and disability scores than the first group at the end of a 1-month period


  • Only the third group that was given spinal manipulations during the follow-up period showed more improvement in pain and disability scores at the 10-month evaluation.


  • In the non-maintained SMT group, pain and disability scores returned back near to their pre-treatment level.


Take home message

SMT is effective for the treatment of chronic nonspecific LBP. To obtain long-term benefit, this study suggests continued spinal manipulation on a less frequent basis after the initial treatments of manipulative therapy.

January 16, 2018
Georgina Smith