Chiropractic Online Continuing Education Courses: The Status of Maintenance Care | CCEDseminars Posted on Oct 11, 2023

Chiropractic Online Continuing Education Courses: Deciphering the Role of Maintenance Care

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A Shift in Perception

For years, chiropractic maintenance care has been a subject of debate and exploration. Early reviews in 1996 and 2008 concluded that evidence supporting this approach was lacking. However, subsequent systematic research in Nordic countries, involving collaboration with U.S. chiropractors, aimed to shed light on maintenance care's potential. Intuitively, the better your adjusting skill set, the more potential for your care program. CCEDseminars provides convenient and engaging chiropractic online continuing education courses that will propel you to the next level! Link 

Method and Findings

In a comprehensive review, 14 original research articles were examined. Maintenance care was described as a preventive approach recommended to patients with prior positive responses to chiropractic care. Approximately 30% of Scandinavian chiropractic patients were found to receive maintenance care. Despite these findings, evidence on the cost-effectiveness of maintenance care remains limited.

Defining Maintenance Care

The natural course of spinal pain has prompted a shift in treatment paradigms. Rather than focusing solely on curing specific conditions, chiropractors are increasingly managing pain trajectories through maintenance care. This approach recognizes that spinal pain, like conditions such as asthma, can become chronic and life-long. Chiropractors have been at the forefront of adopting this perspective.

Chiropractors' motivations for recommending maintenance care vary. Some see it as a preventive measure, while others view it as a way to support patients with chronic or recurring issues. Despite its longstanding use, the term "maintenance care" still lacks an official definition.

The Nordic Maintenance Care Program

A research project called "The Nordic Maintenance Care Program" was launched. It aims to increase understanding about maintenance care by collaborating with chiropractors in Denmark, Sweden, Finland, and Norway.

Review Objectives and Data

The systematic review sought to:

  1. Define the concept of maintenance care and its indications.
  2. Describe chiropractors' beliefs in maintenance care and patients' acceptance.
  3. Establish the prevalence of maintenance care usage and identify characteristics of chiropractors associated with its use.
  4. Determine the efficacy and cost-effectiveness for various conditions.

The studies included in the review were published between 2008 and 2018, originating from Canada, the U.S., and Egypt. A mix of studies, including surveys, observational studies, and randomized controlled trials, provided a multifaceted view.

Patients and Chiropractors on Maintenance Care

From the patient's perspective, maintenance care is often seen as a means to prevent recurrences, remain pain-free, or embrace it as a wellness approach. On the chiropractors' side, the prevalence of maintenance care usage varies, with estimates ranging from 22% to 41% among Scandinavian chiropractors.

American Chiropractors and Maintenance Care

Surveys conducted among chiropractors in various countries revealed that a significant majority believed that maintenance care could serve as a preventive tool. However, the approach varied among chiropractors. Some favored a universal application, considering maintenance care beneficial in preventing diseases. It was also observed that maintenance care usage was more common among experienced chiropractors and clinic owners, especially those who received their chiropractic education in the U.S.

The Status of Maintenance Care

Approximately 30% of chiropractic patients in Nordic countries receive maintenance care, typically on a 1-3 month basis. Chiropractors tend to take a full-spine approach, and clinical indications for maintenance care are based on patients with persistent or episodic pain who have responded well to initial treatments.

Research results suggest that maintenance care can be considered an evidence-based method for secondary or tertiary prevention in patients with previous low back pain episodes. However, it's crucial to note that not all patients receiving chiropractic treatment require maintenance care.

In conclusion, the status of chiropractic maintenance care is evolving, with ongoing research shedding light on its definition, indications, and efficacy. It offers a preventive approach for patients with a history of low back pain, emphasizing the importance of individualized patient care.

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References:

https://chiromt.biomedcentral.com/articles/10.1186/s12998-019-0283-6

https://pubmed.ncbi.nlm.nih.gov/31832142/

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