Expert: Scott F. Gillman, DC, DACBSP - 9/30/2007

Question
I have lower, middle, and upper back pain which really feels like my spine isn't sitting right. If chiropractic can improve this, how many visits do you think it should take before there is any noticeable improvement?

Answer
James,  

This is a simple but very worthwhile question, since you would likely get different answers from different practitioners.  In short, research on chiropractic care for lower back pain patients demonstrated a notable reduction in pain symptoms after about six treatment sessions.  If you find that you feel any improvement following your first treatment session, then odds are you will do well with treatment.  In a study on treating people with more serious back conditions (sciatica) there was significant improvement after about a dozen treatment sessions.  Complete resolve of a condition is another story, since most people find that their spine symptoms tend to return over time when they leave their body unattended, such as failing to continue exercising or failing to take breaks from sitting for hours in front of a computer.  If you find that you are not getting significant relief of your symptoms within a dozen sessions or about a month's care, then odds are the treatment is not working for you.  Either you have a condition that requires additional types of treatment, e.g. exercise program, ergonomic evaluation, medicines, or massage, or your chiropractor is not using all the available tools/protocols to address your problem.  Some chiropractors just perform spinal joint manipulation and nothing else.  Others perform a variety of muscle/soft tissue procedures, exercise therapy, and nutritional guidance (for example) in addition to joint manipulation.  Also, not all joint manipulation is the same.  It is quite popular these days to call anything done to your spine joint manipulation when in fact what is being done is low-force vibrational techniques, muscle-release methods, and simple joint mobilization, none of which represents the classically accepted hands-on procedure deemed joint manipulation.   To sum it up: I'd suggust that if you are not feeling some improvement (about 30-50%) within about six treatment sessions at a frequency of care no less than 2x/week, then you need to address this with the chiropractor.  I would suggest these same terms if you were seeing a PT or DO.

'Hope this helps.

Dr. G