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chiropractic maintenance adjustments, restricted fascia, chronic inflammation, and chronic pain

What are “Chiropractic Maintenance” Adjustments and Why Might There Be a Better Way?

Because of THIS RECENT POST, I received an email from an unnamed chiro accusing me of being a, “pain-based and unprincipled” chiropractor.  In his mind, the only way to deal with chronic underlying issues that patients (i.e. everyone) have is to see them, all of them, lots and lots of times.  Once a certain frequency is achieved (once a week, every other week, once a month, etc), it is maintained forever (at least in theory), which is called “chiropractic maintenance“.

The problem is that while I am certainly not against the principle itself, way too many chiros have things backwards when it comes to chiropractic maintenance. 

It’s not that adjustments done on some sort of periodic basis (chiropractic maintenance) can’t benefit patient’s health in any number of ways (HERE); it’s that no matter how you slice it, seeing the very same patients for the very same problem(s) over and over and over again is not, by definition, maintenance. And it’s not a very fun way to practice.  It’s a given that if given a better way, the average person does not want to be in a clinic, any clinic, three times a week.

It’s why my clinical goals are simple — get you out of pain quickly (see link in 1st paragraph), restore as much function / ROM as possible (HERE), and make sure you leave with appropriate EMPOWERMENT-BUILDERS and DIY self-help ideas from MY CLINIC’S ONLINE HANDOUT.  Could it be simpler? I’m not sure how?  No long, drawn-out treatment schedules, no pre-buys, and no trying to up-sell you on things you don’t really need (be aware that disc herniations can be a different sort of beast and require more care).

Chiropractic Maintenance Definition

Chiropractic Maintenance Adjustments

According to various online sources, the definition of maintenance (think of this definition in terms of chiropractic maintenance) is….

Activities required or undertaken to conserve as nearly, and as long, as possible the original condition of an asset or resource while compensating for normal wear and tear.  The process of preserving a condition or situation or the state of being preserved.  The process of keeping something in good condition.” 

Many chiros would argue that by seeing the same people over and over again because they continually fight the exact same symptoms, the maintenance adjustments are helping to keep them in good (or at least better) condition by ‘maintaining’ spinal function.  Here’s the rub.  While it is undeniable that people sometimes need medical or chiropractic help, true health does not come from something that someone else does for you.  It comes from the blood, sweat, tears, and tough decisions that you have to make for yourself.

All too often the person is coming in to get adjusted because it’s the only thing that gives them any degree of relief.  Nothing ever really gets better, but since an adjustment gives them a few days (or maybe a few hours) with less pain, they’re down with it out of sheer frustration / desperation and the drive to feel better — even if it is short-lived.  So while there is nothing wrong with true “chiropractic maintenance,” (yep, I promote it); frequent adjustments for never-changing problems are usually anything but true chiropractic maintenance.

Is there a different way? A better way? And if so, what does it look like?

When I see patients, whether local or from ELSEWHERE, whose problems are largely relieved by adjustments but the relief is never lasts very long, I automatically think SCAR TISSUE.  Your problem always returns to the same place and in the same essential manner?  I think scar tissue.  You have a great deal of restriction despite having had LOTS OF ADJUSTMENTS or LOTS OF THERAPY (or maintaining a stringent STRETCHING PROTOCOL)? I think scar tissue.  You’ve INJURED yourself or are LOCKED INTO A JOB that holds you in a CONSTANT “BENT FORWARD” POSTURE for hours on end, day after week after month after year?  I think scar tissue.

You see, adjustments alone can’t do it. “Maintenance adjustments are never going to break “through” scar tissue and fascial adhesion if said scar tissue is anything greater than minimal; I don’t really care how many of them you get (HERE is an example of a person that had over a thousand of them under the auspices of “chiropractic maintenance”).  All of this is why a first-time visit to my clinic usually looks 180 degrees different than anything you’ve experienced previously (HERE).  I want what you want — less numbers of treatments instead of more.

Allow me to give you an example.

I recently had a young (very young) woman come see me for CHRONIC LOW BACK PAIN.  Despite being thin, fit, athletic, and in good great physical condition, she could not shake said pain.  The first thing I did was examine her, learning that when I told her to touch the floor, she could barely bend over at all — even with me pushing to the point of pain.  I checked to see if there was scar tissue / adhesions / restrictions / fibrosis in her THORACOLUMBAR FASCIA, and it was present in mass quantities (HERE is the post I wrote about the experience). 

While the immediate results of her treatment were “OK” (not excellent but not terrible either), she ended up coming back in a couple of weeks because her problem had mostly returned. I rechecked everything, broke some more tissue, and talked to her again about her diet (see previous link). Since she was extremely fair-skinned and red-headed, I had suggested to her that GLUTEN SENSITIVITY was a strong possibility (people of Western European descent are GENETICALLY PRONE) for driving hidden inflammation. 

A very big deal because as I have said many a time, inflammation always leads to fibrosis (scar tissue) when looking at physiological pathways (HERE).

Here is what she sent me on Friday — a bit over two months after her first visit.  Among other things she said….

Since following your advice, the pain in my back and neck has stopped entirely, as well as all of my bloating and stomach pain that I used to experience almost every day.” 

Her problems were solved quickly, efficiently, and inexpensively.  She is eating healthier, while exercising and stretching effectively.  All without a huge amount of unneeded treatment.  Pretty cool?  My patients certainly think so. 

What’s doubly cool is the long-term fruit that this sort of approach produces. Long-term fruit?  Darn straight!  Because, as I just told you, inflammation always leads to fibrosis / scar tissue, and scar tissue always leads to degeneration of joints, organs, and tissues (HERE), she headed some serious lifetime problems off at the proverbial pass! And she understands the benefits of adjustments without the idea of chiropractic maintenance as it is usually preached.


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