Why Aren’t Chiropractic Recommendations Consistent?
Chiropractors’ diverse backgrounds and beliefs lead to varied care approaches. Some emphasize symptom relief, while others prioritize long-term spinal health. This variation can make it difficult for patients to identify appropriate care or know whom to trust.
From my experience, some new patients have told me they are asked to commit to and pay for 6 to 12 months of treatment during their first visit at other Chiropractic offices. Sometimes, chiropractors may refuse to provide care without this commitment. This practice can leave patients with a negative view of standard chiropractic care, as other health professionals who offer manual therapy typically do not adopt this approach.
In over 28 years of clinical practice, I have never heard a patient say that previous care with a Physical Therapist or Occupational Therapist takes this approach, so why do Chiropractors?
Several factors contribute to this variation:
-Clinical Judgment/Experience: Chiropractors assess your condition and make recommendations based on their training and experience.
-Philosophical Approach: Some chiropractors believe in ongoing care, while others follow research-based guidelines that focus on short-term treatment.
-Financial Incentives: Financial considerations may influence recommendations, leading some chiropractors to suggest care that does not align with evidence-based care or is not necessary.
What Do Practice Standards Say?
To promote consistency, experts have developed research-based guidelines. Three of the most widely used are:
- Quebec Task Force Guidelines: These guidelines classify spinal disorders and recommend care plans based on severity and duration. For example, most cases of acute low back pain improve within 4–6 weeks, and treatment beyond this period should be justified by clear clinical reasoning.¹
- American College of Physicians (ACP) Guidelines: ACP recommends non-drug therapies, including spinal manipulation, exercise, and self-care, for acute and chronic low back pain. They note that most acute cases resolve over time and discourage unnecessary imaging or prolonged use of additional therapies. ²
- Canadian Chiropractic Guideline Initiative (CCGI): These guidelines support evidence-informed care, such as spinal manipulation with exercise and patient education, and discourage open-ended treatment plans without measurable goals. ³
While these guidelines vary somewhat, none of them recommend long-term care lasting 6-12 months. Instead, they provide an evidence-based starting point for care.
What Should Patients Look Out For?
When considering a chiropractor’s recommendation for care, keep these tips in mind:
1. Clear Diagnosis and Goals: Your chiropractor should explain your condition and outline specific, measurable goals for care.
2. Evidence-Based Plan: Look for treatment plans that align with recognized guidelines, such as the Quebec Task Force or ACP recommendations.
3. Transparency: Be cautious of recommendations for care extending beyond 3 months without clear justification or regular progress assessments.
Our Approach at Mason Family Chiropractic and Wellness
At Mason Family Chiropractic and Wellness, we provide research-based care with a patient-first approach.
Our treatment plans are:
- Evidence Based: We follow standards like the Quebec Task Force and ACP guidelines to ensure care is appropriate and effective.
- Goal-Oriented: Every plan includes measurable outcomes, so you know what progress looks like.
- Collaborative: We listen to your goals, whether you want pain relief, better movement, or long-term wellness.
- Transparent: We explain each recommended step and invite questions from patients on their care plan.
Your health and trust are our top priorities. If you have questions about your care plan, please ask. We are here to help you make informed decisions about your health.
References
1. Spitzer WO, Leblanc FE, Dupuis M, et al. Scientific approach to the assessment and management of activity-related spinal disorders: A monograph for clinicians. Report of the Quebec Task Force on Spinal Disorders. Spine. 1987;12(7 Suppl):S1-S59.
2. Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
3. Canadian Chiropractic Guideline Initiative. Clinical Practice Guideline: Evidence-Based Management of Low Back Pain. Canadian Chiropractic Association; 2023. Available at: https://chiropractic.on.ca/wp-content/uploads/Canadian-Chiropractic-Guideline-Initiative-Apr-2023.pdf.
