Dr. Allan Horowitz, published newspaper article, Richmond Hill Liberal, Copyright October 01, 1986
Question:
Could you please explain the rationale behind chiropractors recommending “regular” spinal examinations and/or treatment?
I had a severe low back injury a few months ago and I got 100 per cent relief and presumed cure after attending a chiropractor for three treatments. He explained to me that my back is the type that should have periodic treatments to ensure that my pain doesn’t come back.
I hope I don’t sound skeptical, but when I asked my chiropractor why he thinks my back needs periodic treatments he told me “because if you don’t have them you’ll probably end up back in my office all bent over again and I don’t want to see that happen.”
That’s a good answer but it didn’t really address my question. Could I have your opinion of the necessity of periodic treatments for a back like mine.
Answer:
Unless you are my patient I have probably never seen your back and so I am not in a position to give my opinion on treatments for a “back like yours.”
However, your question is a very common one and is one I must answer many times in my daily practice.
Patients ask me. Their wives, husbands or parents ask me, and medical doctors also are sometimes curious as to why some chiropractors advise periodic spinal exams and treatment for some patients.
First, I must say that not all chiropractors advise this practice, and even among those that do, not all advise it for all their patients.
Every patient must be assessed independently and a judgment made based on the specifics of the case. Some people who have lower back pain have an identifiable abnormality which may be helped by the chiropractor. If it is a very simple case which responds quickly, and if the patient hasn’t had a long history of back pain, or recurrent episodes in the past, then it is possible that the problem may never come back.
If this is the chiropractor’s opinion then he will likely discuss proper back care with the patient, review an exercise program with him and then, depending on the individual chiropractor’s philosophy and past experience with that particular type of case, either discharge the patient with instructions to return if the pain returns, or suggest the patient come back for a preventive program of spinal care.
The frequency of these visists usually varies between once a month and once a year, but visits more or less frequently might be advised by the chiropractor.
Invariably the question will arise: “Why should I have my back checked and/or treated if I don’t feel any pain?” Here is when my friends the dentists come into the picture to help in my answer.
If a person visists a dentist with a complaint of tooth pain the dentist will likely take one or two sessions to repair the damage and relieve the person’s pain.
Only a negligent dentist will send the patient on his way with instructions to return only if his pain returns.
A good dentist will tell the patient to return for an examination, cleaning, etcetera in six months or a year or whatever the dentist feels is necessary for that patient.
These regular visits will hopefully prevent any serious tooth problems from occurring. This is called “preventive dentistry,” and it is the same concept which most chiropractors follow in the treatment of their patients.
Some back problems require no more than a treatment or two to “fix”, although most chiropractors don’t like to even use the word “fix”. That implies the patient is like a car, which has a new muffler installed. Drive for another 30,000 miles until it rusts and falls out and then a new one can be installed.
People are not cars. Most back problems happen for a reason. If that reason is improper mechanics (motion) in the spine, and the chiropractor feels that the problem is likely to return in the future, then he will likely advise periodic “spinal maintenance visits” to ensure the patient’s spine remains healthy.
If the person does have these check ups he is not guaranteed a healthy back for life, but if the back problem does arise it will likely be less severe, and shorter lived that if the spinal maintenance did not occur.
Keep in mind that every chiropractor’s view is different when dealing with the necessity of maintenance check ups for those who have had incidents of low back pain. Some don’t recommend it at all, others feel it essential for all their patients. Others, myself included, feel it necessary for some, recommended for others, and not needed for others.