As a Chiropractor here in Tampa Florida located in the South Seminole Heights area people often ask how do I determine length of a treatment plan and what to do to treat a person who comes in my office with pain. The very first thing is obviously a history of why the person is having the pain and for how long have they had the pain. There is plenty of research out there on treatment protocols for chronic low back pain as it is one of America's leading cause for pain and disability. It is also one of the leading reasons for people to miss work.
When it comes to length of treatment plan and number of visits I have always turned to peer reviewed articles as well as patient outcome assessments. I read an article recently Dr Mayer, D.C., Ph.D. who is the Lincoln College Endowed Chair in Biomechanical and Chiropractic Research and a tenured faculty member in the College of Medicine at USF (Go BULLS!). He was reviewing a study done by Haas M, Vaverek D, Peterson D, Polissar N, Neradilek MB. Dose-response and efficacy of spinal manipulation for care of chronic low back pain: a randomized controlled trial. Spine J, 2014;14(7): 1106-16. This study was done with 400 patients from nine different offices around the united states found that patients with chronic low back pain showed that at 12 weeks following the end of the treatment protocol people who were treated at least twice a week for six weeks with spinal manipulative therapy had the greatest reduction in pain and disability compared with the control group who did not receive any spinal manipulative therapy. At 52 weeks following the end of the treatment protocol those patients who received spinal manipulative therapy three times per week for six weeks showed the most reduction in pain and disability compared with the control group. It should also be noted that all the physicians in the study used side posture adjusting technique while delivering the spinal manipulative therapy. A six week treatment plan is considered a short term, but effective due to the likelihood episodic reoccurrence of chronic low back pain.
What the specific article pointed out was that treatment twice a week for six weeks is very beneficial.
And after a year of being treated more frequently at three times a week gave the best results.
So in my office I try to see patients at last twice a week between four and six weeks as it seems to give patients the best results for the patients.