Have you ever felt that way? No matter how much you visit your chiropractor, whatever the problem is KEEPS COMING BACK!
Here is Dr. Matt's response to that question:
That's a tough question that depends greatly upon the details of a given patient's case. First, the general answer is no. I don't expect to be adjusting the same joint over and over every day for weeks on end. However, there may be muscle imbalances or repetitive activities that are contributing to the problem; if that is the case, those underlying issues need to be addressed. That's one reason that we tend to add some kind of home exercise to stretch and/or stabilize the joints in the end of a plan of care. We may also address sleep posture, computer posture, job activities or other things that could be causing the joint problems. Second, it is important to distinguish between stuck joints and symptoms. Motion can be restored to a joint, but there can still be symptoms due related soft tissue issues which may or may not be correctable with chiropractic, exercises, ice, massage, medicine or any other number of treatments. These symptoms could come and go with activities that cause the joints to become inflamed. At the same time, it is entirely possible for a joint to be stuck for a while without causing any symptoms at all. Ultimately, I may have a pretty good idea of what I normally feel like when I have joint restriction, but even as a chiropractor I can't say with certainty that I have a stuck joint unless I have someone else check it for me. Thirdly, if a joint has been stuck for a while it isn't uncommon for it to become fixated again shortly after it has been adjusted. That's why most of our patients come in 2-5 times for that first condition that we manage. The second visit is almost always a day or two after the first visit. The idea is that if the joint does get "stuck" again we simply get it moving before the muscles and ligaments become accustomed to it being stuck again so that the soft tissues can heal and recover. From there we spread the visits out more and more until the soft tissues get a chance to accommodate for the restored joint motion and maintain the benefits of the adjustment on their own. Even then, there can be recurrent activities or chronic issues that come into play and can cause the joint to become stuck again. In those situations, a maintenance plan of checking that joint for restriction periodically may benefit a patient by allowing us to detect the fixation before the joint becomes symptomatic. Patients on maintenance plans also find that over time we adjust fewer segments because they are reaping the benefits of a prolonged plan of care that extends beyond what insurance typically covers. I guess the all-inclusive, yet vague, answer is that if you know someone like that I'd advise them to see a chiropractor for evaluation. If the patient follows up and is compliant with the instructions (i.e. ice, exercises, keeping follow-up visits, etc.) it may be time to either see another chiropractor or explore other options for managing the symptoms. Some chiropractors advise patients to get checked every day for a couple of weeks upon starting care, but our clinical protocols tell us that if we move the same joint a few times over a period of a couple of weeks without seeing functional improvement, it might be time to let another chiropractor look at the joint to see if we are missing something. For us, that means that I will see Liz's patients for a visit or two or she will see mine for a visit or two. If the other doc gets better results, we may see them some more until the findings resolve or the symptoms and functional restrictions plateau; however, if we aren't seeing any long-term improvement a few weeks into a plan of care even with the patient doing the home activities we will probably refer that case out for medical evaluation, massage, physical therapy or some other type of alternative treatments.