Table 2

Chiropractic clinical protocol.

ConditionManipulation or MobilizationPassive therapiesActive therapiesEducation/home exercise and adviceTreatment frequency
Myofascial Pain SyndromeJoint manipulation or mobilization if indicated and as tolerated
  • -

    Manual or Instrumented soft-tissue relaxation techniques

  • -

    Muscle stretching

  • - Compress - stretch techniques as tolerated

  • -

    Postural correction exercise(s)

  • -

    Education about condition & treatment

  • -

    Ergonomic advice

  • -

    Self-administered techniques

→Mindfulness/meditation
→Home exercise
  • -

    10 Tx delivered over 14 weeks

  • -

    Alter care and reduce frequency or discharge depending on response

Postural or mechanical spinal disordersJoint manipulation or mobilization as tolerated
  • -

    Manual or Instrumented soft-tissue relaxation techniques when indicated

  • -

    Postural correction exercise(s)

  • -

    Education about condition & treatment

  • -

    Ergonomic advice

  • -

    Self-administered techniques

→Mindfulness/meditation
→Home exercise
  • -

    10 Tx delivered over 14 weeks

  • -

    Alter care and reduce frequency or discharge depending on response

TMDa dysfunctionJoint manipulation or mobilization if indicated and as tolerated
  • -

    Manual or Instrumented soft-tissue relaxation techniques when indicated

  • -

    Compress - stretch techniques

  • -

    Postural correction exercise(s) when indicated

  • -

    Education about condition & treatment

  • -

    Ergonomic advice

  • -

    Self-administered techniques

→Mindfulness/meditation
→Home exercise
  • -

    10 Tx delivered over 14 weeks

  • -

    Alter care and reduce frequency or discharge depending on response

+ aTMD: Temporomandibular; Underlined italics indicates primary treatment approach within each diagnostic category; Standard lettering indicates treatment that may be employed depending on co-occurring clinical findings or recognized need; TMD dysfunction may be caused by joint, postural, and/or myofascial components leaving no default primary treatment approach; Participants may also exhibit a combination of diagnostic categories (e.g., postural/mechanical and myofascial pain syndrome). When this occurs, the treatment approach addresses the identified condition(s) considered most important at any given timepoint within the treatment period.