Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline

doi:10.1089/acm.2020.0181

PMC full text:

J Altern Complement Med. October 2020; 26(10): 884–901.

Published online 2020 Oct 8. doi: 10.1089/acm.2020.0181

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Table 12.

Visit Frequency and Duration of Care for Chiropractic Management of Chronic (>3 Months) Musculoskeletal Pain^15,17

Type of episode	No. of treatment visits	Duration of care	Re-evaluation period
Mild exacerbation	1–6/episode	Per episode	Beginning and end of episode
Moderate or severe exacerbation	2–3/week	2–4 weeks	Every 2–4 weeks
Scheduled interval for ongoing management^36,a,b	1–4/month	Ongoing	Minimum of every 6 visits, or as needed to document changes.^{^c}

^aSupport with documentation of either functional improvement or functional optimization. This may include, but is not limited to the following: (1) substantial symptom recurrence upon treatment withdrawal, (2) minimization/control of pain, (3) maintenance of function and ability to perform, (4) minimization of dependence on interventions with greater risk(s) of adverse events, and (5) maintained or improved work capacity.

^bThree to four visits per month on an ongoing basis only indicated in exceptional circumstance. One to two visits per month may be necessary if care is supported by a well-documented care

management plan.

^cDocument patient's efforts to comply with self-care recommendations.