Table 1

Case management over six chiropractic visits at one-week intervals.

VisitManual TherapyPatient Education/ Home Care AdviceVAS (out of 100mm)PROMIS Pain Interference 6b T-scoreFunctional Improvements
Initial EvaluationReviewed past imaging findings and educated patient on unlikely correlation between these findings and his symptoms
Provided reassurance surrounding the absence of red flags or progressive neurological deficits
Educated patient on the nature of chronic low back pain
Prescribed repeated end range loading exercises
2nd visitSpinal manipulation – due to limited response to home careReviewed hurt versus harm concepts
Education surrounding pacing activity
Increased tolerance to installing docks and performing work duties
3rd visitSpinal manipulationAdvice to stay activeIncreased tolerance to installing docks and performing work duties
4th visitSpinal ManipulationEducation surrounding graded activity34mm65.5Increased tolerance to hunting and performing work duties
5th visitSpinal ManipulationPatient presented wearing a lumbar support brace recently given by physiatrist, we advised limiting its useSuccessfully used pacing methods during his weekend activities
6th visitSpinal ManipulationEducation on sleep hygiene practices15mm56.1Required assistance donning socks only 1 day of the week
Felt he did not need the lumbar brace between visits

VAS = Visual analog scale,
PROMIS= Patient Reported Outcomes Measurement Information System