Newly Published Study Confirms
That “Maintenance Care” Delivers!
SOURCE: Spine (Phila Pa 1976) 2011 (Aug 15); 36 (18): 1427-37
Senna, Mohammed K. MD; Machaly, Shereen A. MD
Shereen A. Machaly, MD,
Rheumatology and Rehabilitation Department,
Mansoura Faculty of Medicine,
Mansoura University, Mansoura, Egypt;
This new, single blinded placebo controlled study, conducted by the Faculty of Medicine at Mansoura University, conclusively demonstrates that maintenance care provides significant benefits for those with chronic low back pain. 
The authors concluded that spinal manipulation is effective for the treatment of chronic nonspecific LBP and that to obtain long-term benefit for the patient, this study suggests maintenance spinal manipulations after the initial intensive manipulative therapy can provide that additional benefit.
BACKGROUND: Spinal manipulation (SMT) is a common treatment option for low back pain. Numerous clinical trials have attempted to evaluate its effectiveness for different subgroups of acute and chronic LBP previously, but the efficacy of maintenance SMT in chronic non-specific LBP has never been studied.
In this study, 60 patients with chronic, nonspecific LBP lasting at least 6 months were randomized into 3 groups:
- One third of them received 12 treatments of sham SMT over a one-month period.
- One third of them received 12 treatments of SMT during a one-month period, with no follow-up care during the next nine months, and
- One third of them received 12 SMT visits during the first month, followed by “maintenance” SMT every two weeks, for the next nine months.
To determine any difference among these 3 care groups, researchers measured pain and disability scores, generic health status, and back-specific patient satisfaction at baseline, and at 1-month, 4-months, 7-months, and at 10-months
RESULTS: Patients in manipulative groups (groups 2 & 3) experienced significantly lower pain and disability scores than the sham group at the end of the first 1-month period.
At the 10-month follow-up, only the maintenance group maintained improvements in pain and disability, while the group that only received 1-months care had reverted to their pretreatment pain and disability levels.
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CONCLUSIONS: This is the first medically managed trial that clearly demonstrates that maintenance care provides significant benefits to those who suffer from chronic low back pain.
This study re-confirms Descarreaux’s virtually identical 2004 JMPT study, which concluded that:
“This experiment suggests that maintenance spinal manipulations after intensive manipulative care may be beneficial to patients to maintain subjective post-intensive treatment disability levels”.
It also confirms the findings of Dr. Ron L. Rupert, in his ground-breaking 2000 JMPT article, titled: Maintenance Care: Health Promotion Services Administered to US Chiropractic Patients Aged 65 and Older, Part II which found that: