The Two Stages of Chiropractic Treatment: Acute Care and Preventative / Maintenance Care

Acute care is the treatment that your chiropractor will perform when you are experiencing musculo­skeletal pain, whether from a specific injury, or even if the pain is idiopathic (of unknown origin) in nature. The goal of acute care is to relieve your pain, reduce any inflammation that is contributing to your pain, and restore normal range of motion to the affected joint. (Inflammation is your bodies way of attempting to stabilize an injured area. It is a two edged sword, in that it compresses an injured body part, and prevents movement, much like an “organic cast” and increases the level of pain which reminds you not to do anything stupid. That being said, it also impedes with the healing process and makes your life miserable in the meantime.) Depending upon the severity of your injury / condition, this stage of care can be as little as one or two treatments, or can involve as many as several treatments per week for several weeks, along with instructions for home care that will aid in speeding the healing process along, thus reducing the overall time frame required to restore you to health.

Preventative / Maintenance care (usually referred to simply as “Maintenance care”) is occasional care, usually once a month or so, in order to keep your joints moving properly and your spine in proper alignment, thereby reducing the likelihood that you will become injured and require more frequent, acute care. Think of Maintenance care as being similar to visiting your dentist for periodic cleanings and routine check ups. It is a whole lot easier, less painful and less expensive to get regular check ups than to wait till you have a toothache before you visit the dentist. With chiropractic care, it works much the same way.

Your spine consists of 24 separate bones or vertebrae. Between each of these bones is a disc of rubbery tissue with a soft gelatinous center which serves to cushion the bones and keep them from grinding against one another. The discs are connected to the bones above and below them. If you bend or twist the spine in any direction, it compresses one side of the disc, while simultaneously stretching the opposite side. This creates a “pumping” action that pulls interstitial fluid (along with oxygen and nutrients) into the disc and pushes the old, stagnant fluid (along with waste products such as lactic acid) out of the disc. This is important because the discs are essentially avascular (have no blood supply of their own) and thus have no other way of receiving nutrients or discarding waste products. Thus, when a joint becomes misaligned or “locked up”, it prevents this pumping action and causes the disc to deteriorate over time.

Complicating this even further are a couple of important things. First of all, your brain causes your body to compensate for a loss of motion. When a spinal joint becomes “locked up” or “hypo-mobile”, the joints above and below it become “hyper­mobile” (and thus more prone to injury) in an attempt to average out your spines range of motion. Therefore, other than some initial discomfort, you may not realize that your spine isn't moving correctly. Next, your discs do not have any nerves in them, so they lack the ability to sense pain when they are being damaged. By the time you feel the radiating pain of a herniated disc, the damage is already done. 

This is why Maintenance care is important. By performing regular examinations of your spine, your chiropractor is able to detect and correct, potential problems before they become serious. This helps to keep you healthier, pain­free and less prone to injury.