What’s the Right “Dose” of Chiropractic Care?

December 20, 2013
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Dose Response to Chiropractic CarePatients new to chiropractic often wonder, “How long will it take to recover from an episode of back or neck pain?” While the answer is highly individual, a team of researchers sought to see whether there were any general trends in how quickly patients recover from back pain when under chiropractic care.

A new study published in the Spine Journal examined patients’ dose responses to chiropractic adjustments for chronic lower back pain. Dose response helps doctors understand how much of a specific treatment is needed for relief. Currently there have been no large-scale studies analyzing the dose response of chiropractic treatment.

In the study, 400 patients with chronic lower back pain were randomly assigned to receive varying levels of treatment: 0, 6, 12, or 18 sessions of spinal manipulation administered by a chiropractor.

Every patient met with a chiropractor three times per week for six weeks, however only patients in the 18 dose group received spinal adjustments at each appointment. The other patients received the number of spinal adjustments they were assigned, and the remaining appointments consisted of light massage as a control.

After 12 sessions, the mean average patient had a 20% improvement in pain and disability. Patients receiving 18 sessions of spinal adjustments did not appear to have additional benefits over the 12 session group. Reductions in pain and disability were sustained at the one-year follow-up. The researchers concluded that 12 sessions of spinal adjustments provided the most favorable outcomes.

Twelve of course may not be the magic number for everyone, since there are a number factors influencing recovery from back pain (such as genetics, obesity, activity level, past injuries, and mental health.) However this study does demonstrate that even patients with persistent back pain can experience meaningful reductions in pain and disability.

Once you’ve recovered from your initial episode of back pain, getting regular chiropractic care can prevent you from experiencing future episodes of pain. Chiropractors can provide maintenance care with advice on using exercise, nutrition, physical therapy, and spinal adjustments to prevent chronic symptoms. Recent research suggests that chiropractic patients fare better than traditional care patients when it comes to this maintenance care period after the initial relief. The study showed that chiropractic patients experienced fewer episodes of recurring back pain than medical care patients.


Haas M, et al. Dose-response and efficacy of spinal manipulation for care of chronic low back pain: a randomized controlled trial. Spine Journal 2013; pii: S1529-9430(13)01390-9. doi: 10.1016/j.spinee.2013.07.468.