Wellness and maintenance chiropractic care in Clarksville

Wellness chiropractic care, which many people call maintenance care, is care that carries on after the problem that first brought you in has settled down, or that's planned around stiffness and tension that keep coming back. At Source Chiropractic in Clarksville, it's one of the longer-term care options Dr. Jeff, Dr. Cindy and Dr. Ali build into a treatment plan, and it centers on how your spine and joints work: joint mobility, spinal function, posture, movement and muscle tension. We like to start each plan from an exam and a specific goal, such as walking farther or managing back pain that tends to flare up again.

What is maintenance chiropractic care?

In the research, maintenance care means visits booked at planned intervals, before pain comes back, instead of coming in only when it flares. Chiropractors have used it for a long time, and a 2019 review estimated it's used with about 30% of chiropractic patients in Scandinavia, where much of the research on it was done. The same review describes who it's meant for: people who have had pain episodes before and who responded well to their first course of chiropractic care.

Wellness care at our office is aimed at:

• keeping your joints moving and your spine working well
• muscle and joint stiffness
• moving comfortably through work, exercise and everyday activity
• muscle tension that keeps coming back
• overall physical function and mobility

It's care for muscles, joints and movement. We don't offer it as a treatment for immune, digestive, heart or lung conditions.

Who is wellness chiropractic care for in Clarksville?

• Patients whose first problem has settled. If your back or neck has calmed down and you want to keep moving the way you are now, longer-term care is something to ask about.
• People whose back pain keeps coming back, or never fully goes away. That's the group the Nordic maintenance care trial studied, among people who had already improved with a first course of care (see below).
• People with stiffness or muscle tension that returns with work, sport or the routine of everyday life.

Who it suits depends on your history, how you're moving now and what you want to be able to do. It's a choice you can revisit.

What happens at a first visit, and what does longer-term care include?

If you're new to our Clarksville office, care starts with a first visit. You'll sit down with Dr. Jeff, Dr. Cindy or Dr. Ali and go over your health history, your symptoms, your concerns and your goals. Then comes a full evaluation, with full-spine X-rays when they're clinically appropriate, looking for joint restriction, muscle tension, inflammation, swelling and signs of an irritated nerve. You'll hear what we found before we recommend anything, and the plan we suggest may include short-term care and longer-term care options, depending on your condition and goals. You can book that first visit online.

The new-patient chiropractic offer has its own terms.

Longer-term care draws on the same care we use for everything else, and which parts of it you get depends on what the exam finds:

• The chiropractic adjustment. A controlled force applied to a specific joint, usually by hand, aimed at a joint that isn't moving well. Many people hear a pop, which comes from gas in the joint fluid, not from bone moving against bone.
• Rehab exercises for weakness, stability and mobility, so the work carries on between visits.
• Dry needling for tight bands and trigger points in muscle.
• Class IV laser therapy for muscle and joint pain and stiffness.

A licensed massage therapist also works out of our office, and we'll put you in touch when soft-tissue work fits your plan. If posture is part of your goal, our posture scan records how you stand so it can be compared later. It's a measurement, not a diagnosis.

How often are maintenance visits, and when do you stop?

There's no single schedule. In the Nordic trial, chiropractors set each person's interval by what they judged that person needed, with visits no more than three months apart. At our office, how often you come in is set from your exam, your condition and your goals, because every plan is built for the person in front of us.

A good ongoing plan covers what happens between visits too: the exercise you do and the activities you adapt. It also says how progress is judged, and what would mean coming in less often or stopping altogether. When symptoms change, or a plan isn't helping, a medical review may be the better next step, and we'll say so. Some back and neck pain needs urgent medical care instead of a routine visit, and the warning signs are listed in full on our back pain and neck pain pages.

What the research on maintenance care shows

• The Nordic maintenance care trial. This 2018 trial followed 328 adults aged 18 to 65 with recurrent or persistent low back pain at chiropractic clinics across Sweden. Everyone had reported feeling definitely improved by their fourth visit. After that first course, half had visits scheduled by their chiropractor before pain returned, and half were asked to call when it came back. Over a year, the scheduled group had 12.8 fewer days with bothersome low back pain, and averaged 6.7 visits against 4.8. No serious adverse events were recorded.
• Who it helped, and who it didn't. A 2019 analysis of the same trial split people by how their pain affected their lives. Those whose pain interfered most with everyday life had 30 fewer days with pain on maintenance care, with the same number of visits. People who were already coping well with their pain had about 11 more days with pain and more visits, and a third group had no difference in days with pain and more visits.
• What it changed and what it didn't. A 2020 analysis found maintenance care didn't change how soon the next episode of back pain arrived, in any group, and attributed the whole benefit to the group whose pain interfered most. In that group, people had fewer days of activity-limiting pain within each episode, and their pain-free stretches between episodes added up to 9.8 more weeks.
• A smaller back pain trial. In a 2011 trial of 60 people with low back pain lasting six months or more, everyone given a month of spinal manipulation improved more than the sham group at one month. Only the group that then had maintenance manipulation every two weeks for nine months showed more improvement at ten months. In the group with no follow-up, pain and disability scores went back to near where they started.
• Neck pain. In a 2011 trial of 98 people with chronic neck pain, monthly spinal manipulation for ten months, with or without home exercise, made no difference compared with a visit with a chiropractor every two months to evaluate and discuss symptoms. All three groups held on to the level they'd reached after their first course of care.

The 2019 review, written by chiropractors involved in the Nordic research, found the results on neck and back pain mixed, and concluded that maintenance care can be considered an evidence-based option for people with earlier episodes of low back pain who did well with their first treatments, though not for every chiropractic patient. That's a small body of evidence, and it describes groups of people rather than predicting your own result.

Is regular chiropractic care safe?

The most common side effects are short-lived. NCCIH reports that mild to moderate effects, most often more pain or discomfort, stiffness or headache, often follow spinal manipulation, and most go away within 24 hours. Serious side effects, such as serious spinal or neurological problems or strokes involving arteries in the neck, have been reported. They're very rare, and there are no accurate estimates of how often they happen. NCCIH adds that the chance of a serious side effect may be greater in people with underlying health problems, which is why a thorough assessment and a full picture of your health conditions and medicines matter. Your history and paperwork are part of how we check for any reason an adjustment isn't right for you, and a change in your health or your medicines since your last visit belongs in that conversation.

What are the other options?

Coming in only when pain returns is an option too: in the Nordic trial it meant fewer visits over the year. Exercise is the other well-supported option. A review of 21 trials found exercise combined with education reduced the risk of a new episode of low back pain (moderate-quality evidence), and exercise alone may as well. For back pain, England's NICE guideline recommends self-management advice tailored to the person, encouragement to keep up normal activities, and manual therapy only as part of a package that includes exercise. Our safe exercise guide covers building up activity, and we'll go over the options that fit you at your exam.

Is chiropractic care safe for older adults?

Age alone doesn't decide if a technique is right for you, or if manual treatment is right at all. Your own assessment does. Underlying health problems can raise the chance of a serious side effect, as NCCIH notes above, so previous falls, osteoporosis, past surgery and the medicines you take all matter before deciding on any manual treatment, and they belong in your health history.

Staying steady on your feet takes a broader plan. The CDC's steps for older adults include strength and balance exercise such as tai chi, asking whether any of your medicines can cause drowsiness or dizziness, a dilated eye exam at least once a year, and clearing trip hazards such as throw rugs.

Can a chiropractor help with stress?

Stress and anxiety can bring tension, headaches or body pain, and lost sleep. Muscle tension that keeps coming back is one of the things wellness care here addresses. If part of what you're feeling is in your muscles and joints, that's the part our care is aimed at, alongside the other care you're getting.

If you're struggling to cope, or stress or anxiety won't go away, NIMH says it may be time to talk to a professional, and that's a conversation for your doctor or a mental health professional. Psychotherapy and medication are the two main treatments for anxiety, and an adjustment doesn't replace them.

Does insurance cover maintenance chiropractic care?

It depends on the plan. Medicare, for one, doesn't pay for chiropractic maintenance therapy, which it defines as a treatment plan that seeks to prevent disease, promote health, and prolong and enhance quality of life, or therapy to maintain a chronic condition or keep it from getting worse. Care also counts as maintenance once further improvement can't reasonably be expected and treatment has become supportive rather than corrective. We accept HSA and FSA accounts, and superbills can be provided to any patient who wants to file with their insurer. Whether your plan pays for longer-term care is a question for your insurance company, so ask the office what the visits in your plan will cost.

Book a visit

Already a patient here, and the problem that brought you in has settled? Ask about longer-term care at your next visit, and we'll talk through whether it fits your goals. New to the office? Whether you're looking for a wellness chiropractor or for help with a problem that's bothering you now, a first visit in Clarksville is where every plan starts. If we are not able to help you with your problem or are unable to reduce your pain levels, we will make sure to give you a recommendation to another experienced provider. Book online or contact us.