Discovering Relief: The 12-Visit Threshold in Chiropractic Care for Chronic Low Back Pain

Ask the Chiropractor-
In Mitchell Haas' seminal research paper, "Dose-response for chiropractic care of chronic low back pain," the critical finding emerges that around 12 visits to a chiropractor are necessary for significant relief from chronic low back pain. This insight underscores the importance of consistency and commitment to a structured chiropractic treatment plan for patients seeking long-term pain management solutions. Understanding this threshold can empower patients and healthcare professionals to optimize the benefits of chiropractic care for chronic low back pain effectively. #healthy815 #icachiropractor #palmerproud 

www.rockforddc.com

Transcript

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Hello, Dr. Brant Hulsebus here and welcome to another edition of Ask the Chiropractor. Ask the Chiropractor is my little podcast that I do when someone has a question about chiropractic or chiropractic care, I try to answer. I'm a chiropractor here in Rockford, Illinois. I'm a proud graduate of Palmer College of Chiropractic and I'm happy to be the team chiropractor of the Rockford Icehogs. Let's dive into it. Hi, thanks for tuning in for another episode of Ask the Chiropractor. This time I'm going to talk a little bit about something I've brought up in the past, but I was sharing some interesting research over the weekend when I was at the state, the national conference. I'm the Illinois delegate of the national conference and our national conference. I was, came down to do a bunch of speakers. I went on my first One of my more favorite speakers, Dr. Chestnut, just keeps spewing out the research validating chiropractic care and what we do. Um, I thought it was very interesting because he talked a little bit about how much does somebody have to come to the chiropractor? Let's, you know, new patients come in. How many times do I have to come? What do I have to do? Is there any benefit for me just coming one time? And you know, when someone says, is there any benefit of me just coming one time, getting adjusted one time, it's kind of like asking the question, Hey, I need to lose some weight. I need to get healthier. Can I just eat better one day and get big results? Or closer terms, I just had shoulder surgery. I need to go to physical therapy. Hey, physical therapy, just, you know, just teach me what I need to do one day. I don't want to keep coming back over and over again. So this to me has always been a silly question. It's just, I don't know why people think they can just come in, uh, as a new patient and get seen one time. Now, if you've been a patient, established patient, and you'd be coming in for wellness based care for a long time, and you do something wrong, you need to come in, just get one quick adjustment to get back on your feet. Well, that works, but that only works because you did the initial care plan, the follow through afterwards and continue with your wellness care. That's the reason that works. It doesn't work the first time you come in. That's like, you know, I go to the gym every day and I work out every day, get good results. That's like me saying, Hey, my friend goes here every day. Can I just come in one time and get the same results they got. Now, of course, you're going to come many, many times. So let me talk a little bit about this research paper and where this research paper is found and a little bit more about it. It's been a while since I've talked a little bit about research. So in my opinion, one of the most trusted sources of research is PubMed. Anything you want to look for, you just type in what you're looking for and type in the word PubMed afterwards. It's P U B M E D. So I want to learn a little bit about, is chiropractic safe? I type in chiropractic safety PubMed. Then I get all the PubMed articles. And they get researched. to accept PubMed articles. It's, there's no questions. No one's arguing PubMed results. Like if I go to my medical doctor and I bring five or six PubMed articles, we're not having a debate about what I'm talking about because I bought PubMed articles. So anybody can write a journal and write a, write a research paper and put in a journal. There's journals out there that are print anything. There's some in my profession that print anything. There's some in everyone else's profession that prints anything. And just because you're reading a journal doesn't mean it's good. It just means somebody published it. Just like anything you read on the internet doesn't mean it's true. Whether it's fact checked or not doesn't mean it's true. It just means somebody was able to let you write it and they're not taking it down. And again something PubMed indexed, the research goes through years and years of scrutiny. Because it's 2024 right now, we're just getting the newest research out about COVID on PubMed because it takes years of scrutiny to validate the research is legit. The example I was taught by one of my mentors, Dr. Dan Murphy, was, we could write a paper right now about whether or not water is good for plants. What we're going to do is we're going to do a double blind random control study. Double blind random control study means half the plants know it's real water, excuse me, half the plants get real water, half the plants get fake water, and we don't tell them who gets what. So the plants are oblivious to what's getting what. So we give the plants fake water, and we give 12 plants real water. So 12 plants get fake, 12 plants get real. We do this exact amount every single day. After two weeks, all of our plants died. So doing double vitamin control study, we were able to prove that water is bad for plants. And we followed the rules exactly same amount of water, same time, every day plants were the same shape and size when we started and they all died. So according to that research in that paper, water is bad for plants. So we sent the PubMed and PubMed looks at our research and looks at all the factors we did our studies and PubMed finds out we did our research in a basement with no sunlight. And the plants were in soil, they were just laying on the concrete and we were just dumping water and fake water on them every day. So the water had nothing to do with whether they had died. But PubMed kicks us out. They say there's no way we're publishing this paper, there's no way. Your research is invalid, it's not accurate, there's no way we're going to publish your paper. So in order to get some PubMed index it goes through a lot of scrutiny. Now that's been said, when you go to PubMed and you type in Dose Response for Chiropractic for Chronic Lower Back Pain. So someone comes in, they've had lower back pain more than six weeks. That's really typical at a chiropractic clinic because we're usually not the first person you go to. Usually you try some NSAIDs, first non steroidal anti inflammatory drugs, which ironically, there is no research, valid research that shows that helps with that. Just saying, if you have it, share it with me, I'd love to see it. Again, make sure it's PubMed index. Otherwise, I don't really care where you found it. And please don't give me something from a drug company that talks about why their drug is good. That's ridiculous. Find some good piece of research that shows me differently. But, it's usually six weeks before somebody finds the chiropractor. And what they did is they took all these people, they did a randomized controlled trial. And they took all these people and they said, how many adjustments do these people need? in order to get better. In this article, let me give you the information on it, was dose responsive for chiropractic care for chronic lower back pain, written by Mitchell Haas, H A A S, and that was in Spine, 2004, the September October edition. So I'm sharing the information. If you're watching this, I'm going to try to put a link below so you can actually pull up the article yourself and take a look at it. And the results was after four weeks of care, some people got two adjustments, some people got eight, some people got this, they found was the magic number was 12. After 12 adjustments, people started to receive the benefits of chiropractic care. So you come in five times, you come in four times, you come in this and that. But if you really want to see the effects of getting better and getting well, the majority of people took 12 adjustments. So when you come to see me and they say, Hey, how many times do I have to come? I always usually start, let's say 12. And then from 12 we can go up if we need to. So most people always need 12. Now there sometimes people need 10. Yeah. There's always gonna be exceptions to the rules. I would say. If you're a young fit conscious of which you eat, maybe a yoga instructor, can you get by with some? Probably. Probably.'cause the 12 wasn't the magic number for everybody, but the majority of people was 12. So when you look at the research and they say, what's it, what's a good sample number that every chiropractor should start every patient with, regardless of their technique or how their style of chiropractic, it should be 12 visits. So if you come to see me, be prepared to give me 12 visits in order to see a change. Now, does that mean in 12 minutes you're perfect? No. That means in 12 minutes we've started to establish the change. From there, we want to do some stabilization stuff. You want to do make sure you hold on to your adjustment. We want to do maintenance adjustments afterwards for a while to make sure you keep up with it. And if you elect to do wellness care after that, which as a chiropractor, obviously I recommend, then I recommend that you do whatever your spine and your x rays and your exam shows. But the magic number is 12. And why do I get that from? I get that from a PubMed research journal written by Haas that showed all the research you did, and it showed the magic number was 12. So if you're gonna try chiropractic care and you want to give it a real try, And you want to invest a little bit of money, a little bit of time in it, and some energy. If you're not willing to commit 12 visits, then you're not willing to commit. Then you're not really giving it a try. So when someone says, Hey, yeah, I tried chiropractic before. I said, You did? Tell me about it. Yeah, I went three times. It did not help. I'm never surprised to hear that answer. I always tell them the 12 days. It didn't help. I went on a diet for three days. It didn't help. So I stopped doing the diet. I didn't see significant changes after three days. So yeah, so give the chiropractor a chance three times a week for 12 visits. That's usually the base level. Then from there it can be more. It might take more. If you have a horrible scoliosis, you can go back and listen to some other podcasts where I talk about the different variables of who gets better and how long and the different things we look at when we do your care plan. That's this kind of stuff we look at. Here we go again. How many times do I have to come? This is a podcast you listen to all the time. So this is a new, updated version of how many times do I have to come. You need to give us at least 12 visits. The research shows 12 chiropractic adjustments to make a change. Not to fix everything, but to make the change. To know that you're going to get better under chiropractic care after 12 visits. If you don't give it 12 visits, you're not giving it a fair shake. Look at the article. Check me. Check to see if I'm telling the truth. Go ahead. I love it. I love to be fact checked. The articles there, like I said, I gave you all the information before I'm gonna look it up one more time. It's low dose response, excuse me, low dose response for chiropractic care for chronic lower back pain. Mitchell Haas. I think it's pretty cool. I think it's pretty cool that we're getting some science now to back up what chiropractors have been saying and noticing for years. It's one thing for me to have the clinical experience to say something, but it's really cool now that we have PubMed research showing you have to give it 12 tries. After 12 tries, you can do a reassessment and see where you are and how much you've progressed. But you can't give up on it or quit on it until at least 12 visits. And after 12 visits, you can go from there. My dad always said, give me 10 visits, let's see if we can make a change. Dad was close. He was real close. It's actually 12 visits. If I know my dad, he would sneak two more in anyways. Just cause he knew it took that much. There you have it everybody. So if you have a question about chiropractic or chiropractic care, remember, only one person can answer that question. And that's the chiropractor. And some of the new research too, but if you make sure you always ask a chiropractor about chiropractic care. I've never asked my dentist questions about my toenails, right? Because that's inappropriate. Just like asking a medical doctor questions about chiropractic. The medical doctor never studies chiropractic. It's not part of their curriculum. They really don't know what we do as a chiropractor. So if you want more go to my website rockforddc. com that's r o c k f o r d then dc like doctor of chiropractic r o c k f o r d d c. com and you can leave me a message there or wherever you're listening to this or watching this you can leave a message there too and maybe next week you'll be the question of the week and ask the chiropractor. Thanks everybody. Thanks for tuning in.