Data regarding 1000 cases of low back pain treated in 30 different chiropractic offices were collected. 293 different variables were collected regarding the patient and his/her condition, history, care, outcomes. *
Days & Visits to Maximum Improvement
To reach maximum improvement (100% relief of pain, 3 months of care, or return to pre-injury state), the mean outcomes regardless of condition were 29 days and 12 visits.
Some Conditions Require More Care
When conditions were taken into account, the outcomes vary. Examples:
L5 disc herniation 86% were maximally improved in less than 3 months 36% needed more than 20 visits 30% needed more than 30 visits
Lumbar Sprain/Strain 91% were maximally improved in less than 3 months 29% needed more than 20 visits 9% needed more than 30 visits
Rule of 50%
50% relief is sought within 30 days.
At 50% relief of pain, visit frequency is reduced by 50%. ex: If you are seen once a day, you would then be seen once every two days.
Imaging and other tests are not generally ordered unless progressive neurological deficit or cauda equina syndrome is present or appears during the course of care.
Note: Often 50% relief is reported in a day or two, sometimes (in more painful conditions) it isn't reported until weeks two to three of care. The physician sets the treatment plan and carefully monitors progress.
* The full article was published in Topics in Clinical Chiropractic 1996; 3(3) and is reprinted in Dr. Cox's Low Back Pain textbook.