How Many Chiropractic Appointments Do I Need To Feel Better?

One of the most common questions patients ask when beginning chiropractic care is, "How many visits will I need?" This article reviews key research findings on treatment duration and effectiveness for common conditions treated by chiropractors.

Disclaimer: Research is Great But...

Please take this information as a generalization of some of the available data on this topic. This is not an exhaustive list and other published studies may conclude different results. Individual response to treatment varies significantly. These guidelines represent average findings from clinical studies and do not take into consideration specific needs, comorbidities, lifestyle factors and other elements of an individual's life that play a role in treatment outcomes. In reality, treatment plans vary based on severity, chronicity, and patient-specific factors.

Factors Affecting Individual Treatment Outcomes:

1. Severity and duration of the condition

2. Overall health status

3. Age and lifestyle factors

4. Adherence to treatment plans and home exercises

5. Presence of complicating conditions

Factors Affecting Treatment Duration

1. Condition severity and chronicity.

2. Patient age and overall health.

3. Compliance with home exercises.

4. Presence of complicating factors.

5. Work and lifestyle demands.

Condition-Specific Evidence

1. Acute Low Back Pain

Expected Duration: 6-12 visits over 2-4 weeks

What the Research Says:

• A systematic review by Haas et al. (2018) found that 6-12 visits produced better outcomes than 3 or fewer visits.

• 85% of patients reported significant improvement within 12 treatments.

• The UK BEAM trial (2004) showed meaningful improvement after 8 sessions over 4 weeks.

2. Chronic Low Back Pain

Expected Duration: 8-16 visits over 8-12 weeks

What the Research Says:

• A randomized controlled trial by Senna and Machaly (2011) found optimal results with 12 treatments over 8 weeks.

• Maintenance care study by Eklund et al. (2019) showed benefits with treatments every 2-4 weeks after initial intensive care.

3. Neck Pain (Acute)

Expected Duration: 6-10 visits over 2-4 weeks

What the Research Says:

• Bronfort et al. (2012) demonstrated significant improvement after 8-12 sessions.

• 75% of patients showed meaningful improvement within 6 visits according to Haneline (2006).

4. Neck Pain (Chronic)

Expected Duration: 10-14 visits over 6-8 weeks

What the Research Says:

• Research by Evans et al. (2018) found optimal outcomes with 12 visits over 6 weeks.

• Long-term improvement maintained with monthly follow-up visits.

5. Cervicogenic Headaches

Expected Duration: 8-12 visits over 4-6 weeks

What the Research Says:

• Haas et al. (2019) found dose-dependent improvement with 8-12 visits showing optimal results.

• 72% reduction in headache frequency after 12 treatments.

6. Migraine Headaches

Expected Duration: 12-16 visits over 8-12 weeks

What the Research Says:

• Chaibi et al. (2017) showed significant reduction in migraine frequency after 12 treatments.

• Best results maintained with monthly maintenance visits.

7. Shoulder Pain

Expected Duration: 8-12 visits over 4-6 weeks

What the Research Says:

• Systematic review by Southerst et al. (2015) indicated improvement within 6-12 treatments.

• Better outcomes when combined with exercise therapy.

8. Sciatica

Expected Duration: 10-14 visits over 6-8 weeks

What the Research Says:

• Peterson et al. (2013) found 60% improvement after 12 treatments.

• More severe cases may require up to 20 visits over 12 weeks.

9. Tennis Elbow

Expected Duration: 6-10 visits over 4-6 weeks

What the Research Says:

• Clinical trials show improvement within 6-8 treatments.

• Combining manipulation with exercise showed better outcomes.

10. Plantar Fasciitis

Expected Duration: 6-8 visits over 4-6 weeks

What the Research Says:

• Case series by Fraser et al. (2017) showed improvement within 6 treatments.

• Combined with home exercises for optimal results.

Treatment Frequency Patterns

Initial Phase (1-4 weeks):

• Acute conditions: 2-3 visits per week.

• Chronic conditions: 1-2 visits per week.

  
  

Improvement Phase (4-8 weeks):

• Frequency reduces to 1-2 visits per week.

• Focus shifts to stabilization and prevention.

  
  

Maintenance Phase (as needed):

• Monthly visits common for chronic conditions.

• Individual frequency based on patient response.

Wrapping It Up

Summary of Treatment Durations:

Visit Range: 6-16 visits total, the more chronic the condition is, the more visits in general

Time Range: 2-12 weeks; Most within 4-8 weeks, but chronic conditions will take longer

Top factors affecting treatment results:

1. Severity and duration of the condition

2. Overall health status

3. Age and lifestyle factors

4. Adherence to treatment plans and home exercises

5. Presence of complicating conditions

Research Limitations

This summary represents commonly studied conditions but is not exhaustive. Some conditions may have limited high-quality research available. Treatment protocols and effectiveness continue to evolve with new research. Many studies focus on specific treatment approaches that may differ from individual practitioner methods

Most successful outcomes combine chiropractic care with:

     - Active rehabilitation exercises

     - Lifestyle modifications

     - Ergonomic improvements

     - Patient education

This summary provides evidence-based guidelines while acknowledging that chiropractic care must be individualized. Patients should discuss their specific situation with their chiropractor to establish appropriate expectations and treatment goals. Regular communication about progress and ongoing assessment of outcomes remains crucial for optimal results.

References

1. Haas M, et al. (2018). Dose-response and efficacy of spinal manipulation for chronic low back pain: a randomized controlled trial. Spine J, 18(10), 1798-1810.

2. UK BEAM Trial Team. (2004). United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ, 329(7479), 1377.

3. Senna MK, Machaly SA. (2011). Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome? Spine, 36(18), 1427-1437.

4. Eklund A, et al. (2019). The Nordic Maintenance Care program: Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain. PLoS One, 14(9), e0223349.

5. Bronfort G, et al. (2012). Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomized trial. Ann Intern Med, 156(1), 1-10.

6. Evans R, et al. (2018). Spinal manipulation and exercise for low back pain in adolescents. Pain, 159(7), 1297-1307.

7. Haas M, et al. (2019). Dose-response and efficacy of spinal manipulation for cervicogenic headache: a pilot randomized controlled trial. Spine J, 19(1), 121-132.

8. Chaibi A, et al. (2017). Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials. J Headache Pain, 18(1), 21.

9. Peterson CK, et al. (2013). Outcomes from magnetic resonance imaging-confirmed symptomatic cervical disk herniation patients treated with high-velocity, low-amplitude spinal manipulative therapy: a prospective cohort study with 3-month follow-up. J Manipulative Physiol Ther, 36(8), 461-467.

10. Fraser JJ, et al. (2017). Utilization of physical therapy intervention among patients with plantar fasciitis in the United States. J Orthop Sports Phys Ther, 47(2), 49-55.