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By Rick L. DaSo, D.C.

The recommendation of maintenance care and supportive care of the spine and body frame is a common concept in chiropractic. I have always struggled with this concept even though my training and education has taught me that a healthy spine is important in preventing injuries and reducing the reoccurrence of many chronic conditions. In chiropractic, we have a saying:

"Structure Effects Function"

By maintaining a good healthy structure, we can improve and maintain function. Structure would be defined as the body frame, primarily the musculoskeletal system and function would be body mechanics and joint/muscle movement. We also know that the breakdown of the body frame will adversely affect the overall function of our nervous system and internal organs.

A breakdown in the structure of our body frame is not just associated with aging. Injuries throughout one’s life can contribute to the structural and functional degradation of our spine and related joints. Work stresses such as sitting at a computer all day or bending and lifting throughout the day can increase stresses to joints and muscles and accelerate joint dysfunction and degeneration. Chronic pain conditions can develop if not managed with supportive care.

A major sign of developing joint and muscle dysfunction is a loss of flexibility. You lose flexibility without even being aware of it. You begin to turn with your shoulders instead of using your neck. You may lift with your back instead of bending your knees. Stiffness in the morning and prolonged soreness after physical activity becomes more evident. This chronic stiffness and soreness effects your vitality. The process may take place over months or even years. Our body has a unique ability to adapt and compensate as these stresses effect our day to day life. Our awareness of this adaptation is limited as our body compensates function to maintain daily activities. As the condition progresses, many will begin to reduce daily activities, exercise, yard work, travel, and basic life’s enjoyment.

We know from experience that a supportive care regimen of chiropractic adjustments, massage therapy, proper exercise, and lifestyle modification can slow or arrest the progression and development of joint and muscle dysfunction. Reducing overall stiffness as we age is a significant factor in maintaining an active lifestyle well into our senior years. Everyone should consider maintenance or supportive care.

So what is the difference between maintenance care and supportive care? Maintenance care would be defined as ongoing regular care (i.e., 1-2 visits per month) for a patient without any symptoms or clinical findings. The purpose of this care is to maintain a healthy level of function and to prevent any flare up or reoccurrence of past issues, as well as identify any problems early on before they can develop.

Supportive care on the other hand, follows appropriate use of active and passive care concepts for patients that have ongoing/recurring symptoms or underlying issues such as degenerative joint disease, disc injuries, scoliosis and past soft tissue injuries. A supportive care program will include exercises, lifestyle modification, proper diet and chiropractic adjustments. Other therapies, such as massage therapy are also important supportive care treatments.

When I look at the evidence for maintenance care, I don’t see the efficacy of treatment in the absence of symptoms or clinical findings to the extent that I do with supportive care. If I see that a patient is doing well and has no symptoms or clinical exam findings, l tend to release them from care and have them return as needed. However, I do inform the patient on the signs to look for when a spine or joint problem is beginning or returning. The sooner treatment is initiated, the better chance of resolving or improving your overall health condition.

Much too often, I see patients that have had a developing problem for months, even years and just lived with the pain, stiffness, and soreness. Many are self-medicating with over the counter pain medications or taking prescription medications to control the pain. Massage and other therapies can be helpful, but may not fully address the true underlying cause of joint dysfunction. This approach in general does not get to the underlying cause of the chronic pain and can allow for the condition to accelerate and degenerate. Allowing the degenerative process to advance, minimizes the ability to manage the condition with conservative supportive care measures.

Don’t let your spine and musculoskeletal system degrade to a point of no return. A pro-active, multi-faceted spinal care program is the most effective way to maintain a healthy, vital and active lifestyle.

Please feel free to discuss your specific needs with us at any time. We can address your nutritional needs, proper exercises for your condition and the need for specific therapies to maintain and support your musculoskeletal system.