What is Maintenance treatment, and do you need it?
Once a patient is pain free we often get asked should I be coming back for treatment to prevent my injury from reoccurring and if so should it be monthly, quarterly, biannually etc?
The honest answer is it is completely case dependent as there are so many variables that go into that decision. Therefor I thought I would try and do my best to explain where it can be useful and why…
A large part of it will hinge on the duration of time you have had the injury, your day-to-day lifestyle and what the day job involves. One thing that we know for certain in the medical world is that the number one risk factor of injury is previous injury. In short if you have hurt yourself before you are more likely to hurt yourself again unless you have gone through an extensive rehabilitative program to eliminate the weakness created by the injury and have addressed the original cause of the injury. In most instances this isn’t the case, as human nature dictates that once it stops hurting, we feel we are better, and we go back to our normal lives.
A common example of this is chronic low back pain, often you will have seen either our Chiropractor or Osteopath as the treatment techniques such as spinal manipulation and mobilisation have a great body of evidence supporting their use in managing lower back pain. Now it is important to point out that if you have never had a back pain episode and come for treatment for the first time this is unlikely to be relevant for you. I am referring to the patient who has had ongoing episodes of lower back pain which are often starting to occur more frequently. For this patient we can gradually increase the spacing between appointments to find the optimal time to have treatment and keep the lower back pain under control. We may also recommend working with our Pilates specialists alongside this to address the weakness that has resulted from their reoccurring injury which in time will reduce the need for treatment.
Another scenario where maintenance can be beneficial is with something like an arthritic knee. Let’s say that it isn’t bad enough that you need surgery but it is painful and preventing you doing the things you enjoy doing. In this instance I would suggest seeing one of our Physiotherapists who use acupuncture in a medical sense which can be a great option to manage your symptoms and enable you to do exactly that. Acupuncture as a treatment modality is now growing a significant body of evidence for its effectiveness in managing chronic pain, as shown here. Of course, the duration of time between appointments will vary from case to case depending on the severity of the arthritis, the degree of pain you are in, and how active you want to be.
Lastly let’s look at Sports Massage and Massage. This is a very different conversation as often these treatments aren’t injury specific. Instead, someone is looking to stay as mobile and relaxed as possible using treatment as a means of doing this. Frequency of massage is much more patient directed in that you could have a massage every week for the rest of your life and it would only do you good. There is no risk of over treating as life creates tension, whether that is stress related, posture related (the good old desk) etc. So when it comes to massage the best thing is to speak to the therapist and they can guide you towards a frequency that will suit you best. Just as an example I have a Sports Massage once a month to help with the tension created from treating, but you may want to come more or less often than this, it will all depend on you.
Clearly, I could go on and on trying to cover every ailment or scenario but hopefully that gives you a rough idea of the options available to you. The best thing to do is simply ask the therapist you see next time you are in, or alternatively get in touch via email or phone and we can look at your case and work with you on what would be the best option.
Sam Pargeter