I asked Chat GTP this question and this is the answer that I got. It is a good answer and one which I tend to agree with. It is how I try to manage my patients.

The frequency of chiropractic visits for simple biomechanical back pain depends on multiple factors, including the severity of the pain, the individual’s response to treatment, and specific goals of care. However, there is no universal guideline supported by definitive research that applies to every patient. Current evidence provides some general insights:

Evidence from Research

1. Acute Low Back Pain:

• Research suggests that patients with acute low back pain (less than 6 weeks duration) may benefit from 6–12 sessions over 2–4 weeks, typically involving spinal manipulation and other therapies.

• A randomized controlled trial (RCT) published in Spine in 2014 showed that high-frequency visits (3 times per week) initially provided better short-term outcomes, but over time, lower frequencies were equally effective.

2. Chronic Low Back Pain:

• For chronic pain (lasting more than 12 weeks), maintenance therapy (1–2 visits per month after the initial treatment phase) might help prevent recurrences. A 2011 study in Spine Journal found that continued care produced better outcomes compared to symptom-guided visits.

3. Individualized Care Plans:

• Systematic reviews highlight the importance of individualized care plans based on patient progress rather than fixed schedules. Overuse of care without clear benefit should be avoided to ensure cost-effectiveness.

Clinical Guidelines

• Guidelines from organizations like the American Chiropractic Association recommend evidence-based care that starts with a higher frequency of visits (e.g., 2–3 times weekly) for acute issues, gradually tapering off as symptoms improve.

• The National Institute for Health and Care Excellence (NICE) in the UK emphasizes the use of manual therapy as part of a broader multidisciplinary approach, recommending treatments over a few weeks rather than long-term, frequent visits.

Practical Considerations

The recommended frequency should always be adjusted based on:

• The patient’s response to initial treatment.

• Any underlying conditions or complicating factors (e.g., herniated disc or sciatica).

• The patient’s goals (e.g., pain relief, functional improvement, or preventative care).

Conclusion

For simple biomechanical back pain:

• Acute Phase: 2–3 visits per week for 2–4 weeks.

• Subacute to Chronic Phase: Reduced frequency, transitioning to 1–2 visits per month if needed for maintenance.

• Treatment frequency should be guided by ongoing assessments of pain and function, with adjustments based on patient improvement and preferences.