What is the Difference Between Maintenance Care and Corrective Care?

Chiropractors treat painful conditions and vertebral subluxations with corrective care. Once the body is functioning normally, maintenance care is performed on a regular basis to maintain wellness.

How do you define and describe chiropractic maintenance care?

Dr. Gregg Rubinstein: So, I would define chiropractic maintenance care, actually I don’t love the word maintenance because maintenance means to stay the same, I like to call it wellness care because it’s really more about optimizing the body. When someone is on maintenance or wellness care, we’re not treating any specific condition, typically they’re not having pain or discomfort, right? We’re just doing periodic checkups to make sure that the spine is in proper alignment.

When the spine is in proper alignment, the spine performs better. So, when everything is centered and lined up properly, your body is stronger and straight and able to handle all the stresses and strains we throw at it. We are pretty hard on our bodies sitting for hours a day or we’re weekend warriors, playing golf or skiing and crashing our bicycles and doing all these different things that we do on a daily basis. Sometimes we can get misalignments that aren’t significant enough to cause pain or discomfort but it’s still important to get checked. If the bone is out of alignment, it is interfering with nerve transmission. Since the nerves don’t just sense pain and move muscle, they control your heart, your lungs, your kidney, your spleen, your immune system. You can have pressure on the nerve system and not even be aware of it. So doing wellness care or maintenance care to prevent the buildup of those misalignments or subluxations, that’s really what’s important and I call that subluxation management or wellness care.

Could you please explain what chiropractic corrective care is?

Dr. Gregg Rubinstein: Absolutely. So, when we look at corrective care, that’s the initial correction. Let’s say you’ve gone 40 years of your life, you are a hardcore mountain biker and you have a desk job and all these different things. And all of a sudden you find yourself, you’re like 35 years old and your back and your neck are killing you and all of a sudden, you’re in all kinds of pain. You go into a chiropractor, they take some x-rays, they examine the alignment, they find that things are misaligned. There might be some arthritic degeneration or degenerative changes or stress on the discs or disc degeneration. And then, you have to go and you have to do what I would call basically a cleanup job, where you need to get the spine to as healthy as it can be for that person. They might have done some permanent damage, but wherever they are, you want to get that spine as healthy as it can be for that particular person.

Usually that requires multiple office visits per week for a period of time. On average, a lot of our initial corrective cases here in my office are usually running about three to four months. We might start them off at twice a week for five to six weeks and then do a reevaluation after 10 or 12 visits and then determine, did we make enough correction? Is now the right time to decrease the frequency down to once a week? And then I might do that for two months. Then we talk to them about transitioning over to wellness or maintenance care, once we’ve done the initial correction. But that’s the initial corrective work. It’s like if I bought a house from you and it was kind of a fixer-upper, the initial correction would be putting up this wall, repairing this, fixing the foundation, fixing all the holes in the roof. And then once all that’s done, then there’s just general maintenance and upkeep on the house. So that would be the best analogy I could give you.

What are some conditions that maintenance care is good for, and which type of conditions could benefit from corrective care?

Dr. Gregg Rubinstein: So mostly the painful conditions, the significant amount of degeneration, those are the things that we’re always doing the corrective work. If someone’s been taking good care of their spine and there’s not a lot of problems, then maintenance is the way to go where it’s just those periodic checkups to make sure things don’t get out of hand and end up needing a corrective care plan.

Again, if it’s a mom who’s been bringing their kid in periodically to get checked all throughout their lifetime, chances are we just continue on a maintenance or a wellness path. But if the child has an accident or falls off the monkey bars, which never got checked and then five years later the kid is having issues trying to play soccer at the high school level, then all of a sudden you’re like, “All right, well now we’ve got some corrective work to do”.

So, the initial correction is the initial phase of care to get the body and the spine as healthy as it can be. And then maintenance or wellness care is to keep it in that state optimized and functioning at its highest level.

Do chiropractors specialize in either type of care or do they generally provide both?

Dr. Gregg Rubinstein: I would say that it really depends on the chiropractor, and I would say it’s probably close to a 50-50 split. There are some chiropractors that are very mechanistic and all they want to do is deal with back pain and neck pain and that’s the banner that they fly. But a lot of chiropractors, myself included, are called principled or philosophical chiropractors that really subscribe to the fact that when your nerve system is optimized and working at its best, your body is going to be healthy, optimized and working at its best because that nerve system is that master system. It controls everything else in the body. Nothing happens in your body without the nerve system say so.

When you optimize the nerve system, you’re really getting the most out of your care. Because if you use chiropractic for just your back aches and neck aches, really you’re getting 10% of what we have to offer because only 10% of your nerve system is dedicated to sensing pain and moving muscle. The other 90% of it is running, regulating and controlling all the healing in your body. Your nerve system does millions of processes that you don’t even have to think about. Your entire autonomic nervous system, which sounds like automatic, handles everything. It breaks down the food you take in and sends the proteins over to the muscle and some to the liver and sends the sugar into the bloodstream and gets rid of the stuff you don’t need. It detoxifies the aspirin and anything that you take in, it does all these things without us thinking about it. The innate wisdom of the nerve system does so many things and it’s so important to make sure that there is no interference to that flow. Because if you interfere with the flow of information from the brain to the body, then you’re going to have a disconnect, the body will break down, it doesn’t function properly and then we have health challenges that start to arise.

Which type of care is considered preventative care for a person with a healthy spine who just wants to maintain their health?

Dr. Gregg Rubinstein: Absolutely, it’s going to be wellness care, that’s really what we want. We want to make sure that they go through a correction if it’s necessary. And then once they’re healthy and want to keep it, then yeah, it’s just wellness or maintenance care.

Even for people who’ve never had pain, sometimes I’ll take x-rays and there is some corrective work that needs to be done. So, it’s really important to understand that in my office, wellness care takes place either once a week or twice per month. A lot of people come twice per month and that’s what I do for myself and everyone that I care about. Some people might need a little bit more maintenance on a maintenance schedule and might need to come weekly depending on what their history was, what their traumatic history was and how healthy and how good they took care of their spine and their body. So, it’s really going to be different. But anyway, preventative care is always going to be more on the wellness side of things for sure.

Learn More

To speak with Dr. Gregg Rubinstein, visit www.ChiropractorMidtown.com or call (212) 977-7094 to schedule an appointment.

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