There are four distinct phases of treatment that each patient can choose to receive. Each phase gives separate and distinct benefits to the patient, and each takes a different time frame to accomplish, depending on the initial patient condition at the time treatment begins.

The four phases are as follows:

1. Acute or relief phase of care
2. Corrective phase of care
3. Strengthening phase of care
4. Maintenance or supportive phase of care

   This phase of care is typically the initial stage because it is the phase in which the patient enters the office in some degree of pain. This phase can be characterized by swelling, lack of motion, muscle spasm, or just plain feeling lousy. It is the stage in which symptoms predominate the patient's concern. Treatment during this stage can consist of various forms of physical therapy, ice therapy to reduce swelling, and chiropractic adjustments of the spine. This stage can last a few days to a few weeks. Treatment is normally at its highest level with many conditions requiring multiple visits each week.

1. Patient's age.
2. Patient's weight.
3. How long the patient has had the condition.
4. To what degree the patient can avoid the activities that aggravate the condition.
5. To what degree the patient follows the advice of the doctor.
6. Patient's threshold level of pain.
7. Does the patient have other health issues?

   The corrective phase begins when the pain has significantly been reduced. This stage is characterized by the patient feeling like he is able to resume hisnormal activities. This is a very important time because if the patient truly resumes all of his activities at this moment, it is common for the pains to begin to increase again. This occurs because the condition has not yet been fully stabilized. Treatment continues to utilize physical therapy in an attempt to continue to keep the muscle spasm in check as well as re-educate those same muscles into their normal tone and length. Ice therapy may continue as well. At this stage the chiropractic adjustments are attempting to increase spinal mobility in order that more normal function may return to the spine and nervous system. This phase of care can take a few weeks with very minor conditions to months in more severe conditions. The frequency of care can still be multiple visits per week, but perhaps not as frequent as in the acute or relief phase.

   This phase of care is characterized by either significant reduction of pain (or no pain) in most cases and continued stabilization of pain in the severely chronic cases. Frequency of visits continues to reduce, while rehabilitative exercises typically increase in this phase. Our goal in this stage is to strengthen the soft tissue that surrounds the affected spinal segments so that proper function becomes consistent in these regions of the spine. Consistent function not only allows for pain reduction of the muscles, tendons, and ligaments, but also allows for the proper function of the organs and tissues that the nerves of the area control.

   The fourth stage of care is the most fun for both the patient and myself. This is the stage in which the pain is either totally gone, or extremely stable in chronic situations. Treatment frequency can range from once per week to once every two months. The goal of this stage is to keep the patient at the he desires. There are great benefits in this stage. Once a patient has worked hard to get to this level, it is much easier to keep it here. Usually a patient has gotten into better work and exercise habits, which promotes good health to begin with. Also, the patient's attitude at this stage is usually very positive. There is a feeling of accomplishment that comes with any job well done. Another tremendous benefit of this stage of care is that, if for some reason an injury to the spine occurs again because of something unforeseen, it is very common that instead of needing a significant amount of treatment to help, a relatively small amount of care usually does the trick. A good example of this is to note how fast highly conditioned athletes recover from injuries that would take most of us a very long time to recover from the same injury.

   Final word- it is always your choice to determine to what degree you choose to benefit from chiropractic treatment. I will always describe to you the benefits of the four stages of care in your particular case so that you can make the most educated decision for your specific situation.