Dear pain patients, high-value care is not in being touched

A lot of people are shocked by how much we charge for our consultation and recovery programmes. They think it’s staggering out of proportion compared to other chiropractors in Singapore. These comparisons are often based on how much we charge versus how much our competitors charge per session, without considering the true value that we deliver.

We have openly discussed our fees previously, and we can tell you for certain that our client lifetime value (i.e., how much our clients spend in total) is a fraction of what people are spending at other chiropractic clinics. We have discussed this before so we won’t be repeating ourselves.

Expectations of what is good recovery needs to change

In our opinion, there is no good reason for you to see a crack-and-go chiropractor. First, research is able to show, through placebo studies, that chiropractic adjustments don’t work. This is not an attack on chiropractic by other health professions. These studies are conducted by chiropractor themselves!

At the end of the day, evidence-based chiropractors need to keep up with times and acknowledge that spinal adjustment is not a magic healing tool!

Similarly, physiotherapists should also stop offering manual therapy such as soft tissue therapy, active release therapy, dry needling, massage, and all forms of electrotherapy. There’s no compelling evidence to suggest these treatments are better than placebo.

Even with hard data aside, most people experience for themselves that their pain always come back after their adjustments or massage. So, why do we perceive them to be worth-the-money?

P. S., don’t forget most chiropractic clinics also sell lifetime maintenance or wellness packages. In doing so, they are admitting their results are only temporary.

Being touched is low value care

Yes, it feels good to be touched. Research shows that being touched releases oxytocin. Oxytocin is the hormone that gives warm, fuzzy feelings. It makes you feel loved. Unsurprisingly, it’s linked to reducing pain sensitivity.

Once all of that is done and dusted, your pain returns. Simple as that. Being touched is not recovery. Being touched, at best, gives you a delusion to feeling better without actually giving you any recovery outcomes.

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The Lancet’s recommendations for low back pain. Spinal manipulation, massage, acupuncture are all considered adjuctive therapies (i.e., not essential to recovery).

When we look at the latest clinical guidelines, ALL of them agree that manual therapy is second line AND adjunct treatment. This roughly translates to that it’s okay to offer them but don’t expect them to work.

You need to invest time and effort to get good recovery outcomes

Honestly, there aren’t that many (if any) things worth having that don’t require an investment from you. To get good grades, you need to study. To get a work promotion, you need to perform well.

You want good recovery outcomes? You need to exercise.

All guidelines agree that exercise is one of the best first-line treatments for chronic pain. Besides exercise, advice to stay active, education and cognitive behavioural therapy are also known to work. All of these treatments require you to do the work. Yes, it takes effort.


Education actually works

We have a super extensive website with over 300 articles. Why? Because we believe in education. Instead of pretending to take your pain away, we help you help yourself find freedom from pain.

For you to achieve good recovery outcomes, you must know about your pain and your body. You must be able to self-manage. All of these is only possible with education.

For example, pain doesn’t equal to damage. Conversely, damage doesn’t equal to pain. This shock a lot of pain sufferers yet, from an academic and clinical perspective, it’s a basic tenet of pain science. You need to know this.

We also have a recovery guide that we can send you for free. To get a copy, drop us a WhatsApp message.

Yes, research says education works!

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The Lancet Low Back Pain series also recommends exercise PLUS education to work better than exercise alone.

A 2021 study looking at 4,107 knee osteoarthritis patients found that patient education works better than usual care. In this case, usual care likely refers to passive treatments like massage, dry needling, etc.

It’s important to note that the study also found exercise to be better than education. And that exercise + education is superior to exercise alone.

The moral of the story? You need to use both your brain and your body to get good recovery outcomes.

Is exercise even part of chiropractic?

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Exercise is a big part of chiropractic since the very beginning. Early chiropractors used exercise to help patients achieve alignment of their spines. What we are doing at our practice is 100% part of chiropractic.

Unfortunately, many chiropractors in Singapore choose to not offer exercise as part of their treatment approach. The reason is because exercise as a treatment takes consideration longer time than just a five-minute full spine adjustment.

Furthermore, the relief from getting cracked is fairly short. Research suggests that it lasts for only 30 minutes. Many chiropractic patients will experience relief for a couple of days at most. This means they will need regular treatments. For this reason, choosing to mainly offer spinal adjustments is good for business! You have to keep coming back for more!

With the growth of science and research, we starting to learn more about body, and what actually helps with recovery. Both chiropractors and pain patients alike would have to keep up in order to achieve good outcomes. Yes, all of us have our own biases, beliefs, values. We are not denying that.

What we are saying is that, at some point, all of these have to go if we want good outcomes. We have to keep up with times. Especially if you are not getting better.

Have a think about it. You can’t keep doing the same thing and expecting a different result. What you need for extraordinary results is a radical change. This can start with the type of treatments you choose.


Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.