Understanding Chiropractic: How many sessions should I have with a chiropractor

With chiropractic adjustments being all the rage in Singapore, it is no surprise you want to know how often should you get adjusted. The problem is that Singapore chiropractors are telling patients they need to 40 or 80-session packages.

But is this true?

In this article we discuss:

  • What exactly does a chiropractor do?
  • Do chiropractic adjustments work?
  • Do you need to see a chiropractor three times a week?
  • How often should you see a chiropractor for optimal results (accordingly to research)?

What is chiropractic?

Chiropractic is an allied health professional concerned with the diagnosis and treatment of musculoskeletal conditions.

In Singapore, chiropractors are obsessed with adjustments or spinal manipulation because it’s a quick-fix solution.

They can collect $80 up to $140 for a five-minute session. It is no wonder that chiropractors want you to think that it’s all in the adjustments.

Chiropractic also include exercise

Curious enough, chiropractors don’t talk much about exercise. Even though chiropractic history tells us that BJ Palmer (son of DD Palmer and one of the developers of modern chiropractic) had an extensive collection of exercise equipment in his rehabilitation lab.

According to him, long-term “dis-use” cannot be corrected for with external manipulation and massage, and that an internal change — driven by the patient himself — is necessary.

What exactly does a chiropractor do?

Understand that chiropractors do more than just chiropractic adjustments.

As part of my training in chiropractic school, I would have covered treatments from spinal adjustments, dry needling, IASTM, Active Release Techqnique, clinical rehabilitation, physical therapy or physiotherapy, and many more!

My role as a chiropractor is to help you recover from your pain and injury. Chiropractors work exclusively with joint and muscle conditions — that is back pain, neck and shoulder aches, rotator cuff tears, tendinopathy, slipped disc, etc.

Not all chiropractors are the 10-minute, crack-and-go type.

Modern, evidence-based chiropractors are trained in a variety of tools and techniques — no different from what they teach at physiotherapy school — to help you find freedom from pain.

Does chiropractic adjustments work?

neck pain, jesse cai, massage
Paul Foster receiving a neck adjustment. Please note that we have moved away from the traditional adjustment method to help our clients find freedom from pain in as little as 4 to 7 sessions.

In short, yes. Maybe. no.

There is some evidence to suggest chiropractic adjustment can help with back pain. We discussed this at the seven hard truths behind a chiropractic adjustment so we won’t go into the details again.

Interesting, a paper published in 2019 is suggesting that chiropractic adjustments DO NOT WORK even in the short-term.

Most clinical guidelines do support spinal manipulation as an adjunctive treatment (i.e. it’s shouldn’t be a core treatment).

It is likely that adjustment-based chiropractic treatments are more feel good therapy that doesn’t result in any long-lasting change. As such, Square One Active Recovery no longer offer manipulation as a core service.

Check out our updated post on chiropractic adjustments for the latest research.

How many chiropractic sessions do I need?

Now if you want to know how often should you get a chiropractic adjustment, we can’t be absolutely sure because there isn’t much research looking specifically at the recommended dosage for spinal manipulation. Nonetheless, there are two trials that had looked into this.

#1 The first study looking at how often should you get a adjusted found that low back pain sufferer who saw a chiropractor three to four times over a 3-week period experienced more pain relief than those who only went once or twice. In short, patients who went to the chiropractor nine or 12 times fared better than those who went only three or six times.

#2 A second trial looking at the recommended dose for spinal adjustment was published in 2014. It compared four doses of care – no treatment, 6, 12, or 18 sessions of chiropractic adjustments. The paper found that 12 sessions over a six week period yielded the best improvement for both pain and functional impairment.

From what we know (as of today), 12 sessions seems like the magic number – way less than the 40-session packages some Singapore chiropractors seem to push for.

It should be noted that these studies did not offer a combination treatment group. Perhaps exercise WITH chiropractic adjustments could lead to shorter recovery times? After all, we do know exercise is first-line treatment when it comes to low back pain.

Does chiropractic work?

chiropractor, achilles tendinitis, chiropractor singapore
Kingsley Tay sought treatment from us in April for knee pain. We worked with him using our unique clinical rehabilitation approach. Within three visits across 10 days, he was completely pain free. Prior to see us, he had treatment from other physiotherapists and sports doctor to no avail.

A 2011 study published in Spine (one of the world’s most prestigious journals) looking at the benefits of regular spinal adjustments separated sixty patients into three groups. First group received 12 sham spinal manipulation (think placebo) over 1 month, the second group received 12 treatments of spinal manipulation over 1 month, and the third group received 12 spinal manipulations over a month followed by maintenance spinal manipulation every two weeks for nine months.

Results? The third group (12 sessions of spinal manipulation plus maintenance spinal manipulation every two weeks) had more improvement in pain and disability scores at the end of ten months.

A bigger, higher quality paper (328 patients) published just this year found that patients who have undergone maintenance chiropractic care experienced 13 fewer days of bothersome low back pain compared to the control group. The average total number of chiropractic visits (over a year) in the maintenance group patients was just under nine! Pretty neat huh?

It should be note that in this study, patients received predominantly chiropractic adjustments but also other therapies including soft tissue therapy and exercise advice!

So if you are thinking you need regular chiropractic sessions to help with your lower back pain, there is some research to say that it does. Based on the 12 chiropractic session plus maintenance care every two weeks, a 40 session chiropractic page should be able to last you over a year!

What is maintenance care?

In symptomatic care, patients are treated based on their symptoms. This means you come in with pain somewhere in your body, your chiropractor uses chiropractic adjustments or a variety of treatment options to get you out of pain. Once your symptoms are gone, you are discharged from care. It is also referred to as sick care (i.e. the care you get when you are sick).

In maintenance care, however, patients are usually committed to a long-term care plan. This means patients regularly receives chiropractic adjustments, soft tissue therapy, stretching, and exercises even after their symptoms have resolved. The interval between visits can be as short as one week to a month. The treatment you received will largely based on what the chiropractor finds. For example, the chiropractor may decide you have some joint restrictions and proceed to perform a chiropractic adjustment. Maybe they think you have “tight” muscles and will use soft tissue techniques to “release” them. Maintenance care is also referred to as wellness care. Because you are still under care despite being well.

Most chiropractors believe maintenance care visits can prevent future pain episodes through optimisation of spinal function. However, there is no agreement on the frequency of treatments required to achieve this.

p.s. chiropractors (or physiotherapists or massage therapists) CANNOT accurately determined if your vertebra is out of place. We briefly mentioned this in Four Things Your Chiropractor Doesn’t Want You To Know.

Reference: The Nordic Maintenance Care Program – An interview study on the use of maintenance care in a selected group of Danish chiropractors

Should I see a chiropractor for lower back pain or neck pain?

The short answer is yes.

Chiropractors are trained musculoskeletal health experts who can help you with your current aches and soreness. While traditional therapists (physiotherapists inclusive) may choose to take a dependency-based “hands on” approach, Square One Active Recovery does not.

With my coaching, exercise and education program, over 80% of my clients achieve their recovery goals within 4 to 7 visits.

My clients are able to achieve such great results because, I DO NOT offer chiropractic adjustments and any treatments that require you to keep coming back at my practice.

If you are sick and tired of not getting better, book in an appointment with me via the form below to discover the difference the right care can make.

Read more about what we do at Square One:


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.

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