Dr. David DeFries
This is the Centers for Medicare & Medicaid Services definition of maintenance care and neither Medicare nor any other insurance company will cover care that " seeks to prevent disease, promote health, and prolong and enhance the quality of life or prevent deterioration."
Patients typically present for care for three reasons:
A: They have an acute injury which is defined by the government as: "A patient's condition is considered acute when the patient is being treated for a new injury, identified by x-ray or physical exam . The result of chiropractic manipulation is expected to be an improvement in, or arrest of progression of, the patient's condition."
B: The patient presents with a chronic condition. CMS defines chronic as: "A patient's condition is considered chronic when it is not expected to significantly improve or be resolved with further treatment (as is the case with an acute condition), but where the continued therapy can be expected to result in some functional improvement. Once the clinical status has remained stable for a given condition, without expectation of additional objective clinical improvements, further manipulative treatment is considered maintenance therapy and is not covered"
C: Patients seeking to maintain their spinal health present for maintenance care. These patients do so for the very reasons stated by the government agency responsible for Medicare and Medicaid,they want to; reduce disease, prolong and enhance their quality of life, prevent further deterioration, avoid acute flare-ups, and maintain their ability to move and function.
I have practiced since 2001 and my family has been practicing chiropractic since the 1930's. I have had the pleasure of treating patients who were also treated by my father and even grandfather for decades. I can honestly say that the majority of patients who have presented for regular preventative care rarely present with moderate or severe acute complaints not related to an obvious injury. This is not to say that these patients don't experience an occasional neck soreness or twinge in their back but that when these incidents arise, they often do so less frequently and severely and resolve much sooner in general. These patients frequently report improvements in complaints they did not associate with their musculoskeletal system such as better sleep, fewer headaches and an improved capacity to handle stress.
Acute injuries and complaints should be treated quickly and appropriately. If proper treatment is not administered, nerve and muscle dysfunction as well as scar tissue formation may ensue which leads to more pain, system dysfunction and deterioration and degeneration and eventually becomes a chronic condition.
Periodic check ups and regular musculoskeletal treatments can help maintain joint function, reduce flare-ups of painful conditions, prevent joint degeneration and improve the quality of life.