Question
I have been going to a chiropractor for about 4 months now.  I was going  three times a week but didn't think I needed to do that so I started twice a week and I now am going once a week.  I want to change it to once a month (if that).  But the office says I should continue with once a week.  Also when you cancel an appointment or go on vacation they want you to double up visits in the weeks before and after.  Is there any  benefit to making up missed appointments? I fell like going two days in a row is not beneficial.  I have received relief from the adjustments for the carpal tunnel.  I just feel I don't need to continue the current schedule.  Thanks!

Answer
Hi Pat,

Yes, this is a typical scenario.   There really has to be a balance between dosing at the right frequency enough to solve a problem, not treating too much or too little, so as to meet the best needs of the patient.   This should be based on how the patient feels (symptoms), how the patient is able to perform daily activities of living such as sleeping, lifting/carrying, opening jars, etc, and how the clinical findings on examination (signs) match these other two parameters (symptoms and activities of daily living).    If a patient with carpal tunnel syndrome says, "I feel okay," but the doctor finds that squeezing the wrist causes lightning bolts of pain into the fingers, then there is justifiable reason to continue treatment at a reasonable frequency (dosage), e.g. once to three times per week depending on just how bad it is.   If you don't have any symptoms, and your daily activities are in full swing with no difficulties, and your pain cannot be reproduced with various tests or positional maneuvers, then odds are you are well and don't need to see the chiropractor (or PT or MD).   I am not convinced that "doubling up" visits before and after a vacation as an across-the-board policy has any benefit except for making the doctor more money...  

'Hope this was helpful,

Dr. G