Fig. 3.

Algorithm for chiropractic case management, applicable to both acute and chronic low back pain. Chiropractic Case Management Algorithm Notes: ¹Maximum therapeutic benefit: Further improvement in symptoms or condition cannot be reasonably expected and treatment is not considered necessary to prevent an immediate decline in status. ²Trial withdrawal may be necessary when a patient reaches maximum therapeutic benefit to determine if condition recovery is stable. If condition deteriorates after the trial, then ongoing care may be necessary to maintain function and minimize symptoms. The therapeutic withdrawal can be gradual, where the patient’s care is reduced through tapered visits. It can also be rapid, with the patient instructed to return for care or evaluation only if symptoms recur or worsen. The patient can be scheduled for an evaluation at a later date to evaluate for signs of regression.