Call for an appointment at (781) 933-5051

Your treatment at the Winchester Hospital Chiropractic Center can be divided into three separate and distinct phases. These stages typically describe the reaction to any musculoskeletal injury: the Acute Stage, the Sub-Acute Stage, and the Chronic Stage. Each stage has characteristics that represent the nature of the particular physiologic processes that are involved at the time. The body's reaction to injury proceeds in a predictable manner and the passage from one stage to the next typically follows a similar time frame and sequence of events. In fact, the length of time that has elapsed since the injury occurred is one of the most common methods of determining which stage the patient is in.

Your program of treatment will be designed to your individual needs. Your treatment will include an approach that will strengthen and rehabilitate the area and help prevent re-occurrences.

Stage 1/ Acute Stage (lasts 48-72 Hours):
The acute stage is defined as that period immediately following the injury. Symptoms are usually most severe in this stage. This period has a relatively short course that typically lasts from 48 to 72 hours, although some patients may remain in this stage for a week of more. The primary characteristic during this stage is inflammation. One of the clinical characteristics is the presence of pain in the early part of the range of motion. In some patients, even the slightest movement may produce pain. Treatment efforts are largely directed at pain relief, controlling swelling and supporting or protecting injured tissues. Patient recovery is usually quicker and more complete when they seek chiropractic intervention during this stage.

Pain, inflammation, and spasm are reduced in the office and home care advice is given. Chiropractic treatment usually involves multiple visits to move you from pain relief to stage 2. Physiotherapeutic modalities are often used in the stage (electrical muscle stimulation, ultrasound and ice.)

Stage 2/ Sub-Acute Stage (lasts 72 hours-several weeks):
After passing quickly through the acute stage the body changes directions from a physiologic point of view. Attention is no longer directed at controlling the impact of the injury. Rather, the body attempts to turn its attention and resources to the task of healing and repair. This sub-acute period has a variable time frame that may last for several weeks. There is a gradual reduction in pain and inflammation. In addition, there is a gradually increasing degree of pain-free motion, with pain present near the end of range of motion. Because many patients are still in pain during this phase, the increase in function may be used as a reasonable guideline to monitor progress. The primary characteristic of the sub-acute stage is the presence of fragile, re-injured tissue. As the pain and symptoms subside during the sub-acute period, it is not uncommon to see patients exceed their functional limitations and exacerbate their condition. If this happens, the patient may re-enter the acute phase. Some patients may vacillate several times between these stages. As a patient begins to feel better, compliance tends to fall off. However, it's important to continue and follow through with a treatment plan to avoid falling back into the acute stage.

A variety of techniques (soft tissue techniques, rehabilitative exercise, stretching ergonomics) are employed to restore proper function so that you are not limited in any activities of daily living.

Stage 3/ Chronic Stage (may last for several months or even years):
In some patients, recovery is delayed or incomplete and they enter the chronic stage. By their very nature, these conditions are long-lasting and may last for several months or even years. Although clinicians may not agree on when a particular problem enters the chronic stage, it is usually agreed that a condition that is not showing continued signs of improvement at 6-7 weeks should be considered chronic. The primary characteristic is shortened connective tissue in the form of fibrosis and adhesions. Pain is present at the end of range of motion, although the total range may be reduced.

Remodeling Stage:
In addition to the three stages described above, recent attention has been directed at the fourth stage, the remodeling stage. As described, following an injury the body goes quickly through the acute and subacute stages. If the injury is not too severe and the treat-ment is appropriate, the problem heals and the condition never reaches the chronic stage. Under less than ideal circumstances, however, tissue healing may be inadequate and chronic problems may develop.

During the remodeling stage, the body attempts to return to normal structure and function. The body responds to the demand placed on it, and if the demand is sufficient, the injury heals with no residual defects or problems. If the demand is not appropriate, if the injury is too severe, or if the treatment is inadequate there may be residual (chronic) deficits. There is some evidence that this stage may last as long as 1-2 years post trauma in some patients.