What straightening teeth taught me about getting out of pain — and staying well.
Imagine wearing braces for a year.
Your teeth look straight. You’re happy with your smile. So you tell your orthodontist you’re finished.
There’s just one problem.
Your orthodontist isn’t finished.
Take your braces off before the correction is finished. What happens? And when the braces finally come off, throw away the retainer. What happens then?
The teeth may look better before the correction is complete. And even after treatment, they may shift without the retention plan. Looking better, finishing correction, and maintaining the result are not the same thing.
After forty years of caring for patients with back pain, I’ve noticed something remarkably similar.
What I Have Watched Happen for Forty Years
Maybe you’ve experienced this. Something hurt. You got help, or you waited it out, and a few weeks later you felt fine. So you went back to your life exactly as it had been.
And then, some months later, the same thing. Same side, same story.
Over the years I have watched patients make different choices once their pain subsides. Some choose relief and stop there. Others keep going — through rehabilitation, through stabilizing what they have rebuilt, and into a plan for holding on to it.
After forty years, I can tell you what I’ve seen. The people who do the work beyond getting out of pain are often the ones who do better in the long run. I see them return to activities they had abandoned, grow more confident in movement, and take a more active role in caring for themselves.
I also see people come back months later with a familiar complaint after stopping at relief. Sometimes an unresolved limitation may have contributed. Other times it is a new strain, a different condition, or simply the recurring nature of back pain. I cannot tell which without examining the person again.
This is not about blaming anyone for stopping care. Patients have different goals, finances, schedules and medical needs. It is about understanding what was accomplished, what remains, and what it would take to go further.
Have we restored what was not working well, or have we reached the point where it no longer hurts?
Those are not always the same thing. Sometimes the problem truly has resolved and no further care is needed. Sometimes pain improves while limitations remain. We find out by reassessing, not by guessing.
We Base Our Recommendations on What We Find
I don’t believe a treatment plan should be determined simply by how much pain you are in, or by how quickly that pain disappears. We begin with a thorough examination and objective findings.
When it is clinically indicated, that examination may include functional spinal X-rays. We use seated imaging because we want to look at the spine under specific, reproducible conditions that can reveal findings another position may not show. What am I looking for? Evidence that helps explain what the examination is telling us and what you are experiencing.
Those findings guide the recommendations, and they give us something to reassess as care goes on. I don’t want to guess whether you are improving. I want to examine you and look for meaningful evidence of it.
And when the findings don’t support further treatment, that matters just as much.
The Road to Recovery
In our office, I explain care as a progression. It is not a rigid schedule, and people do not all need the same steps or the same number of visits. The examination, your goals and your response to care guide the plan. Here is what each stage sounds like in ordinary language.
1. Relief
What you notice: “My back doesn’t hurt as much.”
Get out of pain. This is often the shortest phase, although it may take weeks or months, and sometimes longer. The objective is to reduce symptoms and make everyday activity more comfortable. For some conditions, that may be all the care you need.
2. Rebuild
What you notice: “I can move and do things I couldn’t do comfortably before, and I can keep doing them.”
This is where we work on correction, rehabilitation, strengthening and stabilization. Getting out of pain was the first step. Now we’re working on what your body needs to function better. That may mean restoring movement, building strength, and making those gains reliable enough to hold up outside the treatment room. Can you lift, bend, walk and do the things you want to do with more confidence?
These two phases overlap. Some rehabilitation and gentle strengthening can begin before the pain is entirely gone — you do not have to be pain-free before rebuilding starts.
3. Maintain
What you notice: “I have a plan for keeping what I’ve gained.”
Now we work on keeping what you’ve gained—and building on it. That may mean home exercises, weight training, movement breaks, or periodic reassessment and chiropractic care when appropriate. Maintenance doesn’t mean you’ll never have another problem. It means you have a plan to keep taking care of the progress you’ve made. The habits can last a lifetime, even though the professional care someone needs will vary.
These are illustrative experiences, not guaranteed outcomes.
I Know This Process Because I’ve Lived It
Years ago, I had herniated discs.
I spent two years receiving medical care without getting the recovery I was looking for. Eventually, surgery was offered.
I declined. That was my decision, in my circumstances. Surgery is the right answer for some people, and nothing here is advice about yours.
My own recovery was not quick or simple. I also had asthma, one of several health factors that had to be accounted for along the way.
My relief phase took about a year. Rebuilding my strength and physical capacity took another two.
And maintenance?
I’m still doing it. I see my chiropractor once or twice a week. I weight train two or three times a week. I practice yoga three or four days a week.
Not because I am still trying to get through that original episode of back pain. Because I value what I worked to regain, and I want to keep building on it.
I don’t expect anyone to follow my schedule. My recovery was mine, and other people need very different approaches. But it taught me something that has shaped the way I practice: getting out of pain, rebuilding your body, and maintaining your progress are three different jobs.
I didn’t spend three years recovering so I could stop taking care of myself the moment I felt better.
The Gym Explains the Rest
Nobody expects to build strength at the gym, stop exercising indefinitely, and keep every improvement. We understand that getting into shape and staying in shape require different kinds of effort. Yet when our backs stop hurting, we sometimes assume the work is finished.
A Word About the Research
There is research worth considering here, too. Back pain often comes and goes, even with appropriate treatment. In one randomized trial, selected patients with recurrent or persistent low back pain who received scheduled chiropractic maintenance care had fewer bothersome days than those treated when symptoms returned. That does not mean everyone needs ongoing visits, or that a particular schedule is right for every person. It does support asking what kind of follow-through makes sense for the individual.
Three Questions Before You Decide You Are Finished
When the pain has settled, ask yourself three questions:
- Can you comfortably do the activities that were difficult when your problem began?
- Have you regained the movement, strength or endurance that your examination showed was limited?
- Do you have a realistic plan for maintaining those improvements?
Your answers may tell you that relief was enough. Or they may show you there is more work worth doing. Either way, you’re deciding based on how you function, not simply because today happens to be a good day.
Feeling better is worth celebrating. But before you call yourself finished, ask: am I just hurting less, or am I functioning better?
An Invitation
Whether you live in Santa Monica or are reading this from somewhere else, you are welcome at Ptak Family Chiropractic.
If the same problem keeps returning — or if you feel better but wonder whether you have regained the function you want — come see us. We’ll listen to your history, examine how you’re functioning, and help you understand what may be contributing to the problem and what your options are. We never charge you to sit down and talk about your needs. Call Ptak Family Chiropractic at 310.473.7991 and make an appointment.
Or visit ptakfamilychiropractic.com.
Selected References
Kongsted A, Kent P, Axén I, Downie AS, Dunn KM. What have we learned from ten years of trajectory research in low back pain? BMC Musculoskeletal Disorders. 2016;17:220.
Eklund A, Jensen I, Lohela-Karlsson M, et al. The Nordic Maintenance Care program: effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain — a pragmatic randomized controlled trial. PLoS ONE. 2018;13(9):e0203029.
Mujika I, Padilla S. Detraining: loss of training-induced physiological and performance adaptations. Part I. Sports Medicine. 2000;30(2):79–87.
About the author. Dr. Jeffrey Ptak, DC, DSS, MSS, MA, founded Ptak Family Chiropractic in Santa Monica and has practiced since 1986. He is the author of the forthcoming book It’s Like You Never Left, to be published by Indigo River Publishing.
Educational information only; not a diagnosis or a substitute for individualized care. The personal experience described here is one person’s history and is not a recommendation for or against any treatment, including surgery. Seek prompt medical evaluation for back pain with new or progressive weakness, fever, or bowel or bladder dysfunction.
Ptak Family Chiropractic
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Chiropractic for Adults and Children
3122 Santa Monica Blvd., Suite 102 · Santa Monica, CA 90404
310.473.7991 · ptakfamilychiropractic.com