Five Phases of Care

12 Aug

DancingThere are certain phases that patients have to go through before they achieve total health. Some patients have already started to change before they visit a practitioner, most have not and in fact are so far gone that there doesn’t seem to be much hope of them recovering. But the human body has amazing recuperative powers given the basic ingredients to get well.

Years ago, when people had ready access to nutritious foods there were only four phases of care. Now an initial phase is needed in order for there to be improvement in the patient. Practitioners know that if the patient doesn’t assist in their recovery that total health is an impossible goal. A patient can counter all the practitioner does simply by eating improperly, not exercising, taking unnecessary medication or simply not following good advice. So it is important for the patient to get the idea fully that a Transition to a Healthy Lifestyle is the first step to recovering one’s health.

There are five distinct phases of care that a person who is trying to recover or improve their health goes through. Each phase gives separate and distinct benefits and each takes a different time frame to accomplish, depending on the initial condition at the time care begins.

1. Transition to Healthy Lifestyle phase

2. Acute or relief care phase

3. Corrective care phase

4. Strengthening phase

5. Maintenance or supportive phase

PHASE 1: Transition to Healthy Lifestyle, ideally this phase is completed first. However, some existing patients or new patients either haven’t done this phase or they are in pain and their doctor decides that they must receive Acute or Relief care first. This phase can be done at any time during their Phases of Care Program in conjunction with any other Phase. There are several excellent books for sale that prove beyond a shadow of a doubt that “YOU ARE WHAT YOU EAT!” Dr. Gillian McKeith has sold over 2 million copies of her book with this title. Another all inclusive book is Ultra-Metabolism by Mark Hyman, M.D.

I discovered The WholeFood Farmacy ( while at the Florida Chiropractic Association Convention in Orlando in 2006. I had seen their website months earlier and thought that if their food was exactly what they said it was then it was the food I was looking for. I walked up to their booth and sampled the food and the first think that hit me was that it tasted delicious. I purchased a couple of bags and almost ate a whole bag on the way home while telling my wife that “This is the one!” Their products are raw, organic, whole food that don’t contain any additives, preservatives etc. and eating them instead of junk food promotes weightloss and increase energy along with a zest for life!

PHASE 2: Acute or relief phase of care, this phase of care will be the initial stage if the patient enters the office in some degree of pain. This phase can be characterized by swelling, lack of motion, muscle spasm, or just plain feeling lousy. It is the stage in which symptoms predominate the patient’s concern. Treatment during this stage consists of chiropractic adjustments of the spine, various forms of physical therapy, ice therapy to reduce swelling, massage, Ion Cleanse (, etc. This stage can last a few days or weeks.Treatment is normally at its highest level with many conditions requiring multiple visits each week.

The practitioner will take these factors into account when deciding on an acute care program: patient’s age, weight, how long the patient has had the condition, to what degree the patient can avoid the activities that aggravate the condition, to what degree the patient follows the advice of the doctor, patient’s threshold level of pain, does the patient have other health issues?

PHASE 3: Corrective Phase of Care, this phase begins when the pain has significantly been reduced. It is characterized by the patient feeling like he is able to resume his normal activities. This is a very important time because if the patient truly resumes all of his activities at this moment, it is common for the pains to begin to increase again. This occurs because the condition has not yet been fully stabilized. Treatment continues to utilize therapy in an attempt to continue to keep the muscle spasms in check as well as re-educate those same muscles into their normal tone and length. Ice therapy may continue as well. At this stage the chiropractic adjustments are attempting to increase spinal mobility in order that more normal function may return to the spine and nervous system. This phase of care can take a few weeks with very minor conditions to months in more severe conditions. The frequency of care can still be multiple visits per week, but perhaps not as frequent as in the acute or relief phase.


PHASE 4: Strengthening Phase of Care is characterized by either significant reduction of pain (or no pain) in most cases and continued stabilization of pain in the severely chronic cases. Frequency of visits continues to reduce, while rehabilitative exercises typically increase in this phase. Our goal in this stage is to strengthen the soft tissue that surrounds the affected spinal segments so that proper function becomes consistent in these regions of the spine. Consistent function not only allows for pain reduction of the muscles, tendons, and ligaments, but also allows for the proper function of the organs and tissues that the nerves of the area control.

PHASE 5: Maintenance or Supportive Care, is the most fun for both the patient and the doctor. This is the stage in which the pain is either totally gone, or extremely stable in chronic situations. Treatment frequency can range from once per week to once every two months. The goal of this stage is to keep the patient at the level he desires. There are great benefits in this stage. Once a patient has worked hard to get to this level, it is much easier to keep it here. Usually a patient has gotten into better work, eating and exercise habits, which promotes good health to begin with. Also, the patient’s attitude at this phase is usually very positive. There is a feeling of accomplishment that comes with any job well done. Another tremendous benefit of this stage of care is that, if for some reason an injury to the spine occurs again because of something unforeseen, it is very common that instead of needing a significant amount of treatment to help, a relatively small amount of care usually does the trick. A good example of this is to note how fast highly conditioned athletes recover from injuries that would take most of us a very long time to recover from the same injury.

Final word, it is always up to the patient to determine to what degree he chooses to benefit from treatment and the Phases of Care Program. Doctors should always describe to patients the benefits of the five phases of care for their particular case so that they can make the most educated decision for their specific situation.

Yours in Health,

Paul Turnbull (727) 445-7842

President, EP Management, Inc.


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