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Chiropractic and Rehab: PB&J Analogy

A terrific metaphor was created by a patient from a 2021 study looking at spinal disability in older adults. 182 patients in the study were instructed on corrective/rehabilitative exercises for proper spinal mobility and pain management and also received chiropractic care for both their neck and back related issues (1). Treatment lasted over a 12 week period and following completion of the trial of care, 50 random participants were given a questionnaire regarding their perception of the treatment they received, including whether or not they thought it to be worthwhile, which aspect was most beneficial, and which was least beneficial.

Of those 50 respondents, the majority felt that chiropractic care and exercises were beneficial. Patients’ responses often aligned with their personal beliefs and preferences for health care which were screened prior to participation in the study. 20 participants felt chiropractic was worthwhile for managing spine conditions compared to 9 voicing preference for exercise and 17 for adjunctive therapies such as ice, heat, and massage (1). The most remarkable answer was 45 out 50 of the participants felt the control of symptoms was what made treatment worthwhile, even though there was a broad range in outcomes from “less discomfort” all the way to “made all the pain go away.” However, there were six patients who were dissatisfied with the effects of care, but two of them noted their ability to move had improved despite their lack of satisfaction with care (1). These patients also reported that they were not interested in exercising which would correlate with their unhappiness with the treatment. (1)

The biggest takeaway from the study was a remark made by one of the participants. They equated this type of conservative management to a peanut butter and jelly sandwich. The bread is the context in which patients are presenting before care, all of their comorbidities, preferences, and willingness to participate. These are key to chiropractic care and of course the anchors of a PB&J. The peanut butter is exercise and movement. The foundation of being self efficient and mobile, which is crucial for the older demographic. The jelly represents chiropractic care. It is a great compliment for the exercise because of its help at alleviating pain and increasing one’s mobility, whether that be as a benefit of pain relief or an added bonus. This demonstrates a high level understanding of one’s health and chiropractic’s place in peoples’ lives. Most can make do with just a peanut butter sandwich (exercise), but there are times people prefer to have jelly (chiropractic care) too, and of course the bread (patient specific context) is a must.

Medicare does cover chiropractic care that is deemed medically necessary. If you or someone you know is part of the older demographic and are interested in learning more about how chiropractic care can be of benefit or want to know more about your Medicare coverage, feel free to reach out to our office.


Maiers, M., & Salsbury, S. A. (2022). "Like Peanut Butter and Jelly": A Qualitative Study of Chiropractic Care and Home Exercise Among Older Adults With Spinal Disability. Arthritis care & research, 74(11), 1933–1941.

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