Jeff LangmaidFounder, The Evidence Based Chiropractor

Patients Don’t Come In For Pain

1 Jul 2026 · 1 min

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1:02

In this clinician-focused talk, Jeff Langmaid explains that patients with low back pain typically seek care not because of the pain itself but because the pain interferes with activities they love—a concept he calls "life impact" or "life effect." He notes that patients often report long durations of pain, indicating that pain alone isn’t the motivator for seeking treatment. Langmaid then introduces recent research that goes beyond the basic question of whether chiropractic care helps low back pain. Instead, the study investigates which early changes occur with chiropractic treatment and which of those changes drive longer‑term improvements, aiming to uncover the mechanisms behind successful outcomes.

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And we're going to talk about something that you probably see in your practice every single day, and that's patients coming in with low back pain, uh, and they want the pain to be decreased. And you probably know that there's a bigger story going on than that. We call this the life impact or life effect. People who are coming into your practice for pain, they're not coming in for pain. They're coming in because the pain eventually stopped them from doing something that they love. Many people, if you ask them, how long you been in pain, they will say 2 weeks, 2 months, 2 years, 20 years. So it very clear that pain was not the motivator. It was when the pain hit a point where they were unable to do something they love to do, they made the decision to come into your practice. And that is where this week's research gets interesting, because the study wasn't just asking, does chiropractic care help people with low back pain? It's been studied in this population a lot. It was asking a deeper question and a more nuanced question, and that was when people improve with chiropractic care, what changes first? What seems to drive longer-term improvements?