If the patient decides to begin a course of treatment, a payment on account is required to cover the initial cost of treatment. This initial period of treatment allows the patient to appraise the results without having to pay for a whole course of treatment in advance.
It may not be possible however to obtain an improvement during the initial treatment phase because in many chronic cases an increase in pain or discomfort is experienced following the mobilisation of spinal joints and the consequent irritation of nerve roots. If there is a strong reaction to treatment however, this is usually a good sign that the treatment is working. For example, in regard to cervical nerve root impingement affecting the arm and hand/fingers (radiculopathy), the treatment may initially exacerbate the symptoms. In many acute cases however, a significant reduction in symptoms can be achieved after only a few sessions.