Research makes the healthcare world go ‘round! Research established
the role of healthcare’s pain relieving ability. For
chiropractic healthcare, much research revolves around documenting chiropractic’s benefit for painful musculoskeletal pain
issues like back pain, neck pain, arm
pain and sciatic leg pain. Spinal Care Clinic offers just such effective,
research-documented care to our
Burlington and Hamilton chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One group of back pain researchers
challenged fellow researchers to develop long-term
plans to lower the burden of low back pain
on patients and healthcare systems. They described
that developing effective strategies remains a
daunting task for back pain clinicians, doctors, and
researchers. Frustratingly, back pain disability levels have not
increased despite an increased quantity of
published research reports regarding back pain care.
No consensus on the optimal way to manage low back pain
has been agreed upon. Non-drug and non-invasive options
like exercise, manual therapy, massage, and such are typical
recommendations. Another group of reviewing researchers pointed
to a few issues with back pain research: design
and analysis within the treatment clinical trials. (1) Designing research
studies is difficult. Coming up with a “sham”
protocol for spinal manipulation that seems like spinal
manipulation is really challenging. (Just touching a spine can
help some, but that’s a topic for a
different discussion!) Observational studies are the next in line. How so? Researchers observe how
patients respond when they undergo treatment and describe changes and effects. Fortuitously, Cox®
Technic research has a mix of biomechanical and clinical
observational studies resulting in case reports, case series, as well as
retrospective and prospective clinical studies. Spinal Care Clinic feels this mix of
research support helps outline the expectations our Burlington and Hamilton chiropractic
patients may anticipate.
MINIMAL CLINICAL IMPORTANCE
On occasion, chiropractic
physicians and low back pain patients alike find themselves disappointed
with the outcomes of treatment for back pain. They shouldn’t
be! In medicine, the minimal clinically important difference (MCID) is reported 30% or 20% and even 10% improvement. That’s reported as an “effective” outcome. Cox® Technic has proposed 50%
improvement in 30 days as the goal…and still does. Many
times, chiropractic patients realize that 50% relief in less
than a month and that the 50% relief is more like
70% or 80% or 90%! Sometimes, a patient’s response may be slower in reaching
relief or only reaches 30% or 40%. Some patients desire more while
others, especially patients who have previously
undergone back surgery or sought non-relieving care
from many other providers, are thrilled. A study
of 1232 low back pain subjects discovered a MCID pain intensity of
2 (meaning a 2 point change on a scale of 0 no pain to 10 worst
imaginable pain). That is not a big move but is realistic.
(2) It is a statistic to share. Weighed against medical and surgical outcomes for back pain treatment that are as low
as 10% or 30% expected improvement MCID, our Burlington and Hamilton chiropractic
clinical outcome targets are high and often achieved.
THE CHALLENGE OF CHIROPRACTIC RESEARCH – AND HOW CHIROPRACTIC
ANSWERS
Chiropractic, like other complementary and integrative
healthcare professions, has a little more difficulty
in maintaining a flow of research as many
programs are not in large university situations
with well-established and well-financed research departments. Global
chiropractic researchers are seeking a solution. Australia, Canada, and Denmark chiropractic
researchers have formed a leadership academy (CARL – Chiropractic
Academy for Research Leadership) for early-career chiropractic researchers to stimulate
more chiropractic research. US-based researchers are looking to
the RAND Corporation’s Center for Collaborative CIH Research to assemble
research talent and assets to advance
chiropractic’s quality and quantity of research. (3,4) Solid research carries
on at chiropractic universities to document the
benefits of chiropractic for musculoskeletal-related pain like back pain, neck
pain, arm pain and leg pain.
CONTACT Spinal Care Clinic
Listen to this PODCAST
with Ram Gudavalli, PhD, principal investigator of many Cox® Technic research
studies, on The
Back Doctors Podcast with Dr. Michael Johnson as he
explains research studies he’s managed.
Schedule your next Burlington and Hamilton
chiropractic appointment now. Bring your questions about the research
behind our chiropractic care with you! Spinal Care Clinic loves to share research!