Research makes the healthcare world go ‘round! Research solidifies
the role of healthcare’s relief of pain. For
chiropractic healthcare, much research revolves around documenting chiropractic’s benefit for painful musculoskeletal conditions like back pain, neck pain, arm
pain and sciatic leg pain. Most Chiropractic Clinic offers just such research-documented, effective care to our
Murfreesboro chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One group of back pain researchers
challenged fellow researchers to create long-term
plans to reduce the problem of low back pain
on patients and healthcare systems. They described
that developing effective strategies continues to be a
daunting task for back pain clinicians, doctors, and
researchers. Vexingly, back pain disability levels have not
increased despite a larger number of
published research reports about back pain care.
No consensus on the best way to manage low back pain
has been agreed upon. Non-drug and non-invasive approaches
like exercise, manual therapy, massage, and such are general
recommendations. Other reviewing researchers indicated a few problems 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
be relieving some, but that is a topic for a
different discussion!) Observational studies are the next in line. How so? Researchers observe how
patients respond when they go
through treatment and make note of 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. Most Chiropractic Clinic feels this mix of
research support helps explain to our Murfreesboro chiropractic patients
what clinical outcome relief they may anticipate.
MINIMAL CLINICAL IMPORTANCE
Sometimes, 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 defined
as 30% or 20% and even 10% improvement. That is reported to
be an “effective” outcome. Cox® Technic has offered 50%
improvement in 30 days as the goal…and still does. Many
times, chiropractic patients realize that 50% relief in less
than 30 days 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, particularly patients who have already
gone through back surgery or sought non-relieving care
from many other providers, are quite satisfied. A study
of 1232 low back pain subjects found a MCID pain intensity of
2 (meaning a 2 point change on a scale of 0 no pain to 10 worst
imaginable pain). That’s not a big move but is reasonable.
(2) It is a statistic to consider. Weighed against medical and surgical outcomes for back pain treatment that are as low
as 10% or 30% expected improvement MCID, our Murfreesboro chiropractic
clinical outcome goals are high and frequently
achievable.
THE CHALLENGE OF CHIROPRACTIC RESEARCH – AND HOW CHIROPRACTIC
ANSWERS
Chiropractic, like other complementary and integrative
healthcare professions, experiences 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 turning to
the RAND Corporation’s Center for Collaborative CIH Research to pool
research talent and resources to advance
chiropractic’s quality and quantity of research. (3,4) Solid research continues at chiropractic universities to record the
benefits of chiropractic for musculoskeletal-related pain like back pain, neck
pain, arm pain and leg pain.
CONTACT Most Chiropractic 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 of which he’s been a
part.
Schedule your next Murfreesboro
chiropractic appointment soon. Bring your questions about the research
supporting our chiropractic care with you! Most Chiropractic Clinic is always
ready to share research!