Research makes the healthcare world go ‘round! Research grounds
the role of healthcare’s pain relieving ability. In
chiropractic healthcare, much research entails providing
evidence of chiropractic’s benefit for painful musculoskeletal pain
issues like back pain, neck pain, arm
pain and sciatic leg pain. Back And Neck Care Center offers just such research-documented, effective care to our
Severna Park chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One group of back pain researchers
challenged fellow researchers to come up with long-term
plans to lower the burden of low back pain
on sufferers and healthcare systems. They clarified
that developing effective strategies continues to be a
huge task for back pain clinicians, doctors, and
researchers. Frustratingly, back pain disability levels have not
increased despite a larger number of
published research papers about back pain care.
No consensus on the best way to handle low back pain
has been achieved. Non-drug and non-invasive options
like exercise, manual therapy, massage, and such are typical
recommendations. Other reviewing researchers pointed
to a few issues with back pain research: design
and analysis within the treatment clinical trials. (1) Designing research
studies is tough. Designing a “sham”
protocol for spinal manipulation that feels like spinal
manipulation is especially challenging. (Just touching a spine can
help some, but that’s a topic for another discussion!) Observational studies are the
next best thing. How so? Researchers observe how
patients respond when they go
through treatment and note changes and effects. Fortunately, Cox®
Technic research has a blend of biomechanical and clinical
observational studies resulting in case reports, case series, as well as
retrospective and prospective clinical studies. Back And Neck Care Center feels this mix of
research support helps define to our Severna Park chiropractic patients
what clinical outcome relief they may expect.
MINIMAL CLINICAL IMPORTANCE
On occasion, chiropractic
physicians and low back pain patients alike are 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 to
be an “effective” outcome. Cox® Technic has proposed 50%
improvement in 30 days as the aim…and still does. Many
times, chiropractic patients find that 50% relief in less
than a month and that the 50% relief is closer to
70% or 80% or 90%! Sometimes, a patient’s response may be slower in getting
relief or only reaches 30% or 40%. Some patients desire more while
others, particularly patients who have already
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 huge move but is realistic.
(2) It’s 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 Severna Park 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, experiences a little more effort
in maintaining a flow of research as many
programs are not incorporated into large university situations
with well-established and well-funded 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 combine
research talent and assets to elevate
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 Back And Neck Care Center
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
illustrates research studies of which he’s been a
part.
Make your next Severna Park
chiropractic appointment now. Bring your questions about the research
supporting our chiropractic care with you! Back And Neck Care Center loves to share research!