Research makes the healthcare world go ‘round! Research solidifies
the role of healthcare’s pain relieving ability. For
chiropractic healthcare, much research revolves around providing
evidence of chiropractic’s benefit for painful musculoskeletal pain
issues like neck pain, back pain, arm
pain and sciatic leg pain. Minster Chiropractic Center delivers just such research-documented, effective care to our
Minster chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A set of back pain researchers
challenged fellow researchers to create long-term
plans to decrease the burden of low back pain
on sufferers and healthcare systems. They explained
that developing effective strategies continues to be a
daunting task for back pain clinicians, doctors, and
researchers. Frustratingly, back pain disability levels have not
improved despite a larger number of
published research reports about back pain care.
No consensus on the optimal way to manage low back pain
has been achieved. Non-drug and non-invasive approaches
like exercise, manual therapy, massage, and such are typical
recommendations. Another group of reviewing researchers indicated 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 especially challenging. (Just touching a spine can
be relieving some, but that’s a topic for a
different discussion!) Observational studies are the
next best thing. How so? Researchers observe how
patients respond when they experience treatment and note changes and effects. Fortunately, 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. Minster Chiropractic Center feels this mix of
research support helps outline the expectations our Minster chiropractic
patients may expect.
MINIMAL CLINICAL IMPORTANCE
Occasionally, chiropractic
physicians and low back pain patients alike are frustrated
with the outcomes of treatment for back pain. They should not
be! In medicine, the minimal clinically important difference (MCID) is defined
as 30% or 20% and even 10% improvement. That is reported as an “effective” outcome. Cox® Technic has offered 50%
improvement in 30 days as the aim…and still does. Often, chiropractic patients find that 50% relief in fewer
than 30 days 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 want more while
others, especially patients who have previously
had back surgery or sought non-relieving care
from many other providers, are thrilled. A study
of 1232 low back pain subjects found a MCID pain intensity of
2 (meaning a 2 point move on a scale of 0 no pain to 10 worst
imaginable pain). That’s not a big move but is realistic.
(2) It is a statistic to consider. Compared
with medical and surgical outcomes for back pain treatment that are as low
as 10% or 30% expected improvement MCID, our Minster chiropractic
clinical outcome goals 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 effort
in keeping research flowing 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 promote
more chiropractic research. US-based researchers are turning to
the RAND Corporation’s Center for Collaborative CIH Research to pool
research talent and assets to elevate
chiropractic’s quality and quantity of research. (3,4) Strong research continues at chiropractic universities to document the
benefits of chiropractic for musculoskeletal-related pain like back pain, neck
pain, arm pain and leg pain.
CONTACT Minster Chiropractic 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
explains research studies of which he’s been a
part.
Make your next Minster
chiropractic appointment soon. Bring your questions about the research
behind our chiropractic care with you! Minster Chiropractic Center is always
ready to share research!