Research makes the healthcare world go ‘round! Research grounds
the role of healthcare’s pain relieving ability. In
chiropractic healthcare, much research revolves around providing
evidence of chiropractic’s benefit for painful musculoskeletal conditions like neck pain, back pain, arm
pain and sciatic leg pain. Shoreline Medical Services/ Hutter Chiropractic Office delivers just such effective,
research-documented care to our
Groton chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One set of back pain researchers
challenged fellow researchers to develop long-term
plans to reduce the burden of low back pain
on patients and healthcare systems. They explained
that developing effective strategies remains a
daunting task for back pain clinicians, doctors, and
researchers. Vexingly, back pain disability levels have not
improved despite a larger number of
published research papers about back pain care.
No consensus on the best way to manage low back pain
has been achieved. Non-drug and non-invasive options
like exercise, manual therapy, massage, and such are general
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 tough. Coming up with a “sham”
protocol for spinal manipulation that feels like spinal
manipulation is really challenging. (Just touching a spine can
help some, but that is a topic for another discussion!) Observational studies are the next in line. How so? Researchers observe what happens to patients when they undergo 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. Shoreline Medical Services/ Hutter Chiropractic Office feels this mix of
research support helps explain to our Groton chiropractic patients
what clinical outcome relief they may anticipate.
MINIMAL CLINICAL IMPORTANCE
Occasionally, chiropractic
physicians and low back pain patients alike find themselves disappointed
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’s reported as an “effective” outcome. Cox® Technic has offered 50%
improvement in 30 days as the goal…and still does. Often, chiropractic patients realize that 50% relief in fewer
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 getting
relief or only reaches 30% or 40%. Some patients desire more while
others, especially patients who have already
undergone back surgery or sought non-relieving care
from many other providers, are quite satisfied. 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 Groton chiropractic
clinical outcome objectives 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 effort
in maintaining a flow of research as many
programs are not incorporated into large university settings
with well-established and well-funded research departments. Global
chiropractic researchers are seeking a solution. Australia, Canada, and Denmark chiropractic
researchers have created 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 combine
research talent and resources 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 Shoreline Medical Services/ Hutter Chiropractic Office
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 he’s managed.
Schedule your next Groton
chiropractic appointment today. Bring your questions about the research
supporting our chiropractic care with you! Shoreline Medical Services/ Hutter Chiropractic Office loves to share research!