Research makes the healthcare world go ‘round! Research established
the role of healthcare’s relief of pain. In
chiropractic healthcare, much research entails documenting chiropractic’s benefit for painful musculoskeletal conditions like back pain, neck pain, arm
pain and sciatic leg pain. Palmer Chiropractic Center delivers just such effective,
research-documented care to our
Lynchburg chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One set of back pain researchers
challenged fellow researchers to create long-term
plans to reduce the problem of low back pain
on sufferers and healthcare systems. They described
that developing effective strategies continues to be a
huge job for back pain clinicians, doctors, and
researchers. Vexingly, back pain disability levels have not
improved despite an increased quantity of
published research reports regarding back pain care.
No consensus on the optimal way to handle low back pain
has been agreed upon. Non-drug and non-invasive approaches
like exercise, manual therapy, massage, and such are general
recommendations. Another set 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 in line. How so? Researchers observe how
patients respond when they go
through treatment and describe changes and effects. Fortuitously, Cox®
Technic research has a blend of biomechanical and clinical
observational studies resulting in case reports, case series, plus
retrospective and prospective clinical studies. Palmer Chiropractic Center feels this mix of
research support helps explain to our Lynchburg chiropractic patients
what clinical outcome relief they may expect.
MINIMAL CLINICAL IMPORTANCE
Sometimes, 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’s reported to
be an “effective” outcome. Cox® Technic has offered 50%
improvement in 30 days as the goal…and still does. Often, chiropractic patients find 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 getting
relief or only reaches 30% or 40%. Some patients want more while
others, especially 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 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 is not a huge move but is reasonable.
(2) It’s 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 Lynchburg 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 difficulty
in keeping research flowing as many
programs are not incorporated into large university settings
with well-established and well-funded research departments. Global
chiropractic researchers are looking for 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) Strong 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 Palmer 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
illustrates research studies he’s managed.
Schedule your next Lynchburg
chiropractic appointment soon. Bring your questions about the research
behind our chiropractic care with you! Palmer Chiropractic Center loves to share research!