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. Layden Chiropractic delivers just such research-documented, effective care to our
Plainville chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A group of back pain researchers
challenged fellow researchers to develop long-term
plans to decrease the problem of low back pain
on patients and healthcare systems. They clarified
that developing effective strategies remains a
daunting job for back pain clinicians, doctors, and
researchers. Vexingly, back pain disability levels have not
increased despite a larger number of
published research papers regarding back pain care.
No consensus on the best way to handle low back pain
has been agreed upon. Non-drug and non-invasive options
like exercise, manual therapy, massage, and such are typical
recommendations. Another group of 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. Coming up with a “sham”
protocol for spinal manipulation that feels like spinal
manipulation is really challenging. (Just touching a spine can
be relieving some, but that is a topic for a
different article!) Observational studies are the next in line. How so? Researchers observe how
patients respond when they experience treatment and describe changes and effects. Fortunately, Cox®
Technic research has a mix of biomechanical and clinical
observational studies resulting in case reports, case series, plus
retrospective and prospective clinical studies. Layden Chiropractic feels this mix of
research support helps explain to our Plainville chiropractic patients
what clinical outcome relief they may expect.
MINIMAL CLINICAL IMPORTANCE
Occasionally, 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 defined
as 30% or 20% and even 10% improvement. That is 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 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, particularly patients who have already
had back surgery or sought non-relieving care
from many other providers, are excited. 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 is 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 Plainville chiropractic
clinical outcome targets 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 keeping research flowing as many
programs are not in large university settings
with well-established and well-financed research departments. Global
chiropractic researchers are looking for 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 assemble
research talent and assets to advance
chiropractic’s quality and quantity of research. (3,4) Strong research carries
on at chiropractic universities to record the
benefits of chiropractic for musculoskeletal-related pain like back pain, neck
pain, arm pain and leg pain.
CONTACT Layden Chiropractic
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 he’s managed.
Make your next Plainville
chiropractic appointment soon. Bring your questions about the research
supporting our chiropractic care with you! Layden Chiropractic is always
ready to share research!