Research makes the healthcare world go ‘round! Research grounds
the role of healthcare’s relief of pain. In
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. OrthoIllinois Chiropractic offers just such effective,
research-documented care to our
McHenry chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A group of back pain researchers
challenged fellow researchers to come up with long-term
plans to lower the problem of low back pain
on sufferers and healthcare systems. They explained
that developing effective strategies remains a
huge job for back pain clinicians, doctors, and
researchers. Frustratingly, back pain disability levels have not
improved despite a larger number of
published research reports regarding back pain care.
No consensus on the best way to handle low back pain
has been achieved. Non-drug and non-invasive methods
like exercise, manual therapy, massage, and such are typical
recommendations. Other reviewing researchers indicated a few issues with back pain research: design
and analysis within the treatment clinical trials. (1) Designing research
studies is difficult. Designing 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 another discussion!) Observational studies are the next in line. How so? Researchers observe how
patients respond when they experience treatment and report
on 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. OrthoIllinois Chiropractic feels this mix of
research support helps outline the expectations our McHenry chiropractic
patients may anticipate.
MINIMAL CLINICAL IMPORTANCE
Occasionally, chiropractic
physicians and low back pain patients alike are 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 is reported to
be 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 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 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 change 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 share. Weighed against medical and surgical outcomes for back pain treatment that are as low
as 10% or 30% expected improvement MCID, our McHenry chiropractic
clinical outcome objectives 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 difficulty
in keeping research flowing as many
programs are not incorporated into large university situations
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 combine
research talent and resources to advance
chiropractic’s quality and quantity of research. (3,4) Robust 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 OrthoIllinois 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
illustrates research studies he’s managed.
Schedule your next McHenry
chiropractic appointment soon. Bring your questions about the research
behind our chiropractic care with you! OrthoIllinois Chiropractic is always
ready to share research!