Research makes the healthcare world go ‘round! Research established
the role of healthcare’s relief of pain. For
chiropractic healthcare, much research entails documenting chiropractic’s benefit for painful musculoskeletal pain
issues like neck pain, back pain, arm
pain and sciatic leg pain. Manchester Chiropractic & Sports Injuries delivers just such research-documented, effective care to our
Manchester chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A group of back pain researchers
challenged fellow researchers to develop long-term
plans to reduce the problem of low back pain
on patients and healthcare systems. They clarified
that developing effective strategies continues to be 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 reports regarding back pain care.
No consensus on the optimal way to manage low back pain
has been agreed upon. Non-drug and non-invasive methods
like exercise, manual therapy, massage, and such are general
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 tough. Designing a “sham”
protocol for spinal manipulation that seems like spinal
manipulation is really challenging. (Just touching a spine can
help some, but that is 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 note 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. Manchester Chiropractic & Sports Injuries feels this mix of
research support helps define to our Manchester chiropractic patients
what clinical outcome relief they may expect.
MINIMAL CLINICAL IMPORTANCE
On occasion, chiropractic
physicians and low back pain patients alike find themselves disappointed
with the outcomes of treatment for back pain. They shouldn’t
be! In medicine, the minimal clinically important difference (MCID) is reported 30% or 20% and even 10% improvement. That’s reported to
be an “effective” outcome. Cox® Technic has proposed 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 attaining
relief or only reaches 30% or 40%. Some patients desire more while
others, especially patients who have previously
gone through 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 is not a big move but is reasonable.
(2) It is a statistic to share. Compared
with medical and surgical outcomes for back pain treatment that are as low
as 10% or 30% expected improvement MCID, our Manchester 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, has a little more difficulty
in keeping research flowing as many
programs are not in large university settings
with well-established and well-funded research departments. Global
chiropractic researchers are looking for am amswer. 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 resources to elevate
chiropractic’s quality and quantity of research. (3,4) Solid 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 Manchester Chiropractic & Sports Injuries
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 Manchester
chiropractic appointment soon. Bring your questions about the research
behind our chiropractic care with you! Manchester Chiropractic & Sports Injuries loves to share research!