Research makes the healthcare world go ‘round! Research established
the role of healthcare’s pain relieving ability. In
chiropractic healthcare, much research revolves around documenting chiropractic’s benefit for painful musculoskeletal conditions like back pain, neck pain, arm
pain and sciatic leg pain. Cross Chiropractic Center delivers just such effective,
research-documented care to our
Sandy Springs chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One group of back pain researchers
challenged fellow researchers to create long-term
plans to reduce the burden of low back pain
on patients and healthcare systems. They explained
that developing effective strategies continues to be a
huge task for back pain clinicians, doctors, and
researchers. Frustratingly, back pain disability levels have not
increased despite an increased quantity of
published research reports regarding back pain care.
No consensus on the optimal way to manage low back pain
has been achieved. Non-drug and non-invasive methods
like exercise, manual therapy, massage, and such are general
recommendations. Other reviewing researchers pointed
to 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
help some, but that’s a topic for another article!) Observational studies are the
next best thing. How so? Researchers observe what happens to patients when they undergo treatment and report
on 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. Cross Chiropractic Center feels this mix of
research support helps outline the expectations our Sandy Springs chiropractic
patients 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 should not
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 offered 50%
improvement in 30 days as the goal…and still does. Often, chiropractic patients realize 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 reaching
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 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 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 Sandy Springs 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, has a little more difficulty
in keeping research flowing as many
programs are not incorporated into large university situations
with well-established and well-financed research departments. Global
chiropractic researchers are seeking 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 turning to
the RAND Corporation’s Center for Collaborative CIH Research to pool
research talent and assets to elevate
chiropractic’s quality and quantity of research. (3,4) Solid research carries
on at chiropractic universities to document the
benefits of chiropractic for musculoskeletal-related pain like back pain, neck
pain, arm pain and leg pain.
CONTACT Cross 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
explains research studies he’s managed.
Make your next Sandy Springs
chiropractic appointment soon. Bring your questions about the research
supporting our chiropractic care with you! Cross Chiropractic Center is always
ready to share research!