Research makes the healthcare world go ‘round! Research established
the role of healthcare’s relief of pain. For
chiropractic healthcare, much research entails providing
evidence of chiropractic’s benefit for painful musculoskeletal pain
issues like back pain, neck pain, arm
pain and sciatic leg pain. Vancouver Disc Centers offers just such research-documented, effective care to our
Vancouver chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A set of back pain researchers
challenged fellow researchers to develop long-term
plans to lower the burden of low back pain
on patients and healthcare systems. They described
that developing effective strategies continues to be a
daunting task for back pain clinicians, doctors, and
researchers. Frustratingly, back pain disability levels have not
increased despite a larger number 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 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 tough. Coming up with a “sham”
protocol for spinal manipulation that seems like spinal
manipulation is really challenging. (Just touching a spine can
help some, but that’s a topic for a
different article!) Observational studies are the
next best thing. How so? Researchers observe how
patients respond when they go
through treatment and make note of 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. Vancouver Disc Centers feels this mix of
research support helps outline the expectations our Vancouver chiropractic
patients may anticipate.
MINIMAL CLINICAL IMPORTANCE
Occasionally, chiropractic
physicians and low back pain patients alike are frustrated
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’s reported as an “effective” outcome. Cox® Technic has offered 50%
improvement in 30 days as the aim…and still does. Many
times, chiropractic patients realize that 50% relief in less
than a month and that the 50% relief is closer to
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, particularly patients who have already
had back surgery or sought non-relieving care
from many other providers, are thrilled. A study
of 1232 low back pain subjects discovered a MCID pain intensity of
2 (meaning a 2 point move on a scale of 0 no pain to 10 worst
imaginable pain). That’s not a big 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 Vancouver 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 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 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 Vancouver Disc Centers
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
describes research studies of which he’s been a
part.
Make your next Vancouver
chiropractic appointment now. Bring your questions about the research
behind our chiropractic care with you! Vancouver Disc Centers loves to share research!