Research makes the healthcare world go ‘round! Research solidifies
the role of healthcare’s pain relieving ability. For
chiropractic healthcare, much research revolves around providing
evidence of chiropractic’s benefit for painful musculoskeletal conditions like back pain, neck pain, arm
pain and sciatic leg pain. Manahawkin Chiropractic Center offers just such effective,
research-documented care to our
Manahawkin chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A group of back pain researchers
challenged fellow researchers to create 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
huge job for back pain clinicians, doctors, and
researchers. Frustratingly, back pain disability levels have not
increased despite an increased quantity of
published research reports about back pain care.
No consensus on the optimal way to manage low back pain
has been agreed upon. Non-drug and non-invasive approaches
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 tough. Designing a “sham”
protocol for spinal manipulation that feels like spinal
manipulation is especially challenging. (Just touching a spine can
be relieving some, but that is a topic for a
different discussion!) Observational studies are the
next best thing. How so? Researchers observe what happens to patients when they undergo treatment and make note of changes and effects. Fortunately, Cox®
Technic research has a blend of biomechanical and clinical
observational studies resulting in case reports, case series, plus
retrospective and prospective clinical studies. Manahawkin Chiropractic Center feels this mix of
research support helps outline the expectations our Manahawkin 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 shouldn’t
be! In medicine, the minimal clinically important difference (MCID) is defined
as 30% or 20% and even 10% improvement. That is reported as 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 less
than 30 days 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, particularly patients who have already
undergone 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 change on a scale of 0 no pain to 10 worst
imaginable pain). That is not a huge 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 Manahawkin 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, has a little more effort
in maintaining a flow of research as many
programs are not in large university situations
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 stimulate
more chiropractic research. US-based researchers are looking 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) Robust research continues at chiropractic universities to record the
benefits of chiropractic for musculoskeletal-related pain like back pain, neck
pain, arm pain and leg pain.
CONTACT Manahawkin 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
describes research studies he’s managed.
Schedule your next Manahawkin
chiropractic appointment soon. Bring your questions about the research
behind our chiropractic care with you! Manahawkin Chiropractic Center is always
ready to share research!