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 pain
issues like back pain, neck pain, arm
pain and sciatic leg pain. Executive Chiropractic of Iowa delivers just such research-documented, effective care to our
West Des Moines 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 explained
that developing effective strategies continues to be a
daunting job 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 best 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. Another group of 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 seems like spinal
manipulation is really challenging. (Just touching a spine can
help some, but that is a topic for another article!) Observational studies are the
next best thing. How so? Researchers observe what happens to patients when they go
through treatment and make note of 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. Executive Chiropractic of Iowa feels this mix of
research support helps define to our West Des Moines chiropractic patients
what clinical outcome relief they may anticipate.
MINIMAL CLINICAL IMPORTANCE
Sometimes, chiropractic
physicians and low back pain patients alike find themselves frustrated
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 goal…and still does. Often, chiropractic patients realize that 50% relief in fewer
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 getting
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 excited. 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 is not a big move but is realistic.
(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 West Des Moines chiropractic
clinical outcome goals 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 effort
in maintaining a flow of research as many
programs are not in large university settings
with well-established and well-financed 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 promote
more chiropractic research. US-based researchers are looking 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) 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 Executive Chiropractic of Iowa
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 West Des Moines
chiropractic appointment today. Bring your questions about the research
behind our chiropractic care with you! Executive Chiropractic of Iowa loves to share research!