Apple Country Chiropractic Explains the Value of Chiropractic Research
Research makes the healthcare world go ‘round! Research grounds the role of healthcare’s relief of pain. 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. Apple Country Chiropractic delivers just such research-documented, effective care to our Williamson chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One set of back pain researchers challenged fellow researchers to develop long-term plans to decrease the problem of low back pain on patients and healthcare systems. They explained that developing effective strategies remains a huge task for back pain clinicians, doctors, and researchers. Vexingly, back pain disability levels have not increased despite a larger number of published research papers about 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 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’s a topic for another discussion!) Observational studies are the next in line. How so? Researchers observe how patients respond when they experience treatment and report on changes and effects. Fortuitously, Cox® Technic research has a mix of biomechanical and clinical observational studies resulting in case reports, case series, plus retrospective and prospective clinical studies. Apple Country Chiropractic feels this mix of research support helps explain to our Williamson chiropractic patients what clinical outcome relief they may expect.
MINIMAL CLINICAL IMPORTANCE
On occasion, chiropractic physicians and low back pain patients alike are 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 as an “effective” outcome. Cox® Technic has proposed 50% improvement in 30 days as the aim…and still does. Often, chiropractic patients find that 50% relief in fewer 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 want more while others, particularly patients who have previously undergone back surgery or sought non-relieving care from many other providers, are quite satisfied. 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’s not a huge move but is reasonable. (2) It is 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 Williamson 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 effort in maintaining a flow of research as many programs are not incorporated into large university situations with well-established and well-funded 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 promote more chiropractic research. US-based researchers are looking to the RAND Corporation’s Center for Collaborative CIH Research to pool 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 Apple Country Chiropractic
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 of which he’s been a part.
Make your next Williamson chiropractic appointment soon. Bring your questions about the research supporting our chiropractic care with you! Apple Country Chiropractic is always ready to share research!
