Research makes the healthcare world go ‘round! Research solidifies the role of healthcare’s pain relieving ability. In chiropractic healthcare, much research entails providing evidence of chiropractic’s benefit for painful musculoskeletal pain issues like neck pain, back pain, arm pain and sciatic leg pain. New Hampshire Spine and Sport delivers just such research-documented, effective care to our Southern New Hampshire chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A set of back pain researchers challenged fellow researchers to come up with long-term plans to decrease the problem of low back pain on patients and healthcare systems. They explained that developing effective strategies continues to be a daunting task for back pain clinicians, doctors, and researchers. Vexingly, back pain disability levels have not improved despite a larger number of published research papers about back pain care. No consensus on the optimal way to manage low back pain has been achieved. 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 feels like spinal manipulation is really challenging. (Just touching a spine can be relieving some, but that’s a topic for a different discussion!) Observational studies are the next best thing. How so? Researchers observe how patients respond when they go through treatment and report on 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. New Hampshire Spine and Sport feels this mix of research support helps outline the expectations our Southern New Hampshire chiropractic patients 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 shouldn’t 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. 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 getting relief or only reaches 30% or 40%. Some patients want more while others, especially patients who have already had 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 huge 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 Southern New Hampshire 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, experiences a little more difficulty in keeping research flowing as many programs are not in large university situations with well-established and well-funded research departments. Global chiropractic researchers are seeking 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 combine research talent and resources to advance chiropractic’s quality and quantity of research. (3,4) Robust 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 New Hampshire Spine and Sport
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 Southern New Hampshire chiropractic appointment now. Bring your questions about the research behind our chiropractic care with you! New Hampshire Spine and Sport is always ready to share research!