Research makes the healthcare world go ‘round! Research solidifies
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 neck pain, back pain, arm
pain and sciatic leg pain. Yorkville Chiropractic and Wellness Centre delivers just such research-documented, effective care to our
Toronto chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
A set of back pain researchers
challenged fellow researchers to develop long-term
plans to lower the problem of low back pain
on sufferers 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 about back pain care.
No consensus on the best way to handle low back pain
has been achieved. Non-drug and non-invasive methods
like exercise, manual therapy, massage, and such are general
recommendations. Another group of reviewing researchers indicated a few problems with back pain research: design
and analysis within the treatment clinical trials. (1) Designing research
studies is difficult. Coming up with a “sham”
protocol for spinal manipulation that feels like spinal
manipulation is really challenging. (Just touching a spine can
help some, but that is a topic for another discussion!) Observational studies are the
next best thing. How so? Researchers observe what happens to patients when they go
through treatment and report
on 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. Yorkville Chiropractic and Wellness Centre feels this mix of
research support helps outline the expectations our Toronto chiropractic
patients may anticipate.
MINIMAL CLINICAL IMPORTANCE
Occasionally, chiropractic
physicians and low back pain patients alike find themselves disappointed
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’s reported as an “effective” outcome. Cox® Technic has proposed 50%
improvement in 30 days as the goal…and still does. Often, chiropractic patients find that 50% relief in fewer
than 30 days and that the 50% relief is closer to
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 previously
gone through back surgery or sought non-relieving care
from many other providers, are quite satisfied. A study
of 1232 low back pain subjects discovered 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 big 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 Toronto chiropractic
clinical outcome goals 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 effort
in keeping research flowing as many
programs are not incorporated into large university settings
with well-established and well-financed research departments. Global
chiropractic researchers are seeking am amswer. 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 turning to
the RAND Corporation’s Center for Collaborative CIH Research to combine
research talent and resources to elevate
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 Yorkville Chiropractic and Wellness Centre
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.
Make your next Toronto
chiropractic appointment now. Bring your questions about the research
behind our chiropractic care with you! Yorkville Chiropractic and Wellness Centre loves to share research!