Research makes the healthcare world go ‘round! Research established
the role of healthcare’s relief of pain. In
chiropractic healthcare, much research revolves around documenting chiropractic’s benefit for painful musculoskeletal conditions like back pain, neck pain, arm
pain and sciatic leg pain. Dr. Hoang's Chiropractic Clinic offers just such effective,
research-documented care to our
Montreal chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One group of back pain researchers
challenged fellow researchers to come up with long-term
plans to reduce 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
increased despite a larger number of
published research reports about back pain care.
No consensus on the optimal way to handle low back pain
has been achieved. Non-drug and non-invasive options
like exercise, manual therapy, massage, and such are general
recommendations. Another group of reviewing researchers pointed
to 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
be relieving some, but that’s a topic for another article!) Observational studies are the
next best thing. How so? Researchers observe how
patients respond when they go
through treatment and describe changes and effects. Fortunately, Cox®
Technic research has a blend of biomechanical and clinical
observational studies resulting in case reports, case series, as well as
retrospective and prospective clinical studies. Dr. Hoang's Chiropractic Clinic feels this mix of
research support helps explain to our Montreal chiropractic patients
what clinical outcome relief they may expect.
MINIMAL CLINICAL IMPORTANCE
Sometimes, chiropractic
physicians and low back pain patients alike are 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 offered 50%
improvement in 30 days as the aim…and still does. Often, chiropractic patients find that 50% relief in less
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 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 change 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 Montreal chiropractic
clinical outcome objectives 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 difficulty
in keeping research flowing as many
programs are not in large university situations
with well-established and well-financed 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 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) 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 Dr. Hoang's Chiropractic Clinic
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 of which he’s been a
part.
Make your next Montreal
chiropractic appointment now. Bring your questions about the research
supporting our chiropractic care with you! Dr. Hoang's Chiropractic Clinic loves to share research!