Research makes the healthcare world go ‘round! Research established
the role of healthcare’s pain relieving ability. For
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. Paulette Hugulet, DC, LLC delivers just such effective,
research-documented care to our
La Grande chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One group of back pain researchers
challenged fellow researchers to develop long-term
plans to reduce the problem of low back pain
on sufferers 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
improved despite a larger number of
published research papers regarding back pain care.
No consensus on the optimal way to handle low back pain
has been agreed upon. Non-drug and non-invasive methods
like exercise, manual therapy, massage, and such are typical
recommendations. Other reviewing researchers pointed
to a few problems with back pain research: design
and analysis within the treatment clinical trials. (1) Designing research
studies is tough. Designing a “sham”
protocol for spinal manipulation that feels like spinal
manipulation is especially challenging. (Just touching a spine can
help some, but that’s a topic for a
different article!) Observational studies are the next in line. How so? Researchers observe how
patients respond when they go
through treatment and make note of 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. Paulette Hugulet, DC, LLC feels this mix of
research support helps explain to our La Grande chiropractic patients
what clinical outcome relief they may anticipate.
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’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 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, especially patients who have already
gone through back surgery or sought non-relieving care
from many other providers, are thrilled. 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’s not a big move but is reasonable.
(2) It’s 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 La Grande 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, experiences 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 created a leadership academy (CARL – Chiropractic
Academy for Research Leadership) for early-career chiropractic researchers to stimulate
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 record the
benefits of chiropractic for musculoskeletal-related pain like back pain, neck
pain, arm pain and leg pain.
CONTACT Paulette Hugulet, DC, LLC
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.
Schedule your next La Grande
chiropractic appointment soon. Bring your questions about the research
behind our chiropractic care with you! Paulette Hugulet, DC, LLC loves to share research!