Dr. Paulette Hugulet, DC, LLC Explains the Value of Chiropractic Research
Research makes the healthcare world go ‘round! Research grounds the role of healthcare’s pain relieving ability. In chiropractic healthcare, much research revolves around providing evidence of chiropractic’s benefit for painful musculoskeletal pain issues like neck pain, back pain, arm pain and sciatic leg pain. Dr. Paulette Hugulet, DC, LLC offers just such effective, research-documented care to our La Grande chiropractic patients.
CHALLENGE: DO HIGH QUALITY RESEARCH
One set of back pain researchers challenged fellow researchers to create long-term plans to reduce the problem of low back pain on sufferers and healthcare systems. They clarified that developing effective strategies remains a huge task for back pain clinicians, doctors, and researchers. Frustratingly, back pain disability levels have not increased despite a larger number of published research papers regarding back pain care. No consensus on the best way to manage low back pain has been agreed upon. Non-drug and non-invasive approaches 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. 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’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 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. Dr. Paulette Hugulet, DC, LLC feels this mix of research support helps explain to our La Grande chiropractic patients what clinical outcome relief they may expect.
MINIMAL CLINICAL IMPORTANCE
On occasion, 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 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 realize that 50% relief in less than a month and that the 50% relief is more like 70% or 80% or 90%! Sometimes, a patient’s response may be slower in attaining relief or only reaches 30% or 40%. Some patients desire more while others, particularly patients who have already undergone 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 change on a scale of 0 no pain to 10 worst imaginable pain). That’s not a huge move but is reasonable. (2) It’s 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 La Grande chiropractic clinical outcome objectives are high and frequently achievable.
THE CHALLENGE OF CHIROPRACTIC RESEARCH – AND HOW CHIROPRACTIC ANSWERS
Chiropractic, like other complementary and integrative healthcare professions, has a little more effort in keeping research flowing as many programs are not incorporated into large university settings with well-established and well-funded research departments. Global chiropractic researchers are looking for 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 stimulate 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 advance 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 Dr. 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 he’s managed.
Schedule your next La Grande chiropractic appointment soon. Bring your questions about the research behind our chiropractic care with you! Dr. Paulette Hugulet, DC, LLC loves to share research!
