FEATURE RESEARCH Trailblazer Chiropractic research is paving the way for clinical success M by A nthony L ombArdi hospital outpatient treatment, Meade et al., BMJ 1990; 300:1431. For patients with low back pain in whom manip-ulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison with hospital outpatient management. The benefit is seen mainly in those with chronic or severe pain. Introducing chiropractic into national health-care system practice should be considered. any practising health profes-sionals become so wrapped up in day-to-day clinical practice that sometimes they forget to reflect on the time and effort invested into the research that most clinical protocols are based on. Research is the vehicle that has trans-ported the profession through time and space – from David Palmer’s little office in Davenport, Iowa, in 1895 to the Oval Office and worldwide acceptance in 2013. Historically, practising chiropractors have relied on the outcome of research studies to develop procedures in clinical protocols, interdisciplinary acceptance and development of insurance company policies. In a recent interview, Dr. Cheryl Hawk, dean of research at Logan Chiropractic College, commented on the importance of research to prac-tising chiropractors. “With the emphasis on evidence-based practice and documenting outcomes, if you don’t have re-search, it’s going to be harder and harder to get paid by third-party payers,” Dr. Hawk says. What did this mean? The future is bright for chiropractic research. — Passmore For the first time a well-known medical journal studied chiropractic care in a clinical setting and revealed the significant clinical and financial ben-efits associated with using chiropractors as allied health professionals. This study was monumental in the development of extended health-care plans that began to include chiropractic care as a regular benefit. 2. Magnetic resonance imaging of the lum-bar spine in people without back pain, Jensen et al., N Engl J Med. 1994 Jul 14; 331(2):69-73. On MRI examination of the lumbar spine, many people without back pain have disk bulges or pro-trusions but not extrusions. Given the high preva-lence of these findings and of back pain, the dis-covery by MRI of bulges or protrusions in people with low back pain may frequently be coincidental. Reviewing the past As researchers and as practising chiropractors, it is important to reflect on significant research from the past that have shaped the way insurance com-panies, patients and health professionals view the role of chiropractic care. 1. Low back pain of mechanical origin: Ran-domised comparison of chiropractic and AnThony LomBArdi, dC , is a consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic, based in Hamilton, Ont. He also conducts practice-building workshops for health professionals. Visit www.exstore.ca for more information. 26 Canadian Chiropractor September 2013 What did this mean? 3. The needle effect in the relief of myofascial pain, Karel Lewit, Pain. 1979 Feb; 6(1):83-90. www.canadianchiropractor.ca Photo: Dreamstimephoto.com This study was the first of its kind in such a prom-inent medical journal to illustrate that many disc surgeries may be unnecessary and the use of other forms of conservative care should be given more of an opportunity in patients with low back pain.
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