A New Clinical Research Priority
Written by Editor   
Friday, April 24, 2015 12:00 AM

Chiropractors with clinical research training have traditionally focused on the spine and its related disorders and especially neck and low back pain. Examples include the recent Decade of the Bone and Joint 2000–2010 Task Force on Neck Pain and Its Associated Disorders as well as several excellent randomized trials of spinal manipulative therapy (SMT) for neck and low back pain.

Despite these and many other research successes, from 1990 to 2010 disability from spine-related pain has significantly increased, with low back pain now the leading cause of global disability, affecting 10% of the population or more than 600 million people worldwide. Over the same two decades, disability from other musculoskeletal disorders has also increased by 44.6%, and with an aging and increasingly sedentary society this trend is likely to continue and so too will the demand for improved care and prevention. Even patients seeking care for neck and low back pain rarely have pain isolated to just the spine and frequently report co-occurring non-spinal pain, not to mention other co-morbid diseases. Chiropractors already commonly manage a variety of musculoskeletal disorders and at different anatomical sites, not just those related to the spine. Taken together, these facts provide a good basis to promote the growth of clinical research efforts in other non-spinal musculoskeletal areas.

Moreover, with the growing burden of musculoskeletal disorders there is a need for chiropractors to become more involved and integrated in interdisciplinary collaborative research efforts aimed at improving the understanding and care of such complex disorders. One way to secure the future growth of the chiropractic profession may be to prioritize support for clinical research in musculoskeletal areas beyond the spine and more specifically, clinical research that’s interdisciplinary and collaborative in nature. Presently, a group of chiropractors with post-graduate clinical research training are involved in innovative, collaborative research efforts in important, but less traditional areas of research such as mild traumatic brain injury (MTBI), work disability prevention, undifferentiated chest pain, hip osteoarthritis, and prevention of spine pain in children and adolescents to name a few. 

Chiropractors trained as clinical researchers are making substantial scientific contributions in major non-spinal musculoskeletal areas such as MTBI, arthritis, prevention, WDP and public health. These new collaborative clinical research examples serve to demonstrate the capacity for research success in clinical areas beyond the spine, which is encouraging news for musculoskeletal patients who are in need of better evidence-informed management, but also for the chiropractic profession, which will be able to play a stronger and more integrated role in improving the outcomes for these patients.

A recent commentary on the global challenges for the chiropractic profession suggested the need to prioritize the limited available research funds in order to both maximize the capacity for success and achieve measureable outcomes clinicians can actually use. This serves to highlight the need to challenge the existing state of affairs and possibly for the chiropractic profession to establish a new clinical research priority and more specifically to focus on innovative and higher yield research investment opportunities. To start, prioritizing funds for clinical research, that is to say research that directly benefits and informs the care of patients, in particular clinical research in other non-spinal musculoskeletal areas and that involves interdisciplinary collaboration may garner better and earlier returns per research dollar (i.e., outcomes clinicians can use). With increased funding, clinical researchers can continue to innovate in these and other non-traditional research areas, thereby benefiting patients and the future of the profession.

Source:  http://chiro.org/wordpress/2015/03/07/beyond-the-spinea-new-clinical-research-priority/