010- Adding Chiropractic to Standard Medical Care

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Hello, welcome to the EVANSPACE Chiropractor. I am your host, Dr. Jeff langmaid. This week we're diving back into the Research with a Spine journal article published in 2013. The title is Adding Chiropractic Manipulative therapy to standard medical care for patients with Acute Low Back pain. The results of a pragmatic randomized comparative effectiveness study. But before we get started, let me say a few words about Rocktape. Rocktape is proud to be a sponsor of the Evidence Based Chiropractor. Rocktape offers the world's best kinesiology tape, pain relief, topicals, mobility tools and functional fitness accessories. New from Rocktape is Rocksauce Chill, a powerfully cool pain relief topical in a convenient roll on with 6% menthol. It's stronger than the freeze competition. Rock Tape is more than a tape company, they are a movement company. Learn more and get access to your medical discount by visiting rocktape.com this week's piece of research is really awesome because many times as chiropractors when we have patients come into our clinic, they probably have already visited their primary care provider before coming to see us. Not all the time, but it's very common in the research today as we talked about with the title, it's about adding chiropractic care to what's deemed standard medical care for patients with acute low back pain. So this is a good study again because it's very realistic in terms of the patient that we're seeing in our practice as we speak of all the time in the membership section of the evidence based chiropractor. Treating low back pain in the primary care internal medicine setting is very challenging. The docs have very limited tools. The effectiveness of those tools is not so hot. As chiropractors we should always strive to provide the best evidence based care for our patients by working with these offices because it ultimately helps serve the patients. This fine study shows very clearly that that standard medical care combined with chiropractic care provides clear advantages for the patient suffering from acute low back pain. And not only is it acute low back pain in an axial sense, but 43% of the patients in this study had radicular symptoms. So your sciatic like nerve compression foraminal stenosis type pain. Additionally, the average satisfaction with the Overall results of care was nearly 9 out of 10 for for the spine standard medical care plus Chirogroup compared to a 5 out of 10 for the standard medical care group. So this backs up what we already know and have seen, that there's a very high patient satisfaction in regards to chiropractic care. So let's take a look at a few specific quotes. The researchers found the results of this trial suggest that chiropractic manipulative therapy in conjunction with standard medical care offer a significant advantage for decreasing pain and improving physical functioning when compared to standard care alone for both men and women between the ages of 18 to 35 with acute low back pain. So they're looking at active young adults and not only again looking at the decreasing pain, but improved function, all about function. So that speaks to the heart of what we do as chiropractors. Additionally, the researchers found, quote, they there is a statistically and clinically significant benefit to those patients receiving chiropractic treatment. That's great. Not only is it statistically significant in terms of the benefit, but also clinically significant hits both sides of the coin. That's what many docs are going to be looking for in terms of the top tier research. They also found the majority of systematic reviews find that chiropractic therapy appears to reduce pain and disability at least moderately for many low back pain patients. So the research supports what we do. They finally, they found 73% of participants in the spinal manipulative therapy group rated their global improvement as pain completely gone, much better or moderately better compared to 17% in the standard medical care. So let me frame that a little bit clearer. Nearly 3/4, 73% of the patients that had standard medical care and chiropractic had pain completely gone much better or moderately better. The patients that did not receive chiropractic care so simply had standard medical care. Only 17% of those patients rated their pain as completely gone, much better or moderately better. That is a huge, a huge great divide. And that is why when the researchers look back, it's part of the reason why I should say that they can claim, and rightfully so, that there is a statistically and clinically significant benefit to patients receiving the chiropractic care in addition to the standard medical care. Now I'd like to dive in on a little bit of how you can use this information, this research to position your practice and build referral relationships. Part of that for anybody that's looking for more than we're able to go through in our weekly segments is on Amazon.com, marketing chiropractic to Medical Doctors. My book just was released last week in hard copy form, paperback form, so you can buy it on Amazon. Marketing Chiropractic to Medical Doctors. That book gives you an absolutely step by step guide in terms of building relationships with medical doctors and how to go about it with full integrity in the most ethical way possible. And basically ultimately the goal being serving patients at the highest level. The book, to my surprise, and I'd like to thank anybody listening that has picked it up, it shot directly to number one in Chiropractic on Amazon. Thank you for taking the time, thank you for reading, thank you for paying attention. And if you haven't, I'd highly recommend picking up the book literally for the less than the cost, if it would take to pick up lunch probably this afternoon. You'll be able to get a complete step by step guide in terms of building those relationships. But let's redirect and focus back upon the task at hand. So this Spine Journal article is, you know, coming full circle with it. They're adding chiropractic care to standard medical care. So this is a great segue to practitioners about showing them chiropractic research. And this isn't specifically chiropractic research, but it's really clinical based research. I say that because it's taking patients who have had what we would expect to be a normal course of care, meaning they have an acute issue, they go to see their primary care physician for it, and then they go to see a chiropractor afterward, whether on their own volition or whether by direct referral. Of course, we want to make sure that those referrals are coming into us because we're going to take care of the patients in the most effective way possible. But in any case, patients, people that have had an acute low back pain, almost half with a radicular symptomatology, they go to see their primary care doctor and then they go to see a chiropractor. The addition of chiropractic care and really that it's not about this or that necessarily is the key component to this article. It's not taking chiropractic care and pitting it against, and I love those pieces of research as well, when it's chiropractic care against or shown against different modalities. I think those comparative research studies are extremely important. We dive into them from time to time. But when you can take a realistic natural history, not of the relief of pain, but a natural history of how a patient goes through their process. It adds a lot of value and it shows to any primary care internal medicine doctor, or any practitioner for that matter, that chiropractic care can be used in addition to what they're doing. It doesn't have to be a replacement. Now, we may have our own thoughts on what that practitioner in a primary care setting in terms of the offering of NSAIDs or any upgraded medication and the lack of effectiveness or the challenges associated with that, that's a different topic. The patient is going to go through their process irregardless of many times what the research says. So it's on the practitioners, us and the other healthcare providers they may be seeing to best direct that patient. So that is where research such as this is imperative for chiropractors to be knowledgeable about and also be able to speak about with some depth and fortitude. Because it helps us go one step back to those primary care internal medicine docs and provide the information so they have the patients that go to see those docs have the best opportunity for the best care possible. It doesn't mean that every time that a patient comes in they're going to refer directly to your office, but when they become aware of these things and they're able to see it not only in a chiropractic journal, but also in a journal such as Spine, it adds a lot of credence to what we're talking about day to day. So we had previously featured this exact piece of research for all of our members and it's available in the Members Vault to any new members. But I'd encourage you to get familiar with the research. Check the episode highlights in the episode notes to learn more about this and we will see you next week. Have a great week in practice and we will talk to you soon.

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