The National Institute of Health’s investment in integrative pain care was just ratcheted up a notch. A consortium led by the University of Minnesota’s Earl E. Bakken Center for Spirituality & Healing will receive $14 million for a national study on non-drug therapies for low back pain. A release from the University of Minnesota announced that the Bakken Center will receive $11.2 million. The remaining $2.8-million will be directed to the University of Washington for a data management center.
The study, “Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain Trial (PACBACK)”, is among the largest studies funded by the NIH’s National Center for Complementary and Integrative Health (NCCIH).
In an electronic interview for this article, Bakken Center founder and director Mary Jo Kreitzer, PhD, RN, FAAN shares that the project’s importance is the focus on the big-ticket item of back pain and that it “is designed to test whether early treatment in the acute phase with spinal manipulation or self-management vs usual care can prevent the condition from becoming chronic.” Kreitzer, whose doctorate is in health services research, notes that “this approach has the potential to improve quality of life and save considerable costs.”
Leading the research is a multidisciplinary group—starting from the left—led by some of the nation’s top professionals with research doctorates who are cross-trained as doctors of chiropractic. Gert Bronfort, DC, PhD and Roni Evans, DC, PhD are each directors of the Bakken Center’s Integrative Health and Wellbeing Research Program. They are joined by the interprofessional research team of Michael Schneider, DC, PhD and physical therapist Anthony Delitto, PhD, PT at the University of Pittsburgh. These two will serve as co-principal coordinators for the Clinical Coordinating Center. Patrick Heagerty, PhD, at the University of Washington will lead the $2.8-million Data Coordinating Center (DCC) for the study’s data management and statistical support.
Evans speaks to the timeliness of the investigation: “Back pain is right in the center of the opioid crisis. We need to take a step back and consider other options which truly address patients’ needs and enable them to safely and effectively manage their pain.”
This core team is surrounded by 11 others named in the U Minnesota release. These are based at these two institutions and also at Duke University, University of North Texas, and Oregon Health Sciences University. The later, notably, is Roger Chou, MD, known for primary authorship on influential guidelines on treatment of low back pain. Kreitzer shared that the team “reflects the scope and rigor of research that is possible when Integrative health researchers become senior researchers in research intensive universities.”
Comment: Kreitzer’s last comment, immediately above, would seem to refer particularly to the roles of the chiropractor scientists Bronfort, Evans and Schneider, at their respective conventional academic medical centers.
There is a fascinating back story here, relative to the two Bakken Center chiropractor scientists. In 2014, the NCMIC Foundation, funded by the leading malpractice insurer for the chiropractic profession and the brainchild of Lou Sportelli, DC, made a strategic $500,000 bet. As reported in The Integrator, they invested the half-million to move Bronfort and Evans to Kreitzer’s shop from their prior home at Northwestern Health Sciences University. There, each had a long, successful research career that was, however, in an increasingly under-resourced environment. Via the NCMIC funds, Bronfort and Evans became the founding directors of the Bakken Center’s Integrative Health & Wellbeing Research Program.
I asked Kreitzer for her perspective on NCMIC’s role. She replied: “NCMIC support has been very important to the development of our research program. Dr. Lou Sportelli and Dr. Wayne Wolfson, guiding the NCMIC Foundation, are visionary and absolutely understand how research will drive health policy and ultimately lead to better patient outcomes, increased access and improved reimbursement.”
The $11.2 million NCCIH grant to the Bakken Center makes everything else Bronfort and Evans have already done since their move across town from Northwestern look like gravy for Sportelli and Wolfson’s savvy bet. Of course, the big return, for the field of chiropractic that has floated the boat for NCMIC, will be the hoped for positive outcomes from the trial.
Editor’s note: This article is not edited and the authors are solely responsible for the content. The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Integrative Practitioner.