Ground Breaking Research
The DMR Method is based on research conducted since 2006 by the DMR Method research team. It began as a series of meetings between physical therapists, chiropractors, orthopedists, neurosurgeons, and radiologists whose goal was to learn how to work together better to improve patient care as well as neck and back pain treatment outcomes. The DMR Method, which has since helped thousands of patients avoid spinal surgery and other invasive procedures, is the first integrated protocol of care combining the knowledge and skill of a wide range of healthcare professionals backed by research utilizing pre- and post-treatment MRIs and functional index scores (which track a person’s ability to engage in normal physical activities). What follows is a summary of the DMR Method research conducted thus far, as well as a glimpse at current and future DMR Method research.
The Pilot DMR Method Clinical Case Study
Based upon initial outcomes after introducing the DMR Method to selected patients, an initial pilot DMR Method clinical case study was designed with the following goals:
- measure effectiveness of the method in treating disc herniations, degenerative disc disease, facet syndrome, and other chronic neck and back pain treatment needs using short- and long-term subjective, objective, and functional measures;
- identify patient lifestyle factors—physical, nutritional, and emotional— which may affect outcomes, and develop effective methods to address these factors;
- study changes in disc herniation position and size using recumbent, weight- bearing, and positional MRIs;
- study changes in degenerative disease, alignment, and stability of the spine using recumbent, weight-bearing, and positional MRI;
- use outcome data to further refine and improve the DMR Method procedures, protocols, and outcomes.
Twenty patients participated in the initial pilot DMR Method clinical case study. Seventeen of the twenty completed the study with significant to marked improvements objectively, subjectively, and functionally post neck or back pain treatment. Most notable were the changes evidenced on many of the follow-up MRI evaluations when compared to initial, pre-DMR Method MRI evaluations. These follow-up MRIs showed shrinking and/or complete reabsorption of disc herniations diagnosed on the initial MRI evaluations. Of the three patients who did not show significant improvement, one voluntarily left the program and subsequently had surgery with poor results. The other two patients experienced limited improvement within the eight-week period of treatment. In both cases, it was discovered in follow-up evaluations that neither had been consistent with self-care and rehab procedures aside from the chiropractic adjustments, physical therapy, and other treatments in-office. Following additional DMR Method patient education and rehabilitation, both patients attained excellent results. Significant observations from the initial pilot DMR Method clinical case study include:
- the DMR Method is a highly effective way to treat herniated intervertebral discs as well as offering chronic back and neck pain treatment;
- the DMR Method can significantly decrease the symptoms associated with the above conditions (back/neck/arm/leg pain, numbness, and/or weakness);
- nineteen of the twenty initial case study participants (95 percent) experienced a significant decrease or resolution of their symptoms and an improvement in their ability to be physically active without symptoms (determined by attaining at least 30 percent improvement in functional index scores);
- patient satisfaction with the DMR Method neck and back pain treatment was excellent;
- the collaborative DMR Method evaluation and neck/back pain treatment process is a viable way to treat disc herniations;
- intervertebral disc herniations can partially or completely reabsorb;
- the larger the intervertebral disc herniation, the greater the potential for reabsorption;
- resolution and stabilization of a patient’s condition is not solely reliant on the reabsorption of a herniated intervertebral disc; while partial or complete reabsorption was visualized in many of the follow-up MRIs, some cases with excellent clinical, subjective, and functional improvement showed no change in the size or position of a herniation on the follow-up MRIs;
- the common factor in the two cases that didn’t initially achieve excellent outcomes was their lack of participation in the rehabilitation component of the program;
- the rehabilitation component is essential to long-term success;
- although disc herniations can partially or completely reabsorb, there was no observable change in intervertebral disc hydration to the extent that was visualized on follow-up MRIs (except in two cases);
- when intervertebral disc herniations partially or completely reabsorb, it is unlikely that they reabsorb back into the body of the intervertebral disc. It appears that the herniation is reabsorbed into the surrounding interstitial fluid. This is based on the observation that there was no appreciable change in intervertebral disc thickness after large intervertebral disc herniations were shown to be completely reabsorbed on follow-up MRIs.
The First DMR Method Clinical Case Study (DMR1)
Based on the findings of the initial pilot DMR Method clinical case study, the DMR Method research team refined different components of the DMR Method and also established three distinct phases in the DMR Method treatment protocol: the relief, repair, and rehabilitation phases. Neck and back pain treatment is developed on an individual basis and generally includes components of physical therapy, chiropractic care, and massage. They also developed specific patient education strategies to improve patient compliance and satisfaction. This formed the foundation for the first DMR Method clinical case study, a.k.a. the DMR1 Study.
Key developments based on the DMR1 study include:
- fully 96.4 percent of patients attained significant symptomatic and functional improvement from neck and back pain treatment when including data from lumbar and cervical cases (50% or greater improvement in functional index scores);
- recovery rates improved with the refinement of the DMR Method evaluation, treatment, and education protocols: patients averaged a 51.1 percent decrease in pain and disability as assessed by Oswestry Disability Questionnaire;
- disc herniations completely reabsorbed 100 percent of the time when patients began treatment within eight weeks of disc herniation occurrence, clearly suggesting that early intervention plays a significant role in recovery;
- long-term outcomes are excellent for patients who consistently follow the self-care protocols established during the DMR Method back pain treatment progression;
- a specific progression of joint manipulation was developed by the DMR Method chiropractic team called Integrated Progressive Manipulation (IPM);
- a specific protocol of manual muscle therapy was developed by the DMR Method research team called Dynamic Muscle Technique (DMT);
- A specific progression of standard traction (called DMR Method Progressive Traction) was developed by the DMR Method research team.