March 2019 - chiropracticforward March 2019 - chiropracticforward

Month: March 2019

Inflammation and Cognitive Decline

Today we’re going to talk about brain inflammation, cognitive decline, your brain and your patients’ brains and we’ll talk about my brain. Scary stuff here. Plus we’ll talk about ALS and concussion. What’s the research saying?

But first, here’s that “hell yeah”  bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have stuttered into Episode #66

Introduction

We’re here to advocate for chiropractic while we also make your life easier.  

Store

Part of that is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link

DACO

Let’s talk a bit about the DACO program which is the Dipolomate of the Academy of Chiropractic Orthopedists. Still trucking along and hauling a big load of knowledge nuggets in my big 18-wheeter trailer. I don’t know where that came from. 

Recent classes for me have been Managing preganncy-related SI pain, diagnosing thoracic facet joint pain, managing Scheuermann’s disease, and diagnosing merlagia paraesthetica. 

I have told you before that I’m no guru. I learn all the time because I clearly don’t know it all. I have no problem admitting that I’m not, nor have never been, particularly knowledgable on meralgia paraesthetica. I am crapping you negative, folks, when I tell you that the very day after I had the drill on it, it shows up in my office. I swear, unbelievable. 

I’m not above admitting that I’ve been missing it for all these years. It hurts me a bit to admit but facts are facts and if I’m not honest with you, well then, what’s the point in all of this anyway?

If I can get you pointed in the right direction to get started with the DACO, shoot me an email at dr.williams@chiropracticforward.com. I’m happy to help. I get nothing out of it. No discounts on hours, no special considerations, nothing. I just think it’s that important. 

Personal Happenings

Front desk hunt….still a go. Still no rock star. Still not settling. There’s your update. 

Item #1

On with it. This one is called “Systemic inflammation during midlife and cognitive change over 20 years: The ARIC Study.” It was authored by KA Walker, RF Gottesman, DS Knopman, and a slew of rascally cohorts(Walker KA 2019). It was published in Nuerology in February of 2019. Hot stuff….comin’ through. Brand new people. 

Why They Did It

They wanted to examine the associaiton between systemic inflammation measured during midlife and 20-year cognitive decline. 

You know speaking of cognitive decline……..what the hell was I saying? Why did I even come into this room? : )

Anyway, here’s how they did it

This is REALLY dumbing it down a bit for the purpose of brevity but, within the atherosclerosis risk in communities cohort study, inflammatory biomarkers were measured during middle adulthood. they worked some math magic using the biomarkers, creactive protein, and cognition periodically over 20 years. 

12,336 participants

What They Found

Participants with a midlife inflammation composite score in the top quartile had a 7.8% steeper cognitive decline, compared to participants in the lowest quartile; CRP in the top quartile was associated with an 11.6% steeper cognitive decline. In cognitive domain-specific analyses, elevated midlife inflammatory markers were most consistently associated with declines in memory.

Wrapping It Up

The authors concluded, “Our findings highlight what may be an early pathogenic role for systemic inflammation as a driver of cognitive decline in the decades leading up to older adulthood.”

The weirdest thing. As soon as I went over this article, I went home that night and opened up the lates version of Chiropractic Economics magazine. It’s issue 3: February 22, 2019. 

Anyway, there’s an article in there on this exact very thing because my mind is creepy like that. Seriously, you might do this too but, I can think of a patient I haven’t seen in a little while and Bazinga….that week or the next they show up in my office staring me in the face in live real life and it freaks me out every time to know I have gravitational mind powers like that. Lol. 

Evidently my gravitational mind powers work in the information world as well because that’s the way it happened my friends. 

Now, there was all kinds of research citations present in this article but I did not look them up. I don’t know the quality of them. I just don’t have the time but, in short, if we want to decrease the kind of inflammation we see for cognitive decline, the kind in the paper we just talked about, then we need to look at making sure we have good levels of Curcumin/turmeric as well as good serum levels of vitamin D. 

They say the curcumin plays a role in regenerating neurons, creating new brain cells (lord knows I need that), and refreshing cells that may have once been considered irretrievable. So, all the damage I did in young adulthood….maybe there’s some hope after all. 

And are you realizing all of the information that has come out about Vitamin D in the last several years? There is also data refuting the use of ANY supplement but, knowing there’s no harm in a Vitamin D supplement, why WOULDN’T you consider taking it regularly? Worst case scenario, you lost a very minimal amount on a supplement that did nothing. 

Best case, you’re near superhero level. 

Item #2

Continuing with our brain stuff this week, here is item #2 titled, “Contact Sports as a Risk Factor for Amyotrophic Lateral Sclerosis: A Systematic Review” authored by R Blecher, MA Elliott, E Yilmaz and a plethora of associates(Blecher RA 2019). It waspublished in Global Spine Journal in February 2019 because the new stuff makes the folks tickle. And why not? I love information but there’s just something warm and fuzzy about  NEW informaiton isn’t there?

Why They Did It

They say that environmental factors for ALS have remained largely unknown and recent evidence suggests that participation in certain types of sporting activities are….not may be….but ARE associated with increased risk for ALS. They wanted to test the hypothesis that competitive sports at the highest level that involve repetitive concussive head and cervical spinal trauma result in an increased risk of ALS.

How They Did It

They searched electronic databases adn reference lists of key articles from inception to November 22, 2017.

They used 16 studies fitting the criteria for inclusion. 

The sports they looked at were of course, American football, basketball, cycling, triathlon, and skating. I’m wondering where hockey or rugby is in the mix. 

What They Found

I hate to say it but here’s what they found, “Our review suggests that increased susceptibility to ALS is significantly and independently associated with 2 factors: professional sports and sports prone to repetitive concussive head and cervical spinal trauma. Their combination resulted in an additive effect, further increasing this association to ALS.”

While we love our sports and we hate seeing the sissy-fication of the world in general, we also don’t want people to knowingly and purposefully put themselves in danger like this. 

Certainly not our children. We have to pay attention to this stuff. 

I played from 3rd grade up into college and only had my bell rung one time but I’m thinking I’m the exception, not the rule. I was always taller and bigger than most of the others on teh field so that may be why I escaped. Or at least I think I escaped. I’m 46. I still have time to lose my mind I suppose. 

Anyway, food for thought. 

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Blecher RA, E. M., Yilmaz E, (2019). “Contact Sports as a Risk Factor for Amyotrophic Lateral Sclerosis: A Systematic Review.” Global Spine J 1: 104-118.
  • Walker KA, G. R., Knopman DS, (2019). “Systemic inflammation during midlife and cognitive change over 20 years: The ARIC Study.” Neurology.

CF 060: Medical Marketing & Integration Care Expectations



Tinnitus & New Guides For Neck-Related Headaches

Today we’re going to talk about a couple of papers touching on tinnitus as well as a paper that just came out on practice guides for persistent headaches associated with neck pain. We’ll have some fun learning some new info if you stick around. 

Chiropractic evidence-based products

But first, here’s that ‘better than a back rub’ bumper music

Integrating Chiropractors
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OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have drifted into Episode #65. And I don’t mean drifted like a feather or a piece of wood in the ocean. No, I’m talking about dangerous, careless, speedy drifting in the car around a curve, man. That’s the drifting I’m talking about. I talk like I’ve drifted before. I haven’t. Well, at least not intentionally. We won’t talk about that one time down in Alpine, TX. Lol. Hey, I used to be in a touring band. What do you want from me? I used to be on the on’ry side. That’s all I’m saying. 

I’m still a little ornery but age has settled me quite a bit. Which is a good thing. I look at kids these days. My son is a teenager and really, for the most part, he’s just so good. No drugs, no drinking, loving as he can be. I think back to when I was his age. I was legitimately a menace to society. I mean that literally. It’s a wonder I’m alive but, as with most from my generation, we made it didn’t we? In spite of the lead paint, lack of bicycle helmets, and all that stuff. 

I want to take just a few seconds to thank Dr. David Graber. He gave The Chiropractic Forward Podcast a shout-out to a room of about 1000 chiropractors during his talk at the Parker Seminar in Vegas a week or so ago. While that doesn’t seem like that big of a deal, I’ll just say that, when you feel like a lot of times, you’re on your own and everything depends solely on you and your actions or, in-actions, it is a blessing to have others help share the word. When you guys share or help get the message out in any little way, it’s like I breath a little easier if that makes any sense. It’s like I’m part of a team rather than out here on an island shouting through a megaphone hoping a ship passing by hears me. 

Anyway, I know I thanked you in our private Facebook group but wanted to do so here as well. Very much appreciated, Amigo. 

Introduction

Let’s get on with it here. We’re here to advocate for chiropractic and to give you some awesome information to make your life easier from day-to-day. We’re going to keep you from wasting time in your week and give you confidence in your recommendations and treatments. And I feel confident in guaranteeing that to you if you listen and stick to it here at the Chiropractic Forward Podcast.  

Store

Part of saving you time and effort is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly.

DACO

Let’s talk a bit about the DACO program. That’s the Diplomate of the Academy of Chiropractic Orthopedists. Why do the DACO? Because, if you want to integrated, you need to certificate. Or more accurately, you need to specialize and get accredited. That’s what the Diplomate is about. Bells, whistles, letters behind your name….yes. More importantly, you’ll be leaps and bounds beyond where you were prior to do it. 

Recent classes have been Tinnitus which we’ll talk about in a moment, carpal tunnel syndrome as part of a double crush syndrome, and managing hip osteoarthritis. Fascinating stuff. 

I saw a chiropractic student upset on Facebook the other day. He was upset because of some video that popped up on social media. It was an anti-vaccination speech and, honestly, it was pretty vile and hateful in the stance against vaccines. Look, you have whatever opinion you want on vaccines, we’re never going to get into that here. That’s not why I mention it. 

The student clearly did not agree with this speech from CalJam and was wondering what kind of profession he’s spending all of this money to be a part of. He was basically questioning what kind of future he’s going to have when you have a profession that is getting continuing education hours for speeches like that. 

I could confidently tell him, and you by the way, that there has never been a better time to be a chiropractor. At least not in the last 35-40 years anyway. We’ve all heard about the Mercedes 80’s. They sound real nice but they’re a pipe dream at this point. 

Right now, there has never been the research backing up what we do. We have it overflowing. Not only in our effectiveness either. We have research on how we’re more effective than PT and MDs. We have research on how our patients are more satisfied with our outcomes than any other practitioner. We have research on how we do all of that while costing less. 

Never before have we had a national epidemic. This little thing we call the opioid epidemic that is driving every healthcare practitioner to look for non-pharma means of treating their patients. That means you and me. 

And never before have we had the capability or opportunities that we have now to integrate with our medical colleagues and become more and more a part of a team of healthcare practitioners. 

We are moving more to the center rather than staying out on the fringes of healthcare like the red-headed step child. 

No offense to red-heads or step-children. 

Anyway, Diplomate programs are more than letters behind a name. They’re about progressing you and your profession. Building knowledge and respect. 

I get nothing for talking about the DACO. I just think certification and professional standardization are important things. Email me at dr.williams@chiropracticforward.com if you have some questions about getting started.

Personal Happenings

And the hunt for a front desk rock star continues. I want to share with you the fact that indeed.com and Facebook work ads are great at netting you about 1.3 million resumes but not good, well-qualified candidates. Every damn time I post a job listing, I’ll get around 150 recipients. Only a very limited few are worth anything. Most aren’t even qualified for the job. 

For instance I got a resume yesterday from a dude that can run a fork lift. Hey, I like forklift drivers fine but that won’t get it done at the front desk of a healthcare facility, right? It’s an insane waste of time going through all of these but, what the hell else are you going to do? you have to have an employee. And I’m not going to my friends to ask if they know of anyone because I don’t want my friends hitting me up for a job. Lol. If that doesn’t work out, not only have you lost an employee but you’ve also lost a friend. 

No thanks!

Item #1

I have had an increase in tinnitus in my left ear after a plane ride I took back from Austin a couple of weeks ago. Bad enough that I went to a specialist for it. Turns out, she said I have, in some frequencies, moderate loss. I said, “What?” Lol. 

Well, I’ve been a touring musician before so, what’s new? I could have told you that. But, it’s been bad in just the past couple of weeks so something changed in that window of time. I started taking some DACO classes and noticed one on tinnitus so jumped to that drill for obvious reasons. 

I don’t want to go into details of the class but I do want to talk about some of the research cited for the class and we’ll start with this one called, “Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?” It was authored by S Michiels, P Van de Heyning, and a bunch of other very difficult names and published in Manual Therapy in 2016(Michiels S 2016). 

Why They Did It

Tinnitus can be related to many different etiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Knowing that case studies have suggested a positive effect of cervical spinal treatment on tinnitus, this study wanted to dive a little deeper on it. 

How They Did It

It was a randomized controlled trial of subjects having a combination of tinnitus and neck pain. Like a combo meal, instead of a burger and fries, it was neck ache and ear ringing. Make that two please, thank you. 

Each subject received cervical physical therapy for 6 weeks which equaled 12 sessions. 

What They Found

Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints.

Pretty cool stuff there. 

Item #2

Let’s double down with this one from Oostendorp, et. al. called “Cervicogenic somatosensory tinnitus: An indication for manual therapy? Part 1: Theoretical concept” published in 2016 in Manual Therapy(Oosterndorp RA 2016). 

The Big Idea

Tinnitus can be evoked or modulated by input from the somatosensory and somatomotor systems. This means that the loudness or intensity of tinnitus can be changed by sensory or motor stimuli such as muscle contractions, mechanical pressure on myofascial trigger points, transcutaneous electrical stimulation or joint movements.

Interesting yeah? I think so. 

They go on to say, “The neural connections and integration of the auditory and somatosensory systems of the upper cervical region and head have been confirmed by many studies. These connections can give rise to a form of tinnitus known as somatosensory tinnitus. 

Broadening the current understanding of somatosensory tinnitus would represent a first step towards providing therapeutic approaches relevant to manual therapists. Treatment modalities involving the somatosensory systems, and particularly manual therapy, should now be re-assessed in the subgroup of patients with cervicogenic somatosensory tinnitus”

And that’s just what they’re doing. Fascinating stuff considering that you’ve always heard, “you’ll just have to live with it.” Basically, if you can change the intensity, quality, or frequency of the ringing, by moving your jaw or stressing the cervical spine in different directions, there’s more than a solid chance that you can change it completely through cervical manipulative or manual therapy. 

If I remember correctly the guesstimate was around 65% of the cases may be affected by chiropractors for the positive. 

Hell yeah and pass the potatoes people. 

Item #3

Our last thing today is called “Non‐pharmacological Management of Persistent Headaches Associated with Neck Pain: A Clinical Practice Guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration” written by Pierre Cote, Hainan Yu, Heather Shearer, et. al. and published in European Journal of Pain in February 2019(Cote P 2019). 

Hot off the presses and I know you like it served hot like that. Cold or lukewarm education just isn’t as good as piping hot brain nuggets.

Why They Did It

To develop an evidence‐based guideline for the non‐pharmacological management of persistent headaches associated with neck pain (i.e., tension‐type or cervicogenic).

How They Did It

This guideline is based on systematic reviews of high‐quality studies. A multidisciplinary expert panel considered the evidence of clinical benefits, cost‐effectiveness, societal and ethical values, and patient experiences when formulating recommendations.

What They Found

When managing patients with headaches associated with neck pain, clinicians should: 

  1. rule out major structural or other pathologies, or migraine as the cause of headaches; 
  2. classify headaches associated with neck pain as tension‐type headache or cervicogenic headache once other sources of headache pathology has been ruled out; 
  3. provide care in partnership with the patient and involve the patient in care planning and decision‐making; 
  4. provide care in addition to structured patient education; 
  5. consider low load endurance craniocervical and cervicoscapular exercises for tension‐type headaches (episodic or chronic) or cervicogenic headaches >3 months duration; 
  6. consider general exercise, multimodal care (spinal mobilization, craniocervical exercise, and postural correction), or clinical massage for chronic tension‐type headaches; 
  7. do not offer manipulation of the cervical spine as the sole form of treatment for episodic or chronic tension‐type headaches; 
  8. consider manual therapy (manipulation with or without mobilization) to the cervical and thoracic spine for cervicogenic headaches >3 months duration. However, there is no added benefit in combining spinal manipulation, spinal mobilization, and exercises; and 
  9. reassess the patient at every visit to assess outcomes and determine whether a referral is indicated.

All of this is just a part of making us all better day to day. Those paying attention have the leg up. No doubt. 

Here’s the problem with being patient-centered instead of doctor-centered. We have to be OK with watching the high volume practices running through like cattle….we have to be OK watching them make millions while we have an average case treatment of only 7-10 visits. 

So what? Big deal. I always say that I could have a bigger house and more vacations but I sleep very well at night and, being a Christian as I’ve mentioned before, I’m at peace knowing I’m square with my maker and treat people the way they should be treated. 

Religious or not, patient-centered doctors can always take comfort in the fact that they’re doing what is in the best interest of their patients. 

It’s a lovely thing isn’t it? Honesty, ethics, love, cumbaya, and all that tom foolery….. They’re just little bricks that are the building blocks of an excellent life and career. 

Integrating Chiropractors
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Chiropractic evidence-based products

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

Website

Social Media Links

https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP

https://www.facebook.com/groups/1938461399501889/

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes

https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn

https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Cote P, Y. H., Shearer HM, (2019). “Non‐pharmacological Management of Persistent Headaches Associated with Neck Pain: A Clinical Practice Guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.” European Journal of Pain.

Michiels S, V. d. H. P. (2016). “Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?” Man Ther: 125-135.

Oosterndorp RA, B. I., Mikolajewska E, (2016). “Cervicogenic somatosensory tinnitus: An indication for manual therapy? Part 1: Theoretical concept.” Man Ther: 120-123.

https://www.chiropracticforward.com/proven-means-to-treat-neck-pain/?v=7516fd43adaa

https://www.chiropracticforward.com/debunked-the-odd-myth-that-chiropractors-cause-strokes/








Chiropractic Wins Again, Push Ups Say A Lot, Low Iron & The Disc

CF 064: Chiropractic Wins Again, Push Ups Say A Lot, Low Iron & The Disc

Today we’re going to talk about how chiropractic and spinal manipulative therapy win again, we’ll talk about how push ups may tell us more than what you see on the surface, we’ll discuss some new information on low back discs and how they’re affected by low iron, and then we’ll gloss over a paper on physical therapy to toss you some thought nuggets. 

Chiropractic evidence-based products

But first, jsut for my friend and collegue, Dr. Michael Henry down in Austin, here’s that ‘you know you love it’ bumper music. He’s a big fan. 

Integrating Chiropractors

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have shimmied all 60’s like into Episode #64

Introduction

We’re here to advocate for chiropractic and to give you some awesome information to make your life easier from day-to-day. We’re going to keep you from wasting time in your week and give you confidence in your recommendations and treatments. And I feel confident in guaranteeing that to you if you listen and stick to it here at the Chiropractic Forward Podcast.  

Store

Part of saving you time and effort is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. I noticed an error on the shipping charge. That has been corrected now. 

Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if somehting is out of sorts or isn’t working correctly. 

DACO

Let’s talk a bit about the Diplomate of the Academy of Chiropractic Orthopedists probgram also known as the DACO. I finished up all 50 of the required live hours this weekend down in Austin, TX during the Texas Chiropractic Association’s legislative seminar. 

Not only did I get all of the hours wrapped up but I also got to see a lot of colleagues I have been doing battle along side with for the last 8 years or so. You may or may not know that the Texas Medical Association is particularly aggressive and attacks at will for anything and everything. Which means we have to constantly raise funds to defend the attacks. 

It’s this cute thing we do with each other from year to year. It’s really a special relationship chiropractors have with the TMA. I keep thinking one day they’ll start listening to their own profession and leave us the hell alone but nope. Not so far. Not until they have full and complete control of chiropractic care in Texas. Which is not going to happen. Just so you know.. 

They sued us because 2 docs in texas who were Neuro Diplomates were doing VONT testing. I’d never even heard of VONT until this last time we got sued by TMA. IF you can give me a good reason why a neuro diplomate cannot do VONT testing, I’ll send you a candy bar or some chicklets or something like that. 

It’s enough to make a guy crazy. I got to meet a lot of bright new people ready to help the TCA fight and overcome. Andrea Ohmann recently moved to Texas from Minnesota. She is in a hospital setting if I understood correctly. She’s a bright star to keep an eye on. I also need to thank Dr. Jamie Marshall for listening to us down in Conroe, TX. I really appreciate it!

I got to see Staff Sergeant Shilo Harris speak. I mentioned him a couple of episodes ago but I have to tell you, this man is a hell of a speaker and he’s in our corner specifically. He gives chiropractic care all of the credit for helping him get through all of his injuries and surgeries. He was blown up by an IED in Iraq and has been through absolute hell to get to where he is now and chiropractic was key to getting him there. 

Very emotional and very impactful. I can’t imagine a legislator being confronted by him and his story and not being forced to see it our way. It’s powerful. Thanks to Shilo for eveything he’s doing for this profession. I hope you’ll go to http://shiloharris.com and see what he’s about. 

Beyond that our DACO hours were taught by Jeffrey Miller who is a chiropractor on staff at the University of Missouri medical school. He’s not as sharp as a tack. He’s actually sharper than a tack and told me he’d love to join us on the podcast so I’m going to do us all a favor and get that set up. We also have Dr. Christine Goertz’s episode coming up quickly so keep your eyes peeled for that one too. 

This get on with this deal here. 

Item #1

Our first item here is called “Manipulative Therapies: What Works” and is authored by Dr. Michael Smith, an MD, and his herd of collegues. It was published in American Family Physician on Febraury 15, 2019(Smith M 2019). I got this one from Dr. William Lawson in Austin, TX who is a DABCO and a swell dude on top of that. 

In case you missed it, this herd of authors are medical doctors. They start by saying that manipulative therapies include things like osteopathic manipulative treatment which is the same as chiropractic manipulative treatment. 

They say that, when you compare manipulative therapy to oral analgesics, cervcial manipulation and/or mobilization appears to provide better short-term pain relief and improved funciton in patietns with neck pain. 

They go on to say that manipulative therapy may be as effective as amitriptyline for treating migraine headaches and can reduce the frequency and intesity of pain. 

While there is some evidence showing that manipulative therapy can reduce length of hospital stays for preterm infants, there is ZERO research for some of the other reasons we see chiropractors treating infants. Things like otitis media, colic, allergies, and respiratory conditions. 

That was all in the abstract. That’s the medical world starting to take note. Can you hear it? When do the insurance companies start to take note as well?

THAT’S REALLY when our lives start changing. Oh happy day….I have a dream. A dream where we are no longer pursecuted for being right all the damn time. A dream that chiropractors don’t go around saying crazy crap and making the rest of us look bad. I have a dream people. I’m not going to pretend to be as good of an orator as Martin Luther King Jr. but you get the point. 

You know that the more of these articles that come out, the more they have to start gathering steam. Turn on a light bulb at night in South Texas and see what happens. The bugs start swarming. Turn on this kind of light and you’ll see these articles begin catching more and more attention until we finally have a consensus in the medical field. A consensus that says, “Hell, looks like they’ve been onto something this whole time. We better take another look at it.”

This is an excellent paper. And we need to keep seeing this more and more. Even if they’re talking specifically about osteopathic manipulative therapy, we know that chiropractors do it too and, in fact, chiropractors do almost all of it these days. DO’s have moved almost completely to medicine. We are the ones moving joints. Make no mistake about it. 

Item #2

Pushups…what can they tell us? Well, it appears they can tell us quite a lot from an article in StudyFinds called “Men Who Can Do More Than 40 Push-ups Far Less Likely To Develop Heart Disease.(Finds 2019)”

This article covers a new study that showed that men posessing the ability to perform 40 push-ups in one attempt are much less likely to suffer from heart disease wihtin the next 10 years. 

They showed where middle-aged men who can put in more than 40 in a single try have a 96% less chance of having heart disease when compared to those who could complete no more than 10 push-ups. 

So, it appears, to me…..that it’s time to start doing some push-ups muy pronto. 

Item #3

This one comes to us from the American Journal of Translational Research and is called “Iron defficiency accelerates intervertebral disc degeneration through affectring the stability of DNA polymerase epsilon complex(Zhang C 2015).” 

It was published in November of 2015 and appears to be mostly Chinese researchers. Could be Japanese, Korean, or Vietnamese but the name of the lead author is Chungiang Zhang and whole host of names that appear to be just as difficult to pronounce. 

We will not get deep into the details here because I’m not too proud to admit that the information here goes far above my head in many ways. I’ve said it before, I’m no guru. I’m like Alex Trebec on Jeopardy. He delivers the info but I promise he’s no expert on every question coming across his lips. Lol. 

But, when we stick with the basics, we see that iron serves as an important cofactor of iron-containging proteins that play critical roles in the maintenance of DNA stability and cell cycle progression. They say that disturbed iron homeostasis gives rise to things like cancer and anemia. 

In addition, they say that they found clear correlation between iron deficiency and intervertebral disc degeneration. 

They wrapped up their paper by saying, “In summary, our study suggests that iron deficiency is an important factor in the aggravation of IDD. Proper iron supplementation may be an effective strategy to alleviate the symptoms of patients with intervertebral disc degeneration.”

Item #4

Our last on the list, it has to do with PTs and is called “Minimal physical therapy utilization compared with higher physical therapy utilization for patients with low back pain: a systematic review,” authored by Heidi Ojha and a gaggle of others and published in Physiotherapy Theory and Practice in February 2019(Ojha H 2019).

This was a systematic review to compare the effects of minimal physical therapy utilization (two visits or less) vs. typical physical therapy utilization consisting of 3 or more visits on patient-important outcomes for patients with low back pain. 

They say this research is needed because there is such variation in physical therapy use for those with low back pain. 

Interestingly, they found that, when compared with minimal utilization, higher utilization demonstrated no significant differences on pain, disability, or quality of life at the 1-year follow-up.

Even more interesting was that the conclusion of the paper said the following, “While higher utilization may not result in significant improvements in patient-important outcomes, it may be more cost-effective for patients with chronic or complex LBP conditions when compared to minimal utilization.”

So, what the hell is that? It’s not going to make you any difference to see us a lot but the price point is agreeable so, by all means, we’d like to see you a crap load. Which isn’t as much as a crap ton. By the way. But I think you see what I mean. 

I have noticed so many papers that basically cast a lot of doubt on PT in general while all we seem to find in regards to manipulative therapy are positive reaffirmation of the chiropractic profession. 

It just makes me wonder where the tipping point is to be honest. When does the medical industry start to look at chiropractic as being more effective for these conditions that PT and making those referrals accordingly? I had some insight on a PT private group on Facebook a couple of weeks ago. 

The PTs were piling on a chiropractor’s advertisement techniques. Let’s be fair, the DC was a knucklehead and wasn’t being honest and identifying himself as a chiropractor in his marketing but, for discussion purposes here, that’s beside the point. 

They were bashing not only on that chiropractor but our profession as a whole. I bash on aspects of my profession as well but, where the rubber hits the road, we average better patient outcomes, we are safe, we are effective, and we average higher patient satisfaction. Even if some in our profession would win a county craziness competition. 

Don’t believe me? Go listen to Episode #49 of this podcast where we go over the Parker-Gallup poll. Very interesting episode and there are some valuable marketing nuggets in that one for you as well. Definitely worth the listen. 

Also Episode #26 talks about PTs and DCs. The age old grudge match. Go check them out and see what you think. 

Some in our profession are simply imbeciles. That sounds harsh but for a time after graduating, I held no interest in furthering my education. I wanted to coast. I’d done the hard work, right? I was so smart already after all those years of college. Well, you don’t know what you don’t know. And, I can admit that for a few years there, I was an imbecile. 

They learned enough to pass but that doesn’t make them smart or ethical and that’s sad. But again, when said and done, our profession consistently proves itself and is proven by insurance companies, governments, polls, surveys, and universities. 

From what I’ve seen recently, I can’t say the same for them and I just can’t see where they feel they have some moral high ground or platform to stand on and spout a bunch of denigrating thoughts at us. 

I thought it’d be a good idea once to refer to a PT. I had a car wreck patient and thought they could use PT and at that time, I wasn’t equipped to do much rehab. So onto the PT they went. In two damn weeks, the PT ran up a bill that would have literally taken me 4 months to run up. I was astounded. And, in that two week period, there was little to no improvement for the patient. 

On a separate occasion, I had a disc patient finally settled down and doing great. She was very active and very much into working out. I had her disc settled down to a point that she thought she’d go get PT on top of what I was doing. She did not talk to me about it. She just did it. Her thought process was that it would just be that much better to combine the two. Chiropractic and PT. Honestly, that’s not bad thinking in theory. 

She came back after one visit almost unable to walk or function. We tried and tried to get it to settle back down but she ended up taking herself to a surgeon to get our of pain. Sorry PTs. Quit talking smack and work with us instead of against us.

Ideally, PTs and chiropractors work hand in hand and complement each other. Many offices can and should operate in this manner. In reality though, I see PTs as great for post-operative rehab and rehab after certain types of injury. When it comes to joints and spines in general though, they can’t touch us. They talk bad about us, they steal services from us, they think they have the moral ground on us, but they can’t touch us.

Those of us practicing in an evidence-informed manner anyway. Those not practicing evidence-informed actually continue to provide them with whatever moral ground they believe they have. 

I for one would like to move on from the beginnings and progress our profession much like the MDs have done over the last 150 years. They went from blood-letting, leeches, and labotomies to what they can do now. Yet, there’s still a part of our profession wanting to hold on dearly to our originations of 100+ years ago. 

Chiropractors, let go. Progress. Practice current, in the current day and age. Practice evidence-informed. It’ll help you and it’ll help the profession in general. 

That’s my opinion anyway. Take it or leave it. 

This week, I want you to go forward with

  1. Chiropractic wins and wins and wins again. We made the right decision. We just need to only use our powers for the good. 
  2. Push-ups….let’s get to doing them!
  3. Iron deficiency for disc degeneration is something worth looking at. 
  4. When we are practicing evidence-informed chiropractic care, PTs only wish they could get the results we can get.

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment instead of chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show that many patients get good or excellent results through chiropractic for headaches, neck pain, back pain, joint pain, to name just a few.

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Finds, S. (2019) “Men Who Can Do More Than 40 Push-Ups Far Less Likely To Develop Heart Disease.” StudyFinds.

Ojha H, M. M., Johnston M, (2019). “Minimal physical therapy utilization compared with higher physical therapy utilization for patients with low back pain: a systematic review.” Physio Theory Practice.

Smith M (2019). “Manipulative Therapies: What Works.” AMerican Family Physician 99(4): 248-252.

Zhang C (2015). “Iron deficiency accelerates intervertebral disc degeneration through affecting the stability of DNA polymerase epsilon complex.” Am J Transl Res 10(11): 3430-3442.