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Multivitamins Effect On Mortality & Acupuncture Effect On PTSD

CF 339: Multivitamins Effect On Mortality & Acupuncture Effect On PTSD Hey, folks. Today, we’re gonna talk about multivitamins effect on mortality and acupuncture for PTSD.  But first, here’s that super sweet bumper music. Hey, we’re back. You found the Chiropractic Forward podcast.  

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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  We’re having, we’re having a good time here. We’re giving evidence based chiropractic a little bit of personality, a wink, a smile, an nod, or whatever the hell you wanna call it. But what I will say is we are not that stuffy, judgmental, elitist, pretentious kind of research that we always think about. No. We’re research talk over a couple of beers, so grab you, oh, I don’t know a case. I’m doctor Jeff Williams. I’m your host for the Chiropractic Ford podcast, and I’m glad you’re right here spending time with me. You’re learning just the same as I am. I don’t know this stuff in advance, really. I put it together. I compile it, but we’re learning at the same time. So I’m teaching you something that I’d be learning myself, and I figure, wait, why don’t we just do it together? I’m glad you’re here. If you haven’t yet, I got a few things you need to do. Go to Amazon, buy my book, The Remarkable Truth About Chiropractic, a unique journey into the research. It’s $23, and it helps you stay on top of your research. Why the hell wouldn’t you go get it? The Remarkable Truth About Chiropractic, A Unique Journey Into the Research. Just go do it. Then, go like our Chiropractic Ford Facebook page, join the Chiropractic Ford Facebook group, review the podcast, and then visit our website over at chiropracticford.com. You’ve found yourself right in the middle of 339, episode 339. If you missed last week’s episode, we talked about psychologically treating chronic pain, and we talked about prenatal GLP one safety. Make sure you don’t miss that info. You gotta keep up with the class already. On the personal end of things, well, it’s a short week for me as I will be on my way to Chicago on Thursday morning for our quarterly MCM Mastermind meeting with our master, doctor Kevin Christie and crew. If you don’t listen to doctor Kevin Christie’s podcast, it is very chiropractic specific, and it is very excellent as doctor Kevin Christie. And, yeah, we are in the east cohort of his mastermind, thing. And he’s also got a west mastermind cohort. We’re all gonna meet at the end of next year in New Orleans. As of right now, we don’t mix and mingle. We don’t know each other really for the most part. My east group has about 22, 25 of us, somewhere in that range, all high achieving, all bigger practices for the most part, all trying to do big things. We all have our own talents. For 1 or 2 things, I’m the smart guy in the room. For everything else, I’m not, which is good. If you’re not the smartest person in the room, then you’re in the right room. That means you’ve got plenty of space to learn from others and bring those things home and start changing your own practice. And you have an ongoing network that you can continue to bounce those ideas off of and and ask those questions of, throughout the the next week, the next 2, 3 months until the next quarterly mastermind meeting. So it’s an ongoing network. We keep each other from veering too far off the track, I would say. A mastermind is good, folks. This is my second one I’ve been in, and I think we actually have 1 or 2 spots open for a new member. If you’re interested, just contact doctor Kevin Christie at doctor, because he’s doctor, drk, because his first name’s Kevin, and christie@gmail.com. So once again, that is drkchristie atgmail.com, and tell him that your old uncle Jefro sent you his way. Now I mentioned last week that we have finally become profitable on the medical side of our practice, so, of course, in old uncle Jeffro luck fashion, we’re gonna go ahead and cue the exit of our nurse practitioner because as soon as things start going good, things start going bad in my world. So that’s the way the ball bounces in my universe since about 2020 or so, especially, well, maybe 2022 or 2023. It’s been extremely noticeable. Staffing has been an ongoing nightmare, to be honest. And you know this if you’re a regular listener of of, of this podcast. And I haven’t even been I haven’t even talked about all of the staffing issues, just a lot of them. So I think we just removed the impetus for all of those issues of 2022 and 2023, I think. But the nurse practitioner leaving, I believe, is an aftershock of, that removal, and it’s something we just gotta deal with, you know, it’s kind of a team thing, and when part of the team leaves, maybe both of the team members wanna leave. I don’t know. I really, I don’t know. But what I do know is we’re meeting with another nurse practitioner this week that is interested in what we are doing and how she can help us out. So that’s super exciting. And I gotta say something that, I really truly feel. I’m not afraid of change anymore. The older you get, the more you realize that the only constant in this world is change, which sounds like an oxymoron. Right? But turns out to be fact. The only constant in this world is change. You’re either moving ahead or you’re falling behind. Never never never are we static. I’m no longer afraid of change. I’m anxious when I have uncertainty. As long as I can see a ways down the path, then I’m fine. As long as there’s there’s, mostly a map somewhere, then we’re doing good. When there’s fog kinda settled in and I can’t see the path clearly, that’s when I get fussy, and that’s when I get anxious, and that’s when I wanna club baby seals and pump punt baby bunnies a 100 yards. So change. Yeah. Whatever. It’s fine. Whatever. I don’t love it, but it it is a fact. Uncertainty, I can’t have it. So, sooner or the sooner the better to get a clear path ahead, and then we’re gonna be fine. Now, with this change, big as it is, we got a real opportunity here. Our current nurse practitioner, he was on salary and he’s got a spouse with an excellent professional income. And I mean, great for, but 2 really high achievers. The pressure to provide was probably less, I would guess. Of course, personal finances are none of my business and I would have no idea, but I would guess the pressure is reduced when you have a high income spouse. Also, there were certain obstacles to marketing for us with with the current situation, Like we couldn’t take photos for some reason, he was never active whatsoever on social media, wouldn’t allow himself to be filmed or marketed on our social media. That made it a little bit difficult. And while I have to respect that, you can’t I mean, you gotta respect people’s wishes. It didn’t make a lot of sense to me, but I respected it. And as I mentioned, it presented an obstacle to being able to market and grow our medical services, as you might a and all that good stuff. So, we have a real opportunity to have someone part time, probably not salary, who gets paid for the work they do and doesn’t get paid when they’re not working. Someone that is motivated to, provide for themselves and their family. Someone that does not put up roadblocks, making it more difficult to market them, and build that patient base. Someone that once they’re fully engaged and pushing for our clinic can grow into a full time position with bonuses, should they choose, if that’s what they want. So it’s a chance to do it right. I have the battle scars of starting an integrated structure. I have the cuts and the bruises and the formerly emptied bank account from funding a new venture for over two and a half years. Their, return on investment isn’t quite what ours is, but it’s it’s still worth doing I believe, or we wouldn’t be doing it. There It’s kinda crazy. So when I say their ROI isn’t what ours is, I mean it. I think about it. All we need is a table and our hands. That’s it. The table is a one time cost. With medical, you’ve got all the supplies, and if you’re not a big group or a hospital, I’m not sure how anyone is making a lot of money in the medical field, to be honest. Thank the good Lord for weight loss meds here lately. But outside of that, if we do hormone pellets, for example, the company, the hormone pellet company gets half the cost from the get go. Then the cost of the nurse practitioner’s time, the cost of the room, the cost of, some other supplies that they need. Yeah, there’s just not a lot of meat left on the bone there, in a lot of cases. Anyway, we’re gonna get that nurse practitioner in here to finish what we started and to take us to a different level on the medical side. Then, we’re gonna get a young, hungry doctor of chiropractic associate in here, and we’re gonna get him kicking some butt talks. Then, we’ll look at maybe getting a physical therapist integrated in here, and we will be, firing on all cylinders. All of this, I think, is in line with the investment group that you’ve heard me talking about selling 60% of the clinic to eventually. So we got lots of stuff swirling around. We’ll see how it all shakes out sooner rather than later. Item number 1, our first one today is called multivitamin use and mortality risk in 3 prospective US cohorts by Lofeld et al, published in JAMA Network, open on June 26, 2024, and bam, that’s a hot one. Stuff coming up. Please remember the citations can be found at chiropractic4.com under this episode. Now here’s why they did it. 1 in 3 US adults uses multivitamins with a primary motivation being disease prevention. In 2022, the US Preventive Services Task Force reviewed did I get that right? Preventive Services Task Force reviewed data on multivitamin supplementation owing in part to limited follow-up time and external validity. They wanted to estimate the association of multivitamins use with mortality risk, accounting for confounding, by healthy lifestyle and reverse causation, whereby individuals in poor health initiate multivitamin use. Excuse me, here’s how they did it. This cohort study used data from 3 prospective cohort studies in the US, each with baseline multivitamin use and follow-up multivitamin use, extended duration of follow-up up to 27 years, and extensive characterization of potential confounders. Participants were adults without a history of cancer or other chronic diseases who participated in National Institutes of Health, AARP Diet and Health Study, which that was 327,732 participants, Prostate, lung, colorectal, and ovarian cancer screening trial was another 42,732 participants. Or agricultural health study was about 20,000 participants. The data were analyzed from June 2022 to April 2024. Let’s see, main outcomes. The main outcome was mortality. Cox proportional hazard models were used to estimate hazard ratios. And here’s what they found. They say among 390,124 participants, 164,762 deaths occurred during follow-up. Almost a 160,000 or 40.9% were never smokers, and almost 160,000 participants, were college educated. Among daily multivitamin users, 49.3% and 42% were female and college educated, compared with 39.3 and 37.9% among non users, respectively. In contrast, we’re getting into the weeds a little bit, stick with me, in contrast, 11% of daily users compared with 13% of non users were current smokers. Multivitamin use was not associated with lower all cause mortality risk in the first or second halves of follow-up. In the wrap up, basically they say, in this cohort study of U. S. Adults, multivitamin use was not associated with a mortality benefit. Still, many US adults report using multivitamins to maintain or improve health. So, you know, I remember during COVID, there was a, a pulmonologist here in town, and he was always posting from the uselessness of vitamin supplements. And I, you know, I kinda was like, well, maybe some, but I don’t know. And the more I’ve looked into it, the more I’m like, are vitamins and multivitamins a waste of money? Like, I’m not sure. Like, I still don’t know, like, so I’m not passing judgment here. But the more of these studies I see on vitamin supplementation, multivitamin supplementation, I’m beginning to kind of wonder if they’re worth a damn at all. But that is to be determined. I need to learn more. And if you go and learn more, send me the information. I wanna hear about it. Now, item number 2. Our second one today is called acupuncture for combat related post traumatic stress disorder, a randomized clinical trial by Hollyfield et al, published in JAMA Psychiatry on February 21, 2024, and it’s a lot hot. Hot stuff coming up. Now, here’s why they did it. They say current interventions from PTSD are efficacious, yet effectiveness may be limited by adverse effects and high withdrawal rates. Acupuncture is an emerging intervention with positive preliminary data for PTSD. To compare Verum acupuncture with sham acupuncture. Sorry, the objective is to compare Verum acupuncture with sham acupuncture on clinical and physiological outcomes. Here’s how they did it. They say this was a 2 arm parallel group perspective blinded randomized clinical trial hypothesizing superiority of verum to sham acupuncture. The study was conducted at a single outpatient based site, the Tiber Rubin VA Medical Center in Long Beach, California, with recruitment from 2018 to 2022, and then a 15 week treatment period. Following exclusion for characteristics that are known PTSD treatment confounds, might affect biological assessment, indicate past non adherence or treatment resistance, or indicate risk of harm, 93 treatment seeking combat veterans with PTSD, aged 18 to 55 years old, were allocated to groups by adaptive randomization, and 71 participants completed the intervention protocols. Interventions were, Verum and Sham were provided as 1 hour sessions, twice weekly, and participants were given 15 weeks to complete up to 24 sessions. The outcomes and measures, they, let’s see, the primary outcome was pretreatment to post-treatment change in PTSD symptoms severity on the clinical or sorry, the clinician-administered PTSD scale 5. The secondary outcome was pretreatment to post treatment change in fear-conditioned extinction assessed by fear potentiated startle response. Outcomes were assessed at pretreatment, mid-treatment, and post-treatment. Here’s what they found. A total of 85 male and eight female veterans were randomized. There was a large treatment effect of Verum, a moderate effect of sham, and a moderate between group effect favoring Verum and the intention to treat analysis. In the wrap up, what they say is the acupuncture intervention used in this study was clinically efficacious and favorably affected the psychobiology of PTSD in combat veterans. These data build on the known literature and suggest that clinical implementation of acupuncture for PTSD, along with further research about comparative efficacy, durability, and mechanisms of effects is warranted. Alright. There you have it. Keep on keeping on. Keep changing our profession from your corner of the world. The world needs evidence-based patient centered practitioners driving this bus. The profession needs us in the ACA and involved in the leadership of our state association. So please, please, please quit bitching about the profession if you’re not doing anything on your own to make it better. Get active, get involved, make it happen. Here’s the message like it is every week. I want you to know with absolute certainty that when chiropractic is at its best, you can’t beat the risk versus reward ratio because spinal pain is primarily a movement related pain, and it typically responds better to movement-related treatments rather than chemical treatments like pills and shots. And when you compare it to the traditional medical model, research and clinical experience shows that patients get good to excellent results for headaches, neck pain, back pain, and joint pain. And that’s just for starters. It’s safe and cost effective. It can decrease surgeries and disability, and we do that through conservative nonsurgical means with minimal hassle on the part of the patient. And if the patient treats preventatively after initial recovery, we can usually keep it that way while we raise the overall level of health. At the end of the day, if you don’t remember anything else, remember this, patients should have the guarantee of having the best treatment that offers the least harm. And when it comes to non complicated musculoskeletal complaints, folks, that’s chiropractic. Send us an email at doctor.williams@chiropracticford.com, and let us know what you think of the show. Tell us what your suggestions are for future episodes. Feedback and constructive criticism, those are blessings and so are subscribes and excellent reviews on the podcast platforms. You know how this works in the year 2020. If you value something, you have to share it, you have to interact with it, you gotta hit some buttons and review it, and you gotta talk about it from time to time. It really does make a big difference. We can’t wait to connect with you again next week from the Chiropractic Ford podcast flat deck. This is doctor Jeff Williams saying upward, onward, and forward.    

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  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
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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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    

Psychologically Treating Chronic Pain & Prenatal GLP-1 Safety

CF 338: Psychologically Treating Prenatal Chronic Pain & GLP-1 Safety Today we’re going to talk about Psychologically Treating Chronic Pain & GLP-1 Safety But first, here’s that sweet sweet bumper music  

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable.

We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. 

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together. 

Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com

If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #338

Now if you missed last week’s episode, we talked about PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis

Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things…..

As the clinic turns…..we are back on the right track to getting our team and our culture back in place and ready to grown. And then….which is my perfect luck since 2023 came along, our Nurse Practitioner turns in his notice and will be leaving us in October. 

Yeah…fun times. I’ve done too much and come much much too far to let this be anything BUT and opportunity rather than a set back. So, we will begin hiring another NP this week. 

Here’s how it’s going to be an opportunity, we have basically spa services like massage and acupuncture although acu is much more than a spa treatment. But, here’s where I’m going with it, if I bring in a female NP, we can augment those services and come in with a full blown medspa on that side of things, offering botox and all of that good stuff. 

So, we’ll lose some patients when our current NP leaves. Sure. But there’s an odd thing with him not wanting to have his picture taken so we’ll have someone in here that we can actualy effectively promote. Someone that we can make sure is invested in our clinic and ready to help us build it. 

Our current NP helped us figure it out and get it running. The second one will take us to the next level of where we’ve been trying to go. And….the improving culture can be re-inforced. 

We used to go bowling together and spend time with each other periodically outside of work. We enjoyed all working together. Sure people would come and go but only every 2-3 years. I had a manager for 11 years and another for about 6.5 years. Those were the days. 

Since 2023, it’s been non-stop turnover and turmoil and I’m struggling to just get that stability. A core group of staff that loves what we’re doing and sees the potential in being a strong team with a fun culture. 

So, the search continues but we have a new Medical Assistant starting on Friday. She’s going to be great. I just know it. And then the new NP will be the final piece of the puzzle. If we make the right pick there, we can be unstoppable. The bigger the practice, the bigger the problems I guess. As they say in the military, “Embrace the suck.”

So I am…. But make no mistake, though I’m positive and optimistic and moving forward, the suck has been real for a while now. 

What’s up with your Monday? Lol

Item #1

Our first one today is called, “Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy” by Cesta et al and published in JAMA Internal Medicine in December of 2023 and that’s just spicy enough. 

Remember, the citations can be found at chiropracticforward.com under this episode. 

Cesta CE, Rotem R, Bateman BT, et al. Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy. JAMA Intern Med. 2024;184(2):144–152. doi:10.1001/jamainternmed.2023.6663

Why They Did It

Is periconceptional use of glucagon-like peptide 1 (GLP-1) receptor agonists or other noninsulin second-line antidiabetic medications (ADMs) associated with increased risk of major congenital malformations?

Wrap It Up

Use of second-line noninsulin antidiabetic medications is rapidly increasing for treatment of type 2 diabetes and other indications, resulting in an increasing number of exposed pregnancies. 

Although some estimates were imprecise, results did not indicate a large increased risk of major congenital malformations above the risk conferred by maternal type 2 diabetes requiring second-line treatment. 

Item #2

Our last one this week is called, “Psychologically based interventions for adults with chronic neuropathic pain: a scoping review” by Oguchi et al and published in Pain Medicine in June of 2024, oushywawa! It’s hot!

Mayumi Oguchi, Michael K Nicholas, Ali Asghari, Duncan Sanders, Paul J Wrigley, Psychologically based interventions for adults with chronic neuropathic pain: a scoping review, Pain Medicine, Volume 25, Issue 6, June 2024, Pages 400–414, https://doi.org/10.1093/pm/pnae006

Why They Did It

As psychologically based interventions have been shown to have clinical utility for adults with chronic pain generally, a similar benefit might be expected in the management of chronic neuropathic pain (NeuP). 

However, to date, this has not been established, with existing systematic reviews on this topic being hampered by the scarcity of randomized controlled trials (RCTs). 

This review aimed to identify the type of psychologically based interventions studied for adults with chronic neuropathic pain. It also aimed to assess whether there are enough RCTs to justify undertaking an updated systematic review.

How They Did It

Seven databases and 2 clinical trial registries were searched for NeuP and psychologically based interventions from database inception to December 2021, and the search was updated in February 2023. 

The search was broadened by reviewing the reference list of included studies and contacting field experts. Predetermined study characteristics were extracted.

What They Found

Of 4,682 records screened, 33 articles (less than 1%) met the eligibility criteria. 

Four broad intervention approaches were observed, including cognitive-behavioral approaches, mindfulness/meditation, trauma-focused therapy, and hypnosis. 

Thirteen RCTs were identified, and of these, 9 retained 20 participants in each arm after treatment.

Wrap It Up

Cognitive-behavioral therapy was the most common therapeutic approach identified, whereas mindfulness/meditation was the most frequently used technique. 

Almost half to two-thirds of the studies reported significant improvements in pain, disability, or distress, which suggests that psychologically based interventions are potentially beneficial for adults with chronic NeuP. 

If you’re not up on centralized pain and the upregulated CNS folks, it’s the future of long term pain. We’ve been talking about it for years here and we just keep seeing more and more information confirming it. 

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.

Let’s get to the message. Same as it is every week. 

Store

Remember the evidence-informed brochures and posters at chiropracticforward.com. 

 

 

 

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      

PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis

CF 337: PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis Today we’re going to talk about PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis But first, here’s that sweet sweet bumper music  

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #337 Now if you missed last week’s episode, we talked about Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I just returned from a big weekend in Frisco, TX. Which is basically Dallas. It’s where we held the big Texas Chiropractic Association ChiroTexpo which is what we call our state convention, basically.  We had abotu 300 registered attendees. It’s not up there with Parker Vegas or the Florida state convention but it was well-attended and had some reminders of the way the conventions were prior to COVID. I think that’s our generation’s measuring stick now.  Life before COVID and life after COVID.  I’m trying to quit measuring my practice to pre-COVID. It’s still not there but we have a new reality and we still have goals so…..that’s going to have to be good enough. My goals are pretty clear and defined. For me personally, I got it figured out. Here’s how it goes.  I have three long days and 2 short days. On the long days, I need to see 42 each of the three long days and 30 on each of the 2 short days.  These are relatively easy and straightforward days and at the end of the week, we’ll have seen 186 patients. That’s more than enough to keep my train rolling down the tracks. I’m probably in the area of around 155-160 per week at the moment. And, as you can probably tell, that depends on which week you ask me about it. It’s so up and down lately that it gets pretty frustrating but it seems to be trending up and up overall.  I hope you’re staying involved in your state association. You develop old friends, colleagues, and a network. Not only in the association but, in case you didn’t know it, a lot of folks, when they age out of the association leadership and positions, they transition over to the regulatory board of the state. Which means you also have connections and a network on that board as well and that’s always good to be a part of and have some insight in.  We evidence-based providers sit around fussing about the woo and the crazies in our industry and I promise you….you can’t change it by bitching about it. You HAVE to be active. You HAVE to wield influence and you can only do that if you are involved, if you volunteer, if you sit on committees, if you head departments, if you sit on the Board for a couple of years.  These are the ways we start to have an impact. If you’re so inclined, you can go through the chairs and sit as President of your state association. I promise you can. They need people and all you have to do is start raising   it.  Former State Presidents transition over to the ACA many times and continue to wield influence over there on a national level. The only thing keeping you from doing it is you.  So basically……Quit bitching and raise your hands.  Item #1 Today’s first one is called, “Platelet-Rich Plasma Therapy: An Effective Approach for Managing Knee Osteoarthritis” by Crowley et al and published in Cureus in December of 2023 and it’s steamy! Remember, the citations can be found at chiropracticforward.com under this episode.  Crowley JL, Soti V. Platelet-Rich Plasma Therapy: An Effective Approach for Managing Knee Osteoarthritis. Cureus. 2023 Dec 19;15(12):e50774. doi: 10.7759/cureus.50774. PMID: 38116024; PMCID: PMC10729545. Why They Did It
  • Platelet-rich plasma (PRP) is a promising non-invasive therapeutic intervention for knee osteoarthritis (KOA) that has generated significant interest due to anecdotal accounts of its efficacy, resulting in reduced recovery time in various orthopedic interventions. 
  • This systematic review examines the effectiveness of PRP in managing KOA. 
  • Specifically, it seeks to determine the extent to which PRP can treat KOA patients effectively, alleviate KOA symptoms, and improve patient outcomes. 
  • Additionally, the review aims to identify the optimal concentration and composition of PRP required to achieve therapeutic results in KOA. 
  • Furthermore, the review investigates whether PRP can modify the synovial environment structurally and immunologically to improve outcomes in KOA patients. 
How They Did It We conducted a comprehensive literature search on PubMed, Orthogate, Clinicaltrials.gov, and Embase of clinical trials investigating PRP treatment in KOA patients in the last five years.  What They Found
  • The results indicated that PRP is effective in treating KOA patients. 
  • Evidence shows that PRP therapy can alleviate pain, enhance joint function, increase range of motion, and improve mobility in KOA patients. 
  • PRP was effective in treating KOA when the mean platelet concentration of PRP treatment was 4.83 to 5.91 times higher than the baseline whole blood platelet concentration. 
  • However, studies investigating PRP with a mean platelet concentration of 3.48 to 4.04 times higher than baseline failed to demonstrate statistically significant improvements. 
Wrap It Up
  • PRP therapy slowed down KOA progression, which validates its effectiveness in impeding further structural damage and arresting the degenerative impact of the disease. 
  • Nonetheless, further investigation is necessary to examine how PRP therapy can modify the progression of the disease. 
  • Furthermore, future research should identify the most effective platelet concentration levels that provide optimal symptom relief. 
  • There is a need for further research to identify the specific PRP configuration that is most pertinent in a clinical setting, as there is a lack of standardization in PRP manufacturing protocols, including the variety of experimental setups and dosing schedules utilized in different studies.
Item #2 The second one is called, “Risk of Cervical Dizziness in Patients With Cervical Spondylosis” by Chang et al and published in JAMA network in December of 2023 and it’s equally steamy…. Chang T, Wang Z, Lee X, Kuo Y, Schubert MC. Risk of Cervical Dizziness in Patients With Cervical Spondylosis. JAMA Otolaryngol Head Neck Surg. 2024;150(2):93–98. doi:10.1001/jamaoto.2023.3810 Why They Did It
  • To compare the risk of dizziness between patients with cervical spondylosis and matched controls (ie, patients with lumbar spondylosis after propensity score matching [PSM]).
  • Are patients with cervical spondylosis more likely than patients with lumbar spondylosis to have cervical dizziness?
How They Did It
  • This cohort study used medical claims data from the National Health Insurance Research Database of Taiwan for patients 60 years or older with cervical or lumbar spondylosis newly diagnosed in any outpatient department between January 1, 2010, and December 31, 2015. 
  • Patients diagnosed with cervical spondylosis were included as the study cohort, and those diagnosed with lumbar spondylosis who were matched to the study cohort via propensity score matching were selected as the control cohort. 
  • Both cohorts were followed up for 1 year unless they were diagnosed with dizziness, censored by death, or withdrew from the health insurance program. 
  • The main outcome was the date of outpatient diagnosis of dizziness. The risks of dizziness were compared between groups. The relative risk and incidence rate difference were calculated.
  • A total of 3,638 patients with cervical spondylosis and 3,638 patients with lumbar spondylosis after propensity score matching were selected as the study and control cohorts, respectively.
What They Found
  • The patients with cervical spondylosis had higher risk of dizziness than matched controls, with a 1-year relative risk of 1.20. 
  • The 1-year incidence of dizziness was 10.2% in patients with cervical spondylosis and 8.6% in the matched group of lumbar spondylosis. 
  • The incidence rate difference between the groups was 1.6%
Wrap It Up
  • These data support the association between dizziness and cervical spondylosis, but the small difference between groups reveals that dizziness associated with cervical spondylosis is uncommon. 
  • Clinicians should be wary of diagnosing a cervical cause for dizziness based on an actual history of cervical spondylosis.
Alright, that’s it. Now you know stuff you didn’t know before.  Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.           

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  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
Home
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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter

CF 336: Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter Today we’re going to talk about Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter But first, here’s that sweet sweet bumper music  

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #336 Now if you missed last week’s episode, we talked about Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation.  Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things….. Trying to climb out of the valley again and it appears that we are. New patient number back on the rise and the days are filling up again. Today I have 57 patients. Which is honestly more than I want. I have a staff of 3 full timers in addition to a front desk person to help me do it but thats still just more than I want in one day.  And only 19 tomorrow. Honestly…..couldn’t that have been spread out a little more efficiently? The answer is probably. But our front desk girl is an absolutey rock star and I’m not saying a word. She’s still a bit new and finding her way. Most of you know that scheduling is an art and when she sees we’re struggling to keep up with her schedule, she’ll adjust naturally.  Is that the best way to take care of it?? No. I did send tell her at the start of the day that we are tapped out and cannot fit any more patients so she gets the message from the start. Then as far as the rest of it goes, she’ll find her way. I’d rather be scheduled heavy than light.  But yeah, for an old 51 year old, 57 in one day is a little more than I can chew.  I think it’s the increase in marketing and all of the changes I’ve been mentioning lately. We changed website companies, we increased our marketing and are just doing some things differently lately. And I think we are starting to see the fruits of our efforts.  I’ll keep you updated on what’s up and what we’re doing. Stick around. It’s always interesting. 

Item #1

Our first one today is called “Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty” by Fenton et al and published in Spine Journal in October 2023 and it’s just hot enough. 

Remember, the citations can be found at chiropracticforward.com under this episode. 

Fenton, Joshua J. MD, MPHa,b; Fang, Shao-You PhDb; Ray, Monika PhDb,c; Kennedy, John CCS, CDIPb; Padilla, Katrine MPPb; Amundson, Russell MDd; Elton, David DCd; Haldeman, Scott DC, MD, PhDe; Lisi, Anthony J. DCf; Sico, Jason MD, MHSf,g; Wayne, Peter M. PhDh; Romano, Patrick S. MD, MPHb,c. Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty. Spine 48(20):p 1409-1418, October 15, 2023. | DOI: 10.1097/BRS.0000000000004781  

Why They Did It The objective was to compare utilization patterns for patients with new-onset neck pain by initial provider specialty.Initial provider specialty has been associated with distinct care patterns among patients with acute back pain; little is known about care patterns among patients with acute neck pain.

How They Did It Retrospective cohort study. Used Optum Labs Data Warehouse, which contains longitudinal health information on over 200M enrollees and patients representing a mixture of ages and geographical regions across the United States.  Patients had outpatient visits for new-onset neck pain from October 1, 2016 to September 30, 2019, classified by initial provider specialty.  Utilization was assessed during a 180-day follow-up period, including subsequent neck pain visits, diagnostic imaging, and therapeutic interventions.

What They Found

  • The cohort included 770,326 patients with new-onset neck pain visits. 
  • The most common initial provider specialty was chiropractor (45.2%), followed by primary care (33.4%). 
  • Initial provider specialty was strongly associated with the receipt of subsequent neck pain visits with the same provider specialty. 
  • Rates and types of diagnostic imaging and therapeutic interventions during follow-up also varied widely by initial provider specialty. 
  • While uncommon after initial visits with chiropractors (≤2%), CT, or MRI scans occurred in over 30% of patients with initial visits with emergency physicians, orthopedists, or neurologists. 
  • Similarly, 6.8% and 3.4% of patients initially seen by orthopedists received therapeutic injections and major surgery, respectively, compared with 0.4% and 0.1% of patients initially seen by a chiropractor.

Wrap It Up Within a large national cohort, chiropractors were the initial provider for a plurality of patients with new-onset neck pain. Compared with patients initially seen by physician providers, patients treated initially by chiropractors or therapists received fewer and less costly imaging services and were less likely to receive invasive therapeutic interventions during follow-up.

Item #2 Our second and last one this week is called “Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study” by Trager et al and published in BMC Musculoskeletal Disorders on January 10, 2024. Kabam! That’s a hot one! Trager, R.J., Gliedt, J.A., Labak, C.M. et al. Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study. BMC Musculoskelet Disord 25, 46 (2024). https://doi.org/10.1186/s12891-024-07166-x

Why They Did It Patients who undergo lumbar discectomy may experience ongoing lumbosacral radiculopathy (LSR) and seek spinal manipulative therapy (SMT) to manage these symptoms.  We hypothesized that adults receiving SMT for lumbosacral radiculopathy at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up.

How They Did It They searched TriNetX, Inc. for adults aged  ≥ 18 years with lumbosacral radiculopathy and lumbar discectomy  ≥ 1 year previous, without lumbar fusion or instrumentation, from 2003 to 2023.  They divided patients into two cohorts: (1) chiropractic SMT, and (2) usual care without chiropractic SMT.  They used propensity matching to adjust for confounding variables associated with lumbar spine reoperation (e.g., age, body mass index, nicotine dependence), calculated risk ratios (RR), with 95% confidence intervals (CIs), and explored cumulative incidence of reoperation and the number of SMT follow-up visits.

What They Found Following propensity matching there were 378 patients per cohort with a mean age of 61 years.  Lumbar spine reoperation was less frequent in the SMT cohort compared to the usual care cohort, yielding an risk ratios of 0.55.  In the SMT cohort, 72% of patients had ≥ 1 follow-up SMT visit.

Wrap It Up This study found that adults experiencing lumbosacral radiculopathy at least one year after lumbar discectomy who received spinal manipulative therapy were less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT.  While these findings hold promise for clinical implications, they should be corroborated by a prospective study including measures of pain, disability, and safety to confirm their relevance.  We cannot exclude the possibility that our results stem from a generalized effect of engaging with a non-surgical clinician, a factor that may extend to related contexts such as physical therapy or acupuncture.

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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 https://www.chiropracticforward.com

Social Media Links https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/

Twitter https://twitter.com/Chiro_Forward

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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation

CF 335: Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation Today we’re going to talk about Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation But first, here’s that sweet sweet bumper music

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together. 

Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #334 Now if you missed last week’s episode, we talked about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Still slower this week. Making some tough decisions that maybe I’ll feel more comfortable getting into sometime in the future after it all shakes out. I’ve actually had a few things boiling under the surface that will all be shaking out in the next few months.  One is a staffing issue that we may talk about down the road. But not at this time.  One I mentioned last week. We are trying to move forward with an investment group out of Houston that has proposed purchasing 60% of my practice, taking over the billing, collections, and HR, helping at PT, helping at an associate, and helping us grow the clinic beyond what I’ve been able to grow it in its current state.

Helping me move more and more toward exiting day to day patient care and more into admin work while making more money overall. This cannot happen fast enough if they come with the right offer.  Another is signing on with a legal group and putting my Forensics Diplomate to work finally. I was referrred to and engaged by a large legal group offering counter affidavits and medicolegal work.

Have the Forensics Diplomate and the Neuromusculoskeletal Medicine Diplomate, not to mention certfication in Biomechanics and Traumatology, puts me in a good position to be able to make good money outside of patient care. Which makes it easier to consider sellign 60% of what I’ve built over the years. If the investment group’s projections are fulfilled, I’ll make more money than I’ve ever made next year anyway. But, if not, I will still have the medicolegal work, the Airbnbs, and the Voiceover work.

I will always make money regardless. Even if everything with the clinic buyout and aftermath bluew and and it all went belly up – which will not happen- but assuming it could happen, I can move to Dallas and start over with little to zero issues. 

I’ll always make money and be OK. That’s who I am. That’s who a whole bunch of the people that listen to my podcast are as well. So most of you know exactly where I’m coming from. Big moves are easier when you have that faith and that confidence in your ability to always provide.  Another is being forced to file a grievance on a large law group here in Texas. I’ve been doing PI work since 2007 and have never had to do that before. I’ve thought about doing it several times as you can imagine. There are some amazing attorneys and, as most of you know, there are some miserable SOBs otu there that don’t deserve a law license. 

This firm wormed their way into the state association and I tried to be a good association leader and use them as much as I could. Well, now they owe me $27k and have refused to pay after years of haggling with them. The patients got paid as far as I can tell. But nothing to us. They claim they sent us the checks and they were deposited. That’s not true. We balance out every check that comes in and somehow all 7 of these cases…..we somehow messed up. Nah, dawg…..nope.

Plus, we contacted out bank manager and they investigated and confirmed we never got any funds from them on the cases.  So, I told them it was going to happen and I tried and tried to get them to settle but they refused. So I had to file a grievance with the state bar. We’ll see how that goes. Fun times right there but I’ve had it with sorry PI attorneys over the years and they’re not getting away with this one. 

When I say not much is going on this week….sometimes that’s true. These larger things typically live in the background and they’re just constants to my life that I don’t necessarily have on my radar every day.  Sometimes they’re much more in focus for me depending on where each of them lies in the process of resolution. The staffing one is front and center this week, we sent off P&Ls to the investment firm last week, I engaged with the legal group last week, and the Bar complaint had an extension filed out into July just last week so they’re all kind of front and center this week.  There you have it. Welcome to my life. Time to treat some patients so let’s get to it

 

Item #1 The first one this week is called, “Flavored Vapes Might Expose Users to Hundreds of Dangerous Byproducts” by Emily Harris and published in JAMA Network on June 7, 2024, and OMG that is H-O-T! Remember, the citations can be found at chiropracticforward.com under this episode. 

doi:10.1001/jama.2024.10326

https://jamanetwork.com/journals/jama/fullarticle/2819956?guestAccessKey=749c8b24-8407-42dc-8d29-754707b6f8ed&utm_source=silverchair&utm_medium=email&utm_campaign=jama_network&utm_content=network_highlights&utm_term=061624&adv=000003189471

This is an article that is in reference to a research paper that is linked at this point in the show notes if you want to go and see it.  https://www.nature.com/articles/s41598-024-59619-x The reason I’m not just going through this paper and sticking to this JAMA summary is that….bruh…..it’s a workout for the brain. It’s a deep dive into pyrolysis, organic chemistry, and cold sweats and nightmares from my college days. Things I prefer to not re-live.  God blessed us all with people that love that stuff, understand it, and can use it to benefit us.

But we don’t have to get in the weeds on it. We’ll just get straight to the info.  “The liquid in flavored e-cigarettes likely produces an array of harmful chemicals when heated, as occurs during vaping, a recent study in Scientific Reports found. Again, that is linked above in the show notes. The researchers used artificial intelligence to predict what would happen when 180 substances known to be present in flavored e-cigarettes are exposed to high temperatures. According to their findings, the representative chemicals would transform into 127 acutely toxic products, 153 compounds that are health hazards, and 225 chemicals categorized as irritants based on the Globally Harmonized System classifications.

Long-term exposure to chemicals in e-cigarettes “makes it plausible that we are standing at the starting line of a new wave of chronic diseases that will only emerge in 15 to 20 years from now,” the researchers wrote, noting that the results suggest the number of compounds in e-liquids should be limited.” 127 acutely toxic product and 153 compounds that are health hazards. And I wonder how many of these people go out there and post about the harms of the covid vaccine and all of that stuff right before they hop into their car and vape some strawberry delight? 

 

Item #2

The last one this week is called, “Adverse Events After Cervical Spinal Manipulation – A Systematic Review and Meta-Analysis of Randomized Clinical Trials” by Pankrath et al and published in Pain Physician Journal dated May/June 2024 and that’s some hot damn, smooth like candy. 

https://www.painphysicianjournal.com/linkout?issn&vol=27&page=185&fbclid=IwZXh0bgNhZW0CMTEAAR3cd0i48Y25pF-5JQbXRtMIkg98so7Bg0BIBSKhR8zAVkTGMwNV0vBYQeI_aem_AU0JsgqrIkg6RHuBfM6nq6WJzrB96CUoo-DwiTYJC8n74dbmOyFNL3SUczMkQAEygR_XJRezjaPITCBKeYB8p2zP

Why They Did It

Cervical manipulations are widely used by physiotherapists, chiropractors, osteopaths, and medical doctors for musculoskeletal dysfunctions like neck pain and cervicogenic headache. First of all…..show me these MDs that are using SMT, please? The use of cervical manipulation remains controversial since it is often considered to pose a risk for not only benign adverse events (AEs), such as aggravation of pain or muscle soreness, but also severe AEs such as strokes in the vertebrobasilar or carotid artery following dissections. 

Studies finding an association between cervical manipulation and serious AEs such as artery dissections are mainly case-control studies or case reports.  These study designs are not appropriate for investigating incidences and therefore do not imply causal relationships. Randomized controlled trials (RCTs) are considered the gold standard study designs for assessing the unconfounded effects of benefits and harms, such as AEs, associated with therapies.  Due to the unclear risk level of AEs associated with high-velocity, low-amplitude (HVLA) cervical manipulation, the aim of this study was to extract available information from RCTs and thereby synthesize the comparative risk of AEs following cervical manipulation to that of various control interventions. 

How They Did It The project was a systematic review and meta-analysis. A systematic literature search was conducted in the PubMed and Cochrane databases. This search included RCTs in which cervical HVLA manipulations were applied and adverse events were reported.  Two independent reviewers performed the study selection, the methodological quality assessment, and the GRADE approach.  Incidence rate ratios (IRR) were calculated.  The study quality was assessed by using the risk of bias 2 tool, and the certainty of evidence was determined by using the GRADE approach.

What They Found Fourteen articles were included in the systematic review and meta-analysis.  The pooled Incidence rate ratios indicates no statistically significant differences between the manipulation and control groups.  All the reported adverse events were classified as mild, and none of the events reported were serious or moderate.

Wrap It Up In summary, HVLA manipulation does not impose an increased risk of mild or moderate AEs compared to various control interventions.  However, these results must be interpreted with caution, since RCTs are not appropriate for detecting the rare serious AEs.  In addition, future RCTs should follow a standardized protocol for reporting AEs in clinical trials. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  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 https://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward 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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger          

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15)

CF 334: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15)…..it’s the final part of the series.  But first, here’s that sweet sweet bumper music  

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #334 Now if you missed last week’s episode, we talked about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Up and down, peaks and valleys, getting hit and landing blows, riding the waves or gasping for air, whack-a-freaking-mole.  Slow week this week and last. Two weeks ago and May overall, we killed it. Absolutely killed it. Now, I’m wondering if we should just close the doors and call it a good career. We tried. Lol. 

Yes, that’s super dramatic.

No, we’re not closing up shop. Lol. But that’s how you get sometimes right? Damnit can’t it just be a set it and forget it thing? Well the answer is no. It cannot and will not. The competition is too great to rest solely on your reputation in the community. Yes, it helps but it’s not enough to stay where you want to be. It’s just not.  We all feel important I’m sure but here’s the brutal truth. People start to forget us the minute we go silent. You have to keep that pedal to the metal with the marketing, being involved in the community, constant weekly touches in the community, and telling your current active patients how much you appreciate referrals. They don’t always know, ya know?

So, market market market.  In separate news, I am re-engaging with the group I’ve mentioned in the past about purchasing 60% of the clinic, bringing in an associate or two, and having more time for voice-over work, real estate work, and medicolegal work in the chiropractic realm. 

If my plans are solid and actually happen…..and I have a track record of making things happen……in 2 years, I’ll have more and more time to dedicate to podcast hosting and painting and sculpting and all of the aspects of life outside of the clinic that truly feed my soul.  We’re working on it and so far, it’s looking good. It just takes time and I’ll keep you all updated as we go along. It may be something you want to consider as I go through it and come out the other side. 

Item #1

The last paper in our series is called, “The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial” by Zaworski et al and published in European Journal Of Physical Rehabilitative Medicine in April of 2021. Remember, the citations can be found at chiropracticforward.com under this episode. 

Zaworski K, Latosiewicz R. The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial. Eur J Phys Rehabil Med. 2021 Apr;57(2):280-287. doi: 10.23736/S1973-9087.21.06344-9. Epub 2021 Mar 2. PMID: 33650840.

Last reminder on this series. The WHO recommends spinal manipulative therapy at very low confidence. I’ve been doing this podcast every single week for over 7 years and the amount of research in favor of smt for everything but especially low back pain is honestly pretty staggering.

So, when I see the WHO recommend SMT, I’m like….well of course they do.  And then I see ‘at very low confidence’ which is the same level they recommended ultrasound, well, then I got miffed. I got ‘pressed’ as the kids say these days. Hundo P.  So I found all of the papers the WHO used to make the determination and we went through them one by one and this is the last one. 

Why They Did It

The aim of the study was to determine whether the use of combined therapy consisting of manual therapy and proprioceptive neuromuscular facilitation (PNF) is more effective than the use of manual therapy techniques, proprioceptive neuromuscular facilitation or traditional kinesiotherapy as single methods in the treatment of low back pain.

How They Did It

The setting was a Rehabilitation Department of Hospital in Parczew (Poland). The study was designed as four-arm randomized comparative controlled RCT and conducted on a group of 200 patients aged 27-55y. The patients were randomly divided into four 50-person groups:  1) group A – manual therapy;  2) B – proprioceptive neuromuscular facilitation;  3) C – manual therapy and proprioceptive neuromuscular facilitation; and  4) group D – traditional kinesiotherapy and control group.  Pain intensity was measured using VAS and Laitinen’s questionnaire.  Functional disability was assessed using Oswestry Disability Index (ODI) and Back Pain Functional Scale (BPFS).

What They Found

There was a statistically significant difference in pain reduction (VAS Scale) between Group C (4.8 points) and Group D (3.9 points).  In all the groups there was a statistically significant reduction in a degree of disability as measured by the ODI.  A level of functional capabilities increased significantly only in Group C (8.8 points) as compared to Group D (5.7 points).

Wrap It Up

All the evaluated methods caused pain reduction which lasted for at least 2 weeks after the end of treatment.  The degree of disability as measured by ODI lowered evenly in all groups.  Patients’ functional ability improved significantly in the group treated with combined manual therapy and proprioceptive neuromuscular facilitation as compared to the group of traditional kinesiotherapy.

OK, so there’s yet another paper the WHO used that’s in favor of SMT.  I’m going to try to do a very fast summary of what we’ve learned here, folks. 

For the record, I started this series on December 14, 2023 and today is June 10, 2024.

Yes, we’ve been at it for a while now. So, what DID we learn now that we’re at the end of our efforts? For starters, they cherry picked some pretty crappy papers. One was a pilot study. Why would you place the recommendation of a modality in part on a pilot study? Not sure about that.  Many of them were very small sample sizes. 

More strikingly though were the ages of these papers? Again, we cover new and fresh papers all of the time and low back pain specifically has been covered  and covered and covered again in the last 5 – 10 years and almost all papers have been in favor of SMT.  So why on Earth is the WHO sourcing and using old papers with mostly small sample sizes? I’m talking about papers from 1978, 1985, 1986, 1992, 2003, 2004, 2007, 2011, 2012, 2012 (pilot study), 2013, 2013. 

Yes there are some papers they used that were from 2020, 2019, 2017 or so. But I’d venture a guess that well over 60% of the papers they used were over 10-12 years old and some were as old as 35 years, 38 years, and up to 46 years old. What the holy hell? For real. Wrap your damn heads around that hot garbage.  Please tell me there’s an agenda to keep chiropractors in their place without telling me there’s and agenda to keep chiropractors in their place. It’s ponderous. 

The final score is:

    • In favor of SMT: 19
    • Undetermined: 5
    • Against: 4

So, you folks do what you will with the information. I don’t know that there’s anything that can be done. It’s the WHO out there doing WHO stuff but I’m telling your right now, them rating SMT at ‘very low confidence’ is incorrect in my opinion and I feel that our little experiment proves it beyond simply ‘my opinion’. 

Keep fighting my friends. Lots of work left to do!

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world.

The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    

Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic

CF 333: Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic Today we’re going to talk about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic But first, here’s that sweet sweet bumper music    

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #333 Now if you missed last week’s episode, we talked about Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. Nothiing too special is going on with the clinic this week. We’re just doing our deal. Seeing patients. No big events last week and nothing too huge on the horizon other than the big Texas Chiropractic Association convention called ChiroTexpo goign on in Frisco, TX which is basically Dallas. That will be June 28-30 I believe and if you’re in TX or wish you were, come on and join us.  We’ve always got a great crown and would love to have you down there. Seminars are a great way to get that continuing education but an even better way to network and develop a little bit of influence. Why not? We sit around and we bitch about the state of our profession.

But are we doing anything at all to influence it? Are you a member of the ACA or your state association? If there are a bunch of subbies running your state association, instead of that being a turn-off, shouldn’t that be an amazing opportunity for you and some of your evidence-based friends to get involved and get yourselves in the seats of influence and control so that you can gently start to turn that air craft carrier the right direction? Instead of seeing the obstacle, see the opportunity. Ryan Holliday wrote a book called The Obstacle Is The Way. I highly recommend it.

I promise, when you walk into a board meeting and you realize that only 15-20 people in your entire state run the association, determine the speakers at your events, fight your fights and battles, etc….then you realize what kind of difference you can make. And I mean rather quickly if there’s a handful of you.  So, get it together, get involved, and make this profession respected the way the 2024 brand of chiropractic should be respected. Stop letting the loud-mouthed and angry subbies run the show. It’s your turn now.

Item #1

The first one this week is called “Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer A Systematic Review and Meta-Analysis” by Demb et al and published in JAMA Network Open on May 24, 2024. Aye, Chihuaua!! Es muy caliente! Remember, the citations can be found at chiropracticforward.com under this episode. 

Demb J, Kolb JM, Dounel J, et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(5):e2413157. doi:10.1001/jamanetworkopen.2024.13157

Why They Did It To report the frequency of presenting red flag signs and symptoms among individuals with early-onset colorectal cancer, to examine their association with early-onset colorectal cancer risk, and to measure variation in time to diagnosis from sign or symptom presentation.

How They Did It

  • PubMed/MEDLINE, Embase, CINAHL, and Web of Science were searched from database inception through May 2023.
  • Studies that reported on sign and symptom presentation or time from sign and symptom presentation to diagnosis for patients younger than age 50 years diagnosed with nonhereditary colorectal cancer were included.
  • Data extraction and quality assessment were performed independently in duplicate for all included studies using Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. 
  • Joanna Briggs Institute Critical Appraisal tools were used to measure risk of bias. Data on frequency of signs and symptoms were pooled using a random-effects model.
  • Outcomes of interest were pooled proportions of signs and symptoms in patients with early-onset colorectal cancer, estimates for association of signs and symptoms with early-onset colorectal cancer risk, and time from sign or symptom presentation to early-onset colorectal cancer diagnosis.

What They Found

  • Of the 12,859 unique articles initially retrieved, 81 studies with 24,908 126 patients younger than 50 years were included. 
  • The most common presenting signs and symptoms, reported by 78 included studies, were hematochezia, abdominal pain, and altered bowel habits. 
  • Hematochezia (is the passage of fresh blood through the anus, usually in or with stools), abdominal pain, and anemia were associated with higher early-onset colorectal cancer likelihood. 
  • Time from signs and symptoms presentation to early-onset colorectal cancer diagnosis was a mean of 6.4 months and a median of 4 months.

Wrap It Up

  • In this systematic review and meta-analysis of patients with early-onset colorectal cancer, nearly half of individuals presented with hematochezia and abdominal pain and one-quarter with altered bowel habits. 
  • Hematochezia was associated with at least 5-fold increased early-onset colorectal cancer risk. 
  • Delays in diagnosis of 4 to 6 months were common. 
  • These findings highlight the need to identify concerning early-onset colorectal cancer signs and symptoms and complete timely diagnostic workup, particularly for individuals without an alternative diagnosis or sign or symptom resolution.

Item #2

The second one is called, “Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data” by Trager et al and published in BMJ open in 

Trager RJ, Cupler ZA, Srinivasan R, et al Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data BMJ Open 2023;13:e073258. doi: 10.1136/bmjopen-2023-073258

Why They Did It

Radicular low back pain (rLBP) is often treated off-label with gabapentin or by chiropractors using chiropractic spinal manipulative therapy (CSMT). To date, no studies have examined the association between these interventions.  We hypothesised that adults under 50 years of age receiving CSMT for newly diagnosed rLBP would have reduced odds of receiving a gabapentin prescription over 1 year-follow-up.

How They Did It

Retrospective cohort study. Setting US network including linked medical records, medical claims and pharmacy claims of >122 million patients attending large healthcare organisations (TriNetX), queried 15 June 2023, yielding data from 2017 to 2023.

Participants Adults aged 18–49 were included at their first occurrence of rLBP diagnosis.  Exclusions were severe pathology, other spinal conditions, on-label gabapentin indications and gabapentin contraindications.  Propensity score matching controlled for variables associated with gabapentin use and receipt of prescription medication over the preceding year. Interventions Patients were divided into CSMT or usual medical care cohorts based on the care received on the index date of rLBP diagnosis. Primary and secondary outcome measures OR for gabapentin prescription.

What They Found

  • After propensity matching, there were 1635 patients per cohort. 
  • Gabapentin prescription over 1-year follow-up was significantly lower in the CSMT cohort compared with the usual medical care cohort, with an OR of 0.53. 
  • Sensitivity analyses revealed early divergence in cumulative incidence of prescription; and no significant between-cohort difference in a negative control outcome (gastrointestinal medication) suggesting adequate control for pharmacological care preference.

Wrap It Up

  • Our findings suggest that US adults receiving CSMT for newly diagnosed rLBP have significantly reduced odds of receiving a gabapentin prescription over 1-year follow-up compared with those receiving usual medical care. 
  • Results may not be generalisable and should be replicated in other healthcare settings and corroborated by a prospective study to reduce confounding.

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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 https://www.chiropracticforward.com

Social Media Links https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/

Twitter https://twitter.com/Chiro_Forward

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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion

CF 332: Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion Today we’re going to talk about Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion But first, here’s that sweet sweet bumper music  

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. 

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #332 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14). We’re coming to the end of the series and will be wrapping it up soon.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. I’m typing this out after the Memorial Day weekend here in 2024. They just ran the 150th Kentucky Derby this month and guess what?? I just got back from a trip to Louisville KY for a high school graduation and you better believe your sweet behind that we took that opportunity to go to Churchill Downs and bet on some horses! We won about $5 overall so I’ll take it. We’re not big on gambling so it’s not about the money. It was about the experience and it was quite the experience. What a place. Pretty historic and pretty special. If you’re friends with me on Facebook, go check out the pics and videos.

My 16 year old daughter had never been to the horse races before and she had big ol’ wide eyes. She thought it was pretty darn cool! When you go to Louisville, AKA Bourbon Town, you have to bourbon a little so I had some smoked old fashions out there. One had bacon in it. I wasn’t too excited when they brought it to the table but it was yummo, folks.

Who knew?

Since we had Monday off, we have a short week which means I need to get on with this podcast and get back to work ASAP, mi amigo so let’s get right to it. 

Item #1

Our first one this week is called, “Lower individual alpha frequency in individuals with chronic low back pain and fear of movement” by Ho et al and published in Pain Journal in May 2024 and it’s so incredibly en fuego! Remember, the citations can be found at chiropracticforward.com under this episode. 

Ho, Rachel L.M.a; Park, Jinhana; Wang, Wei-ena; Thomas, James S.b; Cruz-Almeida, Yeniselc; Coombes, Stephen A.a,*. Lower individual alpha frequency in individuals with chronic low back pain and fear of movement. PAIN 165(5):p 1033-1043, May 2024. | DOI: 10.1097/j.pain.0000000000003098

 

Why They Did It

  • Significant progress has been made in linking measures of individual alpha frequency (IAF) and pain. 
  • A lower individual alpha frequency has been associated with chronic neuropathic pain and with an increased sensitivity to pain in healthy young adults. 
  • However, the translation of these findings to chronic low back pain (cLBP) are sparse and inconsistent. 

 

How They Did It

  • They assessed individual alpha frequencys in a cohort of 70 individuals with cLBP, 
  • implemented 3 different individual alpha frequency calculations, 
  • and separated cLBP subjects based on psychological variables. 
  • They hypothesized that a higher fear movement in cLBP is associated with a lower individual alpha frequency at rest. 
  • A total of 10 minutes of resting data were collected from 128 electroencephalography channels.

 

What They Found

  • Our results offer 3 novel contributions to the literature. First, the high fear group had a significantly lower peak alpha frequency. 
  • The high fear group also reported higher pain and higher disability. 
  • Second, we calculated individual alpha frequency using 3 different but established methods; the effect of fear on individual alpha frequency was robust across all methods. 
  • Third, fear of movement, pain intensity, and disability highly correlated with each other and together significantly predicted individual alpha frequency.

 

Wrap It Up They say, “‘Our findings are the first to show that individuals with cLBP and high fear have a lower peak alpha frequency.”

 

Item #2

Our last one this week is called, “McKenzie neck exercise versus cranio-cervical flexion exercise on strength and endurance of deep neck flexor muscles, pain, disability, and craniovertebral angle in individuals with chronic neck pain: a randomized clinical trial” by Chaiyawijit et al and published in Journal of Manual and Manipulative Therapy in October of 2023 and that’s some smoky sausage. Jalapeno flavored.  Chaiyawijit, S., & Kanlayanaphotporn, R. (2024). McKenzie neck exercise versus cranio-cervical flexion exercise on strength and endurance of deep neck flexor muscles, pain, disability, and craniovertebral angle in individuals with chronic neck pain: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 1–11. https://doi.org/10.1080/10669817.2024.2337979

Why They Did It To compare the effectiveness of McKenzie neck exercise and cranio-cervical flexion (CCF) exercise on strength and endurance of deep neck flexor (DNF) muscles, pain, disability, and craniovertebral angle (CVA) in individuals with chronic neck pain.

How They Did It

  • Forty individuals with chronic neck pain were randomly allocated to the McKenzie neck or cranio-cervical flexion exercise group. 
  • Each group performed exercises at home daily. 
  • The strength and endurance of deep neck flexor muscles were measured at baseline, immediately after the first exercise session, and each week follow-up for six weeks. 
  • Average pain over the past week was measured at baseline and each week follow-up for six weeks. 
  • Disability and craniovertebral angle were measured at baseline and the end of six weeks.

What They Found

  • At six weeks, both groups exhibited significant improvements across all outcome variables but there were no differences between groups. 
  • The significant difference from baseline in the strength of deep neck flexor muscles was observed as early as the second week of each intervention. 
  • The significant difference from baseline in the endurance of deep neck flexor muscles was observed as early as the first week in the cranio-cervical flexion exercise group and the second week in the McKenzie neck exercise group. 
  • A significant decrease in pain intensity from baseline was observed after the first week in the McKenzie neck exercise group while it was after the second week in the cranio-cervical flexion exercise group

Wrap It Up

Both the McKenzie neck exercise and cranio-cervical flexion exercise produced similar effects in enhancing the strength and endurance of the deep neck flexor muscles, decreasing pain, alleviating neck disability, and improving the craniovertebral angle. And now you know stuff you didn’t already know.

You’re welcome!

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus.

The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

 

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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 https://www.chiropracticforward.com

Social Media Links https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/

Twitter https://twitter.com/Chiro_Forward

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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14)

CF 331: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14) But first, here’s that sweet sweet bumper music  

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #331 Now if you missed last week’s episode, we talked about Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

It’s a week of still growing. I think. We are currently in the best month we’ve been in since maybe COVID times. It’s been encouraging. I think there are a few things at work and I’m not sure I’m right about any of it.  If you remember more recently, I’ve mentioned that we were in a business valley and that we were using that time to gear up with marketing and trying to make things happen that we haven’t had to make happen in a few years.

Well, Here’s what I think

We started a Cross-promotions campaign partnering with other local companies. We promote their business for one month while they promote our business for one month. 

We changed website companies 6 months ago and have moved from the mid-20s up to about position #7 now so our Google SEO is finally getting back on track and should continue to improve.

External marketing: now that we aren’t constantly battling with staff turnover every single month, we have some stability and have been more able to go around in our community marketing our clinic and taking goodies to people that we know can and will refer to us. Strengthening relationships and making people happy. 

The VA used to send us 5-6 new veterans just about every week. Then they hired their own DC out there at the hospital and the referrals went down to about 2 a month. That was a big hit but I felt that would be short-lived. There are simply too many veterans in the program for one chiro to adequately sustain the treatment on them. 

Plus, a new vet referral yesterday notified me that the DC has already put in his notice and is leaving. I’m not sure if that’s a fact or not but the point is; the VA business seems to be coming back. If they’re booked out more than 28 days, the vets get to pick where they want to go.

Well….they’re booked out so hopefully we’re starting to see the vets come back here where we can see them more regularly and take better care of them.  So those are some of the things that I think have gone right for us in the last 6 months or so. Which we desperately needed.

Honestly, in December….it was pretty bad. Reminds me of that Merle Haggard song..’If We Make It Through December’. It was slim Pickens around here in December. Which led to A LOT of brainstorming and action on my part. 

Which brings up another thing – being alone. Being the owner and chiro at your clinic can get lonely. You feel that it’s all up to you and guess what….it is. But if that bothered you, you wouldn’t have opened up in the first place now, would you?

But it can get lonely. You just learn to count on yourself. When the chips are down, you look at your history, what’s worked in the past? You look at marketing, picking yourself up, maybe innovating, maybe some team meetings, maybe a new attitude. I was ready to retire and check out this time last year.  This time this year….today….I’m in the fight and am fully engaged. And it shows in my stats and numbers. 

Let’s get to it

We are coming to an end to the WHO series and I know my friend Dr. Steve Brown will be glad to hear it. Lol.  The WHO says smt is recommended but only with very low confidence and I think that’s bunk so we’ve spent some time every other week diving into every paper they used to make that determination.  After the two we have today, we’ll have one left and then summarize it a bit. That’ll be in two weeks so look for it

Item #1

The first one today is called, “Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation” by Xia et al and published in Spine Journal in June of 2016.  Remember, the citations can be found at chiropracticforward.com under this episode. 

Xia T, Long CR, Gudavalli MR, Wilder DG, Vining RD, Rowell RM, Reed WR, DeVocht JW, Goertz CM, Owens EF Jr, Meeker WC. Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation. Spine (Phila Pa 1976). 2016 Jun;41(12):E702-E709. doi: 10.1097/BRS.0000000000001373. PMID: 26656041; PMCID: PMC4902754.

Why They Did It

The aim of this study was to compare the short-term effects of a side-lying, thrust spinal manipulation (SM) procedure and a nonthrust, flexion-distraction SM procedure in adults with subacute or chronic low back pain (LBP) over 2 weeks.

How They Did It

  • Participants were eligible if they were 21 to 54 years old, had LBP for at least 4 weeks, scored 6 or above on the Roland-Morris disability questionnaire, and met the diagnostic classification of 1, 2, or 3 according to the Quebec Task Force Classification for Spinal Disorders. 
  • Participants were allocated in a 3:3:2 ratio to four sessions of thrust or nonthrust SM procedures directed at the lower lumbar and pelvic regions, or to a 2-week waitlist control. 
  • The primary outcome was LBP-related disability using the Roland-Morris Disability Questionnaire and the secondary outcomes were LBP intensity using the visual analog scale, the Fear-Avoidance Beliefs Questionnaire, and the 36-Item Short Form Health Survey. 
  • The study was conducted at the Palmer Center for Chiropractic Research with care provided by experienced doctors of chiropractic. 
  • Clinicians and patients were not blinded to the treatment group.

What They Found

  • Of 192 participants enrolled, the mean age was 40 years and 54% were male. 
  • Improvement in disability, LBP intensity, Fear-Avoidance Beliefs Questionnaire-work subscale, and 36-Item Short Form Health Survey-physical health summary measure for the two SM groups were significantly greater than the control group. 
  • No difference in any outcomes was observed between the two SM groups.

Wrap It Up

Thrust and nonthrust SM procedures with distinctly different joint loading characteristics demonstrated similar effects in short-term LBP improvement and both were superior to a waitlist control. How do the chiros that only think thrust, cavitations, and aggressive treatment reconcile that exactly?

I guess it’s not about the noise and more about movement then, right? That’s what I thought. 

Item #2 “Clinical research on lumbar oblique-pulling manipulation in combination with sling exercise therapy for patients with chronic nonspecific low back pain” by Wang et al and published in July 2019 in Revista da Associacao Medica Brasileira.

Wang SQ, Chen M, Wei X, Gao XX, Zhao GD. Clinical research on lumbar oblique-pulling manipulation in combination with sling exercise therapy for patients with chronic nonspecific low back pain. Rev Assoc Med Bras (1992). 2019 Jul 22;65(6):886-892. doi: 10.1590/1806-9282.65.6.886. PMID: 31340321.

Why They Did It To investigate clinical curative effects of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training on chronic nonspecific lower back pain.

How They Did It

  • A total of 60 patients with chronic nonspecific lower back pain in the Outpatient Department were included in this study. 
  • These patients were randomly divided into two groups: the observation group and the control group. 
  • The control group adopted a single sling-exercise-therapy training three times a week, while the observation group adopted lumbar oblique-pulling manipulation in combination with manipulation treatment once a week. The course of treatment lasted for four weeks.

What They Found

  1. Before and after treatment, the ODI score was compared within the group. A remarkable statistical significance was observed from the third day. At the third month of follow-up, the difference in ODI scores between these two groups was statistically significant. 
  2. Before and after treatment, it was observed that differences in VAS scores from the third day were statistically significant. 
  3. The difference in muscle strength between these two groups had remarkable statistical significance in the third month of follow-up

Wrap It Up

The effective rehabilitation function of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training in patients with chronic non-specific low back pain is superior to that of sling-exercise-therapy training alone. Still trying to figure out why they put us at very low confidence. I wonder what the hell got 80% or more and wound up with all of the confidence, quite honestly. Someone needs to track it down and let us all know.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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 https://www.chiropracticforward.com

Social Media Links https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel

CF 330: Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel Today we’re going to talk about Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel But first, here’s that sweet sweet bumper music    

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check out my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #330 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13).  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. What a week so far…..it’s always something isn’t it? While we are still working on the staffer in a bad relationship that I discussed last week, we had what we call a turdfloater here in the Texas panhandle. That rain and hail storm caused an already problematic roof to become even more problematic.  Now we have three massage/acupuncture rooms that have wet carpets and smell moldy. This smell has permeated and percolated throughout the entire office now. Also, SONOS decided to do another update and now my music won’t play through the office. The IT guy is working on it.  So, if you’ve heard me say that owning a clinic is like a big game of whack-a-mole…..it is. Something new daily. If not daily, definitely weekly. 

But, all in all, I have to say, this has been one of the best months business-wise that I’ve had since before COVID. It’s a Tuesday and I have 153 lined up for the week. We know that will increase because Wednesday appointments will reschedule for Friday so it’s looking like a solid week. 

Our acupuncturist has 31 on the schedule this week and our nurse practitioner has only 26 which is down from last week but, again, I’m typing this out on a Tuesday.

We use BlueIQ and we are FAR ahead of expectations for the month of May at the moment and it’s showing no signs of lightening up.  I’m back to using my 7 account system and putting money away…..I have some staffing issues but overall, things are looking pretty positive.  You get to hear me gripe when the tide is against me. You might as well hear me be positive when I’m going with the tide. 

Item #1 The first one today is called “Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA” by Trager et. Al. and published in BMJ Open in June of 2022 Remember, the citations can be found at chiropracticforward.com under this episode.  Trager RJ, Cupler ZA, DeLano KJ, Perez JA, Dusek JA. Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA. BMJ Open. 2022 Jun 13;12(6):e058769. doi: 10.1136/bmjopen-2021-058769. PMID: 35697464; PMCID: PMC9196200.

Why They Did It Although chiropractic spinal manipulative therapy (CSMT) and prescription benzodiazepines are common treatments for radicular low back pain (rLBP), no research has examined the relationship between these interventions.  We hypothesize that utilization of SMT for newly diagnosed rLBP is associated with reduced odds of benzodiazepine prescription through 12 months follow-up.

How They Did It Retrospective cohort study. Setting: National, multicentre 73-million-patient electronic health records-based network (TriNetX) in the USA, queried on 30 July 2021, yielding data from 2003 to the date of query.

Participants: Adults aged 18-49 with an index diagnosis of rLBP were included.  Serious etiologies of low back pain, structural deformities, alternative neurological lesions and absolute benzodiazepine

Outcome measures: The number, percentage and OR of patients receiving a benzodiazepine prescription over 3, 6 and 12 months’ follow-up prematching and postmatching.

What They Found 9206 patients per cohort.  Odds of receiving a benzodiazepine prescription were significantly lower in the CSMT cohort over all follow-up windows prematching and postmatching Sensitivity analysis suggested a patient preference to avoid prescription medications did not explain the study findings.

Wrap It Up These findings suggest that receiving CSMT for newly diagnosed rLBP is associated with reduced odds of receiving a benzodiazepine prescription during follow-up.  These results provide real-world evidence of practice guideline-concordance among patients entering this care pathway. 

 

Item #2 Our second paper today is called, “Efficacy of topical curcumin on mild to moderate carpal tunnel syndrome: a randomized double-blind, placebo-controlled clinical trial” by Razavi et al and published in Pain Medicine in May of 2024 and it’s a hot one, folks!! Athena Sharifi Razavi, Fatemeh Mohajerani, Fatemeh Niksolat, Narges Karimi, Efficacy of topical curcumin on mild to moderate carpal tunnel syndrome: a randomized double-blind, placebo-controlled clinical trial, Pain Medicine, Volume 25, Issue 5, May 2024, Pages 327–333, https://doi.org/10.1093/pm/pnae001

Why They Did It Recently, there has been a renewed interest in traditional medicine for carpal tunnel syndrome (CTS).  Curcumin has been reported as an agent with antioxidant, anti-inflammatory, analgesic, and neuroprotective attributes.  This study is one of the first investigations to assess the effect of curcumin gel on CTS.

How They Did It

  • This study is a prospective, 8-week, randomized, placebo-controlled, parallel-group clinical trial.
  • A total of 70 patients with CTS were analyzed. 
  • The intervention group (n = 35) received a topical curcumin gel and a night wrist splint and the control group (n = 35) received a placebo gel and a night wrist splint for 8 weeks. 
  • The primary outcome was the assessment of the symptom severity scale (SSS) and functional status scale (FSS) of the participants using the Boston Carpal Tunnel Questionnaire (BCTQ) after 8 weeks. In addition, all participants were evaluated by electrodiagnostic (EDX) test at baseline and after 8 weeks.

What They Found

  • The mean scores of SSS demonstrated a significant decrease in the curcumin group compared to the placebo group; P-value= 0.021. 
  • The mean change score of SSS after the intervention was 12.45 ± 8.18 in curcumin and 3.28 ± 7.06 in the placebo group; P-value =0.0001 and the mean change score of FSS were 6.24 ± 4.91 and 2.31 ± 4.95 in curcumin and placebo groups, respectively; P-value =0.002. 
  • However, the EDX study showed no significant changes in both groups.

Wrap It Up

It seems that curcumin gel could be effective in the improvement of the symptom severity and daily activity of patients with CTS. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

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 rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. 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 and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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 – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger