Jeff Williams - evidence-based chiropractor

Physical and Psychological Pain & Disc Herniations And Pain

January 5, 2023 chiropracticforward 00:18:16 0 Comments

CF 262: Physical Pain and Psychological Pain & Disc Herniations And Pain

Today we’re going to talk about physical and psychological aspects of pain and we’ll talk about low back pain after disc herniations

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!

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
Last thing real quick, we also have an evidence-based brochure and poster store at com

You have found yourself smack dab in the middle of Episode 262 Now if you missed last week’s episode, we talked about The Stroke Issue – New Information. This is one of the biggest issues we as chiropractors face so I hope you’ll give it a listen. I think it’s vital. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Alright, New Year is upon us folks. Time to re-focus. Re-energize. Tap into a fresh energy. Energy that may have waned a bit. We got this! I have to say though, I’m not a resolutions guy. I don’t wait until the beginning of a New Year to decide on what I want to make better for the next year. Hell with that. I consider that stuff pretty much every week.

Diet – I work on my diet almost every single meal of every single day. I believe I’m just genetically going to always be a bit bigger. But at least I can eat as healthy as possible. It’s not all what’s on the outside but the inside as well. We know this. Just confirming it for you. Business – if you’re a frequent listener, you know I’m not goal setting once per year. It’s every week. I’m figuring, tweaking, testing, and trying to identify new business acquisition opportunities.

So that’s a good spot to talk about the Fall. Listeners know I’ve had like a COVID numbers type of Fall for some reason. Who the hell knows why I’ve been slower but it’s a fact. If my normal is 185-200 appointments per week, this Fall averaged probably about 135-140 per week. That’s around 200 visits less per month. Day-um. One word – two syllables.

I have a big machine to keep running here people. So that stings and while nobody is broke or starving, I’m not taking home what I’m accumstomed to taking home and it makes your Ol’ Uncle Jeffro more than fussy faced. Since September, I’ve had this perpetual scowl on my face. Makes me want to punt bunnies. But, what I like about a New Year is some re-freshed vigor and determination. Part of that is my work with Darcy Sullivan with Propel. I know well that Google SEO is one of the biggest drivers of new patients.

My search results have continually dropped despite writing new and original content for my blog each and every single week. That’s where Darcy rides in on her big huge powerful white horse and hopefully serves as my secret weapon to save the day!! We’re still early in the process but as I mentioned a week or so ago, we did two phone sessions to get very clear on the direction and wants and needs. That was really helpful.

After that, her team wrote articles and pages for my current site and sent it over to approve. Holy schnikies, folks. This was like 40 pages of content. I read through it all and made my edits in the Google doc so it updates on their end as well. It was a lot but very important for the messaging part of what we do and what we put out there. It helps with what we want to be known for, basically. Then last week I assigned access to my Google Business Page, my website, and some other Google platform that the name escapes me at the moment. So Darcy and team will start uploading all of the changes and tweaking all of that stuff this week. Still a process. A 6-month process. But we’re on the path and I’ll keep you updated. Alright, good talk, folks. Let’s get on with the research shall we??

Item #1 The first on today is called, “Data-driven pathway analysis of physical and psychological factors in low back pain” by Bernard X.W.Liew and published in Journal of Science Direct on 15 November 2022.Dayum. That’s hot. Why They Did It To understand the physical, activity, pain and psychological pathways contributing to low back pain (LBP) -related disability, and if these differ between subgroups. How They Did It

Data came from the baseline observations (n = 3849) of the “GLA:D Back” intervention program for long-lasting non-specific LBP. 15 variables comprising demographic, pain, psychological, physical, activity, and disability characteristics were measured.
Clustering was used for subgrouping, Bayesian networks (BN) was used for structural learning, and structural equation model (SEM) was used for statistical inference.

What They Found

Two clinical subgroups were identified with those in subgroup 1 having worse symptoms than those in subgroup 2.

Psychological factor was directly associated with disability in both subgroups.

For subgroup 1, psychological factor was most strongly associated with disability (β=0.363). Physical factors were directly associated with disability (β=-0.077), and indirectly via psychology.

For subgroup 2, pain was most strongly associated with disability (β=0.408). Psychological factor was a common predictor of physical factors (β=0.078), pain (β=0.518), activity (=−0.101), and disability (β=0.382).

Wrap It Up

The importance of psychological factor in both subgroups suggests their importance for treatment. Physical, pain, and psychological factors interact, albeit differently in different clinical subgroups, to contribute to disability, confirming the need for biopsychosocial management of LBP. Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2 Our last one this week is called, “Prevalence of Long-term Low Back Pain After Symptomatic Lumbar Disc Herniation” by Taylor Wong and published in the National Library of Medicine on November 10, 2022. Hot potato!

Why They Did It

They did it to determine the prevalence of chronic LBP after LDH, understand the relationship between LDH and chronic LBP, and investigate the relationship between radiological findings and postoperative pain outcomes.

How They Did It

They performed a literature review on the PubMed database via a combination medical subject heading and keyword-based approach for long-term LBP outcomes in LDH patients.

What They Found

15 studies (2019 patients) evaluated surgical and/or nonoperative outcomes of LDH patients. Regardless of surgical or nonoperative management, 46.2% of LDH patients experienced some degree of LBP long-term (range 2-27 years) as compared to a point prevalence of LBP in the general population of only 11.9%.

Wrap It Up

LDH patients are more likely to experience long-term LBP compared to the general population (46.2% vs. 11.9%). Additionally, understanding the relationship between radiological findings and pain outcomes remains a major challenge as the presence of radiological changes and the degree of LBP do not always correlate. Therefore, higher quality studies are needed to better understand the relationship between radiological findings and pain outcomes.

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!

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

Bibliography

Bernard X.W. Liew, J. H., Marco Scutari, Alice Kongsted, (2023). “Data-driven network analysis identified subgroup-specific low back pain pathways: a cross-sectional GLA:D Back study.” J Clinical Epidemiology 153(66-77).

Wong T, P. A., Golub D, Kirnaz S, Goldberg JL, Sommer F, Schmidt FA, Nangunoori R, Hussain I, Härtl R, (2022). “Prevalence of Long-Term Low Back Pain After Symptomatic Lumbar Disc Herniation.” World Neurosurg 22: 01571-01576.

The Stroke Issue – New Information

December 29, 2022 chiropracticforward 00:19:34 0 Comments

CF 261: The Stroke Issue – New Information Today we’re going to talk about the age-old issue chiropractors continue to be burdened by. The weird myth that our adjustments cause strokes. We have some newer info I’m going to share with you on it in this week’s episode. 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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. •
Then go Like our Chiropractic Forward Facebook page, •
Join our private Chiropractic Forward Facebook group, and then •
Review our podcast on whatever platform you’re listening to •
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 261

Now if you missed last week’s episode, we had our 5^th year roundup and got ready for our 6^th Season!! Hard to believe honestly. I continue to be blessed by you all. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

You probably remember me talking about Darcy Sullivan and Propel and the work they’re doing on my website. If you don’t recall or haven’t listened lately, I’m usually so busy with patients that I can’t see straight but, ever since September, I’ve been slow as hell. There are lots of factors I’m sure, but I believe website SEO and my Google ranking plays a part in it. So, I decided to act. Darcy and Propel was my first call. They’re still in the building it out mode so no big results yet. It’s a six-month process and I’m literally only about 2 weeks into it so there’s not supposed to be a bit wow yet.

But I did like that they had me on an intro Zoom where Darcy talked with me and we went over my site, metrics, where I could make improvements, where they could help. She gave me several options on what they could do to help. Options like they could do a little bit and teach me to do the rest all of the way up to they could do all of it for me. If you know me, I don’t have time to learn current SEO, so I went all in. Do it all for me please and I’m happy to pay for it. Then, after I was all signed up, we had another Zoom where Darcy went over every single thing we wanted to work on and what that would look like. It really helped me see the light at the end of the tunnel and gave Propel good info on where we needed to go and how to get there.

Now, they are making it happen. So, let’s sit back and see what happens. I’ll keep you updated.

After the last mastermind meeting in November in the gorgeous Florida Keys, I decided that I needed to delegate more of my day. So, I started considering how I spend the majority of my day and what parts of that work can be farmed out to more virtual assistants.

As a result, lots of the content I produce will be farmed out a little bit. I’m still in the middle of it all as oversight but my weekly blog in particular…..I’m going to farm out the meat of the content to a writer, then come in, make my edits, add anything I feel is important that was missed, make it mine, and then get it posted. What do you spend the majority of your days and weeks doing outside of patient care? What duties can you identify that can be farmed out reasonably so that you free up your time and your brain? Work on it and consider it.

Item #1

The first one today is called “Association between cervical artery dissection and spinal manipulative therapy” by Whedon, J.M., Petersen, C.L., Li, Z. et al. (Whedon 2022) and published in Journal of BMC Geriatrics on November 29, 2022. Dayum. That’s hot.

Why They Did It ·

Cervical artery dissection (CAD) is a potentially serious condition that occurs when weakening and disruption of the arterial lining allow blood to get in between and separate the layers of the arterial wall. ·

Patients with CAD often present with neck pain or headache, may be asymptomatic or present as a stroke in progress. The blood that accumulates within the arterial wall can occlude the artery or cause a blood clot that in turn can be dislodged, leading to an ischemic stroke. · They had to figure out what the associations or dangers might be. Even thought it’s already been done a ton of times. But that’s OK. A pile of research in your favor is better than just a couple of papers. So let’s do it!

How They Did It ·

They evaluated the association between cervical spinal manipulation and CAD among older Medicare beneficiaries in the United States. · It was a case-control and case-crossover design ·
It was an analysis of claims data for individuals aged 65+, continuously enrolled in Medicare Part A (covering hospitalizations) and Part B (covering outpatient encounters) for at least two consecutive years during 2007–2015. ·
They created a 3-level categorical variable, (1) any cervical spinal manipulation, 2) evaluation and management but no cervical spinal manipulation and (3) neither cervical spinal manipulation nor evaluation and management.

What They Found ·

The primary outcomes were occurrence of cervical artery dissection, either (1) vertebral artery dissection or (2) carotid artery dissection. · The cases had a new primary diagnosis on at least one inpatient hospital claim or primary/secondary diagnosis for outpatient claims on at least two separate days. ·

The odds of cervical spinal manipulation versus evaluation and management did not significantly differ between vertebral artery dissection cases and any of the control groups at any of the timepoints. ·

Results for carotid artery dissection cases were similar

Wrap It Up

Among Medicare beneficiaries aged 65 and older who received cervical spine manipulation, the association with cervical artery dissection is no greater than that among the control groups, and cervical spinal manipulation does not appear to be a significant risk factor for cervical artery dissection in this population group. If you want a complete breakdown, and shut your pie holes once and for all, summary of the research and related topice, including risk vs. benifts analysis, go to my blog at chiropracticforward.com, click on the blog link, and read the blog called Debunked: the Odd Myth That Chiropractors Cause Strokes.

You’ll have everything you need to debunk the junk. Before getting to the next one,

Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.

I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

Our last one this week is called, “Oral Contraceptives and Ischemic Stroke Risk” by Caitlin Carlton, Matthew Banks and Sophia Sundararajan (Carlton C 2018) and published in ahajournals on March 16, 2018.

Why They Did It ·

They wanted to know if there is a link in increased ischemic stroke when using oral contraceptives containing high-dose estrogens. Several meta-analyses of case–control and cohort studies attempt to clarify the relationship between modern low-dose combination estrogen–progestin oral contraceptives and stroke. ·

Data linking oral contraceptives to stroke is mixed, but most physicians err on the side of caution and discontinue oral contraceptives. They decided to focus on the potential role of oral contraceptives in stroke and the management of patients with stroke who use oral contraceptives.

How They Did It ·

They looked at the first meta-analysis addressing ischemic stroke risk in high-dose estrogen-containing oral contraceptives users evaluated 16 studies from 1960 to 1999 and found an increased relative risk of stroke of 2.75 across estrogen dose, blood pressure, smoking status, and age. · They also looked at the meta-analysis including studies from 1980 to 2002 evaluated only low-dose combination oral contraceptives and found a lower odds ratio of 2.12 for ischemic stroke.

More recently, a study from 1995 to 2009 failed to find any increased relative risk for low-dose ethinyl estradiol formulations, estrogen-containing hormonal contraceptive patches, or vaginal rings.

What They Found ·

Combination oral contraceptives have a lower risk of stroke than earlier formulations containing high-dose estrogens. Stroke risk in oral contraceptives users is impacted by several confounding issues, including oral contraceptives formulation, age, hypertension, smoking, and the presence of migraine with aura. ·
It is important to consider the constellation of stroke risk factors in concert with oral contraceptives formulation to determine individual stroke risk and the best contraceptive to reduce that risk in an individual woman.
Wrap It Up ·
Modern combined oral contraceptive pills have a lower dose of estrogens and less risk of stroke than older contraceptive formulations ·
The risk of ischemic stroke in patients using combined oral contraceptives is increased in patients with additional stroke risk factors, including smoking, hypertension, and migraine with aura. ·
The risk of ischemic stroke because of combined oral contraceptive pills is less than the risk associated with pregnancy.

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!

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

Bibliography

Carlton C, B. M., Sundarararajan S, (2018). “Oral Contraceptives and Ischemic Stroke Risk.” Stroke 49(4).
Whedon, J. M., Petersen, C.L., Li, Z, (2022). “Association between cervical artery dissection and spinal manipulative therapy –a medicare claims analysis.” BMC Geriatr 22(917).

5 Year Chiropractic Forward Roundup and All Time Top Ten Episodes

December 22, 2022 chiropracticforward 00:20:15 0 Comments

CF 260: 5 Year Chiropractic Forward Roundup and All Time Top Ten Episodes

Today we’re going to talk about our 5 Year Roundup and we highlight the All Time Top Ten Episodes 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #260 Now if you missed last week’s episode , we talked about Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff. Make sure you don’t miss that info. Keep up with the class. Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.

On the personal end of things….. We’re not going to do a lot of personal stuff on this show. I want to first just thank those of you that have been listeners of this show. I probably over share sometimes about what’s going on with me or with my clinic. Because of that, those of you that are long-time listeners know a lot about me. Thanks for putting up with me and coming along on this ride with me. You’ve been with me through key staff changes and huge practice changes. You’ve been with me through adding a nurse practitioner and integrating my entire practice medically. You’ve been with me through the ‘I’m so busy I can’t keep up’ stages to the ‘I can’t figure out why I’m so slow’ stages. That’s one I’m climbing out of right now as we speak. The reason I share so much about what I’m doing or going through is

It’s cathartic. It makes me feel better to talk about it. It’s like a weekly journal and if you’re familiar with journaling, it’s helpful mentally and effective.
I know that if I’m going through it and I figure it out, then somebody else is going through it and my experience will help guide them. If you are not going through it currently, there’s a damn good chance you eventually will go through it and my experience will set you up to be able to handle it better.

So, thank you. I continue to be blessed by all of you. I’m glad you find value in what I share. I hope somewhere along the way, I have helped you to be better than you were before. That’s the daily goal for me as well as for you. We’re in it together.

Now, onto the All Time Top Ten most listened to episodes of the Chiropractic Forward podcast.

There were some surprises for me on this one. As I cover these, I’ll also leave the links to them in the show notes so you can easily go listen should you have interest.

10. Our tenth place episode is episode #114 which was titled

Ten Keys to Practice Success –

This one has been piling up the listens since February 11, 2020. Yep, right before the RONA came to town to wreak havoc. https://www.chiropracticforward.com/ten-keys-to-chiropractic-success/ I covered a wide range of the ten keys to my success and broke them down for you. Evidently, you and your buddies found value in it. And that makes me feel warm and fuzzy inside my belly.

9. Our ninth place goes to episode #189 where we were joined by the one and only Dr. Brett Winchester. One of the smartest and funniest human beings I think I’ve ever met in my life. Humble and amazing, Brett makes you proud to be a chiropractor and through Dr. Kevin Christie’s Florida Mastermind group, has become a friend of mine. One I greatly value. On the episode, Brett talked about Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be. It is definitely worth your time.

https://www.chiropracticforward.com/w-dr-brett-winchester-chiropractic-excellence-inspiration-being-the-best-evidence-informed-chiropractor-you-can-be/

8. Our 8th most popular episode goes to episode #139 and was called Chiropractors Affected By COVID, 2019 Opioid Overdoses, Insurance Compensation For Chiropractic. It went live on August 20, 2020 so, still in the pandemic but after a Spring and Summer of the COVID mess and we talked about some research on how it affected us as a profession, we went over fresh at the time opioid overdose info, and then we talked about how insurance companies reimburse us. You probably already know that part. You’re living it! Lol. https://www.chiropracticforward.com/chiropractors-affected-by-covid-2019-opioid-overdoses-insurance-compensation-for-chiropractic/ 7.

Coming in at #7 is episode #113 where we were joined by the current Texas Chiropractic Association President himself, the head hombre, The Illustrious Potentate from Austin, TX, Dr. William Lawson where we covered a paper he played a part in that covered new and updated guidelines on treating cervical pain. https://www.chiropracticforward.com/w-dr-william-larson-brand-new-guidelines-on-neck-pain-treatment/

6. At #6 we have episode #142. In this one, we covered treatment for nonoperative discs, we talked about supplementing Vitamin D3 for depression and what the research says, and we covered the bio psychosocial part of chronic pain. This one is my kind of episode. The bioqsychosocial aspect is something I just find to be fascinating and intriguing. I’m glad you all seemed to find it interesting as well. https://www.chiropracticforward.com/nonoperative-disc-treatment-d3-for-depression-the-biopsychosocial-part-of-chronic-pain/

5. Number 5 this year is episode #136 and it was called ‘Chiropractic’s Effect On Strength and More, Status Of Muscle Relaxers, And The Best Recovery Posture.’ This episode is a pretty standard run of the mill episode. It doesn’t have any of my real estate golden nuggets hidden within….nothing special but everyone likes it so hell yeah. I’ll take it. This one showed how to best recover your breath after exercise, how opioids are still bad, and how active-duty military personnel receiving chiropractic care exhibited improved strength and endurance, as well as reduced LBP intensity and disability, compared with a wait-list control. https://www.chiropracticforward.com/cf-136-chiropractics-effect-on-strength-and-more-status-of-muscle-relaxers-and-the-best-recovery-posture/

4. Still in the top Five since August of 2020, it’s episode #141 called “Lancet Low Back Update & movement Disorders Mean Pain” This one has been one of the top episodes since it was first released and has stayed there. This one covers an update The Lancet released. An update on the huge low back series they came out with originally around 2016/2017 if I recall correctly. We covered the original series here on the podcast toward the very beginning of Chiropractic Forward existence. https://www.chiropracticforward.com/lancet-low-back-update-movement-disorders-mean-pain/

3. Our 3rd most listened to episode is #143 called ‘New Paper: Spinal Manipulation Has No Effect On Chronic Pain – Our Experts Rebuttal’. Basically, some no so flattering research came out trying to prove that spinal manipulative therapy was basically useless. For this episode, I contacted several of our profession’s experts and we gave our own rebuttal to this paper right here on the podcast. The exact conclusion of the paper we talked about said, ““In this randomized clinical trial, neither spinal manipulation nor spinal mobilization appeared to be effective treatments for mild to moderate chronic LBP.” Well, who the hell can say that? Seriously. After all of the papers in support of SMT for chronic low back, someone’s going to pop out with that? Nope. So we talked about it and met it head on. https://www.chiropracticforward.com/new-paper-spinal-manipulation-has-no-effect-on-chronic-pain-our-experts-rebuttal/

2. Hitting number two all time is episode #140 with my buddy, Dr. Chris Howson of the Great State of North Dakota. We talked about Chiropractors In Hospitals & Drop Release. He should know because he is in a hospital-run outpatient clinic and is well-integrated in the medical community. He also invented the Drop Release so of course we talked about that and how he uses it. I use the hell out of mine now too! https://www.chiropracticforward.com/cf-140-w-dr-chris-howson-chiropractors-in-hospitals-drop-release/

Coming in this year at the Number One spot for the most listened to podcast episode in the history of this show is episode #137. In this episode I was joined by Dr. Aric Frisina-Deyo and we talked about Chiropractors In An FQHC Setting & Setting The Bar High Early On. This episode, of course, was excellent and Aric is one of the more impressive individuals you’ll ever meet in our profession. Congratulations to Dr. Frisina-Deyo on being #1.

Alright. That was fun. It’s always cool to go back and re-visit some of these episodes once a year and see what is resonating with our listeners. It’s interesting. Out of the top ten, only four of them included a guest. Also, you’d think the one with did where we were joined by Dr. Stu McGill would be in the top ten somewhere…..but not at all. Dr. McGill came in around #14 all time. We have been fortunate enough to be joined by not only Stu but Dr. William Morgan, Dr. Katie Pohlman, Dr. Christine Goertz, Dr. Tyce Hergert, Dr. Kris Anderson, Dr. Jay Greenstein, Dr. Kevin Christie and the list goes on and on and on. If you are still new to the podcast, I hope you’ll spend some time going back through some of the episodes that peak your interest.

We’ve had a good run so far and, for now, I plan to continue it as long as it’s fun and as long as you listen. 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!

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

Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff

December 15, 2022 chiropracticforward 0:21:36 0 Comments

CF 259: Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff Today we’re going to talk about Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #259 Now if you missed last week’s episode , we were joined by Dr. Anthony Houssain and had an amazing discussion on how to choose a good practice location, on the clinic/gym hybrid model, and one why masterminds are so important for you growth. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. First thing, if you haven’t had enough of my podcast, or you just want to hear my thoughts in a different context and setting, Dr. Jay Greenstein and Brad Cost interviewed me for their podcast called TechTalk and we had a great chat about life, practice, and all things in between. Go check it out. It aired just a week or two ago so it’s one of their newest episodes. So, if you’ve been listening lately, you know I’ve been in a slump. I’m not a slump type of guy. I don’t know what ‘take a step back’ even looks like. It’s not in my vocabulary. All I know is progress, growth, win, win, win. I’m an old college football player and won state here in Texas in the discus. Competition, initiative, and growth are engrained in the very fabric of my being. It’s just how I’m built. So, being slower here in the clinic this year has been challenging for me. A bit financially but also big time mentally. I don’t have mental health issues. That’s now what we’re talking about. Mentally as far as trying to figure it out. Putting the puzzle together so that I can fix it and get back to growing. Part of that has been fixing my outlook day to day. Embracing the suck. Meaning, when I show up on a Monday morning and there’s 48 on the schedule and there are 5 in the lobby before we even open…..instead of being defeated before I even get into my office space, my personal area, instead of being defeated, I need to embrace the stress and anxiety, thank God for our blessings, and get to work making people feel better. So, I wanted to fix that first. Then, what else could be the issue. Well, I used to be #1 on the google search. For years I was the top one because nobody else had figured out the importance at that time so I had a step ahead. But, an internet company I was with screwed up my site, Google changed their algorithms, and boom, I started dropping. So I switched companies. They set up a great site but no real SEO. So I started blogging every single week. New, fresh, completely original content. Guess what, no help at all. Not even a little. I was falling like a rock. So I think website SEO is a big issue so I’m addressing that now too. You all know I’m in the Florida Mastermind with Dr. Kevin Christie. Well Kevin works with Darcy Sullivan of Propel. So, I contacted Darcy and she’s taking me on as a client and a big project I can only assume. Lol. I’m going to be talking every week or so about my experience so you’ll know how it’s going in real time and we’ll be able to see where I started and where I end up with Darcy’s help. It’ll be a learning project we’ll do together. Stick with me for the next 4-6 months on the website SEO thing because this should be interesting. If all works out well, you may be contacting Darcy and Propel as well. Time will tell. Alright, let’s get to the research shall we? Item #1 Our first on his called, “Lumbar spine MRI findings in asymptomatic elite male academy footballers: a case series: by Carmody et. Al. (Carmody S 2022) and published in BMC Sports Science Medical Rehabilitation on October 24th, 2022 and that’s brand new and it’s hot too! Why They Did It

Understanding common MRI findings may allow clinicians to appreciate the sport-specific effects on the lumbar spine, and to discern clinically significant pathology.
Prevalence data regarding radiological abnormalities seen during the surveillance of asymptomatic elite footballers is, therefore, important to help understand injury mechanisms and to prevent associated injuries.
The purpose of this study was to evaluate the magnetic resonance imaging (MRI) findings in the lumbar spines of asymptomatic elite male adolescent footballers.

How They Did It

A prospective case-series study was carried out.
MRI was performed in 18 asymptomatic male elite adolescent footballers recruited from a professional academy in England
The images were independently reported by two consultant musculoskeletal radiologists to achieve consensus opinion.

What They Found

Fifteen players (83%) showed one or more abnormalities, that included facet degeneration, synovial cysts, disc degeneration, disc herniation, and pars injury.
One player had mild (Grade 1) facet joint arthropathy at L4/L5
3/18 showed evidence of bilateral facet joint effusions.
Three synovial cysts were identified in 2 players,
4 presented asymptomatic pars injuries,
4 had a grade 2 subtotal stress fracture and
1 player had a grade 4 chronic stress fracture
Disc degeneration at one or more levels was demonstrated in 7 fo the 18.
Disc herniation was present in 5 or 27% of the players.

Wrap It Up A range of unsuspected findings on MRI of the lumbar spine are common in elite adolescent footballers. Folks, all of those scary words used to send my patients straight to a surgeon for a second evaluation. Now I know better. These are all asymptomatic. No clinical issue whatsoever and these players ranged from 17 years old to almost 19 years old. No pain and almost 30% of them had disc herniations. We can manage these cases. If there is no progressive neurological deficit with regard to bowel and bladder function, DTRs, dermatomes, or motor function, why are you sending them anywhere? Don’t do it. Pain is not a reason for surgery and we can manage them if you are educated and know what to do. If you do not know, get smart and get educated. Good starting points are:

Stu McGill’s book called Back Mechanic
Craig Liebensen
McKenzie Certifications
FMS/SFMA
DNS
Donal Murphy’s Spine Practitioner program and his CRISP Protocol books.

Just that group of stuff right there will put you heads and shoulders beyond what the majority of your colleagues and yes…competitors are able to do. You immediately differentiate yourself and then you lengthen the road between yourself and the others more and more with each cert you get. Then look at Diplomates to solidify a canyon between yourself and the rest. Stop sitting on your ass if you don’t know anything about this stuff. Get on it and make this profession what it should be. Bam. Pow. Smack. Kachunga, Slap! Wowza! Tough talk and tough love. But hopefully motivating works from you Ol’ Uncle Jeffro. You’re welcome. Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Our next one is called, “Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial” by Moustafa et. al. (Moustafa IM 2022)published in Journal of Clinical Medicine on September 29, 2022 and that’s a hot tamale with jalapeños atop of it. And as a side note, I’m still trying to figure out how I got stuck with a boring name like Williams while you got guys walking the Earth with the last name Moustafa. It’s just not fair. Why They Did It

to investigate the effects of sagittal head posture correction on 3D spinal posture parameters, back and leg pain, disability, and S1 nerve root function in patients with chronic discogenic lumbosacral radiculopathy

How They Did It

A randomized controlled study with a six-month follow-up
80 (35 female) patients between 40 and 55 years experiencing chronic discogenic lumbosacral radiculopathy with a definite hypolordotic cervical spine and forward head posture (FHP) and were randomly assigned a comparative treatment control group and a study group
Both groups received TENS therapy and hot packs, additionally, the study group received the Denneroll cervical traction orthotic.
Interventions were applied at a frequency of 3 x per week for 10 weeks and groups were followed for an additional 6-months.
Radiographic measures included cervical lordosis (CL) from C2-C7 and FHP; postural measurements included: lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, and pelvic inclination.
Leg and back pain scores, Oswestry Disability Index (ODI), and H-reflex latency and amplitude were measured

What They Found

Statistically significant differences between the groups at 10 weeks were found: for all postural measures,
No significant difference for back pain, leg pain and ODI at 10 weeks were identified.
Only the study group’s improvements were maintained at the 6-month follow up while the control groups values regressed back to baseline.
At the 6-month follow-up, it was identified in the study group that improved cervical lordosis and reduction of FHP were found to have a positive impact on 3D posture parameters, leg and back pain scores, ODI, and H-reflex latency and amplitude.

OK….a dude who sells the Denneroll did this paper. It’s funny how other researchers find no big deal when it comes to the cervical curve. However, literally ALL of this guy’s ‘papers’ somehow make a big deal out of C-sp decreased curvature. Hinky, huh? It’s so odd. It’s like Firestone doing research and finding out how amazing their tires are. Hey everyone….McDonald’s did a research project and they found out how yummy their food is!! Yay McDonald’s you’re so amazing and thank you for doing your own research on your own company for the rest of us dumbasses. Thank you for being so awesome and kind. Blah. 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!

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 Tweets by 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 Bibliography Carmody S, R. G., Mitchell A, Kryger KO, Ahmad I, Gill M, Rushton A, (2022). “Lumbar spine MRI findings in asymptomatic elite male academy footballers: a case series.” BMC Sports Sci Med Rehabil 14(1): 184. Moustafa IM, D. A., Harrison DE (2022). “Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial.” J Clin Med 11(19): 5768.

w/ Dr. Anthony Houssain – Choosing the Right Location, Clinic/Gym Hybrids, & The Value Of Masterminds

December 8, 2022 chiropracticforward 0:45:30 0 Comments

CF 258 w/ Dr. Anthony Houssain – Choosing the Right Location, Clinic/Gym Hybrids, & The Value Of Masterminds Today we’re going to be joined by my good friend, Dr. Anthony Houssain and we’re going to be talking about several relevant topics that can make a difference for any chiropractor. We’re covering Choosing the Right Location, Clinic/Gym Hybrids, & The Value Of Masterminds 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #257 Now if you missed last week’s episode , we talked about Tensile Force On Vertebral Artery During Adjustments & Exercising For Pain. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Just got through the Thanksgiving holidays and I learned something. For the first time in 24 years, I took off the day after Thanksgiving. What I learned is that I probably want to do that every year. Wow, it was nice to have those 4 days. Here’s the thing, most people don’t really expect you to be open on that Friday anyway so it’s pretty much OK to take it off. I loved being able to just hang out and enjoy myself and my family. Not only that but I caught up on some projects that ahve been sitting for a while. I also started some new projects as well. I am diving headfirst into Gray Cook’s FMS program and we’ll see what happens. I saw Gray talk at Forward ’19 right before COVID came along and ruined the world for a little while. He’s a great speaker and lots of evidence-based folks rave about FMS and SFMA so, I’m going a step beyond my Orthopedics fellowship and adding FMS to it to see where I wind up. It can’t do anything but fill some holes in my knowledge and skills. More tools for the toolbox. Always learning, always getting better. Moving forward or falling behind. We’ll get started soon but I need to tell you about tecnobody.com if it’s in Italian, just click on the English button. Look these products are above and beyond anything else you’ll find out there and will separate your clinic from all of the rest. I own the ISO Free so I’m not talking about something I don’t know anything about. I train balance and proprioception as well as concussion evaluation and even shoulder rehab. Once you check it out and you decide you can’t do without one, email me at creekstonecare@gmail.com and I’ll get you with the dude that can hook you up one on one. Tecnobody.com I’m done talking, I want to get to it with my buddy, Dr. Anthony Houssain. If you aren’t already familiar with Dr. Houssain, I want to tell you a bit about him first. Dr. Anthony Houssain is a lifetime learner. Which is probably why we get along so well. He got is DC degree from National University of Health Sciences, achieved Diplomate status from the American Academy of Pain Management, has done over 100 hours in Chiropractic Rehabilitation from Souther California University, and is trained in McKenzie as well. Dr. Houssain is also certified in post-surgical management of the cervical and lumbar spine, ART, FMS, SFMA, Racket Fit, and Dry Needling. He’s also a former President of the North Alabama Chiropractic Society and has been a guest lecturer at UAB School of Medicine and at the UAB College of Nursing. Now that you know why he’s here, let’s get to it with Dr. Anthony Houssain.

Tell me, Anthony, how’s Huntsville, Alabama today?
Since chiropractic isn’t the typical first answer when someone is deciding what they want to be when they grow up, tell us why you chose chiropractic as your profession.
Now, you’re not originally from Alabama. Now leaving out metrics and specifics (that’s next) give us all a brief history of where you went to school, where you started out, and how you migrated down South.
Now, for providers that may be a bit younger and might can use a little advice on where to set up shop, besides your in-laws being in Huntsville, can you share a little about why you and your wife knew Huntsville was going to work out?
Share with us a bit about what your practices look like? What all do you have your fingers in right now and how did you get there?
As you just mentioned, you have entered the clinic/gym hybrid model and now that’s up and running. Tell us what gave you the idea to make that transition, what the buildout process looked like, and how it’s going so far since it got up and running.
If you could go back and start the clinic/gym process over again from the start, what would tell yourself and what would you change about how you did things the first time?
Tell us how you lead someone from simple pain relief and then transition them into functional and interested in being a part of the gym and the strengthening process. Does that take a lot of sales? Or do you have specific tools that show the patient how it all fits together and why they can benefit.
We’re in Dr. Kevin Christie’s MCM Mastermind and we’ve gotten to know each other fairly well over the last year. Have you been part of a mastermind group before this one?
Other than the weekend we just spent in Key Largo, what value have you gotten out of our current mastermind?
All masterminds are different, of course, but, in general, what do you see as being the best arguments for finding and joining a mastermind or accountability group?
Next year, our mastermind is sold out and has no open spots available but we will be visiting Ft Lauderdale, Naples, Tampa, and maybe Orlando…..maybe back to the Keys. I figure there will be some smoked Negronis on our menu along the way but other than camaraderie, what are you hoping to get out of year 2?

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!

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 Tweets by 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

Tensile Force On Vertebral Artery During Adjustments & Exercising For Pain

December 1, 2022 chiropracticforward 00:15:05 0 Comments

CF 257: Tensile Force On Vertebral Artery During Adjustments & Exercising For Pain Today we’re going to talk about Tensile Force On Vertebral Artery During Adjustments & Exercising For Pain 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #257 Now if you missed last week’s episode , we talked about Aspirin And Fall Risk & Caffeine And Child Growth. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things….. What’s going on with me lately? Well, still riding some inflation and recession stuff here these last two months and working on marketing and my customer experience to right the ship as quickly as possible. My trip to Florida and Thanksgiving are playing hell with some of the recoveries but that is what it is and that’s OK. That’s life.

One of the things we started last week was ‘Your benefits re-start in January so use them while you have them.” Also, am I in too big of a hurry with patients?

Do they feel my need to be in and out or do they each feel special in some way? I am trying to slow down and be more present with each patient. More interested in them and in their story. We can always blame outward forces when our practices slow up a bit. And that’s legit. You have to consider all aspects. Is it the economy? My website SEO? Inflation? What is the outward cause?

But also, what are the potential in-house causes? Am I too rushed? Am I no longer focused on the customer experience and only focusing on all of my stuff that has to be done instead? Is there something going on with our new patient process and our booking procedures? Internally, have we changed anything about how we are functioning and doing things? Let’s review how we’re doing things and let’s figure it out. That’s what I’m looking at right now.

No coach or mastermind has all of the answers to a slowdown. It is up to us as business owners to diagnose the cause and the effect. At least to the best of our abilities. I’m not dramatically slower than in August but September and October and November have been slow enough compared to my regular load that it’s past time to get it fixed and headed back in the right direction.

And that includes looking in the mirror. We should all do that. A good leader doesn’t ask where the staff failed, but asks, where have I failed. That’s what I’m doing.

Also, I’m looking at where I can delegate tasks that have put me in a hurry most days. When I can’t keep up with stuff, it’s time to figure out how to farm out stuff so that I don’t feel rushed and overwhelmed all day every day. I’m an immaculate stat keeper. That’s about to change. I have an excellent virtual assistant in Nigeria that is helping me figure out how to automate and delegate balancing bank statements, which I still do myself and stat keeping.

This will save A LOT of time on Mondays, Tuesdays, and Wednesdays freeing my brain up to work on more productive tasks like the customer experience. Alright, enough introspective discovery for this week. Onto the research.

Item #1

The first on today is called, “Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers” by Gorrell et. al. (Gorrell LM 2022) and published in Journal of Manual Manipulativer Therapy on November 15, 2022. Dayum. That’s hot.

Why They Did It The vertebral artery (VA) may be stretched and subsequently damaged during manual cervical spine manipulation. The objective of this study was to measure vertebral artery length changes that occur during cervical spine manipulation and to compare these to the vertebral artery failure length.

How They Did It

Piezoelectric ultrasound crystals were implanted along the length of the VA (C1 to C7) and were used to measure length changes during cervical spine manipulation of seven un-embalmed, post-rigor human cadavers.
Arteries were then excised, and elongation from arbitrary in-situ head/neck positions to first force (0.1 N) was measured. Following this, vertebral arteries were stretched (8.33 mm/s) to mechanical failure.
Failure was defined as the instance when VA elongation resulted in a decrease in force.

What They Found

From arbitrary in-situ head/neck positions, the greatest average vertebral artery length change during spinal manipulation was 5.1%.
From arbitrary in-situ head/neck positions, arteries were elongated on average 33.5% prior to first force occurrence and 51.3% to failure.
Average failure forces were 3.4 N

Wrap It Up

Measured in arbitrary in-situ head/neck positions, vertebral arteries were slack. It appears that this slack must be taken up prior to vertebral arteries experiencing tensile force. During cervical spine manipulations (using cervical spine extension and rotation), arterial length changes remained below that slack length, suggesting that VA elongated but were not stretched during the manipulation. Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody.

They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

Our last one this week is called, “The Relationship Between Physical Activity and Pain in U.S. Adults” by Ray et. al. (Ray 2022) and published in Medicine and Science in Sports and Exercise on October 26, 2022. Hot potato!

Why They Did It The authors wanted to assess the relationship between physical activity (PA) and pain within the available sample, with secondary aims to assess prevalence of pain, physical activity levels, healthcare seeking behaviors, and impact of pain on daily activities and work.

How They Did It They conducted an epidemiological cross-sectional observational study utilizing National Health Interview Survey (NHIS) data from 2020. They examined the self-reported adherence to current physical activity guidelines and the prevalence of pain. They hypothesized those dealing with pain were less likely to meet physical activity guidelines. physical activity levels, pain prevalence, frequency, and intensity were assessed via the survey and relationships explored via modeling.

What They Found

31,568, subjects
12,429 (39.37%) reported pain on some days, 2,761 (8.75%) on most days, and 4,661 (14.76%) every day.
The odds of engaging in physical activity decreased in a stepwise fashion based on frequency and intensity of pain reporting when compared to no pain.
Importantly, physical activity is a significant correlate affecting pain reporting, with individuals engaging in physical activity (strength and aerobic) demonstrating 2 times lower odds of reporting pain when compared to those not meeting the physical activity guidelines.

Wrap It Up

There is a significant correlation between meeting physical activity guidelines and pain. Meeting both criteria of physical activity guidelines resulted in lower odds of reporting pain. Additionally, the odds of participating in physical activity decreased based on pain frequency reporting.

These are important findings for clinicians, highlighting the need for assessing physical activity not only for those dealing with pain but as a potential risk factor for minimizing the development of chronic pain. Get ‘em moving folks!

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!

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

Bibliography

Gorrell LM, S. A., Edwards WB, Herzog W., (2022). “Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers.” J Man Manip Ther.

Ray, B. M. K., Kyle J.; Eubanks, James E.; Nan, Nan; Ma, Changxing; Miles, Derek, (2022). “The Relationship Between Physical Activity and Pain in U.S. Adults.” Medicine & Science in Sports & Exercise.

Aspirin And Fall Risk & Caffeine And Child Growth

November 23, 2022 chiropracticforward 00:15:22 0 Comments

CF 256: Aspirin And Fall Risk & Caffeine And Child Growth Today we’re going to talk about Aspirin And Fall Risk & Caffeine And Child Growth 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #256 Now if you missed last week’s episode , we talked about Nonpharmacologic Treatment In The ER & Spinal Manipulative Therapy For Non-musculoskeletal Conditions. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

As I’m typing this out, I am in a hammock on the beach at the Playa Largo resort in Key Largo. Which is in the Florida Keys. I wanted to go ahead and get this part of the episode done because I wanted the weekend and the mastermind meeting here fresh in my mind. First, if you don’t know about Dr Kevin Christie’s MCM Mastermind group, it’s 15 or so of the nation’s top chiropractors. We meet four times per year to network, learn, and problem solve. The cost, if I remember correctly, was $8k for the year not including travel and hotels. As the first year wraps up, the group has made me roughly $150,000 or more. That’s no lie. You could say that monetarily it was worth every penny.

Then professionally, I was given the opportunity to build lifelong relationships with colleague as in the profession that are too producers and earners. This weekend we learned about delegating tasks to free up our time and our energy to creat a more free and enjoyable work week. We also learned about 10x-Ing our practices and what that needs to look like to make it happens We exchanged lots of ideas on automating things. Even down to having no front desk staff if we do choose. Lots to consider and think over. This mastermind is closed for the 2023. Because it’s limited to only 25 people and 25 people are members for next year.

However, my point is, if you find a mastermind group, join. If you don’t, think about creating one yourself. The learning is incredible inside and outside of the clinics. The community you find is incredible. And let’s be honest, sometimes, it’s nice to just have someone that knows your life and has been through similar stuff listen To you and bounce back some ideas and suggestions. Alright. On to the research.

Item #1 Our first one this week is called “Daily Low-Dose Aspirin and Risk of Serious Falls and Fractures in Healthy Older People: A Substudy of the ASPREE Randomized Clinical Trial” by Barker et. al. (Barker AL 2022) and published in JAMA Internal Medicine on November 7, 2022 and it sizzles where it sits.

Why They Did It To determine if daily low-dose aspirin (100 mg) reduces the risk of fractures or serious falls (fall-related hospital presentations) in healthy older men and women.

How They Did It

It was a double-blind, randomized, placebo-controlled trial
studied older adult men and women in 16 major sites across Southeastern Australia.
The ASPREE-FRACTURE substudy was conducted as part of the Australian component of the ASPREE trial.
Between 2010 and 2014
Aged 70 years or older
Participants in the intervention group received a daily dose of oral 100 mg enteric-coated (low-dose) aspirin.
The control group received a daily identical enteric-coated placebo tablet.

What They Found

In total, 16,703 people with a median age of 74 years were recruited
9,179 (55.0%) were women.
There were 8,322 intervention participants and 8,381 control participants included in the primary and secondary outcome analysis of 2,865 fractures and 1,688 serious falls over the median follow-up of 4.6 years.
While there was no difference in the risk of first fracture between the intervention and control participants, aspirin was associated with a higher risk of serious falls.
Results remained unchanged in analyses that adjusted for covariates known to influence fracture and fall risk.

Wrap It Up

In this substudy of a randomized clinical trial, the failure of low-dose aspirin to reduce the risk of fractures while increasing the risk of serious falls adds to evidence that this agent provides little favorable benefit in a healthy, White older adult population.

Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2 Our second one is called, “Association of Maternal Caffeine Consumption During Pregnancy With Child Growth” by Gleason et. al. (Gleason JL 2022)and published in JAMA Network Open on October4 31, 2022. Bam a lama that’s some hot mama jama.

Why They Did It Question Is maternal caffeine consumption associated with child growth, and are such associations present in low-consumption groups?

How They Did It

I’m not going to bore you with the deets here because your eyes will gloss and you’ll be thinking about why you drive in parkways and park in driveways.
Let’s just say that Child z scores for body mass index, weight, and height were evaluated, as well as fat mass index and percentage and obesity risk measured at 1 time between age 4 and 8 years
In a secondary analysis of one of the cohorts, child z scores and obesity risk longitudinally through age 8 years were evaluated.

Wrap It Up

Intrauterine exposure to increasing levels of caffeine and paraxanthine, even in low amounts, was associated with shorter stature in early childhood. The clinical implication of reductions in height and weight is unclear; however, the reductions were apparent even with levels of caffeine consumption below clinically recommended guidelines of less than 200 mg per day. 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!

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

Bibliography

Barker AL, M. R., Thao LTP, (2022). “Daily Low-Dose Aspirin and Risk of Serious Falls and Fractures in Healthy Older People: A Substudy of the ASPREE Randomized Clinical Trial.” JAMA Intern Med.

Gleason JL, S. R., Mitro SD, (2022). “Association of Maternal Caffeine Consumption During Pregnancy With Child Growth.” JAMA Netw Open 5(10).

Nonpharmacologic Treatment In The ER & Spinal Manipulative Therapy For Non-musculoskeletal Conditions

November 17, 2022 chiropracticforward 00:18:29 0 Comments

CF 255: Nonpharmacologic Treatment In The ER & Spinal Manipulative Therapy For Non-musculoskeletal Conditions Today we’re going to talk about Nonpharmacologic Treatment In The ER & Spinal Manipulative Therapy For Non-musculoskeletal Conditions 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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.

I want to get to this before getting to the research and even some more real estate investing talk this week.

Go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.

Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #255 Now if you missed last week’s episode , we talked about Gluteal Tendinopathy. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I have a short week this week so I’m preparing to go to Key Largo to be with my MCM Florida Mastermind group. I went to the website and saw that 2023 is sold out for the group. I have to say, it’s really an impressive group, folks. I tried to get you all in. Lol. We will be at this amazing place I recommend you check out someday. It’s in Key Largo and it’s called Playa Largo. It’s a resort and spa with restaurants and all of the comforts. It’s just wonderful and I can’t wait to go back. It’s a Monday now and by Thursday, afternoon, assuming the weather cooperates, we’ll be on the beach.

In other news, I’m curious, on the previous episode, #254, I covered my experience with real estate investing and gave, what I hope, is really interesting and really useful information on investing in short term rentals. Go listen if you’re interested and you missed it. What makes me think about that this week is that we have a first home. We bought it back in 2006 I believe. Very nice neighborhood. The house is 100 years old and I needed something newer and more current. When we moved to our current house about 5 years ago, we kept it as a rental just for giggles.

This was before we got serious about real estate. We were just hoping to make a few hundred a month and have someone else buy our equity. Which is exactly what happened. Fast forward and this year, we re-financed it to get a gob of money out to invest in a short term rental elsewhere. Well, a couple of months ago, we decided, you know what? Why don’t we just sell it to get it off our books so we can qualify for a hefty loan on something more tropical than Amarillo, TX. So we listed it. Guess what? As our luck holds steady, the real estate market takes a dump about a week or two before we got it ready and listed. So now we can’t sell it for it’s appraisal price.

Now, here’s the beauty of real estate. There are lots of options!!

Take a bath and cut the price so deep that we lose money but get rid of the house.
Keep it as a long term rental
Make it a short term rental

If you listened last week, then you probably already know the answer. Instead of taking a $15k-20k hit by cutting the price to sell it, we can take that money and furnish the house and make it a short term rental. So that’s what we’re doing.

I was at the house last night putting together a queen size bed with a trundle while my wife hung curtains. We went to a site called airdna.co and using their Rentalizer tool, we evaluated the potential of that specific address and BAM…..it was a no-brainer. So we are off and running.

One last note, if you go Airbnb and you get a property manager, you’re a sucker! They want 20% of your profits when, once set up, it’ll take you literally 15 minutes per week per listing to self-manage. Go back to last week’s episode and listen but you can manage an STR in Florida from AZ with no problem. You need a wireless thermostat, a wireless Schlage Encode deadbolt, Ring cameras, a maintenance person, a lawn person, and a good cleaner. That’s it. Happy investing.

Now, onto the research. Item #1 The first one is called “The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature” by Cote et. al. (Côté P 2021) and published in Chiropractic Manual Therapeutics on February 17th of 2021 and goes a lil sumpin’ like this.

Why They Did It

A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial.

They say, We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders.

How They Did It

The Global Summit took place on September 14-15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence.

What They Found

We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders.

Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report.

Wrap It Up

Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.

Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

Our last one today is called “Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis” by Sakamoto et. Al. (Sakamoto JT 2018) and published in Academy of Emergency Medicine in March of 2018.

Why They Did It

Pain is a common complaint in the emergency department (ED). Its management currently depends heavily on pharmacologic treatment, but evidence suggests that nonpharmacologic interventions may be beneficial. The purpose of this systematic review and meta-analysis was to assess whether nonpharmacologic interventions in the ED are effective in reducing pain.

How They Did It

We conducted a systematic review of the literature on all types of nonpharmacologic interventions in the ED with pain reduction as an outcome. We performed a qualitative summary of all studies meeting inclusion criteria and meta-analysis of randomized controlled studies measuring postintervention changes in pain. Interventions were divided by type into five categories for more focused subanalyses.

What They Found

Fifty-six studies met inclusion criteria for summary analysis. The most studied interventions were acupuncture (10 studies) and physical therapy (six studies). The type of pain most studied was musculoskeletal pain (34 studies). Most (42 studies) reported at least one improved outcome after intervention. Of these, 23 studies reported significantly reduced pain compared to control, 24 studies showed no difference, and nine studies had no control group. Meta-analysis included 22 qualifying randomized controlled trials and had a global standardized mean difference of -0.46 (95% confidence interval = -0.66 to -0.27) in favor of nonpharmacologic interventions for reducing pain.

Wrap It Up

Nonpharmacologic interventions are often effective in reducing pain in the ED. However, most existing studies are small, warranting further investigation into their use for optimizing ED pain management. 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!

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

Bibliography

Côté P, H. J., Axén I, Leboeuf-Yde C, Corso M, Shearer H, Wong J, Marchand AA, Cassidy JD, French S, Kawchuk GN, Mior S, Poulsen E, Srbely J, Ammendolia C, Blanchette MA, Busse JW, Bussières A, Cancelliere C, Christensen HW, De Carvalho D, De Luca K, Du Rose A, Eklund A, Engel R, Goncalves G, Hebert J, Hincapié CA, Hondras M, Kimpton A, Lauridsen HH, Innes S, Meyer AL, Newell D, O’Neill S, Pagé I, Passmore S, Perle SM, Quon J, Rezai M, Stupar M, Swain M, Vitiello A, Weber K, Young KJ, Yu H (2021). “The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.” Chiropr Man Therap 29(1): 8.

Sakamoto JT, W. H., Vissoci JRN, Eucker SA (2018). “Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis.” Acad Emerg Med.

Gluteal Tendinopathy – You Don’t Know What You Don’t Know

November 9, 2022 chiropracticforward 00:18:14 0 Comments

CF 254: Gluteal Tendinopathy – You Don’t Know What You Don’t Know Today we’re going to talk about Gluteal Tendinopathy – You Don’t Know What You Don’t Know 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research.

We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #254. Now if you missed last week’s episode, we talked about Spinal Cord Stimulators vs. Placebo & we talked about Low Back pain, Chiropractic, And Opioids. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

You may have heard me talk about it a time or two but I’m really impreessed with a contraption that we have in our office. When I bought mine it was only the third purchased in Texas. Texas is a big place, folks! One had been sold to a research lab, one had been sold to a Physical Therapy outfit, and then mine. Definitely we’ve been ahead of the curve. When I have a car crash patient or a chronic pain patient, we can run the BESS test and the mCTSIB tests to test for concussion and proprioception. Not just test proprioception but train it as well. Balance training, rehab training, movement evaluation, and excellent shoulder rehab as well. It’s called the ISO Free by Tecnobody and it’s cool and it makes me different from the rest of my colleagues by giving us capabilities nobody else has. Check out these products and see what you think.

Go to https://www.tecnobody.com/en/products. Once you decide you have to have more information, email me at creekstonecare@gmail.com and I’ll hook you up with the people that can get you a deal on it. This week I’m really starting to look forward to a little trip we’ve been planning for a while. Remember, you should take a solid trip about once per quarter. It’s the only way to preserve your sanity. You have to get out of your office and spend time on your loves or risk losing your mind completely. Our trip this go around is part of Dr. Kevin Christie’s Florida Mastermind. We are all meeting in the Florida Keys. Key Largo to be specific. Which is the first Key south of the mainland.

Kevin picked this resort because my wife and I went there in February 2020. Just one month before the pandemic set in on the world. People were just starting to think seriously about masks and all of that stuff back then. It was a blast and this resort called Playa Largo was the bees knees. Massages every day, drinks poured in cored pineapples on the beach at sunset, ,dining on the beach and being served funny umbrella drinks as you lounge in the hammock reading Stu McGill’s Back Mechanic book was amazing. Check it out.

Just Google up Playa Largo and see what you find. It’ll make you consider Key Largo instead of Key West. So that’s coming up November 11-13 or somewhere around there. We’re taking my daughter with us and I believe all other Mastermind members are bringing wife and kiddos so it should be a really special time of bonding, swapping ideas, and growth. Speaking of growth, you’ve been hearing me fuss about being slow. We’re still slower than I want but it looks to be picking up a bit. Just in time to go to Key largo, right?

I have anxiety about it but I’m going and I’m not letting business worry me or stress me out. I have to compartmentalize that stuff and step away from it. Which I am.

What do you have coming up that you’re looking forward to? I talked about the Tecnobody products earlier. Are you using anything new and cool? I’d love to hear about it and check it out. I love new gadgets that get patients better! Email me at dr.williams@chiropracticforward.com and tell me all about it. Let’s hop into the research

Item #1

Let’s talk about Gluteal Tendinopathy, shall we. My friends at ChiroUp recently put out an awesome rundown of GT through their email list. Check the show notes for the link to their rundown on it at this poin in the show notes. https://chiroup.com/blog/what-is-the-most-common-cause-of-hip-pain After going through the Ortho Diplomate, GT has been on my radar and it’s amazing. Once you know to look for it, you’re going to find it EVERYWHERE!

Literally everywhere.

You just don’t know what you don’t know and I didn’t know before the Ortho Diplomate. First, Why do people get it? They say it’s from excessive tension or compression of the area. Secondly, what does it look like? GT is lateral hip pain and is tendinopathy of the glute medius or minimus. It hurts to walk but very tellingly, it hurts to lay on that side because of the compression but it also hurts to lay on the other side because we always stretch the leg over the other one so there is tension on the area. Pain on going up and down stairs for sure. One of our patients could barely get into and out of their RV and she was unhappy.

Also, there is usually significant pain on palpation of the area. You can get their attention very quickly by poking around on it. Current thinking is away from bursitis and more toward GT. If bursitis is present, it’s probably more a symptom of GT. This thinking is fresh enough that I found myself in a pissing match with an ortho surgeon about whether it’s bursitis or it’s GT.

We’re always going to have less authority than the ortho in this case so, I told the patient what the research shows and said that ultimately, the terminology doesn’t matter because it will be treated the same. That worked out fine. Try to avoid pissing matches on GT because it’s just not widely known about right now. Orthos are injecting corticosteroids into the hip joints of these GT patients and they’re stunned that it has no effectiveness. That’s because the problem isn’t in the joint. It’s in the connection on the posterior aspect of the greater trochanter. How do we test for it and treat it?

Hip Lag Sign
FaberEx
Palpation

What I do in my office is I use the Drop Release, which was invented by my friend, Dr. Chris Howson of the Great State of North Dakota, to beat it up just a little bit. I use regular SMT to make sure things are moving well. Then I recommend they do some cold laser on the insertion to work down some inflammation. We combine that with targeted rehab exercises from ChiroUp. We have also combined my side with trigger point injections from our Nurse Practitioner.

It has been an awesome combination for us here at my clinic and we are helping these people get past GT a lot faster. Recent research is showing, that PRP injections at the site show promise in helping chronic GT recover quickly as well. That’s exciting because we do PRP here at my clinic! I have the luxury of those not responding to the trigger points and my help to also try PRP now. So, let’s cover that paper briefly before wrapping up for this week’s episode. It’s called “The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection” by Fitzpatrick et. al. (Fitzpatrick J 2018) and published in the American Journal of Sports Medicine and was published on January 2, 2018.

Why They Did It

There would be no difference in the modified Harris Hip Score (mHHS) between a single platelet-rich plasma (PRP) injection compared with a corticosteroid injection in the treatment of gluteal tendinopathy.

How They Did It

Randomized controlled trial;
There were 228 consecutive patients referred with gluteal tendinopathy who were screened to enroll 80 participants;
Participants were randomized (1:1) to receive either a blinded glucocorticoid or PRP injection intratendinously under ultrasound guidance.
A pain and functional assessment was performed using the mHHS questionnaire at 0, 2, 6, and 12 weeks and the patient acceptable symptom state (PASS) and minimal clinically important difference (MCID) at 12 weeks.
Participants had a mean age of 60 years, a ratio of female to male of 9:1, and mean duration of symptoms of >14 months.

What They Found

Pain and function showed no difference at 2 weeks or 6 weeks
The mean mHHS was significantly improved at 12 weeks in the PRP group compared with the corticosteroid group

Wrap It Up

Patients with chronic gluteal tendinopathy for greater than 4 months, diagnosed with both clinical and radiological examinations, achieved greater clinical improvement at 12 weeks when treated with a single PRP injection than those treated with a single corticosteroid injection 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!

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 https://traffic.libsyn.com/chiropracticforward/CF_-_Ep._254.mp3

Bibliography Fitzpatrick J, B. M., O’Donnell J, McCrory PR, Zheng MH, (2018). “The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection.” Am J Sports Med 46(4): 9336-9939.

Spinal Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids

November 3, 2022 chiropracticforward 00:23:35 0 Comments

CF 253: Spinal Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids Today we’re going to talk about Spinal Cord Stimulators vs. Placebo & we’ll talk about Low Back pain, Chiropractic, And Opioids 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. 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, drive, smart, 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 educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s 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.
Then go Like our Chiropractic Forward Facebook page,
Join our private Chiropractic Forward Facebook group, and then
Review our podcast on whatever platform you’re listening to
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 #253 Now if you missed last week’s episode, we talked about High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter?. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Alright, if you’ve heard me fussing my face off about being slow for like oh I don’t know…..the last 8 freaking weeks or so….then you’ll be glad to hear that I have 43 on the schedule today with 5 new patients. That’s more like it. That’s 5 new patients, one consultation, and 3 re-exams. So….they’re coming back slowly.

Where the hell did they go in the first place? Who knows? But I talked to my buddy, Tyce Hergert down in Southlake, TX and he’s been slow as hell too. Until just last week. He thinks it’s the economy, inflation, back to school kicked it off, and then we have a big election that makes people a bit pulled back and financially more aware. Who knows, but it makes sense. Maybe it was a perfect storm kind of thing but I know I’m ready to get back to business and running around like my ass is on fire unable to keep up. Then you get to hear me fuss about that. Lol. It’s a cycle.

Why can’t it ever just sit right there in teh perfect pocket where you’re seeing just the right number of patients and are right where you want to be as far as being busy during the work week? Yeah, that’s a pipe dream. Never happening. I’ll tell you this though, I’d rather be running around here with my ass on fire, changing people’s lives, and making money along the way rather than sitting here wondering who I made mad and moping around like a whipped dog. Lol. So, for this week…we’re back toward the top of the mountain.

Just real quick on a side gig kind of thought process. I have people asking me all of the time how I started getting into real estate. I want to help you guys. I read a book that’s in the Rick Dad Poor Dad umbrella that’s called Tax Free Wealth by Tom Wheelright. It started talking about how you can pay lower to zero taxes by buying real estate. Well that got me to listening to the Bigger Pockets podcast and taking their webinars. Then I started delving into the niches of real estate. I decided for lots of reasons that Short Term Rentals, or STRs made the most money and the most sense.

That led to a podcast and a book by Avery Carl called Short Term Rental, Long Term Wealth. They also have a private Facebook group that I’m a member of. In case you don’t know, STR is what an Airbnb or VRBO property is. Short term rental like 3-5 days or so vs. a year long lease. Trust me; people a hell of a lot dumber than you are making a ton on real estate. Here are the ways you make money on real estate:

Cashflow – You have a profitable property so you make monthly cashflow. On average, our STR in Lubbock, TX profits about $2,000/month. That’s above and beyond our overhead on the house.
Appreciation – You never buy property planning on appreciation. However, assuming it’s not in a terrible neighborhood, it usually appreciates. Which is money in your pocket when, or it, you sell.
Equity – Other people are buying your property for you. They are kind enough to buy down the payment and buy your equity in the property. Meaning, because of them paying you every month, you own more and more of your own property.
Taxes – There are multiple ways that real estate benefits your taxes and I’ll leave that up to a CPA since I am not one but in general;
1. With STRs, you can count your losses and depreciate everything on the real estate side, including the curtains to bring down your tax burden in your chiropractic clinic and try to get your tax burden down to zero for the year.
2. The write offs. You can write off all of the furnishings and everything that fits the real estate realm. Including meals where you sit and talk to your business partner (your wife and kids) about your properties.

Not to mention that if you buy an STR in a place you like to visit, you have a place to stay whenever you need it! Also, if the STR is more than 90 miles from your primary residence, you can qualify for a vacation home loan and only pay 10% down instead of the traditional 20% down.

That makes a million dollar home near or on the beach a hell of a lot more do-able for most of us. I’ll give you all a bit of a tip, you don’t have to go into these things blindly. Go to airdna.co and go down to the Rentalizer link on the left of your screen. Once there, put in any address, including your home address, and see what it might make as an STR. You may be surprised! It’s not a fool proof silver bullet but can give you some ideas. Also, don’t pay a 20% management fee. It takes me literally 15 minutes per week per property to manage.

Don’t lose 20% of your profit. You can do it yourself. Use guesty.com for the property management software and combine that with pricelabs.com for automatic and appropriate pricing from week to week and then……let er rip!!! Thank me later, fools! If you have any questions, join our private Chiropractic Forward Facebook group and start a post in there. I’d be happy to help if I have the answer. If I don’t, I can find it. Let’s get started with the research shall we?

Item #1

The first on today is called “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial” by Hara et. al. (Hara S 2022) and published in JAMA on October 18, of 2022 and that’s some hot steamy salsa right there.

Why They Did It The use of spinal cord stimulation for chronic pain after lumbar spine surgery is increasing, yet rigorous evidence of its efficacy is lacking. The authors wanted to investigate the efficacy of spinal cord burst stimulation, which involves the placement of an implantable pulse generator connected to electrodes with leads that travel into the epidural space posterior to the spinal cord dorsal columns, in patients with chronic radiculopathy after surgery for degenerative lumbar spine disorders.

How They Did It

It was a placebo-controlled randomized clinical trial
50 patients were in the study
Done at St. Olavs Univer. Hospital in Norway
Conducted from 2018 – 2021
Patients underwent two 3-month periods with spinal cord burst stimulation and two 3-month periods with placebo stimulation in a randomized order. Which seems like they gave it a good solid chance to work to me
Burst stimulation consisted of closely spaced, high-frequency electrical stimuli delivered to the spinal cord.
The stimulus consisted of a 40-Hz burst mode of constant-current stimuli with 4 spikes per burst and an amplitude corresponding to 50% to 70% of the paresthesia perception threshold.
The primary outcome was difference in change from baseline in the self-reported Oswestry Disability Index

What They Found

The mean changes in ODI score were −10.6 points for the burst stimulation periods and −9.3 points for the placebo stimulation periods None of the pre-specified secondary outcomes showed a significant difference. Nine patients experienced adverse events, including 4 who required surgical revision of the implanted system.

Wrap It Up

The concluded, “Among patients with chronic radicular pain after lumbar spine surgery, spinal cord burst stimulation, compared with placebo stimulation, after placement of a spinal cord stimulator resulted in no significant difference in the change from baseline in self-reported back pain–related disability.” So…..chronic pain…..if you’re a regular listener, you know me and chronic pain. I love learning and talking about it. You can’t solve a problem through burst stimulation that is as much entrenched in the brain as it may be in a physical sense.

You can blast it and blast it and until you treat the centralized portion, you’re pissing up a rope, as they say in Texas. If you don’t have a clue what I’m talking about, start going through this podcast listening to anything on chronic pain, get a book by David Hanscum called Back In Control, and dive into the biopsychosocial aspect of pain. That’ll get you started.

Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

This second one I got from my buddy Dr. Craig Benton down in Lampassas, TX quite a while ago. Thank you Craig. It’s called “Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids” by Whedon et. Al. (Whedon JM 2018) and published in Journal of Alternative and Complementary Medicine in June of 2018.

Why They Did It They say, “Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications.”

How They Did It

The authors used a retrospective cohort design to analyze health insurance claims data.
The data source was the all payer claims database administered by the State of New Hampshire.
The study population was 18-99 year olds, enrolled in a health plan, with at least two clinical office visits within 90 days for a primary diagnosis of low-back pain.
The authors excluded those with a diagnosis of cancer.
The authors measured likelihood of opioid prescription fill among recipients of services delivered by doctors of chiropractic compared with non-recipients.
They also compared the cohorts with regard to rates of prescription fills for opioids and associated charges.

What They Found

The adjusted likelihood of filling a prescription for an opioid analgesic was 55% lower among recipients compared with non-recipients. Average charges per person for opioid prescriptions were also significantly lower among recipients.

Wrap It Up

They concluded, “Among New Hampshire adults with office visits for non-cancer low-back pain, the likelihood of filling a prescription for an opioid analgesic was significantly lower for recipients of services delivered by doctors of chiropractic compared with non-recipients. The underlying cause of this correlation remains unknown, indicating the need for further investigation.” 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!

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

Bibliography

Hara S, A. H., Solheim O, (2022). “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial.” JAMA 328(15): 1506-1514.
Whedon JM, e. a. (2018). “Association Between Utilization of Chiropractic Services for Treatment of Low Bac k Pain and Risk of Adverse Drug Events.” J Manipulative Physiol Ther 17(30): 30136-30137.

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