chiropracticforward, Author at Chiropractic Forward

Jeff Williams - evidence-based chiropractor

High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter?

October 27, 2022 chiropracticforward 00:16:18 0 Comments

CF 252: High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter? Today we’re going to talk about High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter? But first, here’s that sweet sweet bumper music

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

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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, smartness, and easy-to-get-along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do.

Go to Amazon and check out my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an excellent 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 #252 Now if you missed last week’s episode , we talked about Communicating Imaging Findings & Acupuncture For Acute Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Still climbing out of the doldrums of an extended slowdown. It is what it is but shows signs of finally easing. Let’s keep our fingers crossed on that. But yeah, I think we’re back on the upswing. We’re starting the week with 15 new patients on the schedule. I like to see about 20-25 per week but I’ll take starting the week at 15 any day. Now let’s build on it. It’s a balancing act to try to push our medical services and build that side of the clinic while not letting your community forget that you have a chiropractor and all of the other services as well.

We post on social media twice per day. Once during the day and once in the evening. During the week, we post about services. On the weekend, we post funny stuff. Because honestly, what’s the point in posting something about PRP and saying call now? But nobody is at the clinic on the weekend. It makes no sense. So we entertain on the weekends with our posts. It’s fun and our audience likes them and typically responds well with likes, comments, and shares. We are still getting our TikTok game going.

Check it out at creekstonecrew806 if interested. I have a 20-something doing all of the content and she’s pretty darn great at it. It’s been fun to show that personality off. We have some fun folks working here. Nothing incredibly new or interesting to talk about this week so let’s not waste time and let’s hop right in on the research.

Item #1

The first one today is called “Impact of audible pops associated with spinal manipulation on perceived pain: a systematic review” by Moorman et. al (Moorman 2022) and published in Chiropractic and Manual Therapies on October 4, 2022, Kazow that’s hot!

Why They Did It

An audible pop is the sound that can derive from an adjustment in spinal manipulative therapy and is often seen as an indicator of successful treatment. A review conducted in 1998 concluded that there was little scientific evidence to support any therapeutic benefit derived from the audible pop. Since then, research methods have evolved considerably creating opportunities for new evidence to emerge. It was therefore timely to review the evidence.

How They Did It

They searched PubMed, Index to Chiropractic Literature (ICL), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Web-of-Science.
The main outcome was pain.
Two reviewers independently selected studies, extracted data, and assessed risk of bias and quality of the evidence using the Downs and Black checklist.
Results of the included literature were synthesized into a systematic review.

What They Found

Five original research articles were included in the review, of which four were prospective cohort studies and one a randomized controlled trial.
All studies reported similar results: regardless of the area of the spine manipulated or follow-up time, there was no evidence of improved pain outcomes associated with an audible pop.
One study even reported a hypoalgesic effect to external pain stimuli after spinal manipulation, regardless of an audible pop.

Wrap It Up

“While there is still no consensus among chiropractors on the association of an audible pop and pain outcomes in spinal manipulative therapy, knowledge about the audible pop has advanced. This review suggests that the presence or absence of an audible pop may not be important regarding pain outcomes with spinal manipulation.” I tell patients all of the time. Do not relate a popping noise with effectiveness. It is movement we are after. Not sounds. Sometimes the sound is a happy side effect but nothing more.

And…they last thing the want is to be insisting on hearing a popping noise and be treated by a chiropractor that is more than happy to oblige. You can get an extremely aggressive adjustment just to hear a popping noise that doesn’t even matter in the first place and run the risk of getting injured from it.

So, focus on range of motion and movement. Not popping noises, people. I will say this though, pain is multifactorial sometimes and placebo isn’t a cuss word. Sometimes, in my humble opinion, just the noise……well….I can see how it could make a difference in the patient’s mind only. I can see. But you can’t depend on the noise. You just can’t

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 today is called “High blood pressure linked to faster cognitive decline, dementia risk” by John Anderer (Anderer J 2022) with Study Finds and was published on October 3, 2022. Schiza, I love it hot like that. It’s an article so let’s get to summarizing the high points. Researchers from the University of Michigan say people with hypertension may experience a faster deterioration in their cognitive abilities (thinking skills, decision-making, memory) in comparison to those with normal blood pressure.

The team performed a “study of studies” focusing on high blood pressure’s association with declining brain function over a period of several years. They gathered and analyzed datasets collected for six large prior studies. “Our findings suggest that high blood pressure causes faster cognitive decline and that taking hypertension medication slows the pace of that decline,” says lead study author Deborah Levine, M.D., M.P.H., director of the University of Michigan’s Cognitive Health Services Research Program and a professor of internal medicine at the U-M’s academic medical center” Among both Hispanics and non-Hispanics, the team observed the same pace of deteriorating thinking skills and memory linked to high blood pressure.

However, when researchers focused solely on the two studies that had deliberately recruited Hispanics, they noted an undeniably faster decline in overall cognitive performance among Hispanics in comparison to the non-Hispanic white group. Importantly, though, blood pressure differences between those two groups didn’t appear to explain this cognitive decline difference. This may be due to Hispanic participants having lower blood pressure than non-Hispanic whites in these studies, researchers speculate. The same researchers behind this work conducted a similar study two years ago focusing on hypertension and cognitive outcomes among Blacks and Caucasians.

That project found that blood pressure control differences over time helped explain the faster cognitive performance declines seen in Black individuals. 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

Anderer J (2022). “High blood pressure linked to faster cognitive decline, dementia risk.” StudyFinds.

Moorman, A. C., Newell, D (2022). “Impact of audible pops associated with spinal manipulation on perceived pain: a systematic review.” Chiropr Man Therap 30(42).

Communicating Imaging Findings & Acupuncture For Acute Pain

October 20, 2022 chiropracticforward 00:18:21 0 Comments

CF 251: Communicating Imaging Findings & Acupuncture For Acute Pain Today we’re going to talk about Communicating Imaging Findings & Acupuncture For Acute 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 #251 Now if you missed last week’s episode , we talked about Night Owls Diabetes And Heart Disease & Medical Marijuana And Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

It’s been a tough one. My mother in law passed away last week. My wife’s parents live about an hour and 45 minutes to the North of Amarillo in our hometown of Perryton, TX. So, we’ve been back and forth and back and forth so many times I lost track. And there will be lots more back and forths to settle the estate and get Meg’s dad situated in a new town down around Longview TX. Lots of distractions coming up but I’ll do my best to keep this podcast on point, educational, and interesting. It’s like I’m trying to teach my kids right now. My daughter did not want to go to school today, which is a Monday. Her grandmother passed away Wednesday evening. She missed school Thursday and Friday. The memorial will be this Friday so she’ll miss another Thursday – fortunately, they’re out of school Friday. The day of the memorial. My point to her was this; life deals us blows.

We have loss and setbacks that get us down, make us sad, and give us the blues. But we have to do what we can to shoulder obligations, most of the time, give us an opportunity to move forward and take our minds off of our problems. Work can keep us from our lives in a good way as well as in a bad way. Sometimes, work keeps us from being able to enjoy our lives and engage in some of the things we are wanting to do more of. Me, I’m not able to spend time writing songs, playing music, sculpting, or painting and things like that. That’s work getting in the way in a bad way. But, then there’s the work that keeps our minds busy and occupied so that we’re not buried and consumed by worry and fret and the big bad blues life sometimes casts us into. So, for this week and the next, we go to school, we go to work, we occupy our minds, and let time take care of the rest. That may be a Gen X way of going about it but I’m Gen X and that’s what we do. Keep the nose down, work, and life will sort it out. Be upset, mourn, and take care of business, one foot in front of the other. Sorry to be so gloomy on the personal side of it all this week but, I’m always honest with you all and that’s what’s happening on the personal side. I’m certain next week’s episode will be a bit on the brighter side! Now, onto the research!

Item #1 Our first one today is called “Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update” by Nielsen et. al. (Arya Nielsen 2022) and published in Pain Medicine on June 17, 2020 and we got as hot one, people! These researchers by the way, are Phds and MDs. I think that’s notable.

Why They Did It A crisis in pain management persists, as does the epidemic of opioid overdose deaths, addiction, and diversion. Pain medicine is meeting these challenges by returning to its origins: the Bonica model of multidisciplinary pain care. The 2018 Academic Consortium White Paper detailed the historical context and magnitude of the pain crisis and the evidence base for nonpharmacologic strategies. More than 50% of chronic opioid use begins in the acute pain care setting. Acupuncture may be able to reduce this risk. This article updates the evidence base for acupuncture therapy for acute pain with a review of systematic reviews and meta-analyses on postsurgical/perioperative pain with opioid sparing and acute nonsurgical/trauma pain, including acute pain in the emergency department.

How They Did It

To update reviews cited in the 2018 White Paper, electronic searches were conducted in PubMed, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials with additional manual review of titles, links, and reference lists.
There are 22 systematic reviews, 17 with meta-analyses of acupuncture in acute pain settings, and a review for acute pain in the intensive care unit. There are additional studies of acupuncture in acute pain settings.

Wrap It Up

The majority of reviews found acupuncture therapy to be an efficacious strategy for acute pain, with potential to avoid or reduce opioid reliance.
With an extremely low risk profile, acupuncture therapy is an important strategy in comprehensive acute pain care.

We see it every week in my clinic. The VA send over their vets regularly and our acupuncturist is like a golden laced angel to these veterans. It’s been impressive. Before getting to the next one, 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.

Item #2

Our last one today is called “Integrating Epidemiological Information into MRI Reports Reduces Ensuing Radiologic Testing Costs Among Patients with Low Back Pain: A Controlled Study” by The Joint Commission Journal on Quality and Patient Safety 2020 by Weeks et. al. This was brought to me by Spine Care Partners who released a wonderful graphic that I got from Parker President, Dr. William Morgan, and shared in our Chiropractic Forward Facebook private group. The graphic showed what percentages in each age group that you can find ASYMPTOMATIC changes like degenerated discs, facets, bulges, herniations, etc. It was excellent. If you’re not in our private group on Facebook, go do that about right now.

This is more of a review so, let’s review about it shall we? They say, “Research has demonstrated that including epidemiological data along with the standard MRI results report has resulted in reduced opioid prescribing by the provider who ordered the study, as well as reduced referral to spine specialists. This new study includes an assessment of costs when frequency of common findings are included with the standard MRI results report.

The information included data on the prevalence of certain conditions over each decade of life in asymptomatic individuals. For example, degenerative disc disease findings in asymptomatic patients are seen in 68% in those 40-50 years of age, 80% in those 50-60, 88% if 60-70 years old, and 93% of 70-80 year olds. Totally asymptomatic! Which is amazing news for patients. Not great news for predatory providers that use rad findings to scare this holy living schnikees out of their patients so they’ll be forced to come see them a million times. Bad news for those asshats.

Great news for patients though. They say that their study showed that MRI reports with the addition of the prevalence of common findings triggered a downstream costs savings averaging $330 per report when compared to the standard MRI results report of the control group which meant there was no epidemiological charge included with the report. Best of all, repeat MRI use, spinal injection, opioid use, and surgery all decreased in the study group compared to the control group, while muscle relaxers and chiropractic utilization had a slight increase. They point out that one explanation for these findings is that the common language used in spine imaging reports, without statistical reference, is both fear invoking and inappropriately supportive of pathoanatomical understanding of back pain, as compared to the more clinically sound biophyschosocial model.

To put that in you and me speak, chiropractors are still relying heavily on the pathoanatomical model. Here’s the lesion, I’ll pop it, patient fixed. Cancer? Pop it. Bad hearing?? Pop it. Stomach ache? Pop it. COVID? Pop it. That’s so far from factual and being based in the evidence of literature that I cannot even begin to describe it.

They’re saying that chiropractors find stuff on the rad images and scare the crap out of their patients. Either because they’re not educated enough to know, or worst of all, because they’re predatory and miserable human beings that take advantage of their patients’ lack of education. All in order to get more visits and make that boat payment or that second house in the mountains or on the beach payment.

They’re also saying, start leaning into the BIOPSYCHOSOCIAL construct of pain, do right by your patients every day, and the money will just take care of itself. Treat others as you like to be treated. Kindergarten stuff. I don’t want myself or my family being taken advantage of so don’t do it to others. Get educated or get left behind.

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 Arya Nielsen, P., Jeffery A Dusek, PhD, Lisa Taylor-Swanson, PhD, Heather Tick, MD, (2022). “Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update.” Pain Med 23(9): 1582-1612.

Night Owls Diabetes And Heart Disease & Medical Marijuana And Pain

October 13, 2022 chiropracticforward 00:20:28 0 Comments

CF 250: Night Owls Diabetes And Heart Disease & Medical Marijuana And Pain Today we’re going to talk about Night Owls Diabetes And Heart Disease & Medical Marijuana And Pain

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. 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 #250 Now if you missed last week’s episode , we talked about Vertebrogenic Pain. Time for A Thought Shift & Leisure time Physical Activity Effects On Mortality. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

As part of my post as an intern clinic for Parker, I get a new email fairly often requesting I update my profile. I will be honest, it’s a little much for a solo guy that’s busting his hump to stay above water and lives out in Amarillo. Which is an area of Texas that doesn’t have a plethora of interns and associates scrambling to get to, by the way. So, in the year and a half or two years since we got onboarded, we have only hosted one intern and he moved back home near Tulsa, OK after his graduation. I wanted to keep him here but this isn’t his home. I got an email recently that my CPR cert had to be updated to stay in the program. I feel like I just got it renewed last year but, what do I know? I’m busy.

So I decided the whole clinic could use it too. We took Tuesday off and went off-site. We met up at the CPR training place and spend an hour or two getting that re-newed. The staff actually enjoyed it; it was a bit of a teambuilding experience. We got out earlier than we expected so I took the girls to breakfast and it was another opportunity to spend time together outside of work. That was last Tuesday. Then on Saturday, we all met up in downtown Amarillo for the Walk To End Alzheimer’s so had another opportunity for a little team building outside of the job site. Good stuff and a great week. Still slower from the back-to-school slowdown but that’s the way it be. Just trying to get the marketing dialed in and make things happen to spur business back to where it needs to be. I have to mention something kind of cool in my personal life; many of you know I’m a voice-over talent on the side. It’s not just fun. It’s turned into quite an amazing thing. I’m not going to go into financial aspects but let’s say it’s been far beyond anything I ever expected.

I landed my very first video game recently! Google it up. It’s called God Of Rock by Modus and it’s coming out on Xbox and Playstation this Winter. And I cannot wait! It’s so exciting! I played an Elvis-esque character called King. He’s actually one of the main characters of the game. I connected with a group from San Francisco on Zoom and spent a little time recording phrases like Elvis would say them pretty much. It was fun and now, I’m going to have to buy 20 copies of this xbox fighting game! Lol. Anyway, something fun in my life.

I was thinking the other day; I’ve lived so many lives in this one life of mine. I swear. I was a traveling musician for over 8 years a record promoter, a radio station owner, and a venue booking agent. I am a sculptor, sketch artist, and painter. I was a college athlete. My chiropractic career. Hubby and dad. Real estate, VoiceOver….my life is often beyond insane. So, let’s dispense with the chit-chat and get on with it.

Item #1

My first one today is called, “Night owls more likely to develop diabetes, heart disease than early birds” by Study Finds (Allingham 2022) and published on September 20, 2022 bing bang boom pop freakin pow. It’s hot. This is an article more than a research layout so let’s hit the high points and summarize this bad boy. We all like to stay up late. Some of us, like myself, for example, are better at it than others. You’re talking to an ex-traveling musician. A road warrior. A freaking troubadour people. Lots of poor sleep decisions made in my past and in my current, folks. Anyway, they make a statement at the top that says night owls are more like to develop Type 2 Diabetes or heart disease than people who go to bed and wake up early.

They say that researchers have found that night owls are less active than early birds and less sensitive to insulin. I can’t answer the insulin point but I’ll tell you that I’d like to see any early bird more active than me. I’m all over the place all damn day long. I could be the exception to the rule, however. I make myself and my family crazy so I probably am.

Here’s my problem, fatty coming through!

They say that staying up late means we are worse at using fat for energy and this fat can build up in the body and contribute to the risk of disease. Meanwhile, “early birds” appear to be more reliant on fat for energy, more active in the day, and more aerobically fit. Probably true but I feel attacked. Again, I’m not having trouble fitting through the door and I don’t have to buy two airplane seats but damnit, I’m 6’4” and 280. I need to drop some baggage.

The researchers regulated their diet to make sure that was not a factor. The team used advanced imaging, and assessed body mass, body composition, insulin sensitivity, and fat and carbohydrate metabolism using breath samples of each participant’s sleep trends. Over a week, the team monitored participants to figure out their daily activity patterns. Scientists discovered early birds use more fat for energy, both when resting and during exercise. They were also more insulin sensitive.

They end the article by saying, “We also found that early birds are more physically active and have higher fitness levels than night owls who are more sedentary throughout the day. Further research is needed to examine the link between chronotype, exercise and metabolic adaptation to identify whether exercising earlier in the day has greater health benefits,” Before getting to the next one, go to https://www.tecnobody.com/en/products

That’s Tecnobody as in T-E-C no H. Tecnobody.com. They literally have the most impressive clinical equipment I’ve ever seen and that’s saying a lot because I like toys and gadgets for the clinic. 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.

Item #2

Our second one this week is called, “Effect of Medical Marijuana Card Ownership on Pain, Insomnia, and Affective Disorder Symptoms in Adults: A Randomized Clinical Trial” by Gilman et. al. (Gilman JM 2022) and published in JAMA Network Open and published on March 18, 2022 and that’s a steamy stack of stuff.

Why They Did It

Despite the legalization and widespread use of cannabis products for a variety of medical concerns in the US, there is not yet strong clinical literature to support such use. The risks and benefits of obtaining a medical marijuana card for common clinical outcomes are largely unknown.
The authors wanted to answer the question, “What are the risks and benefits of obtaining a medical marijuana card for adults who seek medical marijuana for pain, insomnia, and anxiety or depressive symptoms?”

How They Did It

Pragmatic, single-site, single-blind randomized clinical trial
Greater Boston area from July 1, 2017, to July 31, 2020.
Participants were adults aged 18 to 65 years
Chief concern was pain, insomnia, or anxiety or depressive symptoms.
Participants were randomized 2:1 to either the immediate card acquisition group (n = 105) or the delayed card acquisition group (n = 81).
The immediate card acquisition group was allowed to obtain a medical marijuana card immediately after randomization.
The delayed card acquisition group was asked to wait 12 weeks before obtaining a medical marijuana card.
All participants could choose cannabis products from a dispensary, the dose, and the frequency of use.
Participants could continue their usual medical or psychiatric care.

What They Found

A total of 186 participants
Compared with the delayed card acquisition group, the immediate card acquisition group had more cannabis use disorder symptoms; fewer self-rated insomnia symptoms; and reported no significant changes in pain severity or anxiety or depressive symptoms.
Participants in the immediate card acquisition group also had a higher incidence of cannabis use disorder during the intervention

Wrap It Up

In this RCT, ownership of a medical marijuana card led to rapid onset and increased incidence and severity of cannabis use disorder in some participants, particularly those with a chief concern of anxiety or depressive symptoms. The self-reported improvement in sleep quality warrants further study into the benefits of medical marijuana card ownership for insomnia and the risk of cannabis use disorder. There were no observed benefits of obtaining a medical marijuana card for pain, anxiety, or depressive symptoms. I know it’s not cool these days. I’m fully aware. But you can continue to keep me in the camp that is in no hurry to completely legalize another drug. Make all of your comparisons to the alcohol you want. I get it and you’re not wrong.

They tried to put the genie back in the box in the 1930s and it didn’t work. So that makes it smart to let another genie out of the bottle? No, it doesn’t. While I most definitely enjoy a drink or 10 from time to time, if we’re looking at it from a health perspective, then alcohol is a bad idea. It was a mistake on day one. Why make another when you have more and more research showing the harms and the lack of benefits?

Call me a boomer. Even though I’m Gen X. I care not. My cares were all given out some time ago.

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

Allingham, P. (2022). “Night owls more likely to develop diabetes, heart disease than early birds.” StudyFinds
Gilman JM, S. R., Potter KW, (2022). “Effect of Medical Marijuana Card Ownership on Pain, Insomnia, and Affective Disorder Symptoms in Adults: A Randomized Clinical Trial.” JAMA Netw Open 5(3).

Vertebrogenic Pain – A Thought Shift & Leisure Time Physical Activity Effects On Mortality

October 6, 2022 chiropracticforward 00:19:22 0 Comments

CF 249: Vertebrogenic Pain – A Thought Shift & Leisure time Physical Activity Effects On Mortality Today we’re going to talk about Vertebrogenic Pain. Time for A Thought Shift & Leisure time Physical Activity Effects On Mortality 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. 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 #249 Now if you missed last week’s episode , we talked about steps per day and how that’s related to dementia and we talked about vets and chiropractic. What a wonderful combination. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Ugh, slow Monday man. I hate it and it give me anxiety but I’m using the extra time to make things happen, my friends. Yes indeed. This is being written on September 19th so we are still in the middle of the yearly back to school slowdown. When back to school gets us down, what’s the best way to handle it? Frist, as I’ve mentioned in recent podcasts, you get stuff done! Start through all of the things that have been piling up. Get that stack knocked out. Secondly, marketing wise, what has been successful for you in the past? Have you slowed down on your posting frequency on social media? Pick it up and get to posting. Has it been any community outreach or direct marketing?

Time to re-engage, right? Thirdly, settle the hell down. You didn’t pee on the mayor’s dog and the whole town is not mad at you. Or me. I think this is me talking to me by the way. Lol. Marketing is the most effective thing we can do for our clinic so we are spending this time calling and checking on patients that are more recent but have not really kept up with their schedule. Not in a bully or harrassing kind of way but a ‘staying top of mind’ kind of way and showing concern. What are the big things that speak to people? For me and my practice specifically, I think it can be boiled down to 10 things.

No long waits
Evaluation and treatment on the same day
New patient appointments within 48 hours
They will know the cost before their visit – at least as close as we can get to the cost
Not everyone gets x-rays
No pills and no surgery
Online scheduling
No long treatment plans
Treatment by a Board Certified Orthopedic specialist
Fast and efficient first appointment

These go for our medical side as well as for our chiropractic side. I think hammering these points consistently is an effective strategy. And, they aren’t talking points. It’s how we do things. Here’s another thing I’ll share with myy patients when appropriate; when I have a difficult decision to make as far as recommendations or treatment, I fall back on one principle. That principle is ‘what would I do with this person if this person were an immediate family member?’ That is a guiding principle that will get you the closest to every right answer out there that you can make. Alright, that’s enough of the personal side of things. Let’s get to the meat and taters.

Item #1

The first one is called “Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain” by Conger et. al. (Aaron Conger 2022) and published in Pain Medicine on July 20, 2022. Hot sauce coming up!

Clinicians and researchers have long recognized that better subgrouping of individuals with CLBP is necessary for more targeted and effective treatments. Commonly described sources of CLBP include the zygapophyseal joints, sacroiliac joints, and intervertebral discs (often termed “discogenic” pain)
Historically, the term “discogenic pain” has been associated with disc degeneration and internal disc disruption with the presence of fissures in the annulus fibrosus and associated nociception via branches of the sinuvertebral nerve
Previously, it was thought that pathological neurovascular ingrowth penetrated into annular fissures, leading to increased sensitivity and nociception via the sinuvertebral nerve
However, more recent evidence appears to refute the occurrence of such neurovascular ingrowth in many cases
In the late 1990s, a team of researchers led by Dr. Heggeness reported that vertebral bodies were richly vascularized by vertebral capillaries and innervated by nociceptors that traced back to a single source, the basivertebral nerve. Basivertebral nerve. Let’s call it the BVN, please and thank you.
It’s a branch of the sinuvertebral nerve and it densely innervates the endplates.
With progressive segmental degeneration or acute injury, altered force transfer and endplate stress can result in changes to endplate morphology and composition with concomitant impairment in permeability and transport
Vertebral bodies demonstrated endplate nociceptor densification in areas of damage that were associated with increased disc degeneration.
They also found that only 30% of annular tears in degenerated discs had pathologic neural ingrowth, compared with 90% of adjacent endplates (which were twice as densely innervated)
This distinction between annular and endplate innervation is likely due to differences in nerve ingrowth potential. For the annulus, nerve ingrowth is inhibited by physical pressure and proteoglycans whereas nerves can easily proliferate in fibrovascular bone marrow adjacent to sites of endplate damage
Accumulated damage to the discovertebral complex may result in chemical and mechanical sensitization of endplate nocioceptors
These histopathological findings led to exploration of an “endplate-driven” model of discovertebral pain, with nociception largely occurring via the BVN to a greater extent than the sinuvertebral nerve
This research supports an “endplate-driven” model of anterior column degeneration and existence of a fourth distinct structural source of low back pain, popularly termed vertebrogenic pain

The rest of the article goes on to talk about the research and the benefits of BVN nerve ablation. Of course, that’s not where our minds go immediately when we’re looking at a disc issue, endplate or annular. We’re looking at movement, functionality, and things of that nature.

But, I thought it was interesting because I have been taught over the years, even more recent years, that when an annulus cracks, it’s easier to become painful again because the nerves grow into that fissure and are deep toward the nucleus pulposus upon healing than they were prior to injury. So, for that reason, we have assumed that’s why the biggest predictor of future pain is the presence of prior back pain. This updated information seems to, for the most part refute that information. And I’m OK with that. I love new knowledge.

I love updating my education and staying on top of the cutting edge when I’m able to.

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

The last one this week is called, “Association of Leisure Time Physical Activity Types and Risks of All-Cause, Cardiovascular, and Cancer Mortality Among Older Adults” by Watts et. al. (Watts EL 2022) and published in JaMA Network Open on August 24th 2022. That’s slapy ya mama hot!

Why They Did It

Higher amounts of physical activity are associated with increased longevity. However, whether different leisure time physical activity types are differentially associated with mortality risk is not established..
They wanted to answer the question, “Are different types of leisure time physical activity differentially associated with mortality risks among older adults?”

How They Did It

NIH Cohort study of 272 550 older adults

What They Found A total of 272,550 participants age at baseline, 70.5 years provided information on types of leisure time activity, and 118,153 died during follow-up of 12.4 years.

In comparison with those who did not participate, 7.5 to less than 15 metabolic equivalent of task hours per week of racquet sports and running were associated with the greatest relative risk reductions for all-cause mortality,
Followed by walking for exercise,
other aerobic activity
golf
swimming
and cycling

Each activity showed a curvilinear dose-response association with mortality risk; low metabolic equivalent of task hours per week of physical activity for any given activity type were associated with a large reduction in mortality risk, with diminishing returns for each increment in activity thereafter. Associations were similar for cardiovascular and cancer mortality.

Wrap It Up

This cohort study of older individuals found differences between different types of leisure time activities and mortality risk, but there were significant associations between participating in 7.5 to less than 15 metabolic equivalent of task hours per week of any activity and mortality risk. There you have it go jump into some tennis, racquet ball, or pickle ball and then go for a run. You future self with thank your current self. 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

Aaron Conger, D., Matthew Smuck, MD, Eeric Truumees, MD, Jeffrey C Lotz, PhD, Michael J DePalma, MD, Zachary L McCormick, MD, (2022). “Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain.” Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain 23: S63-S71.

Watts EL, M. C., Freeman JR, (2022). “Association of Leisure Time Physical Activity Types and Risks of All-Cause, Cardiovascular, and Cancer Mortality Among Older Adults.” JAMA Netw Open 5(8). s

Steps Per Day And Dementia & Vets And Chiropractic

September 29, 2022 chiropracticforward 00:15:23 0 Comments

CF 248: Steps Per Day And Dementia & Vets And Chiropractic Today we’re going to talk about Steps Per Day And Dementia & Vets And Chiropractic But first, here’s that sweet sweet bumper music

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

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. 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 #248 Now if you missed last week’s episode, we were joined by the one and only, my friend, Dr. Jay Greenstein and man…..what a great episode. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

First, hey, I’m hiring. I need an asscoiate. Seriously, if you go to work for a franchise people, honest talk here…..you have a cap in salary. You will adjust all day every day and on the weekends. You will work your butt straight off and you’ll never get paid more. At a private practice, like mine for example, you’re not going to have a cap. Once your prove yourself and you’re helping build the clinic, you will get paid without a cap.

You get paid for the work and effort you put in. If you want to work your tail straight off and not get paid what you’re worth, I’m not the right call for you. If you want to work but get mentored by an ortho and forensics diplomate, play a part in this podcast, and set yourself apart from the parts of the profession you don’t like….oh….and get paid for your efforts with a potential buyout down the road, then I am exactly the guy you want to speak with. If you think Amarillo is a great place to live and raise a family, which it absolutely is, send me an email at creekstonecare@gmail.com I want to meet you. Doesn’t matter when you hear this episode.

I’m always looking for top talent and I know if you’re listening to this podcast then you are indeed top talent. 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. Second, we just got back from Vegas. I try take at least one short trip every quarter. Sometimes more. Sometimes less but we have to get out of the clinic. Certainly after you’ve built and you’re on the way. It’s the only way you stay sane. I’m not telling you to close down the clinic and go to Europe for a month as a solo doc. Just a long weekend here and there. It’ll keep you likable. We saw Motley Crue, Def Leppard, Poison, and Joan Jett and it was a great. Just what we needed. I have to admit that I’m still on a bit of a buzz from having Jay Greenstein join me on the show last week. What a freaking gem that guy is. Don’t miss that episode. For any reason. I think that’ll be quite enough of rambling from me. Let’s get it started

Item #1

The first one is called “Association of Daily Step Count and Intensity With Incident Dementia in 78 430 Adults Living in the UK” by del Pozo Cruz, et. al. (del Pozo Cruz B 2022) and published in JAMA on September 6, 2022. Pow! Hottern’ a firecracker!

Why They Did It

The authors wanted to find out if there is a dose-response association of daily step count and intensity with incidence of all-cause dementia among adults living in the UK?

How They Did It

UK Biobank prospective population-based cohort study with 6.9 years of follow-up.
A total of 78,430 of 103,684 eligible adults aged 40 to 79 years with valid wrist accelerometer data were included.
Registry-based dementia was ascertained through October 2021.

What They Found

This cohort study of adults assessed with wrist-worn accelerometers found that accruing more steps per day was associated with steady declines in dementia incidence risk, up to 9800 steps per day, beyond which the benefits upturned.
The dose associated with 50% of maximal observed benefit was 3800 steps per day, and steps at higher intensity (cadence) were associated with lower incidence risk.

Wrap It Up

The findings in this study suggest that accumulating more steps per day just under the popular threshold of 10 000 steps per day and performing steps at higher intensity may be associated with lower risk of dementia onset. 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 this week is called “Health-Related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care Plus Chiropractic Care vs Usual Care Alone: Secondary Outcomes of a Pragmatic Clinical Trial” by Hays et. al. (Ron D Hays 2022) and published in Pain Medicine on January 21 of 2022. Shazzaaammm! It’s sizzlin’ hot. And I want to make note of the authors on this paper. They are among some of my very favorite researchers in our profession. There are lots of them but in particular Rober Vining, Ian Coulter, Katherine Polhman (former guest) and Christine Goertz (also a former guest) Yay for these folks. They are working for you every day.

Why They Did It

This study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to:

Worst pain intensity from a numerical pain rating 0–10 scale,
24-item Roland-Morris Disability Questionnaire (RMDQ); and
Global improvement (modified visual analog scale).

How They Did It

It was a pragmatic, prospective, multisite, parallel-group comparative effectiveness clinical trial comparing usual medical care (UMC) with UMC plus chiropractic care (UMC+CC).
Three military treatment facilities
750 active-duty military personnel with low back pain
Linear mixed effects regression models estimated the treatment group differences.
Coefficient of repeatability to estimate significant individual change.

What They Found

The researchers found statistically significant mean group differences favoring UMC+CC for all PROMIS®-29 scales and the Roland-Morris Questionnaire score.

Wrap It Up

Findings from this pre-planned secondary analysis demonstrate that chiropractic care impacts health-related quality of life beyond pain and pain-related disability. Further, comparable findings were found between the 24-item Roland-Morris Questionnaire and the PROMIS®-29 v1.0 briefer scales. 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

del Pozo Cruz B, A. M., Naismith SL, Stamatakis E, (2022). “Association of Daily Step Count and Intensity With Incident Dementia in 78 430 Adults Living in the UK.” JAMA Neurology.

Ron D Hays, P., Zacariah K Shannon, DC, MS, Cynthia R Long, PhD, Karen L Spritzer, BA, Robert D Vining, DC, DHSc, Ian D Coulter, PhD, Katherine A Pohlman, DC, MS, PhD, Joan A Walter, PA, JD, Christine M Goertz, DC, PhD, (2022). “Health-Related Quality of Life Among United States Service Members with Low Back Pain Receiving Usual Care Plus Chiropractic Care vs Usual Care Alone: Secondary Outcomes of a Pragmatic Clinical Trial.” Pain Med 23(9): 1550-1559.

w/ Dr. Jay Greenstein – Inspiration, Experience, Passion, and Progress

September 26, 2022 chiropracticforward 00:52:25 0 Comments

CF 247: w/ Dr. Jay Greenstein – Inspiration, Experience, Passion, and Progress Today we’re joined by the one and the only, Dr. Jay Greenstein, He’s going to share some amazing insight and you’re going to love every bit of it. 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. 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 #247 Now if you missed last week’s episode , we talked about Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

We are stil in the back to school doldrums around here. Slower than I want to be. What do you tell yourself when you’re slow at the clinic? Do you panic? If I were brand new in practice, I might. Hell, if a slowdown lasts too long, I still panic. But its healthier to understand the ebbs and flows, the peaks and the valleys, and the ups and downs. It just is and I can set my watch by the back to school slow down. It’s every single year. Without fail. So, I settle down and say to myself, ‘Hey self…it’s OK. You didn’t get caught kicking the mayor’s dog. The whole city isn’t mad at you. You have a well-established clinic with hundreds of five star reviews and thousands of happy patients. Some of which you’ve changed their lives. So chill the hell out, take advantage of the extra time, and get some stuff done.” And that’s what I’m doing.

A new opportunity has arisen for me recently. It’s with a company called Woodway which makes the most amazing treadmills and also distribute equipment made by an Italian company called Technobody. You will be hearing more and more about this coming up but they have signed me on as a representative. I will be talking more and more about the piece of Tecnobody equipment I’ve had in my office for a couple of years. It’s amazing and can test proprioception, concussion disorders, balance training, shoulder rehab, movement evaluation, and more. It’s called the ISO-Free by Tecnobody. If you’re interested in learning more, email me at creekstonecare@gmail.com so I can show you more and get you going on it. On a different note, have you noticed that the gremlins tend to sneak in over the weekends? How does that happen exactly? We showed up at work this Monday and the alarm panel at the front door was hanging off of the wall, the mailbox for the whole office complex we are in was broken into and emptied out, the credit card machine wasn’t working, and everyone was losing their minds. Some Mondays are just made out of spending the morning putting everything back together after the weekend Gremlins are done making a mess. But, we are entrepreneurs and basically nothing can stop the steamroller. That’s enough of that, I can’t wait to get to our guest today.

We are joined by the one and only….Dr. Jay Greenstein. I’m fortunate enough to have gotten to know and become good friends with Jay and if you’ve never seen him speak at an event, stop messing around and seek him out. You will learn. Not only is he dynamic but he’s just got this amazing vibe that makes everyone welcome and comfortable and glad they came. We’ll probably talk about it as we get into it a little bit but Jay and I are both in Dr. Kevin Christie’s MCM Mastermind group that you’ve heard me mention so many times on this podcast. Jay was also the presenter at the first Mastermind in January in Del Ray Beach and I was just blown away.

Jay understands so much more about running and managing his businesses aned employees than I’ll ever know. Since then, I got to spend a weekend with Jay at the ChiroTexpo event in Frisco, TX back in June and then I was fortunate to spend another wild and crazy Mastermind weekend with Jay and the crew in Sarasota, Florida back in July. I’m just saying, you folks are in for a treat right now and are going to love this interview so let’s get into it. Let me start by giving Jay a proper intro here. Drum roll and everything.

Dr. Jay is the founder and CEO of Kaizenovate, a technology company that builds custom mobile apps for chiropractic practices helping doctors improve outcomes and income. He is also the founder and CEO of the Kaizo Health Companies. The Kaizo Health companies are comprised of: · Kaizo Health is a multilocation chiropractic and rehabilitation practice. · KaizoX is a sports performance and personal training company. · And Kaizo Clinical Research Institute is a 501-c3 non-profit that runs clinical trials to identify best practices. The Institute is part of a large multi-year NIH study evaluating emerging Healthtech interventions for musculoskeletal conditions. Dr. Jay is a task force member for the Future of Chiropractic Strategic Plan and is the current Chairman the ChiroTech Consortium Workgroup. His is also the chairman of the Federation of International Chiropractic du Sport’s World Olympians Scholarship Program. He is immediate past Chairman for the Clinical Compass,

Dr. Greenstein is a sought out international speaker and consultant, teaching evidence into practice, leadership, business management and emerging technologies. Dr. Greenstein sits on multiple advisory boards in healthcare and technology.

Jay, where in the world are you today?
Since being a chiropractor isn’t always the most obvious choice for many of us, I love to hear how it came about for you. Tell me why did you become a chiropractor?
Now the last time we were together was in Sarasota at the MCM Mastermind. You were leaving that weekend to travel to a St. Petes for a few days on the beach and then you were going to Santa Fe, New Mexico for a chiropractic retreat. I want your life. So, tell us about your companies. Give us the layout of everything you have your digits into today and what allows you the freedom to travel and do the things you do?
That kind of takes me into the question, with you being like the Energizer bunny and all over the place from day to day, what is it that motivates you and drives you and keeps you so on top of what you’re doing?
On this podcast, we have a spotlight or focus each week on 2-4 research papers. I know you and your team have been involved in conducting your own research projects. Can you share some of that with us?
What would you say has been your biggest obstacle you’ve encountered in your career and how were you able to resolve it?
Tell me about your involvement with Clinical Compass.
At this point in your career, you have 4 practices, a tech company, speaking opportunities, and on and on and on. At this point, what is your motivating factor to be a part of the MCM Mastermind group that I’m in with you?
What, so far, has been your biggest impression or lesson or takeaway from the mastermind this year.
You can speak on so many topics at the conferences and seminars around the country. What would you say is your favorite topic to speak about?
What have been the biggest lessons you’ve learned in your career?
is on the down hill and doomed. Some say that enrollment in the schools is up. What do you see as being the future of our profession?

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

Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity

September 15, 2022 chiropracticforward 00:16:20 0 Comments

CF 246: Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity Today we’re going to talk about Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity 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. 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 #246 Now if you missed last week’s episode , we talked about Upregulated Central Nervous System & Shared Decision Making With The Patient. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Back to school has us down in numbers as it dies every year but we are in the rebound already So, I’ve got a few things working as far as marketing goes but let’s talk about something; have you ever hired a full time clinic rep or marketing rep? Someone that has the full time job of promoting your clinic. I have not done this but I was having a conversation about it with a colleague last week.

My friend expressed how $80k per year was just not realistic for a chiropractor. My friend has four clinics in a metroplex so I got to thinking……is it unrealistic? If so, how unrealistic is it exactly? So I started crunching numbers. Let me share my thoughts. First, I’ve always thought that I’d spend $100k to make $150-$200k/ year. Why wouldn’t you? That’s a $50k raise in pay and you can do a lot with $50k. Keeping that in mind, I went to tracking some numbers. First, what’s my case value? What is one patient worth to our practice? $500? $600? $1500? To work this out, you must know this number. Once you have the rep’s salary, we’ll say it’s $80k/year, then you alright, let’s divide the salary by our per patient case value. For easy math let’s take $80k salary divided by let’s say $800 for the case value. That equals 100 patients. So it will take 100 new patients over the course of a year to pay for that rep.

Everything over 100 patients is gravy.

If you were paying a rep that much, would t you expect at least 10 new patients per month from their efforts? If they truly know what they’re doing, I think that’s super conservative. So 10 new patients per month times 12 months in a year is 120 new patients. So 20 are gravy. 20 gravy patients times out case value of $800 is and extra $16,000 that year. But do you think a professional rep that is marketing your clinic all day every day is only going to bring in 10 new patients per month? And is you case value sitting at $800? Your case value may be $1500.

That would be a no brainer then wouldn’t it? Then you’d pay that salary in 53 new patients and at 10 new ones per month,120 let’s year minus 53 = 67 gravy patients and 67 c a case value of $1500 means an extra $100,500 that year, But again, a rep worth anything will be bringing in a lot more than 10 new patients per month. So, think about it. Is a rep out of bounds? I don’t know depends on the salary and the case value but I’d definitely pull a Stu McGill and say……It Depends. If you have experience hiring a rep, I’d love to hear your thoughts. Please email me at Dr.williams@chiropracticfirwars.com so I can get a better idea of how all of it works.

Item #1

First one is called “Risk Factors Associated with Healthcare Utilization for Spine Pain” by Higgins, et al. (Diana M Higgins 2022) He’s a PhD. There are seeveral PhDs on this paper, I see a coupl dof MDs and one DC. It was published in Pain Medicine in August 2022. Shaaaazzzaaam! Hot.

Why They Did It

This study examined potential risk factors associated with healthcare utilization among patients with neck and back pain.

How They Did It

A two-stage sampling approach examined spine pain episodes of care among veterans with a yearly outpatient visit for six consecutive years.

What They Found

Among 331,908 veterans without spine pain episodes of care during the 2-year baseline observation period, 16.5% had a new episode of care during the following 2-year observation period.
Of those 54,852 veterans, 37,025 had an outpatient visit data during the final 2-year follow-up period, with 53.7% evidencing continued spine pain care.
Those with continued care were more likely to be overweight or obese, non-smokers, Army veterans, have higher education, and had higher rates of diagnoses of all medical and mental health conditions examined at baseline.
Among several important findings, women had 13% lower odds of continued care during the final 2-year observation period.

Wrap It Up

A number of important demographics and clinical considerations were associated with increased likelihood of seeking new and continued episodes of care for spine pain 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

The last one today is called, “Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain: A Randomized Clinical Trial” by Bagg, et. al. (Bagg MK 2022) and published in JAMA on the 2nd of August, 2022. Schiizaa, sizzlin’

Why They Did It

The effects of altered neural processing, defined as altering neural networks responsible for perceptions of pain and function, on chronic pain remains unclear..
The authors wanted to estimate the effect of a graded sensorimotor retraining intervention (RESOLVE) on pain intensity in people with chronic low back pain.

How They Did It

Randomized clinical trial recruited participants with chronic nonspecific low back pain from primary care and community settings.
276 adults were randomized to the intervention or sham
Took place in Sydney, Australia.
December 10, 2015 to July 25, 2019.
Follow-up was completed on February 3, 2020.
Participants randomized to the intervention group (n = 138) were asked to participate in 12 weekly clinical sessions and home training designed to educate them about and assist them with movement and physical activity while experiencing lower back pain.
Participants randomized to the control group (n = 138) were asked to participate in 12 weekly clinical sessions and home training that required similar time as the intervention but did not focus on education, movement, and physical activity.
The control group included sham laser and shortwave diathermy applied to the back and sham noninvasive brain stimulation.
The primary outcome was pain intensity at 18 weeks, measured on an 11-point numerical rating scale to 10 for which the between-group minimum clinically important difference is 1.0 point.

What They Found

A graded sensorimotor retraining intervention, compared with a sham procedure and attention control, resulted in a statistically significant improvement in pain intensity at 18 weeks (estimated mean difference, 1.0 point on an 11-point numeric rating scale

Wrap It Up

In this randomized clinical trial conducted at a single center among patients with chronic low back pain, graded sensorimotor retraining, compared with a sham procedure and attention control, significantly improved pain intensity at 18 weeks. 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

Bagg MK, W. B., Cashin AG (2022). “Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain: A Randomized Clinical Trial.” JAMA 328(5): 430-439.

Diana M Higgins, P., Ling Han, MD, PhD, Robert D Kerns, PhD, Mary A Driscoll, PhD, Alicia A Heapy, PhD, Melissa Skanderson, MSW, Anthony J Lisi, DC, Kristin M Mattocks, PhD, Cynthia Brandt, MD, MPH, Sally G Haskell, MD, MS, (2022). “Risk Factors Associated with Healthcare Utilization for Spine Pain.” Pain Med 23(8): 1423-1433.

Upregulated Central Nervous System & Shared Decision Making With The Patient

September 8, 2022 chiropracticforward 00:17:43 0 Comments

CF 245: Upregulated Central Nervous System & Shared Decision Making With The Patient Today we’re going to talk about Upregulated Central Nervous System & Shared Decision Making With The Patient. 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. 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 an 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 #245 Now if you missed last week’s episode , we talked about Recognizing Cervical Artery Dissection. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Things are clicking along pretty normally for a chaotic clinic. Today, let’s talk a little about your relationships with your employees before we get to the research. Everyone has different styles of owning or managing their clinics and staff. Mine has always been to treat them like family. Honestly, we spend more time with our staff than we do with our own families. So why not have friendly and almost family-like relationships with them? Why the hell not? I don’t want awkward forced relationships with the people I’m with every day all day. I want fun, happy, and friendly relationships. With people I look forward to seeing every day.

My staff is hilarious and we have a lot of fun together.

I’ll give you a little story as an example. My office manager is getting married in September. Probably about the time this episode goes live. She had her wedding shower on August 13th at her mother’s house. It wasn’t the regular boring old wedding shower. They had drinks, men and women, cornhole, and beer pong in the back yard…..you get the picture. Pretty much my entire staff of 12 or 13 was there. Which is nice. They feel like family to an extent. That’ll warm your heart, right? Well, I’m of the age that beer pong wasn’t ‘a thing’ in my college years. We played simple games like quarters or something like that. Anyway, I went to the wedding shower. My wife actually helped host it and run it all. She made a huge table full of charcuterie items and it was just all very well done.

So that’s point #1; she felt close enough to us to not only want us at her wedding shower but to have my wife help host it. Then, after gifts were opened and a few filtered out, everyone moved to the backyard and played cornhole and beer pong. My office manager made me be her teammate for a game of beer pong. Now, I told her I can’t play with drinks because I was driving so I just sipped on one beer while we played. Turns out, I actually have a little talent for beer pong. We won the first game against her fiancee and Boom! Instant respectability amongst the kiddos.

So, point #2; when your staff likes you and wants you to participate in aspects of their personal life, I say you just do it. You build friendship, loyalty, camaraderie, and trust the more you just say, “Yes.” Play beer pong. Even when you don’t want to or don’t know how to play it. It’ll pay off in the long run. If you feel differently, let me know. Send me an email at dr.williams@chiropracticforward.com I want your opinion so I can share with the collective.

OK, on to the research.

Item #1

Our first one is called “Does shared decision making results in better health related outcomes for individuals with painful musculoskeletal disorders? A systematic review” by Christopher et. al. (Yannick Tousignant-Laflamme 2017) published in the Journal of Manual and Manipulative Therapy in 2017.

Why They Did It

Shared Decision-Making (SDM) is a dynamic process by which the health care professional and the patient influence each other in making health-related choices or decisions. SDM is strongly embedded in today’s health care approaches and is advocated as an ideal model since it renders individuals more control over the health care they choose to receive, and has been shown to improve patient outcomes. The goal of this systematic review was to investigate the added value of SDM on clinical health-related outcomes in patients with a variety of musculoskeletal conditions.

How They Did It

PubMed and CINAHL. To be considered for review, the study had to meet all the following criteria: (1) prospective studies that involved treatment decision-making; (2) randomized controlled trial design; (3) involving patients faced with having to make a treatment decision; (4) comparing SDM with a control intervention and (5) including one or more of the following outcome measures: well-being, costs, health-related pain or disability measures, or quality of life.

What They Found

We did not find a single study that looked at the true effect of SDM on patient-reported outcomes in a population with musculoskeletal pain.

Wrap It Up

For the management of painful musculoskeletal conditions, in the light of the current evidence (none), we estimate that it would be wise to explore the effectiveness of SDM before forcing its large-scale implementation in rehabilitation. 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

The last one is called, “Mechanisms of chronic pain – key considerations for appropriate physical therapy management” by Courtney et. al. (Carol A. Courtney 2017) and published in the Journal of Manual and Manipulative Therapy in March of 2017. Rather than a full-blown research project, this one is more of an informational article with some future direction.

They say the following: “In the last decades, knowledge of nociceptive pain mechanisms has expanded rapidly. The use of quantitative sensory testing has provided evidence that peripheral and central sensitization mechanisms play a relevant role in localized and widespread chronic pain syndromes. In fact, almost any patient suffering from a chronic pain condition will demonstrate impairments in the central nervous system. In addition, it is accepted that pain is associated with different types of trigger factors including social, physiological, and psychological. This rationale has provoked a change in the understanding of potential mechanisms of manual therapies, changing from a biomechanical/medical viewpoint, to a neurophysiological/nociceptive viewpoint.

Therefore, interventions for patients with chronic pain should be applied based on current knowledge of nociceptive mechanisms since determining potential drivers of the sensitization process is critical for effective management. The current paper reviews mechanisms of chronic pain from a clinical and neurophysiological point of view and summarizes key messages for clinicians for proper management of individuals with chronic pain.”

Now, I don’t know exactly where you’ve been hearing this since 2019. Oh, wait, yes I do. Here!

You’ve been hearing it here and research is catching up. I didn’t invent this stuff, of course. And I’m no smarter than everyone else. I just happened to take the course for the Diplomate of the International Academy of Neuromusculoskeletal Medicine and was taught by Drs. Anthony Nicholson and Matthew Long in that course and THEY are on the cutting edge. They are the reason I’ve been preaching this stuff for so long now. They’re the reason my patients get better at the rate they do.

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

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

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

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

Carol A. Courtney, C. F.-d.-l.-P. S. B. (2017). “Mechanisms of chronic pain – key considerations for appropriate physical therapy management.” Journal of Manual & Manipulative Therapy 25(3): 118-127.

Yannick Tousignant-Laflamme, S. C., Derek Clewley, Leila Ledbetter, Christian Jaeger Cook & Chad E Cook, (2017). “Does shared decision making results in better health related outcomes for individuals with painful musculoskeletal disorders? A systematic review.” Journal of Manual & Manipulative Therapy 25(3): 144-150.

Recognizing Cervical Artery Dissection

September 1, 2022 chiropracticforward 00:16:05 0 Comments

CF 244: Recognizing Cervical Artery Dissection Today we’re going to talk about Recognizing Cervical Artery Dissection 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 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. 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 education for you AND your patients. It saves you time in 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 #244 Now if you missed last week’s episode , we talked about Chiropractic Adjustments To Avoid Other Procedures & we talked about Male Vets With Chronic Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Well, I just turned the big 50 people. It hurt a little. I’m not going to lie. I’ve always been one to really value and enjoy being young. I didn’t just go through it without appreciating my abilities and what I could do and accomplish. I loved being an athlete and running and all of that good stuff. They say it’s just a number but that number is engrained in my joints and I feel it. Part of it is a weight thing.

Being 6’ 4” and 275 or so isn’t great for joints of the body so I’m on it. We’ll get that down. I’m determined. So, 50 is blah for me but it’s over and it’s onward ho. I have too many irons in the file to be worrying about birthdays and all of that stuff.

Business is pretty solid for back-to-school. It’s pretty steady. Which is surprising. I’m changing up some marketing in the near future and will share some of my experience on that. I’m a little nervous to dive more into marketing because if I’m honest, I’m at capacity as it is. I saw 27 new patients last week. Just me. We had a total of about 180 visits and that’s just about as much as I can do. But with the type of marketing, we’re going to be trying, we’ll be more likely to only get the patients in here that we want to work with that are already fully committed and motivated. We shall see. But for now, let’s get on with the research. We have some fun ones this week.

Before I do that though, I have to tell you, that Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. 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. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #1

This first and only one this week is getting some attention due to a recent artery dissection suffered by a woman in Georgia. Unfortunate for sure. I don’t know the particulars so we won’t go into that specifically but, when things like this happen, we start seeing more and more about the chiropractors cause stroke thing. Typically, this isn’t true and there is a lot of research backing that up. I want to cover an article today that just came out called, “How to Recognize A Cervical Artery Dissection’ by James Demetrious, DC, DABCO (DABCO 2022) and published in PostGrad DC on July 18, 2022. Kaplowy!

That’s hot!

Since this is an article, we’ll dispense with the traditional format and hit the high notes. The arrticle highlights an excellent paper that came out not long ago that we covered here on the podcast. It’s by Chaibi et al (Chaibi A 2018) and was in the Annals of Medicine in 2019. In their paper, they cited high-quality research that affirms

Manual therapy doesn’t no result in an increased risk of CAD
There is no strong evidence that manual therapy provokes CAD.

Chaibi and Russell cite high-quality research to support these conclusions:

The rarity of CAD also makes the provision of epidemiological evidence challenging.
However, several extensive cohort studies and meta-analyses have found no excess risk of CAD resulting in secondary ischaemic stroke for chiropractic SMT compared to primary care. [2, 3, 4]
Similarly, retrospective cohort studies have reported no association with traumatic injury to the head or neck after SMT for neuromusculoskeletal pain.
Studies have disproven any misconception about whether SMT strains exceed failure strains.
No changes in blood flow or velocity in the VA of healthy young male adults were found in various head positions and during a cervical SMT.
Thus, these studies support the evidence of spontaneous causality or minimally suggest very low risk for serious AEs following SMT.

For my office, I try my best to minimize the risk to as close to zero as possible. If there is a young person in the office with unilateral neck pain for no reason, especially combined with a severe headache, they’re getting the inquisition, folks. I’m a research nerd and through my years of doing this podcast, I have compiled 19 questions that I feel can give us the best possible screen for CAD. Feel free to use them for yourself. They are as follows:

Is there any difference in upper arm strength from side to side?
Is there pain or numbness in one side of the face?
Can the patient raise both eyebrows equally?
Is there any difference in the size of the pupils?
Does the patient have an even smile?
Is the tongue straight when you have the patient stick it out?
Do they have a mostly even grip bilaterally?
Can they perform a resisted shoulder shrug evenly bilaterally?
Do you have a head pain or headache that developed suddenly and can be sharp or throbbing?
Do you have a headache that is worse when laying down?
Do you have difficulty speaking or swallowing?
Do you have any visual abnormalities?
Do you have unsteadiness or lack of coordination beyond what you consider normal?
Are you having any recent onset hiccups?
Are you having any hearing loss or pulsing tinnitus?
Are you having any nausea or vomiting?
Signs of nystagmus?
Any other neurological symptoms?
Do they have any light-headedness or fainting, disorientation, unexplained anxiety, disturbances in the ears, tremors, or sweating?

Now, if after all of those questions, you have accurately documented this complaint and should have a good direction forward. Most of the time, after the screen, I’m comfortable moving on. I’ve done my due diligence. However, I’m sure I’ve lost some patients over the years because if some of these are answered yes with no clear explanation for them, they’re getting an MR-A or a CT-A or I’m not working on them. Plain and simple. I tell them my first job is to do no harm. My second job is to make them better. Most appreciate it and are happy to do the imaging.

So, there you go. If you’d like more information on why chiropractors are almost never solely responsible for CAD, I put together a very comprehensive and, I think, entertaining rundown of the information and I did it in various forms so that you could get the info however you like. I put it in a blog on my website at chiropracticforward.com. The blog is called Debunked; The Odd Myth That Chiropractors Cause Strokes. The link can be found in the show notes right here at this point in the episode. https://www.chiropracticforward.com/blog-post/debunked-the-odd-myth-that-chiropractors-cause-strokes-revisited/

I also have it in video form on YouTube with the same title And just to be sure you could get the information in your preferred format, I made podcast episodes covering the same information in depth. The episodes of this podcast are Episodes 13, 14, and 15

I invite you to dive in a bit so you can be on top of it all.

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

Chaibi A, R. M. (2018). “A risk-benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: A comprehensive review.” Annals of Medicine.
DABCO, J. D. D. (2022). “How to Recognize a Cervical Artery Dissection?” PostGradDC.

Chiropractic Adjustments To Avoid Other Procedures & Male Vets With Chronic Pain

August 25, 2022 chiropracticforward 00:02:05 0 Comments

CF 243: Chiropractic Adjustments To Avoid Other Procedures & Male Vets With Chronic Pain Today we’re going to talk about Chiropractic Adjustments To Avoid Other Procedures & Male Vets With Chronic 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 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. 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 a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
Then go Like our Facebook page,
Join our private 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 #243 Now if you missed last week’s episode, we talked about effectiveness Of the Neck Exercise For Disc Herniation and Supine vs. Prone MRIs. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

We have been flying all over the place this year. Honestly, I’m making up for lost time during the pandemic. 3 trips already to Florida this year for Kevin Christie’s MCM Mastermind group and another in November to meet the crew in Key Largo. Pumped about that one! As a part of the Forensics diplomate, I go to Chicago every October so we’ll be up there in a couple of months. Not to mention trips to Texas Chiropractic Association functions. There are at least two a year for that. One in June and one in February or March. Now, with my VoiceOver career going little bananas, I have a vo conference that I just go back from in Dallas and one in Atlanta in March. And then anything we want to do that is not work-related. Like, go to Vegas on September 8th to see Motley Crue, Def Leppard, Poison, and Joan Jett. Can I get a hell yes from my fellow 80’s kids? Plus, I want to start visiting some of the practices of the docs in the MCM Mastermind. I’m interested in seeing what they do to make them so efficient and so successful. I can always learn from others.

This brings up a point; have any of you considered identifying you colleagues that are highly productive and very successful and asked them if you can go and hang out and visit for a day or two just to see what they do that you could possibly implement in your own clinic? We can sit in a mastermind and exchange ideas and processes but at the end of the day, it’s when you see it all in action that it sticks and effects change in how you practice and how you manage your patients.

So, I want to start fitting in some trips when I can find some space. Right now, I’m not sure where the heck I can make it fit to be honest. But, it is an investment in my company and in my clinic so I’m going to see if I can make it happen, regardless. I’ll keep you updated. Getting a mentor is key folks. Even if the mentor come in the shape and form of several of your colleagues.

Item #1 This first one is called “Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data” by Davis, et. al. (Davis BA 2022) and published in Journal of Chiropractic Medicine in June of 2022, Kapow!! That’s got some heat on it.

Why They Did It The purpose of this study was to determine whether a sample of older adult male U.S. veterans demonstrated clinically and statistically significant improvement in chronic lower back pain on validated outcome measures after a short course of chiropractic care.

How They Did It

There were 217 individuals who met the inclusion criteria.
We performed a retrospective review of a quality-assurance data set of outcome metrics for male veterans, aged 65 to 89 years, who had chronic low back pain, defined as pain in the lower back region present for at least 3 months before evaluation.
We included those who received chiropractic management from January 1, 2010, to December 31, 2018.
Paired t tests were used to compare outcomes after 4 treatments on both a numeric rating scale (NRS) and the Back Bournemouth Questionnaire (BBQ).
The minimum clinically important difference (MCID) was set at 30% change from baseline.

What They Found

The mean NRS score change from baseline was 2.2 points, representing a 34.1% reduction.
The mean score change for Back Bournemouth Questionnaire was 14.7 points, representing a 35.9% reduction.
The percentage of participants reaching the minimum clinically important difference for the NRS was 57% and for the Back Bournemouth Questionnaire was 59%, with 41% of the sample reaching the minimum clinically important difference for both the NRS and Back Bournemouth Questionnaire.

Wrap It Up

This retrospective review revealed clinically and statistically significant improvement in NRS and Back Bournemouth Questionnaire scores for this sample of older male U.S. veterans treated with chiropractic management for chronic low back pain. 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! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. 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. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #2

This last one is great and is called, “Three Patterns of Spinal Manipulative Therapy for Back Pain and Their Association With Imaging Studies, Injection Procedures, and Surgery: A Cohort Study of Insurance Claims” by Anderson, et. al. (Anderson BR 2021) and published in Journal Of Manipulative And Physicological Therapeutics on November 1, 2021, and it’s just hot enough!

Why They Did It The purpose of this study was to evaluate the relationship between procedures and care patterns in back pain episodes by analyzing health insurance claims.

How They Did It

They performed a retrospective cohort study of insurance claims data from a single Fortune 500 company.
The 3 care patterns analyzed were initial spinal manipulative therapy, delayed spinal manipulative therapy, and no spinal manipulative therapy.
The 3 procedures analyzed were imaging studies, injection procedures, and back surgery.
They considered “escalated care” to be any claims with diagnostic imaging, injection procedures, or back surgery.
Modified-Poisson regression modeling was used to determine relative risk of escalated care.
There were 83 025 claims that were categorized into 10 372 unique patient first episodes.

Wrap It Up

For claims associated with initial episodes of back pain, initial spinal manipulative therapy was associated with an approximately 30% decrease in the risk of imaging studies, injection procedures, or back surgery compared with no spinal manipulative therapy.
The risk of imaging studies, injection procedures, or back surgery in episodes in the delayed spinal manipulative therapy group was higher than those without spinal manipulative therapy.

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

Anderson BR, M. S. (2021). “Three Patterns of Spinal Manipulative Therapy for Back Pain and Their Association With Imaging Studies, Injection Procedures, and Surgery: A Cohort Study of Insurance Claims.” J Man Manip Ther 44(9): P683-689.

Davis BA, D. A., Golley DJ, Chicoine DR (2022). “Chiropractic Clinical Outcomes Among Older Adult Male Veterans With Chronic Lower Back Pain: A Retrospective Review of Quality-Assurance Data.” J Chiropr Med 21(2): 77-82.

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Steps Per Day And Dementia & Vets And Chiropractic

w/ Dr. Jay Greenstein – Inspiration, Experience, Passion, and Progress

Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity

Recognizing Cervical Artery Dissection

Chiropractic Adjustments To Avoid Other Procedures & Male Vets With Chronic Pain

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