CF 306: Pain Neuroscience Education & Cannabis And Bipolar Disorder
Today we’re going to talk about Pain Neuroscience Education & Cannabis And Bipolar Disorder
But first, here’s that sweet sweet bumper music
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OK, we are back and you have found the Chiropractic Forward Podcast where we are 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.
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You have found yourself smack dab in the middle of Episode #306
Now if you missed last week’s episode , we talked about Hip Pain And Corticosteroids & Chronic Pain After Spinal Surgery. Make sure you don’t miss that info. Keep up with the class. On the personal end of things…..
First day back from our 4-day Thanksgiving holiday break. Now, let’s just say this; I was going to work the morning of the Friday after Thanksgiving. But, I had a bit of a mutiny with the employees. And, to be honest, I’m not sure how it sits with me.
I didn’t want to work on Friday to start with but, being honest here, we’ve been a little slower than I’m used to lately and I felt like I needed to. Plus I was in Orlando a week or so ago for our Mastermind meeting so that was slow on my return as well.
Anyway, I was approached and the crew feels they’ve been putting in a lot of energy with being shorthanded, etc and they wanted that day off. And wanted it paid I’m assuming. So my conundrum was, stand my ground and risk losing employees and fostering a low-simmering dislike of me and thee job we are here to do? Or submit to a request I already wanted for myself anyway?
Right or wrong, I chose to give them the day and I have to say that I thoroughly enjoyed it. And today, the staff seems to be in a better overall mood and, I hope, ready to rock n roll and make it happen this week and get things back to normal. Which means busy busy.
How would you handle that? I didn’t dig it. I can tell you that.
Alright, enough clinic stuff, let’s hop into the research! Item #1
The first on today is called, “Pain neuroscience education for reducing pain and kinesiophobia in patients with chronic neck pain: A systematic review and meta-analysis of randomized controlled trials” by Lin et. Al. published in European Journal of Pain on September 11, 2023 and BAM! It’s smokin! https://doi.org/10.1002/ejp.2182 Why They Did It
Chronic neck pain (CNP) is a common musculoskeletal disorder. Pain neuroscience education (PNE) is a promising nonpharmacological intervention for CNP, however, its effectiveness remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of PNE in treating CNP. How They Did It
Electronic databases from inception to February 2023 were searched for randomized controlled trials
The primary outcome was the change in pain intensity, and the secondary outcome was improvement in kinesiophobia,
Two authors independently scrutinized eligible articles, extracted data and assessed quality; a random-effects model was employed for data pooling. What They Found
In total, seven RCTs comprising 479 participants were included and demonstrated that PNE significantly reduced pain intensity
Subgroup analysis revealed that the adult group experienced significant pain reduction after PNE, whereas the adolescent group did not.
PNE also reduced kinesiophobia which was evaluated in four of seven RCTs
There was indication that increased intervention duration contributed to greater pain reduction.
No adverse events were reported following PNE or the control treatment. Wrap It Up
Pain neuroscience education effectively reduced pain intensity and kinesiophobia in patients with chronic neck pain.
A longer PNE time leads to greater pain reduction and is more effective in adults than in adolescents.
According to Physiopedia – Pain Neuroscience Education (PNE) is a strategy that aims to teach patients to reshape their mindset and perception of pain
despite these factors. It provides patients a better understanding of their condition and motivates them to become active participants in their treatment programs.
Based on a large number of high-quality studies, it has been shown that teaching people with chronic pain more about the neuroscience of their pain produces immediate and long-term changes. Item #2
Our last one this week is one of these that always makes me uncool and all and yes, alcohol is worse but we already tried outlawing it so here we go, it’s called, “Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder” by Jensen et. Al. and published in JAMA Psychiatry on May 24, 2023 so it’s still nice and steamy and cozy.
Remember that you can find these citations in our show notes on our website at chiropractscforward.com
Jefsen OH, Erlangsen A, Nordentoft M, Hjorthøj C. Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder. JAMA Psychiatry.
2023;80(8):803–810. doi:10.1001/jamapsychiatry.2023.1256 Why They Did It
They say that Cannabis use is increasing worldwide and is suspected to be associated with increased risk of psychiatric disorders; however, the association with affective disorders has been insufficiently studied.
The question they tried to get clarity on is, “Is cannabis use disorder associated with an increased risk of psychotic and nonpsychotic unipolar depression and bipolar disorder?” How They Did It
This was a prospective, population-based cohort study using Danish nationwide registers included all individuals born in Denmark before December 31, 2005, who were alive, aged at least 16 years, and living in Denmark between January 1, 1995, and December 31, 2021.
Which means 6,651,765 individuals in Denmark that were followed up for 119,526,786 person-years
The main outcome was register-based diagnosis of psychotic or nonpsychotic unipolar depression or bipolar disorder. What They Found
Cannabis use disorder was associated with an increased risk of unipolar depression, psychotic unipolar depression, and nonpsychotic unipolar depression.
Cannabis use was associated with an increased risk of bipolar disorder in men and women, psychotic bipolar disorder, and nonpsychotic bipolar disorder in men and women.
Cannabis use disorder was associated with higher risk for psychotic than nonpsychotic subtypes of bipolar disorder but not unipolar depression. Wrap It Up
This population-based cohort study found that Cannabis use disorder was associated with an increased risk of psychotic and nonpsychotic bipolar disorder and unipolar depression.
They say that These findings may inform policies regarding the legal status and control of cannabis use.
So, do what you will with the info. Don’t punish the messenger.
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….
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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