Chiropractic

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 11)

CF 325: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 11) Today we’re going to talk about “The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 11)” But first, here’s that sweet sweet bumper music     Today we’re going to talk about Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider But first, here’s that sweet sweet bumper music

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #325 Now if you missed last week’s episode, we talked about Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I see the battle coming and I’m trying to build the walls. It’s tough to go from seeing 8-10 new VA patients every week down to seeing about 1 every 2 weeks. Plus they’re reducing their visits to acute conditions only when most of these folks are chronic. They’ve been hurting literally for decades for some of them.  So, yeah, the battle is approaching so I’m trying to build walls. Now, how do we do that? We stop being lazy about marketing and, I’m a Christian so I always believe that when one door is closed, another will open and the one that opens is usually better.  All big changes in my life and business has always been for the best. Even when I thought the changes were catastrophic. This one is inconvenient and it pisses me off a bit. I’d love to have a set it and forget it type of business but it’s just not and never will be.  It’s ups and downs every week so that’s what we’re doing. We’re riding the coaster and preparing for the decrease in our numbers that’s already here and that we know will continue to get worse before it levels off and before we get our marketing in full gear and get after it again before the VA started sending the vets to us.  Yep, fully engaged now. I’ll keep you updated.  I want to congratulate Dr. Steve Brown out in Gilbert, AZ on his new peer reviewed paper that came our recently. Steve is doing good work and trying to help chiropractors stay out of trouble on the smt stroke issue that we’re all having to deal with all of the time.  I’m putting the link to Dr. Brown’s paper right here in the show notes so go grab it and check it out. https://www.cureus.com/articles/239108-plausible-mechanisms-of-causation-of-immediate-stroke-by-cervical-spine-manipulation-a-narrative-review#!/ It may save your collective asses.  Now, due to this paper Steve has the predictable drivel coming from the philosophy wonks that have a stake in the game and that’s OK. He expects that. Heck he even might welcome it with a research-backed response of his own. But, if one looks deeper than the detractors seem to have the brain space to do, his paper pretty much protects us. If we read it, we can prevent dissections most times and, should a pt. Try to state we’re responsible for a VAD the next few days or weeks after an adjustment, his paper provides some protection.  Then, about the same week, we had a knucklehead present a case study called, “Myositis Ossificans Traumatica of Bilateral Sternocleidomastoid Muscles After Chiropractor Adjustment: A Case Report” by Felix et. Al in Cureus where they implied heavily that a chiropractic adjustment was the cause of the myositis ossificans.  I’m going to leave the link here in the show notes at chiropractiforward.com under episode 325.  https://www.cureus.com/articles/234594-myositis-ossificans-traumatica-of-bilateral-sternocleidomastoid-muscles-after-chiropractor-adjustment-a-case-report#!/  I hope you’ll go to the link, scroll down to the comments and watch Dr. Brown chime in and systematically tear this crap paper apart and watch the authors basically apologize and promise to make the necessary changes.  The moral of the story is this; research isn’t here to hold us back and tear us down. It’s here to defend us, make us better, and provide more and more validity as we increase our knowledge base. That’s why I’m here. That’s why Dr. Steve Brown and so many others are here.  One of the biggest hits I see our profession take online is that we’re all quacks because the profession was founded by a belief and a magnetic mystical healer. True as that may be, the medical field once had blood letting, leaches, and lobotomies.  Research pulled them together and out of the catacombs and research will and is doing the same for us as chiropractors. I promise when research came out proving blood letting useless, there were still those that had used blood letting for decades fighting the research, attacking and discrediting the research and researchers, and doing everything they could to clutch their pearls and maintain their box of safety.  All I can say is that flat Earthers will do flat earth stuff and you can’t tell or show them anything differently. Moon landing deniers…….good luck convincing them otherwise. When a certain dogma has taken over and defined one’s life, you can’t and won’t change it.  But that will never stop new thinking, research, and forward movement.  Item #1 We are continuing the series on why the hell the WHO would recommend SMT at very low confidence which, if you’ve been following along, is the same level of confidence they give ultrasound. Well that’s BS and I went and found all of the papers they used to make this determination and we’re going through each and every of them trying to form and impression of our own.  The first one today is called, “United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care” by UK BEAM Trial Team, published in British Medical Journal in December of 2004.  UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004 Dec 11;329(7479):1377. doi: 10.1136/bmj.38282.669225.AE. Epub 2004 Nov 19. PMID: 15556955; PMCID: PMC535454. Remember, the citations can be found at chiropracticforward.com under this episode.  Why They Did It To estimate the effect of adding exercise classes, spinal manipulation delivered in National Health System or private premises, or manipulation followed by exercise to “best care” in general practice for patients consulting with back pain. How They Did It Pragmatic randomised trial with factorial design. Setting: 181 general practices in Medical Research Council General Practice Research Framework; 63 community settings around 14 centres across the United Kingdom. Participants: 1334 patients consulting their general practices about low back pain. Main outcome measures: Scores on the Roland Morris disability questionnaire at three and 12 months, adjusted for centre and baseline scores. What They Found
  • All groups improved over time. 
  • Exercise improved mean disability questionnaire scores at three months by 1.4 more than “best care.” 
  • For manipulation the additional improvement was 1.6 at 12 months. 
  • For manipulation followed by exercise the additional improvement was 1.9 at three months and 1.3 at 12 months. 
  • No significant differences in outcome occurred between manipulation in NHS premises and in private premises. 
  • No serious adverse events occurred.
Wrap It Up Relative to “best care” in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months. Item #2 The second one is called, “Effect of Spinal Manipulative and Mobilization Therapies in Young Adults With Mild to Moderate Chronic Low Back Pain: A Randomized Clinical Trial” by Thomas et. Al published in JAMA Network Open in August 2020 Thomas JS, Clark BC, Russ DW, et al. Effect of Spinal Manipulative and Mobilization Therapies in Young Adults With Mild to Moderate Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2020;3(8):e2012589. doi:10.1001/jamanetworkopen.2020.12589 Why They Did It Low back pain (LBP) is one of the most common reasons for seeking medical care. Manual therapy is a common treatment of LBP, yet few studies have directly compared the effectiveness of thrust (spinal manipulation) vs nonthrust (spinal mobilization) techniques. To evaluate the comparative effectiveness of spinal manipulation and spinal mobilization at reducing pain and disability compared with a placebo control group (sham cold laser) in a cohort of young adults with chronic LBP. How They Did It This single-blinded (investigator-blinded), placebo-controlled randomized clinical trial with 3 treatment groups was conducted at the Ohio Musculoskeletal and Neurological Institute at Ohio University from June 1, 2013, to August 31, 2017.  Of 4903 adult patients assessed for eligibility, 162 patients with chronic LBP qualified for randomization to 1 of 3 treatment groups.  Recruitment began on June 1, 2013, and the primary completion date was August 31, 2017.  Data were analyzed from September 1, 2017, to January 20, 2020. Participants received 6 treatment sessions of 
  1. spinal manipulation, 
  2. spinal mobilization, or 
  3. sham cold laser therapy (placebo) during a 3-week period.
What They Found Coprimary outcome measures were the change from baseline in Numerical Pain Rating Scale (NPRS) score over the last 7 days and the change in disability assessed with the Roland-Morris Disability Questionnaire 48 to 72 hours after completion of the 6 treatments. A total of 162 participants with chronic LBP were randomized.  Fifty-four participants were randomized to the spinal manipulation group, 54 to the spinal mobilization group, and 54 to the placebo group.  There were no significant group differences for sex, age, body mass index, duration of LBP symptoms, depression, fear avoidance, current pain, average pain over the last 7 days, and self-reported disability.  At the primary end point, there was no significant difference in change in pain scores between spinal manipulation and spinal mobilization, spinal manipulation and placebo, or spinal mobilization and placebo.  There was no significant difference in change in self-reported disability scores between spinal manipulation and spinal mobilization, spinal manipulation and placebo or spinal mobilization and placebo.   Wrap It Up In this randomized clinical trial, neither spinal manipulation nor spinal mobilization appeared to be effective treatments for mild to moderate chronic LBP 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.      Today we’re going to talk about Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      

Over Manipulation Syndrome

CF 305: Over Manipulation Syndrome

Today we’re going to talk about Over Manipulation Syndrome But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are 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 #305 Now if you missed last week’s episode , we talked about  Interesting Thoughts On Low Back & Degenerative Cervical Myelopathy. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I skipped last week because I was at the MCM Mastermind. Dr. Kevin Chritstie’s group that I’m a part of. We met in Orlando. What a great trip. The kids went with us and I did the Mastermind meeting and then had a day and a half to hit Disney and hit it we did.  We killed ourselves trying to see everything. While that’s impossible, we did see a lot and had a great time. The Harry Potter stuff at Universal is legit folks. Crazy. The Star Wars stuff at Hollywood Studios is incredible. And the Avatar stuff at Animal Kingdom is cool as hell. I’m just saying.  I’ll add that we went about 10 years ago and I hated it. I hated all of it. This time, for whatever reason, was better. I didn’t absolutely hate it. I actually enjoyed most of it. Maybe because the kids are older and don’t have to be watched. Maybe I just knew more about what to expect. I’m not sure. But it was a good time had.  On the Mastermind…..I got some good tidbits and nuggets out of it and had a great time reconnecting with my tribe. These are my people and I can’t tell you how much we enjoy each other. We learn as much from each other at the bar or eating together than we learn from our speakers.  Our Mastermind is full but Dr. Christie started another Mastermind that has openings. If you are at all interested, I cna’t encouurage you enough to email Dr. Christie at drkchristie@gmail.com and see if you can sneak into his new group. Next year they’ll be meeting in San Diego, Denver, Phoenix, and Jackson Hole, Wyoming. All great places to hang out, learn, and network.  Alright, Happy Thanksgiving. Let’s hop into the research.  Item #1 This isn’t really a research paper we’re going to cover here. This is more a conglomeration to demonstrate something I’ve gotten a lot of push back on in private conversations with other chiropractors over the years. Let me start by saying that I Donn’t want to take money out of Chiros’ pockets. The evidence based folks should be mostly fine with what I’m going to talk about today because they’re not doing crazy stuff.  The more non-evidence based folks aren’t going to like this discussion at all. All I can say is that when someone making the right decision affects their financial status, well, you just never know what you’re going to get.  First thing….I’m not about to advocate not adjusting your patients. The adjustment is the cornerstone of my practice for more than 25 years. What we’re going to talk about, over manipulation syndrome or spinal instability, was never for any reason in any shape, form, or fashion on my radar screen before getting the Neuromusculoskeletal medicine diplomate and diving into ChiroUp.  Let’s start with a personal story. I went to the chiropractor first when I was hurt as a freshman in high school. I was hurt badly and nobody else helped me. After months of pain, my mom took me to the local chiro and in two weeks you’d never know I was hurt.  That’s why I ended up becoming a chiropractor in the first place. While that experience was life changing, it also led to my buddy and I being all cool and popping our own necks all of the time. It was hard to do at first. I really had to use both hands and really crank on it to get that pop noise we all covet so much.  But then, after some time of constantly self-adjusting my neck, it got easier. And easier, and easier. To the point that I could just turn my neck and it would pop incidentally for no reason at all. And if I didn’t pop it, it would get irritated and feel like it needed to pop all of the time.  I had created instability by self-adjusting all of the time.  Our spine wants to be stiff and solid without that extra movement. But I had created extra movement consistently enough that I had loosened all of those tiny muscles and connective tissues. As a compensation, because our spine wants stiffness and stability, the larger postural muscles stiffened up to try to make up for all of those tiny ones that went lax and lazy.  So, that sets up a neck that is stiff but hypermobile. You can share this with all of your self-adjustors if you like.  Anyway, that brings up two thoughts:
  1. When you have an older person, discs degenerate, connective tissue gets loosened through manual labor, people have had injuries, or something issues like Elhers Danlos have started to aggravate…..hypermobility starts to take hold
  2. When you have patients that have been going to chiropractors repeatedly over the years, you can create hypermobility where there was none. Like my time self-adjusting. I’m not talking about responsible and appropriate adjusting like you do with a limited, condition focused treatment plan. I’m talking about, “I need to see you once a week for the rest of your life to treat your immune system and help you avoid cancer.” Or, I need to see you 76 times and 10 sets of x-rays this year to make sure you have the right, perfect degree curvature in your neck. As common sense would dictate, this is probably going to be more common with more aggressive adjusters. 
I’ll tell you that I’m out on the cliff a bit on this topic if I’m being honest. When you go searching, you’ll find Over Manipulation Syndrome. But, it’s not a huge topic with 100’s of articles.  One of them is at hur911injurycenters.com, probably not a chiro friendly page if I’m just guessing. They say, “Over-manipulation syndrome can be caused through self-manipulation as well as through high-velocity adjustments from a chiropractor. If you or a chiropractor have over-manipulated a joint through high-velocity treatments, you might experience damage to the ligament structures. This damage can lead to joint instability and worsening of hypermobility.” One I found is by Dr. Mark Saracino, a Board Certified Chiropractic Neurologist from Pennsylvania. I will put the link to his thoughts in the show notes for you.  Dr. Saracino starts out with a funny/not so funny joke, ““How many Chiropractors does it take to change a light bulb?” Answer: “Just one, but it takes 56 visits!”  https://drsaracino.com/PDFs/INFO/TooManyChiropracticVisits.pdf He says, “To my knowledge, no studies have shown that manipulations, once a month or more, are harmful. Just as dependencies on unnecessary drugs and surgeries should be avoided, patients should not become dependent on frequent manipulations- no more than 6 per year to the same spinal bone. Spinal manipulation is an important, but small part of a chiropractic neurologist’s treatment capabilities. It should be employed as infrequently as possible.” I want to go on record here and disagree with him on that point. If he thinks that 6 adjustments with exercises are going to get some of the veterans I see from the VA out of pain after suffering for 40 years…..well, trust me…..6 adjustments Ain’t gettin it done. He’s got a bias. He’s being a proponent of all of the magic outside of an adjustment that a chiropractic neurologist can perform. So I just disagree on that one point.  But I do agree with the point of avoiding unnecessary consistent and frequent adjustments.  To further clarify, there are some suffering from high impact chronic pain, which is chronic pain with an associated disability. They will never be free of pain and seem to only do well seeing a chiropractor every other week or so on a pain management basis. Then, there is a group called Caring Medical in Florida. They also have a bias. They specialize in prolotherapy to tighten lax ligaments. So, it makes sense they’re going to highlight Over Manipulation Syndrome. That doesn’t make them wrong. But I’m being honest as I can be on this. They have a bias and it should be noted.  I’ll put the link in the show notes as well.  https://www.caringmedical.com/prolotherapy-news/manipulation-syndrome-oms/#:~:text=Over-manipulation syndrome is a,or manipulation by a practitioner. Ross Hauser, MD says from the top of the article, “Over-manipulation syndrome is a condition characterized by chronic pain of the joints or vertebrae from instability due to ligament laxity that is caused by excessive self-manipulation or manipulation by a practitioner.”  To keep from pissing everyone off, he says, “In our opinion, a good chiropractic or osteopathic physician is an invaluable asset to a person’s health and care. Many cases of chronic pain, headaches and health ailments can be resolved with manipulation. Yes, overly aggressive spinal manipulation can be the cause of spinal instability, but when done correctly it can cause immediate (or quick) relief of symptoms.” And more to the point I’m making, “We see a large number of hypermobility cases where the patients present with a history of excessive chiropractic manipulations. A short course of manipulation to relieve pain or tension is understandable. However, patients who sign up for long-term chiropractic packages that include thrusting manipulations often find themselves even more unstable after the treatment course. Good chiropractors treat each patient individually and conservatively.” I agree. Reminder – I’m not advocating not adjusting your patients. The adjustment is the cornerstone of my practice for more than 25 years. I’m not advocating only adjusting your patients 6 times per year.  What I am advocating AGAINST….is long, extended, ongoing, maybe never ending treatment protocols to try to treat pain. When what you may be actually doing is causing a greater problem called instability and hypermobility by over manipulating and loosening the structures that hold the spine tight.  How much is too much? Who the hell knows? Certainly not me. Everyone is different, different ages, different work loads, different injuries throughout the years, different chiropractors over the years, etc.  But if all you’re doing is identifying ‘subluxations’ and knocking down the high spots without also considering instability or hypermobility, then you’re at risk of doing your patients and injustice and potentially making them actually worse.  If they already have hypermobility, what good are more adjustments and mobility really going to do for that particular area of their spine? Not much in my opinion. Why not think outside of the box a little and try stabilizing and strengthening the spot instead of mobilizing it? For neck instability, try a contraption called The Iron Neck. It’s great at strengthening the neck in a 360 degree way. It’s outstanding and I’m not sure there is a better strategy out there for neck stability.  For low back instability, we use McGill’s Big Three and add Dead Bug which is also ChiroUp’s protocol for L-sp instability.  If you don’t know how to look for and test for spinal instability, one of the clues for the low back is that it hurts to roll over in bed. Also, sometimes these people bend over to grab something and get a ‘catch’ or a ‘locked up’ back when trying to stand up from that position. They kind of have to work out of it to finally stand up.  With the low back, you can have a patient prone on their stomach. If it hurts when you palpate the l-sp facets, have them do a ‘superman’ position with their legs straight and lifted backward off of the table. If you palpate again while they’re in that position and it feel better, then you are likely looking at a instability patient. When you stabilize that region and palpate it and it feels better, the back is telling you it has too much mobilization and needs stabilization instead.  Simple sudden movements can hurt as well. The Space Mountain ride fired up the instability in my neck last week. It jerked me around on the roller coaster when it was dark and I couldn’t brace or see what was in front of me.  So there you have it. I’ve had some of the smartest chiros in the evidence-based realm tell me I’m crazy. That chiropractors absolutely cannot create spinal instability. I know that for so many, it’s a completely new thought process but I ask that you seriously give it consideration.  How is it that self-adjustors, like I once was, can create instability from adjusting too much but a chiropractor somehow cannot? I’ll also share that I have no bias on this deal. In fact, advocating against constant, frequent, adjusting does me no good whatsoever considering the adjustment is the literal cornerstone of my clinic. I have zero bias. I just follow research, I read, I observe, I talk to others, and I have personal experience and I’m telling you flat out – some patients will do better with strengthening and stabilization because they’re already got too much mobilization and the wrong chiropractor can potentially be the cause of that hypermobilization.  Convince me I’m wrong at dr.williams@chiropracticforward.com. I’d love to hear your thoughts on this topic. I think it’s important.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as  it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Headaches In Kids & Multiple Myeloma Research

CF 290: Headaches In Kids & Multiple Myeloma Research

 

Today we’re going to talk about Headaches In Kids & Multiple Myeloma Research

 

But first, here’s that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.

 

We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers.

 

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

 

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

 

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

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
  • Then go Like our Chiropractic Forward Facebook page,
  • Join our private Chiropractic Forward Facebook group, and then
  • Review our podcast on whatever platform you’re listening to
  • Last thing real quick, we also have an evidence-based brochure and poster store at com

 

You have found yourself smack dab in the middle of Episode #290

 

Now if you missed last week’s episode, we talked about motor control stiffening and spinal manipulation and the vertebral artery. Make sure you don’t miss that info. Keep up with the class.

 

On the personal end of things…..

Hey, hey, everyone! Welcome – we’ve got a rather interesting topic to dive into, and it’s a bit personal, I must admit.

 

You see, in the world of chiropractic, we have our colleagues we love and then we have the ones we love to gripe about. But what happens when a fellow chiropractor goes completely off the rails and starts attacking others not only professionally, but personally as well? Strap in, folks, because today we’re talking about hate and about handling professional turbulence and keeping your cool in the face of what I perceive to be a sheer craziness.

 

So, picture this – there I am one night at home, minding my own business after a long hard day at work, scrolling on Facebook when I get tagged in a post. It’s brought to my attention out of nowhere that another chiropractor that will go unnamed here, got some hurt feelings by something I said somewhere in almost 300 podcast episodes and posted a hit piece on me that was full of absolute vitriol and hate. It was disgusting. Especially from someone that wants desperately to be a leader for the profession.

 

Certainly considering that I’ve never met the dude in my life. Never shared an email exchange, text, wave, no contact in my 25 years of being in the profession. These really seemed to be some hurt feelings here. This guy decided to unleash a barrage of attacks directly on me that came out of left field because I have never, nor will I ever, attack him, or one of his sycophants, directly by name, place, or person.

 

When I have ever discussed anti-vitalism, it’s in broad terms with no names or identifying factors. That’s intentional. I think it’s important to talk about ideas and why I support them or do not support them or why the evidence supports them or does not support them. But I have never found value in the idea of going after someone by name directly. That’s rude, hateful, it doesn’t demonstrate leadership, and it’s not the way I want to handle things personally.

 

This particular person doesn’t like when someone doesn’t support his brand of chiropractic. If someone says something against it, that person, so it seems, must be destroyed. There are lots of examples in his tabloid. It’s like he woke up and thought, “You know what would be a great idea? I’d like to try ruining someone’s reputation and potentially their license because they don’t agree with me!”

 

Regardless of the work people have put into their careers. Trust me, I’m not the first nor will I be the last to suffer these attacks from this tabloid. This person is on a mission that he thinks is vital at all costs. Regardless.

Now, I’m all for spirited debates and discussions within our profession. It’s healthy, it keeps us sharp, and ultimately benefits our patients and the profession. But attacking someone personally and professionally? Come on, man! We’re supposed to be helping people live better lives and making better doctors of chiropractic, not creating chaos! I mean honestly, it’s astonishing the depths that he went on this deal.

 

I’ve had my moments of frustration, just like anyone else. But I firmly believe that the best way to handle situations like these is with grace and professionalism. Let’s face it, we’re human – emotions can run high. But when someone goes “off the rails” as I like to put it, well, that’s a whole other level of… shall we say, “interesting.”

 

So, what did I do in the face of this unprovoked direct attack? Well, I took a step back, breathed deeply, and reminded myself why I got into this field in the first place. It’s all about helping people lead healthier, happier lives. And if I let someone else’s negativity derail me, then I’m not doing justice to my calling. Then, I called my lawyer who, after reading it, simply couldn’t believe someone would have the gall to write that hit piece but then recommended I let it go for now unless I suffer a personal or professional loss.

 

Because, without one single doubt, several points made at my cost in the hit piece were taken out of context and sensationalized for shock value and to, in my opinion, do nothing more than make me look like a fool and try to discredit me at every turn and on every level. And trust me, there are plenty of our colleagues that are sycophants of this guy that will think just that and believe every word. For example, it was claimed that I advertised I was the best chiropractor in Amarillo when you cannot advertise superiority. Even included a screenshot of a video I posted. But failed to mention that the video was announcing that I was voted Best Chiropractor in Amarillo. Two years in a row as a matter of fact. An accomplishment I’m very proud of.

 

Which I am more than able to post about winning. As many times as I damn well want to post about it. That context was absent from the hit job. When things are deliberately taken out of context and sensationalized in such a manner to attack and result in a personal or professional loss…..well then…legally…..the game changes, doesn’t it?

 

Getting back to it….It’s not always easy to maintain composure when you’re faced with such attacks. But I realized that responding in kind would only perpetuate the negativity. So, I’m choosing a different path – I’ve continued to focus on my patients, on my podcast, on my leadership duties, and on improving myself and my message. I do not plan on having a tick for tat running discussion going on this. He done his damage and I suspect it’ll end right there. I certainly recommend that it does.

 

As they say, ultimately, the best revenge is success. While this unnamed individual may be busy spewing negativity and trying to destroy anyone that disagrees with his brand of chiropractic, I’m busy promoting my brand of chiropractic without the personal and direct attacks on my colleagues. It seems like the ones that want to convince others that they aren’t somehow crazy and maniacal, are always the ones out there doing the crazy things. The crazy things that just go to prove everyone’s point.

 

So, what’s the takeaway from all of this? Well, first and foremost, keep your cool when faced with attacks, whether they’re personal or professional. Do what you can to get effective counsel and rise above the chaos and stay true to yourself and your purpose. I know who I am and I know damn well what I stand for – as do any of you who listen regularly or know me personally. And, Hey….I’m a big boy. Literally and figuratively. I can take it and I suppose if you’re going to take a stance and fight for the things you believe in, you have to be ready for the punches from the trolls. I wasn’t expecting it. But I am now.

 

And secondly, let’s all remember that in the grand scheme of things, we’re here to make a positive impact on the world, not engage in hate or destroying someone personally just because we happen to not agree with them. It’s shameful, desperate, and embarrassing. Hate is going to hate and we can’t change that so we might as well get busy living and doing what we can to be a positive change and a positive force for those around us that love us and have faith in our ideas and in our leadership.

 

 

Item #1

 

The first on today is called “Potential effect modifiers for treatment with chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7–14 years: development of and results from a secondary analysis of a randomised clinical trial” by Susanne Lynge, Werner Vach, Kristina Boe Dissing & Lise Hestbaek and published in Chiropractic & Manual Therapies and on 11 July 2023. Dayum. That’s hot.

 

Why They Did It

 

A recent randomized controlled trial (RCT) investigating the effect of chiropractic manipulation in 199 children aged 7–14 years with recurrent headaches demonstrated a significant reduction of number of days with headache and a better global perceived effect (GPE) in the chiropractic manipulation group compared to a sham manipulation group. However, potential modifiers for the effectiveness of chiropractic manipulation of children with recurrent headaches have never been identified.

 

The present study is a secondary analysis of data from that RCT and will investigate potential effect modifiers for the benefit of chiropractic manipulation for children with headache.

 

How They Did It

 

Sixteen potential effect modifiers were identified from the literature and a summary index was prespecified based on clinical experience. Relevant variables were extracted from baseline questionnaires, and outcomes were obtained by means of short text messages. The modifying effect of the candidate variables was assessed by fitting interaction models to the data of the RCT. In addition, an attempt to define a new summary index was made.

 

 

What They Found

 

The prespecified index showed no modifying effect. Four single variables demonstrated a treatment effect difference of more than 1 day with headache per week between the lower and the upper end of the spectrum: intensity of headache (p = 0.122), Frequency of headache (p = 0.031), sleep duration (p = 0.243), and Socioeconomic status (p = 0.082).

 

Five variables had a treatment effect difference of more than 0.7 points on the GPE scale between the lower and the upper end of the spectrum: Frequency of headache (p = 0.056),

Sport activity (p = 0.110),

Sleep duration (p = 0.080),

History of neck pain (p = 0.011), and

 Headache in the family (0.050).

 

A new summary index could be constructed giving highest weight to History of neck pain and Headache in the family and Frequency of headache. The index suggests a difference of about 1 point in GPE between low and high values of the index.

 

 

Wrap It Up

 

Chiropractic manipulation offers a moderate benefit for a broad spectrum of children. However, it cannot be excluded that specific headache characteristics, family factors, or a history of neck pain may modify the effect. This question must be addressed in future studies.

 

 

Before getting to the next one,

 

Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.

 

When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.

 

 

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

 

 

Item #2

 

Our last one this week is called, “An experimental treatment developed at Israel’s Hadassah-University Medical Center has a 90% success rate at bringing patients with multiple myeloma into remission.” by Judy Siegel-Itzkovich and published in The Jerusalem Post on MAY 29, 2023. Hot potato!

 

Why They Did It

 

The researchers and medical professionals at Hadassah-University Medical Center in Jerusalem’s Ein Kerem developed the innovative treatment for multiple myeloma cancer because it is a significant medical challenge. Multiple myeloma is the second-most common hematological disease and has long been considered incurable, with a poor life expectancy for patients. The motivation behind this research was to find a groundbreaking solution that could improve the prognosis and quality of life for patients suffering from this type of cancer.

 

How They Did It

 

The treatment is based on genetic engineering technology known as CAR-T (Chimeric Antigen Receptor T-Cell Therapy). The process involves the following steps:

 

Apheresis: Blood components are collected from the patient, and the T cells (active cells in the immune system that can fight tumors) are isolated.

 

Genetic Engineering: A genetic segment that encodes a receptor against cancer cells is added to the T cells using a virus.

 

Injection: The engineered T cells are then injected back into the patient’s body.

 

Targeting and Destruction: The engineered T cells target the tumors and destroy the cancer.

 

 

What They Found

 

According to the article, more than 90% of the 74 patients treated at Hadassah with the CAR-T therapy went into complete remission. This represents a highly successful response rate and a significant improvement in the prognosis for patients with multiple myeloma. The treatment also showed minimal side effects, making it even more promising for patients’ well-being.

 

 

Wrap It Up

 

The researchers and medical professionals at Hadassah-University Medical Center have achieved an unprecedented breakthrough in the treatment of multiple myeloma cancer using CAR-T therapy. This innovative approach, based on genetic engineering technology, has shown remarkable success in achieving complete remission for the majority of patients treated.

 

The treatment offers hope to those suffering from a disease that was once considered incurable, greatly improving their life expectancy and quality of life. Moreover, by significantly reducing the cost of the treatment, Hadassah has made it more affordable and accessible to a larger number of patients in Israel and around the world.

 

The success of this treatment could pave the way for the development of future treatments using CAR T cells for other types of cancer as well. The researchers’ efforts represent a major achievement in the field of oncology and immunotherapy, with the potential to revolutionize cancer treatment worldwide.

 

 

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

 

 

Store

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

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

 

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

 

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.

 

And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

 

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

 

That’s Chiropractic!

 

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.

 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.

 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.

 

Connect

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

 

Website

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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

Where To Adjust & Types Of Adjustments

CF 265: Where To Adjust & Types Of Adjustments

 

Today we’re going to talk about knowing where to adjust and different types of spinal manipulation

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.   We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers.   I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.   Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com   If you haven’t yet I have a few things you should do.

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
  • Then go Like our Chiropractic Forward Facebook page,
  • Join our private Chiropractic Forward Facebook group, and then
  • Review our podcast on whatever platform you’re listening to
  • Last thing real quick, we also have an evidence-based brochure and poster store at com

 You have found yourself smack dab in the middle of Episode #265   Now if you missed last week’s episode, we talked about potential early diagnosis of spondylolysis as well as clinical guides on low back pain treatment.

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

On the personal end of things…..

Alright folks, I just got back from Fort Lauderdale hanging out with my MCM Mastermind family of chiropractors. What a good time. We have some new practitioners in the group. Fresh blood! New docs to learn from and new docs to teach.   It’s such a diverse group but all evidence-based. No vitalistic voodoo. Which is why it’s the right spot for me.   We learned from Ray Tuck. Now, Ray has around 9 clinics and his talk was about being the CEO of your company and let’s face it, I’m the worker mule in mine so it hit home with me and gave me some inspiration and some great ideas.  

If you’ve been following along with the podcast, I’ve had a hell of a Fall this year. Numbers down, staffing issues, two deaths in the family…..just lots of stuff piling up that isn’t normally part of our existence.   On the staffing stuff, I lost my office manager that’s been with me 5 years. That was 3 weeks ago. Then, her bestie that works for me quit. That was 2 weeks ago. Then, while I was in Florida, their other bestie that works here sent me a text. It was a Friday night and she decided that she had just completed her last day of work. No two weeks notice. I guess that would show too much respect or gratitude. Lol.   Anyway, if you’re keeping count, that’s 3 employees gone in 3 weeks. I only have 4 full timers to start with. To say it’s a challenge this week is to minimize things. It’s a big thing.  

BUT I have a super hero wife who is here today and who is killing it just like she kills anything she does. I’ve been slow since September. I’ll promise you, with my wife up front, I’m going to be so busy I’m not going to know what the hell to do with myself.   Then, we have two new girls. One is on her 3rd week here and one is on her 2nd week here. We just ran about 32 in one morning and they knocked it out of the park.   So……the story is, we’re OK and if you have a lot of turnover, you’re going to be OK.

We can only do our best. I’ve done everything I know to be good to my staff, treat them like my family, be so good to them and foster an environment that is so fun and positive that they’d never dream of leaving.   Yeah, that doesn’t work. I am who I am. I’ll always treat my people well and take care of them and feel protective of them.

But no more backflips trying to hold onto people. Not anymore. There are so many lessons available to us if we just make sure we’re paying attention.  

That’s the negative. The positive is this; I have a true opportunity to re-set. To put my values and culture out there for the new staff to buy into and understand. I can cultivate what I want this place to always be without any old baggage preventing the message from hitting home.  

What are my values? I’m glad you asked:

  • Customer Service
  • Evidence based
  • Patient centered
  • Honesty
  • Ethical
  • Morals
  • Character
  • Trustworthiness
  • Authentic
  • Kind
  • Supportive
  • Responsible
  • High level
  • Family and
  • Loving

  It’s vital this new crop of staff members understand these things. Understand who we are as owners.   Another thing I learned from Ray Tuck this weekend is don’t be afraid to open up the books and show your staff. You don’t have to show what you’re making each year or any of that but make sure they understand that you’re not buying a yacht while you bitch at them about the things you need from them. Show them your margins are much thinner than they might have imagined.

It has an impact on them.   Also, we are considering hiring two part-timers rather than one full-timer. That will cut down on burn out, they’ll get to see their kids more, they can cover each other’s shifts, and if one quits, there is built-in redundancy to prevent any freak outs. The one staying can simply train the next part timer. Sounds like a solid solution to me. That right there is one benefit of being in a mastermind. Smart people giving you thoughts that are a little out of the box but that are working for them.   So, with my wife in control until new hires are up to speed, we about to kill it and you’ll all be happy to never hear me bellyaching about having a light schedule. Lol.    

Item #1  

The first on today is called, “Review of methods used by chiropractors to determine the site for applying manipulation” by Triano et al and published in Journal of Chiropractic & Manual Therapies on 21 October 2013.   Why They Did It   The authors did the study to evaluate the literature on the validity and reliability of the more common methods used by doctors of chiropractic to inform the choice of the site at which to apply spinal manipulation.  

How They Did It  

  • Structured searches were conducted in Medline, PubMed, CINAHL and ICL, supported by hand searches of archives,
  • The quality of evidence was ranked using QUADAS for validity and QAREL for reliability, as appropriate.

  What They Found  

  • A total of 2,594 titles were screened from which 201 articles met all inclusion criteria. The spectrum of manuscript quality was quite broad, as was the degree to which the evidence favored clinical application of the diagnostic methods reviewed.
  • The most convincing favorable evidence was for methods which confirmed or provoked pain at a specific spinal segmental level or region.
  • There was also high-quality evidence supporting the use, with limitations, of static and motion palpation, and measures of leg length inequality.
  • Evidence of mixed quality supported the use, with limitations, of postural evaluation.
  • The evidence was unclear on the applicability of measures of stiffness and the use of spinal x-rays.
  • The evidence was of mixed quality, but unfavorable for the use of manual muscle testing, skin conductance, surface electromyography and skin temperature measurement

Wrap It Up  

  • A considerable range of methods is in use for determining where in the spine to administer spinal manipulation. The currently published evidence falls across a spectrum ranging from strongly favorable to strongly unfavorable in regard to using these methods.

 

  • In general, the stronger and more favorable evidence is for those procedures which take a direct measure of the presumptive site of care– methods involving pain provocation upon palpation or localized tissue examination.

 

  • Procedures which involve some indirect assessment for identifying the manipulable lesion of the spine–such as skin conductance or thermography–tend not to be supported by the available evidence.

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

Item #2  

Our last one this week is called, “Comparison of spinal manipulation methods and usual medical care for acute and subacute low back pain” by Michael Schneider and published in PubMed on February 15, 2015. Hot potato!    

Why They Did It  

This study was a comparative effectiveness trial of manual-thrust manipulation (MTM) versus mechanical-assisted manipulation (MAM); and manipulation versus usual medical care (UMC).  

How They Did It  

  • A total of 107 adults with onset of LBP within the past 12 weeks were randomized to 1 of 3 treatment groups: manual-thrust manipulation, mechanical-assisted manipulation, or usual medical care. Outcome measures included the Oswestry LBP Disability Index (0-100 scale) and numeric pain rating (0-10 scale).

 

  • Participants in the manipulation groups were treated twice weekly during 4 weeks; subjects in usual medical care were seen for 3 visits during this time. Outcome measures were captured at baseline, 4 weeks, 3 months, and 6 months.

 

What They Found  

  • Linear regression showed a statistically significant advantage of manual-thrust manipulation at 4 weeks compared with mechanical-assisted manipulation and usual medical care.

 

  • Responder analysis, defined as 30% and 50% reductions in Oswestry LBP Disability Index scores revealed a significantly greater proportion of responders at 4 weeks in manual-thrust manipulation (76%; 50%) compared with mechanical-assisted manipulation (50%; 16%) and usual medical care.

 

  • Similar between-group results were found for pain: manual-thrust manipulation; mechanical-assisted manipulation; and usual medical care. No statistically significant group differences were found between mechanical-assisted manipulation and usual medical care, and for any comparison at 3 or 6 months.

   

Wrap It Up  

It was found that manual-thrust manipulation provides greater short-term reductions in self-reported disability and pain scores compared with usual medical care or mechanical-assisted manipulation.     Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.  

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.   When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.   It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.   And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!  

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….   That’s Chiropractic!  

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.   Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.   We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  

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

Website https://www.chiropracticforward.com  

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

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

Twitter https://twitter.com/Chiro_Forward  

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

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

Player FM Link https://player.fm/series/2291021  

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

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

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

Bibliography

Schneider M (2015). “Comparison of spinal manipulation methods and usual medical care for acute and subacute low back pain: a randomized clinical trial.” Spine Feb 15; 40(4): 209-217.  

Triano, J. J., Budgell, B., Bagnulo, A (2013). “Review of methods used by chiropractors to determine the site for applying manipulation.” Chiropr Man Therap 21(36).      

5 Year Chiropractic Forward Roundup and All Time Top Ten Episodes

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

Today we’re going to talk about our 5 Year Roundup and we highlight the All Time Top Ten Episodes But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #260 Now if you missed last week’s episode , we talked about Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff. Make sure you don’t miss that info. Keep up with the class.  Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.  When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.

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

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

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

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

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

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

Ten Keys to Practice Success

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

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

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

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

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

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

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

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

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

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

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

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

We’ve had a good run so far and, for now, I plan to continue it as long as it’s fun and as long as you listen.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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

Website https://www.chiropracticforward.com

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

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

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      

Steps Per Day And Dementia & Vets And Chiropractic

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!

Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are 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: 

  1. Worst pain intensity from a numerical pain rating 0–10 scale, 
  2. 24-item Roland-Morris Disability Questionnaire (RMDQ); and 
  3. 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!

Chiropractic evidence-based products

Integrating Chiropractors

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

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

Website https://www.chiropracticforward.com

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

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

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

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!

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are 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. 

  1. Jay, where in the world are you today?
  2. 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?
  3. 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?
  4. 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?
  5. 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?
  6. What would you say has been your biggest obstacle you’ve encountered in your career and how were you able to resolve it?
  7. Tell me about your involvement with Clinical Compass. 
  8. 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?
  9. What, so far, has been your biggest impression or lesson or takeaway from the mastermind this year. 
  10. 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?
  11. What have been the biggest lessons you’ve learned in your career?
  12.   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!

Chiropractic evidence-based products

Integrating Chiropractors

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

 

The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

Player FM Link https://player.fm/series/2291021

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

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

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

Upregulated Central Nervous System & Shared Decision Making With The Patient

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!

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are 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!

Chiropractic evidence-based products

Integrating Chiropractors

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg

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

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

Website https://www.chiropracticforward.com

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

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

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.  

Benzodiazepines and Mirror Therapy

CF 238: Benzodiazepines and Mirror Therapy  In today’s episode, we cover Benzopdiazapines and Mirror Therapy  But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are 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 #238 Now if you missed last week’s episode , we talked about Chronic Pain and current thinking. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I usually type up the podcast ideas and outline on a Monday. Well, we were off this Monday for July 4th so I’m short a day this week which means that this personal happenings part of the podcast has to be short so I can make everything happen in this short week.  So here we go. I’m still on the hunt for an associate chiropractor. One who is a go-getter determined to be successful.

One that understands they can go to work for the Joint and get paid more currently. In the now and here. But there will be a cap and they will not be able to exceed that cap. One that understands that there is no cap with me. The more they bring in and grow the clinic and themselves, the more I want to take good care of them. Plain and simple. If that’s you, email me at creekstonecare@gmail.com.

I want to get to know you. 

I am getting ready and looking forward to being in Sarasota with the Florida MCM Mastermind for the weekend of July 22nd. It’s a good time of networking with my fellow mastermind people and helping each other build our businesses. Hell yeah. I thrive in masterminds. Even if I don’t necessarily have the time to implement everything I want to implement. I get inspiration, ideas, and actionable steps I can take almost immediately most of the time.  Lots of little tips and tricks and I learn as much or more from the Mastermind members outside of the classroom at the hotel bar as I learn in the classroom. If you’re interested in joining, send me a message, and let’s get you connected with Dr. Kevin Christie and hopefully get you plugged into the group ASAP. I mean really, we’re meeting in Sarasota on July 22nd and there’s still room for you but in November, we’re meeting a Playa Largo in Key Largo, FL. Everyone’s bringing their family too so you know you don’t want to miss that one. Reach out and let me help you get plugged in.  You have to be grossing $350,000 per year and growth-minded to play so holla.  Let’s get started today. 

Item #1

Our first one today is called “Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA” by Trager et. al. (Trager RJ 2022) and was published in BMJ Open on June 13, 2022. The sizzle…..it’s hot

Why They Did It

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

How They Did It Retrospective cohort study. National, multicentre 73-million-patient electronic health records-based network (TriNetX) in the USA 2003 – 2021

What They Found

  • Odds of receiving a benzodiazepine prescription were significantly lower in the CSMT cohort over all follow-up windows prematching and postmatching (p<0.0001). 
  • Sensitivity analysis suggested a patient preference to avoid prescription medications did not explain the study findings.

Wrap It Up

  • These findings suggest that receiving CSMT for newly diagnosed rLBP is associated with reduced odds of receiving a benzodiazepine prescription during follow-up. 
  • These results provide real-world evidence of practice guideline-concordance among patients entering this care pathway. 
  • Benzodiazepine prescription for rLBP should be further examined in a randomized trial including patients receiving chiropractic or usual medical care, to reduce residual confounding.

Before getting to the next one, I have to tell you, that Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s life 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

The last one today is called “3D augmented reality mirror visual feedback therapy applied to the treatment of persistent, unilateral upper extremity neuropathic pain: a preliminary study” by Mouraux et. Al. (Dominique Mouraux) and published in the Journal of Manual and Manipulative Therapy in 2017.

Why They Did It

The authors assessed whether or not pain relief could be achieved with a new system that combines 3D augmented reality system (3DARS) and the principles of mirror visual feedback.

How They Did It

Twenty-two patients between 18 and 75 years of age  All of whom suffered of chronic neuropathic pain.  Each patient performed five 3DARS sessions treatment of 20 mins spread over a period of one week.  The following pain parameters were assessed: 

  1. visual analogic scale after each treatment session 
  2. McGill pain scale and DN4 questionnaire were completed before the first session and 24 h after the last session.

What They Found

  • The mean improvement of VAS per session was 29%. 
  • There was an immediate session effect demonstrating a systematic improvement in pain between the beginning and the end of each session. 
  • They noted that this pain reduction was partially preserved until the next session. 
  • If we compare the pain level at baseline and 24 h after the last session, there was a significant decrease of pain of 37%. 
  • There was a significant decrease on the McGill Pain Questionnaire and DN4 questionnaire.

Wrap It Up

Our results indicate that 3DARS induced a significant pain decrease for patients who presented chronic neuropathic pain in a unilateral upper extremity.  While further research is necessary before definitive conclusions can be drawn, clinicians could implement the approach as a preparatory adjunct for providing temporary pain relief aimed at enhancing chronic pain patients’ tolerance of manual therapy and exercise intervention.

You can decide how well-related this is BUT, with phantom limb pain, in addition to cognitive behavioral therapy, they have treated using mirror 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!

Chiropractic evidence-based products

Integrating Chiropractors

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

 

The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Chronic Pain Talk & Thoughts

CF 237: Chronic Pain Talk & Thoughts Today we’re going to talk about one of my favorite topics; 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!

Chiropractic evidence-based products

Integrating Chiropractors

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

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are 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 #237 Now if you missed last week’s episode , we talked about how You Are What You Eat & Screen Time For Kids. Make sure you don’t miss that info. Keep up with the class. 

 the personal end of things…..

I just don’t have a lot to report on the personal end of things. We’re a little slower lately. I think it’s because gas prices are sky freaking high and you have to take out a small loan just to fill up your vehicle. I think it’s depressing for a lot of folks.  Any time there is confusion or uncertainty with the economy, people pull back. Understandably. Unfortunately, many see chiropractic as an extra and when people are trimming the budget, chiropractic, and healthcare in general, get trimmed and we take a hit.  I think that’s what’s up right now.

I’ve talked to a couple of my colleagues in the Dallas area and there are feeling the same dial-back in business. I am used to about 45-50 on a Monday. This week, we have 35. I don’t dig it. Especially when I know I’m marketing and doing the smart stuff. It’s discouraging.  But, at the end of the day, there are things out of our control, and rolling with the flow is all we can do. Be moral, ethical, honest, loving, evidence-based, and patient-centered, and treat people right. That’s what good and successful practices should consist of. Those build the base, the foundation of big things in life and in business. 

Before getting to the next one, 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 one is called “Manual physical therapy for chronic pain: the complex whole is greater than the sum of its parts” by Coronado et. al. and published in the Journal of Manual and Manipulative Therapy in 2017.  They say that “Manual physical therapists can effectively treat patients with chronic pain and other musculoskeletal disorders; however, the field is at a crossroads. The traditional approach to manual therapy assumes that proper technique selection and precise implementation is the primary driver of a successful outcome.  In this view, the resultant outcomes are directly attributed to the applied intervention. 

They go on, “We propose manual physical therapists will only be recognized as ideal providers for individuals with chronic pain if we accept an updated paradigm acknowledging the complexity of the manual physical therapy experience and accept the robustness of varying contextual elements inherent in our interactions. For some clinicians, this will require a revolutionary shift in their perception of the development, maintenance, and modulation of pain “

You may have heard me say that I’m teaching a 2-hour course called “Chronic Pain And The Upregulated CNS” and this paradigm shift isn’t anywhere near where it will need to be. The information I’m teaching is brand new to 90% of the providers from my experience.  “Pain is an experience orchestrated by dynamic sensory, cognitive, and affective processes and is strongly influenced by patient’s expectations (AKA Yellow Flags), mood, desires, and past experiences.

Limiting pain perception to a peripheral impairment is outdated and a more comprehensive, albeit complex, approach to manual therapy accounts for a myriad of interacting factors impacting chronic pain outcomes” “A comprehensive approach acknowledges the impact of patient and therapist factors, which not only include personal and condition-specific patient characteristics, but also the cultural biases, beliefs, and experiences of both the patient and therapist” “Additionally, this view acknowledges the interaction between patient and manual physical therapist, which may yield important outcome contributions, either directly (as in….what techniques we use) or indirectly (like addressing the yellow flags).” “Finally, this approach acknowledges the integration of targeted adjunct interventions such as psychosocial strategies and exercise that may (1) enhance the effectiveness of manual therapy for reducing the impact of pain, and/or (2) promote and maintain positive behavioral change”

We know that when people are sedentary, they have deeper depression, pain, and anxiety. Sleep issues and mood disorders. This is well-researched. On the other hand that movement and exercise reverse these things. Less depression, less anxiety, more fitness, better sleep, and less pain as the CNS becomes more comfortable with the movement and becomes more and more functional. 

Pain signals and signals of all sorts run through a filter before they are felt…..or not felt at all. That filter can amplify the signals or dampen them. It’s no longer a straight biomedical view we take. It’s the biopsychosocial construct we use to approach pain now and if we only look at the bio part, we are cheating our patients out of 2/3 of the effectiveness we could have for them.  In the end, if your CNS thinks it should hurt, it will. Regardless of whether there is tissue pathology or not. On the other hand, if your tissue is completely jacked up but the CNS determines there is no danger or threat, it will not hurt. Moseley and Butler lay it out straight like that in their book called Explain Pain. 

They say it’s as simple and as difficult as that. 

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

Store

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

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

Chiropractic evidence-based products

Integrating Chiropractors

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg

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

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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