Chronic Pain

Psychologically Treating Chronic Pain & Prenatal GLP-1 Safety

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

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

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Integrating Chiropractors

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

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

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

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

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

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

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

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

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

 

On the personal end of things…..

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

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

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

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

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

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

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

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

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

What’s up with your Monday? Lol

Item #1

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

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

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

Why They Did It

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

Wrap It Up

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

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

Item #2

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

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

Why They Did It

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

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

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

How They Did It

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

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

What They Found

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

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

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

Wrap It Up

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

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

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

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

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

Store

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

 

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

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

Who knew?

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

Item #1

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

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

 

Why They Did It

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

 

How They Did It

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

 

What They Found

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

 

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

 

Item #2

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

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

How They Did It

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

What They Found

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

Wrap It Up

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

You’re welcome!

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

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

 

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

 

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Chronic Pain Central Sensitization & Patient Barriers To Physical Therapy

CF 316: Chronic Pain Central Sensitization & Patient Barriers To Physical Therapy Today we’re going to talk about Chronic Pain Central Sensitization & Patient Barriers To PT and, I would argue….chiropractic care. But first, here’s that sweet sweet bumper music    

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

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #316 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 6).  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Man, we’re going through some stuff at the office recently and it centers around collections. Remember when I said last week that practice is a big long game of whack-a-mole? Well, it’s a fact and what I’m currently dealing with is really a ‘death by a thousand cuts’ type of scenario with one glaringly large issue.  The bright neon sign issue right now is collections. We are billing appropriately but the checks aren’t showing up. We’ve had such a struggle with in-house billing in the past. We lost hundreds of thousands on that years ago so we’ve moved to off-site billers. We are now on our 4th, I believe.  I think we’re in the right spot with this one. However, in the transition, our collections have taken a nose dive and I mean a nose dive. As in, if we billed out $70k+, we had a collections of $28k. Right. Now, carry that out over 3 months with that kind of deficit, your resources that are meant to cover issues start to vanish fairly rapidly.  Remember, I have an overhead of $55k-$60k/month. I remember when I was younger and newer in practice. At the time, my overhead was about $25k. I was talking to an older chiro buddy of mine at a TX Chiro Assoc event and he told me his overhead was $45k/month. And he wasn’t integrated either. It blew me away. I couldn’t imagine having an overhead that high.  And…..well here we are. With 4 full time employees, a full-time NP, an acupuncturist, and 2 massage therapists…..it just sort of happens. All of the medical supplies….holy cow. That’s a pretty penny, folks. Massage supplies, acupuncture needles, 4,000 sq ft. Office, utilities…you get the point. It adds up fast and if you’re not cognizant of what’s up, it’ll get out of hand on you. That’s why I balance my own bank account each month. I know what’s coming in and what’s going out.  It’s why I know that we have a collections issue.  Remember we have death by a thousand cuts, right? Well, other issues of late are that we aren’t performing and charging for codes we could be. We’re letting cold laser patients walk out the door without doing laser. We’re letting exercise patients exit the building without doing their exerrcises. This is happening with patients that are covered under PI or on their insurance plan for rehab.  That’s just a training issue and we’re whacking that mole currently.  Another issue is that we’re still recovering from COVID on some level. In 2019, I had 220 more new patients over the course of that year than I had in 2023. What the hell? So, we’re whacking that mole by ramping up some marketing and website SEO efforts.  I have a call with the collection company today at lunch and I have addressed the other issues. Now, if we can get it happening on the collections, you’ll get to hear happy Jeff in future episodes. Yay!! Why do I share this stuff with you? I like to think this is not just a research article podcast. This is real life. If you know the struggles I’m dealing with and the successes I’m enjoying, you’re either going through the same and can learn, or you WILL be going through the same and can learn from my experiences.  Even when you’re riding the wave of success, things can short circuit and you have to always be paying attention so that you can catch it as quickly as possible so you can avoid disaster. After years of not having to give finances much consideration at all, it’s time to lean on some folks that owe the clinic money, lean on our biller a bit, get ourselves in order, and market.  Easy peasy right? I’ll keep you posted on our progress. Don’t cry for me, Argentina! You’ll be mad at me soon because I’ll be back to seeing 70+ new patients per month. Wait for it. When you’ve got my attention, you’ve got my attention and I have a tendency to really lean in and get focused. That’s where we are right now. While I don’t recommend it, it is a bit exhilerating. I’ll admit.  Item #1 Our first one today is called, “Nociplastic pain and central sensitization in patients with chronic pain conditions: a terminology update for clinicians” by Nijs et. Al. published in Brazillian Journal of Physical Therapy in May of 2023 and that’s hot enough! Remember, the citations can be found at chiropractscforward.com under this episode.  Nijs J, Malfliet A, Nishigami T. Nociplastic pain and central sensitization in patients with chronic pain conditions: a terminology update for clinicians. Braz J Phys Ther. 2023 May-Jun;27(3):100518. doi: 10.1016/j.bjpt.2023.100518. Epub 2023 Jun 14. PMID: 37348359; PMCID: PMC10314229. Why They Did It Acute pain has been tremendously beneficial throughout evolution as it enables us to identify potential harmful stimuli, and as it ensures we protect damaged tissue while it heals.  However, once evolved into a chronic state, its protective role diminishes with a wide range of negative and maladaptive sequelae that massively impact both the individual and society.  Neuroscientific research has significantly advanced our understanding about pain and chronic pain in particular, including the role of central (nervous system) sensitization in the generation and amplification of (persistent) pain experiences. This knowledge innovation created a massive implementation potential but also a challenge for clinicians to remain up-to-date in daily practice.  Particularly the variety of and rapid change in concepts and terminology used can be challenging for clinicians. For these reasons, this second part of the comprehensive pain management editorial series1 provides a terminology update regarding central sensitization and nociplastic pain in a clinically applicable way.  Essentially, central sensitization is the major underlying mechanism of nociplastic pain, which is a pain phenotype. To facilitate the understanding of the concept of central sensitization, it is crucial to understand that central sensitization is a homeostatic mechanism. This implies, similar to inflammation, that central sensitization is adaptive in the short term (e.g., in the days following surgery or following a motor vehicle accident). As such, it avoids further deterioration in acute pain situations.  However, central sensitization becomes maladaptive in the long term, with pain losing its protective value as commonly seen in patients with persistent pain (e.g., months after successful surgery or a motor vehicle accident).  In addition, central sensitization and inflammation – although physiologically very divert mechanisms – share many features, including the notion that multiple biomarkers together rather than a single gold standard are required for assuming its presence, the fact that they are both umbrella terms covering various clinical & biological presentations, that their clinical presentation varies substantially from patient to patient, and that they are both key mechanism in a wide variety of clinical conditions/diseases The presence of clinical features of central sensitization predicts poor treatment outcomes in patients with a variety of chronic pain conditions, at least when the treatment targets local tissues as the presumed source of nociception.  This applies to conservative interventions, but also to surgical interventions. These observations illustrate the need for early recognition of central sensitization in patients with chronic pain, in combination with tailored treatment. Item #2 Our last one today is called, “Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review”’ by Dickson et. Al. and published in Pain Medicine in February 2024 and that one’ll burn your damn eye brows off.  Cameron Dickson, Rutger M J de Zoete, Carolyn Berryman, Philip Weinstein, Kexun Kenneth Chen, Paul Rothmore, Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review, Pain Medicine, Volume 25, Issue 2, February 2024, Pages 104–115, https://doi.org/10.1093/pm/pnad134 Why They Did It To identify and synthesize patient-related barriers to… and enablers of ….the implementation of high-value physiotherapy (HVP) for chronic pain.  Furthermore, to review what patient-related interventions have been used to facilitate the implementation of high-value physiotherapy for chronic pain, as well as their efficacy. How They Did It The authors systematically searched the APA PsycInfo, Embase, CINAHL, Medline, Scopus, and PEDro databases for peer-reviewed studies (published in English) of adults with chronic pain.  They used the Theoretical Domains Framework of behavior change to synthesize identified themes relating to barriers and enablers. Outcomes from studies reporting on interventions were also qualitatively synthesized. What They Found
  • Fourteen studies reported on barriers and enablers, 8 of which related to exercise adherence. 
  • Themes common to barriers and enablers included perceived efficacy of treatment, interrelationship with the physiotherapist, exercise burden, and the patient’s understanding of exercise benefits. 
  • Other barriers included fear of movement, fragmented care, and cost. 
  • Ten studies explored interventions, 9 of which aimed to improve exercise adherence. 
  • Of these, evidence from 4 randomized controlled trials of technology-based interventions demonstrated improved exercise adherence among intervention groups compared with controls.
Wrap It Up
  • Patients with chronic pain experience barriers to high value PT, including their beliefs, the nature of their interaction with their physiotherapist, perceived treatment efficacy, and cost. 
  • Enablers include rapport with their physiotherapist, achievable exercises, and seamless cost-effective care. 
  • Technology-based interventions have demonstrated effectiveness at increasing exercise adherence. 
  • Our findings suggest that interventions seeking to enhance implementation of high value PT, need to consider the multifactorial barriers experienced by patients with chronic pain.
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
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

Omnivorous vs Vegan & SMT For Chronic Neck Pain

CF 314: Omnivorous vs Vegan & SMT For Chronic Neck Pain Today we’re going to talk about Omnivorous vs Vegan & SMT For Chronic Neck Pain 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 #314 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 5).  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Let’s start by giving Dr. Steven Brown out in Gilbert, AZ a shoutout. If you listened last week, we had a paper that was just the abstract. It was a paper that the WHO is using in part to help them formulate their opinion that SMT is recommended but at very low confidence.  The paper used orthopedic manual physical therapy, whatever the hell that is.  “The protocol consisted of accessory mobilizations (posteroanterior), traction of the lumbar region, mobilization with movement in the coxofemoral joint, and global techniques of neural mobilization of the lumbar spine. The duration of the orthopedic manual physical therapy was 20–25 minutes per session.”  Dr. Brown says, “They did not get actual lumbar spine, SI joint, or hip manipulation at all. Just 20-25 minutes of mobilization.” So, there you have it from one of last week’s papers. I think as we go through them, it’s getting clearer and clearer that the WHO may have an agenda. Which chiropractors expect, honestly. When you have MDs running the show, they’re going to be super slow to promote SMT to the MainStage for anything. Using papers like we’ve been seeing to make their determination is just, quizzical. For lack of a better word. It’s perplexing when we know there is more current and more impactful research in favor of SMT.  Moving on this week, I just got back from Jupiter, FL and the MCM Mastermind with Dr. Kevin Christie, Dr. Brett Winchester, Dr. Lindsey Mumma, and many more. Florida wasn’t warm. It was in the 50s and 60s but we were in a classroom most of the time anyway. We had some fine dining at The Woods, which is Tiger Woods’ restaurant. No Tiger sightings but none were expected. Lots of Bentleys, Mercedes, Lambos, and the like. It’s always a little crazy in Florida when you consider the amount of money strolling around those towns.  Lots of great discussions, lots of thoughts and plans. Now to have the time to organize the thoughts and take action on them. One fun one came from my little friend, Dr. Tiffany Armstrong from Iowa. Her and her husband have a great practice out there and are adding a gym to the mix. Fun fun.  She was talking about Storybrand and what are your Big 3? She said patients and clients can’t really keep up with more than three things. It got me to thinking and here’s what I came up with:
  1. Pain Relief
  2. Function, Stability, Strength
  3. Performance Care
That’s why you join a mastermind. That was a little comment on a discussion that we had in class. Nothing game changing but enough to give me some clarity and direction with some things I’ve been wanting to tweak and change. Imagine how many of those little comments and conversations we have over the weekend.  Lots of direction this morning outside of the. Podcast so I’m hopping into it  Item #1 Our first one today is called, “Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial” by Landry et. Al and published in JAMA Network Open November 30, 2023. Kapow! It’s hottern’ a teapot! Remember, the citations can be found at chiropractscforward.com under this episode.  Landry MJ, Ward CP, Cunanan KM, et al. Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(11):e2344457. doi:10.1001/jamanetworkopen.2023.44457 Why They Did It Increasing evidence suggests that, compared with an omnivorous diet, a vegan diet confers potential cardiovascular benefits from improved diet quality (ie, higher consumption of vegetables, legumes, fruits, whole grains, nuts, and seeds).  The researchers wanted to compare the effects of a healthy vegan vs healthy omnivorous diet on cardiometabolic measures during an 8-week intervention. How They Did It This single-center, population-based randomized clinical trial of 22 pairs of twins randomized participants to a vegan or omnivorous diet (1 twin per diet).  Participant enrollment began March 28, 2022, and continued through May 5, 2022.  The date of final follow-up data collection was July 20, 2022.  This 8-week, open-label, parallel, dietary randomized clinical trial compared the health impact of a vegan diet vs an omnivorous diet in identical twins.  Twin pairs were randomized to follow a healthy vegan diet or a healthy omnivorous diet for 8 weeks.  Diet-specific meals were provided via a meal delivery service from baseline through week 4, and from weeks 5 to 8 participants prepared their own diet-appropriate meals and snacks. The primary outcome was difference in low-density lipoprotein cholesterol concentration from baseline to end point (week 8).  Secondary outcome measures were changes in cardiometabolic factors, plasma vitamin B12 level, and body weight. Exploratory measures were adherence to study diets, ease or difficulty in following the diets, participant energy levels, and sense of well-being. A total of 22 pairs of twins What They Found After 8 weeks, compared with twins randomized to an omnivorous diet, the twins randomized to the vegan diet experienced significant mean (SD) decreases in low-density lipoprotein cholesterol concentration, fasting insulin level, and body weigh Wrap It Up In this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet.  Clinicians can consider this dietary approach as a healthy alternative for their patients. Item #2 OK, the last one this week is called, “A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain” by Liu et. Al. published in Complementary Therapies in Clinical Practice in August of 2023 and it’s just hot enough! Zhen Liu, Jiao Shi, Yubo Huang, Xingchen Zhou, Huazhi Huang, Hongjiao Wu, Lijiang Lv, Zhizhen Lv, A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain, Complementary Therapies in Clinical Practice, Volume 52, 2023, 101751, ISSN 1744-3881, https://doi.org/10.1016/j.ctcp.2023.101751. Why They Did It An increasing number of people suffer from chronic neck pain due to increased telecommuting. Manual therapy is considered a safe and less painful method and has been increasingly used to alleviate chronic neck pain.  However, there is controversy about the effectiveness of manipulation therapy on chronic neck pain.  Therefore, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effectiveness of manipulative therapy for chronic neck pain. How They Did It A search of the literature was conducted on seven databases from the establishment of the databases to May 2022.  This study included RCTs on chronic neck pain managed with manipulative therapy compared with sham, exercise, and other physical therapies.  The retrieved records were independently reviewed by two researchers.  Further, the methodological quality was evaluated using the PEDro scale.  The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment was used to evaluate the quality of the study results. Seventeen RCTs, including 1190 participants, were included in this meta-analysis. What They Found Manipulative therapy showed better results regarding pain intensity and neck disability than the control group.  Manipulative therapy was shown to relieve pain intensity and neck disability.  However, the studies had high heterogeneity, which could be explained by the type and control interventions.  In addition, there were no significant differences in adverse events between the intervention and the control groups. Wrap It Up Manipulative therapy reduces the degree of chronic neck pain and neck disabilities. Hurry, someone run and the the World Health Organization that we got a new paper to add to their crap recommendations…. More on the papers they’re using to recommend SMT at very low confidence in next week’s Part 6 of that series.  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
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    

Pain Neuroscience Education & Cannabis And Bipolar Disorder

CF 306: Pain Neuroscience Education & Cannabis And Bipolar Disorder Today we’re going to talk about Pain Neuroscience Education & Cannabis And Bipolar Disorder But first, here’s that sweet sweet bumper music  

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 #306 Now if you missed last week’s episode , we talked about Hip Pain And Corticosteroids & Chronic Pain After Spinal Surgery. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. First day back from our 4-day Thanksgiving holiday break. Now, let’s just say this; I was going to work the morning of the Friday after Thanksgiving. But, I had a bit of a mutiny with the employees. And, to be honest, I’m not sure how it sits with me.  I didn’t want to work on Friday to start with but, being honest here, we’ve been a little slower than I’m used to lately and I felt like I needed to. Plus I was in Orlando a week or so ago for our Mastermind meeting so that was slow on my return as well.  Anyway, I was approached and the crew feels they’ve been putting in a lot of energy with being shorthanded, etc and they wanted that day off. And wanted it paid I’m assuming. So my conundrum was, stand my ground and risk losing employees and fostering a low-simmering dislike of me and thee job we are here to do? Or submit to a request I already wanted for myself anyway? Right or wrong, I chose to give them the day and I have to say that I thoroughly enjoyed it. And today, the staff seems to be in a better overall mood and, I hope, ready to rock n roll and make it happen this week and get things back to normal. Which means busy busy.  How would you handle that? I didn’t dig it. I can tell you that.  Alright, enough clinic stuff, let’s hop into the research! Item #1 The first on today is called, “Pain neuroscience education for reducing pain and kinesiophobia in patients with chronic neck pain: A systematic review and meta-analysis of randomized controlled trials” by Lin et. Al. published in European Journal of Pain on September 11, 2023 and BAM! It’s smokin! https://doi.org/10.1002/ejp.2182 Why They Did It Chronic neck pain (CNP) is a common musculoskeletal disorder. Pain neuroscience education (PNE) is a promising nonpharmacological intervention for CNP, however, its effectiveness remains unclear. This systematic review and meta-analysis aimed to evaluate the effectiveness of PNE in treating CNP. How They Did It Electronic databases from inception to February 2023 were searched for randomized controlled trials  The primary outcome was the change in pain intensity, and the secondary outcome was improvement in kinesiophobia,  Two authors independently scrutinized eligible articles, extracted data and assessed quality; a random-effects model was employed for data pooling. What They Found In total, seven RCTs comprising 479 participants were included and demonstrated that PNE significantly reduced pain intensity  Subgroup analysis revealed that the adult group experienced significant pain reduction after PNE, whereas the adolescent group did not.  PNE also reduced kinesiophobia which was evaluated in four of seven RCTs  There was indication that increased intervention duration contributed to greater pain reduction.  No adverse events were reported following PNE or the control treatment. Wrap It Up Pain neuroscience education effectively reduced pain intensity and kinesiophobia in patients with chronic neck pain.  A longer PNE time leads to greater pain reduction and is more effective in adults than in adolescents. According to Physiopedia – Pain Neuroscience Education (PNE) is a strategy that aims to teach patients to reshape their mindset and perception of pain despite these factors. It provides patients a better understanding of their condition and motivates them to become active participants in their treatment programs. Based on a large number of high-quality studies, it has been shown that teaching people with chronic pain more about the neuroscience of their pain produces immediate and long-term changes.  Item #2 Our last one this week is one of these that always makes me uncool and all and yes, alcohol is worse but we already tried outlawing it so here we go, it’s called, “Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder” by Jensen et. Al. and published in JAMA Psychiatry on May 24, 2023 so it’s still nice and steamy and cozy.  Remember that you can find these citations in our show notes on our website at chiropractscforward.com Jefsen OH, Erlangsen A, Nordentoft M, Hjorthøj C. Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder. JAMA Psychiatry. 2023;80(8):803–810. doi:10.1001/jamapsychiatry.2023.1256 Why They Did It They say that Cannabis use is increasing worldwide and is suspected to be associated with increased risk of psychiatric disorders; however, the association with affective disorders has been insufficiently studied. The question they tried to get clarity on is, “Is cannabis use disorder associated with an increased risk of psychotic and nonpsychotic unipolar depression and bipolar disorder?” How They Did It This was a prospective, population-based cohort study using Danish nationwide registers included all individuals born in Denmark before December 31, 2005, who were alive, aged at least 16 years, and living in Denmark between January 1, 1995, and December 31, 2021. Which means 6,651,765 individuals in Denmark that were followed up for 119,526,786 person-years The main outcome was register-based diagnosis of psychotic or nonpsychotic unipolar depression or bipolar disorder.  What They Found Cannabis use disorder was associated with an increased risk of unipolar depression, psychotic unipolar depression, and nonpsychotic unipolar depression.  Cannabis use was associated with an increased risk of bipolar disorder in men and women, psychotic bipolar disorder, and nonpsychotic bipolar disorder in men and women.  Cannabis use disorder was associated with higher risk for psychotic than nonpsychotic subtypes of bipolar disorder but not unipolar depression. Wrap It Up This population-based cohort study found that Cannabis use disorder was associated with an increased risk of psychotic and nonpsychotic bipolar disorder and unipolar depression.  They say that These findings may inform policies regarding the legal status and control of cannabis use. So, do what you will with the info. Don’t punish the messenger.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     

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

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

Neuroplasticity and Chronic Pain & Surgeons Showing Excised Disc Fragments To Postsurgical Patients

CF 285: Neuroplasticity and Chronic Pain & Surgeons Showing Excised Disc Fragments To Postsurgical Patients

Today we’re going to talk about Neuroplasticity and Chronic Pain & Surgeons Showing Excised Disc Fragments To Postsurgical Patients

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 #285

Now if you missed last week’s episode, we talked about acupuncture for IBS and how chronic pain develops. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I love conferences. I don’t always love the classes and continuing education but you gotta do it, right? So might as well get after it and maybe even learn something.

I remember when I was first out of school and had to go to conferences. I hated it. Every bit of it. It was something being forced on me and I don’t like to be told what to do. It’s chaps my behind and gives me a rash. I’ve gotten better through the years though. I’ll admit.

I remember growing up, my step-dad always told us, “You might as well get used to the idea right now, you’ll always have someone else to answer to.” Regardless – it may be your spouse, you rparents, your teachers, your practice owners, you own your practice? – OK, maybe it’s you state regulating board for your license, maybe it’s your city, your patients, your local, state, or federal government….whatever it is, you answer to someone.

If you don’t think you answer to anyone, you may just be a problem and I don’t mean that as a compliment. Being humble, a team player, and cooperative within reason all has value.

Anyway, I somehow began to enjoy and see the value of conferences and the connections that could be made there. I also started enjoying some of the education you can get there.

At this point now, I’ve even taught at a few of them.

It started by getting involved in thee Texas Chiropractic Association. Once you meet the whole crew and become embedded in the group, the conferences mean more all of the sudden. It’s all for one, one for all. You’re all driving the same direction with the same or similar goals. It’s rather unique actually. It becomes a brotherhood.

Sooner or later, people from around the state begin to know you and, dare I say, maybe even respect you on some level. Especially the more you are willing to demonstrate your unique talents and value to the profession.

Then, I began loving conferences. Which is why I hate that I’ve had to miss both big TCA conferences here in Texas this year. One is called the MidWinter conference in Lubbock, TX. I had to be in Atlanta at a voiceover conference. Y’all….I like conferences, OK

Then this week, TCA is having the big ChiroTexpo event in the Dallas area. It’s the yearly state convention and I’m missing it for the first time in about 10 years because I have to be at a conference in Boston. Are you seeing the theme here? Lol. Except Boston is a conference my 16 year old mega mind daughter is going to. She was invited to the future medical professionals thingy majig. She gets to hear TED talks from nobel laureates for a few days and see a live surgery. She’s like 5th out of 290 kids in her class. Super proud of this little one but yeah, I have to miss my TCA conference.

That means I have to figure out other ways to get the hours to maintain my license. So, I found a great way and I want to share it with you.

If you’ve been listening to this podcast since 2019 or so, you know I got my Diplomate in Neuromusculoskeletal Medicine. Formerly the DACO or orthopedic Diplomate.

A huge portion of the learning is online through the CDI which is an Australian group and this program is beyond any learning you’ll get anywhere else in the chiropractic realm. Maybe the Donald Murphy, Spine Practitioner learning but you get what I’m saying.

It’s special. And now, the credits are good for lots of states and their CEUs. So you can dabble in some of their online learning and use them for your continuing ed. Let’s say you love the classes, well….just keep taking them and end up with a Diplomate.

If you don’t love them, you got your continuing ed knocked out and learned a ton.

I love this group, I love the lectures and the lecturers, I’ve learned more through them in 6 months than I learned in three years of chiropractic school, and I know you’re going to love them too.

No affiliate code. No kick backs. Just mad respect for this group.

Go to cdi.edu.au

Go poke around there and see what you find. Then thank me later.

Item #1

 

The first on today is called The effect of manual therapy and neuroplasticity education on chronic low back pain: a randomized clinical trial” by Adriaan Louw, Kevin Farrell, Merrill Landers, Martin Barclay, Elise Goodman, Jordan Gillund, Sara McCaffrey, Laura Timmerman and published in PubMed on December 25, 2017.

Why They Did It

To determine if a neuroplasticity educational explanation for a manual therapy technique will produce a different outcome compared to a traditional mechanical explanation.

How They Did It

 

  • Sixty-two patients with chronic low back pain (CLBP) were recruited for the study.
  • Pain ratings obtained for low back pain and leg pain, Numeric Pain Rating Scale, Oswestry Disability Index, Fear-Avoidance-Beliefs Questionnaire, forward flexion (fingertips-to-floor), and straight leg raise (SLR)

  • Patients were then randomly allocated to receive one of two explanations – either neuroplasticity or mechanical, a manual therapy technique to their lumbar spine, followed by post-intervention measurements of LBP, leg pain, forward flexion, and SLR.

What They Found

  • There were no statistically significant interactions for LBP, leg pain, and trunk flexion between the groups, but SLR showed a significant difference in favor of the neuroplasticity explanation.

  • Additionally, the neuroplasticity group were 7.2 times more likely to improve beyond the MDC on the SLR than participants in the mechanical group.

Wrap It Up

 

The results of this study show that a neuroplasticity explanation, compared to a traditional biomechanical explanation, resulted in a measurable difference in SLR in patients with CLBP when receiving manual therapy.

 

 

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 cant live without those products, send me an email and Ill 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, Improved outcome after lumbar microdiscectomy in patients shown their excised disc fragments: a prospective, double blind, randomised, controlled trial” by M J Tait, J Levy, M Nowell, C Pocock, V Petrik, B A Bell, M C Papadopoulos published in PubMed on 9 September 2009. !

Why They Did It

Lumbar microdiscectomy (LMD) is a commonly performed neurosurgical procedure. We set up a prospective, double blind, randomised, controlled trial to test the hypothesis that presenting the removed disc material to patients after LMD improves patient outcome.

How They Did It

  • Adult patients undergoing LMD for radiculopathy caused by a prolapsed intervertebral disc were randomised into one of two groups, termed experimental and control.

  • Patients in the experimental group were given their removed disc fragments whereas patients in the control group were not. Patients were unaware of the trial hypothesis and investigators were blinded to patient group allocation.

  • Outcome was assessed between 3 and 6 months after LMD. Primary outcome measures were the degree of improvement in sciatica and back pain reported by the patients. Secondary outcome measures were the degree of improvement in leg weakness, paraesthesia, numbness, walking distance and use of analgesia reported by the patients.

 

What They Found

  • Data from 38 patients in the experimental group and 36 patients in the control group were analysed. The two groups were matched for age, sex and preoperative symptoms.

  • More patients in the experimental compared with the control group reported improvements in leg pain (91.5 vs 80.4%; p<0.05), back pain (86.1 vs 75.0%; p<0.05), limb weakness (90.5 vs 56.3%; p<0.02), paraesthesia (88 vs 61.9%; p<0.05) and reduced analgesic use (92.1 vs 69.4%; p<0.02) than preoperatively.

Wrap It Up

Presentation of excised disc fragments is a cheap and effective way to improve outcome after LMD.

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 cant 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….

Thats 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 cant 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

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

Acupuncture For IBS & How Chronic Pain Develops

CF 284: Acupuncture For IBS & How Chronic Pain Develops

 

Today we’re going to talk about Acupuncture For IBS & How Chronic Pain Develops

 

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

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

 

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 #283.

 

Now if you missed last week’s episode, we talked about The Rate of Chronic Pain in the US & Adolescents And Cannabis Use. Make sure you don’t miss that info. Keep up with the class.

 

On the personal end of things…..

Welcome to this week, happy to have you and happy to be here. Numbers in the clinic are still coming back up a bit and I’m digging it.

 

Let’s talk about the difference in the providers in the medical world vs. our world for a sec. We are integrated here in my clinic. It’s me, a nurse practitioner, an acupuncturist, and 2-3 massage therapists depending on what day you’re asking.

 

Here’s what I have discovered. Those in the medical world are not entrepreneurial by general rule. They are used to going into a clinic and patients are there waiting on them. They treat and then they go home. So nurse pracs, PAs, and PTs are not out beating the streets.

 

So if you think you’re going to hire one of these providers and they’re going to be out and about helping your clinic grow, as a general rule, that is not going to happen. They’re show up and they’re going to learn fast and do a wonderful job. But they’re not going to build your practice by actively marketing. So don’t expect it.

 

I’ve seen acupuncturists build their clientele but not mine. Until the VA came on board, that was a barren wasteland for us and I couldn’t tell that there was any effort on that end of things.

 

Massage therapists…..if it’s theirs, they’ll build it. Some will push it a bit in their circles but it’s rare for them to be out beating the streets.

 

But chiropractors…..look guys and gals…..we are one of a freaking kind my friends. We, for the most part, are owners and marketers and builders and entrepreneurs. Not to mention driven and ambitious.

 

Some are too ambitious to be honest with you. Some want to make money and grow so badly to the detriment of their patients. So keep an eye on that. Don’t sell multilevel marketing to your patients. Don’t look like a street corner huckster. That’s not a good look folks.

 

So kudos on your entrepreneur game. Keep crushing it in an evidence-informed, patient centered way.

 

Crack Addicts: have you seen the new TV series on TLC yet? I believe it comes on on Wednesday nights. It’s Dr. Alessandra Colon somewhere in Florida. For me, there are some cringy things like in one episode she said, “The power is on!” after an adjustment. Well, that’s the vitalist saying and I’m just not a fan but that’s my baggage. The rest of the world probably knows nothing about that stuff.

 

She talks about alignment here and there and we evidence-informed chiros know that alignment isn’t really a thing but, for the most part, I’ll say that she’s doing a good job.

 

If her job is to walk the line between vitalists and the evidence-informed camps, then she’s doing a pretty good job. I think that the overall score is a net gain for chiropractic in general and we haven’t had a positive light shined on us like this in a long time. If ever. There is so much opportunity with this show for the profession. I hope she knows that and I hope continues to keep it between the lines. So far, I think I’m a fan.

 

Dr. Kevin Christie and the Mastermind. You’ve been hearing me talk about our Florida Mastermind for a couple of years now. Well, Dr. Kevin Christie has started a West Coast Mastermind. Their meetings will be in San Diego, Denver, Arizona, and Jackson Hole, Wyoming. Great locations and great learning, bonding, and networking. I cannot tell you how valuable the group has been for me and our Florida group.

 

I suggest you visit the link I’m putting in my show notes right here at this point in the text. Visit that link and get signed up. He only allows approximately 25 providers into each group so don’t sit around on your butt. Get it going.

 

https://www.modernchiropracticmarketing.com/mastermind-2024-west?mc_cid=03245907d3&mc_eid=8424d1275e

 

Alright, that’s it, let’s get into the research.

 

 

Item #1

 

The first one today is called “Acupuncture for the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome” by Ling-Yu Qi, MM; Jing-Wen Yang, PhD; Shi-Yan Yan, PhD and published in JAMA Network Open on December 29, 2022. Dayum. That’s hot.

 

 

 

Why They Did It

 

To preliminarily test the feasibility of using US Food and Drug Administration (FDA)–recommended end points to evaluate the efficacy of acupuncture in the treatment of IBS.

 

 

How They Did It

 

  • This pilot, multicenter randomized clinical trial was conducted in 4 tertiary hospitals in China from July 1, 2020, to March 31, 2021, and 14-week data collection was completed in March 2021.
  • Individuals with a diagnosis of IBS with diarrhea (IBS-D) were randomized to 1 of 3 groups, including 2 acupuncture groups

 

 

 

What They Found

 

  • Ninety patients were enrolled, with 30 patients in each group.
  • There were substantial improvements in the primary outcomes for all groups although the difference between them was not statistically significant

 

  • The response rates of adequate relief at week 4 were 64.3% in the specific acupoints group, 62.1% in the nonspecific acupoints group, and 55.2% in the nonspecific acupoints group

 

  • Adverse events were reported in 2 patients (6.7%) in the specific acupoints group and 3 patients (10%) in nonspecific acupoints or nonspecific acupoints group.

 

 

Wrap It Up

 

In this pilot randomized clinical trial, acupuncture in both the specific acupoints and nonspecific acupoints groups showed clinically meaningful improvement in IBS with diarrhea symptoms, although there were no significant differences among the 3 groups. These findings suggest that acupuncture is feasible and safe; a larger, sufficiently powered trial is needed to accurately assess efficacy.

 

 

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 cant live without those products, send me an email and Ill 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, “Mechanisms behind the Development of Chronic Low Back Pain and Its Neurodegenerative Features” by Abdullah Mosabbir published in Molecular and Cellular Mechanisms in Neurodegenerative Diseases on 28 December 2022. Hot potato!

 

 

Why They Did It

 

To understand and update the current state of knowledge of the pathophysiology of back pain in educating patients as well as guiding the development of novel therapeutics.

 

How They Did It

 

Many clinicians, caregivers and researchers aim to help educate patients about their pain and try to help them live a better quality of life despite their condition. This may include using strategies such as pain neuroscience education (PNE) and cognitive behavior therapy

 

What They Found

 

A systematic review and meta-analysis demonstrated that PNE can have a significant effect in reducing pain catastrophizing as well as kinesiophobia. This is highly beneficial in pain management, as reduced catastrophic thinking can help orient a person away from their pain and towards living their life, and reduced fear helps patients to be more open to active interventions like physical therapy and exercise.

 

 

Wrap It Up

 

  • cLBP is complex and there is no guarantee that treating its potential causes will cause the pain to go away. Therefore, rather than attempting to “cure” chronic pain, many clinicians, caretakers and researchers aim to help educate patients about their pain and try to help patients live a better quality of life, despite their condition. Understanding and updating our current state of knowledge of the pathophysiology of cLBP is important in educating patients as well as guiding the development of novel therapeutics.

 

  • The current understanding of the source of cLBP stems from damage to the ligamentous structures of the body due to prolonged poor posture, sub-failure injury, or major trauma. These contribute to abnormal forces acting on the spine, which leads to the degeneration of intervertebral discs and joints that directly or indirectly stimulate a painful sensation.

 

  • If these sensations persist, acute pain transitions to a chronic state that sustains the pain independent of the source of the initial damage. Once this occurs, further degeneration occurs in the spinal cord and brain, leading to peripheral sensitization, central sensitization, apoptosis of neurons and the reduction of grey matter in the brain. This ultimately can lead to cognitive impairment among cLBP patients.

 

 

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 cant 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….

 

Thats 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 cant 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

 

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

 

 

The Rate of Chronic Pain in the US & Adolescents And Cannabis Use

CF 283: The Rate of Chronic Pain in the US & Adolescents And Cannabis Use

 

Today we’re going to talk about The Rate of Chronic Pain in the US & Adolescents And Cannabis Use

 

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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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, 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 #283

 

Now if you missed last week’s episode, we talked about new dietary ideas and how the doctor’s words matter. Make sure you don’t miss that info. Keep up with the class.

 

On the personal end of things…..

Summer is upon us and let’s talk about what happens in the Summer, you and your patients typically go places. When school is away, people tend to go out and play.

 

I’d be lying if I didn’t share that I have a little anxiety about it. Here’s why, if you listen regularly here, you know I’ve been a little slow this year and kind of hating life as a result. I’m very growth minded. Maybe life is just telling me to slow down, I don’t know. But, it’s looking like things are picking up. And what’s the quickest way to kill your momentum, yeah…..take days off. Of course.

 

With that being said, I have a trip to Boston in a couple of weeks. I’m only missing 2 days but it is what it is. My daughter was invited to a future medical professionals conference out there and you just have to go.

 

Then, we have an Alaskan cruise in late July early August. That’s a WEEK off and I’m so anxious about this.

 

Then in September, we have a front row seats for my wife’s favorite band on her birthday, it’s a Trane concert in Charleston, SC and the night before that, we’ll be at a Savannah Bananas game in Savannah, GA.

 

So here’s my thought process. In 10 years, I won’t remember the patients I saw in my clinic if I had stayed in town and not taken these trips. But I’ll always remember my daughter going to the conference in Boston. I’ll always remember the Alaskan cruise that we took. And I’ll always remember The Savannah/Charleston trip.

 

I guess my point is, we can experience only our clinic or we can experience life. Responsibly! You can’t abandon the responsibilities but life isn’t life if we’re not partaking in it. I’m all about my patients but I spent years and years so concerned about numbers that I lost sanity on some level. I’m still concerned about numbers.

 

Don’t get me wrong. I’m at 150 a week now instead of my usual 185-190 a week. That’s a solid hit folks but, I can hunker down and lose my mind about a practice that has shrunk a bit, or I can say it is what it is and I can keep on cooking but also stay busy living.

 

I’m going on my trips. My patients are going to go on their trips too. I’m going to freak out about being gone a little bit. It’s just going to happen. It’s going to be really slow when I get back and you know what? It’s going to be OK because my clinic has a reputation and the patients will continue to come.

 

So, if you’re where I’m at and you have some anxiety about taking trips with your family and enjoying your people, get your butt out fo the clinic and enjoy yourself. We only get one spin on the Earth. Let’s do it and let’s not worry about it.

 

 

 

Item #1

 

The first one today is called Nondisordered Cannabis Use Among US Adolescents” by Ryan S. Sultan et al and published in JAMA Network Open on May 3, 2023. Dayum. That’s hot.

 

 

 

Why They Did It

 

To describe the prevalence and demographics of nondisordered cannabis use and to compare associations of cannabis use with adverse psychosocial events among adolescents with no cannabis use, of nondisordered cannabis use, and cannabis use disorder.

 

How They Did It

 

This cross-sectional study used a nationally representative sample derived from the 2015 to 2019 National Survey on Drug Use and Health. Participants were adolescents aged 12 to 17 years, separated into 3 distinct groups: nonuse (no recent cannabis use), of nondisordered cannabis use (recent cannabis use below diagnostic threshold), and cannabis use disorder.

 

Analysis was conducted from January to May 2022.

 

 

What They Found

 

  • The 68 263 respondents) included in the analysis represented an estimated yearly mean of 25 million US adolescents during 2015 to 2019.
  • Among respondents, 1675 adolescents had cannabis use disorder, 6971 adolescents had of nondisordered cannabis use, and 59 617 adolescents reported nonuse.
  • Compared with nonusers, individuals with of nondisordered cannabis use had approximately 2 to 4 times greater odds of all adverse psychosocial events examined, including major depression, suicidal ideation, slower thoughts, difficulty concentrating, truancy, low grade point average, arrest, fighting, and aggression.
  • Prevalence of adverse psychosocial events was greatest for adolescents with cannabis use disorder, followed by of nondisordered cannabis use, then nonuse

 

 

Wrap It Up

 

In this cross-sectional study of US adolescents, past-year of nondisordered cannabis use was approximately 4 times as prevalent as past-year cannabis use disorder. A stepwise gradient association was observed for odds of adverse psychosocial events between adolescent of nondisordered cannabis use and cannabis use disorder. In the context of US normalization of cannabis use, prospective research into of nondisordered cannabis use is necessary.

 

 

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 cant live without those products, send me an email and Ill 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, “Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020” by Richard L. Nahin, MPH; Termeh Feinberg, MPH; Flavia P. Kapos, DDS, M; et al published in JAMA Network Open on May 16, 2023. Hot potato!

 

 

Why They Did It

 

To estimate rates of chronic pain and high-impact chronic pain (HICP) incidence and persistence in US adults across demographic groups.

 

How They Did It

 

  • This cohort study examined a nationally representative cohort with 1 year of follow-up.
  • Data from the 2019-2020 National Health Interview Survey (NHIS) Longitudinal Cohort were used to assess the incidence rates of chronic pain across demographic groups.

 

  • The cohort was created using random cluster probability sampling of noninstitutionalized civilian US adults 18 years or older in 2019.

 

  • Of the 19 081, the final analytic sample of 10 415 adults also participated in the 2020 NHIS. Data were analyzed from January 2022 to March 2023.

 

What They Found

 

  • Among 10 415 participants included in the analytic sample, 51.7% were female, 54.0% were aged 18 to 49 years, 72.6% were White, 84.5%were non-Hispanic or non-Latino, and 70.5% were not college graduates.

 

  • Among pain-free adults in 2019, incidence rates of chronic pain and high-impact chronic pain in 2020 were 52.4 and 12.0 cases per 1000 PY, respectively.

 

  • The rates of persistent chronic pain and persistent high-impact chronic pain in 2020 were 462.0 and 361.2 cases per 1000 PY, respectively.

 

Wrap It Up

 

In this cohort study, the incidence of chronic pain was high compared with other chronic diseases. These results emphasize the high disease burden of chronic pain in the US adult population and the need for early management of pain before it becomes chronic.

 

 

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 cant 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….

 

Thats 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 cant 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

 

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

 

 

New Dietary Ideas & The Doctor’s Words Matter

CF 282: New Dietary Ideas & The Doctor’s Words Matter

Today we’re going to talk about new dietary ideas and the doctor’s words matter.

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

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

 

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 #282

 

Now if you missed last week’s episode, we were joined by Dr. Lindsay Mumma and talked about clinical excellence and pelvic floors.

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

 

On the personal end of things…..

What’s going on in my world these days? It’s interesting always. To say the least.

 

The biggest on our radars at the moment are three things actually.

  1. We have always leased our space and I would love to own the property for obvious reasons. But prices are just ridiculous, honestly. So it’s been a challenge when we’re looking at property. We still have one year on our current lease but just had this building come open that is looking pretty good both size-wise and price-wise. So it has to be looked at. We know our current space is going to go up in a year and our monthly nut on the building will probably be about the same so, why not? But there’s still the process of moving everything, the IT stuff, the making it all work stuff, setting up a clinic/gym hybrid and all that gobbled gook. Geez. It’s daunting.
  2. The second thing we’re looking at is hiring an associate. But can both of these be done at the same time? Hiring an associate and moving into a new building. I don’t think they can be done simultaneously without putting us in a precarious position financially. The extra info on that thought is that it doesn’t seem to matter because associates are getting out of school and they’re going to work for a franchise and aren’t really doing associate-ships anymore. Every chiro I know out in the world that is looking for an associate tells me they’re not to be found and in the last 7 months or so that I’ve been looking, they’re exactly right. Plus, living in Amarillo, TX isn’t as appealing as living in Dallas or Houston or wherever. A person has to almost be from the Texas Panhandle to see my job offering as a blessing. So, if the associate situation continues the way it is, it’ll be no question. We’ll just move into the new building. Lol.
  3. The third thing is that there is a company out of the Houston, TX area that is an investment gropu and they’re buying 60% of practices that qualify within their metrics and they take over all of the soul-crushing parts of your clinic. They do the HR, the billing, and the collecting. The clinics keep their name and nobody but the owner and the staff will ever even know that part of the practice was sold. Dentists have been doing this model for years. Clinic owners make a solid salary and make their 40% commission. They can bill on the medical E&M scale and get paid at a higher level than we could on our own DC codes so the same work for more money. Plus they help bring in medical if you want and they help bring in PT if you want. And they’ll help bring in associates as well. My colleagues working with the company tell me they’re working less and making more and it was the best decision they ever made. So, I’m looking at seriously. With a little side eye but the wife is on board, which is the most important thing. I just need to get the price I’m looking for. Then we shall see.

 

So, there are 3 biggies that are weighing me down because not a one of those are small decisions. They’re actually monumental decisions and they’re all sitting on my plate currently. I’ll let you know how it unfolds as it unfolds.

 

Stay tuned. For now, let’s dive into the research.

 

 

Item #1

 

The first one today is called “Dietary recommendations for cardiovascular health challenged by new evidence on saturated fatty acids’ effects on LDL-C and Lp(a) levels” by Dr. Chinta Sidharthan and published in News Medical Life Sciences on May 15, 2023. Dayum. That’s hot.

 

 

 

Why They Did It

 

The study was conducted to investigate the effects of dietary modifications on cardiovascular health, specifically focusing on the impact of reducing saturated fatty acid intake on lipid profiles and the risk of cardiovascular diseases.

 

 

How They Did It

 

  • The research on the relationship between dietary modifications, lipoprotein A, and cardiovascular disease risk is based on a review of existing scientific literature and studies.

 

  • The research involved analyzing and synthesizing data from multiple studies that investigated the effects of dietary modifications, particularly the reduction of saturated fatty acids, on lipoprotein A and LDL-C levels.

 

  • To assess the impact of dietary modifications on lipoprotein A and LDL-C levels, the researchers collected and analyzed data from participants, including their dietary intake, lipoprotein A and LDL-C levels, and potentially other relevant markers or risk factors for cardiovascular disease. Statistical was performed to determine the associations between different variables and to assess the significance of the findings.

 

 

 

What They Found

 

  • Despite the lack of data for conclusive inferences, it appears that the risk of cardiovascular disease depends on a relative balance between the levels of the two lipoproteins — LDL-C and lipoprotein A — and the baseline values of both in each individual.

 

  • Furthermore, while reducing cardiovascular risk due to high LDL-C levels through the modulation of saturated fatty acid intake remains important, the clinical LDL-C measurements also include the cholesterol component from lipoprotein A.

 

 

Wrap It Up

 

  • Overall, the evidence indicated that the standard recommendations for a heart-healthy diet which includes reduced consumption of saturated fatty acids, might have a negative impact by increasing the lipoprotein A levels despite lowering the LDL-C levels.

 

  • Since dietary changes are the most prevalent non-pharmacological form of disease prevention, tailored recommendations for dietary changes after considering individual lipid profiles might be required.

 

  • Furthermore, additional cardiac health markers such as lipoprotein A cholesterol content are necessary to assess cardiovascular disease risk accurately.

 

 

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 cant live without those products, send me an email and Ill 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. drop-release.com and the discount code is HOTSTUFF. Go do it.

 

 

 

 

Item #2

 

Our last one this week is called, The enduring impact of what clinicians say to people with low back pain” by Ben Darlow, Anthony Dowell, G David Baxter, Fiona Mathieson, Meredith Perry, Sarah Dean published in PubMed on December 11, 2013. Hot potato!

 

 

Why They Did It

 

The purpose of this study was to explore the formation and impact of attitudes and beliefs among people experiencing acute and chronic low back pain.

 

How They Did It

 

Semistructured qualitative interviews were conducted with 12 participants with acute low back pain (less than 6 weeks’ duration) and 11 participants with chronic low back pain (more than 3 months’ duration) from 1 geographical region within New Zealand. Data were analyzed using an Interpretive Description framework.

 

 

What They Found

 

  • Participants’ underlying beliefs about low back pain were influenced by a range of sources. Participants experiencing acute low back pain faced considerable uncertainty and consequently sought more information and understanding.

 

  • Although participants searched the Internet and looked to family and friends, health care professionals had the strongest influence upon their attitudes and beliefs. Clinicians influenced their patients’ understanding of the source and meaning of symptoms, as well as their prognostic expectations. Such information and advice could continue to influence the beliefs of patients for many years.

 

  • Many messages from clinicians were interpreted as meaning the back needed to be protected.

 

  • These messages could result in increased vigilance, worry, guilt when adherence was inadequate, or frustration when protection strategies failed.

 

  • Clinicians could also provide reassurance, which increased confidence, and advice, which positively influenced the approach to movement and activity.

 

 

Wrap It Up

 

Health care professionals have a considerable and enduring influence upon the attitudes and beliefs of people with low back pain. It is important that this opportunity is used to positively influence attitudes and beliefs.

 

When a patient is standing on the ledge of chronic pain, we can push them in or pull them back literally based on what we say and how we behave. If you make a big deal out of ddd, they’re gone, echoing as they fall into the pit. If you tell them that everyone has ddd at some point and usually zero pain associated with it, you start pulling them back. Certainly after you encourage them to move, go for a walk, hurt doesn’t mean harm, and you get some pain free movement wins through your treatment and exercises…..well then we’re having two completely different outcomes altogether now, aren’t we?

 

Be smart with your words and your behavior. It’ll make you look like you’re up on your research and education and it’ll make all the difference in the world in your patients.

 

 

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 cant 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….

 

Thats 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 cant 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

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

 

Spinal Stabilization For Chronic Pain & Dry Needling

CF 274: Spinal Stabilization For Chronic Pain & Dry Needling

 

Today we’re going to talk about a dry needling and we talk about spinal stabilization for chronic back pain.

 

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,
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  • 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 #274   Now if you missed last week’s episode, we talked about SMT and Fibromyalgia as well as SMT and adverse events. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things….. Today has been a little bit of a whirlwind. In fact the last month or so has been a bit of a whirlwind. I started with a new company called BlueIQ that some of you will be familiar with.   What an incredibly powerful tool! Full of functions I’ll never use but full of functions that I will use as well. I have no affiliation with them. Just sharing my experience. My colleague uses them and loves them so I thought I’d give it a try. I’m a bit of a stats nerd after all. Anyway, this thing is like $150/month.  

I don’t like my overhead getting any higher than it already is so I went and found things I could cut to make the room. That, honestly, wasn’t very hard to do. I should do more of that, by the way.   I’ve had two onboarding calls with them so far and I’m just blown away at all of the cool things it can do as far as tracking my business through implementing with my EHR so it’s up to date. Every hour it updates actually so it’s current to the hour.   I always know my stats. Right where I’m at. It sets goals for me and even has a page for team meetings where we can go over our KPIs easily and quickly.   I’m kind of blown away by them honestly.

So, super excited about BlueIQ right now.   Other than that, just trying to maintain some momentum with clinic numbers. We blew back up and have now kind of slowed again. We were back up to my comfortable 180 or so visits per week. Now, back down to about 150 or so last week.  

Just keeping an eye on that and keeping an eye on the newer front desk staff to make sure we’re booking correctly and all that good stuff. Just watching. That’s something that’s on my radar basically.   Just got back from the voice over conference in Atlanta last week and headed off to Florida at the end of this month for my quarterly Mastermind meeting with Dr. Kevin Christie and crew.   Lots of stuff happening all at once. Such is life and, since it’s a little crazy at the moment, I’mma jump right into the research so let’s do it!  

 

Item #1   The first on today is called, “Immediate Effects of Dry Needing or Manual Pressure Release of Upper Trapezius Trigger Points on Muscle Activity During the Craniocervical Flexion Test in People with Chronic Neck Pain: A Randomized Clinical Trial” by Jorge Rodríguez-Jiménez, PT, MSc and published in Pain Medicine on 18 February 2022. Dayum. That’s hot.    

Why They Did It   To compare the effects of dry needling or manual pressure release on an active trigger point in the upper trapezius on craniocervical flexion test performance, pressure pain thresholds, and cervical range of motion in chronic neck pain.    

How They Did It  

  • Subjects were randomized to receive dry needling (n = 25) or manual trigger point pressure release (n = 25) on upper trapezius active trigger points.
  • Surface electromyography from the upper trapezius, splenius capitis, sternocleidomastoid, and scalene muscles during performance of the craniocervical flexion test was assessed before and immediately after the intervention as the primary outcome. Neck pain intensity, range of motion, and pressure pain thresholds were the secondary outcomes.

    What They Found  

  • A decrease in sternocleidomastoid activity at all stages of the craniocervical flexion test (time effect, P < 0.001) was found in both groups after the interventions, with no significant between-group difference.
  • Pressure pain thresholds measured over the cervical spine and second metacarpal increased after dry needling when compared with manual trigger point pressure release (P < 0.05). Pain intensity decreased immediately after both treatments with moderate to large effect sizes, whereas cervical range of motion increased for both groups but with small effect sizes.

 

Wrap It Up  

A single session of dry needling or manual pressure release over upper trapezius active trigger points promotes limited effects on muscle performance during the craniocervical flexion test, pressure pain thresholds, and cervical range of motion in patients with chronic neck pain.   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 cant live without those products, send me an email and Ill 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, “Effectiveness of Spinal Stabilization Exercises on Movement Performance in Adults with Chronic Low Back Pain” by Khalid Alkhathami and published in PubMed on 1st Feburary 2023. Hot potato!  

Why They Did It   The purpose of this study was to determine the effects of spinal stabilization exercises (SSEs) on movement performance, pain intensity, and disability level in adults with chronic low back pain (CLBP).  

How They Did It  

  • Forty participants, 20 in each group, with CLBP were recruited and randomly allocated into one of two interventions: spinal stabilization exercises and general exercises (GEs).
  • All participants received their assigned intervention under supervision one to two times per week for the first four weeks and then were asked to continue their program at home for another four weeks.
  • Outcome measures were collected at baseline, two weeks, four weeks, and eight weeks, including the Functional Movement Screen (FMSTM), Numeric Pain Rating Scale (NPRS), and Modified Oswestry Low Back Pain Disability Questionnaire (OSW) scores.

  What They Found  

  • There was a significant interaction for the Functional Movement Screen  scores (p = 0.016), but not for the Numeric Pain Rating Scale and Modified Oswestry Low Back Pain Disability Questionnaire scores.
  • Post hoc analysis showed significant between-group differences between baseline and four weeks (p = 0.005) and between baseline and eight weeks (p = 0.026) favor spinal stabilization exercises over general exercises.
  • Further, the results demonstrated that all participants, regardless of group, had significant improvements in movement performance, pain intensity, and disability level over time.

 

Wrap It Up  

The results of the study favor spinal stabilization exercises over general exercises in improving movement performance for individuals with CLBP, specifically after four weeks of the supervised spinal stabilization exercises program.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.  

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

Bibliography  

  • Rodríguez-Jiménez J. Immediate Effects of Dry Needing or Manual Pressure Release of Upper Trapezius Trigger Points on Muscle Activity During the Craniocervical Flexion Test in People with Chronic Neck Pain: A Randomized Clinical Trial. Pain Medicine. 2022 Feb 18:pabc018. doi: 10.1093/pm/pabc018. PMID: 34902236

 

  • Alkhathami K, Alshehre Y, Brizzolara K, Weber M, Wang-Price S. Effectiveness of Spinal Stabilization Exercises on Movement Performance in Adults with Chronic Low Back Pain. Int J Sports Phys Ther. 2023 Feb 1;18(1):169-172. doi: 10.26603/001c.68024. PMID: 36793568; PMCID: PMC9897033.