Jeff Williams - evidence-based chiropractor

Subacromial Dry Needling & Lumbar Discs With Stenosis Present

April 19, 2023 chiropracticforward 0:17:04 0 Comments

CF 276: Subacromial Dry Needling & Lumbar Discs With Stenosis Present

Today we’re going to talk about Subacromial Dry Needling & Lumbar Discs With Stenosis Present

But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #276 Now if you missed last week’s episode , we talked about Remote Myofascial Release & Manual Versus Instrumental Spinal Manipulation. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. As we speak, I’m getting ready to meet my friends from the MCM Florida Mastermind this coming weekend. Now, I’m a couple of weeks ahead on these podcast episodes for most of you so by the time you hear this one, it’ll have come and gone but that’s what’s happening right now. What the hell is the MCM Mastermind you might ask? Well, Dr. Kevin Christie of the Modern Chiropractic Marketing podcast put it all together a couple of years ago. It started out at about 15 of us from around the country and I think we’re up to about 24 right now. Pretty capped out I believe. Kevin doesn’t want it any bigger than that but listen up!! He has talked about starting a West Coast mastermind as well. A separate sister group. They won’t be the OGs like our Florida group or anything but just as important…..as far as they know. : ) Anyway, it’s a very unique and very professionally run and organized thing. Lots of masterminds are thrown together a little willy nilly but Kevin, through his work with Strategic Coach, has this down to a science. The education and the speakers are always top notch, the networking and bonding opportunities are ideal for the exchange of ideas and inspiration, and it’s a damn good reason to get out of your clinic and experience something besides those walls. Plus, Kevin has some pretty talented connections. Our members include Brett Winchester, Mark King of MPI, Jay Greenstein, Ben Fergus, and lots lots more. Also, you get perspectives from a range of areas of the country. For example, our members are from

Texas
Alabama
Florida
North Carolina
Montana
Ohio
Connecticut
Illinois
Missouri
New Jersey

And I probably missed a few states but you get the idea. It’s a pretty cool thing to be a part of and I value the incredible connections I’ve made over the last two years. Whether it’s one of Kevin Christie’s masterminds or it’s another you come across, I highly encourage you hop into one….or form your own. You’ll thank yourself. In addition, I’m lining up my stuff for the big 100 Men Who Give A Damn event tonight. I’ve talked about this on the podcast before but we have to be in the community. You must. You can’t do business sitting on your ass in the words of Dan Kennedy so get out and go and do. One of the easiest and best ways to do that is through setting up your own 100 Men Who Give A Damn. Although I’d just go ahead and drop the Men from it and say 100 Who Give A Damn because when the wives come, the men spend more so let’s get all inclusive and get everyone there. You don’t have to do much. I asked 3-4 folks to help me and I picked them from different areas of the community and different industries for a wider net. One being internet, website, etc. We got a site up and were off and running. You have one event per quarter. Most businesses are happy to donate their space for charitable events. No membership, no committees or regular meetings. Low maintenance way to have your very own philanthropic group. Check out our site at www.100menamarillo.com and ask me any questions at creekstonecare@gmail.com I’m happy to help you get up and running if interested. No paper work or anything. Just start. Item #1 The first on today is called, “Dry Needling for Subacromial Pain Syndrome: A Systematic Review with Meta-Analysis” by David Griswold and published in Pain Medicine on 26 August 2022. Dayum. That’s hot. Why They Did It The authors of this systematic review with meta-analysis evaluated the evidence for the effectiveness of various applications of dry needling (DN) combined with other conservative treatments for subacromial pain syndrome (SAPS). How They Did It

Six databases (PubMED, CINAHL, Biosis, Web of Science, SPORTDiscus, and Cochrane Central Register of Controlled Trials) were searched after the study had been registered in PROSPERO.
The authors included randomized clinical trials investigating the clinical effects of DN in combination with other conservative interventions for SAPS.
Outcomes included pain and disability.

What They Found

Eight studies were selected. All eight studies involving 10 comparisons were included in the analyses (N = 538). A random-effects model was used to analyze between-group effects.
Dry needling performed in combination with other conservative interventions produced favorable outcomes at all time points for pain and disability.

Wrap It Up The meta-analysis suggests that various applications of DN performed with other conservative interventions are more effective than conservative treatment alone for reducing pain and disability in patients with SAPS. Direct-comparison studies are needed to determine whether one application of DN is superior to another. Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Our last one this week is called, “Conservative Treatments for Lumbar Disc Herniation at L3-4 or L4-5 Were More Likely to Fail When Ipsilateral Foraminal Stenosis Was Present at the Caudally Adjacent Segment” by Shuchen Ding and published in PubMed on 14 February 2023. Hot potato! Why They Did It To prove conservative treatments are important in lumbar disc herniation (LDH), but predictors for poor outcomes are unclear. How They Did It

Consecutive patients with unilateral single-level LDH at L3-4 or L4-5 were enrolled. Baseline clinical data were collected, and lumbar spine magnetic resonance imaging was evaluated.
Foraminal stenosis was evaluated using Lee’s approach and further categorized as absence (grade 0 and 1) or presence (grade 2 or 3).
Each patient underwent conservative treatments (oral meloxicam and dexamethasone, corset, back extension exercise, physiotherapy, and manual therapy) for 6 weeks.
Conservative treatments were defined as failed if a patient underwent surgery within 6 weeks or reported poor recovery at 6-week follow-up.
Multivariate logistic regressions were used to examine the associations of failed conservative treatments with baseline characteristics and magnetic resonance imaging findings.

What They Found

The study included 222 patients (mean age 45.5 ± 9.8 years). Of patients, 48 (21.6%) had concurrent ipsilateral foraminal stenosis at the caudal segment, and conservative treatments failed in 39 (17.6%).
At baseline, patients with LDH and caudal foraminal stenosis were older (50.79 ± 6.14 years vs. 44.10 ± 10.13 years, P < 0.001), had greater leg pain (7.06 ± 1.17 vs. 6.39 ± 1.40, P = 0.003), and had a higher rate of positive straight leg raising test (54.2% vs. 33.3%, P = 0.008) than patients without caudal foraminal stenosis.
In multivariate regression, failure of conservative treatments was associated with positive straight leg raising test (odds ratio 2.26, P = 0.046), and caudal foraminal stenosis (odds ratio 3.20, P = 0.007).

Wrap It Up In the presence of caudal foraminal stenosis and positive SLR test, conservative treatments were more likely to fail in patients with LDH. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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

The Message

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

Spinal Stabilization For Chronic Pain & Dry Needling

April 6, 2023 chiropracticforward 00:15:18 0 Comments

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, 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!

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 #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 can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2 Our last one this week is called, “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!

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

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.

Evidence based chiropractic forward podcast

Dry Needling, Types of Exercise Count, Motor Skills For Chronic Back, and Blood Pressure & Dementi

February 24, 2021 chiropracticforward 0:31:41 0 Comments

CF 166: Dry Needling, Types of Exercise Count, Motor Skills For Chronic Back, and Blood Pressure & Dementia

Today we’re going to talk about Dry Needling, how the types of exercising count in the long run, we talk about Motor Skills For Chronic Back Pain, and we wrap it up with a paper on Blood Pressure & Dementia

But first, here’s that sweet sweet bumper music

We’re the fun kind of research. The AC/DC, Motley Crew, Metallica kind of research.

Not the stuffy, high-brow, Beethoven and Mozart kind of research.

We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.

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

Like our Facebook page,
Join our private Facebook group and interact, and then
go review our podcast on iTunes and other podcast platforms.
We also have an evidence-based brochure and poster store at chiropracticforward.com
While you’re there, join our weekly email newsletter.

You have found yourself smack dab in the middle of Episode #166

Now if you missed last week’s episode, we talked about chiropractors working on kids. A controversial topic in some areas of the land and some professions don’t like chiropractors doing so. We talk about it. Check it out. You might learn something

Keep up with the class.

On the personal end of things…..

Alright, if you listen regularly, you know I just lost my office manager of over 11 years to a little higher paying job.

You know that my main computer that contains my whole life decided to take a dirt nap. It’s dead now.

You know I have been up on the ropes a little here lately with slower numbers and all so let’s get into the nitty gritty here and see if we can make lemonade our of a crappy bunch of lemons, shall we?

Let’s start with the manager taking an exit. We can make these things positive or negative. I choose to make it a positive. Think about it; after 11 years, this person was by far my most highly paid employee. Probably overpaid honestly because I was trying to keep her happy.

She had some difficulties financially at one point a couple of years ago so my wife and I created a marketing position for her so that we could justify paying her quite a bit more money per month while getting some marketing benefit out of it as well.

So, not only was she highly paid for the office work, in addition, she made a good amount with the marketing side too. So, her leaving is an impact for sure. Not to mention the fact that she’s my buddy. She’s basically family. So it was an impact professionally but a bit personally.

Here’s the thing though; do we let that paralyze us or do we make it positive? I make things positive when I can. Where are the positives here?

Well, first thing is….I’m going to save a TON of money. Even when I get her replacement hired, I’m still getting about $1800 raise every month. Who the hell doesn’t want that kind of raise in their lives? Yes please, may I have another?

Also, with her having been out a bunch marketing, the other girls know how to do everything around the office that she used to do. That’s a big benefit.

So, do we sit on that money or do we invest it? I invest. Remember, my ultimate goal is growth to the point I can remove myself and we do that be integrating and replacing me while making sure there are enough of alternatives to provide a comfortable retirement.

Investing that money means it’s time to get off my tookus and integrate my practice. I’ve talked about it for years but never pulled the trigger. It’s time now and that’s what I’m doing.

There is also the option of owning a Rural Health Clinic. That is on the table as well and I’ve got a call set up on Thursday to explore that option as well.

Let’s say the RHC isn’t viable in Texas. OK, integration with the nurse prac is the path. I have an attorney in place and waiting on my to set it all up and I have a consulting company set up to help me get there.

Here’s what I love about how life has created me. The best way to make sure I do something is to tell me that I can’t. The best way to see what I can do is to underestimate me or put me on the ropes and throw a few jabs. That’s when I tend to come out firing.

I think we have to approach life like that every day but most definitely when life takes its jabs at our rib cage or our nethers.

Instead of taking it, absorbing it, and letting it work us, come out firing on all cylinders. Prove yourself worthy of the things you really really desire

Now, that doesn’t mean be stupid and financially dangerous. I take measured risks. I never jump off of cliffs. But, I have a pile of PPP money to pay employees and I just got an unexpected raise so now is the time to pounce. I may not have a chance quite like this again so let’s make it happen. And I will.

The new computer will be here tomorrow. I’ve been without it for a couple of weeks now but, overall it hasn’t been too miserable. Macs have this cool thing called iCloud and a lot of my info including browser book marks and anything I had moved over just to my desktop screen….they’re all in iCloud so I started bringing my MacBook laptop to work and signed in and BAM….it was all there. I’m missing some important stuff but overall, I’ve been able to do the things I need to do. Including keeping up with this podcast.

The big thing I’m behind on right now is keeping stats because it’s all in my computer memory. I’m working on a solution for that. For me and for you so keep your eyes and ears on the lookout for that in the coming months. You’ll see what I mean when I get it ready for you. That’s another good reason to be in our private Facebook group. I’ll be announcing it and the need for some beta testers and I’ll only make that available in the private group so make sure you’re in there for that special opportunity.

In other big news, I got a call from Dr. James Lehman and he shared with me the existence of a Diplomate program called Forensics. I have to admit I’d never heard of it. He told me it’s a subspecialty of the Neuromusculoskeletal Diplomate. Which I already have. And he said that since I already have it, then to get the Forensics Diplomate, all I’d need to do is get 100 additional hours. It would break down into 60 hours online through ChiroCredit, 20 hours taking the AMA’s Impairment Rating course, and 20 hours in a conference in Chicago.

Once completed, I would have the Diplomate in Forensics as well as the Neuromusculoskeletal Diplomate and I’d be able to command some hefty prices serving as a court expert and consultant.

Well, that fit into the retirement plan doesn’t it? It’s not exactly retiring but it is getting our of the day to day, in-person tasks of daily patient treatment. Which is the goal eventually. And it fits that path.

So, as you guessed, I’m signed up and have already knocked out about 2 hours of the 60. If you’ve been a listener since the start, you know that I gave you updates on the Neuromusculoskeletal Diplomate as I went through it. I told you all about it and what I was working on and learning.

I plan on doing some of the same here for you on the Forensics thing. That way you’ll be able to learn more about it and might consider it for yourself. Plus, I’ll have Dr. Lehman come on in a future podcast and share more about it.

The goal for the profession is to eventually get more and more chiropractors exploring the Diplomates and specializing. Raising the game of this profession one chiropractor at a time.

CHIROUP

Item #1

This first one is called “Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis” by Fernandez-de-las-Penas et. al. (1) and published in Pain Medicine on December 18, 2020 and that’s a lot hot in the pot!

Why They Did It

To evaluate the effects of muscle dry needling alone or combined with other interventions on post-stroke spasticity (muscle tone), related pain, motor function, and pressure sensitivity.

How They Did It

Electronic databases were searched for randomized controlled trials including post-stroke patients where at least one group received dry needling and outcomes were collected on spasticity and related pain
Secondary outcomes included motor function and pressure pain sensitivity
Data were extracted by two reviewers
7 studies were included

What They Found

The meta-analysis found significantly large effect sizes of dry needling for reducing spasticity, post-stroke pain, and pressure pain sensitivity as compared with a comparative group at short-term follow-up
The effect on spasticity was found mainly in the lower extremity
No effect on spasticity was seen at 4 weeks
No significant effect on motor function
The risk of bias was generally low, but the imprecision of the results downgraded the level of evidence.

Wrap It Up

The authors ended it by saying, “Moderate evidence suggests a positive effect of dry needling on spasticity (muscle tone) in the lower extremity in post-stroke patients. The effects on related pain and motor function are inconclusive.”

Item #2

Our second on today is called “Effect of Motor Skill Training in Functional Activities vs Strength and Flexibility Exercise on Function in People With Chronic Low Back Pain: A Randomized Clinical Trial” by Van Dillen, et. Al (2) and published in JAMA Neurology on December 28, 2020 and it’s a lot hot in the pot as well.

Why They Did It

For people with chronic, nonspecific low back pain, does person-specific motor skill training in functional activities result in better short-term and long-term outcomes than strength and flexibility exercise? You all know I love me some chronic pain research! I gobble it up like meat lover’s pizza.

How They Did It

Single-blind, randomized clinical trial of people with chronic, nonspecific LBP
149 participants
12-month follow-up
Recruitment spanned December 2013 to August 2016
Testing and treatment were performed at an academic medical center
Participants received 6 weekly 1-hour sessions of motor skill training in functional activity performance or strength and flexibility exercise of the trunk and lower limbs
Half of the participants in each group received up to 3 booster treatments 6 months following treatment.
The primary outcome was the modified Oswestry Disability Questionnaire (MODQ) score (0%-100%) evaluated immediately, 6 months, and 12 months following treatment.

Wrap It Up

“People with chronic low back pain who received motor skill training had greater short-term and long-term improvements in function than those who received strength and flexibility exercise.

Person-specific motor skill training in functional activities limited owing to low back pain should be considered in the treatment of people with chronic low back pain”

Item #3

Item 3 is called “Association of Physical Activity Intensity With Mortality A National Cohort Study of 403 681 US Adults” by Wang et. al. (3) and published in JAMA Internal Medicine on November 23, of 2020. It’s a skootch steamy, Sir!

Why They Did It

They asked the question, “Is vigorous physical activity associated with additional mortality risk reduction compared with moderate physical activity?” Great question. I’ve been working out but wouldn’t it be nice if moderate was just as effective as rigorous? I say it would be. So let’s see how it plays out.

How They Did It

Cohort study
403,681 adults from the National Health Interview Survey 1997-2013. Hello big, large sample size!
provided data on self-reported physical activity and were linked to the National Death Index records through December 31, 2015.
Statistical analysis was performed from May 15, 2018, to August 15, 2020.

Wrap It Up

“This study suggests that, for the same volume of moderate physical activity, a higher proportion of vigorous physical activity to total physical activity was associated with lower all-cause mortality. Clinicians and public health interventions should recommend 150 minutes or more per week of moderate physical activity but also advise on the potential benefits associated with vigorous physical activity to maximize population health.”

Dammit, looks like it’s as I feared. Vigorous is superior. Which honestly is pretty obvious but I was hoping for the keys to the kingdom with as little work as possible.

Item #4

The last one is called “Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment A Systematic Review and Meta-analysis” by Hughes, et. al. (4) and published in JAMA on May 19, of 2020 and I say it’s hot enough, fools. Stand back!

Why They Did It

The authors asked the question, “Is there an association between blood pressure lowering with antihypertensive therapy and the incidence of dementia or cognitive impairment?”

We are answering so many good questions today, people!!

How They Did It

Meta-analysis
Search of PubMed, EMBASE, and CENTRAL for randomized clinical trials published from database inception through December 31, 2019, that evaluated the association of blood pressure lowering on cognitive outcomes
The control groups consisted of either placebo, alternative antihypertensive agents, or higher blood pressure targets.
Data were screened and extracted independently by 2 authors
The primary outcome was dementia or cognitive impairment.
The secondary outcomes were cognitive decline and changes in cognitive test scores.

Wrap It Up

“In this meta-analysis of randomized clinical trials, blood pressure lowering with antihypertensive agents compared with control was significantly associated with a lower risk of incident dementia or cognitive impairment.”

So, besides stroke and other similar dangers, add dementia and cognitive abilities to the list of reasons to keep blood pressure in check.

Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.

Store

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

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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

César Fernández-de-las-Peñas, PT, PhD, Albert Pérez-Bellmunt, PT, PhD, Luis Llurda-Almuzara, PhD, Gustavo Plaza-Manzano, PT, PhD, Ana I De-la-Llave-Rincón, PT, PhD, Marcos J Navarro-Santana, PT, MSc, Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis, Pain Medicine, Volume 22, Issue 1, January 2021, Pages 131–141, https://doi.org/10.1093/pm/pnaa392
van Dillen LR, Lanier VM, Steger-May K, et al. Effect of Motor Skill Training in Functional Activities vs Strength and Flexibility Exercise on Function in People With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Neurol. Published online December 28, 2020. doi:10.1001/jamaneurol.2020.4821
Wang Y, Nie J, Ferrari G, Rey-Lopez JP, Rezende LFM. Association of Physical Activity Intensity With Mortality: A National Cohort Study of 403 681 US Adults. JAMA Intern Med. 2021;181(2):203–211. doi:10.1001/jamainternmed.2020.6331
Hughes D, Judge C, Murphy R, et al. Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment: A Systematic Review and Meta-analysis. JAMA. 2020;323(19):1934–1944. doi:10.1001/jama.2020.4249

w/ Dr. Aric Frisina-Deyo – Chiropractors In An FQHC Setting & Setting The Bar High Early On

August 6, 2020 chiropracticforward 00:55:45 1 Comment

CF 137: w/ Dr. Aric Frisina-Deyo – Chiropractors In An FQHC Setting & Setting The Bar High Early On

Today we’re going to be joined by Aric Frisina-Deyo. We’re going to discuss the ins and outs of working in an FQHC. You’ve heard us talk about it before with Dr. James Lehman. How do you do it, what can you expect out of it, and what does it look like? But first, here’s that sweet sweet bumper music

Like our Facebook page,
Join our private Facebook group and interact, and then
go review our podcast on iTunes and other podcast platforms.
We also have an evidence-based brochure and poster store at chiropracticforward.com
While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it.

You have found yourself smack dab in the middle of Episode #137

Now if you missed last week’s episode, we talked about adjustments making a person stronger, providing more endurance, and providing improved balance. We talked about new evidence on muscle relaxers, and we talked about the best recovery posture after some intense training. Find out if it’s better to recover having your hands on your knees or standing up with your hands behind your head like we’ve been taught over the years. Make sure you don’t miss that info. Keep up with the class.

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper.

On the personal end of things….. So far, so good. Staying steady, healthy, and strong. No big drop-offs in business but no big growth beyond our 80% mark either. Like I said last week, 80% is my new normal for now and, if that’s my new cap, then it’s time to simply start comparing my weekly numbers to the 80% mark and just continue growing and comparing to that. Basically, my 80% is what I’m now accepting as my new 100% if that makes sense. That’s my roof or my ceiling. I have stopped comparing my numbers currently to the numbers of last year or the numbers of pre-COVID.

It’s not fair to me or my employees. Like it or hate it, there is a new normal for now and for the foreseeable future and I’m living and operating in that world for now. That just makes more sense to me. Otherwise, I’m trying to reach a bar that is very difficult to reach and I think I’ll be perpetually frustrated and nobody’s got time for that.

So, I’m comparing my numbers to last week’s numbers and last month’s numbers. It just makes more sense. I have a new assistant taking care of the Chiropractic Forward website. You’ll have to go check it out here and there. She’s in the process of updating the Store link where we have evidence-based patient education brochures and brand new posters for your offices. Just go to chiropracticforward.com and click on the Store link while you’re there. Maybe sign up for our weekly email newsletter while you’re at it. No spam, just a weekly reminder on Thursdays when the new episodes go live. That’s it.

Introduction Alright, let’s get on with the show and introduce our guest today. Today we’re joined by Dr. Aric Frisina-Deyo. Being in only his second year of practice, Aric was wondering why I’d be interested in his story. Well, it’s simple, he is integrated into and working for an FQHC. Meaning, he’s already functioning at the top of the game and I want to know about it.

I’m guessing if I want to know about it, many of you would like to know about it. First, you may think your area doesn’t have an FQHC and for the most part, you’re probably wrong. Just pull out your Google machine and type in ‘FQHC and the area you live in’. See what it pulls up. Dr. James Lehman pulled that one on me when I told him I didn’t think my area had any.

Well, turns out we had two of them and I had no idea. One more in the win column for Dr. Lehman. What is an FQHC, you might ask? It stands for Federally Qualified Health Center. If you have listened to either of the episodes we have had with Dr. James Lehman from the Neuromusculoskeletal Medicine Diplomate of the University of Bridgeport. to start the second year of the three year Neuromusculoskeletal Medicine Residency through the University of Bridgeport. Very active while a student holding numerous positions in clubs and student government, Aric was able to take MDT and MPI which, along with this schooling, has helped to shape his practice style.

He is currently providing care to underserved populations in New Britain, Danbury and Clinton, CT in Federally Qualified Health Centers in a multidisciplinary setting alongside MDs, DOs, APRNs, PAs, Podiatrists, Dentists, Dieticians, other Allied Health Professionals. Aric is also working toward his diplomate in Neuromusculoskeletal Medicine and has had the privilege to assist in instruction for the orthopedic and neurological examination labs at UBSC. When not treating patients, studying or moderating FTCA, Aric can be found spending time with his wife and two children. He has already co-authored 6 research publications.

So let’s welcome Aric to the show thank you for joining us today.

Tell us where you are located and a little about the area if you don’t mind.

Before we get to the FQHC’s, tell me a bit about your journey to becoming a chiropractor. I always say that it’s not the first thing that comes to mind when most kids are deciding what they want to be when they grow up.

Tell me about where you attended college and your unique experience there that has led to your position and the current practice environment.

Is there an advantage to being a resident in an FQHC? Explain the pros and cons of your experience.

Do you evaluate or see many chronic pain patients?

Do your patients tend to present with many co-morbidities or are they usually just spinal pain.

If so, how do you manage the co-morbidities?

Do you care for many high-impact chronic patients with disabilities? And…..for our audience, can you explain the difference between high-impact chronic pain and run-of-the-mill chronic pain?

Tell us about your experience working with and interacting with your medical field counterparts there at the FQHC.

Do you see the FQHC being your preferred practice setting going forward or is a private practice in your future?

Before we wrap up here, I met you through Dr. Kris Anderson up in North Dakota. He’s been a previous guest on our podcast. He has suggested you have something working with dry needling research. Can you share some of that information with us?

Alright, that’s it. Y’all be safe. Keep changing the world and our profession from your little corner of the world. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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 preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!

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

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About the Author & Host Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Giving, Maintenance Care, Dry Needling, and Vitalism

July 2, 2020 chiropracticforward 0:25:36 0 Comments

CF 132: Giving, Maintenance Care, Dry Needling, and Vitalism Today we’re going to talk about Giving, Maintenance Care, Dry Needling, and Vitalism

But first, here’s that sweet sweet bumper music

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.

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

Like our Facebook page,
Join our private Facebook group and interact, and then
go review our podcast on iTunes and other podcast platforms.
We also have an evidence-based brochure and poster store at chiropracticforward.com
While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it.

You have found yourself smack dab in the middle of Episode #132

Now if you missed last week’s episode , we talked about 5 principles to change clinical practice. There was some great information in that one all based on a recent paper that came out. Make sure you don’t miss that info. Keep up with the class.

Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper.

On the personal end of things…..

One foot in front of the other. I’ve been thinking a lot lately. I know this concept but I don’t do it intentionally. Still….I definitely do it. I give away stuff and help others when I like them, their product, or service. I promote them without expecting anything in return. Because I don’t expect anything in return. I do it because of the reasons stated.

Then, what happens is that through giving to others, things come back around and are given to you. That’s the way it works. Again, I don’t give to get something back. To me, that’s just not how it works. You have to give because you have a giving heart. Not a greedy heart just giving to get.

I talk about people that I believe in and things that I use because I like them and I think they’d be useful to you. I talk about other people’s stuff more than I talk about my own stuff. I have some awesome evidence based patient education brochures and posters on our website but I talk more about Forward Thinking Chiropractic Alliance than you hear me talk about my stuff.

If you’re evidence-based, I firmly believe you need to be a part of the FTCA. It’s that simple. We had Kevin Christie with Modern Chiropractic Marketing Podcast on a couple weeks ago. He does it right. That’s why he was on. I believe in Dr. Christie, I like Dr. Christie, and I support him.

ChiroUp, not only do I really like the co-owners personally, but I don’t know what I ever did without the product. Honestly, I have no idea. I was less than before I had ChiroUp in my office.

It’s why you always hear me speak about the diplomate/fellowship through the international academy of neuromusculoskeletal medicine. I’m not sure I’ve ever professionally believed in anything more than the education you get through them.

It’s why I talk often about involvement with the Texas Chiropractic Association. It’s because I hope you’ll see the value in being active and involved in your own associations. Doing so was one of the key gamechangers in my professional life. You can count on that.

Same goes for philanthropy. If you’re not giving back to your local non-profits monthly, you really should consider doing so. It’s easy and it’s fun. We’ve made it a cornerstone of my personal business.

This isn’t a ‘oh look at me and how awesome I am’ thing here. It’s just an honest conversation about something I was thinking the other day. Does any of this come back to benefit me financially? I don’t know. I really don’t have a clue. And honestly, I don’t care. Once again, that’s not why we give. We give because we have a giver’s heart. Not only do I like and believe in the people and the products or the causes, but I also think that our listeners will find value in it. If I’m providing you value, then you know you’ll get the best, most valuable information through this podcast.

So, maybe, even if others aren’t necessarily talking us up or pumping our tires, it still comes back, huh? Either way, there’s nothing better than giving. At least for me. I came across a quote that made some sense recently. Pablo Picasso said that the meaning of life is to find your gift. The purpose of life is to give it away.” That’s a giver’s heart. Exactly what I’m talking about. Seems like it worked out for Pablo.

I think about give vs. take and I think of people that are takers. Taking money from patients when they don’t need the treatment. But a doctor scared them into a ton of extra visits because it’s good for stats and the bottom line. That’s a taker.

Being in a position to help but deciding to never do anything to help anyone unless it benefits them personally or financially. That’s a taker.

Just being in the world to see what you can get out of it instead of what you can contribute. That’s a taker. What can you do to make your space better? How can you spread a little love and kindness?

Just some random thoughts today. Hope it meant something to you.

Item #1

Let’s get started with this one called “The Nordic maintenance care program: maintenance care reduces the number of days with pain in acute episodes and increases the length of pain free periods for dysfunctional patients with recurrent and persistent low back pain – a secondary analysis of a pragmatic randomized controlled trial” by andreas Eklund et al(Eklund A 2020) and published in Chirorpactic and Manual Therapies in April 2020. Hot cakes coming up, hot cakes people.

Why They Did It

Eklund has shown in two previous papers the benefit of treating preventatively but thae benefit varied across psychological subgroups.

The aims of this study were to investigate

pain trajectories around treatments,
recurrence of new episodes of LBP, and
length of consecutive pain-free periods and total number of pain-free weeks, for all study participants as well as for each psychological subgroup.

How They Did It

A secondary analysis of data from a randomized controlled trial of patients seeking chiropractic care for recurrent or persistent LBP used 52 weekly estimates of days with low back pain that limited activity.

What They Found

Patients receiving maintenance care had flat pain trajectories around each new treatment period and reported fewer days with pain compared to patients receiving the control intervention.
The entire effect was attributed to the dysfunctional subgroup who reported fewer days with activity limiting pain within each new LBP episode as well as longer total pain-free periods between episodes with a difference of 9.8 weeks compared to the control group.
There were no differences in the time to/risk of a new episode of LBP in either of the subgroups.

Wrap It Up

Data support the use of MC in a stratified care model targeting dysfunctional patients for MC. For a carefully selected group of patients with recurrent and persistent LBP the clinical course becomes more stable and the number of pain-free weeks between episodes increases when receiving MC.

Item #2

Item 2 is called ‘Dry needling for spine related disorders: a scoping review’ by Funk et. al(Funk MF 2020). published in Chiropractic and Manual Therapies in May of 2020…..bringin’ the heat people! Bringing the heat!

Why They Did It

The depth and breadth of research on dry needling (DN) has not been evaluated specifically for symptomatic spine related disorders (SRD) from myofascial trigger points (TrP), disc, nerve and articular structures not due to serious pathologies. Current literature appears to support dry needling for treatment of trigger points. Goals of this review include identifying research published on dry needling treatment for spine related disorders, sites of treatment and outcomes studied.

How They Did It

A scoping review was conducted following Levac et al.’s five part methodological framework to determine the current state of the literature regarding dry needling for patients with spine related disorders.

That sound fine and freaking dandy but what the hell is a scoping review vs. a systematic review? Well, I did the work for you and here’s what we have. Within the framework of research methods, a well- done scoping review is considered at a higher level than a straightforward review of literature or an integrative review, but not as in depth as a Cochrane or Johanna Briggs model systematic review

Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions.

Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy.

And now we’ve both learned something so that’s awesome.

Wrap It Up

Back to the paper here; I’m not even going to get into the meat and taters here on this paper because you’ll zone off and might even tune out. I have it cited in the show notes if you really want to find it and dive in. Getting straight to the conclusion, the authors say, “For spine related disorders, dry needling was primarily applied to myofascial structures for pain or TrP diagnoses. Many outcomes were improved regardless of diagnosis or treatment parameters. Most studies applied just one treatment which may not reflect common clinical practice. Further research is warranted to determine optimal treatment duration and frequency. Most studies looked at dry needling as the sole intervention. It is unclear whether dry needling alone or in addition to other treatment procedures would provide superior outcomes.”

We covered a paper on dry needling last year that suggested it had little use. It appears it does indeed have some use. They just don’t know how to best use it yet. If that makes sense.

Item #3

Our last one today is called ‘Vitalism in contemporary chiropractic:a help or a hinderance?” by J. Keith Simpson and Kenneth J. Young(Simpson J 2020) and published in Chiropractic and Manual Therapies June 11, 2020. See the sizzle on that stacks of steaming sizzlers.

Why They Did It

Chiropractic emerged in 1895 and was promoted as a viable health care substitute in direct competition with the medical profession. This was an era when there was a belief that one cause and one cure for all disease would be discovered. The chiropractic version was a theory that most diseases were caused by subluxated (slightly displaced) vertebrae interfering with “nerve vibrations” (a supernatural, vital force) and could be cured by adjusting (repositioning) vertebrae, thereby removing the interference with the body’s inherent capacity to heal. DD Palmer, the originator of chiropractic, established chiropractic based on vitalistic principles. Anecdotally, the authors have observed that many chiropractors who overtly claim to be “vitalists” cannot define the term. Therefore, we sought the origins of vitalism and to examine its effects on chiropractic today.

Discussion

Vitalism arose out of human curiosity around the biggest questions: Where do we come from? What is life? For some, life was derived from an unknown and unknowable vital force. For others, a vital force was a placeholder, a piece of knowledge not yet grasped but attainable. Developments in science have demonstrated there is no longer a need to invoke vitalistic entities as either explanations or hypotheses for biological phenomena. Nevertheless, vitalism remains within chiropractic. In this examination of vitalism within chiropractic we explore the history of vitalism, vitalism within chiropractic and whether a vitalistic ideology is compatible with the legal and ethical requirements for registered health care professionals such as chiropractors.

They say that despite the obstacle of vitalism, chiropractic has made extraordinary inroads into the health care system worldwide. Having emerged from the pre-scientific health care era in the United States of America (USA) in the early twentieth century it now has a global footprint with representation in approximately 100 countries. It is the third largest regulated primary contact health care profession in the western world

Conclusion

Vitalism has had many meanings throughout the centuries of recorded history. Though only vaguely defined by chiropractors, vitalism, as a representation of supernatural force and therefore an untestable hypothesis, sits at the heart of the divisions within chiropractic and acts as an impediment to chiropractic legitimacy, cultural authority and integration into mainstream health care.

Y’all know by now how I feel about it. When you have someone following current research, updating their procedures and thought process as the knowledge base expands, and taking care of their patients and running their businesses in an ethical way with the highest of morals and love, then you’re my kind of person. I respect you and I’m proud of you. Most of our listeners are that kind of practitioner.

If you’re scaring people into a bunch of visits based on stuff research says is no big deal, if you’re convincing people they depend on seeing you consistently, if you’re engaging in vaccine discussions when you’ve read a book or two but never been proper educated to do so, when you’re stats and your profits come before the true needs of the patient, then I don’t respect you and I wonder how you sleep at night with the knowledge of how you are screwing and stealing from patients coming to you for your help weighing heavily on your conscience. They come to you for your help. Not to buy you a big house. Not to be lied to. Not to have false, fake, or outdated ideas shoved up their poop shoot and to be taken advantage of.

Stop it dammit. It’s gross and you give everyone that truly works their asses off a bad name. You’re the reason someone that gets a diplomate or some other significant continueing education ro certification…..you’re the reason they still get laughed at behind their backs. You should be ashamed of what you do to yourselves, your colleagues, and your profession.

I’m really not a bitchy guy. I’m a fun-loving ‘let’s have a beer’ kind of guy. But very few things grind my geears worse than this stuff. Honestly. It’s the wrench in my gears, the salt in my wound if you will. I think about it and I start breaking out in hives and get all rashy. My eyes about roll out of my damn head onto the floor.

I’ll be in a better mood next week. I hope.

Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it.

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

The Message

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 preventativly 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.

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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Eklund A, H. J., Jensen I, Leboeuf-Yde C, (2020). “The Nordic maintenance care program: maintenance care reduces the number of days with pain in acute episodes and increases the length of pain free periods for dysfunctional patients with recurrent and persistent low back pain – a secondary analysis of a pragmatic randomized controlled trial.” Chiropr Man Therap 28(19).

Funk MF, F.-D. A. (2020). “Dry needling for spine related disorders: a scoping review.” Chiropr Man Therap 28(23).

Simpson J, Y. K. (2020). “Vitalism in contemporary chiropractic: a help or a hinderance?” Chiropr Man Therap 28(35).

Dry Needling

Subacromial Dry Needling & Lumbar Discs With Stenosis Present

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.

Dry Needling, Types of Exercise Count, Motor Skills For Chronic Back, and Blood Pressure & Dementi

CF 166: Dry Needling, Types of Exercise Count, Motor Skills For Chronic Back, and Blood Pressure & Dementia

w/ Dr. Aric Frisina-Deyo – Chiropractors In An FQHC Setting & Setting The Bar High Early On

Giving, Maintenance Care, Dry Needling, and Vitalism

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