Jeff Williams - evidence-based chiropractor

SMT and The Low Back & How Much Exercise Is Actually Needed

May 4, 2023 chiropracticforward 00:14:10 0 Comments

CF 278: SMT and The Low Back & How Much Exercise Is Actually Needed

Today we’re going to talk about SMT and The Low Back & How Much Exercise Is Actually Needed

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 278 Now if you missed last week’s episode, we talked about the safety of SMT in the cervical spine and we talked about Chiropractors’ beliefs around the need for x-rays. That one was surprising given the fact that it’s now 2023. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

First thing’s first, yours truly voiced the Elvis character in a video game that just came out on Xbox and Playstation. It’s called God of Rock and the company that released it is called Modus. If you’re a gamer and you like fighting games, go google up god of rock by Modus and see what you think. The Elvis character is named King and yep, that’s my voice. Even the grunts and groans, the punches and the taking damage. All of it. Crazy. Life. I lead, folks. Just insane but blessed too. It’s warming up outside for most of us. At least here in the South it is. You Yankees feel free to correct me if you like. I can handle your ridicule. It got me to thinking, with it getting warmer outside now, how does that affect your marketing efforts? Here’s what I’m thinking; what do we do more of when it warms up/

We do more yard work
Runners run more
Bikers bike more
Hikers hike
You’ve got Summer baseball, basketball, and whatnot.
Some of you will have rowing, waterskiing, and watersports. Note – that wouldn’t be Amarillo, TX just in case you’re wondering.

The point being that your marketing might shift a bit to make sure you’re talking to the people that are out there putting their bodies under more stress than they have in the last 6 or so months. So, go do all of the stuff. Build it this Summer

Item #1 The first on today is called “Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomized controlled trials” by Sidney M Rubinstein, Annemarie de Zoete, Marienke van Middelkoop, Willem J J Assendelft, Michiel R de Boer, Maurits W van Tulder and published in PubMed on March 13 2019.

Why They Did It

To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain.

How They Did It

Two reviewers independently selected studies, extracted data, and assessed risk of bias and quality of the evidence.
The effect of SMT was compared with recommended therapies, non-recommended therapies, sham (placebo) SMT, and SMT as an adjuvant therapy.
Main outcomes were pain and back specific functional status, examined as mean differences and standardized mean differences (SMD), respectively. Outcomes were examined at 1, 6, and 12 months. Quality of evidence was assessed using GRADE. A random effects model was used and statistical heterogeneity explored.

What They Found

47 randomised controlled trials including a total of 9211 participants were identified, who were on average middle aged (35-60 years).

Most trials compared SMT with recommended therapies. Moderate quality evidence suggested that SMT has similar effects to other recommended therapies for short term pain relief (mean difference -3.17, 95% confidence interval -7.85 to 1.51) and a small, clinically better improvement in function (SMD -0.25, 95% confidence interval -0.41 to -0.09).

High quality evidence suggested that compared with non-recommended therapies SMT results in small, not clinically better effects for short term pain relief (mean difference -7.48, -11.50 to -3.47) and small to moderate clinically better improvement in function (SMD -0.41, -0.67 to -0.15). In general, these results were similar for the intermediate and long term outcomes as were the effects of SMT as an adjuvant therapy.

Evidence for sham SMT was low to very low quality; therefore these effects should be considered uncertain. Statistical heterogeneity could not be explained.

About half of the studies examined adverse and serious adverse events, but in most of these it was unclear how and whether these events were registered systematically. Most of the observed adverse events were musculoskeletal related, transient in nature, and of mild to moderate severity.

One study with a low risk of selection bias and powered to examine risk (n=183) found no increased risk of an adverse event (relative risk 1.24, 95% confidence interval 0.85 to 1.81) or duration of the event (1.13, 0.59 to 2.18) compared with sham SMT. In one study, the Data Safety Monitoring Board judged one serious adverse event to be possibly related to SMT.

Wrap It Up

SMT produces similar effects to recommended therapies for chronic low back pain, whereas SMT seems to be better than non-recommended interventions for improvement in function in the short term. Clinicians should inform their patients of the potential risks of adverse events associated with SMT. 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, “How much exercise is needed to live longer” by Sara Berg, MS and published in American Medical Association on March 16, 2018.

Why They Did It To know many minutes of moderate or vigorous physical activity are needed to lower the risk of premature mortality.

How They Did It From two large prospective U.S. cohorts, 116,221 adults self-reported leisure-time physical activity—defined as exercise that is not done at work—through a validated questionnaire. The questionnaire was repeated up to 15 times over the course of 30 years.

What They Found

The study found that those who worked out two to four times beyond the minimum physical activity recommendations had a lower risk of death from cardiovascular disease.

Those who worked out two to four times above the moderate physical activity recommendations—about 300 to 599 minutes each week—saw the most benefit.

Participants had a 26% to 31% lower all-cause mortality while 28% to 38% had lower cardiovascular mortality. On top of that, 25% to 27% experienced lower non-cardiovascular mortality.

Wrap It Up Adults who worked out two to four times more than the vigorous physical activity recommendations—about 150 to 299 minutes per week—were found to have 21% to 23% lower all-cause mortality, according to the study. They were also reported to have 27% to 33% lower cardiovascular mortality and 19% lower non-cardiovascular mortality. 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.

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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

Tensile Force On Vertebral Artery During Adjustments & Exercising For Pain

December 1, 2022 chiropracticforward 00:15:05 0 Comments

CF 257: Tensile Force On Vertebral Artery During Adjustments & Exercising For Pain Today we’re going to talk about Tensile Force On Vertebral Artery During Adjustments & Exercising For Pain But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #257 Now if you missed last week’s episode , we talked about Aspirin And Fall Risk & Caffeine And Child Growth. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things….. What’s going on with me lately? Well, still riding some inflation and recession stuff here these last two months and working on marketing and my customer experience to right the ship as quickly as possible. My trip to Florida and Thanksgiving are playing hell with some of the recoveries but that is what it is and that’s OK. That’s life.

One of the things we started last week was ‘Your benefits re-start in January so use them while you have them.” Also, am I in too big of a hurry with patients?

Do they feel my need to be in and out or do they each feel special in some way? I am trying to slow down and be more present with each patient. More interested in them and in their story. We can always blame outward forces when our practices slow up a bit. And that’s legit. You have to consider all aspects. Is it the economy? My website SEO? Inflation? What is the outward cause?

But also, what are the potential in-house causes? Am I too rushed? Am I no longer focused on the customer experience and only focusing on all of my stuff that has to be done instead? Is there something going on with our new patient process and our booking procedures? Internally, have we changed anything about how we are functioning and doing things? Let’s review how we’re doing things and let’s figure it out. That’s what I’m looking at right now.

No coach or mastermind has all of the answers to a slowdown. It is up to us as business owners to diagnose the cause and the effect. At least to the best of our abilities. I’m not dramatically slower than in August but September and October and November have been slow enough compared to my regular load that it’s past time to get it fixed and headed back in the right direction.

And that includes looking in the mirror. We should all do that. A good leader doesn’t ask where the staff failed, but asks, where have I failed. That’s what I’m doing.

Also, I’m looking at where I can delegate tasks that have put me in a hurry most days. When I can’t keep up with stuff, it’s time to figure out how to farm out stuff so that I don’t feel rushed and overwhelmed all day every day. I’m an immaculate stat keeper. That’s about to change. I have an excellent virtual assistant in Nigeria that is helping me figure out how to automate and delegate balancing bank statements, which I still do myself and stat keeping.

This will save A LOT of time on Mondays, Tuesdays, and Wednesdays freeing my brain up to work on more productive tasks like the customer experience. Alright, enough introspective discovery for this week. Onto the research.

Item #1

The first on today is called, “Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers” by Gorrell et. al. (Gorrell LM 2022) and published in Journal of Manual Manipulativer Therapy on November 15, 2022. Dayum. That’s hot.

Why They Did It The vertebral artery (VA) may be stretched and subsequently damaged during manual cervical spine manipulation. The objective of this study was to measure vertebral artery length changes that occur during cervical spine manipulation and to compare these to the vertebral artery failure length.

How They Did It

Piezoelectric ultrasound crystals were implanted along the length of the VA (C1 to C7) and were used to measure length changes during cervical spine manipulation of seven un-embalmed, post-rigor human cadavers.
Arteries were then excised, and elongation from arbitrary in-situ head/neck positions to first force (0.1 N) was measured. Following this, vertebral arteries were stretched (8.33 mm/s) to mechanical failure.
Failure was defined as the instance when VA elongation resulted in a decrease in force.

What They Found

From arbitrary in-situ head/neck positions, the greatest average vertebral artery length change during spinal manipulation was 5.1%.
From arbitrary in-situ head/neck positions, arteries were elongated on average 33.5% prior to first force occurrence and 51.3% to failure.
Average failure forces were 3.4 N

Wrap It Up

Measured in arbitrary in-situ head/neck positions, vertebral arteries were slack. It appears that this slack must be taken up prior to vertebral arteries experiencing tensile force. During cervical spine manipulations (using cervical spine extension and rotation), arterial length changes remained below that slack length, suggesting that VA elongated but were not stretched during the manipulation. 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, “The Relationship Between Physical Activity and Pain in U.S. Adults” by Ray et. al. (Ray 2022) and published in Medicine and Science in Sports and Exercise on October 26, 2022. Hot potato!

Why They Did It The authors wanted to assess the relationship between physical activity (PA) and pain within the available sample, with secondary aims to assess prevalence of pain, physical activity levels, healthcare seeking behaviors, and impact of pain on daily activities and work.

How They Did It They conducted an epidemiological cross-sectional observational study utilizing National Health Interview Survey (NHIS) data from 2020. They examined the self-reported adherence to current physical activity guidelines and the prevalence of pain. They hypothesized those dealing with pain were less likely to meet physical activity guidelines. physical activity levels, pain prevalence, frequency, and intensity were assessed via the survey and relationships explored via modeling.

What They Found

31,568, subjects
12,429 (39.37%) reported pain on some days, 2,761 (8.75%) on most days, and 4,661 (14.76%) every day.
The odds of engaging in physical activity decreased in a stepwise fashion based on frequency and intensity of pain reporting when compared to no pain.
Importantly, physical activity is a significant correlate affecting pain reporting, with individuals engaging in physical activity (strength and aerobic) demonstrating 2 times lower odds of reporting pain when compared to those not meeting the physical activity guidelines.

Wrap It Up

There is a significant correlation between meeting physical activity guidelines and pain. Meeting both criteria of physical activity guidelines resulted in lower odds of reporting pain. Additionally, the odds of participating in physical activity decreased based on pain frequency reporting.

These are important findings for clinicians, highlighting the need for assessing physical activity not only for those dealing with pain but as a potential risk factor for minimizing the development of chronic pain. Get ‘em moving folks!

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

Gorrell LM, S. A., Edwards WB, Herzog W., (2022). “Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers.” J Man Manip Ther.

Ray, B. M. K., Kyle J.; Eubanks, James E.; Nan, Nan; Ma, Changxing; Miles, Derek, (2022). “The Relationship Between Physical Activity and Pain in U.S. Adults.” Medicine & Science in Sports & Exercise.

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

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

CF 249: Vertebrogenic Pain – A Thought Shift & Leisure time Physical Activity Effects On Mortality Today we’re going to talk about Vertebrogenic Pain. Time for A Thought Shift & Leisure time Physical Activity Effects On Mortality But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

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

You have found yourself smack dab in the middle of Episode #249 Now if you missed last week’s episode , we talked about steps per day and how that’s related to dementia and we talked about vets and chiropractic. What a wonderful combination. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

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

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

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

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

Item #1

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

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

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

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

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

Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.

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

Item #2

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

Why They Did It

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

How They Did It

NIH Cohort study of 272 550 older adults

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

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

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

Wrap It Up

This cohort study of older individuals found differences between different types of leisure time activities and mortality risk, but there were significant associations between participating in 7.5 to less than 15 metabolic equivalent of task hours per week of any activity and mortality risk. There you have it go jump into some tennis, racquet ball, or pickle ball and then go for a run. You future self with thank your current self. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

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

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

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

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

Thoracic Adjustments For Neck, Not Headache & Physical Activity In Children

May 19, 2022 chiropracticforward 00:17:28 0 Comments

CF 229: Thoracic Adjustments For Neck, Not Headache & Physical Activity In Children Today we’re going to talk about T-sp Adjustments For Neck, Not Headache & Physical Activity In Children But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

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

You have found yourself smack dab in the middle of Episode #229 Now if you missed last week’s episode , we talked about Exercise For Depression & Manipulation For Tendinopathy. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I’ll be honest with you all…..I always am anyway…..I feel like I’m as busy as I’ve ever been but when I look at the numbers, they’re down a bit still. I’m not fully recovered to the numbers that we saw prior to the pandemic setting in in 2020. I know many of you are. I’m not yet. I’m not far off. But I’m not there dependably month after month yet. As a result of my involvement in Dr. Kevin Christie’s Florida Mastermind that you’ve heard me mention, and at Kevin’s suggestion, I read a book called Who Not How by Dan Sullivan and Ben Hardy. I highly suggest it. This book is telling us to quit looking for how you do things and start looking for WHO can help you accomplish your goal. This isn’t really a new concept but really sheds some light on the topic.

We need a team. We need helpers. We cannot ever hope to do it all ourselves and do it a high level. To start looking at bringing on team members as investments rather than costs. It’s eye-opening for sure. Give it a try and see what you think. As a result, I’m looking for Whos. I have some Whos already. I make good use of virtual assisstants. I have one in Pakistan, one in Nigeria, and one in India.

They help me with marketing voice over, with my Chiropractic Forward website, with a website I’m trying to build for another business, and with stat keeping and monthly balancing and close outs in my chiro business. But I’m still doing a lot of tasks weekly that can be farmed out to a Who. What daily and weekly worker bee tasks are you doing yourself that can be farmed out while investing in a new Who? My biggest one is an associate. I’m on the hunt. If you or someone you know is interested in interviewing with me for a potential position here in my clinic, I’d love to speak with you.

The Texas Panhandle has pros and cons like everywhere else but I will say that one of our biggest draws is our incredible people. We are kind, friendly, and helpful. That, and hey, we have the second largest canyon in the nation called Palo Duro Canyon. It’ll knock your socks and your shoes off. Anyway, send me an email at creekstonecare@gmail.com if you’re intersted and we’ll connect.

Before we get to the research, I recently connected with a personal injury attorney and as a result, I have a gift for you! I’m going to turn you on to a system that will result in your getting tons of PI cases from attorneys. Yes, getting these referrals can be done. Paul Samakow, a veteran PI attorney, put this system together. He knows what attorneys want to hear – inviting them to lunch doesn’t work, folks. His system, delivered to you in both written and video form, is insightful and hits the mark.

Over 25 concepts on how you can not only get attorneys to refer to you, but endear yourself to them. Samakow’s system costs $997 and he guarantees satisfaction or your money back. You have to check this out. Even if you only get one case, you’ve made at least 4 or 5 times the investment. Go to gettingpicases.com/cs That’s gettingpicases.com/cs One more time so you get it right: gettingpicases.com/cs

Item #1

The first one today is called, Thoracic spine thrust manipulation for individuals with cervicogenic headache: a crossover randomized clinical trial by McDevitt et. al. (Amy W. McDevitt 2022) and published in the Journal of Manual and Manipulative Therapy July of 2021. Shazam….it’s steamy.

Why They Did It

To determine if thoracic spine manipulation (TSM) improves pain and disability in individuals with cervicogenic headache (CeH). Now, let’s take a step back just a bit and I’ll share some knowledge from the Neuromusculoskeletal Diplomate program about where Cervicogenic headaches lie in terms of prevalence. Tension-type headaches are the overwhelming winners.

They make up about 40% or more of the headaches that present to just about any clinic. Second place goes to migraines. True migraines make up only about 10%. Not nearly as much as you might expect. Since Tension type and migraine live on the same continuum of headaches, they can share some characteristics of each other so, many times, a tension type can behave like a migraine and vice versa. True migraines, however, are only about 10% of cases. Then comes cervicgenic headaches at only about 4% of the cases of headaches you see in clinic. The good news is that tension type and cervicogenic are the ones we really have a lot of success with since they typically come from the suboccipital and/or neck region and that’s our bread and cinnamon butter, baby. That’s hero territory right there because we can turn someone’s life around muy pronto, mi amigo.

How They Did It

It was a randomized controlled crossover trial
It was conducted on 48 participants with cervicogenic symptoms.
Participants were randomized to 6 sessions of thoracic spine manipulation or no treatment and after 4-weeks, groups crossed over.
Outcomes were collected at 4, 8 and 12 weeks and included: headache disability inventory (HDI), neck disability index (NDI), and the global rating of change (GRC).

What They Found

Comparing no-treatment group to the active treatment group, the Headache Disability Index outcomes were not significantly different between groups at any timepoint;
The Neck Disability Index outcome, however, was significant at 4 weeks.

Wrap It Up

Thoracic spine manipulation had no effect on headache-related disability but resulted in significant improvements in neck-related disability and participant reported perceived improvement. Muy bueno, muy bueno. Don’t forget to adjust the T-spine for the neck pain. Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again.

Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #2

This one is called, “Physical Activity In Children” by Michel et. al. (Michel J 2022) published on April 25, 2022….brand spankin new in the skillet. It’s burns! This is an article really rather than a research project so lets summarize this bad boy.

They start by saying “The US received an overall grade of D− for physical activity in children, with only about 1 in 4 children meeting the daily recommendation of 60 minutes or more per day.

With the recent COVID-19 pandemic, this has worsened because children are even less active, missing out on daily activities and group sports, and increasing screen time.” “Being inactive has numerous harmful effects on health and well-being. It is linked to many chronic diseases and conditions, such as obesity, diabetes, high blood pressure, heart disease, cancers, and early death. In contrast, there are numerous benefits to physical activity for children, including decreased risk for developing all of these diseases and conditions.

Physical activity can also help to decrease stress and improve school performance, sleep, and mental health.” “US physical activity guidelines recommend that children aged 3 to 5 years be physically active throughout most of the day and that children aged 6 to 17 years have at least 60 minutes of moderate to vigorous physical activity daily. Moderate to vigorous activity means the heart rate is raised higher than the normal resting range and is associated with sweating and deeper breathing.” “How can you help your child meet these goals? First, be an example.

Children copy you, so if you make exercise a part of your routine, they are more likely to follow in your footsteps. You can also help by making physical activity a part of your whole family’s daily routine by setting a time every day, especially when your children are young. In addition, try to make activity fun. If your child enjoys physical activity from an early age, this will likely continue as they grow older.

It can also be helpful to make a list of physical activity options, both for outside and indoors for when the weather is not appropriate. “ These are recommendations for us as parents but also as providers that can guide and encourage out younger patients toward more activity.

Do you do anything outside of your office to encourage your patients to get active? What if one of your staff members wanted to host a walk in the park? A hike in nature? Or something similar? Good for your patients and good for practice building. 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

The Importance of Movement & Steps

March 24, 2022 chiropracticforward 0:11:40 0 Comments

CF 221: The Importance of Movement & Steps Today we’re going to talk about The Importance of Movement & Steps But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

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

You have found yourself smack dab in the middle of Episode #221 Now if you missed last week’s episode, we talked about Sleep, Energy, and Pain & Depression and Rehab. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Business is still slowly creeping back up to where we’d like to see it. Now if the employee aspect of it will follow. So, I told you all we’d been a month since the 7-week front desk staffer we had quit. So we’ve been hiring for a damn month. We found one but she needed to give her two-week notice. So we’ve been waiting on her to start. So the Thursday before the Monday she’s supposed to start, she calls to let us know that she took another job. Holy guaca freakin moly.

Ya can’t make this stuff up. So we get in the horn….two weeks after we closed out the hiring process and started calling some of the old resumes.

Luckily, our #2 answered and still wanted the job and she can start on Monday. The day the loser was supposed to start anyway.

Hallelujah crap fire, save the queen, the new Batman is too damn emo and God bless America.

I’ll let you know if she lasts more than 7 weeks. I don’t have high hopes by this point in time. As the great Texas singer/songwriter Ray Wylie Hubbard once said, let’s rock n roll and hootchie coo. Here we go

Item #1

This one is called “Estimated Number of Deaths Prevented Through Increased Physical Activity Among US Adults” by Saint-Maruice et. al. ( Saint-Maurice PF 2022) and published in Jama Internal Medicine on January 24, 2022……schiza!! It’s muy Caliente on my plate. That’s three languages right there people.

Why They Did It

Previous studies suggest that a substantial number of deaths could be prevented annually by increasing population levels of physical activity. But they say previous attempts at quantifying it have been lackluster. They accelerometer measurements

to examine the association of physical activity and mortality in the US
to estimate the number of deaths prevented annually with modest increases in moderate-to-vigorous physical activity (MVPA).

How They Did It

It doesn’t matter. Lol. Well, technically, of course, it matters. But, you’re not going to want to hear it. Sometimes, it’s like sausage. You really don’t want to see how it’s made. You just want to enjoy the results so….let’s just enjoy the results so y’all don’t tune out on me.

Wrap It Up In this cohort study, we estimated that approximately 110,000 deaths per year could be prevented if US adults aged 40 to 85 years or older increased their moderate-to-vigorous physical activity by a small amount (ie, 10 minutes per day).

Item #2 Our last one this week is called, “Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study” by Paluch et. al. and published in JAMA Network Open on September 3, 2021.

Why They Did It

To estimate the association of steps per day with premature (age 41-65 years) all-cause mortality among Black and White men and women.

How They Did It

It was a prospective cohort study.
Participants were aged 38 to 50 years and wore an accelerometer from 2005 to 2006.
Participants were followed for a mean of 10.8 years.
Daily steps volume, classified as

low (<7000 steps/d),
moderate (7000-9999 steps/d), and
high (≥10 000 steps/d) and

Stepping intensity classified as

peak 30-minute stepping rate and
time spent at 100 steps/min or more.

All-cause mortality was the outcome measure.
A total of 2110 participants from the CARDIA study were included,

Wrap It Up

This cohort study found that among men and women in middle adulthood, participants who took approximately 7000 steps/d or more experienced lower mortality rates compared with participants taking fewer than 7000 steps/d. There was no association of step intensity with mortality. So get moving rock n roll and hootchie coo. Like you know you’re supposed to do. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the 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

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

Tweets by 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

Cholewicki J, P. J., Reeves NP, DeStefano L, (2021). “The Effects of Osteopathic Manipulative Treatment on Pain and Disability in Patients with Chronic Neck Pain: A Single-Blinded Randomized Controlled Trial.” PM R.

Saint-Maurice PF, G. B., Troiano RP (2022). “Estimated Number of Deaths Prevented Through Increased Physical Activity Among US Adults.” JAMA Intern Med 182(3): 349-352.

Intermittent Fasting & Dementia And Your Level Of Activity

January 13, 2022 chiropracticforward 1:27:38 0 Comments

CF 212: Intermittent Fasting & Dementia And Your Level Of Activity

Today we’re going to talk about Intermittent Fasting & Dementia And Your Level Of Activity But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and your patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
Then go Like our Facebook page,
Join our private Facebook group, and then
Review our podcast on whatever platform you’re listening to
The 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 #212 Now if you missed last week’s episode, we talked about Chiropractic And Colicky Babies & Breathing With Thoracic Outlet Syndrome. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Things slow down in January for most of us. That’s a time to set some goals, a time to get your taxes prepped for your CPA, and a time to reflect on the year we just wrapped up and where we can leverage our experience to springboard beyond next year. You never can tell with some offices. But for me, January through the end of February is traditionally slower than the rest of the year. We usually see a slow down again around back-to-school time in late August. Other than those times of the year, it’s typically nonstop busy busy. So, while it’s slow, we use that to our advantage. Have you lined up your marketing plan for the next year? Have you started gathering your tax info for your accountant? It’s probably a decent time to do a recall effort. Have your staff contact patients you haven’t seen in forever and ask them how their holidays went and make sure they’re doing good. Just a check-in type of thing. You’d be amazed at how many people just like to know they weren’t forgotten and how a checkin from our office can spur them to go ahead and come on back in because their back has been nagging lately or those headaches have started creeping back in later. Employees. If you’ve followed along, we just recently replaced the front desk staffer. Now, just this morning we got a 2-week notice for one of our best back-office staff members. Ugh, right?? So, now it’s off I go to find a replacement there. You always hate losing one of your best. The job she’s going to pays $1.50 more per hour and offers a 401k. Well, she was due next month for a yearly raise and we’ve offered 401ks in the past but no employees ever took us up on the offer. But, she never asked and I’m never going to beg someone to stay. That’s not in my DNA. But if employees would talk to us before jumping ship, there may be something we can do to hold on to the best of them. But it is what it is. Now, we have a staffer trying to take vacation days she doesn’t have and it’s just blah around here so here we go. I’m just going to get into this episode and forget all my woes. Item #1 The first one today is called “Intermittent Fasting and Obesity-Related Health Outcomes An Umbrella Review of Meta-analyses of Randomized Clinical Trials” by Patikorn et. al. (Patikorn C 2021) and published in JAMA Network Open on December 17, 2021, Hot tamale! Why They Did It The authors wanted to answer the questions, “What is the association of intermittent fasting with health outcomes and what is the strength of evidence of studies on intermittent fasting?” How They Did It

This was a meta-analysis of Randomized Controlled Trials
They went through databases that included Embase, PubMed, and Cochrane
The search was done from April 2021
They found 11 meta-analyses comprising 130 RCTs, 38 participants

What They Found

There were 28 statistically significant associations (27%) that demonstrated the beneficial outcomes for body mass index, body weight, fat mass, low-density lipoprotein cholesterol, total cholesterol, triglycerides, fasting plasma glucose, fasting insulin, homeostatic model assessment of insulin resistance, and blood pressure.
IF was found to be associated with reduced fat-free mass.
One significant association (1%) supported by high-quality evidence was modified alternate-day fasting for 1 to 2 months, which was associated with a moderate reduction in body mass index in healthy adults and adults with overweight, obesity, or nonalcoholic fatty liver disease compared with regular diet.
Six associations (6%) were supported by moderate-quality evidence.

Wrap It Up In this umbrella review, we found beneficial associations of IF with anthropometric and cardiometabolic outcomes supported by moderate to the high quality of evidence, which supports the role of IF, especially modified alternate-day fasting, as a weight loss approach for adults with overweight or obesity. Item #2 Our last one today is called “Association of Physical Activity Level With Risk of Dementia in a Nationwide Cohort in Korea” by Yoon et. al. (Yoon M 2021) and published in JAMA Network Open on December 16th of 2021. Hot hot hot. A lot hot. Why They Did It The authors wanted to answer the question, “Is physical activity, especially light-intensity physical activity, independently associated with new-onset dementia?” How They Did It

It was a nationwide retrospective cohort study,
They analyzed 62,286 participants aged 65 years or older without preexisting dementia who had available health checkup data from the Korean National Health Insurance Service database from January 2009 to December 2012.
Participants were followed up until December 31, 2013, and
data analysis was performed from July 2020 to January 2021.
Physical activity level was assessed using a standardized, self-reported questionnaire at baseline.
Physical activity-related energy expenditure was calculated by summing the product of frequency, intensity, and duration.

What They Found I’m not going to tell you. Because we try to keep it simple light and fun around here and getting into the specifics here will make you wonder what happens when you turn on your headlights if you’re car were to be moving the speed of light. Like….why are there braille dots on a drive-up ATM? What’s up with that? Anyway, we’re skipping right to the conclusions. Wrap It Up In older adults, an increased physical activity level, including a low amount of light-intensity physical activity, was associated with a reduced risk of dementia. Promotion of light-intensity physical activity might reduce the risk of dementia in older adults. This is a bit different from previous findings. They recommended medium intensity or higher to reduce dementia risk. They also have now shown that total sedentary behavior is associated with unfavorable health outcomes. Which is really no surprise, is 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 the 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

Home

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by 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 Patikorn C, R. K., Veettil SK, (2021). “Intermittent Fasting and Obesity-Related Health Outcomes: An Umbrella Review of Meta-analyses of Randomized Clinical Trials.” JAMA Netw Open 4(12). Yoon M, Y. P., Jin M (2021). “Association of Physical Activity Level With Risk of Dementia in a Nationwide Cohort in Korea.” JAMA Netw Open 4(12).

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

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. 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.

Website

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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

Chiropractic Misinformation, Patients Need Movement & Love

December 23, 2020 chiropracticforward 00:33:14 1 Comment

CF 157: Chiropractic Misinformation, Patients Need Movement & Love

Today we’re going to talk about misinformation on the part of chiropractors during the COVID pandemic, we’ll talk about three papers covering pain and how patients need a little love while they also need movement and physical activity.

But first, here’s that sweet sweet bumper music

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

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

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

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

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 #157. The first episode to kick off our 4th year in the podcasting business. To be 100% honest, it doesn’t seem like I’ve been doing this for that long. It’s crazy to think about.

Now if you missed last week’s episode , we talked about our Top Ten episodes over the previous 3 years. It was our 3rd Year Anniversary episode. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I had a pretty decent weekend. Still just staying in and being smart. We drove around and looked at lights with the kiddos. More just to get outta the damn house and do something different. The wifey, myself, and the two kiddos are about ready to give each other the People’s Elbow from time to time. People are all like….COVID is a time we get to slow down and reconnect with our families.

I’m all like, I’d like to connect with some of them. Physically. With my hands and tinged with some level of aggression. Lol. It’s hard as a parent to watch your kids waste away into boredom and just allow it to happen. I’m a big believer in doing things. Creating things. Being busy on some level. I believe an idle mind is a dangerous thing. So, I’m the parent telling them to get the hell up and make something of themselves. Maybe it’s me or maybe it’s my generation. Generation X is a generation of do-ers I believe.

Either way, they get tired of me urging them to do, to make, or just to freaking be. Be something! No, you can’t lie on your bed reading fictional books all day long. Maybe for an hour or so at night before bed instead of the xbox. That’s a good time to read don’t you think? Not for hours smack dab in the middle of the day.

I’m a big believer in art of all forms. So they get pushed to play the guitar, the piano, draw something, paint something. Write a story or a poem. Freaking create something. ANYTHING! Just don’t lay or sit around like a lump on a log all day. I won’t have it. I won’t create lazy bums to put out into the world. I just won’t. Yeah, it probably sucks to be my kid. I know. I admit it. My daughter is a 7th grader and I’ve already got her learning the discus. Pumping my own tires for a second here, I won state here in Texas in the discus and went to state in the shot put so I love re-visiting those days by coaching others. My son had no interest but Joss….she’s in and she’s doing great! My son, I’ve got him on the guitar and piano and he’s doing great too. All I ask for is activity and some progress. That’s all.

It actually snowed in Amarillo this weekend. Yes, we get snow somewhat regularly in my part of TX. We’re in the northern plains of Texas. We are flat and there are really no trees unless someone planted them. But we do have the nation’s second largest canyon called Palo Duro canyon and it’s awesome! If you’re ever close to Amarillo, you gotta check it out. Well worth it.

I’m typing this up on Monday morning 12/14. I saw on the news this morning that the first healthcare workers are getting the vaccine today. That’s pretty dang exciting. I already called my doctor buddies here in town and told them that when they feel it’s appropriate for us to have one, my wife and I would love to be on their list. I know a lot of folks are freaky about the vaccine and here’s my deal; by the time it’s my turn, any adverse events will already be well-known. They started in the UK las week. Adverse events are pretty much sorted out in about 8 weeks.

I’m tired of it. I’m over it. I’ve said it before here but, if I get the Rona, I have to shutter my clinic for 2-4 weeks. I can’t afford that. Well, technically, I can afford it but it would drain resources that don’t need to be drained if I just try to stay smart and healthy. So why wouldn’t I do everything I can? Besides that, I’m ready to get back to my life. Traveling, building things, and moving forward instead of this stagnate state we’ve all been in for 8 or more months. The vaccine is the first real step out of it.

I am so over other chiropractors out there. One of the vitalists I talked about and was ashamed of in Episode 153 called Some Chiropractors Could Be Better…..well that Flat-Earther has been on his Facebook railing against the vaccines and acting like he is an epidemiologist and trained in the safety and efficacy of vaccines.

He wasn’t. I went through chiropractic school. Other than chiro philosophy, no real education on vaccines was had and certainly not enough to pretend to be an authority on them. One way or another. For or against them. So why the hell are so many wading out into those waters? Just stay the hell out of the discussion. It’s so dumb. It really is.

Can you imagine telling a young mother their baby doesn’t need the measles vaccine because your magical powers of subluxation slaying will protect them by boosting their immune system? And then the baby actually gets measles?

Why in the hell would you want to put yourself or that mother and baby in that position. Just shut up. Back off. Stay in your lane, pal. You’re not that cool. Same goes for COVID. Do you really want to be in the position of telling your patient they really shouldn’t take that vaccine because you’re a spine whisperer and detecting subluxations protects from viruses if they’ll just come to see you every week for the rest of their lives? First you create dependency on YOU. That’s not right and it’s damn sure not evidence-based. Good for the ol’ wallet though isn’t it?

Second, you weren’t trained on it. So back off.

Third, can you imagine that patient getting it anyway and, God forbid, dying from it. What if that patient mentioned to their family members that they weren’t getting the vaccine because Dr. Jackhole told them they didn’t need it and shouldn’t take it. Would the family have a legal claim against you? My opinion is hell yes they do and you should be calling your malpractice carrier to see how to handle it.

The point being. Just remove all of that by keeping your mouth closed and staying out of vaccine discussions. It’s completely appropriate to say that getting it is an individual choice and they should talk to their doctor about the risks vs. the benefits and take it from there. Because that really is what they should be doing.

This vitalist and others like him are going to get more people killed because they love themselves on a level that leads them to believe they have all of the answers. They don’t. In fact, when they’re recording selfie videos of themselves walking around their offices or sitting and driving in their cars, they look insane. Crazy-eyed insane people.

Enough of that. I made my point. Some of you listen enough or we’re friends on Facebook so you know that I’m an artist of sorts. Guitar singer songwriter, charcoal drawing and portraits and sculpting. I’ve been sculpting a race horse lately and I did the bridle and saddle this weekend. Looking back on it, I may rather take a swift kick in the cajones then repeat that. Geez. Straps, buckles, loops, cuss words. But, it’s shining up finally. If you want to follow some of my artistic escapades on Facebook, go like and follow River Horse Art. It’s fun. If nothing else, I’m keeping life interesting at the very least.

Another thing totally unrelated to chiropractic is Hot chocolate bombs. Here’s a tip from your Ol’ Uncle Jeffro. Be damned careful what you put on FB during the holidays people. My wife Meg and daughter Bitsy… her real name is Joss….they were making these things and I shared it in FB just to brag on them a bit. They were just making them for family and friends and they are pretty cool.I’m on Weight Watchers…down 33 pounds now…and so I can’t indulge but I did share one with my wife and they are absolutely sinful, people. Holy cow. They’ll make your hair stand up.

Anyway, now it’s an overnight success business sort of thing. Geez. She has orders for about $300 worth of these things and a guy that may order around $1500 worth of them for his business connections and marketing purposes. What in the holy chocolate hell? So now I have a factory in my kitchen with two bumblebees buzzing all over it.

In business, you have probably heard me mention that we have been down since the second spike hit. Down quite a bit. I used to gripe that my new norm was 145 a week rather than my pre-COVID average of about 190 per week. Well, turns out it could get worse. We’ve been averaging about 125 a week since the second spike came on BUT…..but….this week is starting off right with 41 and four new patients today. Fingers crossed.

I told you we did a radio run and, believe it or not, people are starting to tell me they’ve been hearing our ads. Which is encouraging. It’s still too early for me to share what we’ve done and it that’s why this week is better. I’m not sure the powers at play just yet. I’m going to keep monitoring it and will let you know.

Enough, let’s get to the research, shall we?

Item #1

This first one is new and it goes with one of my talking points in the intro section. It’s called “Misinformation, chiropractic, and the COVID-19 pandemic” by Iben Axen, et. al. and published in Chiropractic & Manual Therapies in November of 2020. Hopping jalapeños that’s hot!

Why They Did It

Before we get to why they did it, I think we all know. Yes, we know. If fact, look, I knew people were crazy before COVID. There are just crazy people out there in the world. That’s a given. But I had no idea how many truly crazy and impressionable people there really are until this pandemic. Holy huge balls of insanity, people. I have seen the most disappointing stuff coming from people. Not just chiropractors but definitely some chiropractor as well. No doubt. They crazier than bed bugs. Crazier than a craphouse rat.

They begin by saying, “During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements.

We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies.”

Despite this grave situation, some chiropractors have advocated a misbelief that spinal manipulative therapy (SMT) or “adjustments” can boost immunity and thus should be offered as a preventive measure for viral infections. The World Federation of Chiropractic (WFC) noted this development on March 17th 2020 and refuted this in a public statement: “… .there is no credible scientific evidence to support this notion and to suggest otherwise is potentially dangerous to public health” . Nevertheless, some chiropractors continue promoting misinformation on social media putting the chiropractic profession at odds with scientific evidence.

The chiropractor (and I use that term loosely) I discussed is 100% one of these people. Geez, he’s embarrassing. But he takes videos of his huge pool and big backyard he got from seemingly bilking the holy crap out of impressionable patients and young dumb chiropractors but whatever.…

Anyway…they say that the estimate is that 20% of the chiropractic profession has the vitalist, faith-based, philosophy, I’m going to pop this and protect you from virus approach to taking advantage of patients. I mean….going about their business.

They say, “Misinformation about adjustments and immunity taints public understanding of viral prevention, undermines the coordinated efforts of health authorities, and has become a cause for concern among researchers and public health authorities”

Wrap It Up

Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

CHIROUP ADVERTISEMENT

Item #2

This one is called “Effect of Physical Exercise Programs on Myofascial Trigger Points–Related Dysfunctions: A Systematic Review and Meta-analysis” by Guzman-Pavon, et. al. (Guzman-Pavon MJ 2020) and published in Pain Medicine on October 4, of 2020. Sizzlin’ succotash! It’s hot!

Why They Did It

Remember, this is a systematic review and meta-analysis and those are at the top of the research pyramid. They’re mostly reliable.

They say, “Myofascial pain syndrome is one of the primary causes of health care visits. In recent years, physical exercise programs have been developed for the treatment of myofascial trigger points, but their effect on different outcomes has not been clarified. Thus, this study aimed to assess the effect of physical exercise programs on myofascial trigger points.”

How They Did It

A systematic search was conducted in Pubmed, Web of Science, and Scopus.
Articles analyzing the effect of physical exercise programs on pain intensity, pressure pain threshold, range of motion, and disability were included
24 randomized controlled trials were included

Wrap It Up

Physical exercise programs may be an effective approach in the treatment of pain intensity, pressure pain threshold, and range of motion among patients with myofascial trigger points.

Let me just tell you that physical exercise programs are absolutely effective. Not just in the physical sense but in the biopsychosocial aspect as well. When people are gradually moving more and gradually building their confidence in movement and their abilities, the brain, or the centralized part of the pain experience is affected in for the positive which brings the pain level down overall. It’s just fascinating but in short, moving means more than just physical activity when we’re talking about pain.

Item #3

Item #3 here is called “Excess Body Mass and Leisure Time Physical Activity in the Incidence and Persistence of Chronic Pain” by Shiri, et. al (Shiri R 2020) and published in Pain Medicine on November 11, 2020. Which makes hotter than a habanero. And that’s real hot.

Why They Did It

To estimate the effects of excess body mass and leisure time physical activity on the incidence and persistence of chronic pain.

How They Did It

A prospective cohort study.

three cohorts of employees of the City of Helsinki (18,562 observations) and defined incident chronic pain as having pain in any part of the body for more than three months at follow-up in participants without chronic pain at baseline. This was a great sample size.

Persistent chronic pain was defined as having pain for more than three months at both baseline and follow-up

Wrap It Up

As if we didn’t know this already, they say, “Obesity not only increases the risk of developing chronic pain, but also increases the risk of persistent pain, while leisure time physical activity reduces the risk of developing chronic pain.”

Now consider the obesity issue in America today.

Item #4

And finally, our last one is called “Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain” by Penn et. al. (Penn T 2020) and published in Pain Medicine on April 24, 2020 which is hot enough because it just came out in the November 2020 issue. It’s not steaming but it is indeed very hot.

Why They Did It

For most patients with chronic low back pain (cLBP), the cause is “nonspecific,” meaning there is no clear association between pain and identifiable pathology of the spine or associated tissues. Just for the record here, Dr. Stuart McGill and his mustache would call total BS on the idea that nonspecific back pain exists. He’s say you just aren’t looking hard enough.

Anyway, they go on to say, “Laypersons and providers alike are less inclined to help, feel less sympathy, dislike patients more, suspect deception, and attribute lower pain severity to patients whose pain does not have an objective basis in tissue pathology. Because of these stigmatizing responses from others, patients with cLBP may feel that their pain is particularly unjust and unfair. These pain-related injustice perceptions may subsequently contribute to greater cLBP severity. The purpose of this study was to examine whether perceived injustice helps explain the relationship between chronic pain stigma and movement-evoked pain severity among individuals with cLBP.”

And honestly, these are things I haven’t considered before and I think it’s interesting as hell.

How They Did It

Participants included 105 patients with cLBP who completed questionnaires assessing chronic pain stigma and pain-related injustice perception, as well as a short physical performance battery for the assessment of movement-evoked pain and physical function.

What They Found

Findings revealed that perceived injustice significantly mediated the association between chronic pain stigma and cLBP severity and physical function.
Greater chronic pain stigma was associated with greater perceived injustice, which in turn was associated with greater movement-evoked pain severity.

Wrap It Up

“These results suggest that perceived injustice may be a means through which chronic pain stigma impacts nonspecific cLBP severity and physical function.”

So, today’s take-aways…..

Be a science driven healthcare leader and practitioner. Don’t be crazy because you look insane and you make everyone else in your profession appear to be insane as well. That’s just rude as hell. Especially when you’re proving Parento’s Law by just 20% of you making the rest of us look like crazy people. We don’t appreciate it. Stop it now, dammit.
Love your patients and if you worry about the outcomes, you won’t have to worry about the income
And get them moving.

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 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.

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

Guzman-Pavon MJ, C.-R. I., Martinez-Vizcaino V, (2020). “Effect of Physical Exercise Programs on Myofascial Trigger Points–Related Dysfunctions: A Systematic Review and Meta-analysis.” Pain Med 21(11): 2986-2996.
Penn T, O. D., Aroke E, (2020). “Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain.” Pain Med 21(11): 3161-3171.
Shiri R, L. T., RAhkonen O, Leino-Arjas P, (2020). “Excess Body Mass and Leisure Time Physical Activity in the Incidence and Persistence of Chronic Pain.” Pan Med 21(11): 3092-3101.

Vegans & Broken Bones, Daily Step Count, Medical Cannabis

December 10, 2020 chiropracticforward 00:20:26 0 Comments

CF 155: Vegans & Broken Bones, Daily Step Count, Medical Cannabis

Today we’re going to talk about new research for vegans and the risk of broken bones, we’ll cover new information pertaining to a patient’s daily step count, and we’ll talk about a study on medical cannabis and it’s effectiveness in treating chronic pain. Good stuff today, folks. But first, here’s that sweet sweet bumper music

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

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 #155 Now if you missed last week’s episode , we talked about the shake up with the World Federation of Chiropractic and all of the goings on that went on with that. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

As of the typing of this, it is the Monday following Thanksgiving. I hope you all had a good one. I have a nice back patio, outdoor kitchen area with a fireplace and quite a bit of room to move around. I have my mom and my stepdad over as well as my brother and his wife. With the four of my regular crew, that made 8 of us. Nobody went inside. We all just gathered outside on the patio and ate outside. It was great. It was safe. And we still got to have Thanksgiving.

We had two separate tables. One for my crew and one for the other four. We had my crew at one table because I work with 140 or so appointments per week, my son goes to a high infection rate college, and my daughter goes to junior high with over 1,000 kids every day. So, my crew was the wildcard in that crowd. So we sat separated just a bit to be sure we were protecting the others from any asymptomatic hoo ha. It seemed to work very well. Again, I hope you all did well and stayed safe and happy and healthy.

It was different for sure, right? Definitely one to remember. No doubt.

Think of all of the things we took for granted before this mess. I know many of you have but I haven’t taken a trip or vacation or anything since February when we went to Key Largo. I’m used to going on little vacays about once per quarter just to preserve my sanity. I think that’s important. Getting out of the office and getting some sea air or some mountain air in your face.

But we haven’t been able to do any of that in the last 9 to 10 months and I’m missing it. I’m a traveler. This has really taught us what we do and what we do not have control over. We do not have control over nature from what I can tell. Certainly not this virus. At least not yet we don’t. This second spike has been severe where I live. Over 1,000 new cases in one day on the last count, over 750 FEMA staffers here helping our healthcare system keep up with the hospitalized patients. I haven’t seen this week’s numbers yet but we lost 24 residents to COVID in just two days last week. 24 deaths in two days. That was unheard of just a couple of months ago. I have lost a couple of patients to it.

Fortunately, I haven’t lost any friends as of yet. I hope your friends are all staying safe and weathering the storm the same. PRactice is just there. Nothing special going on right now. We are running a radio spot for this holiday season but I’m not sure how smart that is. Luckily, they gave us a killer deal on the run so we couldn’t resist. They made us a deal we couldn’t refuse. I’m not sure all of the ads in the world will get everyone out of the mental and financial funk any time in the next several months. But I’ll report back. If it works, I’ll share what we did so you can do the same.

On the other hand, if you’re doing something that is working for your clinic and getting people back in the numbers you want to see, send me an email at dr.williams@chiropracticforward.com and let us know so we can let others know and help everyone out with getting their numbers back closer to normal.

Item #1

Let’s start with one called “Medical Cannabis for the Management of Pain and Quality of Life in Chronic Pain Patients: A Prospective Observational Study” by Safakish, et. al. (Safakish R 2020) published in Pain Medicine in November of 2020. And it sizzles and steams as it sits.

Why They Did It

To evaluate the short-term and long-term effects of plant-based medical cannabis in a chronic pain population over the course of one year.

How They Did It

751 chronic pain patients initiating medical cannabis treatment.
A longitudinal, prospective, 12-month observational study.
Study participants completed the Brief Pain Inventory and the 12-item Short Form Survey (SF-12), as well as surveys on opioid medication use and adverse events, at baseline and once a month for 12 months.

What They Found

Medical cannabis treatment was associated with improvements in pain severity and interference (P < 0.001) observed at one month and maintained over the 12-month observation period.
Significant improvements were also observed in the SF-12 physical and mental health domains (P < 0.002) starting at three months.
Significant decreases in headaches, fatigue, anxiety, and nausea were observed after initiation of treatment
In patients who reported opioid medication use at baseline, there were significant reductions in oral morphine equivalent doses (P < 0.0001), while correlates of pain were significantly improved by the end of the study observation period.

Wrap It Up

Taken together, the findings of this study add to the cumulative evidence in support of plant-based medical cannabis as a safe and effective treatment option and potential opioid medication substitute or augmentation therapy for the management of symptoms and quality of life in chronic pain patients. Alright, I’ll be upfront; I don’t like marijuana. I know some of you love the sweet sweet weed. I’ll never understand it. Trust me, I’ve been around it so many times I can’t count. I’m a former traveling muscian. For 10 years I traveled the circuit so you can only imagine. I’ve been against its legalization from Day 1.

I’ve seen it turn famiily members into lazy, unmotivated bums. I hate it. I hate the smell. I hate what it does to people and I hate the culture surrounding it. But, I can’t argue with research and this says it helps. I’ve seen other reports that it works. Regardless, I’m for pill form, chewables, or gels. I will never before inhaling it. There is no amount of evidence on the planet that will make me think it’s OK to take smoke into your lungs. Especially when there are other options for it’s utilization. So, this is encouraging.

I hope its medical use becomes more widespread and more common because it sure as hell looks like it works for chronic pain and, at the end of the day, that’s what we’re here for.

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Item #2 This second one is called, “Association of Daily Step Count and Step Intensity With Mortality Among US Adults” by Saint-Maurice et. al. (Saint-Maurice P 2020) and published in JAMA in March of 2020. Dammit it’s hot enough.

Why They Did It

Describe the dose-response relationship between step count and intensity and mortality.

How They Did It

Representative sample of US adults aged at least 40 years in the National Health and Nutrition Examination Survey who wore an accelerometer for up to 7 days ( from 2003-2006).
Mortality was ascertained through December 2015.
Accelerometer-measured number of steps per day and 3 step intensity measures
Accelerometer data were based on measurements obtained during a 7-day period at baseline.
They adjusted for for age; sex; race/ethnicity; education; diet; smoking status; body mass index; self-reported health; mobility limitations; and diagnoses of diabetes, stroke, heart disease, heart failure, cancer, chronic bronchitis, and emphysema.

Wrap It Up

Based on a representative sample of US adults, a greater number of daily steps was significantly associated with lower all-cause mortality. There was no significant association between step intensity and mortality after adjusting for total steps per day. I personally found it interesting that they found no big association between step intensity and mortality. Very interesting. So, let’s make sure we’re all moving. No matter the age.

Item #3

This one is an article by Rupert Steiner(Steiner R 2020) called “Vegans and non–meat eaters are more likely to suffer broken bones, Oxford University research show” and it was published in Market Watch on November 24, 2020 and it’s it’s hotter than the burning sun!

We just hit the highlights for the articles so here we go:
They start right off getting into the meat and taters by saying, “Non–meat eaters, especially vegans, are at higher risk of breaking their bones due to lower intakes of calcium and protein, according to new research by the University of Oxford published on Monday
The EPIC-Oxford study, which involved almost 55,000 British people, concluded: “Non–meat eaters, especially vegans, had higher risks of either total or some site-specific fractures, particularly hip fractures
Participants were categorized into four diet groups composed of 29,380 meat eaters, 8,037 fish eaters, 15,499 vegetarians and 1,982 vegans.
The results showed over an average of 17.6 years of follow-up, researchers observed 3,941 cases of total fractures.

Food for thought and the damn pun was absolutely intended. 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 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. 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

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

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

Bibliography

Safakish R, K. G., Salimpour V, Hendin B, Shoanpal I, (2020). “Medical Cannabis for the Management of Pain and Quality of Life in Chronic Pain Patients: A Prospective Observational Study.” Pain Med 21(11): 3073-3086.
Saint-Maurice P, T. R., Bassett D, (2020). “Association of Daily Step Count and Step Intensity With Mortality Among US Adults.” JAMA 323(12): 1151-1160.
Steiner R (2020). “Vegans and non–meat eaters are more likely to suffer broken bones, Oxford University research show.” MarketWatch.

Preventable Disease And the Impact & Whole Body Vibration For Function and Bone Density

October 29, 2020 chiropracticforward 0:21:47 0 Comments

CF 149: Preventable Disease And the Impact & Whole Body Vibration For Function and Bone Density Today we’re going to talk about the costs of preventable disease and then we’ll talk about whole body vibration for function and bone mineral density in postmenopausal, osteoporotic women. But first, here’s that sweet sweet bumper music

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

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 #149 Now if you missed last week’s episode , we talked about manipulation for concussion, sleep and cognitive decline, and we talked aobut demential predictors and prevention. Super interesting stuff. 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 On the personal end of things….. We were busier last week. If you’ve listened for very long, I’ve tried to be open and honest about my numbers each week so that listeners will know where they stand. They’re either doing better or they’re doing about the same. Some will be doing worse. Either way, maybe I can be a measuring stick of some sort. The best I have done since COVID reared it’s stupid face is 145 visits in one week. That’s down from an average of 182 per week in 2019. So, that’s quite a difference. I keep immacualte stats so I know that in 2020, I have averaged 117 per week but that includes when we were closed and then when we were emergency only. Since we finally got up and running full steam back in May, I have averaged 136 per week. That puts me at about 75% of my pre-COVID point. So, I just need to average about 46 more visits per week to get back to 100%. No big deal right? Lol. That’s a solid jump but I’m a do-er and I have positive energy and a healthy amount of confidence. And, we got a good start last week. Last week for the first time, I beat the 145 mark that I had been limited to and saw 158. Just in time for the Rona to start surging back and freaking people out again. Lol. Such is my luck. We shall keep trudging, keep being smart, and keep doing what we can to stay healthy. If it all works out, we should be back to 100% by the end of the year. That’s my goal at least. As I type this out, we have 48 on the books today which is about 10-12 more than we’ve been seeing on Mondays. So things are looking up. Be safe folks, we’re not out of the crap yet. In fact, as of the time I’m typing this, it’s worse than it has been for a while. Just keep being safe, keep working, and do what you can to take care or yourself and those around you. Item #1 The first one we’re going to talk about today is called, “The cost of preventable disease in the USA” by Galea, et. al(Galea S 2020). published in The Lancet on October 1, 2020. Aye chiuaua. es too mucho caliente. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30204-8/fulltext?fbclid=IwAR3VMx1p1cZZTdT9o3_b6GkgSzfbImiOPPKLJFElqMKaHN5Vi-3OpkqwDTg This is more article and discussion so as usual when we cover stuff like this, we’ll just hit the high points and summarize it for you. They start by stating that a substantial proportion of poor health in populations is preventable and cite the Global Burden of Diseases, INjuries, and Risk FActors Study that suggests nearly half of all health burdern in the US is attributable to a list of 84 modifiable risk factors. They say that globally, up to half of all deaths fall into the category of preventable deaths. They estimate that more than 1/4 of health-care spending was due to these preventable illnesses. Not only that but the US heatlhcare spending is notoriously expensive spending 16.9% of its GDP on healthcare which is TWICE as much as the average of other similar countries. In fact, our spending is mroe than the 2019 GDP of 171 coutnries in the world. All but the 19 wealthiest. They ask a wonderful question, “Why do we continue to accept such a high burden of preventable disease, even when the cost of it is known?” Great question. Especially when you’re looking at it from a chiropractor’s point of view. Fusion surgeries run around $50,000 each, are basically useless, and put the patient at signficant risk of additional, expensive surgery. Epidural injections are useless as well. We have plenty of studies showing how we save money and cost much less than traditional medical care for back pain. We have surveys and research showing that our patient outcomes and satisfaction are superior to PT and general practitoners. We have the American College of Physicians, The Joint Commission, and The Lancet recommending spinal manipulation and exercise as first-line treatments. Yet, we are not inundated with referrals for chronic and acute low back pain. We should be absolutely flooded with referrals. We should be emptying out lobbies of furniture so we have more room in the corner to put a new referral. But nope. Hell no. My opinion is because we have vitalist chiropractors trying to convince patients they have to see them every week for the rest of ever…..as long as ye shall live….forever and ever amen. Taking x-rays and convincing them they’re going to die if they don’t fix that decreased curvature. Telling patients they’re going to pop their back and fix their gall bladder issue. THAT’S why we can’t have nice things. You have these evidence-based, patient-centered chiropractors over here going, “What they hell? We can help these people so much!” But we’ll never get the chance because vitalists don’t know how to stay in their lane. To be fair, they were taught their lane was much larger than research suggests it is. We do what we’re taught. The difference is, some of us are better at smelling BS than others. Too many chiropractors have a stopped up nose and can’t seem to smell very well. Which is unfortunate. Back to the article, they say, “The high burden and cost of preventable disease should push us to think differently about health at a foundational level.” And to that I say, “Indeed, Sir.” They also say that we should embrace the notion that no amoutn of preventable death or illness is acceptable and that about $730 billion could be repurposed. Like to pay our debt…..just a suggestion. They conclude by saying, “high body-mass index, high systolic blood pressure, high fasting plasma glucose, dietary risks, and tobacco smoke exposure account for most of the spending on preventable illness. Preventing these risk factors would require an engagement with subsidising the availability of nutritious foods, disincentivising the commercial production of harmful products, investing in early childhood education that leads to healthy exercise and dietary habits, and creating cities that encourage healthy behaviours.” For example, why does healthy food cost more than garbage food? That’s exactly reverse of what it should be. If we really care about lower socioeconomic folks and you want to fight for universal healthcare and things of that sort, wouldn’t it make sense to protest stuff like that? Why aren’t we seeing picket lines outside of Tyson food factories or in front of grocery stores. They could be carrying signs that say, “Stop keeping our poor fat” or “make healthy affordable” or stuff like that. I’ll keep watching the TV. I’m not holding my breath though. Making healthy food affordable isn’t quite as sexy as all of the other reasons people are finding to stay outraged these days. Don’t get me wrong, I’m not making light of peaceful and respectful protest. That’s what Amercia is built on. I’m less understanding of the destruction, riots, and death that have come with so many of the more recent activities. Anyway, it’s a great article and I’ve linked it in the show notes at chiropracticforward.com if you’d like to go a little further in depth in the thing. Chiropractors can help this issue though. The research is there. They just have to start giving it a try. I think they’d be surprised with the results. Unless they referred to a vitalist. Then, when the patient reported back to the MD, the MD would probably never make another referral to a chiropractor as long as they lived once they realize that their referral made them look like an idiot. Just a guess. CHIROUP ADVERTISEMENT Item #2 This one is called “Effect of Whole-Body Vibration Exercise on Power Profile and Bone Mineral Density in Postmenopausal Women With Osteoporosis: A Randomized Controlled Trial” by ElDeeb, et. al(ElDeeb A 2020). published in the Journal of Manipulative and Physiological Therapeutics in May of 2020…..eh….it’s not fresh from the fire but it’s still steaming out of the microwave. https://www.jmptonline.org/article/S0161-4754(20)30044-0/fulltext Why They Did It To investigate the effect of whole-body vibration (WBV) on muscle work and bone mineral density (BMD) of the lumbar vertebrae and femur in postmenopausal women. How They Did It

43 postmenopausal women with low bone mineral density
randomly assigned to WBV and control groups
Both groups got calcium and Vit D supplementation once per day
The WBV group additionally got WBV exercises 2x/week for 24 weeks
Hip power generation and absorption, knee power absorption and generation, ankle power generation adn absoprtion were all measured.
Dual-energy X-ray absorptiometry was used to measure bone mineral density of the lumbar spine and femor before and after intervention

What They Found

There were significant increases in the hip muscle work, knee muscle work, ankle musle work during gait in the WBV group.
Bone mineral densityof the lumbar spine and femur were significantly increased in the WBV group.
However, there were no significant changes in teh control group
The posttreatment values of the hip, knee, and ankle muscle work and the bone mineral density of the WBV group were significantly higher htan the posttreatment values of the control group.

Wrap It Up The conclusion states, “Whole-body vibration training improved the leg muscle work and lumbar and femoral bone mineral density in postmenopausal women with low bone mineral density.” Pretty interesting stuff, folks. Is this definitive proof? No. The sample size is small but it is randomized which is good. Would I advertise that I’m going to increase osteoporotic BMC? Nope. If my mom had osteoporosis, would I have her on the WBV? You bet your sweet bippy I would. 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 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. 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 Tweets by 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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger Bibliography

ElDeeb A, A.-A. A. (2020). “Effect of Whole-Body Vibration Exercise on Power Profile and Bone Mineral Density in Postmenopausal Women With Osteoporosis: A Randomized Controlled Trial.” J Manipulative Physiol Ther 43(4): P384-393.
Galea S, M. N. (2020). “The cost of preventable disease in the USA.” The Lancet 5(10): E513-E514.

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