Low Back Pain

Discs In Low Back Pain & Unnecessary Surgeries Via COVID

CF 292: Discs In Low Back Pain & Unnecessary Surgeries Via COVID

Today we’re going to talk about Discs In Low Back Pain & Unnecessary Surgeries Via COVID

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #292

Now if you missed last week’s episode, we talked about Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use . Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Isn’t it funny how things work sometimes? I had something odd happened recently here in the clinic. We found out that our acupuncturist was moving to a different chiropractor’s office. She’s been with us for about eight years. What she’s credentialed through me to see veterans through our VA system.

So the VA randomly called us one day inquiring on her moving to another office and when that is happening, etc. Well, it was news to us. So we reached out to the acupuncturist and she admitted that she had plans to move but had not shared them with us yet. Although Amarillo Texas is about 225,000 people, there are only 3 acupuncturists in the entire area. It’s just not that popular here.

Although, it is definitely gaining in popularity. So the prospects of us being able to bring on another acupuncturist quickly are very slim. However, we went ahead and reached out to the one we really wanted to work with us. I have a good relationship with her, but things have just not worked out to where we could’ve actually worked together before. It turns out that she was tired of her current situation and was interested in making a move.

So she came in for an interview, we talked, and she was on board. We started the credentialing process with the VA that very day, so, while it takes 90 days to get credentialed, at this point, we are already almost a month into the process. That should significantly shorten the waiting period for our veterans to switch to a new acupuncturist and soften the landing.

Oh, in the meantime, if our previous acupuncturist, had any plans of stealing our patients, and taking them to a new place, that is going to be hard for her to accomplish. She hast to get completely re-credentialed, and I promise you were ahead of her on getting that done. In addition, the veterans have to get authorization to see her and she hast to get credentialed before they can even start the process of getting authorized through her. Whereas here in my clinic the machine is already built. The gears are already oiled and greased, and we are at fine-tune the machine. I think there’s no doubt we are going to come out ahead on this transition.

One thing we all know is that the one constant in life is that things are always changing.

Many of us are going through changes with staff. I have 3 CA’s and that third spot. It’s just a constant turnover. I have another one that will start in two weeks. The last one lasted for about two weeks. The one before her lasted about three months. It’s been miserable but when we find the right one I think it will have been worth it anyway, that’s what’s on my mind this morning. Getting acupuncture back up and running and marketed, and getting another new staff member up and going.

It’s a constant churn and, as they say in the military, just embrace the suck and keep trucking. It all pays for your life and for the life of your family members. Might as well enjoy all of it that you can and embrace the parts you feel suck your soul and keep that part in the proper context.

Item #1

 

The first on today is called “Intervertebral disc degeneration and how it leads to low back pain” by Ashish D Diwan, James Melrose and published in Pub Med on Nov14 2022. Dayum. That’s hot.

Why They Did It

  • The purpose of this review was to evaluate data generated by animal models of intervertebral disc (IVD) degeneration published in the last decade.
  • The review aimed to highlight the valuable contributions of these animal models in identifying molecular events associated with pain generation.
  • IVD degeneration is a complex process contributing to spinal pain, and understanding the underlying mechanisms is crucial for developing effective therapeutic strategies to alleviate pain, promote disc repair and regeneration, and prevent associated neuropathic and nociceptive pain.

How They Did It

 

  • The researchers conducted a review of existing studies that employed animal models of IVD degeneration.
  • They likely searched relevant databases, academic journals, and publications from the past decade to gather a comprehensive dataset.

  • The selected studies would have used various animal models and experimental methods to induce IVD degeneration.

  • These animal models mimic certain aspects of human IVD degeneration, allowing researchers to study the molecular events and mechanisms involved in pain generation.

What They Found

  • Through their review, the researchers observed that in degenerated IVDs, there is nerve ingrowth and an increased number of nociceptors (pain-sensing neurons) and mechanoreceptors (sensors of mechanical stimuli).
  • The biomechanically incompetent and abnormally loaded degenerated IVDs experience increased mechanical stimulation, leading to heightened low back pain.
  • This finding helps establish a link between IVD degeneration and pain generation, shedding light on the complexity of the process.

  • The review also highlighted the potential of a specific factor called “growth and differentiation factor 6” in addressing IVD degeneration. Studies using this factor in IVD puncture and multi-level IVD degeneration models, along with a rat xenograft radiculopathy pain model, demonstrated its ability to prevent further deterioration in degenerate IVDs. The factor exhibited regenerative properties that promoted the recovery of normal IVD architectural functional organization and inhibited the generation of inflammatory mediators, which contribute to disc degeneration and low back pain.

Wrap It Up

 

  • The review of animal models of IVD degeneration provided valuable insights into the molecular events underlying pain generation in degenerate IVDs. It emphasized the importance of understanding the complex multifactorial process of IVD degeneration to identify potential therapeutic targets for pain relief and disc repair.

 

  • One promising candidate identified through the review was “growth and differentiation factor 6,” which showed considerable potential in preventing further deterioration of degenerate IVDs, promoting regeneration, and inhibiting the generation of inflammatory mediators.

 

  • The findings from these animal models suggest the need for human clinical trials with this compound to assess its efficacy in treating IVD degeneration and preventing low back pain generation in humans. Overall, this review underscores the significance of animal models in advancing our understanding of IVD degeneration and pain mechanisms, ultimately leading to improved treatment strategies for patients suffering from low back pain.

 

Before getting to the next one,

 

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

 

When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.

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

Item #2

Our last one this week is called, “100,000 older Americans got unnecessary surgeries during dangerous first year of COVID-19” by Aaron Toleos and published in Lown Institute on May 17, 2022. Hot potato!

Why They Did It

The Lown Institute conducted this analysis to shed light on the issue of overuse of medical procedures in American healthcare, particularly during the COVID-19 pandemic. The aim was to bring attention to the fact that even during a public health crisis, unnecessary procedures were still being performed on vulnerable patients, potentially exposing them to harm and wasting healthcare resources.

How They Did It

The analysis was based on Medicare claims data from January to December 2020. The Lown Institute used the 100% Medicare claims database to evaluate the volume of overuse for eight common low-value procedures. The specific procedures and criteria for overuse were determined based on the institute’s previously published research into the measurement of low-value care at hospitals.

 

 

What They Found

  • The Lown Institute found that a total of 106,474 unnecessary procedures were identified during the analyzed period. The most overused procedure by volume was coronary stents, with 45,176 procedures performed. Other procedures with high rates of overuse included vertebroplasty for osteoporosis, hysterectomy for benign disease, and spinal fusion for back pain.

  • The analysis also revealed that approximately one in five of these low-value procedures met the criteria for overuse across the country. Even some of the nation’s most well-regarded hospitals had rates of overuse above the national average. For example, all of the top 20 hospitals ranked by U.S. News had rates of coronary stent overuse above the national average, with four of them having rates at least double that.

 

Wrap It Up

The analysis conducted by the Lown Institute highlights the persistence of overuse of medical procedures in U.S. hospitals, even during a major public health crisis like the COVID-19 pandemic. Despite previous knowledge that certain procedures, such as coronary stents for stable coronary disease, are of limited clinical benefit, they continue to be performed at high rates. This raises concerns about patient safety, healthcare costs, and the need to address the issue of overuse in the American healthcare system. The findings call for greater attention to evidence-based practices and the promotion of appropriate and necessary medical interventions to ensure better patient outcomes and more efficient use of healthcare resources.

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

 

Store

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

 

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

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

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

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

 

Key Point:

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

Thats Chiropractic!

Contact

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

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

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

Connect

We cant wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

Website

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

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

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

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

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #285

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

On the personal end of things…..

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Go to cdi.edu.au

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

Item #1

 

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

Why They Did It

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

How They Did It

 

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

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

What They Found

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

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

Wrap It Up

 

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

 

 

Before getting to the next one,

 

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

 

When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.

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

Item #2

Our last one this week is called, Improved outcome after lumbar microdiscectomy in patients shown their excised disc fragments: a prospective, double blind, randomised, controlled trial” by M J Tait, J Levy, M Nowell, C Pocock, V Petrik, B A Bell, M C Papadopoulos published in PubMed on 9 September 2009. !

Why They Did It

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

How They Did It

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

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

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

 

What They Found

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

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

Wrap It Up

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

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

 

Store

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

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

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

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

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

Key Point:

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

Thats Chiropractic!

Contact

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

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

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

Connect

We cant wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

Website

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

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

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, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

  You have found yourself smack dab in the middle of Episode 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 cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.   I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.  

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

Chiropractic evidence-based products

Integrating Chiropractors

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

 

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

We cant wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

Risk/Reward For Low Back Pain Treatments & Chiropractors In An Interprofessional Practice Setting

CF 266: Risk/Reward For Low Back Pain Treatments & Chiropractors In An Interprofessional Practice Setting

Today we’re going to talk about Risk/Reward For Low Back Pain Treatments & Chiropractors In An Interprofessional Practice Setting

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  You have found yourself smack dab in the middle of Episode #266   Now if you missed last week’s episode , we talked about where to adjust and the types of adjustments that were most beneficial. Make sure you don’t miss that info. Keep up with the class.   On the personal end of things…..

Man oh man…..we’ve been having such an interesting time around these parts. If you’ve been listening along with me, I lost 3 of my 4 full time employees within only a 2 week span. That’s almost like starting completely over. Stressful, kind of shock and awe type of thing.   But, turns out, if you have a spouse or partner that knows the front desk and has the flexibility in their work schedule to put other things on the back burner and come in and help you turn it around, then that’s freaking gold, people. Listen to the words exiting my piehole. “Make sure your significant other knows how to run the front desk, bill, verify insurance, and put in charges.   Without this, we would have been in terrible shape. My wife is my failsafe. She’s fierce when backed into a corner as well. So, when we kind of feel on the defensive, BAM!

Mama bear comes out and makes it happen.

And she has. She’s the gamechanger.   In case you haven’t followed along, we lost all 3 within 2 weeks. The first two both gave us one month notice. The last one, our front desk staffer, gave us no notice at all. Just up and quit. Thanks to my wife, we were up and running on day one and haven’t missed a beat. In fact, we’ve already grown our weekly visits. Just two weeks in with a new front desk that cares and is knocking it out for us.  

Turns out, my low numbers all this Fall and Winter weren’t bad marketing and all that. It was that the simple jobs or booking and re-booking weren’t being tended to the way we asked. That didn’t just fall on the shoulders of one person. It was several. Now that we’ve started from scratch, our systems are being re-implemented and it’s making a difference quickly.   Now you get to not hear about it anymore very soon. I’m only sharing with you so that, should you go through some of the stuff I’ve dealt with recently, you’ll have a broader knowledge base to make corrections from. When you’d increased your marketing yet the numbers remain low, it’s probably internal. Not external.  

I’m 50 and still learning lessons.  

During the Fall 2022 Slowdown ….that’s what it will forever be referred to by the way….the Fall 2022 Slowdown…..we brought Darcy Sullivan of Propel on board to get our website SEO enpoint and dialed in. If I’m going to have a slowdown, it’s not going to be because of being cheap and not taking care of the #1 source of referrals….which is Google.  

So I brought Darcy on and did the package where they basically do the whole thing for me because, let’s be honest, I don’t have the time nor the expertise for it.   We’ve gone through the process and now she’s updated my website and we’re ready to see what happens with the Google machine. Between Darcy at Propel and my wife handling front desk duties until she gets the new staffer trained up….I’m in a no-lose situation my friends.   I’m looking forward to reporting back on how well Darcy’s crew does for us.   Now, let’s get going with the research, shall we?          

Item #1  

The first on today is called, “Benefits and harms of treatments for chronic non-specific low back pain without radiculopathy: Systematic review and meta-analysis” by Ronald J. Feise and published in The Spinal Journal on November 15, 2022. Dayum. That’s hot.    

Why They Did It  

The aim of this review was to compare the benefits and harms of treatments for the management of chronic low back pain without radiculopathy and to report the findings in a format that facilitates direct comparison (Benefit-Harm Scale: level 1 to 7).    

How They Did It  

  • This was a registered systematic review and meta-analysis of randomized controlled trials. I
  • nterventions included non-pharmacological (acupuncture, spinal manipulation), pharmacological and invasive treatments compared to placebo.
  • Best evidence criteria were used. Two independent reviewers conducted eligibility assessment, data extraction and quality appraisal.

    What They Found  

  • The search retrieved 17,362 records.
  • Three studies provided data on the benefits of interventions, and 30 provided data on harms.
  • Studies included interventions of acupuncture (n=8); manipulation (n=2); pharmacological therapies (n=9), including NSAIDs and opioid analgesics; surgery (n=8); and epidural corticosteroid injections (n=3).
  • Acupuncture and manipulation were effective in reducing pain intensity compared to sham.
  • The benefit of the other interventions was scored as uncertain due to not being effective, statistical heterogeneity preventing pooling of effect sizes, or the absence of relevant trials.
  • The lowest risks were for acupuncture, spinal manipulation, NSAIDs, combination ingredient opioids, and steroid injections, while they were higher risks for single ingredient opioid analgesics (level 4) and surgery (level 6).

    Wrap It Up  

  • There is uncertainty about the benefits and harms of all the interventions reviewed due to the lack of trials conducted in patients with chronic non-specific low back pain without radiculopathy.
  • From the limited trials conducted, non-pharmacological interventions of acupuncture and spinal manipulation provide safer benefits than pharmacological or invasive interventions.
  • There were high harms ratings for opioids and surgery.

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

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

Item #2  

Our last one this week is called, “Chiropractors in interprofessional practice settings: a narrative review exploring context, outcomes, barriers and facilitators” by Corrie Myburgh and published in Biomed central on 16 December 2022. Hot potato!    

Why They Did It  

To determine the added value of interprofessional interventions over existing mono-professional practice, elucidation of specific health care issues, service delivery contexts and benefits of combining multiple service provider is required.  

How They Did It  

  • A search of relevant databases was performed
  • The search was conducted in October 2021.
  • Two reviewers independently screened the articles. In case of disagreement consensus was reached through discussion.
  • An article was included if it described interprofessional practice including a chiropractor and outcome measurements relating to interprofessional service delivery were reported.
  • In particular, articles were included if they had peer-reviewed scientific content in the form of journal articles, book chapters, and conference proceedings

    Wrap It Up  

  • Very limited evidence from which to judge the value of interprofessional practice interventions involving chiropractors is currently available. Exploratory studies have outlined issues relating to feasibility and potential value of interprofessional practice initiatives across at least four domains of practice.
  • However, only one study was identified with the specifically stated purpose of investigating an interprofessional practice practice intervention for a particular health care issue; this being low back pain in older patients.
  • The discourse relating to interprofessional practice involving chiropractors appears to be at an early stage of development and further studies conducted specifically to evaluate interprofessional practice solutions for specific health care issues are urgently required.

So, we need some research. We want to be part of the team so let’s prove that we can provide value and be a valuable member of the team.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.  

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

 

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

We cant wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

Early Diagnosis Of Spondylolysis and Clinical Guides For Low Back Pain

CF 264: Early Diagnosis Of Spondylolysis and Clinical Guides For Low Back Pain

Today we’re going to talk about potential early diagnosis of spondylolysis as well as clinical guides on low back pain treatment. But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.   We’re the fun kind of research. Not the stuffy, high-brow, 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 #264   Now if you missed last week’s episode, we talked about spinal surgery for low back pain & white rice and your heart. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Man, life is crazy. I think we’re just given what we’re supposed to have at the time we need it. I don’t really know what that means but let’s put it this way; in my personal clinic, I was overwhelmed to a point I had no idea how to keep up. September came and boom, I’ve been down 150-200 visits per month for the entire Fall.  

I’m a Christian so, is it a God thing that when I’m about to pull my hair out, the bottom feels like it drops out and we take a step back?? Who knows? Not me. But Voice over has picked up. So income is steady. Not up or down. Just different sources. It’s weird.   I spent this last weekend playing a singer-songwriter showcase on Saturday night here in Amarillo and then flying to Dallas and back to Amarillo on Sunday to emcee a cheer and dance competition. I got paid very well for both of them. It was outstanding.

Getting paid well for doing things you love doing is pretty refreshing.   Don’t get me wrong; I love working with patients. But when it’s just you and you’ve got 190-200 appointments per week, staffing issues, billing issues, decreased reimbursements, blah blah blah….well that can take away from you job and life enjoyment. I realize I’m preaching to the choir here but you see what I mean.   Still, with the clinic, it looks like it’s coming back around a little in the last 2 weeks or so. We’ll see.

I’m still working with Darcy Sullivan at Propel but still very new to the journey with her so no real wow results yet. It’s a process and I’ll keep you updated.   Also this week, I’m headed to Ft. Lauderdale as part of my MCM Florida Mastermind group. It’s always a great time connecting with this group and with it being a new year, we’ve grown by about 6 or 7 members so more people to solve our problems and more people we can all learn from and, in turn, teach.   I’ll let you know how Ft. Lauderdale goes and if we get into any shenanigans!    

Item #1

Our first one is called “Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021”, and is a clinical practice guidelines published in the Journal of Orthopaedic and Sports Physical Therapy in October of 2021.

This one is a full blown huge article on PT recommendations for 2021. It’s always a year behind and all. So we’re going to just hit some of the interesting points that work for chiropractors too.   They say that providers may use exercise training interventions, including trunk muscle strengthening and endurance and specific trunk muscle activation, to reduce pain and disability in patients with acute LBP with leg pain.   For chronic pain, they say providers should use exercise training interventions, including trunk muscle strengthening and endurance, multimodal exercise interventions, specific trunk muscle activation exercise, aerobic exercise, aquatic exercise, and general exercise.  

Here’s one I found particularly interesting, “Physical therapists should use thrust or nonthrust joint mobilization to reduce pain and disability in patients with acute LBP.”   The hell you say! All these years PTs have been making fun of chiros. Now they’re recommending SMTs. Let’s be fair to the medical world though. They’re not making fun of movement, smt, and strengthening chiros.

They’re making fun of vitalists. And who can blame them?  

They also said, “Physical therapists may use massage or soft tissue mobilization for short-term pain relief in patients with acute LBP.”   Again, we’ve been doing this stuff for-ev-er. Welcome to the party PTs!   You’ll never believe the recommendations for chronic low back pain, that right….” Physical therapists should use thrust or nonthrust joint mobilization to reduce pain and disability in patients with chronic LBP and with chronic pain with associated leg pain.”  

They go on to add massage and soft tissue manipulation as well as dry needling and nerve flossing as well as even mechanical traction   So, two things here:

  1. If you for some reason didn’t feel validated today, feel validated. If you are evidence-informed, you are doing the right stuff and you have been forever and ever regardless of what people from the medical side have said about you over the years. Buncha freaking Chads and Karens showing their asses.
  2. PTs are going to put you out of business because they’re doing everything we’re doing including our one thing, spinal manipulative therapy. Not only are they doing what we do, but they have more cultural authority in the medical community, they are the MDs’ first referral, and they get paid more for it all. Unless we ban together, run the garbage out of our profession, police our own, and move this profession in the direction of evidence-informed, patient-centered care models. Otherwise, bend over and kiss your ass goodbye.

    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

#2 today is called, “Lateral bending differentiates early-stage spondylolysis from nonspecific low back pain in adolescents“ by Sugiura et. Al and published in Musculoskeletal Science and Practice in April of 2022 and it’s still a steamy pile of hot stuff.

  Why They Did It Early-stage spondylolysis (ESS) is one of the common causes of acute low back pain (LBP) in adolescents. Although accurate diagnosis of Early-stage spondylolysisis important for providing appropriate treatment, differentiating Early-stage spondylolysis from other low back disorders is difficult by physical signs alone. They wanted to elucidate the most common characteristic, namely, motion-provoking LBP, in patients with Early-stage spondylolysis.

How They Did It

  • We included and categorized adolescents with acute LBP (<1 month) into the Early-stage spondylolysis and nonspecific LBP groups based on magnetic resonance imaging (MRI) findings.
  • Patients were evaluated using a visual analog scale (VAS), Oswestry Disability Index (ODI), and degree of pain using a numerical rating scale (NRS) provoked by hyperextension, hyperflexion, right and left rotations, and lateral bending in standing position

  What They Found

  • The mean scores for VAS and ODI and NRS of each test were compared between groups
  • The Early-stage spondylolysis group had a significantly greater number of LBP cases provoked by lateral bending than the NS-LBP group.

  Wrap It Up  

Our results indicate that lateral bending is the greatest motion-provoking characteristic of LBP in patients with Early-stage spondylolysis.      

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

Website https://www.chiropracticforward.com  

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

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

Twitter https://twitter.com/Chiro_Forward  

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

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

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

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

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

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

Bibliography

  • George S, F. J., Silfies S, Schneider M, (2021). “Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021.” J Ortho Sports Phys Ther 51(11): CPG1-CPG60.  
  • Sugiura S, A. Y., Toyooka T, Shiga T, Takato O, Ishizaki T, Omori Y, Takata A, Kiguchi Y, Tsukioka A, Okamoto Y, Matsushita Y, Inage K, Ohtori S, Nishikawa S (2022). “Lateral bending differentiates early-stage spondylolysis from nonspecific low back pain in adolescents.” Musculoskelet Sci Pract 58.      

Low Back Surgery & White Rice And Your Heart

CF 263: Low Back Surgery & White Rice And Your Heart

Today we’re going to talk about spinal surgery for low back pain & white rice and your heart.

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  You have found yourself smack dab in the middle of Episode #263   Now if you missed last week’s episode, we talked about physical and psychological factors in low back pain and we talked about the prevalence of long-term low back pain after symptomatic lumbar disc herniation. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Let’s talk about employees and my situation shall we? After I get through this short story, if you thought you were in a crappy spot, you may change your mind and feel blessed while feeling sorry for your Ol’ Uncle Jeffro here in Amarillo, TX.   So, many of you know, this has been a challenging time for me. We started slowing down here in the clinic in September and not intentionally, by the way. Then lost my mother in law at the end of September. Then got a subpoena to testify in a court case that a family member is involved in. That added to our general level of stress for sure. Then started having some staffing issues.  

My office manager decided to leave to open her own day care. About the same time, my second most important office member got a job offer to run a urgent care type facility. All the while, my numbers have been down from about 185 appointments per week down to about 135 or so per week. 50 less per week means 200 fewer per month. It’s a hit man. Especially when you carry that through for an entire quarter; September through December.  

Especially when you consider I’m also funding starting a nurse practitioner from scratch.   Then during this time we opened our second short term rental Airbnb house and fully furnished that sucker and worked on it day in and day out. Throw Thanksgiving, Christmas, and New Year’s in on all that and you’re starting to get the picture of what it’s been like around here.  

So, we got one replacement hired and so far, she’s out-freaking-standing! The second replacement, after we hired her a little over 2 weeks ago, decided she just wouldn’t show up for her first day of work today. So, back to the drawing board while the girl that would be training her…..well her last day is in 4 days so, yeah.   Oh, and I almost forgot, one of my best staff members on my spa side of the business has been having marital problems and had to take a 2-week vacation to work that out.  

Then I have two others that I had to give hefty raises to in order to keep them. It’s been a time folks, a real real time.   I do not understand employees right now. Especially the ones that get hired and don’t show up for work on Day 1. That’s TWICE in the last month that we hired someone that did not show up for their first day. What is wrong with people right now?   I hope you’re having more luck with employees right now than I am.   Here’s the thing though, screw it! We’re still getting up and showing up for our staff, for each other, and for our patients. Pain doesn’t disappear because we’re having problems in our personal and/or professional lives. Surgeons are still doing unnecessary surgery that we can prevent regardless of our problems.  

If I have to go down to one employee for a while, we’ll figure it out. My wife will answer the phones and set appointments and I’ll bust my tail in the back office until we find another game-changing team that’s ready to make a difference for our patients. The mission is stead and unchanged. We will provide world class care to the population of my area. Period.   I promise, I’m not going to gripe on every episode because you won’t stick around but part of my point in sharing with you is:

  1. To let you know that if you’re having issues, you’re not alone. A lot of business owners are having staffing issues.
  2. If I’m going through it and find the way out, you can copy that. Or at least copy my attitude and stay strong through the valleys so you can enjoy the peaks when they come back around.

 

Item #1

The first on today is called, “The role of spinal surgery in the treatment of low back pain”by Lachlan Evans and published in Medical Journal of Australia on 12 December 2022. Dayum. That’s hot.

 

Why They Did It   Low back pain (LBP) is common, increasingly prevalent and the leading cause of lost productivity worldwide. Most LBP is generated by non‐specific degenerative changes affecting the bone and soft tissue of the spine, with congenital and acquired deformity, infection, malignancy and trauma comprising a much smaller cohort.  

 

How They Did It  

  • This narrative review focused on studies of any design involving adult patients (aged ≥ 18 years) with axial pain affecting the region of the lumbar spine. We acknowledge the myriad aetiologies of axial LBP and the corollary that treatment strategies must address the underlying cause and, as such, are similarly diverse.

 

  • Studies on neurogenic claudication or radiculopathy treated with surgery were excluded as were those evaluating patients with significant structural abnormalities such as spondylolisthesis and fractures.

 

  • Studies reporting spinal cord stimulation, radiofrequency ablation or percutaneous administration of epidural analgesia were also considered beyond the scope of our discussion.

 

  • They performed an electronic search of the MEDLINE database for articles published from 1 January 1991 to 31 December 2021, without restriction of language. Theyemployed the following search strategy: “lower back pain OR lumbar back pain” AND “surg* OR operati*”. Articles were not excluded based on study design. The study quality was assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.

 

What They Found  

  • Acute LBP is frequently self‐resolving, but recurrence is common, and a significant proportion of patients will develop chronic pain. This transition is perpetuated by anatomical, biological, psychological and social factors.

 

  • Chronic LBP should be managed with a holistic biopsychosocial approach of generally non‐surgical measures.

 

  • Spinal surgery has a role in alleviating radicular pain and disability resulting from neural compression, or where back pain relates to cancer, infection, or gross instability.

 

  • Spinal surgery for all other forms of back pain is unsupported by clinical data, and the broader evidence base for spinal surgery in the management of LBP is poor and suggests it is ineffective. Emerging areas of interest include selection of a minority of patients who may benefit from surgery based on spinal sagittal alignment and/or nuclear medicine scans, but an evidence base is absent.

      Wrap It Up

  • The increasing burden of LBP presents a significant challenge to health care systems throughout the world. Its management should be overseen by primary care physicians and centred upon a holistic biopsychosocial approach of generally non‐surgical interventions.
  • Even though spinal surgery does have a role in alleviating symptoms of radiculopathy or neurogenic claudication, or in circumstances where back pain is related to cancer, infection or gross instability, its role in the management of degenerative LBP is not supported by the studies currently available.

 

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

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

 

Item #2   Our last one this week is called, “White rice and pasta are just as bad for your heart as candy” by Caitlin Tilley and published in Dailymail on October 3rd, 2022. Hot potato!    

 

Why They Did It  

They examined the risk of heart disease among people whose diets were high in refined grains compared to whole grains.    

How They Did It  

  • The study looked at 1,168 healthy patients and compared them to 1,369 patients with coronary artery disease.

 

  • Participants answered a food frequency questionnaire to determine how often they ate whole and refined grains.

 

What They Found  

  • They found those who ate refined grains – processed to give them a finer texture and longer shelf life – were more likely to develop coronary artery disease in middle-age.
  • They found that a diet that includes consuming high amount of unhealthy and refined grains can be considered similar to consuming a diet containing a lot of unhealthy sugars and oils

 

Wrap It Up  

As more studies demonstrate an increase in refined grains consumption globally, as well as the impact on overall health, it is important that we find ways to encourage and educate people on the benefits of whole grain consumption.     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.      

But first, heres that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

  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

Lachlan Evans, T. O. D., Andrew Morokoff and Katharine Drummond, (2022). “The role of spinal surgery in the treatment of low back pain.” Med J Aust II.  

Tilley C (2022). “White rice and pasta are just as bad for your heart as CANDY, study suggests.” DailyMail.      

Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff

CF 259: Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff Today we’re going to talk about Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
  OK, we are back and you have found the Chiropractic Forward Podcast where we are 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 #259 Now if you missed last week’s episode , we were joined by Dr. Anthony Houssain and had an amazing discussion on how to choose a good practice location, on the clinic/gym hybrid model, and one why masterminds are so important for you growth. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. First thing, if you haven’t had enough of my podcast, or you just want to hear my thoughts in a different context and setting, Dr. Jay Greenstein and Brad Cost interviewed me for their podcast called TechTalk and we had a great chat about life, practice, and all things in between. Go check it out. It aired just a week or two ago so it’s one of their newest episodes.  So, if you’ve been listening lately, you know I’ve been in a slump. I’m not a slump type of guy. I don’t know what ‘take a step back’ even looks like. It’s not in my vocabulary. All I know is progress, growth, win, win, win. I’m an old college football player and won state here in Texas in the discus. Competition, initiative, and growth are engrained in the very fabric of my being.  It’s just how I’m built.  So, being slower here in the clinic this year has been challenging for me. A bit financially but also big time mentally. I don’t have mental health issues. That’s now what we’re talking about. Mentally as far as trying to figure it out. Putting the puzzle together so that I can fix it and get back to growing.  Part of that has been fixing my outlook day to day. Embracing the suck. Meaning, when I show up on a Monday morning and there’s 48 on the schedule and there are 5 in the lobby before we even open…..instead of being defeated before I even get into my office space, my personal area, instead of being defeated, I need to embrace the stress and anxiety, thank God for our blessings, and get to work making people feel better.  So, I wanted to fix that first. Then, what else could be the issue. Well, I used to be #1 on the google search. For years I was the top one because nobody else had figured out the importance at that time so I had a step ahead.  But, an internet company I was with screwed up my site, Google changed their algorithms, and boom, I started dropping. So I switched companies. They set up a great site but no real SEO. So I started blogging every single week. New, fresh, completely original content. Guess what, no help at all. Not even a little. I was falling like a rock.  So I think website SEO is a big issue so I’m addressing that now too. You all know I’m in the Florida Mastermind with Dr. Kevin Christie. Well Kevin works with Darcy Sullivan of Propel. So, I contacted Darcy and she’s taking me on as a client and a big project I can only assume. Lol.  I’m going to be talking every week or so about my experience so you’ll know how it’s going in real time and we’ll be able to see where I started and where I end up with Darcy’s help. It’ll be a learning project we’ll do together.  Stick with me for the next 4-6 months on the website SEO thing because this should be interesting. If all works out well, you may be contacting Darcy and Propel as well. Time will tell.  Alright, let’s get to the research shall we? Item #1 Our first on his called, “Lumbar spine MRI findings in asymptomatic elite male academy footballers: a case series: by Carmody et. Al. (Carmody S 2022) and published in BMC Sports Science Medical Rehabilitation on October 24th, 2022 and that’s brand new and it’s hot too! Why They Did It
  • Understanding common MRI findings may allow clinicians to appreciate the sport-specific effects on the lumbar spine, and to discern clinically significant pathology. 
  • Prevalence data regarding radiological abnormalities seen during the surveillance of asymptomatic elite footballers is, therefore, important to help understand injury mechanisms and to prevent associated injuries. 
  • The purpose of this study was to evaluate the magnetic resonance imaging (MRI) findings in the lumbar spines of asymptomatic elite male adolescent footballers.
How They Did It
  • A prospective case-series study was carried out. 
  • MRI was performed in 18 asymptomatic male elite adolescent footballers recruited from a professional academy in England 
  • The images were independently reported by two consultant musculoskeletal radiologists to achieve consensus opinion. 
What They Found
  • Fifteen players (83%) showed one or more abnormalities, that included facet degeneration, synovial cysts, disc degeneration, disc herniation, and pars injury. 
  • One player had mild (Grade 1) facet joint arthropathy at L4/L5
  • 3/18 showed evidence of bilateral facet joint effusions. 
  • Three synovial cysts were identified in 2 players, 
  • 4 presented asymptomatic pars injuries, 
  • 4 had a grade 2 subtotal stress fracture and 
  • 1 player had a grade 4 chronic stress fracture 
  • Disc degeneration at one or more levels was demonstrated in 7 fo the 18. 
  • Disc herniation was present in 5 or 27% of the players.
Wrap It Up A range of unsuspected findings on MRI of the lumbar spine are common in elite adolescent footballers. Folks, all of those scary words used to send my patients straight to a surgeon for a second evaluation. Now I know better. These are all asymptomatic. No clinical issue whatsoever and these players ranged from 17 years old to almost 19 years old.  No pain and almost 30% of them had disc herniations. We can manage these cases. If there is no progressive neurological deficit with regard to bowel and bladder function, DTRs, dermatomes, or motor function, why are you sending them anywhere? Don’t do it. Pain is not a reason for surgery and we can manage them if you are educated and know what to do. If you do not know, get smart and get educated. Good starting points are:
  • Stu McGill’s book called Back Mechanic
  • Craig Liebensen
  • McKenzie Certifications
  • FMS/SFMA
  • DNS
  • Donal Murphy’s Spine Practitioner program and his CRISP Protocol books. 
Just that group of stuff right there will put you heads and shoulders beyond what the majority of your colleagues and yes…competitors are able to do. You immediately differentiate yourself and then you lengthen the road between yourself and the others more and more with each cert you get. Then look at Diplomates to solidify a canyon between yourself and the rest.  Stop sitting on your ass if you don’t know anything about this stuff. Get on it and make this profession what it should be.  Bam. Pow. Smack. Kachunga, Slap! Wowza! Tough talk and tough love. But hopefully motivating works from you Ol’ Uncle Jeffro. You’re welcome.  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 next one is called, “Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial” by Moustafa et. al. (Moustafa IM 2022)published in Journal of Clinical Medicine on September 29, 2022 and that’s a hot tamale with jalapeños atop of it.  And as a side note, I’m still trying to figure out how I got stuck with a boring name like Williams while you got guys walking the Earth with the last name Moustafa. It’s just not fair.  Why They Did It
  • to investigate the effects of sagittal head posture correction on 3D spinal posture parameters, back and leg pain, disability, and S1 nerve root function in patients with chronic discogenic lumbosacral radiculopathy
How They Did It
  • A randomized controlled study with a six-month follow-up
  • 80 (35 female) patients between 40 and 55 years experiencing chronic discogenic lumbosacral radiculopathy with a definite hypolordotic cervical spine and forward head posture (FHP) and were randomly assigned a comparative treatment control group and a study group
  • Both groups received TENS therapy and hot packs, additionally, the study group received the Denneroll cervical traction orthotic.
  • Interventions were applied at a frequency of 3 x per week for 10 weeks and groups were followed for an additional 6-months. 
  • Radiographic measures included cervical lordosis (CL) from C2-C7 and FHP; postural measurements included: lumbar lordosis, thoracic kyphosis, trunk inclination, lateral deviation, trunk imbalance, surface rotation, and pelvic inclination.
  • Leg and back pain scores, Oswestry Disability Index (ODI), and H-reflex latency and amplitude were measured
What They Found
  • Statistically significant differences between the groups at 10 weeks were found: for all postural measures, 
  • No significant difference for back pain, leg pain and ODI at 10 weeks were identified. 
  • Only the study group’s improvements were maintained at the 6-month follow up while the control groups values regressed back to baseline. 
  • At the 6-month follow-up, it was identified in the study group that improved cervical lordosis and reduction of FHP were found to have a positive impact on 3D posture parameters, leg and back pain scores, ODI, and H-reflex latency and amplitude.
OK….a dude who sells the Denneroll did this paper. It’s funny how other researchers find no big deal when it comes to the cervical curve. However, literally ALL of this guy’s ‘papers’ somehow make a big deal out of C-sp decreased curvature. Hinky, huh? It’s so odd.  It’s like Firestone doing research and finding out how amazing their tires are.  Hey everyone….McDonald’s did a research project and they found out how yummy their food is!! Yay McDonald’s you’re so amazing and thank you for doing your own research on your own company for the rest of us dumbasses. Thank you for being so awesome and kind.  Blah.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     

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

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  Bibliography Carmody S, R. G., Mitchell A, Kryger KO, Ahmad I, Gill M, Rushton A, (2022). “Lumbar spine MRI findings in asymptomatic elite male academy footballers: a case series.” BMC Sports Sci Med Rehabil 14(1): 184.   Moustafa IM, D. A., Harrison DE (2022). “Does Improvement towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Trial.” J Clin Med 11(19): 5768.      

Spinal Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids

CF 253: Spinal Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids Today we’re going to talk about Spinal Cord Stimulators vs. Placebo & we’ll talk about Low Back pain, Chiropractic, And Opioids But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

You have found yourself smack dab in the middle of Episode #253 Now if you missed last week’s episode, we talked about High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter?. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Alright, if you’ve heard me fussing my face off about being slow for like oh I don’t know…..the last 8 freaking weeks or so….then you’ll be glad to hear that I have 43 on the schedule today with 5 new patients. That’s more like it.  That’s 5 new patients, one consultation, and 3 re-exams. So….they’re  coming back slowly.

Where the hell did they go in the first place? Who knows? But I talked to my buddy, Tyce Hergert down in Southlake, TX and he’s been slow as hell too. Until just last week. He thinks it’s the economy, inflation, back to school kicked it off, and then we have a big election that makes people a bit pulled back and financially more aware.  Who knows, but it makes sense. Maybe it was a perfect storm kind of thing but I know I’m ready to get back to business and running around like my ass is on fire unable to keep up. Then you get to hear me fuss about that. Lol. It’s a cycle. 

Why can’t it ever just sit right there in teh perfect pocket where you’re seeing just the right number of patients and are right where you want to be as far as being busy during the work week? Yeah, that’s a pipe dream. Never happening.  I’ll tell you this though, I’d rather be running around here with my ass on fire, changing people’s lives, and making money along the way rather than sitting here wondering who I made mad and moping around like a whipped dog. Lol.  So, for this week…we’re back toward the top of the mountain. 

Just real quick on a side gig kind of thought process. I have people asking me all of the time how I started getting into real estate. I want to help you guys. I read a book that’s in the Rick Dad Poor Dad umbrella that’s called Tax Free Wealth by Tom Wheelright.  It started talking about how you can pay lower to zero taxes by buying real estate. Well that got me to listening to the Bigger Pockets podcast and taking their webinars. Then I started delving into the niches of real estate. I decided for lots of reasons that Short Term Rentals, or STRs made the most money and the most sense. 

That led to a podcast and a book by Avery Carl called Short Term Rental, Long Term Wealth. They also have a private Facebook group that I’m a member of.  In case you don’t know, STR is what an Airbnb or VRBO property is. Short term rental like 3-5 days or so vs. a year long lease.  Trust me; people a hell of a lot dumber than you are making a ton on real estate. Here are the ways you make money on real estate:

  1. Cashflow – You have a profitable property so you make monthly cashflow. On average, our STR in Lubbock, TX profits about $2,000/month. That’s above and beyond our overhead on the house. 
  2. Appreciation – You never buy property planning on appreciation. However, assuming it’s not in a terrible neighborhood, it usually appreciates. Which is money in your pocket when, or it, you sell. 
  3. Equity – Other people are buying your property for you. They are kind enough to buy down the payment and buy your equity in the property. Meaning, because of them paying you every month, you own more and more of your own property. 
  4. Taxes – There are multiple ways that real estate benefits your taxes and I’ll leave that up to a CPA since I am not one but in general;
    1. With STRs, you can count your losses and depreciate everything on the real estate side, including the curtains to bring down your tax burden in your chiropractic clinic and try to get your tax burden down to zero for the year. 
    2. The write offs. You can write off all of the furnishings and everything that fits the real estate realm. Including meals where you sit and talk to your business partner (your wife and kids) about your properties. 

Not to mention that if you buy an STR in a place you like to visit, you have a place to stay whenever you need it! Also, if the STR is more than 90 miles from your primary residence, you can qualify for a vacation home loan and only pay 10% down instead of the traditional 20% down.

That makes a million dollar home near or on the beach a hell of a lot more do-able for most of us.  I’ll give you all a bit of a tip, you don’t have to go into these things blindly. Go to airdna.co and go down to the Rentalizer link on the left of your screen. Once there, put in any address, including your home address, and see what it might make as an STR. You may be surprised! It’s not a fool proof silver bullet but can give you some ideas. Also, don’t pay a 20% management fee. It takes me literally 15 minutes per week per property to manage.

Don’t lose 20% of your profit. You can do it yourself. Use guesty.com for the property management software and combine that with pricelabs.com for automatic and appropriate pricing from week to week and then……let er rip!!! Thank me later, fools! If you have any questions, join our private Chiropractic Forward Facebook group and start a post in there. I’d be happy to help if I have the answer. If I don’t, I can find it.  Let’s get started with the research shall we?

Item #1

The first on today is called “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial” by Hara et. al. (Hara S 2022) and published in JAMA on October 18, of 2022 and that’s some hot steamy salsa right there. 

Why They Did It The use of spinal cord stimulation for chronic pain after lumbar spine surgery is increasing, yet rigorous evidence of its efficacy is lacking. The authors wanted to investigate the efficacy of spinal cord burst stimulation, which involves the placement of an implantable pulse generator connected to electrodes with leads that travel into the epidural space posterior to the spinal cord dorsal columns, in patients with chronic radiculopathy after surgery for degenerative lumbar spine disorders.

How They Did It

  • It was a placebo-controlled randomized clinical trial
  • 50 patients were in the study
  • Done at St. Olavs Univer. Hospital in Norway
  • Conducted from 2018 – 2021
  • Patients underwent two 3-month periods with spinal cord burst stimulation and two 3-month periods with placebo stimulation in a randomized order. Which seems like they gave it a good solid chance to work to me
  • Burst stimulation consisted of closely spaced, high-frequency electrical stimuli delivered to the spinal cord. 
  • The stimulus consisted of a 40-Hz burst mode of constant-current stimuli with 4 spikes per burst and an amplitude corresponding to 50% to 70% of the paresthesia perception threshold.
  • The primary outcome was difference in change from baseline in the self-reported Oswestry Disability Index

What They Found

The mean changes in ODI score were −10.6 points for the burst stimulation periods and −9.3 points for the placebo stimulation periods None of the pre-specified secondary outcomes showed a significant difference.  Nine patients experienced adverse events, including 4 who required surgical revision of the implanted system.

Wrap It Up

The concluded, “Among patients with chronic radicular pain after lumbar spine surgery, spinal cord burst stimulation, compared with placebo stimulation, after placement of a spinal cord stimulator resulted in no significant difference in the change from baseline in self-reported back pain–related disability.” So…..chronic pain…..if you’re a regular listener, you know me and chronic pain. I love learning and talking about it. You can’t solve a problem through burst stimulation that is as much entrenched in the brain as it may be in a physical sense. 

You can blast it and blast it and until you treat the centralized portion, you’re pissing up a rope, as they say in Texas.  If you don’t have a clue what I’m talking about, start going through this podcast listening to anything on chronic pain, get a book by David Hanscum called Back In Control, and dive into the biopsychosocial aspect of pain. That’ll get you started. 

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

This second one I got from my buddy Dr. Craig Benton down in Lampassas, TX quite a while ago. Thank you Craig. It’s called “Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids” by Whedon et. Al. (Whedon JM 2018) and published in Journal of Alternative and Complementary Medicine in June of 2018. 

Why They Did It They say, “Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications.”

How They Did It

  • The authors used a retrospective cohort design to analyze health insurance claims data.
  • The data source was the all payer claims database administered by the State of New Hampshire. 
  • The study population was 18-99 year olds, enrolled in a health plan, with at least two clinical office visits within 90 days for a primary diagnosis of low-back pain. 
  • The authors excluded those with a diagnosis of cancer.
  • The authors measured likelihood of opioid prescription fill among recipients of services delivered by doctors of chiropractic compared with non-recipients. 
  • They also compared the cohorts with regard to rates of prescription fills for opioids and associated charges.

What They Found

The adjusted likelihood of filling a prescription for an opioid analgesic was 55% lower among recipients compared with non-recipients.  Average charges per person for opioid prescriptions were also significantly lower among recipients.

Wrap It Up

They concluded, “Among New Hampshire adults with office visits for non-cancer low-back pain, the likelihood of filling a prescription for an opioid analgesic was significantly lower for recipients of services delivered by doctors of chiropractic compared with non-recipients. The underlying cause of this correlation remains unknown, indicating the need for further investigation.” Alright, that’s it. Keep on keepin’ on.

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

  • Hara S, A. H., Solheim O, (2022). “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial.” JAMA 328(15): 1506-1514.  
  • Whedon JM, e. a. (2018). “Association Between Utilization of Chiropractic Services for Treatment of Low Bac k Pain and Risk of Adverse Drug Events.” J Manipulative Physiol Ther 17(30): 30136-30137.      

Chiropractic Adjustments For The Cervical Spine Really Work & Lumbar Radiculopathy Treatment

CF 205: Chiropractic Adjustments For The Cervical Spine Really Work & Lumbar Radiculopathy Treatment Today we’re going to talk about research backing the use of spinal manipulative therapy for neck pain. A systematic review and meta-analysis even! Big stuff. Then we’ll talk about treatment for lumbar radiculopathy. What extra tips can you pick up? But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

You have found yourself smack dab in the middle of Episode #205 Now if you missed last week’s episode, we talked about The Case Of The Disappearing Disc & Vitamin D And Back Pain. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Alright, we got some stuff shaking folks. So, let’s talk about it. First thing, Drake leaving. Who the hell is Drake you might ask? Well, that’s our Parker university intern that’s been with us since last August. We’re spoiled as hell having Drake with us these days. We’re going to miss his help and honestly, he’s just a good guy. We’ll miss him personally as well.  Yes, I tried to hire him but not everyone wants to move to Amarillo so getting associates in this area can be a bit of a challenge. So I’m saying it, if you want to come to Amarillo, you’re always more than welcome to send me a resume at dr.williams@chiropracticforward.com and I’m happy to take a look. 

We have fun. We get people better. And life is good.  I mentioned a couple of weeks ago that we had a turnover and we’d be having a new front desk staffer coming on board. Well, this is the week and here we go. We may have gotten lucky on this one people. 

First, we hire off of Indeed. I’m sure they think I’m a bit of a prick but I use the assessment tools. They have to fill out a couple of assessments that test their knowledge. One is on EHR, another is general office procedure and stuff like that. Well, so many of them just go down the line clicking jobs and submitting without understanding that the assessments weed that out. If they don’t take the time to fill out the assessments, they didn’t care enough about the job to read about it. Which means I don’t care enough about them to waste my time learning more about them. So I move right past them. 

This girl has worked for an urgent care and only looked elsewhere because they didn’t have a full-time position like she needed. My friends actually work at the urgent care and vouched for her. We have the ones we’re interested in come in for a working interview. All of the staff agreed she was the clear choice both in experience as well as in personality.  Our office culture is one defined by fun. We jump scare each other. We laugh. We kid. We are always appropriate but there are times we could be more professional but….again…we have fun. And Our patients love it.

They commonly comment in our Google Reviews about how they love that everyone is so happy, having fun, and enjoying their work.  It’s easy when you have the crew I have. We do work. We work hard. Some days suck. Some days fly by. But think about it, we spend more time with our staff than we spend with our own families for the most part. Right? So why not having fun? Why not have a sense of family, of belonging, and a sense of being a team? Why not? So we’ll be making a new teammate this week. She’s going to be amazing. I just have a feeling. 

Also, I believe it was last week we discussed side gigs.  I mentioned my recent success in the voice over industry and that I’ve been schooling up on real estate investing and all that good stuff. I mentioned that I planned on parlaying that voice over success into real estate investments.  Well, I’ve been analyzing houses and I’ve been learning about remote management of short-term rentals and the pros and cons vs having a long-term rental and all of that good stuff.  Well, I identified 9 properties down in Lubbock TX. Lubbock is about an hour and a half to the south of Amarillo. It’s the home of Texas Tech and Buddy Holly. It’s also where one of my kids goes to college. It’s also the place where my other kid who is currently an 8th grader will likely go if I haven’t retired and moved to Florida when she goes to college. 

Lots of football games, basketball games, baseball games….lots of visits to the medical school there in town….lots of big-name concerts. It’s all good news for having a short-term rental.

Go back and listen to last week’s episode if you want to know why short-term rentals make more sense for tax reasons than other investments right now.  Anyway, I found 9 houses that my wife went to look at last week. She made an offer on one and, once we refi our rental house here in Amarillo, we’ll be able to pull out about $150,000 to put on 1-2 others. One of which is a flip we think we can profit $30k in about three months if there are no surprises or hiccups.  So…..I’m a fact finder. I’ve been finding facts for about a year now. Watching YouTubes. Taking little classes. Listening to podcasts. Reading books. Meeting people and building a small network. So, we’re on it. We’re excited. We’re pumped. We’re busy as hell. 

It’s kind of crazy the faith I have in my wife’s decisions. In lots of ways, she’s the smartest person I believe I’ve ever met. Our first house we bought together, I was on the road traveling with my band somewhere down in south Texas when she made an offer on it. I’d never even seen the house. 

The one I live in now, I actually saw and agreed on. 

The 2-3 down in Lubbock, I haven’t seen either. But I’m buying them. Lol. It’s crazy but she’s a hell of a teammate on this stuff and her vision of what she can do with a house has blown me away. She has some serious skills and I can’t wait to see what happens when she puts them to use on these investments. 

OK, on to the first paper.  Spinal Manipulative Therapy for Acute Neck Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials – PubMed

Item #1

The first one is called “Spinal Manipulative Therapy for Acute Neck Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials” by Chaibi et. al. (Chaibi A 2021) and published in the Journal of Clinical Medicine in October 2021 and that’s got some smoke on it! Let me say that I’ve been yelling for some research on the effectiveness of SMT for neck pain for 4 years here on this podcast. I’ve talked to different researchers about it. They said they couldn’t get funding for it. Now, here we are with a small step for a chiropractor but a giant leap for chiropractor-kind…..or something like that. 

Why They Did It

Acute neck pain is common and usually managed by medication and/or manual therapy. General practitioners (GPs) hesitate to refer to manual therapy due to uncertainty about the effectiveness and adverse events (AEs); 

How They Did It

  • To review original randomized controlled trials (RCTs) assessing the effect of spinal manipulative therapy (SMT) for acute neck pain. 
  • Data extraction was done in duplicate and formulated in tables. 
  • Quality and evidence were assessed using the Cochrane Back and Neck (CBN) Risk of Bias tool and the (GRADE) criteria
  • Six studies were included. 

What They Found

  • The overall pooled effect size for neck pain was very large -1.37 (95% CI, -2.41, -0.34), favoring treatments with SMT compared with controls. 
  • They had a single study that showed that SMT was statistically significantly better than medicine (30 mg ketorolac im.) one day post-treatment. 
  • Minor transient adverse events reported included increased pain and headache, while no serious adverse events were reported

Wrap It Up

SMT alone or in combination with other modalities was effective for patients with acute neck pain. However, limited quantity and quality, pragmatic design, and high heterogeneity limit our findings. So, once again, researchers….please listen. We have enough information on the low back. We know we knock it out of the park on low back pain. Even our haters mostly know we kill it on low back pain. Those douches over at sciencebasedmedicine.whatever mostly admit we’re good on low back pain. And trust me, if you change their damn minds, you’re on to something.  So, let’s expand to the neck, please. Pretty please? Dr. Goertz, Dr. Pohlman, Drs influential with Chiropractic Compass, can we please continue down this path of exploring our effectiveness and low risk for adverse events in the neck because honestly, THIS clinically is what is holding us back. 

Professionally, it’s the vitalists in our profession. But clinically, it’s the perception that we do harm when treating the neck. Can we do harm? Well hell yes we can. Do we commonly do harm and are we likely or probable to do harm? Oh hell no. Why would you ask such a dumb question?

 

Item #2

https://pubmed.ncbi.nlm.nih.gov/30521781/

This one is called “The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial” by Satpute et. al. (Satpute K 2019) and published in Archives of Physical Medicine and Rehabilitation on December 3rd of 2018. It’s mushy…not solidified but not as warm as we like. 

Why They Did It

To evaluate the effect of spinal mobilization with leg movement (SMWLM) on low back and leg pain intensity, disability, pain centralization, and patient satisfaction in participants with lumbar radiculopathy.

How They Did It

  • A double-blind randomized controlled trial.
  • The setting was in a General hospital.
  • 60 adults with the mean age of 44 years old were included
  • They were al diagnosed with subacute lumbar radiculopathy
  • They were randomly allocated to receive spinal mobilization with leg movement  exercise and electrotherapy or exercise and electrotherapy alone. 
  • All participants received 6 sessions over 2 weeks.
  • The primary outcomes were leg pain intensity and Oswestry Disability Index score. Secondary variables were low back pain intensity, global rating of change (GROC), straight leg raise (SLR), and lumbar range of motion (ROM)
  • Variables were evaluated blind at baseline, post-intervention, and at 3 and 6 months of follow-up

What They Found

  • Significant and clinically meaningful improvement occurred in all outcome variables. 
  • At 2 weeks the spinal mobilization with leg movement group had significantly greater improvement than the control group in leg pain and disability. 
  • Similarly, at 6 months, the spinal mobilization with leg movement group had significantly greater improvement than the control group in leg pain and disability. 
  • The spinal mobilization with leg movement group also reported greater improvement in the global rating of change and in SLR range of motion.

Wrap It Up In patients with lumbar radiculopathy, the addition of spinal mobilization with leg movement provided significantly improved benefits in leg and back pain, disability, SLR ROM, and patient satisfaction in the short and long term. 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!

Chiropractic evidence-based products

Integrating Chiropractors

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  The Message

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

Key Point:

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

Contact

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

Connect

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

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About the Author & Host

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

Bibliography

  • Chaibi A, S. K., Russell MB (2021). “Spinal Manipulative Therapy for Acute Neck Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.” J Clin Med 10(21): 5011.
  • Satpute K, H. T., Bisen R, Lokhande P, (2019). “The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial.” Arch Phys Med Rehabil 100(5): 828-836.  

How Car Wrecks Contribute To Future Neck and Back Pain

CF 196: How Car Wrecks Contribute To Future Neck and Back Pain

Today we’re going to talk about How Car Wrecks Contribute To Future Neck and Back Pain. I have two different papers with what I thought were surprising conclusions in one way or another. Not only did I find themm a bit surprising but I don’t think the defense attorneys in PI cases will like either paper much. Just an assumption on my part. All of that coming up in this episode. But first, here’s that sweet sweet bumper music      

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

Chiropractic evidence-based products

Integrating Chiropractors

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

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an invaluable resource for your patient education and for you. It can save you time in putting talks together or just staying current on research. It’s categorized into sections so that the information is easy to find and it’s written in a way that is easy to understand for practitioner as well as patient. You have to check it out. 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 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 #196 Now if you missed last week’s episode , we talked about Spinal Manipulative Therapy vs. Opioids and Young Elite Pitchers, Hips, and Elbow Pain. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things…..

We just ended our fourth week as an integrated practice and starting our fifth. It’s a struggle. I’m not going to lie. You see the money going out but you don’t see it coming in. That’s why, to pull this off, you need to be a busy Chiro and you need to have reserves in place.

Otherwise, it could be doomed. Unless you’re a hype machine. A marketing mastermind that fills the schedule before the integration even takes place. Let’s be honest, most of us just aren’t. I know the value of marketing. I know how to market on a fundamental level. But it’s hard. It’s hard to get your message out there and it’s hard to break through.

So, week one, maybe 4-5 appointments. Week two, maybe 18 appointments. Week 2 was about the same. Then last week was maybe only 8-9. So it’s up and down. We aren’t covering the salary but, we have reserves set back AND I’m fortunate enough to be busy.  The trick is just getting the message out and I feel like we’re doing that both externally as well as internally.

We have in-office brochures, flyers, and posters. Email marketing, social media, and all that good hoopla. It’s happening. We’re making it happen. 

In other news, I recovered from my five days in Washington DC. Geez. What a go-cation. It’s not the cost of taking a trip. It’s the cost of being gone. How much money you lose by not being in the office. That’s the real number and it just kills me!! So, I don’t think about it because I truly believe we need to be taking a trip once per quarter. You have to so you don’t lose your damn mind. It’s just a must.

Speaking of, I have a trip in just about three weeks to Chicago for business to finish off my Fellowship in Forensics. I’m looking forward to that and to networking with everyone involved with that whole side of the profession. Multiple streams of income folks. I do it inside the office as well as outside. Speaking, mentoring, authoring, medico-legal, Ortho fellowship, personal injury, family, triwest, acupuncture, massage, laser, esthetician, Texas Chiropractic Association, Texas Council of Chiropractic Orthopedists, Nurse Prac, and everything that falls under that.

That’s inside.

Outside is music, voice-over, art, real estate investing, and all kinds of other things I’m looking at.  What would it be like to just do a couple Of things?  Who knows? That’s just not me.  I make myself crazy but I honestly don’t know any other way. 

If you were thinking you could get into business for yourself and sit on the computer half the day fiddle assing on the computer, I got news. Your competition is out there getting Diplomates, certifications, and expertise to run circles around you.

Get busy.

Or wonder where all of those new patients are going since they don’t seem to be coming to see you.

Item #1

Alright, let’s hop in with our first one today called “Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis” by Nolet et. al. (Nolet PS 2019) and published in PM&R in November of 2019. In case you didn’t know, PM&R stands for physical medicine and rehabilitation. 

Why They Did It

They say in the abstract that neck injury resulting from a crash is associated with a high rate of chronicity. Prognosis studies indicate 50% of injured people continue to experience NP a year after the collision. This is difficult to interpret due to the high prevalence of NP in the general population. In other words, those that have not been in a car wreck still have neck pain, right? The stated goal of the authors here was to summarize the literature that has examined the association between a motor vehicle collision (MVC) related neck injury and future neck pain (NP) when compared to the population that has not been exposed to neck injury from a crash.

How They Did It

  • They performed a systematic review of the literature using five electronic databases, searching for risk studies on exposure to a car crash and future neck pain published from 1998 to 2018. 
  • The outcome of interest was future neck pain. 
  • Eligible risk studies were critically appraised using the modified Quality in Prognosis Studies (QUIPS) instrument. 
  • Eight articles were identified of which seven were of lower risk of bias. Six studies reported a positive association between a neck injury in an MVC and future NP compared to those without a neck injury in an MVC

What They Found

  • Pooled analysis of the six studies indicated an unadjusted relative risk of future neck pain in the car crash-exposed population with neck injury of 2.3, which equates to a 57% attributable risk to those having been in a car wreck. 
  • In two studies where exposed participants were either not injured or injury status was unknown, there was no increased risk of future neck pain

Wrap It Up

They wrap it up by saying, “There was a consistent positive association among studies that have examined the association between MVC-related neck injury and future neck pain. These findings are of potential interest to clinicians, insurers, patients, governmental agencies, and the courts.” I see personal injury patients. This is good info for their reports, their file, and their attorneys if they’re represented. 

 

Item #2 This one is called, “Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis” by Nolet, et. al.  (Paul S. Nolet 2020)and this one was published in Accident Analysis and Prevention in 2020.  It’s not that hot but I’m using it anyway just because I like it and cuz I say so….

Why They Did It The purpose of this study is to summarize the evidence for the association between exposure to a motor vehicle collision (MVC) and future low back pain (LBP).

How They Did It

  • A systematic search of five electronic databases from 1998 to 2019 was performed. 
  • Eligible studies describing exposure to a MVC and risk of future non-specific LBP were critically appraised using the Quality in Prognosis Studies (QUIPS) instrument. 
  • The search strategy yielded 1136 articles, three of which were found to be at low to medium risk of bias after critical appraisal. 

What They Found

  • All three studies reported a positive association between an acute injury in a MVC and future LBP. 
  • Pooled analysis of the results resulted in an unadjusted relative risk of future LBP in the MVC-exposed and injured population versus the non-exposed population of 2.7, which equates to a 63 % attributable risk under the exposed.

Wrap It Up

There was a consistent positive association in the critically reviewed literature that investigated the risk of future LBP following an acute MVC-related injury. For the patient with chronic low back pain who was initially injured in a MVC, more often than not (63 % of the time) the condition was caused by the MVC.  Thats a lot right, folks? Look, it’s obvious to say an injury was caused by a car wreck. It’s common as a chiropractor to hear patients tell you that their neck pain started with a car wreck they had 20 years before. We hear it all of the time.  But for reals, 57% for the neck and 63% of the back?

That’s solid and flies directly in the face of the other side of the courtroom when they try to tell jurors that the forces experienced in a low-speed impact are about the same as stepping off of a curb on the street. This is, by the way, one of the most ridiculous things I’ve ever heard in my entire life but an argument that they most certainly use periodically.  Fools!!!! The fools we must suffer in life!! I’m sure plenty of folks refer to me in the same manner. It is what it is. Let’s all just try to be the least of the fools…., if that makes any sense at all. 

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 so get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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  The Message

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

Key Point:

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

Contact

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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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

Nolet PS, E. P., Kristman VL, Murnaghan K, Zeegers MP, Freeman MD (2019). “Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis.” PM R. 11(11): 1228-1239.  

Paul S. Nolet, P. C. E., Vicki L. Kristman, Kent Murnaghan, Maurice P. Zeegers, Michael D. Freeman (2020). “Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis.” Accid Anal and Prev 142.