Nutrition

Vertebrogenic Pain & Fish Oil Benefit Claims

September 21, 2023 chiropracticforward Nutrition, Vertebrogenic Pain 0:19:14 0 Comments
CF 296: Vertebrogenic Pain & Fish Oil Benefit Claims Today we’re going to talk about Vertebrogenic Pain & Fish Oil 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

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 chiropracticforward.com
You have found yourself smack dab in the middle of Episode #296 Now if you missed last week’s episode , we talked about Two Surgeries, Two Outcomes & Cervical Artery Dissection and Spinal Manipulative Therapy. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Ugh, the dreaded September slowdown is upon me and the Tri-State Fair. We have a big fair here mid-to end of September every year and people literally take out small loans to take their families to this thing. Who does thtat? I don’t know. Not this family. Even if we were broke.  But, I digress. The point being that September is always a challenging month for us and this year is no exception whatsoever. But, we know it’s going to be this way and we expect it so it’s not a surprise or terribley upsetting. It just is so we do the things we gotta do to deal with it.  We take that extra time to market. I know that’s called reactive marketing but we have a constant online presence. Constant and consistent. We have email marketing and we have constant internal marketing strategies. It’s not like we only market when we’re slow.  We just have MORE time to market when it’s slow. So, we will continue to broaden our footprint this month and see the fruits of our efforts in the next couple of weeks. Time is the same for us all but are you going to waste time? OR are you going to invest time? We choose to invest it. I invest my time in all aspects of my life. You’ll rarely find me sitting idle or just laying around the house with no purpose, goals or achievement happening. Is that healthy? Who knows? But I get a lot done annd I consistently have people asking me how I seem to get so much more done than everyone else?? How do I seem to have more hours in the day compared to others? Well, because I invest time instead of waste it.  Item #1 This one is called, “Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain” by Conger et al published in Pain Medicine in August of 2022. https://doi.org/10.1093/pm/pnac081 Why They Did It The reasons we’re looking at this one is not to promote ablasions but to get us thinking a bit about vertobrogenic low back pain, endplates, sensitization, and all kinds of other stuff.  Vertebrogenic low back pain (LBP) is a type of chronic LBP that is thought to originate from the vertebral endplates. The vertebral endplates are richly innervated by nociceptors, which are nerve endings that sense pain. When the vertebral endplates are damaged, the nociceptors can be activated, sending pain signals to the brain. The researchers say in t his paper that where we used to think that nerves would develop ingrowth into the cracks of a previously injured disc, this may not be an adequate explanation of disc pain. Specifically, they say, “Previously, it was thought that pathological neurovascular ingrowth penetrated into annular fissures, leading to increased sensitivity and nociception via the sinuvertebral nerve. However, more recent evidence appears to refute the occurrence of such neurovascular ingrowth in many cases.” I found that interesting and notable. The paper continues – Vertebral endplate damage can occur due to a variety of factors, including aging, disc degeneration, osteoarthritis, spinal injuries, and repetitive stress.  The type of pain caused by vertebral endplate damage is often described as a dull, aching pain that is localized to the lower back. It may be aggravated by sitting or standing for long periods of time, and it may also radiate into the buttocks and legs. Once vertebrogenic pain has been diagnosed, there are a number of treatment options available. These options include physical therapy, medication, injections, and surgery. The current standard of care for vertebrogenic low back pain is intraosseous basivertebral nerve ablation (BVN RFA). This procedure has been shown to be effective in reducing pain and improving function in patients with Modic changes (MC1 or MC2) on MRI.  The results of basivertebral nerve ablation appear to be durable, with improvements lasting for at least 2 to 5 years. Other treatments for vertebrogenic pain have been proposed, but there is less evidence to support their use. These treatments include extraosseous epiduroscopic basivertebral nerve ablation or bipolar RFA, intraosseous plasma rich growth factor, intraosseous injection of bioresorbable cement, and full endoscopic disc debridement surgery. Oral therapies for presumed low grade infection affecting the discovertebral complex are also controversial, but research is ongoing to determine which subpopulations of patients might benefit from this treatment. Finally, there is some evidence that paraspinal muscle quality may be associated with vertebrogenic pain, but it is not yet clear how treatments to address paraspinal muscle deficits might impact patients with this condition. Wrap It Up
  • Accumulated damage to the discovertebral complex may result in chemical and mechanical sensitization of endplate nocioceptors resulting in chronic vertebrogenic LBP.
  • Midline LBP, pain exacerbation by physical activity, sitting, and forward flexion are factors associated with treatment success after basivertebral nerve ablation 
  • In appropriately selected patients, basivertebral nerve ablation results in substantial reduction in pain and disability in the majority of those treated at 12 months, with similar long term outcomes at 5 years.
  • The presence of MC1 or MC2 is currently the best radiographic indicator of vertebrogenic pain. Outcomes after basivertebral nerve ablation are not impacted by the volume of MC, location of MC, degree of disc degeneration, or presence/size of endplate defects. Patients with MC1 vs MC2 experience similar rates of success after basivertebral nerve ablation
Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.  When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 The last one today is called, “Health Claims and Doses of Fish Oil Supplements in the US” by Assadourian, et. Al. and published in JAMA Cardiology on August 23, 2023 and dayum it’s got sizzle for shizzle.  Why They Did It One in 5 US adults older than 60 years takes fish oil supplements often for heart health despite multiple randomized clinical trials showing no data for cardiovascular benefit for supplement-range doses. Statements on the supplement labels may influence consumer beliefs about health benefits. The authors wanted to answer the questions, “What health claims are made on the labels of fish oil supplements, and what is the total daily dose of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) in commonly available fish oil supplements? How They Did It his cross-sectional study used data from labels of on-market fish oil (and nonfish ω-3 fatty acid) supplements obtained from the National Institutes of Health Dietary Supplement Label Database. The study was conducted and data analyzed from February to June 2022. The frequency and types of health claims made on fish oil labels and the organ system referenced were evaluated.  The total daily doses of combined EPA and DHA were assessed for supplements from 16 leading manufacturers and retailers. What They Found
  • Across 2,819 unique fish oil supplements, 2082 (73.9%) made at least 1 health claim. 
  • Of these, only 399 (19.2%) used an FDA-approved qualified health claim; the rest (1683 [80.8%]) made only structure/function claims (eg, “promotes heart health”). 
  • Cardiovascular health claims were the most common (1747 [62.0%]). 
  • Across 16 leading brands/manufacturers, 255 fish oil supplements were identified. Among these, substantial variability was found in the daily dose of EPA, DHA, and total EPA+DHA. 
  • Only 24 of 255 supplements (9.4%) evaluated contained a daily dose of 2 g or more EPA+DHA.
Wrap It Up Results of this cross-sectional study suggest that the majority of fish oil supplement labels make health claims, usually in the form of structure/function claims, that imply a health benefit across a variety of organ systems despite a lack of trial data showing efficacy.  Significant heterogeneity exists in the daily dose of EPA+DHA in available supplements, leading to potential variability in safety and efficacy between supplements.  Increasing regulation of dietary supplement labeling may be needed to prevent consumer misinformation. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.       

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/   About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger
  1. Aaron Conger, Matthew Smuck, Eeric Truumees, Jeffrey C Lotz, Michael J DePalma, Zachary L McCormick, Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain, Pain Medicine, Volume 23, Issue Supplement_2, August 2022, Pages S63–S71, https://doi.org/10.1093/pm/pnac081
  2. Assadourian JN, Peterson ED, McDonald SA, Gupta A, Navar AM. Health Claims and Doses of Fish Oil Supplements in the US. JAMA Cardiol. Published online August 23, 2023. doi:10.1001/jamacardio.2023.2424
       
Jeff Williams - evidence-based chiropractor

Low Back Surgery & White Rice And Your Heart

January 17, 2023 chiropracticforward Low Back Pain, Nutrition 00:17:50 0 Comments

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, 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

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

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

 

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

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.      

Jeff Williams - evidence-based chiropractor

Does Imaging Mean Better Outcomes & Melatonin Slowing Down Disc Degeneration

December 9, 2021 chiropracticforward Degeneration, Disc Herniations, Imaging, Nutrition, Supplements 00:19:35 0 Comments

CF 207: Does Imaging Mean Better Outcomes & Melatonin Slowing Down Disc Degeneration

Today we’re going to talk about….Does Imaging Mean Better Outcomes & Melatonin Slowing Down Disc Degeneration 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

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 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 #207 Now if you missed last week’s episode, we talked about how Vertebral Dysfunction Alters Neuro Function & The Gender Of Your Provider May Matter. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

It’s a bit hectic around here this week being the week after Thanksgiving as of this recording. Being off for 4 days straight was a very welcome respite from the normal day-to-day.  Nothing too crazy around here this week. We are missing our intern who left last week. We’re just re-acclimating to life as it was before we had an extra hand here in the office. But we’re getting there. We’re stretched a little thin because we added the nurse practitioner.

Well, when he has a procedure, he needs an extra set of hands so that takes up one of our CAs. That leaves us short on this end of the business.  But, the NP is not busy enough consistently enough for us to need to hire another set of hands full time. So, we’re in a growth period and growth can stretch you. And it’s stretching us.

But that’s OK. I know it’ll all be worth it eventually.  We started our integrated journey back on August 1st and here we are at almost December 1st. So that’s about 4 months in. We are averaging around 18-20 visits per week for the medical services and just trying to build build build.  Our most common services would probably be trigger point injections, primary visits, and maybe the hormone pellets or IV therapy. It’s a slow grow thing as with any new venture. It takes time to get your message out. And we’re working on it. We start radio ads next week.  Other than that, outside of chiropractic, we are setting up a short term rental/Airbnb, VRBO type of house.

It is a brand new flip so we’re stepping into a basically new place and it’s ready to go. We’ve been buying all of the stuff to outfit it, getting all wireless stuff so we can manage it ourselves remotely, hiring a contractor to build a deck on the back, and are getting our AirBNB and VRBO listings in order and all that good stuff.  It’s a mess for about a month but once you get it set up, it should only take us about 15-30 minutes per week to manage it from an hour and a half away. And, according to AirDNA which is an analysis software for short term rentals, we stand to profit around $30,000+ per year on the thing. That’s pretty exciting. 

I always talk about the exit strategy. This is part of it. Getting more stuff in line outside of your day to day. 30 minutes a week is not completely passive work but it’s damn near passive and gives us a good raise through the year. And $30k is a nice down payment on another house. Especially when you combine it with what I’m doing in voice over industry currently.  Now, if I can just get a rock star associate to come in and take some of the heat off of me on the day to day hands-on chiropractic treatment. THEN….then we might be on our way.  Enough of that, let’s get to it. 

Item #1

The first one this week is called “What are the effects of diagnostic imaging on clinical outcomes in patients with low back pain presenting for chiropractic care: a matched observational study” by Jenkins et. al.  (Jenkins 2021)and published in Chiropractic and Manual Therapies on November 23rd of 2021, aye chi Wawa….it’s so hot. 

Why They Did It

Evidence suggests that diagnostic imaging for low back pain does not improve care in the absence of suspicion of serious pathology. However, the effect of imaging use on clinical outcomes has not been investigated in patients presenting to chiropractors. The aim of this study was to determine if diagnostic imaging affects clinical outcomes in patients with low back pain presenting for chiropractic care.

How They Did It

  • A matched observational study using prospective longitudinal observational data with one year follow up was performed in primary care chiropractic clinics in Denmark. 
  • Data were collected from November 2016 to December 2019. 
  • Participants included low back pain patients presenting for chiropractic care, who were either referred or not referred for diagnostic imaging during their initial visit. 
  • Patients were excluded if they were less than 18 years old, had a diagnosis of underlying pathology, or had previous imaging relevant to their current clinical presentation. 
  • Mixed linear and logistic regression models were used to assess the effect of imaging on back pain intensity and disability at two-weeks, three-months, and one-year, and on global perceived effect and satisfaction with care at two-weeks.
  • 2162 patients were included, with 24.1% referred for imaging. 

What They Found

Participants referred for imaging had slightly higher back pain intensity at two-weeks and one-year, and disability at two-weeks, but the changes are unlikely to be clinically meaningful.  No difference between groups was found for the other outcome measures. Similar results were found when sensitivity analysis, adjusted for age and leg pain intensity, was performed.

Wrap It Up

Diagnostic imaging did not result in better clinical outcomes in patients with low back pain presenting for chiropractic care. These results support that current guideline recommendations against routine imaging apply equally to chiropractic practice. I know some of you will say “I found so and so on a person that would have never been found, etc.” I get it. And some of you just feel better if you’ve seen what’s going on underneath. I get it and I don’t fault that. I really don’t BUT….you MUST acknowledge that the vast majority of your x-rays that you insist on taking on every patient that walks through your doors, ultimately, weren’t absolutely necessary and didn’t change a thing about how you would be treating them.  That is of course unless you’re a technique philosophy wonk and you think you find listings on x-rays. A strategy that I’ve seen little research that can support.  If you follow Choosing Wisely, you are typically in safe and calm waters. 

Item #2

The second one is called “The potential role of melatonin in retarding intervertebral disc ageing and degeneration: A systematic review” by Cheng et. al. (Zhangrong Cheng 2021) and published in Ageing Research Reviews in September of 2021

Why They Did It

They start by setting the stage here.  Low back pain (LBP) is the leading cause of years lived with disability in the world population, which has increased by over 50 % in the past 20 years, mainly due to population ageing Intervertebral disc degeneration (IDD) is a common degenerative disease of the musculoskeletal system that develops with age. It is regarded as the main cause of chronic low back pain in the elderly. IDD has various causes, including ageing, mechanical overloading, and nutritional deficiency.

Melatonin is a pleiotropic indole hormone secreted by the pineal gland and plays an important role in resisting various degenerative diseases.  The serum levels of melatonin decline with age and are reported to be negatively correlated with the symptomatic and histopathological scores of IDD. In vivo studies have shown that exogenous administration of melatonin could maintain the structural integrity of the intervertebral disc and inhibit the development of IDD. Mechanistically, by interacting with its membrane or intracellular receptors, melatonin can promote autophagic flux, scavenge free radicals, inhibit the release of pro-inflammatory factors, and block apoptotic pathways, thereby enhancing anti-stress abilities and matrix anabolism in different types of disc cells.  Several studies have explored the effects of melatonin on IDD.

This was first discovered when surgical removal of the pineal gland in chickens depleted their serum melatonin levels and accelerated IDD onset Therefore, melatonin supplementation may be a promising therapeutic strategy for IDD. This review aimed to summarize the latest findings regarding the therapeutic potential of melatonin in IDD.

Wrap It Up

From the perspective of therapeutic strategies for IDD, the benefits of melatonin are comprehensive. The existing evidence supports melatonin as a potential therapy for the prevention and treatment of IDD Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

  The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website https://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  Bibliography Jenkins, H. J., Kongsted, A., French, S.D (2021). “What are the effects of diagnostic imaging on clinical outcomes in patients with low back pain presenting for chiropractic care: a matched observational study.” Chiropr Man Therap 29(46).   Zhangrong Cheng, Q. X., Juntan Wang, Yukun Zhang, (2021). “The potential role of melatonin in retarding intervertebral disc ageing and degeneration: A systematic review.” Ageing Research Reviews 70.    

Jeff Williams - evidence-based chiropractor

The Case Of The Disappearing Disc & Vitamin D And Back Pain

November 18, 2021 chiropracticforward Back Pain, Disc Herniations, Nutrition 0:19:12 0 Comments
CF 204: The Case Of The Disappearing Disc & Vitamin D And Back Pain Today we’re going to talk about The Case Of The Disappearing Disc & Vitamin D And Back Pain. But first, here’s that sweet sweet bumper music  

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

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 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 #204 Now if you missed last week’s episode, we talked about Reduced Access To Chiropractic & The Ideal Diet. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. The clinic numbers have cooled a bit. Still busy but more manageable. Since things have cooled a bit on that end of things, let’s switch focus to side gigs. I see questions about side gigs periodically in the forward-thinking chiropractic alliance group.  We chiros are doing all kinds of different things from being real estate agents and hunting guides to selling stuff on eBay and Etsy.  Here’s some of what I do and why. First, I’m very happy with my income from chiropractic but, as with anything, I don’t like my eggs being in one basket, and let’s face it, we’re in a business where if something were to happen to us, it’s game over. If we are not at work and able to perform, then we can kiss all of those years of hard work goodbye.  In our profession, we are literally on a knife’s edge and it could go good or bad in a heartbeat. Literally.  So, I like other options. Do you know what else I like? Success, freedom, achievement, and wealth. All of that gives you a better chance at happiness. People say you can’t buy happiness. Well, that’s what people with no money tell themselves so they feel better. It’s like someone saying it’s not all about looks. Well….that’s true but looks sure as hell to help land a suitable partner. Wouldn’t you agree? In the say way, wealth helps you have more security and security helps you have a better chance at happiness.  So, for all of those reasons, I do a lot of stuff. I’m an artist as many of you might know. I just finished up a series of several Charlie Chaplin watercolor paintings and a sculpture of a horse and jockey in the middle of a race. They’re flying down the track!  You can see all that stuff on Facebook at Jeff Williams Art.  I have a band and have been a traveling musician in my past. It seems like another life at this point. You can check that out on Facebook at Flying Elbows Perspective. Can you imagine another band would have the band name Flying Elbows? Well they do. It’s a fiddle band from Massachusetts. That’s not us. We’re the ones from Amarillo, TX I created evidence-based posters and brochures for you guys over at chiropracticforward.com Then I create live edge furniture. But I like to be honest, nobody has ever bought any of the pieces but that’s not because they’re not good. It’s because they’re expensive! You can see that on Facebook at Amarillo Furniture – Live Edge and Customs. It’s fun. My office and home are full of these original pieces.  The idea is to be able to retire and still be comfortable. Still have income in retirement. How are you going to accomplish that and what is your exit number? What do you have to have at the end that allows y But here’s where things have freaking gone nuts. It’s in the land of voice-over. Holy cow, y’all. Now, my results are not normal as I’m coming to find out. But, just in the last 10 months, I’ve made about $50,000 I never planned on having in my life. I’ve done over 400 commercials in the last 10 months in about 22% of the countries throughout the world and landed talent agencies that represent California, Texas, Indiana, Ohio, Kentucky, and New Jersey/New York.  How at the age of 49 this voice over thing has just come into my life is a twisted tale but briefly, the drummer for my very first band way back in college in Natchitoches, LA became a Lieutenant Colonel in the Army and we stayed in touch. Well, he became the voice of Hand Unit in the video game called Five Nights At Freddie’s. He got to do a bunch of other really cool stuff too but when the pandemic came along, it got me thinking that I need to have options.  That’s when I hit him up about voice over. A year and a half later, here we are it’s crazy.  Now, what do we do with the extra money? Well, we put it to work. That’s what we do. I’ve also spent the last 6-12 months educating myself on real estate investing. Long-term rentals, multi-plexes, short-term rentals, vacation rentals, flipping, wholesaling, and things like that. So, you may have guessed it, voice over will be funding down payments on investment properties.  What a deal. Right?!? The problem in this market if finding a good deal but we’re on some good ones and are hoping to land them in the next week or two.  Here is a little real estate tip for you. Two tips actually. First, money has always been in real estate and it always will be. Through ups and downs, the money is still there. Secondly, losses in your real estate business can offset gains in your chiropractic business come tax time. That’s if you can qualify as a real estate expert. Well…..they made it really hard to qualify so basically, if you have a job like we all have, you can’t. Your loophole, however, is this; short-term rentals don’t count.  Short-term rentals can offset tax gains without you having to qualify as a real estate expert. So, if you’re a chiropractor, short-term rentals probably make a lot of sense so that real estate losses and depreciation can offset the money you make in your chiropractic business so that you can reduce or eliminate taxes.  As a disclaimer, I am not a lawyer nor a CPA so make sure you run that by them.  OK, just some tips from you Ol’ Uncle Jeffro.  Now to the good stuff.  Item #1 This first one is called “Relationship between Vitamin D and Nonspecific Low Back Pain May Be Mediated by Inflammatory Markers”’ by Xu et al   (Xu HW 2021) and published in Pain Physician in November of 2021 and that’s a steamy as a sizzling sirloin.  I believe I got this one from my esteemed colleague, Dr. David Graber who always always posts great research findings. He’s a fountain of knowledge nuggets so go search him up on Facebook and follow his page. One of the smartest guys you’ll find out there.  Why They Did It To explore the mediating effects of inflammatory markers on the relationship between vitamin D levels and pain outcomes. How They Did It
  • This study was done at the Department of Spinal Surgery of a hospital affiliated to a medical university.
  • It was a cross-sectional study
  • They selected patients with non-specific acute low back pain and non-specific chronic low back pain, 
  • The study included 60 people without Ns-LBP as controls, 
  • The study was done from January 2018 to January 2019. 
  • Serum 25(OH)D and inflammatory marker levels were examined.
  • Regression and causal mediation analysis were used to evaluate the mediating effects of inflammatory markers on the association between vitamin D and pain.
What They Found
  • After adjustment for clinical factors, vitamin D deficiency was associated with Ns-LBP
  • however, when the interleukin 6 (IL-6) level was added to the multivariable models, the association was no longer significant in Ns-CLBP patients
Wrap It Up Patients with Ns-LBP had lower vitamin D and higher inflammatory marker levels. This association between hypovitaminosis D and Ns-CLBP may be mediated by IL-6.  Very interesting findings. They do say there are some limitations to the study. They say a retrospective study may include inevitable bias. More sensitive biomarkers were not investigated in this study. Pain intensity evaluation using the visual analog scale is inevitably subjective. Item #2 Alright, item 2 is called “Clinical and Radiological Follow-Up Results of Patients with Sequestered Lumbar Disc Herniation: A Prospective Cohort Study” by Sucuoglu et. al. (Sucuoğlu H 2021) and published in Medical Principles and Practice in February of 2021 and that’s got my glasses fogged up! Why They Did It The authors wanted to assess radiological changes and clinical outcomes of patients with sequestered lumbar disc herniation (LDH) and evaluate the relationship between them. How They Did It
  • Patients diagnosed with sequestered LDH were followed up in 2 groups: operated (within the 1st month after diagnosis) and nonoperated. 
  • Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores at baseline and 1st , 3rd, and 6th-month visits were used. 
  • Radiological evaluation was performed by measuring the sequestered herniation level and herniation volume using 2 MRIs spaced out between 1st and 4th months
  • After the second MRI, patients in the nonoperated group were divided into 3 groups: non-regression, partial regression, and complete resolution
What They Found
  • Signifi
  • cant improvements were observed in VAS and Oswestry scores at month 2 and month 3 in all groups and at month 4 in partial regression and complete resolution groups. 
  • VAS and Oswestry score improvements at months 2 and 3 were significantly higher in the operated group than in other groups. 
  • At month 4, there were no significant differences in VAS and ODI scores between the operated group and partial regression and complete resolution groups.
Wrap It Up
  • Spontaneous regression was observed in the 6th month post-MRI in most of the nonoperated sequestered herniation patients with conservative treatment.
  • Improvements in pain and disability scores were higher among the operated patients at the early stage, whereas they were not significantly different compared to patients with spontaneous regression at the 6th month.
If you remember, I did a whole episode on disappearing discs. Here’s the deal. You have to know this. The more a disc herniates, protrudes, or extrudes into the spinal canal and migrates either cephalad or caudal, the more likely the body is to recognize it as foreign and gobble it up like the cookie monster.  What I thought was instant surgery several years ago, I now know may be a waiting game that ends up being non-surgical.  Here’s the thing that episode taught me though; the disc material can be dissolved but the symptoms remain. At least for a while while the nerve tissue in the region undergoes the healing process.  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

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

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

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerBibliography Sucuoğlu H, B. A. (2021). “Clinical and Radiological Follow-Up Results of Patients with Sequestered Lumbar Disc Herniation: A Prospective Cohort Study.” Med Princ Pract 30(3): 244-252.   Xu HW, Z. S., Yi YY, Chen H, Hu T, Wang SJ, Wu DS, (2021). “Relationship between Vitamin D and Nonspecific Low Back Pain May Be Mediated by Inflammatory Markers.” Pain Physician 24(7): E1015-E1023.      
Evidence based chiropractic forward podcast

Nutrition for Pain, CBT for Pain, TMJ, & 2020 Deaths

April 15, 2021 chiropracticforward CBT, CFT, Nutrition, Tech Neck 0:23:07 0 Comments

 CF 173: Nutrition for Pain, CBT for Pain, TMJ, & 2020 Deaths

Today we’re going to talk a lot about pain. Nutrition for chronic pain, CBT and CFT for chronic pain, we’ll talk about TMJ treatment, and we’ll talk about deaths in 2020. This episode is full of info so let’s dive in. 

But first, here’s that sweet sweet bumper music

 

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #173

Now if you missed last week’s episode , we talked about useless research and we talked about insult vs. inflammation. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I don’t know if I mentioned it or not but I got my book back from Dr. Chris Howson up in the Great State of North Dakota. He spent some time editing it. Dr. Howson is the inventor of the Drop Release tool and is just a super dude on top of being brilliant. If you don’t know about Drop Release, go check it out at https://droprelease.com. It’s pretty cool and something you can use to speed up soft tissue work in your practice. 

Now that we have gone through that process, I am teaching myself the way to self-publish this dude. When there are so many options, it can be daunting. It’s hard to know exactly where to go and how to do it. 

So that is the process I’m undergoing currently. Fortunately, I just noticed a colleague of mine that has recently published a book and it’s #1 on Amazon in its category. I reached out to her and she gave me a path to follow. So down the path I go. 

Still working on the medical integration here at the office. I’ve been having weekly calls with the integration consultant we are using. We are using Dr. Tyce Hergert down in Southlake, TX who has been integrated for 5-6 years at this point. Maybe even longer. He’s been through it for sure. If you are going through integration and need a little guidance, email me at dr.williams@chiropracticforward.com and I’ll get you in touch with Dr. Hergert. 

Our attorney and CPA group got together and got it all figured out so we are moving forward with that aspect of it. Now, if we can just get that Nurse Practitioner hired. I made a mistake that could be seen as misleading. On the Indeed ad I placed, I put the wage at $65/hr. What wasn’t in the ad because there wasn’t a place for it, is that we have only about 33 hrs of hands on time per week. We are starting our NP off at around $85-$90k per year. 

I think one of the NPs got PO’d at me because I was absolutely hiring her. No doubt. She was the one. When it came down to it, she asked my the yearly salary. I told her and she said she wouldn’t and couldn’t do it for less than $125k/year. 

Well, damn. Back almost at square one on that end of things. I had made my mind up on her. Not only that, I think she was mad at me. Lol. So, I went and changed it to the yearly salary to make sure I wasn’t being misleading in any way. 

Now, the goal is to start at $85k and have them up to $120k within 3-4 years. But you can’t start something brand new at that level when you have no clue how it’s going to all work out and come together. It’s already a huge risk to start with. Why make any riskier from the get go?

So, that’s where all of that stands for now. Getting the book together, getting the medical entity rolling, and getting busy as hell again. Oh my gosh. It’s going to take a minute to get used to treating the numbers we were treating back before COVID came along. Today, as I found a little window to start typing today, I’ve got 56 on the schedule. That hasn’t happened since December of 2019. Maybe January of 2020. Maybe. 

February 2020 came along and destroyed business. BAM…..30% at least was gone. We went from 185-200 visits per week all the way down to 115 or so. It wasn’t awesome. I’m not going to lie. OK, it was awful actually. We paid the bills but nobody made any money. That’s for damn sure. 

Now, for the last 2-3 weeks, things are beginning to get a little crazy again. Thank goodness. I hope you are experiencing the resurgence I am experiencing. I think deep down, we all know it’s going to be OK but it’s sure refreshing to finally start to feel it and see it. 

Onto the research!

Item #1

The first one today is called “Do Nutritional Factors Interact with Chronic Musculoskeletal Pain? A Systematic Review” by Elma et. al. [1] and published in the Journal of Clinical Medicine in March of 2020 and that’s only a little smoky but still hot enough!

Why They Did It

They say, “Dietary patterns may play an important role in musculoskeletal well-being. However, the link between dietary patterns, the components of patients’ diet, and chronic musculoskeletal pain remains unclear. Therefore, the purpose of this review was to systematically review the literature on the link between dietary patterns, the components of patients’ diet and chronic musculoskeletal pain”

How They Did It

  • (PRISMA) guidelines were used
  • Online databases PubMed, Embase, and Web of Science were used 
  • 20,316 articles screened and only 12 found eligible to be included in this review
  • They consisted of 9 experimental and 3 observational studies

What They Found

  • 7 out of 9 experimental studies showed a pain-relieving effect of dietary changes
  • Protein, fat, and sugar intake were found to be associated with pain intensity and pain threshold

Wrap It Up

In an interesting conclusion, the authors say, “Plant-based diets might have pain relieving effects on chronic musculoskeletal pain. Patients with chronic rheumatoid arthritis pain can show inadequate intake of calcium, folate, zinc, magnesium, and vitamin B6, whilst patients with fibromyalgia can show a lower intake of carbohydrates, proteins, lipids, vitamin A-E-K, folate, selenium, and zinc. Chronic pain severity also shows a positive relation with fat and sugar intake in osteoarthritis, and pain threshold shows a positive association with protein intake in fibromyalgia.”

CHIROUP ADVERTISEMENT

Item #2

This second one is called “CBT and CFT for Chronic Pain” by Graham Hadley and Matthew Novitch [2] and published in Current Pain and Headache Reports on April 1, 2021. Dammit stand back, we got a hot one. 

Why They Did It

Chronic pain is a widespread public and physical health crisis, as it is one of the most common reasons adults seek medical care and accounts for the largest medical reason for disability in the USA. 

  • Chronic pain is associated with decreased functional status, opioid dependence and substance abuse disorders, mental health crises, and overall lower perceived quality of life. 
  • Evidence suggests that persistent low back pain (pLBP) is a multidimensional biopsychosocial problem with various contributing factors. Emotional distress, pain-related fear, and protective movement behaviors are all unhelpful lifestyle factors that previously were more likely to go unaddressed when assessing and treating patient discomfort….
  • and as we just covered, diet might play a part in it as well. 
  • Those that are not properly assisted with these psychosocial issues are often unlikely to benefit from treatment in the primary care setting and thus are referred to multidisciplinary pain rehabilitation physicians. 
  • This itself increases healthcare costs, and treatments can be invasive and have risks of their own. 
  • Therefore, less expensive and more accessible management strategies targeting these psychosocial issues should be started to facilitate improvement early. 
  • As a biopsychosocial disorder, chronic pain is influenced by a range of factors including lifestyle, mental health status, familial culture, and socioeconomic status. 
  • Physicians have moved toward multi-modal pain approaches in order to combat this public health dilemma, ranging from medications with several different mechanisms of action, lifestyle changes, procedural pain control, and psychological interventions. 
  • Part of the rehabilitation process now more and more commonly includes cognitive behavioral and cognitive functional therapy. 
  • Cognitive functional therapy (CFT) and cognitive behavioral therapy (CBT) are both multidimensional psychological approaches to combat the mental portion of difficult pain control. 
  • While these therapies are quite different in their approach, they lend to the idea that chronic pain can and should be targeted using coping mechanisms, helping patients understand the pathophysiological process of pain, and altering behavior.
  • CFT differs from CBT functionally, as instead of improving managing/coping mechanisms of pain control from a solely mental approach, CFT directly points out maladaptive behaviors and actively challenges the patient to change them in a cognitively integrated, progressive overloading functional manner
  • With a robust set of data, one can conclude that CBT and CFT are exceptional therapeutic methods in improving chronic pain or the overall well-being of our patients. 

Item #3

This one is called “The Leading Causes of Death in the US for 2020” by Ahmad et. al. [3] and published in JAMA on March 31, 2021 and that’s definitely some hot stuff right there. 

This is more of an article rather than research and it won’t take us long to hit the high points here. 

  • Provisional estimates indicate a 17.7% increase in the number of deaths in 2020 (the increase in the age-adjusted rate was 15.9%) compared with 2019, with increases in many leading causes of death.1 The provisional leading cause-of-death rankings for 2020 indicate that COVID-19 was the third leading cause of death in the US behind heart disease and cancer
  • Cause-of-death data are based on the underlying cause of death, which is the disease or condition responsible for initiating the chain of events leading to death.
  • The provisional number of deaths occurring in the US among US residents in 2020 was 3 358 814, an increase of 503 976 (17.7%) from 2019
  • COVID-19 was the third leading cause of death in 2020, with an estimated 345 323 deaths, and was largely responsible for the substantial increase in total deaths from 2019 to 2020.
  • Substantial increases from 2019 to 2020 also occurred for several other leading causes. Heart disease deaths increased by 4.8%, the largest increase in heart disease deaths since 2012

I know……I know….car wrecks were reported as COVID and all that. I know….you do you boo. 

Item #4

This last one is called “Manual therapy for temporomandibular disorders: A review of the literature” by Kalam ir et. al. [4] and published in Journal of Bodywork and Movement Therapies in January of 2007. Definitely not hot. 

Why They Did It

The contemporary biopsychosocial health paradigm emphasizes a reversible and conservative approach to chronic pain management. Manual therapy for temporomandibular disorders (TMDs) claims to fulfil these criteria. An assessment of the utilization and efficacy of manual therapy for this condition is therefore required. 

How They Did It

  • A review of the literature pertaining to manual therapy for TMDs was undertaken between September and December 2005. Keywords used in the search were: TMD, manual therapy, massage, manipulation, mobilization, adjustment, chiropractic, osteopathy, physiotherapy, exercise.
  • A four member reviewer panel identified eight (n=8) randomized controlled trials of sufficiently reliable power to be suitable for inclusion in the review, of which only three included manipulative treatment of the temporomandibular joint. 

Wrap It Up

The results of manual therapy trials for this condition suggest that manual therapy is a viable and useful approach in the management of TMD. Manual therapy has also been shown to be more cost effective and less prone to side effects than dental treatment. 

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

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

Store

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

Subscribe Button

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

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

 

Bibliography

1. Elma O, Y.S., Deliens T, Coppieters I,, Do Nutritional Factors Interact with Chronic Musculoskeletal Pain? A Systematic Review. J Clin Med, 2020. 9(3): p. 702.

2. Hadley G, N.M., CBT and CFT for Chronic Pain. Current Pain Headache Reports, 2021. 25(35).

3. Ahmad F, A.R., The Leading Cause of Death in the US for 2020. JAMA, 2021.

4. Kalamir A, P.H., Vitiello A,, Manual therapy for temporomandibular disorders: A review of the literature. J Bodyw Mov Ther, 2007. 11(1): p. 84-90.

Evidence-based Chiropractic Podcast

No Immunity Boosting Benefit, Coconut Oil Fails, and Screen Time & Autism

May 21, 2020 chiropracticforward Autism, Chiropractic Marketing, COVID-19, Evidence-based Chiropractor, Nutrition 00:19:33 0 Comments
CF 126: No Immunity Boosting Benefit, Coconut Oil Fails, and Screen Time & Autism Today we’re going to talk about Immune boosting via spinal manipulative therapy, we’ll talk about coconut oil and it’s a mirage, and we’ll talk about autism and screen time. It’s a good one today folks! But first, here’s that sweet sweet bumper music 
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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 
  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!
Do it do it do it.  You have found yourself smack dab in the middle of Episode #126 Now if you missed last week’s episode, we talked about current knowledge on making a robust low back pain diagnosis. Make sure you don’t miss that info. Keep up with the class.  While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.  Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper.  On the personal end of things….. We’re still hanging in there. For me personally, I shut down in the beginning for two weeks. Completely shut down. Some stayed open the whole time and never made a lot of changes. So at this point, understandably, they’re ahead as far as getting their patient base back to 100%.  For me, I’m more around 65%-70% of my normal load. While the entrepreneur in me is not real happy with that, the business owner that was needing to take a breath and breathe a little bit is happy about it. At this point, it is what it is. Literally. There’s only so much we have control over. I am a saver by nature. I started a multi-account system years ago that socks money away for different purposes. I have about 7 or 8 different accounts that I move money to at the end of each week. So, fortunately, I don’t take loans. Other than student loans and house loans, I don’t get into much debt at all.  That only goes so far and I’m not willing to drain it all just to keep employees when I don’t have enough business but, if things continue to go well and we see the numbers coming back to a more normal state and then hopefully stabilize, I don’t believe I’ll have to do anything like drain accounts or let employees go. I love my staff and I’ll fight for them. But I won’t go broke for anyone. Except maybe my kids or my mom.  So far so good. This crap has a time limit. We won’t be stuck with it like this forever. Maybe longer than we want but not forever. One foot in front of the other, one day at a time. We’ll get there.   Item #1 Let’s start out easy today. This one is called “Association of Early-life social and digital media experiences with the development of autism spectrum disorder-like symptoms” by Karen Heffler, et. al. (Heffler K 2020) and published in JAMA on April 20, 2020 and that’s a hot one folks.  Why They Did It They wanted to answer the question, “Are screen media exposure and social and demographic factors associated with the risk for autism spectrum disorder on a modified checklist for autism in toddlers at 2 years of age? How They Did It
  • Data for this cohort study were derived from the National Children’s Study, 
  • A total of 2152 children were enrolled at birth from October 1, 2010, to October 31, 2012. 
  • Data were analyzed from December 1, 2017, to December 3, 2019.
  • Caregivers reported whether the child viewed television and/or videos (yes or no) at 12 months of age, hours of viewing at 18 months of age, time spent by the caregiver reading to the child (number of days per week compared with daily) at 12 months of age, and frequency of playing with the child (daily or less than daily) at 12 months of age
  • Prematurity, maternal age at birth, child sex, household income, race/ethnicity, and caregiver English-language status were included in analysis.
Wrap It Up “This cohort study found greater screen exposure and less caregiver-child play early in life to be associated with later ASD-like symptoms. Further research is needed to evaluate experiential factors for potential risk or protective effects in ASD.” Basically, “Less screen exposure and more parent-child play at 12 months of age were associated with fewer ASD–like symptoms at 2 years of age” Before we get to the next item this week, I did a thing Being an evidence-informed practitioner can present a set of problems at times. Mostly problems with regard to patient volume because we don’t typically treat patients with long-term recommendations. So we see them come and go depending on if they hurt or not. It can lead to lulls, disappointment, and boredom if there’s not a steady stream of new patients coming through your pearly gates each and every month. I have taken various courses over the years at Udemy so when I decided to create a course, I immediately thought Udemy would be a good place to start.  While I’m still building the course and adding content every week, it’s live and ready to go for those interested in getting started. I’m putting the link to the course at this point in the show notes. You can go to chiropracticforward.com, go to Episodes and find this episode and just scroll till you find it.  https://www.udemy.com/course/marketing-evidence-based-chiropractic/?referralCode=36A4D91C66B48300360B Over the last two years or so, I’ve averaged almost 80 new patients every month as a solo practitioner. If you’re interested, I created, basically, my playbook for marketing and my thoughts on each topic or technique. I also have created downloads, checklists, and examples to show what my stuff looks like.  Just go to udemy.com and do a search on Marketing An Evidence-Based Chiropractic Practice and check it out. It will grow and expand in the coming months and if you get just one patient from the ideas shared in it, it paid for itself. Now imagine if you get a bunch….well then it’s priceless. udemy.com and the course is called Marketing and Evidence-based Chiropractic Practice. Item #2 Item #2 is called “Coconut Oil’s Health Halo A Mirae, Clinical Trials Suggest” by Jennifer Abbasi (Abassi J 2020)and published in JAMA on April 8, 2020….hot cakes, smokin’ hotcakes.  This one is an article so let’s just get to the highlights.  She starts by saying that clinical trials don’t support the public’s positive perception of coconut oil. She points to a study that was published in Circulation that found coconut oil actually increases low-density lipoprotein cholesterol (which is the bad kind of cholesterol) and offers no benefit for weight, blood glucose, or inflammation markers.  She says coconut oil has been marketed as a miracle for about a decade and a 2016 New York Times survey showed 72% of Americans consider it a health product. This while on 37% of nutritionists felt it was beneficial when compared to other oils.  What they’ve learned more recently include:
  • Compared to nontropical vegetable oils, coconut oil significantly increased total cholesterol. 
  • Coconut oil did not significantly affect triglycerides or markers of glycemia, inflammation, and body fat compared with others
  • Researchers calculated that coconut oil use could translate to a 6% increase risk of major vascular events and a 5.4% increase in teh risk of coronary heart disease mortality. 
There’s much more to the article so I encourage you to find it and read it if you’re interested in coconut oil but in summary: Coconut oil should not be viewed as a healthy oil for cardiovascular disease risk reduction and limiting coconut oil consumption because of its high saturated fat content is warranted and it offers no proven health benefits compared to other cooking oils and seems detrimental on important blood lipids. As such, the prudent approach would be to avoid it in comparison to other cooking oils” Item #3 Alright here’s we arrive at the main event. This brand new article coming out on May 4, 2020….there’s a serious amount of sizzle on this sucker and not just because it’s brand new but also because a large number of chiropractors are going to call shenanigans on it. The topic of chiropractors helping boost immune function through spinal manipulative therapy has been such a hot topic on social media since this pandemic started that I won’t get on and read a general chiropractic group and it’s posts. I won’t do it. My eyes start rolling out of my damn head so why intentionally punish myself? Honestly.  This article is called “A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity” and is authored by the biggest of the big chiropractic researchers that include Pierre Cote, Andre Bussieres, JD Cassidy….hello stroke research…Jan Hartvigsen, Greg Kawchuk, Charlotte Leboeuf-Yde, Silvano Mior, Michael Schneider and more than 140 signatories.  It was published in Chiropractic and Manual Therapies just a week or so ago as I mentioned.  Background – As I said this pandemic has made chiropractors lose their minds. Including myself, if I’m being honest. Not about the immune system. But about safety and keeping myself and my people and patients safe.  Anyway, they say that during this time, the ICA posted reports claiming that chiropractic care can impact the immune system. These claims aren’t in line with the WHO and the World Federation of Chiropractic.  The researchers reviewed the two reports posted by the ICA on their website on March 20th and the 28th. They explored the method used to develop the claim that SMT can boost the immune system and they discuss the scientific merit of the claim. They go on to explain why the claim lacks scientific credibility and is dangerous to the public.  Get this; over 150 researchers from 11 countries reviewed and endorsed this article and response.  Some of the more notable quotes include: Advancing extraordinary claims without providing extraordinary evidence should raise significant concerns about the scientific validity of the ICA’s position. In their reports, the ICA claims that individuals who received chiropractic care during the 1918 Spanish flu pandemic were 51 to 91 times less likely to die than those who were treated by medical doctors.  These effect sizes are too large to be trustworthy and are a red flag of pseudoscience because extraordinary claims require extraordinary evidence. Using data from a 100-year-old non-published, non-randomized controlled trial to suggest that chiropractic adjustments reduce mortality from the flu is scientifically and socially irresponsible. We consider that proclaiming the benefits of chiropractic adjustment/spinal manipulation on immunity during a pandemic is plainly irresponsible and demonstrates a lack of understanding of science, the coronavirus pandemic, and public health risks. By only citing basic science experiments, the ICA appears to have overlooked the WHO guidance on implementation research, which clearly states that basic science experiments do not provide relevant justification for the implementation of a health intervention We call on the ICA to explain why it does not adhere to internationally accepted standards of research implementation but instead rely on unconnected basic science studies when linking chiropractic care to immune system function. Pseudoscience has the potential to mislead and misinform at any time; even more so in the midst of a pandemic when the public is vulnerable. The current coronavirus pandemic demands that we act responsibly by adopting sound public health practices as recommended Their conclusion is that, in the ICA reports, they provided no valid clinical scientific evidence that chiropractic care can impact the immune system. Not only that but they call on political and regulatory forces to hold accountable those making the claims.  Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Key Takeaways Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     
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 preventativly after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography Abassi J (2020). “Coconut Oil’s Health Halo a Mirage, Clinical Trials Suggest.” JAMA 323(16): 1540-1541. Heffler K, S. D., Subedi K, (2020). “Association of Early-Life Social and Digital Media Experiences With Development of Autism Spectrum Disorder-Like Symptoms.” JAMA Pediatr.