Obesity

Jeff Williams - evidence-based chiropractor

Obesity In Youths With Chronic Pain, The Healing Journey of Pain, and Fibromyalgia Treatment

August 12, 2021 chiropracticforward Back Pain, Chiropractic, Chiropractic Forward Podcast, Chronic Pain, Evidence Based Chiropractic, Evidence-Based Chiropractic, Evidence-based Chiropractor, Fibromyalgia, Obesity 00:18:58 0 Comments

CF 190: Obesity In Youths With Chronic Pain, The Healing Journey of Pain, and Fibromyalgia Treatment

Today we’re going to talk about obesity in youth and chronic pain, we’ll talk about fibromyalgia and hyperbaric oxygen chambers, and we’ll talk about chronic pain and the healing journey.  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 an invaluable resource for your patient education and for you. It can save you time in putting talks together or just staying current on research. It’s categorized into sections so that the information is easy to find and it’s written in a way that is easy to understand for practitioner as well as patient. You have to check it out. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. 
You have found yourself smack dab in the middle of Episode #190 Now if you missed last week’s episode , we were joined by the amazing Dr. Brett Winchester from the St. Louis area. This doctor is just phenomenal in everything he does and says and we are all fortunate to have him in this profession. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Day 1 of our nurse practitioner starting is today. This morning has, of course, had its hiccups. We have the EHR where we have him set up but he has to have his own login and password and all that good stuff so that’s been one challenge so far.  Just getting oriented with where all of the stuff is, lidocaine, lab tubes, swabs, blah blah blah. Still waiting on the autoclave and still getting the malpractice policy in place this morning. What a process that’s been.  But we knew there’d be hiccups, and we’re getting them addressed. Then I have my regular life to contend with. I have patients to treat and a podcast to write so here we go. Short and sweet on this one because my cup is running over this morning.  Item #1 Our first item today is called “Obesity in Youth with Chronic Pain: Giving It the Seriousness It Deserves” by Hainsworth et. al. (Keri R Hainsworth 2021) and published in Pain Medicine in June of 2021 and day-um…..that’s hot! Why They Did It The aim of this commentary is to review the current science on co-occurring chronic pain and obesity in children and adolescents. In so doing, we also highlight some of the current gaps in knowledge. It is our hope that this commentary will draw attention to an overlooked area of research and clinical endeavors within the field of pediatric pain. The authors note that it is becoming increasingly clear that we should be familiar with this research. Both chronic pain and obesity have been rising in children for some time and studies are showing that obesity exacerbates the negative outcomes associated with chronic pain.  In addition, accumulating research exists on all facets of the co-occurrence of chronic pain and obesity in adults. Given all this, the paucity of research in this area of pediatric chronic pain and obesity is at a minimum, disheartening, and at a maximum, unconscionable. Ooooweee! That’s like putting a white glove on and smacking some clown around the room a little bit, isn’t it? I like it. It give me a little tickle.  Here are their main points:
  • On average, it can take 2 years longer for youth with obesity to be referred to a pediatric pain clinic than it does for youth with a normal weight
  • Pediatric patients with CPO have health-related quality of life that is more impaired in every domain than patients with chronic pain and a healthy body mass index percentile
  • Although systemic inflammation is commonly elevated in youth with obesity, patients with CPO have significantly higher levels of systemic inflammation than those with chronic pain alone or obesity alone 
  • Children with CPO are at increased risk of being treated as though they bear more responsibility for their health (and by extension, their pain) than youth without obesity and are at increased risk of pain dismissal and biased medical care
  • CPO in children and adolescents is associated with more impaired physical functioning and lower levels of physical activity than youth with chronic pain alone or obesity alone Further, parents report that their children with CPO (particularly girls) have greater functional disability (one of the most important outcomes in our field) than parents of youth with chronic pain and a normal body mass index
  • While multidisciplinary pain management programs work well for patients with a healthy weight, this is not true for those with comorbid obesity. Patients with a healthy weight improve in functional disability within 3 months of intake, whereas patients with CPO stagnate
First, even though we as clinicians and researchers need to address obesity in the context of chronic pain, we must be extremely thoughtful about how we move forward. Weight is a very sensitive subject, therefore, the call for more research in this area must strongly consider the need for sensitivity. CPO is the co-occurrence of a typically “invisible,” debilitating condition coupled with a condition so visible that it is sadly associated with victimization from important people in the child’s life, including peers, parents, and teachers Second, we would do well to closely follow the admonitions and advice of our colleagues whose primary clinical and research focus is on obesity and stigma. Suggestions from these experts include first recognizing that weight bias exists even among pediatric health care providers [20]. Additionally, language must be very carefully considered. Puhl et al. [20] offer the practical and sensitive suggestion to ask the patient and family about preferred words or terms in discussions about weight-related health Third, like other health care professionals, we would benefit from a greater understanding of the complexity of obesity and the “potential benefits and disadvantages of introducing weight-management discussions with patients” [14](p865). Certainly, there will be times when weight-related discussions would be contraindicated by the patient’s and/or family’s psychological or emotional state. However, when weight needs to be raised in relation to a child’s chronic pain, it may be best received in the context of health implications. Obesity is a multifactorial disease with strong genetic contributions. It is also associated with systemic inflammation, metabolic syndrome, and increased risk for diabetes and cardiovascular disease, as well as chronic pain. In fact, most are unaware that obesity is a risk factor for migraines in pediatric populations. That said, weight-related health or weight-related pain discussions cannot focus entirely on losing weight. For many, it is a struggle to change their weight status, and even if it is possible, this process takes time. We must not ignore managing pain while we wait for possible weight reduction. CHIROUP ADVERTISEMENT Item #2 Our second one today is called “Evaluation of a Hyperbaric Oxygen Therapy Intervention in Individuals with Fibromyalgia” by Curtis et. al.(K Curtis 2021)  and published in Pain Medicine in June of 2021…….pork chops and apple sauce.  Why They Did It To evaluate the feasibility and safety of hyperbaric oxygen therapy (HBOT) in patients with fibromyalgia (FM). How They Did It
  • A total of 17 patients completed the study
  • A cohort study with a delayed treatment arm used as a comparator.
  • Hyperbaric Medicine Unit, Toronto General Hospital, Ontario, Canada.
  • Eighteen patients diagnosed with FM according to the American College of Rheumatology and a score ≥60 on the Revised Fibromyalgia Impact Questionnaire.
  • Participants were randomized to receive immediate HBOT intervention (n = 9) or HBOT after a 12-week waiting period
  • HBOT was delivered at 100% oxygen at 2.0 atmospheres per session, 5 days per week, for 8 weeks
  • Both groups were assessed at baseline, after HBOT intervention, and at 3 months’ follow-up.
What They Found
  • HBOT-related adverse events included mild middle-ear barotrauma in three patients and new-onset myopia in four patients
  • The efficacy of HBOT was evident in most of the outcomes in both groups
  • This improvement was sustained at 3-month follow-up assessment.
Wrap It Up HBOT appears to be feasible and safe for individuals with FM. It is also associated with improved global functioning, reduced symptoms of anxiety and depression, and improved quality of sleep that was sustained at 3-month follow-up assessment. I don’ tank about you but I’m not going to go out and buy an oxygen chamber this afternoon but, it’s interesting and I’ve always heard positive things about them so this one peaked my interest a bit. I figured it would with you as well.  Item #3 The last one is called “A Healing Journey with Chronic Pain: A Meta-Ethnography Synthesizing 195 Qualitative Studies” by Toye et. al. and also published in Pain Medicine in June of 2021….Smoke show!! You know, it’s almost like I got an email from Pain Medicine last week highlighting some of their newest research in their June edition. Weird how all of these articles were all in the same month and in the same episode here. Right? Why They Did It There is a large body of research exploring what it means for a person to live with chronic pain. However, existing research does not help us understand what it means to recover. We aimed to identify qualitative research that explored the experience of living with chronic pain published since 2012 and to understand the process of recovery. How They Did It
  • A synthesis of qualitative research using meta-ethnography.
  • We used the seven stages of meta-ethnography. 
  • We systematically searched for qualitative research, published since 2012, that explored adults’ experiences of living with, and being treated for, chronic pain. 
  • We used constant comparison to distill the essence of ideas into themes and developed a conceptual model.
  • We screened 1,328 titles and included 195 studies.
Wrap It Up The innovation of our study is to conceptualize healing as an ongoing and iterating journey rather than a destination. Health interventions for chronic pain would usefully focus on validating pain through meaningful and acceptable explanations; validating patients by listening to and valuing their stories; encouraging patients to connect with a meaningful sense of self, to be kind to themselves, and to explore new possibilities for the future; and facilitating safe reconnection with the social world. This could make a real difference to people living with chronic pain who are on their own healing journeys. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus so get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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

Chiropractic evidence-based products

Integrating Chiropractors

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 & Vlogger Bibliography
  • K Curtis, P., J Katz, PhD, C Djaiani, BSc, G O’Leary, MD, FRCPC, J Uehling, MS, CCRP, J Carroll, BHA, D Santa Mina, PhD, H Clarke, MD, PhD, FRCPC, M Gofeld, MD, PhD, FRCPC, R Katznelson, MD, FRCPC, (2021). “Evaluation of a Hyperbaric Oxygen Therapy Intervention in Individuals with Fibromyalgia.” Pain Med 22(6): 1324-1332.
  • Keri R Hainsworth, P., Monica L Gremillion, PhD, W Hobart Davies, PhD, Stacy C Stolzman, PT, MPT, PhD, Steven J Weisman, MD, (2021). “Obesity in Youth with Chronic Pain: Giving It the Seriousness It Deserves.” Pain Med 22(6): 1243-1245.
       
Jeff Williams - evidence-based chiropractor

Hypermobile Patients, Sports-Related Concussion, & Obesity’s Pain Connection

July 22, 2021 chiropracticforward Concussion, Ehlers-Danlos, Hypermobile, Obesity, Uncategorized 00:26:54 0 Comments

CF 187: Hypermobile Patients, Sports-Related Concussion, & Obesity’s Pain Connection

Today we’re going to talk about Hypermobile Patients, Sports-Related Concussion, & Obesity’s Pain Connection 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. 

  • 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 #187 Now if you missed last week’s episode , we talked about the western diet and its effects and we talked about some pretty cool acupuncture research. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Our nurse practitioner starts on August 2nd but we are having a hard time getting our malpractice person to respond to us and get that in place. We can’t get credentialing until that happens. Credentialing takes at least 2 months typically.  So, you see the issue. That was an unplanned obstacle.  We are in the process of changing our signage on the front of the building as well. We have one big sign out on the main street so that’s two inserts…..one for each side. 

Then we have two suites here so we have two doors. Which means we have two signs on the front of the building. So, added up, we get to order 4 inserts. Signs aren’t cheap if you’ve had to put one in lately.  Those are just some of the things that we’re messing with lately.  Clinic numbers, we are in week 3 with some good solid numbers. Not pre-COVID numbers but getting there. I’ll be honest with you, I’m not sure I want pre-COVID numbers. There were weeks I was at 220 appointments for the week. 25 new patients, re-exams running out my ears.  Now, that’s not bragging. I’m not there anymore. What I’m saying is that sometimes, it’s too much. In healthcare, you really can be too busy. Things start falling through the cracks.  My mom had a bone density test misread because her primary is simply too busy. He took responsibility and, other than putting her back surgery off longer than it should have, no harm was done. But the point is, we can get too busy.  I am extremely conservative in my finances. I don’t like taking big chances. I don’t like huge what-ifs. I like small, measured, and reasonable risks. You cannot eliminate risks. But we can mitigate them. We can make them minute instead of big gaping holes.  I should have hired an associate. And to be fair, we started to do that. It just simply fell through. And it was a blessing in disguise when you consider what COVID did to our practice. Now we get a chance to potentially say, “‘If I could go back and do that all over again…..” 

At this time, I’m at a point in my caseload that it’s all fairly easily manageable. We’re at probably 165-170 per week. That’s manageable for evidence-based, patient-centered practice. We are rehab-heavy. Rehab takes time and I have an excellent staff and ChiroUp to help me make it all happen.  However, if we get to the 190-200 appointments per week range, it’s time to start shopping for an associate. It’s too much and too many other things I’m trying to accomplish both personally and professionally suffer from that caseload.  And my brain space is just destroyed if I’m being honest. It’s not fun to go to work when you’re overwhelmed every day. It’s unpleasant. Even when the majority of your patients are amazing people. Nobody wants to go to doctors that are overwhelmed like that and I don’t want to be one of those doctors either.  So, just a little brain dump there and some free-flow thought for you. I have an intern coming in from Parker College in September. That’ll be my first intern to have onboard so who knows….maybe that ends up being a long-term thing.

Maybe not.

Time will tell.  On the horizon for me, real estate investing!! Regular listeners may have heard me talk about exit strategies. If you’re a thinker, you’re not only thinking about today but what you want out of tomorrow. I’ve been in business for over 23 years at this point and have never taken more than 5-7 days of vacation at a time. I’ve never been to Europe or anywhere outside of the Caribbean.  So, smart moves is what get us there. We are in a business where our presence is mandatory for a business to continue. In essence, our business owns us. Not the other way around. So how do we flip it? Well, we need people in place that fill the gap when we are out. We need to be the CEO instead of the hands-on worker. That’s part of the reason we are bringing in a nurse practitioner. That’s part of the reason we’ll be looking for an associate when the numbers truly rebound.

That’s the reason I started a voice-over side gig, which is going amazingly by the way. What a blessing that has been, y’all. I can’t even begin to tell you how well that’s going. I’ve voiced over 200 spots just since January. That’s over 33 per month. It’s been insane. That’s also the reason that real estate investing is my next mountain.  Mailbox money, y’all. Now, real estate investing takes effort and work so it’s not technically mailbox money but, when done right, is the fastest path to financial freedom. That’s the reason for the book I wrote and the speaking opportunities I’m getting involved in.  These are all potential paths toward early, comfortable, happy, partial retirement. Retirement to me doesn’t mean any work. It means control of my time. So in that context, retirement cannot come quite soon enough.  So, what’s your exit strategy? Are you going to work until you’re 88 and die at your desk in your office?

Which some want…and there’s not a thing in the world wrong with that. Or, do you have other things in your life to accomplish and need to start planning for that? Some say you need to start with the ending in mind. If you want to sell your business someday, shouldn’t you plan for that from the start? How do you build a business that’s ready to sell when it’s your time? Something to think about. I’m not sure I have all of those answers because they continue to unfold as I progress but I’m getting closer to solid ideas and strategies on it.  Alright….on to the research. 

Item #1

Let’s get it started this week talking about hyper mobility, Ehlers-Danlos, and all that good stuff. If you don’t really consider hypermobility in your daily treatment…..please….for the love of everything holy, please listen up and pay attention. This is where so many chiropractors are getting it wrong.  It’s becoming more and more clear every year that a good chiropractor should know when to mobilize and when to stabilize. Some of you are no doubt asking yourselves, what the hell does that mean? Sometimes the spine doesn’t want to be adjusted. There is already a plethora of movement there. Adjusting only increases the motion in an area that the increased motion is what is actually causing the complaint. In these cases, when in the hands of a vitalistic, subluxation, philosophy, doctor-centered chiropractor, this patient is going to get adjustment after adjustment for weeks and weeks.  I’m sure you can predict the eventual outcome here. And it’s not corrections of a subluxation. It’s spinal instability that compounds the issue.  The condition and patient population that is at increased risk here would be self-adjusters but mostly, those suffering from Ehlers-Danlos, which if you are unfamiliar, is a connective tissue disorder that allows these folks to behave a bit like an elastic rubber band. 

A hint of whether someone is EDS is the Beighton Scale. If I stand a new patient up and have them touch their toes and they put their hands flat on the floor, they’re getting put through the Beighton Scale to test for hypermobility. We need to know if they have too much movement in their joints. Because instead of more adjustments and more movement in the segments of the spine, they typically respond better to weight training, supportive activities and strengthening. 

This paper is called “Physical therapy treatment of hypermobile Ehlers–Danlos syndrome: A systematic review” by Gregory Reychler and Maya-Mafalda De Backer et. al. (Reychler 2021) and published in the American Journal of Medical Genetics on June 19, 2021…. My glasses….they’re steamed up..it’s hot.  Why They Did It The objective of this systematic review was to investigate the effect of the different physiotherapy techniques related to the children and adult patients with hEDS How They Did It

  • PubMed, SPORTDiscus, Cochrane Library, PEDro, Scopus, and Embase databases were analyzed from inception to April 2020.
  • Characteristics of the studies (authors), patients (sample size, sex, age, Beighton score), and non-pharmacological treatment (length of the program, number of sessions, duration of the session, and type of intervention), and the results with the dropout rate were extracted. 
  • From the 1045 retrieved references, 6 randomized controlled trials with a sample size ranging from 20 to 57 patients were included in the systematic review
  • There was a huge heterogeneity in the interventions. The duration of the program were from 4 to 8 weeks

What They Found

  • Pain or proprioception demonstrated significant improvements in the intervention group regardless of the type of intervention. 
  • A benefit of the inspiratory muscle training was observed on functional exercise capacity.
  • The quality of life was systematically improved.

Wrap It Up

Physiotherapy benefits on proprioception and pain in patients with hEDS even if robust randomized control studies are missing. Now, the full paper isn’t available for me to ingest so who the hell knows what all interventions these patients underwent. We don’t know. But, physiotherapy is Europe and Canada and Australia’s term for physical therapy. We know what PT is and in these patients, I’m assuming it is exercise and building strength and proprioception and balance.  All of that also helps clear up the joint and movement map in the brains of chronic pain patients. Which leads to more accurate sensorimotor function, less aberrant movement in the joints, more confidence in abilities and future capabilities, and less pain as an overall result.  And yes, I just tossed a bucket of Neuromusculoskeletal Medicine Diplomate on top of all of your heads. And didn’t it feel warm and fuzzy??

Of course it did and you’re welcome.  Let’s hear from our awesomely amazing sponsors. 

CHIROUP ADVERTISEMENT

Item #2 This second one is called “Lose Pain, Lose Weight, and Lose Both: A Cohort Study of Patients with Chronic Pain and Obesity Using a National Quality Registry” by Dong et. al. (Dong HJ 2021) and published in the Journal of Pain Research in February of 2021 and that’s holy mother of Hades hot. 

Why They Did It It is known that chronic pain makes it difficult to lose weight, but it is unknown whether obese patients (body mass index ≥ 30 kg/m2) who experience significant pain relief after interdisciplinary multimodal pain rehabilitation (IMMPR) lose weight. This study investigated whether obese patients with chronic pain lost weight after completing interdisciplinary multimodal pain rehabilitation in specialist pain units. The association of pain relief and weight change over time was also examined.

How They Did It

  • Data from obese patients included in the Swedish Quality Registry for Pain Rehabilitation for specialized pain units were used, including baseline and 12-month follow-up after IMMPR from 2016 to 2018
  • Patients reported body weight and height, pain aspects (eg, pain intensity), physical activity behaviors, psychological distress, and health-related quality of life
  • A reduction of at least 5% of initial weight indicates clinically significant weight loss. 

What They Found

  • A significant reduction of pain intensity was found after interdisciplinary multimodal pain rehabilitation 
  • A similar proportion of patients in the three groups with different pain relief levels had clinically significant weight loss 
  • Significant improvements were reported regarding physical activity behavior, psychological distress, and health-related quality of life, but weight change was not associated with changes of pain intensity.

Wrap It Up

“About one-fifth of obese patients achieved significant weight reduction after interdisciplinary multimodal pain rehabilitation. Obese patients need a tailored pain rehabilitation program incorporating a targeted approach for weight management.”

Item #3

The last on his called “Injury Reduction Programs for Reducing the Incidence of Sport-Related Head and Neck Injuries Including Concussion: A Systematic Review” by Eliott, et. al. (Elliott 2021) and published in Sports Medicine on June 18, 2021. It’s a big ol’ pot of hot. 

Why They Did It To systematically review the literature to investigate: (1) the relationship between neck strength and sport-related head and neck injuries (including sport-related concussion (SRC); and (2) whether neck exercise programs can reduce the incidence of (a) sport-related head and neck injuries; and (b) sport-related concussion.

How They Did It

  • Five databases and research lists of included studies were searched
  • From an initial search of 593 studies, six were included in this review

What They Found

  • The results of two observational studies reported that higher neck strength, but not deep neck flexor endurance, is associated with a lower risk of sustaining a sports-related concussion. 
  • Four intervention studies demonstrated that injury reduction programs that included neck exercises can reduce the incidence of sport-related head and neck injuries including sports-related concussion.

Wrap It Up

Consideration should be given towards incorporating neck exercises into injury reduction exercise programs to reduce the incidence of sport-related head and neck injuries, including sports-related concussion. 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.       

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

Bibliography

  • Dong HJ, D. E., Rivano Fischer M, Gerdle B, (2021). “Lose Pain, Lose Weight, and Lose Both: A Cohort Study of Patients with Chronic Pain and Obesity Using a National Quality Registry.” J Pain Res 14(1863-1873).  
  • Elliott, J., Heron, N., Versteegh, T, (2021). “Injury Reduction Programs for Reducing the Incidence of Sport-Related Head and Neck Injuries Including Concussion: A Systematic Review.” Sports Med.  
  • Reychler, G., De Backer, M.-M., Piraux, E., Poncin, W., & Caty, G, (2021). “Physical therapy treatment of hypermobile Ehlers–Danlos syndrome: A systematic review.” American Journal of Medical Genetics: 1-9.