Jeff Williams - evidence-based chiropractor

Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use

August 17, 2023 chiropracticforward 0:13:48 0 Comments

CF 291: Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use

Today we’re going to talk about Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use

But first, here‘s that sweet sweet bumper music

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

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

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

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

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

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

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

You have found yourself smack dab in the middle of Episode 291

Now if you missed last week’s episode, we talked about headaches in kids, multiple myelomas, and unprovoked direct personal attacks. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Well today is my birthday so we gonna keep it short. I remember my daughter asking me when she was about 14 or so….Hey, Dad….what do you do on your birthday? Do you actually still go to work? Yes, dear. Yes I do.

It’s just another day that I’m thankful for. Thankful for being alive and for my kids, my wife, my family, patients, staff and for my friends. Thanks for everyone that’s doing life with me.

That’s the sentimental stuff there. Outside of that, we are just living life. We got back from an Alaskan cruise the weekend before last. Please put that on your bucket list if you haven’t yet. It was amazing. We went to Anchorage, caught a 4-hour train ride down to Seward. The train ride is NOT to be missed. Our good Lord blessed us all with some amazing scenery on that train ride. Then we caught a ship and started sailing. We went to Juneau, Skagway, Sitka, Haines, Wrangell, and then finally Vancouver.

What an experience. A sea plane, a canoe on a glacier fed lake, and a whale watching tour rounded it all out. Just do it. Make the time.

The week I got back, we saw 196 patients. Holy cow that was some catching up. This week is a more laid back week so far. We shall see how it turns out but school starts back this week and things typically get fairly slow comparatively during back to school. So it’s time to ramp up marketing then, right?

So I’m going to get on with this so we I can take off my podcast host hat and put on my marketing hat here in the clinic.

Let’s do it.

Item #1

The first on today is called “Racial and Ethnic Disparities in the Incidence of High-Impact Chronic Pain Among Primary Care Patients with Acute Low Back Pain: A Cohort Study” by Eric J Roseen, DC, MSc and published in Pain Medicine on 19 December 2022. Dayum. That’s smoky.

Why They Did It

We assessed whether race or ethnicity was associated with the incidence of high-impact chronic low back pain (cLBP) among adults consulting a primary care provider for acute low back pain (aLBP).

How They Did It

In this secondary analysis of a prospective cohort study, patients with aLBP were identified through screening at seventy-seven primary care practices from four geographic regions.
Incidence of high-impact chronic low back pain was defined as the subset of patients with chronic low back pain and at least moderate disability on Oswestry Disability Index at 6 months.
General linear mixed models provided adjusted estimates of association between race/ethnicity and high-impact chronic low back pain.

What They Found

We identified 9,088 patients with aLBP
Black/Hispanic patients compared to White patients, were younger and more likely to be female, obese, have Medicaid insurance, worse disability on ODI, and were at higher risk of persistent disability on STarT Back Tool

At 6 months, more Black and Hispanic patients reported high-impact chronic low back pain compared to White patients
After adjusting for measured differences in socioeconomic and back-related risk factors, compared to White patients, the increased odds of high-impact chronic low back pain remained statistically significant for Black but not Hispanic patients

Wrap It Up

We observed an increased incidence of high-impact chronic low back pain among Black and Hispanic patients compared to White patients.

This disparity was partly explained by racial/ethnic differences in socioeconomic and back-related risk factors. Interventions that target these factors to reduce pain-related disparities should be evaluated.

Before getting to the next one,

I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! 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, “Prenatal cannabis exposure associated with mental disorders in children that persist into early adolescence” by Nora D. Volkow, et al, and published in National Institutes of Health Post on September 12, 2022.

Why They Did It

The researchers conducted this study to investigate the long-term effects of prenatal cannabis exposure on children’s attention, social behavior, and overall behavioral development as they progress into early adolescence.

With the increasing prevalence of cannabis use among pregnant women and the potential risks associated with it, the study aimed to provide evidence-based information that could help raise awareness and inform public health policies concerning cannabis use during pregnancy.

How They Did It

The study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which is the largest long-term study of brain development and health in children and teenagers in the United States.
The ABCD Study involves tracking nearly 12,000 youth from childhood to young adulthood, regularly assessing brain structure and activity using MRI, collecting psychological, environmental, and cognitive information, as well as biological samples.

What They Found

The research findings revealed that prenatal cannabis exposure, occurring after five to six weeks of fetal development (middle of the first trimester), was associated with attention, social, and behavioral problems in children as they progressed into early adolescence (11 and 12 years of age).
These problems persisted beyond the initial stages of development and could potentially put the affected children at a higher risk of mental health disorders and substance use during late adolescence, a critical period of vulnerability.

Wrap It Up

The study supported an expanding body of research on the effects of cannabis use during pregnancy. The researchers found a clear association between prenatal cannabis exposure and adverse developmental outcomes in children.

As the main psychoactive substance in cannabis, delta-9-tetrahydrocannabinol (THC) was shown to cross the placenta and

potentially affect brain development.

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

Store

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

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

The Message

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

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

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

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

Key Point:

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

That‘s Chiropractic!

Contact

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

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

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

Connect

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

Website

Home

Social Media Links

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

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

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Tweets by Chiro_Forward

YouTube

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iTunes

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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

Remote Myofascial Release & Manual Versus Instrumental Spinal Manipulation

April 13, 2023 chiropracticforward 00:22:19 0 Comments

CF 275: Remote Myofascial Release & Manual Versus Instrumental Spinal Manipulation

Today we’re going to talk about Remote Myofascial Release & Manual Versus Instrumental Spinal Manipulation

But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #275 Now if you missed last week’s episode, we talked about spinal stabilization for chronic pain and we talked about dry needling. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Damnit….OK…..I’m pulling out the soapbox. You ready? Here we go. I love certain aspects of this profession. I absolutely ABHOR others. One popped its ugly head up this morning. I have a brand new patient, 23 yrs old, a little knee pain I think is Pes Anserine, a little low back pain that seems facet-related, and some neck soreness. Most likely due to him self-adjusting it all of the time. He came to me from another local chiropractor. This local chiro took x-rays on him. Which is not evidence-based by the way. No trauma, no steroid use, no systemic illness, no IV drug use….he’s good. Shouldn’t have had x-rays to begin with. Regardless, because chiropractors are chiropractors, he gets x-rays and then the mind screwing begins. Guess what, he’s got a ‘tweak’ and his neck is straight and if he doesn’t handle that and get it fixed, it could be the end for him up to and including….get this…..cognitive decline. Are you with me? Freaking cognitive decline.

He’s 23 people.

Not only does he think he’ll forget his wife’s name some day if he doesn’t fix his neck, he is recommended to be treated for 4x/week for a YEAR! Who the hell needs 4x/week for a year? WHO??? In case you were curious, the answer to that question is absolutely nobody on the face of the planet. Unless they’re looking to have their spine become unstable from too much mobilization. I mean, those people maybe but that would just be out of pure ignorance. So I did some math and bam….that’s 208 visits this year. Let’s say that’s a conservative $45 per visit. I know this clinic and it’s likely more but let’s go with a safe bet. At $45 per visit that’s a grand total of $9,360. Out-freaking-standing.

This 23 yr old that needs to quit popping his own neck needs to spend almost $10k in a clinic? Insanity and if you are a predatory, ignorant chiropractor of this caliber, I want you to stop it now. Get some damn education. Because this is garbage, rubbish, and utter stupidity. Chiropractors like this should be ashamed of themselves and should surrender their license if they refuse to be moral, ethical, read research, and do smart things. If you don’t do smart things, you’re and idiot and I got zero use for you as a supposed professional.

OK, putting the soapbox away now…..

Business is weird man. Ups and downs so we keep an eye on it but don’t let us go crazy unless we notice a sustained downturn. I was in a sustained down turn from September through February. We’ve been on the upswing once we had the 75% staff turnover. I like our team and, while I think we’re coming out of the downturn, it’s not without its bumps and potholes. Last week was awful. But we had Easter and coming off of Spring Break. It’s whatever.

This week, as I type this out on a Monday, I’m looking at 127 for me for the week. Which means, if I’m right, we’ll wind up somewhere around 155 or 165 before the week is through. And I’m totally good with that. I have been playing around a lot lately with content creation, figuring out how to delegate more, and reclaim my time to the extent that I can. I’ve even been toying with the new AI stuff coming out. It’s scary but for where it is right now, it’s pretty incredible for business owners that don’t have the time they’d like to have to market. I remember when we used to just join the rotary or Kiwanis Club, run an ad in the newspaper and yellow pages, and if you were fancy, you’d run a radio ad…..maybe. That was pretty uptown. Life was pretty simple for us back then. Just get into the community and let them know you’re open for business.

There are so many more things to try to keep track of these days. It’s tough on business owners. Especially chiropractors because we are paid less and less but the price of everything has gone up and up while the price of treatment and its value in the eyes of the consumer has remained consistent with 10 years ago. Our margins are thinner and thinner. We can’t just go out and grab up a marketing rep to grow our clinic for us like the medical boys. Well, most of us can’t anyway. So, when you find tools that can lighten your burden, you figure it out. That’s what I’m doing. I suggest, if you’re behind on it, you better catch up muy pronto, mi amigo. Or you might never catch up. Early adopters are either roasted or champagne toasted. I think when it comes to AI, it’s not going anywhere so you might as well jump on and hold on tight because it’s going to get crazy in the years to come.

Item #1

The first on today is called, “Effect of Remote Myofascial Release on Lumbar Elasticity and Pain in Patients With Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial” by Hassan Tamartash PhD and published in Journal of Chiropractic Medicine on 14 February 2023. Dayum. That’s hot.

Why They Did It The purpose of this study was to evaluate the effects of myofascial release technique of a remote area on lumbar elasticity and low back pain (LBP) in patients with chronic nonspecific LBP.

How They Did It

For this clinical trial, 32 participants with nonspecific LBP were assigned to a myofascial release group (n = 16) or a remote release group (n = 16).
Participants in the myofascial release group received 4 sessions of myofascial release to the lumbar region. The remote release group received 4 myofascial release sessions to the crural and hamstring fascia of the lower limbs.
Low back pain severity and elastic modulus of the lumbar myofascial tissue were assessed before and after treatment by the Numeric Pain Scale and ultrasonography examinations.

What They Found The mean pain and elastic coefficient in each group before and after myofascial release interventions were significantly different (P ≤ .0005). The results showed that the changes in mean pain and elastic coefficient of the 2 groups after myofascial release interventions were not significantly different from each other.

Wrap It Up The improvements in the outcome measures for both groups suggest that remote myofascial release was effective in patients with chronic nonspecific LBP. The remote myofascial release of the lower limbs reduced the elastic modulus of the lumbar fascia and LBP. 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, “Effects of Manual Versus Instrumental Spinal Manipulation on Blood Flow of the Vertebral and Internal Carotid Arteries in Participants With Chronic Nonspecific Neck Pain: A Single-Blind, Randomized Study” by Burcu Kocabey and published in Journal of Chiropractic Medicine on 14 February 2023. Hot potato!

Why They Did It The aim of this study was to compare the hemodynamic effects of manual spinal manipulation (MSM) and instrumental spinal manipulation (ISM) on the vertebral artery (VA) and internal carotid artery (ICA) in participants with chronic nonspecific neck pain (NNP).

How They Did It

Thirty volunteers aged 20 to 40 years old with nonspecific neck pain over 3 months duration were included.
Participants were randomly divided into the following 2 groups: (1) spinal manipulation group (n = 15) and (2) instrumental spinal manipulation group (n = 15). Ipsilateral (intervention side) and contralateral (opposite side of intervention) VAs and internal carotid arteries were evaluated using spectral color Doppler ultrasound before and immediately after manipulation.
Measurements were recorded by visualizing the internal carotid artery carotid sinus (C4 level) and the VA at the V3 segment (C1-C2 level).
The blood flow parameters of peak systolic velocity, end-diastolic velocity, resistive index, and volume flow (only for VA) were evaluated. The spinal segment, in which biomechanical aberrant movement was detected by palpation in the upper cervical spine, was manually manipulated in the spinal manipulation The same methodology was performed for the instrumental spinal manipulation group using an Activator V instrument (Activator Methods).

What They Found

Intragroup analysis exhibited no statistically significant difference between the spinal manipulation and instrumental spinal manipulation groups in terms of peak systolic velocity, end-diastolic velocity, resistive index of ipsilateral and contralateral internal carotid artery and VA, in addition to volume flow of both VAs preintervention and postintervention.
Within the intergroup analysis, there was a significant difference in ipsilateral internal carotid artery peak systolic velocity in the spinal manipulation
Other parameters did not show any significant difference

Wrap It Up

Manual and instrumental spinal manipulations applied to the upper cervical spine in participants with chronic nonspecific neck pain did not appear to alter blood flow parameters of the VAs and internal carotid arteries. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

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

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

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

Tweets by Chiro_Forward

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Bibliography

Hassan Tamartash, Farid Bahrpeyma, Manijhe Mokhtari Dizaji,
Effect of Remote Myofascial Release on Lumbar Elasticity and Pain in Patients With Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial,
Journal of Chiropractic Medicine,
Volume 22, Issue 1,
2023,
Pages 52-59,
ISSN 1556-3707,
https://doi.org/10.1016/j.jcm.2022.04.002.
(https://www.sciencedirect.com/science/article/pii/S1556370722000645)

Burcu Kocabey, Dilber Karagözoğlu Coşkunsu, Koray Güven, Mustafa H. Ağaoğlu, Selvi Yüce,
Effects of Manual Versus Instrumental Spinal Manipulation on Blood Flow of the Vertebral and Internal Carotid Arteries in Participants With Chronic Nonspecific Neck Pain: A Single-Blind, Randomized Study,
Journal of Chiropractic Medicine,
Volume 22, Issue 1,
2023,
Pages 1-10,
ISSN 1556-3707,
https://doi.org/10.1016/j.jcm.2022.05.006.
(https://www.sciencedirect.com/science/article/pii/S1556370722000876)

Outdoor Play, Screentime, And The Impact Of Exercise

March 15, 2023 chiropracticforward 00:19:04 0 Comments

CF 271: Outdoor Play, Screentime, And The Impact Of Exercise

Today we’re going to talk about outdoor play, screen time, and the impact of exercise.

But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #271 Now if you missed last week’s episode, we talked about Spinal Manipulative Therapy Adverse Events & SMT With Lumbar Herniation. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Things are still back on the growth pattern here at my clinic, we are on the right path. Part of what I’ve tried to do here at 50 years old, is to start trying to diversify in a way that I can begin to remove myself gradually from my practice. I started removing my face from marketing years ago when I read a Dan Kennedy book where he said, how can you sell something that is tied up only in you, your image, and only your abilities to perform the function? Made a lot of sense to me.

I wanted my clinic to be more of a brand that stands on its own rather than something that depends solely on my full time involvement. So that was step one. Now, to be clear, our social media marketers think I have to be involved so I am but, as soon as we get an associate in place, they will be the majority of the presence. Step 2 has been to be able to replace my income if the bottom were to completely fall out of the deal. Belly up.

Kablam….here’s a nuclear COVID bomb coming to destroy my practice.

Would I survive financially??

Well, we know from COVID that I would survive. I’d be unhappy but I’d make it. But what if I gradually start turning more and more of my patients over to an associate and then a second associate? Well, through real estate investing, through voice over (which is going gang busters), through Board Certifications giving me other opportunities in the medicolegal and speaking realms, and…..if I’m honest, I can make a gob of cash playing the guitar and singing if I wanted to….then lets look at it. I could bail out completely today if I wanted and voice over by itself has almost replaced my salary and the rest is gravy on the top.

Also on the horizon, I have an opportunity, under the right conditions, to sell 60% of my practice to an investment group and that would set us up for retirement and for success riding into the sunset. So, steps 1 and 2 are firmly in place. Now step 3. I need an associate, then I need another once DC 1 is up and running and full. With 2 in place, I begin to work on the clinic instead of in it and that’s exciting. But I have to find one that will come to Amarillo and love it like I love it. Love the people. Love our staff and love our clinic. We’ll see. I’m on the hunt. Just some thoughts about what’s going on in my corner of the world. It’s been interesting and I expect it will only get more and more interesting in the very near future.

Item #1 The first on today is called, “Outdoor Play as a Mitigating Factor in the Association Between Screen Time for Young Children and Neurodevelopmental Outcomes” by Mika Sugiyama and published in Jamapediatrics on January 23, 2023. Dayum. That’s hot. Why They Did It To investigate whether higher screen time at age 2 years is associated with neurodevelopmental outcomes at age 4 years and whether this association is mediated by frequency of outdoor play at age 2 years 8 months.

How They Did It Standardized scores for communication, daily living skills, and socialization domains of the Vineland Adaptive Behavior Scale, second edition, at age 4 years were used (mean [SD], 100 [15]). The mediating factor was frequency of outdoor play at age 2 years 8 months, with 6 or 7 days per week coded as frequent outdoor play.

What They Found

Of 885 participants, 445 children (50%) were female; mean (SD) screen time per day was 2.6 (2.0) hours.
Causal mediation analyses revealed that higher screen time at age 2 years was associated with lower scores in communication at age 4 years (non-standardized coefficient b = −2.32; 95% CI, −4.03 to −0.60), but the association was not mediated by frequency of outdoor play.
Higher screen time was also associated with lower scores in daily living skills (b = −1.76; 95% CI, −3.21 to −0.31); 18% of this association was mediated by frequency of outdoor play. Frequency of outdoor play was associated with socialization (b = 2.73; 95% CI, 1.06 to 4.39), whereas higher screen time was not (b = −1.34; 95% CI, −3.05 to 0.36).

Wrap It Up

Higher screen time at age 2 years was directly associated with poorer communication at age 4 years.
It was also associated with daily living skills, but frequency of outdoor play at age 2 years 8 months alleviated it, suggesting outdoor play mitigated the association between higher screen time and suboptimal neurodevelopment.
Future research should specify the nature of the associations and intervention measures, enabling targeted interventions that reduce the potential risk in screen time.

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, “Massive study uncovers how much exercise is needed to live longer” by Sara Berg, MS and published in American Medical Association on October 26, 2022. Hot potato!

Why They Did It

They author wanted to know how many minutes of moderate or vigorous physical activity are needed to lower the risk of premature mortality?

How They Did It

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

What They Found

The study found that those who worked out two to four times beyond the minimum physical activity recommendations had a lower risk of death from cardiovascular disease.
Those who worked out two to four times above the moderate physical activity recommendations—about 300 to 599 minutes each week—saw the most benefit.
Participants had a 26% to 31% lower all-cause mortality while 28% to 38% had lower cardiovascular mortality. On top of that, 25% to 27% experienced lower non-cardiovascular mortality.
Additionally, adults who worked out two to four times more than the vigorous physical activity recommendations—about 150 to 299 minutes per week—were found to have 21% to 23% lower all-cause mortality, according to the study. They were also reported to have 27% to 33% lower cardiovascular mortality and 19% lower non-cardiovascular mortality.

Wrap It Up

This study suggests there is no harmful effect of high, long-term vigorous physical activity on cardiovascular health. More studies are needed to better understand the effects of high amounts of vigorous physical activity on cardiovascular outcomes and to identify the optimal amount and intensity of long-term exercise for health benefits. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

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About the Author & Host

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

Spinal Manipulative Therapy Adverse Events & SMT With Lumbar Herniation

March 9, 2023 chiropracticforward 00:18:04 1 Comment

CF 270: Spinal Manipulative Therapy Adverse Events & SMT With Lumbar Herniation

Today we’re going to talk about Spinal Manipulative Therapy Adverse Events & SMT With Lumbar Herniation

But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode 270 Now if you missed last week’s episode , we talked about Children, Activity, and Depression and Axially Loaded MRIs. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Isn’t it weird? You have one group of staff for an amount of time, they all leave, then you are forced to replace them all at once basically…..then you get so busy that your cup runneth over? For the last 6 months I’ve been running on maybe 30-35 appointments on a Friday and 130 for the whole week. Which is abysmal for me. I have a large machine to keep running and those numbers are just barely enough. Now, we have 52 on my schedule today, which is a Monday as I type. I’ve got 153 for the week but I’m typing at 10am on Monday morning so none of Monday’s patients have been set up for Wednesday or Friday appointments. We ended up last week at 175 appointments.

The point is not to brag but to demonstrate. You can do everything you can think of up to and including banging your head against the wall…and get nowhere if you have a staff that is not fully supporting the mission of not only getting patients better but ALSO growing your clinic. You can meet with them, you can encourage them, you can show them the way to bonuses and extra pay, you can treat them like family, and all of the other stuff we do for our teams. But if they’re not growth minded hustlers, they work against you. And I use hustlers in a complimentary context. A go-getter. Someone with drive. Someone that gets it and has some hustle.

That’s a hustler to me.

Don’t get me wrong here. Except for one of them, I absolutely love those girls. I would still do anything for them. No sweeter and no more caring people ever existed. You can have the most loving and caring people on the planet in place and still not be growth minded. The best people on the planet can still fall into ruts and get stuck in the daily grind. My old team fell into bad habits that did not support growth. They were all besties. They all quit at the same time and we were forced to start completely over almost from scratch. And what seemed like a complete and utter disaster has become one of the greatest comeback stories of my career.

We’ve done some other things as well. We started with a social media company. I’ve never done that before. We hired Darcy Sullivan with Propel for our website SEO to get that back up to snuff. We know Google is the biggest driver of new patients so it makes sense to spend the money to make sure it’s on par.

But the biggest game changer has been our new staff. Hands down. I tell you this for one reason only. If you’re down, here’s what you do and probably the order you should do it in:

Take a long, hard, and very honest look at yourself and your habits. Are you doing the things you need to be doing to grow and to be successful? Are you paying attention to customer service and putting that #1? Are you properly training your staff and properly motivating them? It starts at the top so make sure you have a tight ship before you go looking anywhere else.
Look at your marketing. Have you slacked on your internal and external marketing? If so, get those gaps filled.
Website SEO – make sure it’s where it should be
Pay very close attention to your staff. Their habits between patients. Their interactions with patients. The conversations they have with your patients on the way to therapy or rehab. Start phasing out the ones that do not fully support your mission and your clinic’s growth.

That’s the advice you’re getting this week from your Ol’ Uncle Jeffro. Hopefully I dropped some good solid knowledge nuggets on some of you. Take it or leave it but that’s the way I see it at the moment and it’s based on the school of hard knocks over the last 6 months. And, by the way and as a side note, isn’t it interesting that at 50 years old and in practice 25 years, we still learn lessons like this? Damnit. Alright, here we go with this week’s research.

Item #1

The first one today is called, “A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy” by Eric Chun-Pu Chu and published in Scientific Reports on 23 January 2023. Dayum. That’s hot. Why They Did It This study examined the incidence and severity of adverse events (AEs) of patients receiving chiropractic spinal manipulative therapy (SMT), with the hypothesis that < 1 per 100,000 spinal manipulative therapy sessions results in a severe AE.

How They Did It

This study adhered to the Open Science Framework. The Ethics Committee of the Chiropractic Doctors Association of Hong Kong approved the study which included a waiver of patient consent.

All methods were performed in accordance with the relevant guidelines and regulations.

The current study was a retrospective database analysis of a complaints log including adverse events from January 1, 2017, through August 31, 2022.

Wrap It Up

This current study, which retrospectively studied a large dataset from integrated chiropractic clinics in Hong Kong, found that severe AEs potentially occurring in relation to SMT were rare, yielding an incidence of 0.21 per 100,000 SMT sessions.

No AEs were identified that were life-threatening or resulted in death.

The sample size of 39 AEs across 960,140 SMT sessions in 54,846 patients was insufficient to identify independent predictors of severe AEs.

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, “Effects of Lumbar Manipulation Spinal in Patients with Pain Caused by a Lumbar Disc Herniation: A Systematic Review” by Guillermo Cano-Escalera and published in Indian Journal of Physiotherapy and Occupational Therapy on 2023-01-16. Hot potato! Why They Did It Herniated discs usually present with pain accompanied with paresthesia and loss of muscle strength, causing limitations in the activities of daily life. Among the therapeutic strategies aimed at obtaining an improvement in the symptomatology, highlights the Osteopathic manipulation.

How They Did It

11 computerized databases were consulted.
Only randomized controlled clinical trials were included.
The tool for assessing the risk of bias was the one proposed by Cochrane.

What They Found

A total of 3 randomized controlled clinical trials were selected and considered low risk of bias.
The results showed an improvement in all the variables measured in the experimental group of osteopathic manipulation.
However, the improvement was greater in the study group that underwent surgery.

Wrap It Up

Lumbar manipulation spinal is an effective technique to improve the symptomatology of pain originating from a herniated lumbar disc.
None of the participants had adverse reactions and their outcome improved significantly in the short and long term.

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

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

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

The Message

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

Key Point:

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

Contact

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

Connect

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

Cano-Escalera, G. “Effects of Lumbar Manipulation Spinal in Patients with Pain Caused by a Lumbar Disc Herniation: A Systematic Review.” Indian Journal of Physiotherapy & Occupational Therapy Print- (ISSN 0973-5666) and Electronic –(ISSN 0973-5674) 17(1).
Chu, E. C., Trager, R.J., Lee, L.YK (2023). “A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy.” Sci Rep 13: 1254.

Physical and Psychological Pain & Disc Herniations And Pain

January 5, 2023 chiropracticforward 00:18:16 0 Comments

CF 262: Physical Pain and Psychological Pain & Disc Herniations And Pain

Today we’re going to talk about physical and psychological aspects of pain and we’ll talk about low back pain after disc herniations

But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode 262 Now if you missed last week’s episode, we talked about The Stroke Issue – New Information. This is one of the biggest issues we as chiropractors face so I hope you’ll give it a listen. I think it’s vital. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Alright, New Year is upon us folks. Time to re-focus. Re-energize. Tap into a fresh energy. Energy that may have waned a bit. We got this! I have to say though, I’m not a resolutions guy. I don’t wait until the beginning of a New Year to decide on what I want to make better for the next year. Hell with that. I consider that stuff pretty much every week.

Diet – I work on my diet almost every single meal of every single day. I believe I’m just genetically going to always be a bit bigger. But at least I can eat as healthy as possible. It’s not all what’s on the outside but the inside as well. We know this. Just confirming it for you. Business – if you’re a frequent listener, you know I’m not goal setting once per year. It’s every week. I’m figuring, tweaking, testing, and trying to identify new business acquisition opportunities.

So that’s a good spot to talk about the Fall. Listeners know I’ve had like a COVID numbers type of Fall for some reason. Who the hell knows why I’ve been slower but it’s a fact. If my normal is 185-200 appointments per week, this Fall averaged probably about 135-140 per week. That’s around 200 visits less per month. Day-um. One word – two syllables.

I have a big machine to keep running here people. So that stings and while nobody is broke or starving, I’m not taking home what I’m accumstomed to taking home and it makes your Ol’ Uncle Jeffro more than fussy faced. Since September, I’ve had this perpetual scowl on my face. Makes me want to punt bunnies. But, what I like about a New Year is some re-freshed vigor and determination. Part of that is my work with Darcy Sullivan with Propel. I know well that Google SEO is one of the biggest drivers of new patients.

My search results have continually dropped despite writing new and original content for my blog each and every single week. That’s where Darcy rides in on her big huge powerful white horse and hopefully serves as my secret weapon to save the day!! We’re still early in the process but as I mentioned a week or so ago, we did two phone sessions to get very clear on the direction and wants and needs. That was really helpful.

After that, her team wrote articles and pages for my current site and sent it over to approve. Holy schnikies, folks. This was like 40 pages of content. I read through it all and made my edits in the Google doc so it updates on their end as well. It was a lot but very important for the messaging part of what we do and what we put out there. It helps with what we want to be known for, basically. Then last week I assigned access to my Google Business Page, my website, and some other Google platform that the name escapes me at the moment. So Darcy and team will start uploading all of the changes and tweaking all of that stuff this week. Still a process. A 6-month process. But we’re on the path and I’ll keep you updated. Alright, good talk, folks. Let’s get on with the research shall we??

Item #1 The first on today is called, “Data-driven pathway analysis of physical and psychological factors in low back pain” by Bernard X.W.Liew and published in Journal of Science Direct on 15 November 2022.Dayum. That’s hot. Why They Did It To understand the physical, activity, pain and psychological pathways contributing to low back pain (LBP) -related disability, and if these differ between subgroups. How They Did It

Data came from the baseline observations (n = 3849) of the “GLA:D Back” intervention program for long-lasting non-specific LBP. 15 variables comprising demographic, pain, psychological, physical, activity, and disability characteristics were measured.
Clustering was used for subgrouping, Bayesian networks (BN) was used for structural learning, and structural equation model (SEM) was used for statistical inference.

What They Found

Two clinical subgroups were identified with those in subgroup 1 having worse symptoms than those in subgroup 2.

Psychological factor was directly associated with disability in both subgroups.

For subgroup 1, psychological factor was most strongly associated with disability (β=0.363). Physical factors were directly associated with disability (β=-0.077), and indirectly via psychology.

For subgroup 2, pain was most strongly associated with disability (β=0.408). Psychological factor was a common predictor of physical factors (β=0.078), pain (β=0.518), activity (=−0.101), and disability (β=0.382).

Wrap It Up

The importance of psychological factor in both subgroups suggests their importance for treatment. Physical, pain, and psychological factors interact, albeit differently in different clinical subgroups, to contribute to disability, confirming the need for biopsychosocial management of LBP. 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, “Prevalence of Long-term Low Back Pain After Symptomatic Lumbar Disc Herniation” by Taylor Wong and published in the National Library of Medicine on November 10, 2022. Hot potato!

Why They Did It

They did it to determine the prevalence of chronic LBP after LDH, understand the relationship between LDH and chronic LBP, and investigate the relationship between radiological findings and postoperative pain outcomes.

How They Did It

They performed a literature review on the PubMed database via a combination medical subject heading and keyword-based approach for long-term LBP outcomes in LDH patients.

What They Found

15 studies (2019 patients) evaluated surgical and/or nonoperative outcomes of LDH patients. Regardless of surgical or nonoperative management, 46.2% of LDH patients experienced some degree of LBP long-term (range 2-27 years) as compared to a point prevalence of LBP in the general population of only 11.9%.

Wrap It Up

LDH patients are more likely to experience long-term LBP compared to the general population (46.2% vs. 11.9%). Additionally, understanding the relationship between radiological findings and pain outcomes remains a major challenge as the presence of radiological changes and the degree of LBP do not always correlate. Therefore, higher quality studies are needed to better understand the relationship between radiological findings and pain outcomes.

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

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

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

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

Bernard X.W. Liew, J. H., Marco Scutari, Alice Kongsted, (2023). “Data-driven network analysis identified subgroup-specific low back pain pathways: a cross-sectional GLA:D Back study.” J Clinical Epidemiology 153(66-77).

Wong T, P. A., Golub D, Kirnaz S, Goldberg JL, Sommer F, Schmidt FA, Nangunoori R, Hussain I, Härtl R, (2022). “Prevalence of Long-Term Low Back Pain After Symptomatic Lumbar Disc Herniation.” World Neurosurg 22: 01571-01576.

High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter?

October 27, 2022 chiropracticforward 00:16:18 0 Comments

CF 252: High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter? Today we’re going to talk about High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter? But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look-down-your-nose-at-people kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smartness, 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 out my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an 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 #252 Now if you missed last week’s episode , we talked about Communicating Imaging Findings & Acupuncture For Acute Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Still climbing out of the doldrums of an extended slowdown. It is what it is but shows signs of finally easing. Let’s keep our fingers crossed on that. But yeah, I think we’re back on the upswing. We’re starting the week with 15 new patients on the schedule. I like to see about 20-25 per week but I’ll take starting the week at 15 any day. Now let’s build on it. It’s a balancing act to try to push our medical services and build that side of the clinic while not letting your community forget that you have a chiropractor and all of the other services as well.

We post on social media twice per day. Once during the day and once in the evening. During the week, we post about services. On the weekend, we post funny stuff. Because honestly, what’s the point in posting something about PRP and saying call now? But nobody is at the clinic on the weekend. It makes no sense. So we entertain on the weekends with our posts. It’s fun and our audience likes them and typically responds well with likes, comments, and shares. We are still getting our TikTok game going.

Check it out at creekstonecrew806 if interested. I have a 20-something doing all of the content and she’s pretty darn great at it. It’s been fun to show that personality off. We have some fun folks working here. Nothing incredibly new or interesting to talk about this week so let’s not waste time and let’s hop right in on the research.

Item #1

The first one today is called “Impact of audible pops associated with spinal manipulation on perceived pain: a systematic review” by Moorman et. al (Moorman 2022) and published in Chiropractic and Manual Therapies on October 4, 2022, Kazow that’s hot!

Why They Did It

An audible pop is the sound that can derive from an adjustment in spinal manipulative therapy and is often seen as an indicator of successful treatment. A review conducted in 1998 concluded that there was little scientific evidence to support any therapeutic benefit derived from the audible pop. Since then, research methods have evolved considerably creating opportunities for new evidence to emerge. It was therefore timely to review the evidence.

How They Did It

They searched PubMed, Index to Chiropractic Literature (ICL), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Web-of-Science.
The main outcome was pain.
Two reviewers independently selected studies, extracted data, and assessed risk of bias and quality of the evidence using the Downs and Black checklist.
Results of the included literature were synthesized into a systematic review.

What They Found

Five original research articles were included in the review, of which four were prospective cohort studies and one a randomized controlled trial.
All studies reported similar results: regardless of the area of the spine manipulated or follow-up time, there was no evidence of improved pain outcomes associated with an audible pop.
One study even reported a hypoalgesic effect to external pain stimuli after spinal manipulation, regardless of an audible pop.

Wrap It Up

“While there is still no consensus among chiropractors on the association of an audible pop and pain outcomes in spinal manipulative therapy, knowledge about the audible pop has advanced. This review suggests that the presence or absence of an audible pop may not be important regarding pain outcomes with spinal manipulation.” I tell patients all of the time. Do not relate a popping noise with effectiveness. It is movement we are after. Not sounds. Sometimes the sound is a happy side effect but nothing more.

And…they last thing the want is to be insisting on hearing a popping noise and be treated by a chiropractor that is more than happy to oblige. You can get an extremely aggressive adjustment just to hear a popping noise that doesn’t even matter in the first place and run the risk of getting injured from it.

So, focus on range of motion and movement. Not popping noises, people. I will say this though, pain is multifactorial sometimes and placebo isn’t a cuss word. Sometimes, in my humble opinion, just the noise……well….I can see how it could make a difference in the patient’s mind only. I can see. But you can’t depend on the noise. You just can’t

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 second one today is called “High blood pressure linked to faster cognitive decline, dementia risk” by John Anderer (Anderer J 2022) with Study Finds and was published on October 3, 2022. Schiza, I love it hot like that. It’s an article so let’s get to summarizing the high points. Researchers from the University of Michigan say people with hypertension may experience a faster deterioration in their cognitive abilities (thinking skills, decision-making, memory) in comparison to those with normal blood pressure.

The team performed a “study of studies” focusing on high blood pressure’s association with declining brain function over a period of several years. They gathered and analyzed datasets collected for six large prior studies. “Our findings suggest that high blood pressure causes faster cognitive decline and that taking hypertension medication slows the pace of that decline,” says lead study author Deborah Levine, M.D., M.P.H., director of the University of Michigan’s Cognitive Health Services Research Program and a professor of internal medicine at the U-M’s academic medical center” Among both Hispanics and non-Hispanics, the team observed the same pace of deteriorating thinking skills and memory linked to high blood pressure.

However, when researchers focused solely on the two studies that had deliberately recruited Hispanics, they noted an undeniably faster decline in overall cognitive performance among Hispanics in comparison to the non-Hispanic white group. Importantly, though, blood pressure differences between those two groups didn’t appear to explain this cognitive decline difference. This may be due to Hispanic participants having lower blood pressure than non-Hispanic whites in these studies, researchers speculate. The same researchers behind this work conducted a similar study two years ago focusing on hypertension and cognitive outcomes among Blacks and Caucasians.

That project found that blood pressure control differences over time helped explain the faster cognitive performance declines seen in Black individuals. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

Store

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

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

Anderer J (2022). “High blood pressure linked to faster cognitive decline, dementia risk.” StudyFinds.

Moorman, A. C., Newell, D (2022). “Impact of audible pops associated with spinal manipulation on perceived pain: a systematic review.” Chiropr Man Therap 30(42).

Lumbar Stenosis

May 26, 2022 chiropracticforward 00:18:33 0 Comments

CF 230: Lumbar Stenosis

Today we’re going to talk about lumbar stenosis

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.

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

You have found yourself smack dab in the middle of Episode #230

Now if you missed last week’s episode , we talked about T-sp Adjustments For Neck, Not Headache & Physical Activity In Children. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

As I mentioned last week, I just finished the book called Who Not How by Dan Sullivan and another dude. Lol I can’t remember his name and don’t have time to look. Brad Hanby or something like that. Anyway, I’m on the hunt for an associate as a result. Great book and I know that with some help, not only will I have more time available to be a more effective clinic owner and doctor, but I’ll have the opportunity to grow the practice as well. It’ll be great. Give me a holler if interested in working in a busy evidence-based, patient -centered and medically integrated clinic that is making a difference int he Texas Panhandle. That’s us.

Now, I’ve started reading a book recommended to me by Ben Fergus of the GRIP method fame and a fellow member of the MCM Mastermind you’ve heard me mention. This book is called Think Again by Adam Grant. It’s all about learning to search for the things you don’t really know and be willing to re-think your thoughts and stances on things. I’m still just getting into it a bit but it’s pretty alright and it’s teaching me some stuff.

I also started a book by Gray Cook called The Business Of Movement I saw recommended by Jason Hulme recently in a Facebook group. It’s probably the Forward Thinking Chiropractic Alliance group if I’m guessing. Anyway, that one just came in the mail. Hell, I need an associate just so I’ll have time to read and get up to date. I also just joined an online class called Quadrant Analysis that I’m looking forward to diving into.

So, I’m not perfect. Don’t follow everything I do. I could do better soap notes. I could do a lot of things better but….#1 our patients are 99% likely to refer us to their friends and family #2 ChiroUp tells me our clinic has about an 80% improvement rate for any and all conditions considered. #3 I’m 49, been in this sucker for 24 years, and I can’t wait to learn more and more. We can always learn more. We can always get better. We never know it all. If I ever find an associate that wants to come to the Texas Panhandle, that’ll be one of the first things I make sure they understand. If you ever stop learning, you’re either ignorant or you’re arrogant. Each is equally appalling.

Boom, snap, pow, slap.

Some of you may have seen a post by a ‘chiropractor’ …..I use the term loosely when referring to this dummy. She put on social medial recently the following, “An ovarian cyst is a functional gift from nature to make your more attractive and fertile after a traumatic loss. An enlarged prostate is a fit from nature to make you more potent after feeling degraded as a man. Tumors are not mistakes, they are purposeful adaptations.”

Bless her heart…. This little knucklehead is running around spouting this stuff and, yup you guessed it…is a chiropractor. I’m quoted in an article now saying she’s insane. Mostly because that’s my opinion and the only one I can think of that makes any sense with regard to a statement like that.

I bring it up because you have to know these loony birds are out there soiling our names and our hard work. The people that listen regularly here are normal, educated, and hard working evidence based patient centered chiropractors out there changing the world and elevating this profession beyond quack BS that has held the profession back for so long. If however you stumbled upon this podcast and you believe stuff like this is plausible, please, don’t leave. Don’t go anywhere.

Let me introduce you to evidence and research and sanity.

Before getting into the research, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Let’s get to it.

Item #1

This frist one is called “Diagnosis and Management of Lumbar Spinal Stenosis A Review” by Katz et. al. (Katz JN 2022) and published in JAMA on May 3, 2022, that was just like 3 weeks ago damn the heat….It burns

This is more of an article than a standard research paper so lets hit the high points with some relevant quotes from the report.

“Affects an estimated 103 million persons worldwide. Most are treated nonoperatively. Approximately 600 000 surgical procedures are performed in the US each year for lumbar spinal stenosis.”

The prevalence of the clinical syndrome of lumbar spinal stenosis in US adults is approximately 11% and increases with age.”

“The diagnosis can generally be made based on a clinical history of back and lower extremity pain that is provoked by lumbar extension, relieved by lumbar flexion, and confirmed with cross-sectional imaging, such as computed tomography or magnetic resonance imaging (MRI)”

More specifically, from my learning through the Neuromusculoskeletal diplomate program, a little clinic pearl here is the shopping cart sign. If they have to use a shopping cart to lean forward over in order to be able to walk through the grocery store, and sitting almost immediately alleviates the pain, there’s a great chance you have some stenosis on your hands. Pain on extension or extension/rotation can bolster the diagnosis.

Then, on the MRI or CT, if you see the sedimentation sign where the nerve roots stay suspended in teh central canal rather than settling on the bottom of the canal due to gravity. You now have pretty convincing evidence of stenosis.

“In a series of patients with lumbar spinal stenosis followed up for up to 3 years without operative intervention, approximately one-third of patients reported improvement, approximately 50% reported no change in symptoms, and approximately 10% to 20% of patients reported that their back pain, leg pain, and walking were worse.”

That makes a strong argument for no surgery doesn’t it? Look, most do fine with targeted exercise. There is a stenosis protocol in ChiroUp if you’re not usiing the program. While I am a ChiroUp devotee, I actually use the protocol and program from Dr. Carmen Amendolia. You can find all of his info at spinemobility.com It’s excellent and we see really good results using it.

“Multiple clinical trials have studied manual therapy for spinal stenosis, including lumbar distraction mobilization, hip and sacroiliac joint mobilization, manual stretching, and muscle strengthening. In a clinical trial³³ of 58 participants with lumbar spinal stenosis, 79% reported being at least somewhat better following a 6-week program that included manual therapy, treadmill walking, and strengthening and stretching exercises compared with 41% of patients randomized to the flexion exercise group.

The results were similar at 1 year. Schneider et al³¹ randomized 259 patients with lumbar spinal stenosis to 1 of 3 treatment groups: medications with or without epidural injections, manual therapy with individualized exercise, and group exercises. Participants randomized to manual therapy combined with individual exercises had improved their Zurich Claudication Questionnaire scores significantly more at the 2-month follow-up (mean difference, 2.0; 95% CI, 0.4 to 3.6) than did those randomized to medications with or without injections. Participants randomized to group exercises had similar improvement to those receiving medications and/or epidural injections (mean difference, −0.4; 95% CI, −2.1 to 1.3). The differences between groups were negligible at 6 months.”

“Epidural steroid injections may offer modest short-term pain relief but do not appear to last more than 3 weeks.”

“Long-term benefits of epidural steroid injections for lumbar spinal stenosis have not been demonstrated. Surgery appears effective in carefully selected patients with back, buttock, and lower extremity pain who do not improve with conservative management. “

Wrap Up

Lumbar spinal stenosis affects approximately 103 million people worldwide and 11% of older adults in the US. First-line therapy is activity modification, analgesia, and physical therapy. Long-term benefits from epidural steroid injections have not been established. Selected patients with continued pain and activity limitation may be candidates for decompressive surgery.

The key to remember about stenosis is that it isn’t necessarily the size of the hole rather what is happening to the structures going through the hole. If there is no realy inflammation or complication, stenosis patients may never know they have it.

Alright, that’s it this week. 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.

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

Tweets by Chiro_Forward

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Bibliography

Katz JN, Z. Z., Mass H, Makhni MC, (2022). “Diagnosis and Management of Lumbar Spinal Stenosis: A Review.” JAMA 327(17): 1688-1699.

Exercise For Depression & Manipulation For Tendinopathy

May 12, 2022 chiropracticforward 00:14:47 0 Comments

CF 228: Exercise For Depression & Manipulation For Tendinopathy Today we’re going to talk about Exercise For Depression & Manipulation For Tendinopathy But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #228 Now if you missed last week’s episode , we talked about nerve flossing carpal tunnel and we talked about catastrophizing. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things….. I just got back from the MCM Mastermind that was started by Dr. Kevin Christie. This group is just outstanding y’all. I mean honestly, Dr. Mark King of the Motion Palpation Institute is a member. How do you beat that?? Dr. Jay Greenstein of Kaizenovate and Kaizo care clinics in Washington DC. Dr. Ben Fergus of the GRIP method. Seriously. THE Dr. Brett Winchester is joining us at the next one. You can’t make this stuff up.

One theme we discussed a lot this weekend was The Front Stage and Back Stage Systems in your practice. Strategic Coach was kind enough to be our guest presenter and they rocked it. Another theme I kept on bringing up was whatever you can have a vision on and take consistent action on, will happen for you. BUT YOU MUST HAVE BOTH VISION AND ACTION.

In our Mastermind Group we have:

- A Doc who takes one week off per month
- A Doc who lives in a different state than
- where is practice is located
- At least 5 practices clear well over 1M in revenue (and they are high quality of evidence informed care)
- One that is exiting patient care in the Fall
- A Doc who is building a short term rental business – that’s me!
- All Docs who no matter their accomplishements and the size of their practices…..they are still pushing the envelope and humble enough to come to each meeting with a Beginner’s mind. Eager to learn and eager to share thier knowledge and experience.

Remember, it’s not HOW….it’s WHO.

Who do you know that can help you get where you want to be? I know 14 others right now in this group. What would you love to have in 5 years that is big? Our group has top chiros from North Carolina, Texas, Florida, Connecticut, Missouri, Montana, Ohio, Maryland, Minnesota, Alabama, and Illinois. We meet four times a year to raise our games. World class care through a mastermind and collaboration of some of the best in the country. To be the best, it makes sense to learn from the best. It’s pretty exciting!

Next meeting is in July in Sarasota. I’m already making plans. I believe Dr. Christie is interested in growing the group by about 5 or so more seats. If you’re interested, let Dr. Christie know. Send him and email to drkchristie@gmail.com

Before we get to the research, we all know that the number one type of case that we want is a personal injury case – they are gold because the clients are more compliant, and we get paid at rates far above insurance or Medicare or Medicaid. The patient’s attorney tells them to go for treatment as doing so enhances their legal case and gets them more money. The problem is, how do we get PI cases? Attorneys don’t generally respond to your invitation for lunch. And let’s face it, they’re a tough bunch. I have the answer. An attorney I know has put together a system, that is both in written and video form, that shares how to approach attorneys and get them to send their PI clients to you. This is the real deal. Attorney Paul Samakow’s system costs $997 and he guarantees satisfaction or your money back. You have to check this out. Even if you only get one case, you’ve made at least 4 or 5 times the investment.

Go to gettingpicases.com/cs

That’s gettingpicases.com/cs

One more time so you get it right: gettingpicases.com/cs

Item #1

This first one is called, “Association Between Physical Activity and Risk of Depression A Systematic Review and Meta-analysis” by Pearce et. al. (Pearce M 2022) and published in Jama Psychiatry on April 13, 2022 – Dayumm that’s fresh and hot.

Why They Did It

To systematically review and meta-analyze the dose-response association between physical activity and incident depression from published prospective studies of adults.

How They Did It

PubMed, SCOPUS, Web of Science, PsycINFO, and the reference lists of systematic reviews retrieved by a systematic search up to December 11, 2020

What They Found

Fifteen studies comprising 191,130 participants and 2,110,588 person-years were included.
Heterogeneity was large and significant.
Those accumulating HALF the recommended volume of physical activity had 18% lower risk of depression.
Adults accumulating the recommended volume of 8.8 marginal metabolic equivalent task hours per week had 25% lower risk with diminishing potential benefits and higher uncertainty observed beyond that exposure level.

Wrap It Up

This systematic review and meta-analysis of associations between physical activity and depression suggest significant mental health benefits from being physically active, even at levels below the public health recommendations. Health practitioners should therefore encourage any increase in physical activity to improve mental health.

Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #2

The last one today is called, “”The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review” by Savva et. al. (Savva C 2021) and was published in the Journal of Manual and Manipulative Therapy in 2021 – aye chi wa wa. Steamy.

Why They Did It

To summarize the available literature with regards to the potential analgesic effect and mechanism of joint mobilization and manipulation in tendinopathy.

What They Found

The effect of these techniques in rotator cuff tendinopathy and lateral elbow tendinopathy, applied alone, compared to a placebo intervention or along with other interventions has been reported in some randomized controlled trials which have been scrutinized in systematic reviews.
Literature in other tendinopathies such as medial elbow tendinopathy, de Quervain’s disease and Achilles tendinopathy is limited since the analgesic effect of these techniques has been identified in few case series and reports.
Therefore, the low methodological quality renders caution in the generalization of findings in clinical practice.
Studies on the analgesic mechanism of these techniques highlight the activation of the descending inhibitory pain mechanism and sympathoexcitation although this area needs further investigation.

Wrap It Up

Study suggests that joint mobilization and manipulation may be a potential contributor in the management of tendinopathy as a pre-conditioning process prior to formal exercise loading rehabilitation or other proven effective treatment approaches. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

Store

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

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (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

Pearce M, G. L., Abbas A, (2022). “Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis.” JAMA Psychiatry.

Savva C, K. C., Korakakis V, Efstathiou M, (2021). “The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review.” J Man Manip Ther 29(5): 276-287.

Forward Head Posture And Spinal Manipuative Therapy Effectiveness

March 31, 2022 chiropracticforward 00:17:33 0 Comments

CF 222: Forward Head Posture And Spinal Manipuative Therapy Effectiveness Today we’re going to talk about spinal manipulative therapy and forward head posture. But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #222 Now if you missed last week’s episode , we talked about The Importance of Movement & Steps. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Business is back. Time is getting more limited. Especially for someone like me that tends to bite off as much as I can possibly chew. It’s a bad habit of mine but I always seem to be in hyperdrive. I get everytihng done and I have to say a whole bunch of ‘no’s’ in order to get it all done…..but I do indeed typically get most of it done. It would not be possible without a To Do list. I keep it open in a document on my computer. It’s a life saver. The problem right now is that I have abotu 15-20 items on it that need to be done. So how do you address that? Prioritize them. Put them in order from most important to least. I also list them keeping in mind the time and energy each will take to complete. Not to mention the fact that I do what I can to identify which can be delegated and how they’ll be delegated. Meaning, my office manager is typically overwhelmed. I want to limit what gets delegated to her and try to utilize the other 4 girls that work for us on our chiropractic and medical side of the office. So, which tasks are the most important or the most time sensitive. Then, which tasks can be easy and fast ‘wins’ so I can pop them out and knock them off with ease. Like an important phone call or email I’m supposed to send. Then delegate what can be delegated to the people most capable. Up to and including virtual assisstants. I have a VA in South Africa, one in Nigeria, and one in India. Those are for the chiro side of things. I also have one for voice over marketing and he’s in Pakistan. When you’re busy busy, a VA can be the difference in being heavily buried vs. being slightly buried. So, when you have an integrated office like I do, a voice over side gig that is demanding more and more time, and real estate investments…..VAs are lifesavers. If you are interested in exploring the world of VAs, look into upwork.com, fiverr.com is an excellent site as well. There are virtual networks here in America as well. There is one that I’ve heard great things about based in the Phillipines called virtualstaff.ph. Alright, just a tip from your ol’ Uncle Jeffro. Now, let’s get to the research, shall we? Item #1 This one is called “Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain” by Gevers-Montoro, et. al. (Gevers-Montoro C 2021) and published in Frontiers In Pain on October 25 of 2021. Aye chi wa wa… Why They Did It For the vast majority of patients with back and neck pain, a specific pathology cannot be identified as the cause for their pain, which is then labeled as non-specific. In a growing proportion of these cases, pain persists beyond 3 months and is referred to as chronic primary back or neck pain. To decrease the global burden of spine pain, current data suggest that a conservative approach may be preferable. One of the conservative management options available is spinal manipulative therapy (SMT), the main intervention used by chiropractors and other manual therapists. The aim of this narrative review is to highlight the most relevant and up-to-date evidence on the effectiveness and efficacy of SMT for the management of neck pain and low back pain. Wrap It Up SMT may be as effective as other recommended therapies for the management of non-specific and chronic primary spine pain, including standard medical care or physical therapy. Currently, SMT is recommended in combination with exercise for neck pain as part of a multimodal approach. It may also be recommended as a frontline intervention for low back pain. Despite some remaining discrepancies, current clinical practice guidelines almost universally recommend the use of SMT for spine pain. Due to the low quality of evidence, the efficacy of SMT compared with a placebo or no treatment remains uncertain. Therefore, future research is needed to clarify the specific effects of SMT to further validate this intervention. In addition, factors that predict these effects remain to be determined to target patients who are more likely to obtain positive outcomes from SMT. They say that the main gap identified in clinical research on SMT for spine pain lies in the low quantity and quality of studies addressing its efficacy against inactive controls. Hence, the effects of SMT against placebo or sham SM remain uncertain. This parallels the state of research on most interventions for spine pain, as no treatment has been demonstrated to be superior to any other or to placebo Item #2 Our last one this week is called “The association between forward head posture and non-specific neck pain: A cross-sectional study” by Bahat et. al. (Sarig Bahat H 2022) and published in Physiotherapy Theory & Practice. And this one should get the CBP people riled up. Mostly because it’s more and more apparent that you don’t need to charge your patients $5,000 for 80 visits this year to correct a curve issue or forward head posture that honestly likely doesn’t cause much of an issue long term. Why They Did It Poor posture is traditionally associated with various musculoskeletal disorders. Consequently, educators in the musculoskeletal field have been teaching postural observation as part of the physical assessment. Forward head posture (FHP) is hypothesized to be associated with neck pain; however, evidence in this topic remains inconclusive. To investigate the association between FHP and neck pain intensity, disability, and cervical kinematics in individuals with neck pain compared to asymptomatic individuals. A secondary aim of this study was to explore the possible effect of a head-mounted display (HMD) used in a virtual reality (VR) assessment on FHP. How They Did It

The study was conducted with 43 volunteers
20 asymptomatic individuals, 23 individuals with neck pain
Aged 19 to 62.
FHP was assessed by measuring craniovertebral angle on profile photographs.
Secondary outcome measures included pain intensity, the neck disability index (NDI) questionnaire, and neck kinematics using specialized virtual reality software.

What They Found

There were no significant differences between individuals with neck pain and asymptomatic individuals in FHP
The neck pain group demonstrated a restricted range of motion and slower neck movements (p < .05).
We found no significant correlation between FHP and visual analog scale, NDI, and most neck kinematic measures.

Wrap It Up Our findings cannot support a clinically applicable association between FHP and neck pain. I know there is research to the contrary but those projects are typically low quality and performed by one of the biggest stakeholders who owns a company that promotes treating patients based on forward head posture and decreased cervical curvature. So that stakeholder has a specific and direct bias. The research likely reflects that. At the end of the day, my recommendation is to not treat patients like a sales target. They don’t usually need $5,000 of treatment over 80 visits in a year to fix a lack of curve that longitudinal research suggests is of little to no consequence. Treat them like you’d treat your mom or your child. Period. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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

The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website

Home

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger Bibliography Gevers-Montoro C, P. B., Descarreaux M, (2021). “Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain.” Front Pain Res. Sarig Bahat H, L. A., Yona T, (2022). “The association between forward head posture and non-specific neck pain: A cross-sectional study.” Physiother Theory Pract: 1-10.

Neurodynamic Moves Solve Problems – So Does The Inversion Table

March 10, 2022 chiropracticforward 00:17:12 0 Comments

CF 219: Neurodynamic Moves Solve Problems – So Does The Inversion Table Today we’re going to talk about inversion tables and Neurodynamic exercises. But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #219 Now if you missed last week’s episode , we talked about Masterminds – chiropractic masterminds and the MCM Mastermind I’m in specifically with Dr. Kevin Christie. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

What a weekend down in Lubbock, TX for the Texas Chiropractic Association’s MidWinter conference. I got to hang out with my friend Dr. Tim Bertlesmen. What a guy, what a teacher, and what a positive force for our entire profession. Sitting through one of his courses is like having golden knowledge nuggets just chunked at you from a nerf gun. Pow, pow, kablam, splat. Just like that. Over and over. Only you don’t dodge the nuggets. You just step right into them and let them sink right in. He as good as it gets out there.

One of his nuggets I’ll share with you is hip abductors. If you are not assessing your new patients for weak hip abductors, get to researching and make it happen, muy pronto mi amigo. Luckily, in my coursework with the Diplomate of the International Academy of Neuromusculoskeletal Medicine, Dr. Bertlesman is an instructor and taught us about hip abductors a few years ago. Now, my secret is out!! Lol. Really though, be checking those hip abductors because they can be the missing puzzle piece to longstanding low back pain, hip pain, knee pain and chondromalacia patellae, and ankle and foot problems. Up to and including plantar fasciitis.

I got to teach while at the conference. I’ve taught a couple of courses for the TCA but they were COVID-era virtual courses. This was the first 2-hour live crowd presentation that I’ve been the presenter on and I have to say; I was a tad anxious but once I got started and into the material, it went very well and smoothly. I had some good buddies in the crowd so it was even a bit like a conversation rather than a presentation. I had several tell me that was the most they’ve taken away from a course in several years. Made me feel good and gave me encouragement that I’m going in the right direction.

Then if you’ve been listening, you know I have a rental down there on Airbnb so spent Sunday at the rental staining the deck and the fence. A not-so-nice end to the seminar weekend. Business seems to be picking back up which seems to be directly related to the omicron variant settling back down here in the Texas Panhandle. But, we can’t discount the fact that more people are meeting their deductibles in mid-February to early March as well. Either way, who cares? It equals to more business! Onward to research

Item #1

I’m just going to say that I got the research today from ChiroUp’s research roundup and thank you again to Dr. Tim Bertlesmen and Dr. Brandon Steele for being outstanding. This one is called “Lumbar disc disease: the effect of inversion on clinical symptoms and a comparison of the rate of surgery after inversion therapy with the rate of surgery in neurosurgery controls” by Mendelow et. al. (Alexander D. Mendelow 2021) and was published in Journal of Physical Therapy Science in 2021 so it’s hot hot hot.

Why They Did It

We have previously shown inversion therapy to be effective in a small prospective randomised controlled trial of patients with lumbar disc protrusions. Our purpose now was to measure symptoms and to compare the surgery rate following inversion for 85 participants with the surgery rate in 3 control groups.

How They Did It

Each of the 85 inverted participants acted as their own control for the “symptomatic” part of the study.
In the “Need for surgery” part of the study, one control group was made up of similar patients with leg pain and sciatica who were referred to the same clinic in the same year.
Two additional control groups were examined: the original control group from the pilot trial and the lumbar disc surgery waiting list patients.

What They Found

Inversion therapy relieved symptoms: there were improvements in the Visual Analogue Score, Roland Morris and Oswestry Disease indices, and Health Utility Score compared with their pre-treatment status.
Also, the 2-year surgery rate in the inversion participants in the registry (21%) was significantly lower than in the matched control group (39% at two years and 43% at four years).
It was also lower than the surgery rate in the other 2 control groups.

Wrap It Up

Inversion therapy relieved symptoms and avoided surgery. And let me tell you personally, we do decompression, we do inversion, we do McKenzie….we have lots of ways of going at low back pain. I’ve seen inversion poo poo’ed in evidence-based FB groups. I’m telling you, they don’t know what they’re talking about, for the right patient, inversion can be a game-changer. Insurance won’t pay for it but the patient will if it’s reasonable and makes sense.

Item #2

The second one today is called “Effect of Neural Mobilization Exercises in Patients With Low Back-Related Leg Pain With Peripheral Nerve Sensitization: A Prospective, Controlled Trial” by Alshami et. al. (Ali M. Alshami 2021) and published in the Journal of Chiropractic Medicine in June of 2021 and it’s hot hot hot as well If you don’t know what Neurodynamic moves, exercises, etc are….go Google up nerve flossing or nerve gliding or neurodynamic exercises. That should get you up to speed.

Why They Did It

The aim of this study was to investigate the short-term effect of slider and tensioner exercises on pain and range of motion (ROM) of straight leg raise (SLR) and slump tests in patients with low back-related leg pain with peripheral nerve sensitization.

How They Did It

It was a prospective, controlled trial,
51 patients with low back-related leg pain with peripheral nerve sensitization
They were divided into 3 treatment groups:
slider (slider neural mobilization exercise + transcutaneous electric nerve stimulation [TENS]),
tensioner (tensioner neural mobilization exercise + TENS), and
control (only TENS).
Each patient received 6 sessions over 2 weeks.
The following outcomes were measured at baseline and after the first, third, and sixth sessions: visual analog scale (VAS) for pain and ROM of SLR and slump tests were performed for the symptomatic side.

What They Found

Compared with controls, patients receiving the slider and tensioner exercises showed a greater decrease in pain at the third and sixth sessions
There was a significant difference in the ROM of the SLR test between the slider and controls at only the sixth session
Patients in the slider and tensioner groups demonstrated greater improvements in the ROM of slump test at all sessions compared with controls
There were no significant differences between the slider and tensioner groups in any outcome at any session.

Wrap It Up

Patients in both slider and tensioner neural mobilization exercise groups demonstrated improvements in pain and ROM in patients with low back-related leg pain with peripheral nerve sensitization compared to those in the control group. Item #3 Number three today is called “Effectiveness of Neural Mobilization Techniques in the Management of Musculoskeletal Neck Disorders with Nerve-Related Symptoms: A Systematic Review and Meta-Analysis with a Mapping Report”‘ by Varangot-Reille et. al. (Clovis Varangot-Reille 2021) and published in Pain Medicine on October 11, 2021, steamy plate of knowledge nuggets coming up!

Why They Did It

The objective was to assess the effectiveness of neural mobilization (NM) techniques in the management of musculoskeletal neck disorders with nerve-related symptoms (MND-NRS).

How They Did It

They conducted a systematic review with meta-analysis, using pain intensity, disability, perceived function, cervical range of motion, and mechanosensitivity as the main outcome measures. The systematic review included 22 studies

Wrap It Up

Neural mobilization appeared to be effective to improve overall pain intensity when embedded in a physiotherapy treatment in the management of musculoskeletal neck disorders with nerve-related symptoms. When compared with no intervention, it was effective to improve neck rotation, disability, and function. However, it was not superior to other types of treatments in improving overall pain intensity, neck pain intensity, arm pain intensity, cervical range of motion and disability, except for mechanosensitivity.

Item #4

I’m an overachiever today, our fourth paper is called, “Neurodynamics is an effective intervention for Carpal Tunnel Syndrome” by Stephanie Wise and Jordon Bettleyon (Stephanie Wise and Jordan Bettleyon 2021) and published in the Journal of sport Rehabilitation on December 20th, 2021 – Kablamo – that’s some heat people.

Why They Did It

Is neurodynamics effective in reducing pain and reported symptoms in those with CTS?

How They Did It

Four studies were included, with 2 studies utilizing passive neural mobilizations, one study using active techniques, and one study using active neural mobilizations with splinting.

What They Found

All studies showed large effect size for pain, symptom severity, and physical function.

Wrap It Up

Neurodynamics is an effective treatment for CTS. Splinting is only effective when combined with neurodynamics. I’m hammering this home because radiculopathy doesn’t have to go directly to surgeons and it’s not just a pop and street them either. We have lots of things we can do McKenzie, we have decompression, we have neurodynamic exercises, low-level laser may be a possible treatment, traction, is it TOS??? Lots of stuff to run through before we need to worry about something more intensive and invasive.

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

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

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

The Message

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

Key Point:

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

Contact

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

Connect

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

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

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