Jeff Williams - evidence-based chiropractor

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!

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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 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.

Postoperative Acupuncture & Activity And Depression

February 23, 2023 chiropracticforward 00:14:10 0 Comments

CF 268: Postoperative Acupuncture & Activity And Depression

Today we’re going to talk about Postoperative Acupuncture & Activity And Depression

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 #268 Now if you missed last week’s episode, we talked about Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Things are steadily picking back up here at Jeff Central. One of our new hires is having a Zoom meeting with our social media crew from the UK this week to get their heads together on TikTok stuff, YouTube ads, and all of that fun stuff. Some of the older guys will fondly remember the days when all you had to do was place an ad in the YellowPages, an ad in the town newspaper, and if you were really fancy, an ad on the radio. Then join Lion’s Club or the Rotary Club. From there…..you were pretty good to go. No other effort really required.

Not only that but reimbursements were better, co-pays cheaper, deductibles less, and premiums cheaper. It’s just dumb to be a healthcare provider these days when you think about it sometimes. You damn well better be in it for the right reasons. That’s for sure. If it’s all about the money, you’re in the wrong place, pal. Now, we have social media, podcasts, content marketing, website SEO, keywords, Google ranking, and all of the other BS that comes along with it. It’s a bunch of crap. But, it’s a bunch of necessary crap if you want to compete and build a business in 2023. Damnit.

Those that have better systems and better people helping them with it all are just naturally going to do better. I’ve tried doing it myself for years. I’m an early adopter. But, it’s gotten too difficult. I’m trying to gather a team of helpers because, honestly, my practice can be so much larger with the right team in place. We’re working on it. Stay tuned. And, in the meantime, if you know of an associate that wants to come to Amarillo and is certified in acupuncture, or can be, send them my email and tell them to get hold of Ol’ Uncle Jeffro at creekstonecare@gmail.com

Item #1 Speaking of acupuncture.

The first one today is called, “Wrist–Ankle Acupuncture as Additional Therapy for Postoperative Multimodal Analgesia in Orthopedic Surgery: Systematic Review and Meta-Analysis” by Ning Xu and published in Pain Medicine on 28 April 2022. Dayum. That’s hot.

Why They Did It The present meta-analysis analyzed the efficacy and safety of wrist–ankle acupuncture (WAA) as an additional therapy for postoperative multimodal analgesia after orthopedic surgery.

How They Did It

Electronic databases, including Cochrane Library, PubMed, EMBASE, Web of Science, CNKI, SinoMed, Wanfang, and VIP, were searched to identify randomized controlled trials and cohort studies that reported details of WAA as an additional therapy for postoperative multiple analgesia in orthopedic surgery before October 1, 2021.

Analyzed outcomes included time points of the visual analog scale, use of patient-controlled intravenous analgesia (PCIA), and postoperative adverse events. Subgroup analysis was performed according to time points and complication type.

What They Found

Eleven randomized controlled trials and one cohort study were included in the meta-analysis. Among a total of 845 patients, there were 422 patients in the wrist–ankle acupuncture groups and 423 patients in the control groups.

The wrist–ankle acupuncture groups showed a better analgesic effect, lower use of patient-controlled intravenous analgesia, and lower occurrence of postoperative adverse events than did the control groups.

Wrap It Up Wrist–ankle acupuncture as an additional therapy for postoperative multimodal analgesia in orthopedic surgery showed advantages over control treatment in terms of pain relief, use of patient-controlled intravenous analgesia, and occurrence of postoperative adverse events.

Item #2 Our last one this week is called, “Association Between Physical Activity and Risk of Depression” by Matthew Pearce, PhD and published in JAMA Psychiatry on April 13, 2022. Hot potato!

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

They used information from PubMed, SCOPUS, Web of Science, PsycINFO, and the reference lists of systematic reviews retrieved by a systematic search up to December 11, 2020, with no language limits. The date of the search was November 12, 2020.

They included prospective cohort studies reporting physical activity at 3 or more exposure levels and risk estimates for depression with 3000 or more adults and 3 years or longer of follow-up.

Data extraction was completed independently by 2 extractors and cross-checked for errors. A 2-stage random-effects dose-response meta-analysis was used to synthesize data. Study-specific associations were estimated using generalized least-squares regression and the pooled association was estimated by combining the study-specific coefficients using restricted maximum likelihood.

What They Found

This systematic review and meta-analysis of 15 prospective studies including more than 2 million person-years showed an inverse curvilinear association between physical activity and incident depression, with greater differences in risk at lower exposure levels. Adults meeting physical activity recommendations (equivalent to 2.5 h/wk of brisk walking) had lower risk of depression, compared with adults reporting no physical activity.

Wrap It Up This systematic review and meta-analysis of associations between physical activity and depression suggests 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. 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

Ning Xu, M., Lu-lu Liu, BN, Wei Rong, MD (2022). “Wrist–Ankle Acupuncture as Additional Therapy for Postoperative Multimodal Analgesia in Orthopedic Surgery: Systematic Review and Meta-Analysis.” Pain Medicine 23(10): 1654-1669.
Pearce M, G. L., Abbas A, (2022). “Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis.” JAMA Psychiatry.

Gluteal Tendinopathy – You Don’t Know What You Don’t Know

November 9, 2022 chiropracticforward 00:18:14 0 Comments

CF 254: Gluteal Tendinopathy – You Don’t Know What You Don’t Know Today we’re going to talk about Gluteal Tendinopathy – You Don’t Know What You Don’t Know But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research.

We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do.

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

You have found yourself smack dab in the middle of Episode #254. Now if you missed last week’s episode, we talked about Spinal Cord Stimulators vs. Placebo & we talked about Low Back pain, Chiropractic, And Opioids. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

You may have heard me talk about it a time or two but I’m really impreessed with a contraption that we have in our office. When I bought mine it was only the third purchased in Texas. Texas is a big place, folks! One had been sold to a research lab, one had been sold to a Physical Therapy outfit, and then mine. Definitely we’ve been ahead of the curve. When I have a car crash patient or a chronic pain patient, we can run the BESS test and the mCTSIB tests to test for concussion and proprioception. Not just test proprioception but train it as well. Balance training, rehab training, movement evaluation, and excellent shoulder rehab as well. It’s called the ISO Free by Tecnobody and it’s cool and it makes me different from the rest of my colleagues by giving us capabilities nobody else has. Check out these products and see what you think.

Go to https://www.tecnobody.com/en/products. Once you decide you have to have more information, email me at creekstonecare@gmail.com and I’ll hook you up with the people that can get you a deal on it. This week I’m really starting to look forward to a little trip we’ve been planning for a while. Remember, you should take a solid trip about once per quarter. It’s the only way to preserve your sanity. You have to get out of your office and spend time on your loves or risk losing your mind completely. Our trip this go around is part of Dr. Kevin Christie’s Florida Mastermind. We are all meeting in the Florida Keys. Key Largo to be specific. Which is the first Key south of the mainland.

Kevin picked this resort because my wife and I went there in February 2020. Just one month before the pandemic set in on the world. People were just starting to think seriously about masks and all of that stuff back then. It was a blast and this resort called Playa Largo was the bees knees. Massages every day, drinks poured in cored pineapples on the beach at sunset, ,dining on the beach and being served funny umbrella drinks as you lounge in the hammock reading Stu McGill’s Back Mechanic book was amazing. Check it out.

Just Google up Playa Largo and see what you find. It’ll make you consider Key Largo instead of Key West. So that’s coming up November 11-13 or somewhere around there. We’re taking my daughter with us and I believe all other Mastermind members are bringing wife and kiddos so it should be a really special time of bonding, swapping ideas, and growth. Speaking of growth, you’ve been hearing me fuss about being slow. We’re still slower than I want but it looks to be picking up a bit. Just in time to go to Key largo, right?

I have anxiety about it but I’m going and I’m not letting business worry me or stress me out. I have to compartmentalize that stuff and step away from it. Which I am.

What do you have coming up that you’re looking forward to? I talked about the Tecnobody products earlier. Are you using anything new and cool? I’d love to hear about it and check it out. I love new gadgets that get patients better! Email me at dr.williams@chiropracticforward.com and tell me all about it. Let’s hop into the research

Item #1

Let’s talk about Gluteal Tendinopathy, shall we. My friends at ChiroUp recently put out an awesome rundown of GT through their email list. Check the show notes for the link to their rundown on it at this poin in the show notes. https://chiroup.com/blog/what-is-the-most-common-cause-of-hip-pain After going through the Ortho Diplomate, GT has been on my radar and it’s amazing. Once you know to look for it, you’re going to find it EVERYWHERE!

Literally everywhere.

You just don’t know what you don’t know and I didn’t know before the Ortho Diplomate. First, Why do people get it? They say it’s from excessive tension or compression of the area. Secondly, what does it look like? GT is lateral hip pain and is tendinopathy of the glute medius or minimus. It hurts to walk but very tellingly, it hurts to lay on that side because of the compression but it also hurts to lay on the other side because we always stretch the leg over the other one so there is tension on the area. Pain on going up and down stairs for sure. One of our patients could barely get into and out of their RV and she was unhappy.

Also, there is usually significant pain on palpation of the area. You can get their attention very quickly by poking around on it. Current thinking is away from bursitis and more toward GT. If bursitis is present, it’s probably more a symptom of GT. This thinking is fresh enough that I found myself in a pissing match with an ortho surgeon about whether it’s bursitis or it’s GT.

We’re always going to have less authority than the ortho in this case so, I told the patient what the research shows and said that ultimately, the terminology doesn’t matter because it will be treated the same. That worked out fine. Try to avoid pissing matches on GT because it’s just not widely known about right now. Orthos are injecting corticosteroids into the hip joints of these GT patients and they’re stunned that it has no effectiveness. That’s because the problem isn’t in the joint. It’s in the connection on the posterior aspect of the greater trochanter. How do we test for it and treat it?

Hip Lag Sign
FaberEx
Palpation

What I do in my office is I use the Drop Release, which was invented by my friend, Dr. Chris Howson of the Great State of North Dakota, to beat it up just a little bit. I use regular SMT to make sure things are moving well. Then I recommend they do some cold laser on the insertion to work down some inflammation. We combine that with targeted rehab exercises from ChiroUp. We have also combined my side with trigger point injections from our Nurse Practitioner.

It has been an awesome combination for us here at my clinic and we are helping these people get past GT a lot faster. Recent research is showing, that PRP injections at the site show promise in helping chronic GT recover quickly as well. That’s exciting because we do PRP here at my clinic! I have the luxury of those not responding to the trigger points and my help to also try PRP now. So, let’s cover that paper briefly before wrapping up for this week’s episode. It’s called “The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection” by Fitzpatrick et. al. (Fitzpatrick J 2018) and published in the American Journal of Sports Medicine and was published on January 2, 2018.

Why They Did It

There would be no difference in the modified Harris Hip Score (mHHS) between a single platelet-rich plasma (PRP) injection compared with a corticosteroid injection in the treatment of gluteal tendinopathy.

How They Did It

Randomized controlled trial;
There were 228 consecutive patients referred with gluteal tendinopathy who were screened to enroll 80 participants;
Participants were randomized (1:1) to receive either a blinded glucocorticoid or PRP injection intratendinously under ultrasound guidance.
A pain and functional assessment was performed using the mHHS questionnaire at 0, 2, 6, and 12 weeks and the patient acceptable symptom state (PASS) and minimal clinically important difference (MCID) at 12 weeks.
Participants had a mean age of 60 years, a ratio of female to male of 9:1, and mean duration of symptoms of >14 months.

What They Found

Pain and function showed no difference at 2 weeks or 6 weeks
The mean mHHS was significantly improved at 12 weeks in the PRP group compared with the corticosteroid group

Wrap It Up

Patients with chronic gluteal tendinopathy for greater than 4 months, diagnosed with both clinical and radiological examinations, achieved greater clinical improvement at 12 weeks when treated with a single PRP injection than those treated with a single corticosteroid injection 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 https://traffic.libsyn.com/chiropracticforward/CF_-_Ep._254.mp3

Bibliography Fitzpatrick J, B. M., O’Donnell J, McCrory PR, Zheng MH, (2018). “The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection.” Am J Sports Med 46(4): 9336-9939.

Communicating Imaging Findings & Acupuncture For Acute Pain

October 20, 2022 chiropracticforward 00:18:21 0 Comments

CF 251: Communicating Imaging Findings & Acupuncture For Acute Pain Today we’re going to talk about Communicating Imaging Findings & Acupuncture For Acute Pain But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #251 Now if you missed last week’s episode , we talked about Night Owls Diabetes And Heart Disease & Medical Marijuana And Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

It’s been a tough one. My mother in law passed away last week. My wife’s parents live about an hour and 45 minutes to the North of Amarillo in our hometown of Perryton, TX. So, we’ve been back and forth and back and forth so many times I lost track. And there will be lots more back and forths to settle the estate and get Meg’s dad situated in a new town down around Longview TX. Lots of distractions coming up but I’ll do my best to keep this podcast on point, educational, and interesting. It’s like I’m trying to teach my kids right now. My daughter did not want to go to school today, which is a Monday. Her grandmother passed away Wednesday evening. She missed school Thursday and Friday. The memorial will be this Friday so she’ll miss another Thursday – fortunately, they’re out of school Friday. The day of the memorial. My point to her was this; life deals us blows.

We have loss and setbacks that get us down, make us sad, and give us the blues. But we have to do what we can to shoulder obligations, most of the time, give us an opportunity to move forward and take our minds off of our problems. Work can keep us from our lives in a good way as well as in a bad way. Sometimes, work keeps us from being able to enjoy our lives and engage in some of the things we are wanting to do more of. Me, I’m not able to spend time writing songs, playing music, sculpting, or painting and things like that. That’s work getting in the way in a bad way. But, then there’s the work that keeps our minds busy and occupied so that we’re not buried and consumed by worry and fret and the big bad blues life sometimes casts us into. So, for this week and the next, we go to school, we go to work, we occupy our minds, and let time take care of the rest. That may be a Gen X way of going about it but I’m Gen X and that’s what we do. Keep the nose down, work, and life will sort it out. Be upset, mourn, and take care of business, one foot in front of the other. Sorry to be so gloomy on the personal side of it all this week but, I’m always honest with you all and that’s what’s happening on the personal side. I’m certain next week’s episode will be a bit on the brighter side! Now, onto the research!

Item #1 Our first one today is called “Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update” by Nielsen et. al. (Arya Nielsen 2022) and published in Pain Medicine on June 17, 2020 and we got as hot one, people! These researchers by the way, are Phds and MDs. I think that’s notable.

Why They Did It A crisis in pain management persists, as does the epidemic of opioid overdose deaths, addiction, and diversion. Pain medicine is meeting these challenges by returning to its origins: the Bonica model of multidisciplinary pain care. The 2018 Academic Consortium White Paper detailed the historical context and magnitude of the pain crisis and the evidence base for nonpharmacologic strategies. More than 50% of chronic opioid use begins in the acute pain care setting. Acupuncture may be able to reduce this risk. This article updates the evidence base for acupuncture therapy for acute pain with a review of systematic reviews and meta-analyses on postsurgical/perioperative pain with opioid sparing and acute nonsurgical/trauma pain, including acute pain in the emergency department.

How They Did It

To update reviews cited in the 2018 White Paper, electronic searches were conducted in PubMed, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials with additional manual review of titles, links, and reference lists.
There are 22 systematic reviews, 17 with meta-analyses of acupuncture in acute pain settings, and a review for acute pain in the intensive care unit. There are additional studies of acupuncture in acute pain settings.

Wrap It Up

The majority of reviews found acupuncture therapy to be an efficacious strategy for acute pain, with potential to avoid or reduce opioid reliance.
With an extremely low risk profile, acupuncture therapy is an important strategy in comprehensive acute pain care.

We see it every week in my clinic. The VA send over their vets regularly and our acupuncturist is like a golden laced angel to these veterans. It’s been impressive. Before getting to the next one, 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.

Item #2

Our last one today is called “Integrating Epidemiological Information into MRI Reports Reduces Ensuing Radiologic Testing Costs Among Patients with Low Back Pain: A Controlled Study” by The Joint Commission Journal on Quality and Patient Safety 2020 by Weeks et. al. This was brought to me by Spine Care Partners who released a wonderful graphic that I got from Parker President, Dr. William Morgan, and shared in our Chiropractic Forward Facebook private group. The graphic showed what percentages in each age group that you can find ASYMPTOMATIC changes like degenerated discs, facets, bulges, herniations, etc. It was excellent. If you’re not in our private group on Facebook, go do that about right now.

This is more of a review so, let’s review about it shall we? They say, “Research has demonstrated that including epidemiological data along with the standard MRI results report has resulted in reduced opioid prescribing by the provider who ordered the study, as well as reduced referral to spine specialists. This new study includes an assessment of costs when frequency of common findings are included with the standard MRI results report.

The information included data on the prevalence of certain conditions over each decade of life in asymptomatic individuals. For example, degenerative disc disease findings in asymptomatic patients are seen in 68% in those 40-50 years of age, 80% in those 50-60, 88% if 60-70 years old, and 93% of 70-80 year olds. Totally asymptomatic! Which is amazing news for patients. Not great news for predatory providers that use rad findings to scare this holy living schnikees out of their patients so they’ll be forced to come see them a million times. Bad news for those asshats.

Great news for patients though. They say that their study showed that MRI reports with the addition of the prevalence of common findings triggered a downstream costs savings averaging $330 per report when compared to the standard MRI results report of the control group which meant there was no epidemiological charge included with the report. Best of all, repeat MRI use, spinal injection, opioid use, and surgery all decreased in the study group compared to the control group, while muscle relaxers and chiropractic utilization had a slight increase. They point out that one explanation for these findings is that the common language used in spine imaging reports, without statistical reference, is both fear invoking and inappropriately supportive of pathoanatomical understanding of back pain, as compared to the more clinically sound biophyschosocial model.

To put that in you and me speak, chiropractors are still relying heavily on the pathoanatomical model. Here’s the lesion, I’ll pop it, patient fixed. Cancer? Pop it. Bad hearing?? Pop it. Stomach ache? Pop it. COVID? Pop it. That’s so far from factual and being based in the evidence of literature that I cannot even begin to describe it.

They’re saying that chiropractors find stuff on the rad images and scare the crap out of their patients. Either because they’re not educated enough to know, or worst of all, because they’re predatory and miserable human beings that take advantage of their patients’ lack of education. All in order to get more visits and make that boat payment or that second house in the mountains or on the beach payment.

They’re also saying, start leaning into the BIOPSYCHOSOCIAL construct of pain, do right by your patients every day, and the money will just take care of itself. Treat others as you like to be treated. Kindergarten stuff. I don’t want myself or my family being taken advantage of so don’t do it to others. Get educated or get left behind.

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 Arya Nielsen, P., Jeffery A Dusek, PhD, Lisa Taylor-Swanson, PhD, Heather Tick, MD, (2022). “Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update.” Pain Med 23(9): 1582-1612.

Does Supplementation Work & Non-Surgical Treatment For Stenosis

August 11, 2022 chiropracticforward 00:18:17 0 Comments

CF 241: Does Supplementation Work & Non-Surgical Treatment For Stenosis Today we’re going to talk about if vitamin Supplementation Works for preventing cardiovascular issues or cancer and we’ll talk about Non-Surgical Treatment For Stenosis 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 #241 Now if you missed last week’s episode, we talked about Brain Activity From Spinal Manipulative Therapy & PT Is As Good As Arthoscopic Surgery For Meniscus Issues. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

What an amazing weekend in Tampa Florida, y’all. Seriously. When you think about a mastermind weekend, you think about learning stuff. And yes….absolutely, we’re learning. Friday from 8-5 we’re learning. Saturday from 8-1, we’re learning. What doesn’t get counted or thought about is the discussion between the members during the classroom time.

We’re not talking about your chiropractor down the street. In some cases, we’re talking about the cream of the crop in the evidence-based chiropractic world. We’re talking about doctors that have taught around the world. We’re talking about chiropractors that have 6+ associates under them. We’re having discussions with people on that level involved and contributing and sharing. But what also doesn’t get counted or thought about is what happens outside of the classroom.

The bonds that have been forged over the past 7 months of being in this group. The friendships that have been formed. The networking and the sharing of tools, thoughts, and processes. Little things like…..have you ever considered charging a small $2.00 admin fee on every checkout so that you can cover ordering a patient’s records, filing and dealing with insurance companies, denials, etc….credit card fees, writing mattress and freaking hot tub notes, and all of the other crap we have to do for free?

Well, that came up in the group, we brainstormed it, came up with a sign for the lobby to warn patients, and knock it out. A $2.00 fee per transaction will bring in an additional $25,000 or so per year and cover my credit card fees with a little left over for other admin costs. Not one word from the patients has been said according to those in the group already doing it.

That’s just the beginning.

Did you know there are lots of government credits you probably qualify for that you’re not getting? I didn’t either until I joined this group. We estimate most of us have made 20x the return on investment so far. So that’s pretty amazing. And then….the bonds. I have been fortunate enough to create a network and bonds with these folks that will be with me for the rest of my life. Not just professionally but personally as well. And they don’t just help me with my practice but referrals for speaking engagements and things that are professional but outside of the clinic. It’s been great, folks. If you’re an earner and go-getter and you want to be a part of it, email Kevin Christie at drkchristie@gmail.com or email me at dr.williams@chiropracticforward.com and we’ll get you connected to see if you’re right for the group.

Alright, let’s dive in.

Item #1

Our first one today is called, “Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement” by the US Preventive Services Task Force (Force 2022) and published on June 21, 2022. And it’s hotter than Tampa in July!

Why They Did It

According to National Health and Nutrition Examination Survey data, 52% of surveyed US adults reported using at least 1 dietary supplement in the prior 30 days and 31% reported using a multivitamin-mineral supplement. The most commonly cited reason for using supplements is for overall health and wellness and to fill nutrient gaps in the diet. Cardiovascular disease and cancer are the 2 leading causes of death and combined account for approximately half of all deaths in the US annually. Inflammation and oxidative stress have been shown to have a role in both cardiovascular disease and cancer, and dietary supplements may have anti-inflammatory and antioxidative effects.

Objective

To update its 2014 recommendation on the evidence on the efficacy of supplementation with single nutrients, functionally related nutrient pairs, or multivitamins for reducing the risk of cardiovascular disease, cancer, and mortality in the general adult population, as well as the harms of supplementation.

How They Did It

Community-dwelling, nonpregnant adults.

What They Found

The USPSTF concludes with moderate certainty that the harms of beta carotene supplementation outweigh the benefits for the prevention of cardiovascular disease or cancer.
The USPSTF also concludes with moderate certainty that there is no net benefit of supplementation with vitamin E for the prevention of cardiovascular disease or cancer.
The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with multivitamins for the prevention of cardiovascular disease or cancer. Evidence is lacking and the balance of benefits and harms cannot be determined.
The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with single or paired nutrients (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. Evidence is lacking and the balance of benefits and harms cannot be determined.

Wrap It Up

So….nothing firm for beta carotene, Vitamin E, or multivitamins or a combo for preventing cardiovascular disease and cancer.

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 Our last one this week is called, “Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review” by Ammendolia et. al. (Ammendolia C 2022) and published in BMJ Open on January 19, 2022. Sizzle baby. It’s hot.

Why They Did It

Neurogenic claudication due to lumbar spinal stenosis (LSS) is a growing health problem in older adults. We updated our previous Cochrane review (2013) to determine the effectiveness of non-operative treatment of LSS with neurogenic claudication.

How They Did It

A systematic review.
We only included randomised controlled trials published in English where at least one arm provided data on non-operative treatment and included participants diagnosed with neurogenic claudication with imaging confirmed LSS.

What They Found

Of 15,200 citations screened, 156 were assessed and 23 new trials were identified.
There is moderate-quality evidence from three trials that:
Manual therapy and exercise provides superior and clinically important short-term improvement in symptoms and function compared with medical care or community-based group exercise;
Manual therapy, education and exercise delivered using a cognitive-behavioral approach demonstrates superior and clinically important improvements in walking distance in the immediate to long term compared with self-directed home exercises and
Glucocorticoid plus lidocaine injection is more effective than lidocaine alone in improving statistical, but not clinically important improvements in pain and function in the short term.

Wrap It Up

There is moderate-quality evidence that a multimodal approach that includes manual therapy and exercise, with or without education, is an effective treatment and that epidural steroids are not effective for the management of LSS with neurogenic claudication.
All other non-operative interventions provided insufficient quality evidence to make conclusions on their effectiveness.

We use Dr. Ammendolia’s program for stenosis patients in our office and it’s legit. It really helps. Our patients get outstanding results when they’re on the program, being good teammates and doing the things they’re supposed to be doing. Stenosis is a lack of real estate. It’s frustrating for patients and practitioners but over the years, Dr. Ammendolia’s course has been the most impressive way of treating it I’ve ever experienced.

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

Ammendolia C, H. C., Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J (2022). “Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review.” BMJ Open 12(1).

Force, U. P. S. T. (2022). “Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement.” JAMA 327(23): 2326-2333.

Vertebral Dysfunction Alters Neuro Function & The Gender Of Your Provider May Matter

December 2, 2021 chiropracticforward 00:19:51 0 Comments

CF 206: Vertebral Dysfunction Alters Neuro Function & The Gender Of Your Provider May Matter Today we’re going to talk about Vertebral Dysfunction Alters Neuro Function & The Gender Of Your Provider May 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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

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

You have found yourself smack dab in the middle of Episode #206 Now if you missed last week’s episode , we talked about Chiropractic Adjustments For The Cervical Spine Really Work & Lumbar Radiculopathy Treatment. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Alright, let’s see, where are we this week? We’ve got 51 patients today and our intern just left Who the hell knows? But we’ll get through them all and before you know it, I’ll be headed home to eat some din din. We can be overwhelmed sometimes and then we just go to work and work through them all one by one. Next thing you know, you did it. This is being written and recorded just prior to Thanksgiving so we’re taking off Thursday and Friday. So kind of like a 4 day little holiday. I’m excited as hell about that.

Mostly because I’m not driving anywhere. It’s really going to be 4 days of sitting around the house, enjoying family, and giving some Thanks along the way. I have a whole lot to be thankful for. I’ve been very blessed. Many of you know I’m a musician. I used to be a traveling musician. I’d work for four days every week and then hop in the van with the boys and pull a trailer all over Texas, Oklahoma, New Mexico, Colorado, and even out to Arizona….every single weekend.

We’d play like that for 6 months straight without having a weekend off. We’d be home here in Amarillo every 4-6 weeks but we’d still be playing. We used to average around 115 or 120 or so shows per year. It was amazing. Chiropractic was plan B, folks. It was so much fun. You can’t describe driving down the highway and hearing your song on the radio for the first time.

You can’t describe what it feels like when you put an album out and then travel for a show 8 hours away and see the people out in the crowd singing along to your songs that you wrote. It’s addicting. It’s absolutely a drug. People give up everything to chase that kind of feeling. I know I did. I was just fortunate enough to have been a chiropractor the whole time so I could fall back on that if all didn’t work out. And when my wife and I started having kiddos, that’s exactly what I did. I gave everyone else a good 8-10 year head start on me. I was out trying to be something I felt was special. And we did pretty darn good for quite a while.

Then it was time to do something else and re-focus energy somewhere else. It’s funny. They say energy goes where focus flows. Or something like that. I’ve never been a halfway kind of dude. I’m obsessive. If I’m going to do something, I want to do it well, efficiently, and more than competently.

So, then it was time to get serious about chiropractic. Here we are 13 years after getting off of the road and we just integrated the clinic and I don’t know how I’m going to keep up today. That’s when you just sit back and try not to gripe about success or a job well done.

That’s when you step back, look at it with fresh, new eyes, and be grateful. I’m a Christian so for folks like me, it’s when we thank God for our blessings.

Speaking of blessings, many of you know I’ve turned a lot of energy and attention to real estate investing recently. Well, we just closed on a house in Lubbock, TX and we’re going to turn it into a short-term rental. We are going through the process of getting everything in place and set up. It’s tough because it’s the first one. So, we’re learning. The next one will be easier because the systems will be in place. This one is a bit challenging but it’ll all be worth it. Wifi deadbolts, routers, wifi thermostats, ring doorbell cameras, dishes, laundry soap, a dependable cleaning crew, a good handyman, and on and on. But we’ll get there. And it’s going to be great. I’ll keep you updated if you like.

Just some free-flow thoughts there. I hope you don’t mind. This podcast isn’t always only educational. Sometimes it’s my therapy, ya know.

Item #1

The first one is called “The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function” by Haavik et. al. (Haavik H 2021) and published in European Journal of Applied Physiology in October of 2021it’s so damn hot.

Why They Did It

There is growing evidence that vertebral column function and dysfunction play a vital role in neuromuscular control. This review summarises the evidence about how vertebral column dysfunction, known as a central segmental motor control (CSMC) problem, alters neuromuscular function and how spinal adjustments and spinal manipulation alters neuromuscular function.

How They Did It

The current review summarises the contemporary model that provides a biologically plausible explanation for central segmental motor control problems, the manipulable spinal lesion.
This review also summarises the contemporary, biologically plausible understanding about how spinal adjustments enable more efficient production of muscular force.
The evidence showing how spinal dysfunction, spinal manipulation and spinal adjustments alter central multimodal integration and motor control centers will be covered in a second invited review.

What They Found

Many studies have shown spinal adjustments increase voluntary force and prevent fatigue, which mainly occurs due to altered supraspinal excitability and multimodal integration.
The literature suggests physical injury, pain, inflammation, and acute or chronic physiological or psychological stress can alter the vertebral column’s central neural motor control, leading to a central segmental motor control problem.
The many gaps in the literature have been identified, along with suggestions for future studies.

Wrap It Up

Spinal adjustments of central segmental motor control problems impact motor control in a variety of ways. These include increasing muscle force and preventing fatigue. These changes in neuromuscular function most likely occur due to changes in supraspinal excitability. The current contemporary model of the central segmental motor control problem, and our understanding of the mechanisms of spinal adjustments, provide a biologically plausible explanation for how the vertebral column’s central neural motor control can dysfunctional, can lead to a self-perpetuating central segmental motor control problem, and how HVLA spinal adjustments can improve neuromuscular function.

Item #2

The last one is called “Variations in Processes of Care and Outcomes for Hospitalized General Medicine Patients Treated by Female vs Male Physicians” by Sergeant et. al. (Sergeant A 2021) and published in JAMA on July 16, 2021 and that’s a lot hot.

Why They Did It

They wanted to answer the question, “Is physician gender associated with mortality and other patient outcomes in a general internal medicine inpatient setting?

How They Did It

It was a retrospective cross-sectional study including patients admitted to general medical wards at 7 hospitals in Ontario, Canada, between April 1, 2010, and October 31, 2017.
The association of physician gender with patient outcomes was examined while adjusting for hospital fixed effects, patient characteristics, physician characteristics, and processes of care.
All patients were admitted to a general internal medicine service through the emergency department and were cared for by a general internist or family physician-hospitalist.
Patients were excluded if length of stay was greater than 30 days or if the attending physician cared for less than 100 hospitalized general medicine patients over the study period.
A total of 171,625 hospitalized patients with a median age of 73 years were included

What They Found

Patients were cared for by 172 attending physicians (54 female physicians and 118 male physicians.
In fully adjusted models, female physicians ordered more imaging tests, including CTs, MRIs, and Ultrasounds.
Patients treated by female physicians had lower in-hospital mortality.
This difference persisted after adjustment for patient characteristics but was no longer statistically different after adjustment for other physician characteristics.
The difference was similar after further adjustment for processes of care.

Wrap It Up

Patients cared for by female physicians had lower mortality rates than those treated by male physicians, adjusting for patient characteristics. This finding was nonsignificant after adjustment for other physician characteristics. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

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

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

The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website 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 Haavik H, K. N., Holt K, Niazi IK, Amjad I, Pujari AN, Türker KS, Murphy B (2021). “The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function.” Eur J Appl Physiol121(2675-2720). Sergeant A, S. S., Shin S (2021). “Variations in Processes of Care and Outcomes for Hospitalized General Medicine Patients Treated by Female vs Male Physicians.” JAMA Health Forum 2(7).

To Do Lists, Frailty, and Pain & Lost Work Days

August 26, 2021 chiropracticforward 00:17:16 0 Comments

CF 192: To-Do Lists, Frailty, and Pain & Lost Work Days

Today we’re going to talk about To-Do Lists, Frailty, and Pain & Lost Workdays

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 an invaluable resource for your patient education and for you. It can save you time in putting talks together or just staying current on research. It’s categorized into sections so that the information is easy to find and it’s written in a way that is easy to understand for practitioners as well as patient. You have to check it out. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
Then go Like our Facebook page,
Join our private Facebook group and interact, and then
go review our podcast on iTunes and other podcast platforms.
We also have an evidence-based brochure and poster store at chiropracticforward.com
While you’re there, join our weekly email newsletter.

You have found yourself smack dab in the middle of Episode #192 Now if you missed last week’s episode, we talked about chiropractic preventing opioids and chiropractic adverse events. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I am starting week three of the medical integration. It’s stressful but it’s exciting too. Every day I’m convinced more and more that we picked the right nurse practitioner. Super smart and excellent with patients. I’m lying if I act like there’s no anxiety in this deal though. Damn. The money flying out the doors in a direction is almost stunning. With little money coming in on the medical side. Everything has to start at ground zero. That’s a given. Everything has to grow from seed. That’s a given. The trick is to get to maturity and profitability as quickly as humanly possible. That’s what we’re trying to do. We’ve been doing social media and are about to do a direct Mail piece as well. We’re trying to get this thing on its feet muy pronto! Switching gears here, how do you stay productive? My means of staying productive is really pretty simple.

I keep a ToDo list and I follow it daily. I have it broken down into two sections. One is a grid. The days of the week are along the top of the grid. What HAS to be accomplished are listed below the day it has to be done. Then, I have a simple list outside of the grid. They’re things that need to be done when time allows. Outside of the must-do’s they’re the need to do’s if you will. So, for example, on Mondays, I have to write, record, edit, and upload the podcast. It’s a scramble from start to finish when I also have 40 or more patients to contend with as well. Sometimes I get it all done. Sometimes I just get it written and record it as time allows the rest of the week Don’t forget about email. I get at least 50-100 every day so that’s a job all by itself sometimes. I unsubscribe as often as I can.

I don’t like garbage and minutiae. Can’t have it. No time for that. Tuesdays, it’s my clinic’s blog that has to be written, the corresponding video is recorded, and it’s uploaded to YouTube and Facebook. Again, all accomplished between patients. I get off on Tuesdays around 2 pm. Sometimes that extra afternoon time is used to catch up. Sometimes I go home, work out, do voice-over, and then take classes toward the Forensics Diplomate. As you can see, Monday and Tuesday is go time. Wednesdays I write and send a mass email to my emailing list with the blog and video I recorded the day before included. Usually, things start to loosen up a bit by the time Wednesday rolls around and I’m able to give attention to the Need To-Dos. Some marketing and all that good stuff. Thursdays I upload the new podcast episode, I post it on Facebook, I send out an email to my list, and lost it in our private Facebook group.

Then marketing, patients, voice-over, another website project I’m working on, and whatever else crosses the desk. Friday, I get off at 1 pm. The afternoon is spent catching up, taking classes, getting in phone calls with people that think they just have to get you on a phone call, or I hit happy hour if I’m lucky. So that’s my week. I don’t get on phone calls. If it can’t be texted or emailed, don’t bother. I don’t talk to salespeople. I don’t entertain anything that takes me off task if I can help it. I can’t. So that’s how I get it all done. The list is my priority and I make sure each item is accomplished. It keeps me on track, it keeps this podcast rolling, it keeps my clinic rolling, and it keeps my brain from exploding. Tel me how you stay on track. I’d love to hear about it. Email me at dr.williams@chiropracticforward.com

Item #1

The first one today is called “The Predictability of Frailty Associated with Musculoskeletal Deficits: A Longitudinal Study” by Tembo et. al. (Tembo 2021) and published in Calcified Tissue Interrnational……which is as niche-y as niche can be and it was published on May 20 of 2021. Good Lawd….the heat.

Why They Did It

They wanted to investigate and quantify the predictability of frailty associated with musculoskeletal parameters.

How They Did It

It was a longitudinal study Involved 287 men over 50 years old Baseline musculoskeletal measures included femoral neck bone mineral density appendicular lean mass index whole-body fat mass index lower limb strength Frailty at the 15 year follow-up was defined as > or = to 3 of the following 1. Untintentional weight loss 2. Weakness 3. Low physical activity 4. Exhaustion 5. Slowness

What They Found

48 men were frail. That’s 16.7%
Musculoskeletal models were better predictors of frailty
Musculoskeletal parameters improved the predictability model as measured by AUROC for frailty after 15 years

Wrap It Up In general, muscle models performed better compared to bone models. Musculoskeletal parameters improved the predictability of frailty of the referent model that included lifestyle factors. Muscle deficits accounted for a greater proportion of the risk for frailty than did bone deficits. For getting musculoskeletal health could be a possible avenue of intervention in regards to frailty.

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Item #2

This one is called “Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system” by Gaspar et. al. (Gaspar FW 2021) and published in PLoS ONE on June 17, of 2021 and that’s stuh, stuh, stuh, steamy people.

Why They Did It

The authors wanted to quantify the influence of adherence to guideline-recommended interventions in the first week of treatment for an initial low back pain (LBP) injury on lost workdays.

How They Did It

It was a retrospective cohort of California’s workers’ compensation claims data from May 2009 to May 2018
41 diagnostic and treatment interventions were abstracted from the medical claims for workers with acute LBP injuries and compared with guideline recommendations.
Lost workdays within 1-year post-injury were compared by guideline adherence using quantile regressions.
Of the 59,656 workers who met the study inclusion criteria, 66.1% were male and the average (SD) age was 41 (12) years

What They Found

The median number (IQR) of lost workdays was 27 (6–146) days.
In the first week of treatment, 14.2% of workers received only recommended interventions, 14.6% received only non-recommended interventions, and 51.1% received both recommended and non-recommended interventions
Opioid prescriptions fell 86% from 2009 to 2018
Workers who received only guideline-recommended interventions experienced significantly fewer lost workdays (11.5 days; 95% CI: -13.9, -9.1), a 29.3% reduction, than workers who received only non-recommended interventions
The percentage of workers receiving only recommended interventions increased from 10.3% to 18.2% over the 9 years.

Wrap It Up

When workers received guideline-recommended interventions, they typically returned to work in fewer days. The majority of workers received at least one non-recommended intervention, demonstrating the need for adherence to guideline recommendations. Fewer lost workdays and improved quality care are outcomes that strongly benefit injured workers.

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus so get active, get involved, and make it happen.

Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography Gaspar FW, T. M., Wizner K, Hegmann K, (2021). “Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system.” PLoS One 16(6). Tembo, M. C., Mohebbi, M., Holloway-Kew, K.L, (2021). “The Predictability of Frailty Associated with Musculoskeletal Deficits: A Longitudinal Study.” Calcified Tissue Int.

Western Diet Hurts and Acupuncture

July 15, 2021 chiropracticforward 00:24:07 0 Comments

CF 186: Western Diet Hurts and Acupuncture Today we’re going to talk about new research based on chronic pain and our regular Western diet. Then we discuss 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.

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

You have found yourself smack dab in the middle of Episode #186 Now if you missed last week’s episode , we talked about high impact chronic pain and we talked about newer research on the use of cannabinoids in adolescence. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I’m feeling pretty good today, folks. I’m feeling pretty optimistic. If I had known what a process building a medical clinic truly is, I may have thought it through just a little bit more than I did. There really is a solid reason more chiropractors don’t take the steps to do it. And that’s because it isn’t easy. Attorneys, medical directors, hiring the nurse pracs, setting up training, getting the malpractice in place, getting the DEA number of the medical director to have your address on it so your NP can order the things they need, getting your NP credentialed, getting the entities created correctly by the CPAs……it’s a process for damn sure.

I remember when I started this path, my good buddy and consultant on it, Dr. Tyce Hergert in Southlake, TX, he told me get your seatbelt on because the majority of the work is in the first 90 days. I feel like it’s starting to loosen up a bit and the clouds are clearing on this integration deal. Which is exciting. Because then you can go from wading through the paperwork and minutiae and start focusing on their training and growing the word of mouth and actually start working on the business. That’s where my skill level lies. I’m not 100% out of the initial struggle to get it set up and off the ground but I’m getting toward the rear end of it and that’s encouraging. For instance, my morning this morning was setting up an account with a medical supplies company and getting started with my first order of IV equipment, cotton swabs, medipore tape, and things of that nature. Right…..I know…..ugh.

But it’ll be worth it eventually. At least it damn sure better be! Beyond that, last week was better as far as clinic numbers. Moving in the right direction. I believe as a solo practitioner I had about 167. Still not pre-COVID numbers but not awful. I can deal with stuff mentally when I know it’s moving the right direction. It’s when it’s staying slim and there’s no longer rhyme or reason for it that makes me lose my mind.

So, the mind is intact today and I’m looking forward. Onward and upward today. Still no emails from any of you on what you’ve done to help the rest of you get your patients back. So, any help and advice from the think tank here would be good for the rest of the crew. Share. Give. It’ good for you.

Item #1

This first one his an article that appeared in the Seattle Times called “Study finds correlation between high-fat Western diet and pain” by Theresa Braine of the New York Daily News (Braine 2021). It was published on June 24, 2021 and it’s hotter than hot stuff! And on a side note, You’d be in a hell of an awkward position if you last name was Braine but you were an idiot wouldn’t you? Think about that a minute. Your name is brain but you’re basically walking around bumping into walls…..people snickering behind your back…..Brain….right, right. Anyway, that’s a little peak into my brain for you.

Anyway…since it’s an article, as always I just basically summarize and hit the high spots.

They say the Western diet is associate with many ills and now chronic pain might be added to the list.
A new study looks at the potential for omega-6 fats’ influence on neuropathic pain in people with diabetes and other conditions.
Researchers at the University of Texas Health Science Center at San Antonio studied the effects of omega-6 fatty acids themselves by measuring the role of these dietary lipids in pain conditions and found that the substances themselves seem to cause pain and inflammation.
Diabetes, autoimmune disorders and cardiovascular diseases are known to be affected by nutritional choices, the researchers said. But excessive consumption of omega-6 fats, which are found largely in commonly consumed processed foods, had not been studied in terms of the acids themselves and their role specifically in pain.
They studied polyunsaturated fatty acids in both mice and humans.
The five-year study was published in the June edition of the journal Nature Metabolism.
Omega-6 fats mainly occur in foods with vegetable oils
“But Western diets associated with obesity are characterized by much-higher levels of those acids in foods from corn chips to onion rings, than healthy omega-3 fats, which are found in fish and sources like flaxseed and walnuts,” the researchers’ statement said. “Generally, unhealthy foods high in omega-6 fats include processed snacks, fast foods, cakes, and fatty and cured meats, among others.”
Reversing those dietary habits and increasing omega-3 fats “greatly reduced these pain conditions,” the researchers found. “Also, the authors demonstrated that skin levels of omega-6 lipids in patients with Type 2 diabetic neuropathic pain were strongly associated with reported pain levels and the need for taking analgesic drugs.”

So, we’re seeing more and more studies like this talking about inflammatory diets, high-fat, and things of that nature. All being related to increased levels of pain. This is something chiropractors can get behind. I can be very honest when I say that the main gap missing in my clinic is weight loss. Diet and nutrition. Things of that nature. As a result, I’m having our nurse practitioner trained in medical weight loss so we can fill that gap and be well-rounded.

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Item #2

Next up, I’ve been asked to put together a talk based on evidence-based, patient-centered practice and what makes it the future of our profession. The special request was to end the talk with some research-based around acupuncture research. Texas chiropractors continue to go through battles and one of them is against the acupuncturists in the state. So, with that, I’m going to offer up a couple of papers. I’ve got a bunch of good ones but thought I’d just cover a couple here. The first one is called “Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain A Systematic Review and Meta-Analysis” by He et. al. (He Y 2019) and published in JAMA Oncology on December 19, 2019 and it goes a little sumpin’ like this.

The first thing that jumps out here, especially for those somewhat new to reading through research, is that this is a systematic review and meta-analysis. That is at the top of the research pyramid. For example simple little case studies and animal studies, pilot studies….things of that nature….they live at the bottom, less meaningful or less impactful part of the pyramid. As you climb the pyramid to the more important stuff, you’ll see cohort studies and randomized controlled trials. Then, at the very top, the most meaningful studies are the systematic reviews topped off by the meta-analysis. What I’m saying is that this paper is good stuff. It’s good information. And it appears in a very respected journal. The Journal of the American Medical Association’s Oncology branch. It’s high level from several aspects.

Why They Did It

The authors wanted to answer the question, “Is the use of acupuncture and acupressure associated with improved cancer pain management compared with sham intervention and/or analgesic therapy alone?

How They Did It

It was a systematic review of 17 randomized clinical trials and meta-analysis of 14 trials in the current English-language and Chinese-language literature
Three English-language databases and 4 Chinese-language biomedical databases were searched for RCTs published from database inception through March 31, 2019.
Randomized clinical trials that compared acupuncture and acupressure with a sham control, analgesic therapy, or usual care for managing cancer pain were included.
The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool
The primary outcome was pain intensity measured by the Brief Pain Inventory, Numerical Rating Scale, Visual Analog Scale, or Verbal Rating Scale.

What They Found

A significant association was found between real (compared with sham) acupuncture and reduced pain, and acupuncture combined with analgesic therapy was associated with decreased analgesic use. However, heterogeneity lowered the level of certainty of the evidence.

Wrap It Up

This study found a moderate level of evidence that acupuncture and/or acupressure was significantly associated with lower pain intensity in patients with cancer compared with a sham control, which suggests a potential for a combination of acupuncture and acupressure to help reduce opioid doses in patients with cancer.

Item #3

This last one is called “Acupuncture for neck disorders (Review for The Cochrane Collaboration)” by Trinh et. al. (Trinh K 2016) and it can be found in the Cochrane Library published in May of 2016 so it’s about 5 years old at this point.

Why They Did It

Acupuncture has been used as an alternative to more conventional treatment for musculoskeletal pain. This review summarises the most current scientific evidence on the effectiveness of acupuncture for acute, subacute and chronic neck pain.
To determine the effects of acupuncture for adults with neck pain, with focus on pain relief, disability or functional measures, patient satisfaction and global perceived effect.

How They Did It

They searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Manual, Alternative and Natural Therapy Index System (MANTIS), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Index to Chiropractic Literature (ICL) from their beginning to August 2015
They searched reference lists, two trial registers and the acupuncture database Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS) in China to 2005.
We included published trials that used random assignment to intervention groups, in full text or abstract form. We excluded quasi-randomized controlled trials
Of the 27 included studies, three represented individuals with whiplash‐associated disorders (WADs) ranging from acute to chronic (205 participants), five explored chronic myofascial neck pain (186 participants), five chronic pain due to arthritic changes (542 participants), six chronic non‐specific neck pain (4011 participants), two neck pain with radicular signs (43 participants) and six subacute or chronic mechanical neck pain (5111 participants). So there was a big mix of conditions represented with a solid sample size when you add them all up.

What They Found

For mechanical neck pain, we found that acupuncture is beneficial at immediate‐term follow‐up compared with sham acupuncture for pain intensity; at short‐term follow‐up compared with sham or inactive treatment for pain intensity; at short‐term follow‐up compared with sham treatment for disability; and at short‐term follow‐up compared with wait‐list control for pain intensity and neck disability improvement.
This effect does not seem sustainable over the long term. Whether subsequent repeated sessions would be successful was not examined by investigators in our primary studies.

Wrap It Up

Moderate‐quality evidence suggests that acupuncture relieves pain better than sham acupuncture, as measured at completion of treatment and at short‐term follow‐up, and that those who received acupuncture report less pain and disability at short‐term follow‐up than those on a wait‐list. Moderate‐quality evidence also indicates that acupuncture is more effective than inactive treatment for relieving pain at short‐term follow‐up. Alright, for those not yet on the acupuncture train, take another look.

The VA here locally are sending veterans to us right now for our acupuncturist to work with them and these old grizzly vets absolutely love it. Yep, that’s anecdotal as hell but I’m telling you, there’s something to it and research seems to be catching up to it. Patients ask me how it works and I have to be honest……I’m not sure. I have some guesses but it’s a lot like a damn TV. I can’t tell you the exact way a program’s signal gets to my house and shows up when I turn the damn TV on. But I know how to enjoy the results. Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.

Store

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

https://www.amazon.com/dp/B096RST3WW

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

Bibliography

Braine, T. (2021). Study finds correlation between high-fat Western diet and pain. Seattle Times.
He Y, G. X., May BH, (2019). “Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis.” JAMA Oncol 6(2): 271-278.
Trinh K, G. N., Irnich D, Cameron ID, Forget M (2016). “Acupuncture for neck disorders. Cochrane Database of Systematic Reviews 2016,.” Cochrane Database of Systematic Reviews 5.

Evidence based chiropractic forward podcast

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

April 15, 2021 chiropracticforward 0:23:07 0 Comments

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

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

But first, here’s that sweet sweet bumper music

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

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

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

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

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

On the personal end of things…..

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

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

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

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

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

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

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

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

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

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

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

Onto the research!

Item #1

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

Why They Did It

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

How They Did It

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

What They Found

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

Wrap It Up

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

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Item #2

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

Why They Did It

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

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

Item #3

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

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

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

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

Item #4

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

Why They Did It

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

How They Did It

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

Wrap It Up

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

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

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

Store

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

Subscribe Button

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

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YouTube

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

TuneIn

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

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

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

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

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

Chiropractic Forward Podcast - Jeff Williams, DC

Forward ’19, Decompression Research, Curveball or Pitch Count?

October 3, 2019 chiropracticforward 00:32:21 0 Comments

CF 094: Forward ’19, Decompression Research, Curveball or Pitch Count?

Today we’re going to talk about my Forward ’19 experience, we’ll talk about decompression research, and we’ll cover some new research on whether it’s the curveball or the pitch count that injures young players on the baseball diamond.

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 and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.

You have rattled and rolled into Episode #94

Now if you missed last week’s episode on the bigger the disc the better and what early improvement in treatment tells you, make sure you don’t miss that info. Every episode offers some good take-aways so make sure you’re up to date and not falling behind the rest.

I like to look at this podcast as an ongoing, fun way of learning and making each other just a little bit better every week so don’t just hop in for one episode. Stack them up one after another and, before you know it, you’re going to start retaining the info and you’re going to start recalling something we talked about down the road when you’re interacting with a patient and they ask you a question.

You’ll see. Even though I’m the host, it happens to me. Someone will ask me a question and I’ll remember an episode we did on that topic and BOOM!! Pow!! There it is, the answer comes to me. Pretty cool.

Forward ’19 – For you newbies here you’re probably wondering what the hell Forward ’19 is. A quick rundown is that it is a yearly seminar/conference that was born from an online Facebook group called the Forward Thinking Chiropractic Alliance aka FTCA. They have a website as well.

The group is very much evidence-based or evidence-informed. Whichever is your preferred verbiage. The group has about 7800 or so doctors in it and they are interacting on a daily basis mostly to try and make each other better. Overall, it’s a good group. I’ve heard people griping because they see griping here and there in the group but, in general, it’s a very positive, very smart, and very helpful group. I encourage you joining it if you’re a doctor or student.

Anyway, Forward 19 – What an event. The group puts on several events through the year but this is the key event put on by the FTCA every year. This is year #2. It was in St Louis at the campus of Logan Chiropractic College.

First thing is, holy smokes what a campus man. I bet they pay a fortune just to mow the grass. Just wow. The landscaping, the tower in the middle, and Purcer Center where it was all held. Just gorgeous. Having gone to Parker, that was the Chiro campus I’d been on and don’t get me wrong, Parker is impressive. I’d say Logan most definitely is as well. Kudos.

Speakers:

Gray Cook SFMA – SFMA stands for Selective Functional Movement Assessment – I have to admit that this was my first exposure to Gray Cook but it won’t be my last. I had heard of SFMA but was not all that familiar with it. I really enjoyed his talk and some of the concepts he puts forward. I can’t wait until I get through with my Diplomate program – hopefully in November – so that I can dive into Gray Cook’s stuff and just keep building on the knowledge pile.

Greg Kawchuk – He is the Research Chair for the World Federation of Chiropractic.

So, outside of the FTCA, I had little knowledge of Greg Kawchuk. But, Greg gave a speech at the World Federation of Chiropractic last year in Berlin that got some people a little fussy and some people elated. It definitely got the attention of chiropractors around the world to say the least. He gave the same speech last weekend in St. Louis and it had people on the edge of their seats.

Backing up a bit, Greg is a dynamic speaker. One of the more humorous and engaging speakers I’ve seen in maybe forever. He’s immediately like-able and that make for a good speech from the top. The talk was all about putting the ACT back in Chiropractic. A play on the way the philosophy guys use the TOR and the TIC garbage. You know….the principled vs. un-principled hoohah.

I happened to think that evidence-informed docs are the principled ones and if you need more info on why I think that, just go back about 3-4 episodes and listen to my podcast on the topic of Closing Patients. A principled, ethical person doesn’t carry themselves in that manner and the philosophy folks are much more likely to be out there closing patients than offering responsible treatment plans that are based on commonly accepted guidelines. In my experience at least. It’s always made me a bit hot under the collar when someone asks whether another chiropractor is principled or not.

Makes me want to principle them in the forehead…..with a mighty slap.

Anyway, putting the ACT back in chiropractic: he asked what are we doing right now? What are you doing right now to move the needle forward? To bring chiropractic into this current century we are in? He suggests we do a lot of sciencing and consume at least 1 science per day and I agree with him.

Hell, here at the Chiropractic Forward podcast, we distribute about 3-4 sciences per episode so we almost got you covered for the whole week if you’re a regular listener.

I think the part of his presentation that some took exception to was the part where he feels the evidence group may, at some point, consider a divorce from the philosophy geared group. He said it may not be an official divorce but could be very much a divorce in the way we act, carry ourselves, communicate with our patients, and things of that nature.

He says, at the end of the day, it could be something similar to….. we went out for a pack of smokes and…..just never came back.

Now, as you sit in your car or truck or your office hearing me say that, you can take that all in as you will. I’m going to tell you that, as a doctor that considers himself very much on the research end of things and very little on the philosophy end of it, and as a doctor that does everything he can to be ethical, honest, and all that…..it is so hard to sit and hear patients talking to me about being forced to sign of on a contract for thousands of dollars for a year long schedule for umpteen visits based on a curve correction that research suggests isn’t that big of a deal.

It’s hard to hear about the knuckleheads in Oakland claiming they can reverse degenerative spurring by seeing someone 3x/per day for 3 weeks. It’s hard to watch Mr. man bun top not from the coffee house talking about fixing kids with no research to back his claims.

It’s hard to hear about chiropractors scaring the crap out of patients with x-rays and convincing them that they are somehow damaged and in a dire circumstance unless they undergo 60 visits and another 3 sets of x-rays….

These are just a few of the stories. There are so so so many of them and at some point, I just don’t want to be associated with that anymore. At all. If that’s not understandable and that makes no sense to you and that makes you mad at me, well….I’d say I’m sorry but I’m just….I’m just not.

Even though I don’t smoke in the physical meaning of the word, I think I went out for a pack of smokes and never came back about 15 years ago.

Christine Goertz – If you are a regular listener of our podcast, you know Dr. Goertz has been on our show before and you know I’m a nerdy fan of her and her contribution to our profession. Any chance to listen to Dr. Goertz is a chance that should be seized upon. She’s a giant in our industry.

Annie O’Connor – World Of Hurt – OK, I’m admitting something again. I wasn’t familiar with Annie O’Connor. Annie is fun and vivacious and really another very dynamic speaker but she is full of knowledge nuggets. The kind that you can really put to use. She spoke on how words can harm so how key communication can be for some patients. She talked about yellow flags and she talked about classifying pain patients so that we can help them with more efficiency. You can believe that World Of Hurt is on my reading list after Forward ’19.

Greg Friedman – documentation documentation. Greg is Greg. Smart, laid back, fun, and just likable immediately. It was great to get to meet him in person and share a good discussion prior to his documentation class. He’s full of excellent information and not just on documentation so, if you get a chance and you need the hours, search out a class. He’s flying all over the nation every weekend.

Mike Massey – he shared teaching duties with Greg on the documentation class. He told me he’s a listener of our podcast and he’s an active member of the FTCA so I’ve been a fan of his for a while now. It’s always a cool deal to put the online world into a 3D context and it was sure nice to meet Dr. Massey. Hopefully next time I’ll get to sit and speak a while with him. I think our personalities probably match up pretty closely from what I can tell.

Some of the others I got to see and speak with are Brandon Steele

Kevin Christie

Jon Morrison

Robert Jones, President Of The ACA was there the whole weekend sitting in on the classes himself. What a super guy.

Budweiser tour

Meeting people

Kris Anderson

Chris Howson

Rob Pape

Bobby Maybee

Bobby Mozafari

Mike Massey

Greg Friedman

Dale Thompson

Kevin Christie

Anne Maurer

My biggest regret is that I didn’t get any real one on one time with very many of these folks but That’s OK. All’s well.

If I didn’t come up and speak with you but you saw me there, please don’t take it personally, believe it or not, I have a bit of a shy streak. Once I’ve had a conversation with someone, it’s all good. But, if I don’t know you yet….ugh….I have a podcast. I was a traveling musicians for 7 years. Why would a guy like me be shy at all? Yeah I don’t know. I’m in control in those other situations. Maybe it’s when I’m not in control or I’m a newbie….who knows?

Anyway, if you ever see me at an event, regardless of the event, please come say hi. I’d love to meet you.

We are about to get to our two articles. One is new research on traction/decompression information for low back discs and the other is on young baseball pitchers and how the curveball isn’t the culprit.

First though, we have backed off and rather than having two show sponsors, we have one and it’s a company you all know how much I love.

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it.

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That’s ChiroUp.com and super double secret code Williams99.

Item #1

The first article today is called “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis” by Cheng, et. al(Cheng Y 2019). and published in Clinical Rehabilitation in August 28, 2019. Smoking hot folks. Stand back. Watch your eyebrows!

First thing, recognize in the title there, this is a systematic review and meta-analysis. That’s at the top of the research pyramid.

Why They Did It

To evaluate the effectiveness of traction in improving low back pain, functional outcome, and disk morphology in patients with herniated intervertebral disks.

How They Did It

They did a big time search PubMed, Scopus, Embase, and the Cochrane Library and they did this search from the earliest record all the way up to July 2019.
They included RCTs that involved adult patients with low back pain associated with herniated disc confirmed by MRI or CT
RCTs that compared lumbar traction to sham or no traction
RCTs that provided quantitative measurements of pain and function before and after intervention.
The initial search came up with 3,015 records which they whittled down to 7 involving 403 patients.

What They Found

Compared to the control group, the patients that had traction showed significantly greater improvements in pain and function in the short term

The differences were not significant enough to support the long-term effects on pain and function, nor the effects on herniated disc size.

Wrap It Up

Compared with sham or no traction, lumbar traction exhibited significantly more pain reduction and functional improvements in the short term, but not in the long term. There is insufficient evidence to support the effect of lumbar traction on herniated disk size reduction.

Here’s where I’m at on that. I use decompression. I just need to know more about this study. Did they do simple traction? Did they do a cycling pull phase from a pull to a rest phase? How much weight was the pull? How long did they do each treatment and how many treatments did they do?

There’s also patient preference and clinical experience factoring into using decompression.

Reading down through this sucker, it’s just too varied to make any assumptions. The intervention programs differed among the studies from 10 sessions to 60. The treatment protocols varied from 2 weeks to 10 weeks. Some of the studies included had no information on the weight of the pull while a handful went up to 50% of the body weight. Some of the studies used continued traction while others had intermittent traction. Some even used self-suspended, inversion table type traction.

Are you getting a whiff of what I’m dumping here?

Out of the 7 studies they included, only 2 measure the disc height and one measured the disc ratio.

Overall, when you read through the paper, these authors freely admit, this is a tough one but they wanted to start somewhere. They suggest several ways to go forward and say that there are a couple of studies out there that show a trend toward long-term decompression reducing the size of a disc herniation but no longer papers have been done to investigate it.

It’s anecdotal as hell but I’m going to go ahead and anecdote the hell of you. Right to your face. Or….to your ears as it may be. I’ve been doing decompression for about 7 years and I’ve yet to see anything as effective. Including exercises, McKenzie, all of it. In some cases, it has absolutely amazed me. But, like I said, that is anecdotal but I hope some of these really super smart researchers out there in the profession start to dial down into it and figure it out. Mostly because I know it works. I’ve just seen it too many times.

Item #2

This last item is called “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers” by Oliver et. al(Oliver G 2019). and was published in Journal of Pediatric Orthopedics in September of 2019. Wait, it’s September of 2019 right now right? Steaming pile of fresh knowledge nuggets, big platter, sizzling.

Why They Did It

The purpose of this study was to examine differences in pelvis, torso, and upper extremity pitching mechanics and muscle activations between the fastball, change-up, and curveball pitches in youth baseball pitchers following a simulated game.

How They did It

14 youth baseball pitchers with no history of injury were included
All major muscles and mechanics were measured
The pitchers were instructed to throw with max effort during a simulated game that provided random game situations
They were limited to 85 pitches
Data from 3 fastballs, curveballs, and change-ups thrown in the first and last innings were selected for analysis

Wrap it up

The principle findings of this study revealed that pitching to the age-restricted pitch count limit did not result in altered pitching mechanics or muscle activations, and no differences occurred between the 3 pitches. These results support previous research that indicate the curveball pitch is no more dangerous for youth than the other pitches commonly thrown. This is supported by the pitcher’s ability to maintain a proper arm slot during all 3 pitches and indicates that they are obtaining the spin on the ball from their grip and not by altering upper extremity mechanics.

So….it is not the curveball it seems but, rather, it’s the pitch count in young pitchers, it’s treating them like professionals when they’re still developing, it’s that they tend to play only one sport aka specialize, and that they need to be treated like developing children and human beings rather than the Dad’s lost glory or a future paycheck for the whole family.

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly.

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders.

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it.

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 instead of chemical treatments like pills and shots.

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

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient.

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

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 or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out.

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

Bibliography

Cheng Y, H. C., Lin Y, (2019). “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis.” Clin Rehabil.
Oliver G, P. H., Henning L, (2019). “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers.” J Pediatr Orthop 39(8): 387-393.

amarillo chiropractor

Spinal Manipulative Therapy Adverse Events & SMT With Lumbar Herniation

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

Postoperative Acupuncture & Activity And Depression

Gluteal Tendinopathy – You Don’t Know What You Don’t Know

Communicating Imaging Findings & Acupuncture For Acute Pain

Does Supplementation Work & Non-Surgical Treatment For Stenosis

Vertebral Dysfunction Alters Neuro Function & The Gender Of Your Provider May Matter

To Do Lists, Frailty, and Pain & Lost Work Days

CF 192: To-Do Lists, Frailty, and Pain & Lost Work Days

Today we’re going to talk about To-Do Lists, Frailty, and Pain & Lost Workdays

Western Diet Hurts and Acupuncture

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

Forward ’19, Decompression Research, Curveball or Pitch Count?

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