Jeff Williams - evidence-based chiropractor

Safety of SMT in the Cervical Spine & Chiropractors’ Beliefs Around the Need for X-rays

April 27, 2023 chiropracticforward 00:19:55 0 Comments

CF 277: Safety of SMT in the Cervical Spine & Chiropractors’ Beliefs Around the Need for X-rays

Today we’re going to talk about the safety of SMT in the cervical spine & Chiropractors’ beliefs around the need for x-rays.

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 277 Now if you missed last week’s episode, we talked about Subacromial Dry Needling & Lumbar Discs With Stenosis Present. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I have just returned from the Tampa mastermind meeting so this likely will be shorter than normal. Mostly because after I’ve been gone a few days, the stuff has piled up and I’m usually tied up trying to get my desk cleared off and back to business as usually. The youz as the kids would say. Tampa was good stuff, we had a talk from the Scheduling Institute and I was really impressed.

Wow.

I think this is a path I need to be going down and I think that path should start yesterday. Eye opening is just the most minimal way to put it. We have hot seat sessions where one of us sits in the middle and tells the group their issues then the entire group asks questions and tries to offer help and advice to solve and move past those problems.

We have Each One Teach One sessions to help learn what’s working for others in their practices. Kevin Christie and myself presented a 30 minute spot on ChatGPT.

Lindsey Mumma did one on niching your practice. And Ben Fergus did one on automating his front desk and check-in procedures. He’s done a lot of interesting things with his practice. Again, get yourself into a Mastermind or create one. It’s outstanding. Kevin is looking to maybe start another, separate group for the West Coast and Mountain area so keep your eyes and ears out. We’ll probably have Kevin on the podcast in the near future talking about that as well. Let’s get at it.

Item #1

The first one today is called “Safety of chiropractic manipulation of the cervical spine: a prospective national survey” by Haymo W Thiel, Jennifer E Bolton, Sharon Docherty, Jane C Portlock and published in PUBMED on October 1, 2007.

Why They Did It

To estimate the risk of serious and relatively minor adverse events following chiropractic manipulation of the cervical spine by a sample of U.K. chiropractors.

How They Did It

They studied treatment outcomes obtained from 19,722 patients.

Manipulation was defined as the application of a high-velocity/low-amplitude or mechanically assisted thrust to the cervical spine.

Serious adverse events, defined as “referred to hospital A&E and/or severe onset/worsening of symptoms immediately after treatment and/or resulted in persistent or significant disability/incapacity,” and minor adverse events reported by patients as a worsening of presenting symptoms or onset of new symptoms, were recorded immediately, and up to 7 days, after treatment.

What They Found

Data were obtained from 28,807 treatment consultations and 50,276 cervical spine manipulations. There were no reports of serious adverse events.

This translates to an estimated risk of a serious adverse event of, at worse approximately 1 per 10,000 treatment consultations immediately after cervical spine manipulation, approximately 2 per 10,000 treatment consultations up to 7 days after treatment and approximately 6 per 100,000 cervical spine manipulations.

Minor side effects with a possible neurologic involvement were more common. The highest risk immediately after treatment was fainting/dizziness/light-headedness in, at worse approximately 16 per 1000 treatment consultations.

Up to 7 days after treatment, these risks were headache in, at worse approximately 4 per 100, numbness/tingling in upper limbs in, at worse approximately 15 per 1000 and fainting/dizziness/light-headedness in, at worse approximately 13 per 1000 treatment consultations.

Wrap It Up

Although minor side effects following cervical spine manipulation were relatively common, the risk of a serious adverse event, immediately or up to 7 days after treatment, was low to very low. Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

Our last one this week is called, “Examining Clinical Opinion and Experience Regarding Utilization of Plain Radiography of the Spine: Evidence from Surveying the Chiropractic Profession” by Philip A. Arnone, Steven J. Kraus, Derek Farmen, Douglas F. Lightstone, Jason Jaeger 4 and Christine Theodossis and published in Journal of Clinical Medicine on 10 March 2023. Hot potato!

Why They Did It

Plain Radiography of the spine (PROTS) is utilized in many forms of healthcare including the chiropractic profession; however, the literature reflects conflicting opinions regarding utilization and value.
Despite being an essential part of Evidence-Based Practice (EBP), few studies assess Doctors of Chiropractic (DCs) clinical opinions and experience regarding the utilization of Plain Radiography of the spine in practice.

How They Did It

In creating the survey for this study, the authors intended to be consistent with Evidence-Based Practice and developed a series of 11 questions to adequately reflect the clinical opinion and experience of the US DCs on the utilization of Plain Radiography of the spine in a chiropractic clinical setting.

The survey included a variety of both Likert and binary response options that could accurately reflect each DCs’ clinical opinions and experience rather than solely binary response options.

Many aspects of the clinicians’ decision process were considered during the process, including why practitioners would or would not order Plain Radiography of the spine, what value DCs attribute to Plain Radiography of the spine, how to adequately reflect DCs’ clinical opinion and experience of Plain Radiography of the spine as it relates to patient care, and issues related to plain radiography utilization safety and research.

What They Found

There is an inverse relationship in the responses between DCs that do and do not utilize Plain Radiography of the spine in their practice; however, the clinical opinion of US DCs who utilized Plain Radiography of the spine in their practice assigns a high value to the utilization of Plain Radiography of the spine.

These doctors believe it to be safe and that the DCs’ clinical experience is adequate for recommending Plain Radiography of the spine.

In summary, 77.6% of these DCs indicated that Plain Radiography of the spine has value beyond the identification of pathology, 79.1% indicate that x-rays important regarding biomechanical analysis of the spine, 83.0% noted they are vital to chiropractic practice and 84.7% believe they aid in measuring outcomes.

Wrap It Up

This survey provides the most extensive insight into the clinical opinion of the US chiropractic profession regarding Plain Radiography of the spine and suggests that the majority of the DCs consider utilization of x-rays to have value beyond the identification of pathology, to be vital to chiropractic practice and essential to biomechanical analysis.

The DCs who utilized Plain Radiography of the spine only to rule out pathology in the presence of red flags are, in fact, statistical outliers in this study and may represent a minority of US DCs.

A majority of the DCs also consider the doctors’ clinical experience and expertise, coupled with patient preferences, to be appropriate for recommending Plain Radiography of the spine.

Most DCs in this survey found that sharing spinal radiographic findings with the patient is beneficial for patient outcomes. All participants in the survey believed that patient outcomes would benefit from continued research regarding appropriate utilization of Plain Radiography of the spine.

The results of this survey clearly indicate the value of Plain Radiography of the spine reflected by DCs and demonstrate the need for continued research to help understand how this value can affect the quality of care, conservative correction of spinal alignment and patient 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.

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About the Author & Host

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

SMT And Fibromyalgia & SMT And Adverse Events

March 30, 2023 chiropracticforward 0 Comments

CF 273: SMT And Fibromyalgia & SMT And Adverse Events

Today we’re going to talk about SMT And Fibromyalgia & SMT And Adverse Events

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 #273 Now if you missed last week’s episode, we talked about Postpartum VAD and Pregnancy CAD. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things….. If you listened in on the pod last week, I mentioned I’d be heading to VOAtlanta, the nation’s largest voice over conference. I done did it and it was fun. It’s so much like chiro conferences it’s amazing. Except on a larger scale. Not that many tend to go to DC conferences. There were over 1,000 voice actors at this thing. Tons. Lots of classes, lots of teachers, lots of people. Every freaking where. It dawned on me; every profession has its big dogs and it’s peasants. In the vo world, I’m not royalty. I’m a peasant trying to figure out how to be royalty. Lol. In the chiro world, I’m probably middle management I suppose. Definitely not a peasant but not considered royalty either. I think it comes down to notoriety and nationally, the big dogs are just better known.

This means they made the moves, made the connections, built the network, put themselves out there, and then began reaping the rewards. I imagine even the tiddlywinks circuit has its big dogs and its peasants. I don’t know. I just find it so interesting on some level. I think if you want authority or notoriety, I think the base it’s built on is notoriety. Which means you have to do things that make you remarkable and…..notorious. In a positive way, of course. That means being active in your state and national association.

That means doing something other people would be interested in. I wrote a book. I host a podcast and Facebook group. I speak and present when the opportunities arise, and I network through my Mastermind and throughout the profession. That’s got me to upper to middle management I suppose. I’m also considering putting some courses together as well to continue helping colleagues and this profession. What are you doing every day and every year to consistently be 10% better? Are you networking? Or are you an introvert? Believe it or not, I’m a bit of an introvert. I’m great once I’m engaged in conversation but starting the conversation isn’t something I excel at, to be honest. But, I learned a fun little tactic from a fellow VO in Atlanta this weekend.

He said, “If you see a casting director or agent you’re really wanting to talk to but don’t know how, just compliment them. People love compliments.” Nice jacket, those shoes are amazing, man…..what I’d give for a watch like that…..blah blah blah. You get what I’m saying. I watched him do it to a casting director. She walked by and he said “Can I just say real quick that you are just a ray of sunshine and I really enjoyed the info you shared in your session.” She ate it up! Lol. Anyway, I don’t know where I’m going with this other than to say, if you want to be a big dog in whatever industry you are in, get to work marketing yourself and don’t wait for someone else to do it for you. Notoriety doesn’t happen on its own. You have to manifest it. So get out there an start manifesting it everywhere.

Item #1 The first on today is called, “Effectiveness of spinal manipulation in addition to pharmacological treatment in fibromyalgia: A blinded randomized trial” by Bugra Ince and published in National Library of Medicine on Jan 25, 2023. Dayum. That’s hot. Why They Did It To investigate the effectiveness of spinal manipulation in addition to pharmacological treatment in patients with fibromyalgia. How They Did It

A single-center, randomized, and placebo-controlled trial with three parallel arms SETTING: Outpatient clinics at a tertiary health care facility. Female patients aged 18-55 years receiving pharmacological treatment.
Spinal manipulation, sham manipulation, and control groups. Patients in the spinal manipulation group received high-velocity low-amplitude manipulation treatment twice a week for 3 weeks.
Patients in the sham group received an application that was very similar to the active treatment but was not expected to have any real therapeutic effect. Patients in the control group continued to receive pharmacological therapy.

What They Found

Sixty patients with a mean age of 41.7 years (SD = 8.0) were enrolled in the study. A mixed-design repeated analysis of covariance was used to test the data.
At 1 month after randomization, pain scores did not differ between groups. At 3 months after randomization, the spinal manipulation group had a significantly lower pain score (adjusted mean = 4.3 cm, SE: 0.4) than the control group (adjusted mean = 6.8 cm, SE: 0.4) and the sham manipulation group (adjusted mean = 5.7 cm, SE: 0.4).
PPT did not differ between groups at any time point. FIQR, WPI, and FSS showed some improvement 1 or 3 months after randomization in favor of the spinal manipulation group.

Wrap It Up Spinal manipulation used in addition to pharmacological treatment in young/middle-aged female patients with fibromyalgia could be an effective treatment for pain, disease severity, and functionality. 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, “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. Hot potato! 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 SMT sessions results in a grade ≥ 3 (severe) AE.
A secondary objective was to examine independent predictors of grade ≥ 3 AEs.

How They Did It Data originated from 30 affiliated chiropractic clinics with 38 chiropractors (New York Chiropractic & Physiotherapy Center, EC Healthcare, Hong Kong). These clinics are integrated into a larger healthcare organization, including several medical specialties and imaging and laboratory testing centers that utilize a shared medical records system.

What They Found The authors had 85% agreement of independent AE grades, with six of 39 cases having discrepant scores. All discrepant scores were either graded “1” or “2” and ultimately were resolved via mutual discussion.

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. Further research on this topic is needed, possibly via a practice-based research network which could increase the sample size and allow for such analysis.

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

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

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

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Tweets by Chiro_Forward

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

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

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https://player.fm/series/2291021

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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 (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

Chu, E. C. P., Lin, L. W., Lee, Y. C., & Lin, J. C. (2023). A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy. Scientific Reports, 13(1), 2484. doi: 10.1038/s41598-022-10584-0

Early Diagnosis Of Spondylolysis and Clinical Guides For Low Back Pain

January 30, 2023 chiropracticforward 00:19:16 0 Comments

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #264 Now if you missed last week’s episode, we talked about spinal surgery for low back pain & white rice and your heart. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

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

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

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

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

Item #1

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

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

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

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

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

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

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

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

I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2

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

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

How They Did It

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

What They Found

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

Wrap It Up

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

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

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

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

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

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

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

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #252 Now if you missed last week’s episode , we talked about Communicating Imaging Findings & Acupuncture For Acute Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

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

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

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

Item #1

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

Why They Did It

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

How They Did It

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

What They Found

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

Wrap It Up

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

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

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

Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products

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

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

Item #2

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

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

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

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

Store

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

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

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

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

Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity

September 15, 2022 chiropracticforward 00:16:20 0 Comments

CF 246: Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity Today we’re going to talk about Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity 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. 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 #246 Now if you missed last week’s episode , we talked about Upregulated Central Nervous System & Shared Decision Making With The Patient. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Back to school has us down in numbers as it dies every year but we are in the rebound already So, I’ve got a few things working as far as marketing goes but let’s talk about something; have you ever hired a full time clinic rep or marketing rep? Someone that has the full time job of promoting your clinic. I have not done this but I was having a conversation about it with a colleague last week.

My friend expressed how $80k per year was just not realistic for a chiropractor. My friend has four clinics in a metroplex so I got to thinking……is it unrealistic? If so, how unrealistic is it exactly? So I started crunching numbers. Let me share my thoughts. First, I’ve always thought that I’d spend $100k to make $150-$200k/ year. Why wouldn’t you? That’s a $50k raise in pay and you can do a lot with $50k. Keeping that in mind, I went to tracking some numbers. First, what’s my case value? What is one patient worth to our practice? $500? $600? $1500? To work this out, you must know this number. Once you have the rep’s salary, we’ll say it’s $80k/year, then you alright, let’s divide the salary by our per patient case value. For easy math let’s take $80k salary divided by let’s say $800 for the case value. That equals 100 patients. So it will take 100 new patients over the course of a year to pay for that rep.

Everything over 100 patients is gravy.

If you were paying a rep that much, would t you expect at least 10 new patients per month from their efforts? If they truly know what they’re doing, I think that’s super conservative. So 10 new patients per month times 12 months in a year is 120 new patients. So 20 are gravy. 20 gravy patients times out case value of $800 is and extra $16,000 that year. But do you think a professional rep that is marketing your clinic all day every day is only going to bring in 10 new patients per month? And is you case value sitting at $800? Your case value may be $1500.

That would be a no brainer then wouldn’t it? Then you’d pay that salary in 53 new patients and at 10 new ones per month,120 let’s year minus 53 = 67 gravy patients and 67 c a case value of $1500 means an extra $100,500 that year, But again, a rep worth anything will be bringing in a lot more than 10 new patients per month. So, think about it. Is a rep out of bounds? I don’t know depends on the salary and the case value but I’d definitely pull a Stu McGill and say……It Depends. If you have experience hiring a rep, I’d love to hear your thoughts. Please email me at Dr.williams@chiropracticfirwars.com so I can get a better idea of how all of it works.

Item #1

First one is called “Risk Factors Associated with Healthcare Utilization for Spine Pain” by Higgins, et al. (Diana M Higgins 2022) He’s a PhD. There are seeveral PhDs on this paper, I see a coupl dof MDs and one DC. It was published in Pain Medicine in August 2022. Shaaaazzzaaam! Hot.

Why They Did It

This study examined potential risk factors associated with healthcare utilization among patients with neck and back pain.

How They Did It

A two-stage sampling approach examined spine pain episodes of care among veterans with a yearly outpatient visit for six consecutive years.

What They Found

Among 331,908 veterans without spine pain episodes of care during the 2-year baseline observation period, 16.5% had a new episode of care during the following 2-year observation period.
Of those 54,852 veterans, 37,025 had an outpatient visit data during the final 2-year follow-up period, with 53.7% evidencing continued spine pain care.
Those with continued care were more likely to be overweight or obese, non-smokers, Army veterans, have higher education, and had higher rates of diagnoses of all medical and mental health conditions examined at baseline.
Among several important findings, women had 13% lower odds of continued care during the final 2-year observation period.

Wrap It Up

A number of important demographics and clinical considerations were associated with increased likelihood of seeking new and continued episodes of care for spine pain Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

The last one today is called, “Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain: A Randomized Clinical Trial” by Bagg, et. al. (Bagg MK 2022) and published in JAMA on the 2nd of August, 2022. Schiizaa, sizzlin’

Why They Did It

The effects of altered neural processing, defined as altering neural networks responsible for perceptions of pain and function, on chronic pain remains unclear..
The authors wanted to estimate the effect of a graded sensorimotor retraining intervention (RESOLVE) on pain intensity in people with chronic low back pain.

How They Did It

Randomized clinical trial recruited participants with chronic nonspecific low back pain from primary care and community settings.
276 adults were randomized to the intervention or sham
Took place in Sydney, Australia.
December 10, 2015 to July 25, 2019.
Follow-up was completed on February 3, 2020.
Participants randomized to the intervention group (n = 138) were asked to participate in 12 weekly clinical sessions and home training designed to educate them about and assist them with movement and physical activity while experiencing lower back pain.
Participants randomized to the control group (n = 138) were asked to participate in 12 weekly clinical sessions and home training that required similar time as the intervention but did not focus on education, movement, and physical activity.
The control group included sham laser and shortwave diathermy applied to the back and sham noninvasive brain stimulation.
The primary outcome was pain intensity at 18 weeks, measured on an 11-point numerical rating scale to 10 for which the between-group minimum clinically important difference is 1.0 point.

What They Found

A graded sensorimotor retraining intervention, compared with a sham procedure and attention control, resulted in a statistically significant improvement in pain intensity at 18 weeks (estimated mean difference, 1.0 point on an 11-point numeric rating scale

Wrap It Up

In this randomized clinical trial conducted at a single center among patients with chronic low back pain, graded sensorimotor retraining, compared with a sham procedure and attention control, significantly improved pain intensity at 18 weeks. 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

Bagg MK, W. B., Cashin AG (2022). “Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain: A Randomized Clinical Trial.” JAMA 328(5): 430-439.

Diana M Higgins, P., Ling Han, MD, PhD, Robert D Kerns, PhD, Mary A Driscoll, PhD, Alicia A Heapy, PhD, Melissa Skanderson, MSW, Anthony J Lisi, DC, Kristin M Mattocks, PhD, Cynthia Brandt, MD, MPH, Sally G Haskell, MD, MS, (2022). “Risk Factors Associated with Healthcare Utilization for Spine Pain.” Pain Med 23(8): 1423-1433.

Change Your Mind About Pain

July 28, 2022 chiropracticforward 00:16:53 0 Comments

CF 239: Change Your Mind About Pain Today we’re going to talk about changing your mind when it comes to pain and how looking at it differently can help our patients get in control of it. 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 #239 Now if you missed last week’s episode , we talked about Benzopdiazapines and Mirror Therapy. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Folks, not a lot going on right now in practice. It seems like I’m just in a holding pattern of sorts at the moment. You’ve probably heard me mention that we’ve been slower lately. For whatever reason. That’s true. I’m not sure why. The economy, gas prices, who knows?

This week though, sitting here on a Monday morning, and counting, I have 162 patients set up for the week and we know more will jump in as the week progresses. That’s 17 new patients set up so far this week as well. That will usually bump up to about 23-25 if I’m guessing. Whack-a-mole people. So, now that numbers are back on the rise, another hole will appear in the bucket. Another mole will pop up and have to be whacked on the noggin with my oversize sledgehammer.

So what’s it going to be?

Patients failing to stay on their schedules because we didn’t have the time available to educate them about the schedule? Not chasing A/R with any real intention? Where’s it going to be? Who knows? It’s always a great mystery but, as one thing improves, the pipes start busting elsewhere.

You better believe I have my eyes out too. At the ChiroTexpo event in Frisco a few weeks ago, I met a vendor that does billing, chases A/R, and things of that nature. They’re spending this week auditing our EHR billing records to make sure we’re up to speed and on target. I’m paying particular attention to the report of findings. I don’t do anything elaborate but when I get in a hurry, I tend to simply gloss right over it and keep scooting.

Not this time. Being in the Florida Mastermind has helped me slow down and give it the importance it deserves. And patient care will not take a step back regardless so….. We’ll see where the next a-hole mole comes popping up but believe me, I’m waiting and ready with binoculars!! Alright, let’s dive in

Item #1

Our first one this week is called, “A clinical perspective on a pain neuroscience education approach to manual therapy” by Louw et. al. (Adriaan Louw 2017)and published in the Journal of Manual and Manipulative Therapy on May 22, 2017 It’s 5 years old but I included it because it’s relevant to a lot of what I teach and talk about here on the podcast.

Before we get into these two papers today, I want you to understand that I don’t for a second discount the biomedical aspect of pain and I fully believe hands-on chiropractors are in an amazing spot and well-placed to handle the biopsychosocial pain model. But only if we understand it and know how to leverage our tools in our favor. Otherwise, we make it worse.

Why They Did It

In recent years, there has been an increased interest in pain neuroscience education (PNE) in physical therapy. There is growing evidence for the efficacy of PNE to decrease pain, disability, fear-avoidance, pain catastrophization, limited movement, and health care utilization in people struggling with pain. So what is PNE? PNE teaches people in pain more about the biology and physiology of their pain experience including processes such as central sensitization, peripheral sensitization, allodynia, inhibition, facilitation, neuroplasticity and more.

PNE’s neurobiological model often finds itself at odds with traditional biomedical models used in physical therapy. Traditional biomedical models, focusing on anatomy, pathoanatomy, and biomechanics have been shown to have limited efficacy in helping people understand their pain, especially chronic pain, and may in fact even increase a person’s pain experience by increasing fear-avoidance and pain catastrophization. Trust me, from the stories I get from my patients, the traditional bio-medical model doesn’t just cause catastrophization, it causes downright fear and terror in some patients. An area of physical therapy where the biomedical model is used a lot is manual therapy. I would add chiropractic to the discussion here as well.

This contrast between PNE and manual therapy has seemingly polarized followers from each approach to see PNE as a ‘hands-off’ approach even having clinicians categorize patients as either in need of receiving PNE (with no hands-on), or hands-on with no PNE. In this paper, the authors explored the notion of PNE and manual therapy co-existing.

PNE research has shown to have immediate effects of various clinical signs and symptoms associated with central sensitization. Using a model of sensitization, they argue that PNE can be used in a manual therapy model, especially treating someone where the nervous system has become increasingly hypervigilant. You guys and gals….if you have chronic pain patients, you have to start listening and paying attention to central sensitization, upregulated central nervous systems, cognitive behavioral therapy, mindfulness, yellow flags, fear avoidance, catastrophization, oh my.

Seriously, if these terms are unfamiliar to you, please do yourself and your patients a favor and go get the smarts. You can start the smarts right here in our podcast episodes. I talk about this stuff non-stop and have been for years here so dive in.

It’s not one thing over the other. Either….or. It’s a broad management protocol that includes PNE, SMT, exercise, massage, yoga, tai chi, low level laser, and some other stuff all piled on top. Oh, and a good provider that communicates in a hopeful and encouraging manner. Put the puzzle together. Start by getting the smarts. And quit being confusion as the kids would say. Do research about it. Lol.

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

Item #2

The second one is called “Changes in psychosocial well-being after mindfulness-based stress reduction: a prospective cohort study” by Hill et. al. (Renee J. Hill 2017) and also published in The Journal of Manual and Manipulative Therapy on May 4, 2017. Again, yes, old man river here as far as research goes but relevant

Why They Did It

The primary purpose of the current study was to assess the effects of a mindfulness-based stress reduction (MBSR) program, facilitated by non-psychologist clinicians, for improving psychosocial well-being. A secondary purpose of the current study was to explore the role of self-compassion as a potential underlying factor for improvements in emotional distress.

How They Did It

130 participants with a variety of medical complaints completed an eight-week mindfulness-based stress reduction program at Vanderbilt.
Before treatment and at the 8-week time point, participants completed measures for emotional distress, stress, mindfulness, and self-compassion.
Linear model estimation using ordinary least squares was used to evaluate the association between changes in self-compassion with changes in emotional distress.
I’m not going to lie….I’m ignorant of that last part. Made be feel stupid. Which, of course, isn’t hard to do.

What They Found

Following mindfulness-based stress reduction, participants reported significant reductions in emotional distress.
Additionally, participants reported improvements in mindfulness and self-compassion.
Linear regression model revealed that changes in self-compassion were significantly associated with changes in emotional distress.

Start getting the smarts. Research at least once per day.

Alright, that’s it.

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

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

The Message

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

Key Point:

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

Contact

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

Connect

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

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About the Author & Host

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

Bibliography

Adriaan Louw, J. N. E. J. P. (2017). “A clinical perspective on a pain neuroscience education approach to manual therapy.” Journal of Manual & Manipulative Therapy 25(3): 160-168.

Renee J. Hill, L. C. M., Li Wang & Rogelio A. Coronado, (2017). “Changes in psychosocial well-being after mindfulness-based stress reduction: a prospective cohort study.” Journal of Manual & Manipulative Therapy 25(3): 128-136.

The Complexity & Treatment of Chronic Pain

April 14, 2022 chiropracticforward 00:17:23 0 Comments

CF 224: The Complexity & Treatment of Chronic Pain Today we’re going to talk about manual therapy for chronic pain the complexities within. 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 a round. 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 #224 Now if you missed last week’s episode , we talked about Kids’ Mental Status & Zero Calorie Drinks. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Still no real results on trying out the lead generation marketing that I’ve spoken about recently. We’ve tweaked it and will continue seeing if we can make a go of it. Polls have shown it and I forget. Every now and then I recall; people aren’t nearly as interested in wellness and talk about maintenance or preventative. They want RELIEF from pain points.

As chiropractors, we want them to care about wellness and maintenance, and prevention. But they don’t. Pain is a hell of a motivator. In fact, it’s unmatched as the main motivator. Does that mean there aren’t amazing wellness clinics? Of course not. There are but they’re more the unicorn than the run-of-the-mill horse trotting around.

Also, more recently, I have a new competitor in town that is copying everything I am doing. Copying my providers and copying my services. But, severely discounting everything. To the point of embarrassment. The Joint is one thing. They serve a specific gap. ‘I feel great. No issues. Just wanna be popped.” They serve that demographic and I can make sense of their discounted rate. They aren’t solving problems there. But this place that’s copying me now, they are solving problems. Or at least trying to. And charging $29 for that first visit with the exam and all of the rigamarole. That’s rubbish, garbage, clown stuff right there.

I hope the type of chiropractor that listens to this podcast knows better than that. Knows what that does to our industry. Have you noticed that when a chiropractor owns the clinic, charges are pretty appropriate? When someone that is not a chiro owns it, services are devalued to an embarrassing point. Either that or the chiro is desperate. All of it equals devaluing what we do. It’s poor form.

My least expensive adjustment is $45 US American Greenback Benjamins. It took me some years to start valuing my service. Now, thanks to research and guidelines and colleagues and mentors, I understand the value, the time, the education, the work, the responsibility, and the effort.

Hell with anyone that wants to sell an exam, x-rays, report of findings, and adjustment for $29. That’s the way I see it. Pick up your game and be better. as well.

You’ll be hearing more about it in upcoming episodes. We all know that the number one type of case that we want is a personal injury case.

Remember, I just said pain is the motivator and if you don’t know why personal injury patients are so valuable, you haven’t been paying attention. They are gold because the clients are more compliant, and we get paid at rates far above insurance or Medicare or Medicaid. The patient’s attorney tells them to go for treatment because it enhances their legal case and gets them more money.

But we know that if they aren’t moving from the start, recovery from pain and getting back to normal might not happen at all. We can help these patients so much and medical practices in most markets are turning them away now. The problem is, how do we get PI cases? Attorneys don’t generally respond to your invitation for lunch. And let’s face it, they’re a tough bunch. I have the answer.

An attorney I recently connected with has put together a system, that is both in written and video form, that shares how to approach attorneys and get them to send their PI clients to you. I checked it out personally and I like it. Attorney Paul Samakow is an attorney teaching how to speak to attorneys. His system costs $997 and he guarantees satisfaction or your money back. You have to check this out. Even if you only get one case, you’ve made at least 4 or 5 times the investment. Just one of my PI cases averages $3000-$3500 for example. It’s a win-win.

Go to gettingpicases.com/cs ‘C’ as in cat and ’S’ as in sweet.

That’s gettingpicases.com/cs

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

Alright, let’s get on with the research, shall we?

Item #1

This one is called “Manual physical therapy for chronic pain: the complex whole is greater than the sum of its parts” by Coronado et. al. (Rogelio A. Coronado & Joel E. Bialosky 2017)and published in the Journal of Manual and Manipulative Therapy in June 12 of 2017 and that is not hot. It’s not in the freezer. But it’s not hot.

Why They Did It

They start by saying that chronic pain affects nearly one-third of the American population. That’s pretty stout, yeah? And sitting here 5 years later, we know that it’s only gotten worse. Then they pop out with something fairly powerful. They say, “For manual physical therapists to play a key role in the management of individuals with chronic pain conditions, simply being a safer option is not good enough. Instead, we must practice in an effective manner as well. Manual physical therapists can effectively treat patients with chronic pain and other musculoskeletal disorders; however, the field is at a crossroads.

The traditional approach to manual therapy assumes that proper technique selection and precise implementation is the primary driver of a successful outcome [10,11]. In this view, the resultant outcomes are directly attributed to the applied intervention. A similar perspective on intervention may be witnessed in traditional medicine when, for example, a pharmaceutical agent is prescribed to manage cholesterol or blood pressure, or a surgical approach is elected based on abnormal imaging findings. We propose manual physical therapists will only be recognized as ideal providers for individuals with chronic pain if we accept an updated paradigm acknowledging the complexity of the manual physical therapy experience and accept the robustness of varying contextual elements inherent in our interactions. For some clinicians, this will require a revolutionary shift in their perception of the development, maintenance, and modulation of pain [12].

Pain is an experience orchestrated by dynamic sensory, cognitive, and affective processes and is strongly influenced by patient’s expectations, mood, desires, and past experiences. Limiting pain perception to a peripheral impairment is outdated and a more comprehensive, albeit complex, approach to manual therapy accounts for a myriad of interacting factors impacting chronic pain outcomes.”

What did the five fingers say to the face? Slap!!

That was like Will Smith Rocking Chris Rock…..

“Maladaptive neuroplastic changes are evident in patients presenting with chronic pain conditions, suggesting intriguing targets for effective treatments. “Pain sensitivity can serve as a proxy measure for central sensitization – a phenomenon that may impact prognosis and treatment response – and perhaps provide a more effective therapeutic target for treating patients with chronic pain” How many times have you heard me talk about upregulation and pain sensitization?? This is it, right here. Patients with chronic musculoskeletal pain often report co-existing psychosocial complaints known to worsen their prognosis and limit the effectiveness of interventions.

Manual therapists are in need of clinical strategies to minimize the influence of negative psychosocial factors and boost positive thinking and outlook. Just a diagnosis with zero treatment has been shown to be helpful. How many times have you heard that words matter?? With our words alone, we can push someone into chronic pain or bring them more toward the surface.

“Manual therapy is often a component of a comprehensive treatment package and multiple interventions may interact to influence clinical response.” – exactly – a broad management approach and not one single intervention solve the puzzle. “Patient education is an important component of a manual physical therapy interaction and the manner and content of education, specifically related to pain, can greatly influence treatment effectiveness. “ – If you’re not properly educating and explaining without the catastrophization and doctor dependency garbage we see in our profession, then you’re missing the boat and doing more damage than good. “Manual physical therapists should recognize the multidimensional nature of chronic pain as well as the complex interactions of contributing factors accounting for manual therapy-related treatment effects.

Continuing to attribute an effective manual physical therapy intervention to the correction of a peripheral impairment is too simplistic and prevents conscious attempts to augment contributing factors known to enhance outcomes in patients with chronic pain. While perhaps a safer avenue than opioids, we believe the continuation of an outdated approach to manual physical therapy will result in suboptimal provision of care.” While this is geared to PTs it’s speaking to us chiros equally and we better pay attention because, in my learning and in my experience, it’s hitting every nail right on the head.

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

Rogelio A. Coronado & Joel E. Bialosky (2017). “Manual physical therapy for chronic pain: the complex whole is greater than the sum of its parts.” J Man Manip Ther 25(3): 115-117.

The Importance of Movement & Steps

March 24, 2022 chiropracticforward 0:11:40 0 Comments

CF 221: The Importance of Movement & Steps Today we’re going to talk about The Importance of Movement & Steps 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 #221 Now if you missed last week’s episode, we talked about Sleep, Energy, and Pain & Depression and Rehab. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Business is still slowly creeping back up to where we’d like to see it. Now if the employee aspect of it will follow. So, I told you all we’d been a month since the 7-week front desk staffer we had quit. So we’ve been hiring for a damn month. We found one but she needed to give her two-week notice. So we’ve been waiting on her to start. So the Thursday before the Monday she’s supposed to start, she calls to let us know that she took another job. Holy guaca freakin moly.

Ya can’t make this stuff up. So we get in the horn….two weeks after we closed out the hiring process and started calling some of the old resumes.

Luckily, our #2 answered and still wanted the job and she can start on Monday. The day the loser was supposed to start anyway.

Hallelujah crap fire, save the queen, the new Batman is too damn emo and God bless America.

I’ll let you know if she lasts more than 7 weeks. I don’t have high hopes by this point in time. As the great Texas singer/songwriter Ray Wylie Hubbard once said, let’s rock n roll and hootchie coo. Here we go

Item #1

This one is called “Estimated Number of Deaths Prevented Through Increased Physical Activity Among US Adults” by Saint-Maruice et. al. ( Saint-Maurice PF 2022) and published in Jama Internal Medicine on January 24, 2022……schiza!! It’s muy Caliente on my plate. That’s three languages right there people.

Why They Did It

Previous studies suggest that a substantial number of deaths could be prevented annually by increasing population levels of physical activity. But they say previous attempts at quantifying it have been lackluster. They accelerometer measurements

to examine the association of physical activity and mortality in the US
to estimate the number of deaths prevented annually with modest increases in moderate-to-vigorous physical activity (MVPA).

How They Did It

It doesn’t matter. Lol. Well, technically, of course, it matters. But, you’re not going to want to hear it. Sometimes, it’s like sausage. You really don’t want to see how it’s made. You just want to enjoy the results so….let’s just enjoy the results so y’all don’t tune out on me.

Wrap It Up In this cohort study, we estimated that approximately 110,000 deaths per year could be prevented if US adults aged 40 to 85 years or older increased their moderate-to-vigorous physical activity by a small amount (ie, 10 minutes per day).

Item #2 Our last one this week is called, “Steps per Day and All-Cause Mortality in Middle-aged Adults in the Coronary Artery Risk Development in Young Adults Study” by Paluch et. al. and published in JAMA Network Open on September 3, 2021.

Why They Did It

To estimate the association of steps per day with premature (age 41-65 years) all-cause mortality among Black and White men and women.

How They Did It

It was a prospective cohort study.
Participants were aged 38 to 50 years and wore an accelerometer from 2005 to 2006.
Participants were followed for a mean of 10.8 years.
Daily steps volume, classified as

low (<7000 steps/d),
moderate (7000-9999 steps/d), and
high (≥10 000 steps/d) and

Stepping intensity classified as

peak 30-minute stepping rate and
time spent at 100 steps/min or more.

All-cause mortality was the outcome measure.
A total of 2110 participants from the CARDIA study were included,

Wrap It Up

This cohort study found that among men and women in middle adulthood, participants who took approximately 7000 steps/d or more experienced lower mortality rates compared with participants taking fewer than 7000 steps/d. There was no association of step intensity with mortality. So get moving rock n roll and hootchie coo. Like you know you’re supposed to do. 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

Home

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TuneIn

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

About the Author & Host

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

Bibliography

Cholewicki J, P. J., Reeves NP, DeStefano L, (2021). “The Effects of Osteopathic Manipulative Treatment on Pain and Disability in Patients with Chronic Neck Pain: A Single-Blinded Randomized Controlled Trial.” PM R.

Saint-Maurice PF, G. B., Troiano RP (2022). “Estimated Number of Deaths Prevented Through Increased Physical Activity Among US Adults.” JAMA Intern Med 182(3): 349-352.

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).

w/ Dr. Brett Winchester: Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be

August 5, 2021 chiropracticforward 00:59:18 0 Comments

CF 189: w/ Dr. Brett Winchester: Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be

Today we’re going to be joined by the illustrious potentate himself, Dr. Brett Winchester. You all are in for a real treat today folks. They say that the US Marines are the tip of the spear, well, when it comes to our profession, he’s just that. If you don’t get something out of this interview, you’re just not paying attention, my friends. Get ready for the waterfall of knowledge nuggets heading your way. 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 practitioner as well as patient. You have to check it out. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
Then go Like our Facebook page,
Join our private Facebook group and interact, and then
go review our podcast on iTunes and other podcast platforms.
We also have an evidence-based brochure and poster store at chiropracticforward.com
While you’re there, join our weekly email newsletter.

You have found yourself smack dab in the middle of Episode #189 Now if you missed last week’s episode , we talked with Dr. Rob Pape of the Quadrant Analysis procedure as well as Practice Mechanics. Excellent discussion and plenty of nuggets dished out on that episode. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Trucking along with the medical integration. Nothing worth doing is easy. If it were easy, we’d all be in the middle of it. But I do think that once it’s up and running, we’re going to be doing great and getting patients well. And….maybe even free up a little of my time as well. It’s a big time for me. Setting up relationships with medical supplies companies, with pharmacies, figuring out how our NP orders scripts through the EHR, and figuring out stuff that just has never been a part of my life. It’s interesting. All the while getting contracts signed and getting new accounts set up that I share with the medical director and getting cabinets put in the room to store the things I never needed stored.

I bought a damn autoclave and then bought a damn centrifuge, y’all. Seriously, it’s all new to me but I’m getting there. My biggest concern is that everything is ready to roll on day one perfectly. Which means I’ve set myself up for failure. That’s because we’re definitely going to forget something. It’s just going to happen. No doubt about it. There are so many moving parts and different supplies to get that there is literally zero chance of having it all on Day One.

But it’ll all unfold.

How’s practice going for you folks? Send me an email. I want to know how you’re all doing. I’m still hovering around about 160 or so appointments per week. That’s not much for the straights but for an evidence-based dude with therapies, exercises, and things like that, it’s quite a bit.

The joke of a chiropractor up in Oklahoma that sees like 100 patients in three hours including 9 new patients….160 wouldn’t mean much for that doctor….and I use the term loosely when I say doctor…. It takes longer than that when done properly and responsibly though, doesn’t it. Listeners of this show know that. You’re smart. You get it. We’re not where we were pre-COVID and I’m afraid the Delta-Vid has some folks scared again and staying at the casa. I don’t blame them.

Who knows if we ever totally get the VID under control but either way, it’ll become a way of life, we’ll adapt, and things will stabilize eventually. One way or another. That’s enough about me, Delta VID, and the personal happenings. Our guest is too good to waste time. Let’s get to our amazing sponsor first.

CHIROUP ADVERTISEMENT

Dr. Brett Winchester lectures throughout the world, teaching his functional approach to patient care. Combining manual therapy, including joint manipulation and neuromuscular stabilization, with therapeutic exercise, Dr. Winchester effectively treats functional pathologies and acts as a catalyst for patients working to enhance their performance. Dr. Winchester is the founder of Winchester Spine & Sport located outside St. Louis, Missouri. His current appointments include:

Advanced biomechanics course instructor at Logan College of Chiropractic
Technique instructor at Logan College of Chiropractic
Biomechanics instructor at Maryville University
Instructor and board member for the Motion Palpation Institute
Chiropractic Rehabilitation Diplomate instructor
Dynamic Neuromuscular Stabilization instructor trained by Pavel Kolar
Mechanical Diagnosis and Therapy (MDT) certified
Gestalt Performance (owner)

Dr. Winchester’s published research includes topics such as offering a multidisciplinary approach for treatment of the pregnant population and foot dysfunction.

Various chiropractic journals have also featured Dr. Winchester for his patient-driven treatment model. He also has authored two chapters for textbooks. Dr. Winchester enjoys treating professional and collegiate athletes and has gained a reputation for his sports medicine background. His expertise has placed him at the forefront of the ulnar collateral ligament rupture epidemic in professional baseball pitchers, providing insights into causation and effective treatment protocols. + Dr. Winchester served as the chiropractor for the St. Louis Cardinals from 2014-2018 and still consults with various Major League Baseball teams.

Still, his passion remains with diagnosing and treating the ailments of a diverse patient population with conservative-based protocols.

Welcome to the show Dr. Winchester! It’s great to have you with us on the podcast. Thank you for joining us.

Just briefly before we get into the meat and taters here, tell me a little about your family Everyone has the chiropractic story. Of all of the professions in the world, why are you a chiropractor?

People say they don’t know how I get all of the things done in the day that I do, reading through your bio, I can say the same about you. What does a regular day or week look like for you?

Where did you make the break from traditional philosophy-based chiropractic teaching and move firmly and confidently into the evidence, the research side of our profession?

What’s the future of chiro look like?

Why is being good at manipulation so important?

We both exist on the evidence-based spectrum of this profession.

What is your response if the more philosophy, vitalistic-based side of the profession says we are medi-practors and that practitioners like us don’t value the adjustment?

Why do people suck at joint play?

What makes for great adjusting?

What does a multi-modal approach mean?

What is it truly like to work with a professional sports team like St. Louis Cardinals? Is it worth it? Or is it just too much?

With your involvement in Motion Palpation Institute, MDT, the rehab diplomate and all of the rest, for the docs out there looking to take the next step toward being the best, what do you think made the largest leap forward for you in terms of knowledge that led to significant positive results in your patients?

What would the colleagues that are close to you say is your best attribute?

And the worst?

Tell everyone about the Gestalt Podcast, where does the name come from, and why they need to tune in?

I think that about wraps up for this episode. Tell me you’ll come back sometime.

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

chiropractic forward podcast

Safety of SMT in the Cervical Spine & Chiropractors’ Beliefs Around the Need for X-rays

SMT And Fibromyalgia & SMT And Adverse Events

CF 273: SMT And Fibromyalgia & SMT And Adverse Events

Today we’re going to talk about SMT And Fibromyalgia & SMT And Adverse Events

But first, here’s that sweet sweet bumper music

Early Diagnosis Of Spondylolysis and Clinical Guides For Low Back Pain

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

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

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

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

Healthcare Utilization for Spine Pain & Sensorimotor Retraining on Pain Intensity

Change Your Mind About Pain

The Complexity & Treatment of Chronic Pain

The Importance of Movement & Steps

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

w/ Dr. Brett Winchester: Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be

CF 189: w/ Dr. Brett Winchester: Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be

CONTACT

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