Over Manipulation Syndrome

November 22, 2023 chiropracticforward 0:29:34 0 Comments

CF 305: Over Manipulation Syndrome

Today we’re going to talk about Over Manipulation Syndrome 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 chiropracticforward.com

You have found yourself smack dab in the middle of Episode #305 Now if you missed last week’s episode , we talked about Interesting Thoughts On Low Back & Degenerative Cervical Myelopathy. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. I skipped last week because I was at the MCM Mastermind. Dr. Kevin Chritstie’s group that I’m a part of. We met in Orlando. What a great trip. The kids went with us and I did the Mastermind meeting and then had a day and a half to hit Disney and hit it we did. We killed ourselves trying to see everything. While that’s impossible, we did see a lot and had a great time. The Harry Potter stuff at Universal is legit folks. Crazy. The Star Wars stuff at Hollywood Studios is incredible. And the Avatar stuff at Animal Kingdom is cool as hell. I’m just saying. I’ll add that we went about 10 years ago and I hated it. I hated all of it. This time, for whatever reason, was better. I didn’t absolutely hate it. I actually enjoyed most of it. Maybe because the kids are older and don’t have to be watched. Maybe I just knew more about what to expect. I’m not sure. But it was a good time had. On the Mastermind…..I got some good tidbits and nuggets out of it and had a great time reconnecting with my tribe. These are my people and I can’t tell you how much we enjoy each other. We learn as much from each other at the bar or eating together than we learn from our speakers. Our Mastermind is full but Dr. Christie started another Mastermind that has openings. If you are at all interested, I cna’t encouurage you enough to email Dr. Christie at drkchristie@gmail.com and see if you can sneak into his new group. Next year they’ll be meeting in San Diego, Denver, Phoenix, and Jackson Hole, Wyoming. All great places to hang out, learn, and network. Alright, Happy Thanksgiving. Let’s hop into the research. Item #1 This isn’t really a research paper we’re going to cover here. This is more a conglomeration to demonstrate something I’ve gotten a lot of push back on in private conversations with other chiropractors over the years. Let me start by saying that I Donn’t want to take money out of Chiros’ pockets. The evidence based folks should be mostly fine with what I’m going to talk about today because they’re not doing crazy stuff. The more non-evidence based folks aren’t going to like this discussion at all. All I can say is that when someone making the right decision affects their financial status, well, you just never know what you’re going to get. First thing….I’m not about to advocate not adjusting your patients. The adjustment is the cornerstone of my practice for more than 25 years. What we’re going to talk about, over manipulation syndrome or spinal instability, was never for any reason in any shape, form, or fashion on my radar screen before getting the Neuromusculoskeletal medicine diplomate and diving into ChiroUp. Let’s start with a personal story. I went to the chiropractor first when I was hurt as a freshman in high school. I was hurt badly and nobody else helped me. After months of pain, my mom took me to the local chiro and in two weeks you’d never know I was hurt. That’s why I ended up becoming a chiropractor in the first place. While that experience was life changing, it also led to my buddy and I being all cool and popping our own necks all of the time. It was hard to do at first. I really had to use both hands and really crank on it to get that pop noise we all covet so much. But then, after some time of constantly self-adjusting my neck, it got easier. And easier, and easier. To the point that I could just turn my neck and it would pop incidentally for no reason at all. And if I didn’t pop it, it would get irritated and feel like it needed to pop all of the time. I had created instability by self-adjusting all of the time. Our spine wants to be stiff and solid without that extra movement. But I had created extra movement consistently enough that I had loosened all of those tiny muscles and connective tissues. As a compensation, because our spine wants stiffness and stability, the larger postural muscles stiffened up to try to make up for all of those tiny ones that went lax and lazy. So, that sets up a neck that is stiff but hypermobile. You can share this with all of your self-adjustors if you like. Anyway, that brings up two thoughts:

When you have an older person, discs degenerate, connective tissue gets loosened through manual labor, people have had injuries, or something issues like Elhers Danlos have started to aggravate…..hypermobility starts to take hold
When you have patients that have been going to chiropractors repeatedly over the years, you can create hypermobility where there was none. Like my time self-adjusting. I’m not talking about responsible and appropriate adjusting like you do with a limited, condition focused treatment plan. I’m talking about, “I need to see you once a week for the rest of your life to treat your immune system and help you avoid cancer.” Or, I need to see you 76 times and 10 sets of x-rays this year to make sure you have the right, perfect degree curvature in your neck. As common sense would dictate, this is probably going to be more common with more aggressive adjusters.

I’ll tell you that I’m out on the cliff a bit on this topic if I’m being honest. When you go searching, you’ll find Over Manipulation Syndrome. But, it’s not a huge topic with 100’s of articles. One of them is at hur911injurycenters.com, probably not a chiro friendly page if I’m just guessing. They say, “Over-manipulation syndrome can be caused through self-manipulation as well as through high-velocity adjustments from a chiropractor. If you or a chiropractor have over-manipulated a joint through high-velocity treatments, you might experience damage to the ligament structures. This damage can lead to joint instability and worsening of hypermobility.” One I found is by Dr. Mark Saracino, a Board Certified Chiropractic Neurologist from Pennsylvania. I will put the link to his thoughts in the show notes for you. Dr. Saracino starts out with a funny/not so funny joke, ““How many Chiropractors does it take to change a light bulb?” Answer: “Just one, but it takes 56 visits!” https://drsaracino.com/PDFs/INFO/TooManyChiropracticVisits.pdf He says, “To my knowledge, no studies have shown that manipulations, once a month or more, are harmful. Just as dependencies on unnecessary drugs and surgeries should be avoided, patients should not become dependent on frequent manipulations- no more than 6 per year to the same spinal bone. Spinal manipulation is an important, but small part of a chiropractic neurologist’s treatment capabilities. It should be employed as infrequently as possible.” I want to go on record here and disagree with him on that point. If he thinks that 6 adjustments with exercises are going to get some of the veterans I see from the VA out of pain after suffering for 40 years…..well, trust me…..6 adjustments Ain’t gettin it done. He’s got a bias. He’s being a proponent of all of the magic outside of an adjustment that a chiropractic neurologist can perform. So I just disagree on that one point. But I do agree with the point of avoiding unnecessary consistent and frequent adjustments. To further clarify, there are some suffering from high impact chronic pain, which is chronic pain with an associated disability. They will never be free of pain and seem to only do well seeing a chiropractor every other week or so on a pain management basis. Then, there is a group called Caring Medical in Florida. They also have a bias. They specialize in prolotherapy to tighten lax ligaments. So, it makes sense they’re going to highlight Over Manipulation Syndrome. That doesn’t make them wrong. But I’m being honest as I can be on this. They have a bias and it should be noted. I’ll put the link in the show notes as well. https://www.caringmedical.com/prolotherapy-news/manipulation-syndrome-oms/#:~:text=Over-manipulation syndrome is a,or manipulation by a practitioner. Ross Hauser, MD says from the top of the article, “Over-manipulation syndrome is a condition characterized by chronic pain of the joints or vertebrae from instability due to ligament laxity that is caused by excessive self-manipulation or manipulation by a practitioner.” To keep from pissing everyone off, he says, “In our opinion, a good chiropractic or osteopathic physician is an invaluable asset to a person’s health and care. Many cases of chronic pain, headaches and health ailments can be resolved with manipulation. Yes, overly aggressive spinal manipulation can be the cause of spinal instability, but when done correctly it can cause immediate (or quick) relief of symptoms.” And more to the point I’m making, “We see a large number of hypermobility cases where the patients present with a history of excessive chiropractic manipulations. A short course of manipulation to relieve pain or tension is understandable. However, patients who sign up for long-term chiropractic packages that include thrusting manipulations often find themselves even more unstable after the treatment course. Good chiropractors treat each patient individually and conservatively.” I agree. Reminder – I’m not advocating not adjusting your patients. The adjustment is the cornerstone of my practice for more than 25 years. I’m not advocating only adjusting your patients 6 times per year. What I am advocating AGAINST….is long, extended, ongoing, maybe never ending treatment protocols to try to treat pain. When what you may be actually doing is causing a greater problem called instability and hypermobility by over manipulating and loosening the structures that hold the spine tight. How much is too much? Who the hell knows? Certainly not me. Everyone is different, different ages, different work loads, different injuries throughout the years, different chiropractors over the years, etc. But if all you’re doing is identifying ‘subluxations’ and knocking down the high spots without also considering instability or hypermobility, then you’re at risk of doing your patients and injustice and potentially making them actually worse. If they already have hypermobility, what good are more adjustments and mobility really going to do for that particular area of their spine? Not much in my opinion. Why not think outside of the box a little and try stabilizing and strengthening the spot instead of mobilizing it? For neck instability, try a contraption called The Iron Neck. It’s great at strengthening the neck in a 360 degree way. It’s outstanding and I’m not sure there is a better strategy out there for neck stability. For low back instability, we use McGill’s Big Three and add Dead Bug which is also ChiroUp’s protocol for L-sp instability. If you don’t know how to look for and test for spinal instability, one of the clues for the low back is that it hurts to roll over in bed. Also, sometimes these people bend over to grab something and get a ‘catch’ or a ‘locked up’ back when trying to stand up from that position. They kind of have to work out of it to finally stand up. With the low back, you can have a patient prone on their stomach. If it hurts when you palpate the l-sp facets, have them do a ‘superman’ position with their legs straight and lifted backward off of the table. If you palpate again while they’re in that position and it feel better, then you are likely looking at a instability patient. When you stabilize that region and palpate it and it feels better, the back is telling you it has too much mobilization and needs stabilization instead. Simple sudden movements can hurt as well. The Space Mountain ride fired up the instability in my neck last week. It jerked me around on the roller coaster when it was dark and I couldn’t brace or see what was in front of me. So there you have it. I’ve had some of the smartest chiros in the evidence-based realm tell me I’m crazy. That chiropractors absolutely cannot create spinal instability. I know that for so many, it’s a completely new thought process but I ask that you seriously give it consideration. How is it that self-adjustors, like I once was, can create instability from adjusting too much but a chiropractor somehow cannot? I’ll also share that I have no bias on this deal. In fact, advocating against constant, frequent, adjusting does me no good whatsoever considering the adjustment is the literal cornerstone of my clinic. I have zero bias. I just follow research, I read, I observe, I talk to others, and I have personal experience and I’m telling you flat out – some patients will do better with strengthening and stabilization because they’re already got too much mobilization and the wrong chiropractor can potentially be the cause of that hypermobilization. Convince me I’m wrong at dr.williams@chiropracticforward.com. I’d love to hear your thoughts on this topic. I think it’s important. 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

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Hip Pain And Corticosteroids & Chronic Pain After Spinal Surgery

November 2, 2023 chiropracticforward 0:19:01 0 Comments

CF 303: Hip Pain And Corticosteroids & Chronic Pain After Spinal Surgery Today we’re going to talk about Hip Pain And Corticosteroids & Chronic Pain After Spinal Surgery But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #303 Now if you missed last week’s episode , we talked about Spinal Manipulative Therapy And Bezodiazepines & Yanking Someone’s Head Off. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Back at it. You remember when I told you last week that I think we’re on a turnaround after having been out sick and then the next week having to spend half a week in Chicago for the Forensics conference? I think the trend is continuing. I’m looking at 46 appointments today. That’s including 3 new patient exams, 2 PI intakes, and 3 re-exams. So it’s going to be a busy one today. I’ll be glad when the day wraps up at 6:00 pm this evening. Thursday is looking a little light but it’s 8:30 on a Monday morning right now. We have plenty of time to fill that day out in the next few days. We had our first cold blast of the year and guess who’s not happy about it? This guy. This guy that love the Summer and green things and birds chirping and shiny happy people out running around and enjoying the warm weather. This guy. In fact, cold weather and Winter basically piss me off a bit if I’m being honest. It’s terrible. Everything goes dormant, the clocks change so it’s dark before I even get off of work, the cold wind and wet rain and ice and snow…..I’m getting triggered just to talk about it honestly. So, the point is, it’s a mental battle for me on some very low level. It’s in the background for sure but it’s a battle for me. I hate it and yet, I have to learn to live with it every year and just get through it. Maybe I’m dramatic about it. Sure. But don’t we have our challenges that work our mental state? We’re all different so I’m sure yours is likely different than mine in lots of cases. Another thing that has been working my mental state is the lack of a good billing company. I tried to have in-house billing for years. I lost almost a million dollars over the course of 3 years because I trusted too much. She didn’t steal. She just didn’t re-submit when denied so once timely filing passes, you’re outta luck. Well, we were outta luck a bunch it seems and by the time I found it, it was pretty far gone. A lot of beer will get you past something like that. They don’t share these things with you when you’re going through school but there are some soul-sucking parts to being a clinic owner. What would it be like to just show up and go to work and go home without the worry and the fret of the HR part….the billing and collecting part? What would that all be like?? I don’t know but I’m moving down the path of finding that out. I’m working on a potential partial buyout in the next 6 months. And ya know what? I’m not even nervous about it. Because the business end of it isn’t my special skill. Not my special talent. It gives me loss of enjoyment. So as I go down that path, I’ll be updating you. It may be something you’ll be interested in as well in the coming years. Especially if you’re 50-something and getting long in the tooth. We shall see. To be continued. Item #1 Our first one this week is called, “Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip” by Okie et. Al. and published in Journal of Bone Joint & Surgery on November 17, 2021. Okike K, King RK, Merchant JC, Toney EA, Lee GY, Yoon HC. Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip. J Bone Joint Surg Am. 2021 Nov 17;103(22):2070-2079. doi: 10.2106/JBJS.20.02155. PMID: 34550909. Why They Did It While recent reports have suggested that hip corticosteroid injections can hasten joint degeneration, there are few published data on the topic. The purpose of the present study was to evaluate for an association between corticosteroid injection and rapidly destructive hip disease (RDHD) and to determine the rate of, and risk factors for, occurrence. How They Did It

This study was conducted in 2 parts. First, to assess for a potential association between hip corticosteroid injection and RDHD, a case-control analysis was performed.
Patients who developed RDHD between 2013 and 2016 served as cases, whereas those who underwent total hip arthroplasty for diagnoses other than RDHD during the same period served as controls, and the exposure of interest was prior intra-articular hip corticosteroid injection.
Second, in a retrospective cohort analysis, we analyzed all patients who received a fluoroscopically guided intra-articular hip corticosteroid injection at our institution from 2013 to 2016.
The rate of post-injection RDHD was determined, and logistic regression was used to identify risk factors for occurrence.

What They Found

In the case-control analysis, hip corticosteroid injection was associated with the development of RDHD.
There was evidence of a dose-response curve, with the risk of RDHD increasing with injection dosage as well as with the number of injections received.
In the retrospective cohort analysis, the rate of post-injection RDHD was 5.4%.
Cases of post-injection RDHD were diagnosed at an average of 5.1 months following injection and were characterized by rapidly progressive joint-space narrowing, osteolysis, and collapse of the femoral head.

Wrap It Up

This study documents an association between hip corticosteroid injection and RDHD.
While the risk of RDHD following a single low-dose (≤40 mg) is low, the risk is higher following high-dose (≥80 mg) injection and multiple injections.
These findings provide information that can be used to counsel patients about the risks associated with this common procedure.
In addition, caution should be taken with intra-articular hip injections utilizing ≥80 mg of corticosteroid and multiple injections.

Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Our last one this week is called, “Prevalence of Chronic Pain After Spinal Surgery: A Systematic Review and Meta-Analysis” by Alshammari et. Al. and published in Cureus on July 13, 2023 and Damnit that’s sizzlin’ hot! Why They Did It Degenerative disc disease and low back pain are common challenges that persist even after a discectomy. However, characterizations and quantifications of these illnesses from the patients’ perspective are insufficient. We aimed to perform a systematic review of the literature and meta-analysis to determine the frequency of chronic pain after spinal surgery. How They Did It

They searched all of the common libraries of research to retrieve articles describing the frequency of persistent back pain, reoccurring disc herniation, and undergoing another operation following primary lumbar discectomy.
They excluded articles that did not disclose the proportion of patients who experienced ongoing back or leg pain for over six months after the operation.
They included 16 studies evaluating 85,643 patients.

What They Found The pooled prevalence of persistent pain was 14.97% Wrap It Up With all advancements in technology and operation techniques, many patients (14.97%) still have failed back surgery syndrome. Appropriate preoperative communication and multidisciplinary and coordinated treatment strategies yielded the best results. I would argue that it’s actually higher than that. In a book that I highly recommend called Back In Control by spinal surgeon Dr. David Hanscum, he cites research showing that when surgery is performed on a patient with chronic pain syndrome, that person is 60% more likely to develop chronic pain at the new site of injury….the site of surgery. That’s when everything goes perfectly. I have a friend that is a neurosurgeon in our market and he regularly tells his patient that spinal surgery is about a 50/50 chance of success or failure. I haven’t asked him for research on that but I’m passing the info along as it was passed to me. Take it or leave it. 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

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Jeff Williams - evidence-based chiropractor

Excessive Generalization Of Fear Avoidance

October 19, 2023 chiropracticforward 0:19:04 0 Comments

CF 301:

Excessive Generalization Of Fear Avoidance

Today we’re going to talk about Excessive Generalization Of Fear Avoidance 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.
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 #301 Now if you missed last week’s episode , we talked about disc resorptions and pickleball injuries. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. I just got back from Chicago. Long long long conference. It’s serious on the CEUs folks. 27 hours of classroom sitting. That’s rough. But, I will say, it’s one of the smartest groups of docs you’ll be in the same room with. This conference was put on by the ACCC which is the American College of Chiropractic Consultant in conjunction with the America Board Of Forensic Professionals. Or somethiing like that. It’s the consultants with the forensics So basically you have the coding and compliance specialists with the medicolegal expert witness folks and you have a nice mix of really detail-oriented, research knowledgeable, and super smart people. The presenters at this conference gotta be tough and on their games because these folks are smart and, for the most part, know what the heck they’re talking about. I wouldn’t present to them. Lol. Anyway, one of my buddies, David Graber, presented and did a great job. He was from 8-10 on a Saturday afterr we all stayed out a little too late but he was full of energy and did a great job keeping eveyrone engaged. On Friday a new connection made out there presented. I did not know Dr. Steven Brown from Gilbert, AZ before this conference but we got to spend some quality time getting to know each other this weekend. It was funny how we met. I was in the elevator speaking to someone, I don’t remember who….and this voice from behind be goes….”Hey, aren’t you that chiropractor with the podcast?” Not thinking anyone ever listens to my podcast, I was surprised and just said, “Yeah….I have a podcast!” He said, “I recognized your voice!” So, that was Dr. Steven Brown. Lol. Turns our Steven was a presenter at the conference and was talking about when it is actually possible for chiros to cause strokes from SMT and how we can potentially avoid the pitfall. Great talk, plenty of discussion and interaction and he knows his stuff. No doubt. I got the opportunity to hang out with a friend and quasi-mentor of mine, Dr. James Lehman of the University of Bridgeport. I can’t say enough about Jim. He’s just a special guy and a great friend to me that I very much value. My buddy, Ben Fergus, who lives in Chicago, came down to visit me and meet Dr. Graber and Dr. Lehman. So, basically, a trip that I was not looking forward to at all turned into a great trip with lots of new connections made along the way. I don’t like classrooms filling up any of my weekends but this thing turned out A-OK. If you’ve ever throught about a Diplomate in Forensics, I have some advice. Get the Neuromusculoskeletal Medicine Diplomate at 300 hours through the University of Bridgeport like I did. Then, for only 100 extra hours, you can get the Forensics Diplomate. Then with both of those in your pocket, you’ll be well-positioned to be a medicolegal expert witness. If you had told me 5 years ago that I would have a Diplomate, I would have told you that you need to quick smoking the Devil’s lettuce. Now, sitting here in 2023, I am double board certified with two Diplomates. It’s weird how things change and interests change. I was in a hurry and I loved the Neuromusculoskeletal information so much that I burned through the course in 6 months and you can too. For the most part, none of you are any busier with business and life than I am. I promise. That forensics diplomate probably only took me roughly 3 months to complete. If you’d like any information on them, I’ll put the links in the show notes here. Just go to episode #301 at chiropracticforward.com and check it out. https://www.bridgeport.edu/academics/programs/hs-postgrad-programs/orthopedics-neuromusculoskeletal-medicine https://www.acatoday.org/aca-membership/aca-specialty-councils/council-on-forensic-sciences/ Since it’s a little long, we’re just going with one paper this week. It’s called, “Excessive generalization of pain-related avoidance behavior: mechanisms, targets for intervention, and future directions” by Vandael et. Al. and was published in Pain Journal for November 2023 and that’s so hot not a man can hold it! Vandael, Kristofa,b; Vervliet, Bramb; Peters, Madelona; Meulders, Anna,c,*. Excessive generalization of pain-related avoidance behavior: mechanisms, targets for intervention, and future directions. PAIN 164(11):p 2405-2410, November 2023. | DOI: 10.1097/j.pain.0000000000002990 When you have chronic pain, it is natural to want to avoid activities that you think will cause pain. However, if you avoid too many activities, it can make your pain worse and lead to disability. One reason why people with chronic pain avoid activities is because they fear that those activities will cause pain. This fear is often based on past experiences of pain. However, the fear can sometimes spread to activities that are unlikely to cause pain. This is known as overgeneralization of pain-related fear. Overgeneralization of pain-related fear is a key feature of chronic pain disability. There are a number of things that can be done to reduce overgeneralization of pain-related fear, including:

Learning about pain and how it works
Gradually exposing yourself to activities that you fear will cause pain
Identifying and changing the negative thoughts and beliefs that contribute to your avoidance behavior
Learning to accept your pain and focus on living a meaningful life despite your pain

There are a few potential intervention targets to reduce overgeneralization of pain-related avoidance:

Competing goals: Encouraging people to pursue valued goals, even if it means experiencing some pain, can help to weaken the fear-avoidance relation.
Perceptual accuracy: Training people to more accurately perceive their movements can help to reduce generalization, as people are less likely to avoid activities that they know are safe.
Positive affect: Inducing positive affect can help to inhibit fear from spreading to novel safe stimuli and may also increase willingness to approach fear-evoking stimuli.

Other potential intervention targets include executive functions such as working memory and attentional control, and anxious traits such as anxiety, sensitivity, and intolerance of uncertainty. Future research on overgeneralization of pain-related avoidance should focus on:

Establishing the diagnostic and predictive validity of paradigms developed to study generalization of avoidance behavior in pain research.
Testing experimental interventions to reduce overgeneralization in both healthy subclinical and clinical samples.
Investigating the role of social factors in generalization.
Examining observational and instructed learning as mechanisms of generalization.
Conducting preventive trials in the acute pain stage.
Translating experimental interventions into practice to test for clinically relevant improvements.

This research is important to inform and strengthen evidence-based treatment for chronic pain. All of this is just building on what we’ve been learning in the last 5-10 years with regard to pain. Fear avoidance is huge. We must address it before de-conditioning sets in. Hurt doesn’t equal harm Movement at the joint and at the global level is healing, it improves proprioceptive input, it clears up a muddied and blurry neural map of our joints and our movements, it has an effect on neuroplasticity, and it increases our confidence in movement while lowering our overall pain levels. So let’s get our patients moving as quickly as we can responsibly and appropriately. 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

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Disc Resorption & Pickleball Injuries

October 10, 2023 chiropracticforward 0:15:12 0 Comments

CF 300: Disc Resorption & Pickleball Injuries Today we’re going to talk about Disc Resorption & Pickleball Injuries. But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #300 Now if you missed last week’s episode , we talked about Colorectal Cancer In The Young & AI-Powered Chronic Pain Management. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. So let’s talk about unplanned time off. Because that’s when the he’ll happened to me last week. Holy cow my friends. I got sick. And when I say sick, I mean really sick. I’m not talking about a man cold thing. I’m talking sick like maybe hospital kind of sick. Last week, I went to work on Wednesday feeling pretty damn poor. It only got worse through the day. By the end of the day, I was done. I was full blown sick and getting messy. I missed Thursday and Friday at work because I was out sick with a stomach bug. I do not cancel a day full of patients. Ever. So you know it’s serious when I cancel. Especially two days. You that are regulars here know that I commonly see 40 or so per day so I had to cancel 80 or so patients and I never take that lightly for personal as well as financial reasons. But let’s back up. When I say ‘stomach bug’, that seems to minimize what I’m now referring to as ‘The Incident’. What I really mean by ‘bug’ is a big alien Chuck Norris bug with a fu man chu and ninja stars that smells of Marlboros and diesel. I haven’t been that sick in 7 or 8 years. I almost went to the ER twice and seriously questioned if I’d ever eat any food at all again. Ever. I was thinking, “So….this is how it ends…I’ve had a good life….it’s been a pretty good run” I’ve had COVID three or four times and would take that over the alien Chuck Norris stomach bug any day. My stomach is still giving me little zingers and reminders of what we went through together every now and then but I’m mostly good to go at this point. Thank God. I’ll share that an IV up at Creek Stone on Friday with heartburn and nausea meds added to it was very helpful. On a slightly related note; I’ve never had Pedialyte before ‘The Incident’ and, after three or four gallons, I have to say……it’s actually pretty tasty and low calorie! 😎 So, this my recommendation based on personal first hand experience, if you are approached by an alien Chuck Norris bug with a fu man chu and ninja stars that smells of Marlboros and diesel, my advice is to go to the other side of the street and keep walking with your head down. Oh, and figure out a way to make the clinic run without your presence requires at all times. I’ve tried and I am trying. Trust me. I’m not a solo Chiro on purpose. You hear me advertise for an associate at the top of every show, right? Right. So, still considering hiring. Just have to get the right one. When it’s time, it’ll happen naturally. Item #1 The first one this week is called “Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-analysis” by Zou et. Al. and published in Clinical Spine Surgery on July 31, 2023, and that’s a zinger! Why They Did It This study aimed to analyze the incidence of spontaneous resorption of lumbar disk herniation (LDH) after conservative treatment. How They Did It

We strictly refer to the standard established in the PRISMA (Preferred Reporting Items for a Systematic Review and Meta-analysis) statement, comprehensively searched electronic databases using the terms related to the spontaneous resorption of LDH.
Two reviewers independently evaluated the potential studies, extracted, and analyzed the enrolled data.
Thirty-one studies with 2233 patients who received conservative treatment were included for this analysis.

What They Found

We found that the pooled overall incidence of disk resorption was 70.39%, 87.77% for disk sequestration, 66.91% for disk extrusion, 37.53% for disk protrusion, and 13.33% for disk bulge, respectively.

Wrap It Up The existing evidence shows that the overall resorption incidence of LDH was 70.39%, the resorption incidence of ruptured LDH is higher than that of contained LDH. There are significant differences in the resorption incidence among countries. The resorption process mainly occurred within 6 months of conservative treatment. 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 “Pickleball injuries could cost Americans up to $500 million this year, analysis finds” by Megan Cerullo and published in Money Watch and CBS News on June 27, 2023, hot tamale! It’s an article so the high spots we shall hit. The explosive growth of Pickleball in recent years is contributing to higher injury rates and health care costs, particularly among seniors, according to analysts at UBS. They estimate in a report that injuries related to pickleball could cost Americans between $250 million and $500 million in medical costs this year, mostly related to wrist and leg sprains and fractures. The investment bank was prompted to examine the issue after UnitedHealth Group, whose stocks the Wall Street firm covers, said that health care utilization rates have jumped in recent months among Medicare users. Sounds like a damn insurance company now doesn’t it? Trust me, the know the numbers. Which is stil stunning that they’re not requiring referrals to chiros for non-complicated msk pain. I bet it’s because so many damn chiropractors are crazy and doing non-evidence-based, doctor-centered care still. Just a guess. Anyway, Over roughly the last three years the number of recreational players around the U.S. has soared 159%, from 3.5 million in 2019 to 8.9 million in 2022, according to data from the Sports and Fitness Industry Association. And the sport is poised for even faster growth. UBS analysts forecast that more than 22 million “Picklers,” as players are known, will be thwacking balls back and forth this year. Seniors make up a third of the most avid players, according to the firm’s estimate, which defines that as people who whip out their paddles at least eight times per year. UBS analyzed this rapid growth, while also examining common pickleball-related injuries, to come up with its projection of medical costs directly attributable to sport. Overall, UBS estimates that $377 million worth of medical costs in 2023 will stem from pickleball. Roughly 80% — or $302 million — of the total relates to outpatient treatment in settings such as emergency rooms and doctor’s offices, the bank said. 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

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger Zou T, Liu XY, Wang PC, Chen H, Wu PG, Feng XM, Sun HH. Incidence of Spontaneous Resorption of Lumbar Disc Herniation: A Meta-analysis. Clin Spine Surg. 2023 Jul 31. doi: 10.1097/BSD.0000000000001490. Epub ahead of print. PMID: 37559207. https://www.cbsnews.com/news/pickleball-injuries-will-cost-americans-up-to-500-million-this-year/

Patterns Of Cancer In The Young & BMI And Mortality

September 28, 2023 chiropracticforward 0:15:49 0 Comments

CF 298: Patterns Of Cancer In The Young & BMI And Mortality

Today we’re going to talk about Patterns Of Cancer In The Young & BMI And Mortality

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 #298

Now if you missed last week’s episode, we talked about vertibrogenic pain and fish oil benefit claims. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Lots of things going on personally and professionally. I was having a conversation with a friend yesterday while we watching our Dallas Cowboys stinking it up against the Cardinals and we were talking about me being on semaglutide.

I told him it hasn’t worked all that well on my. I’ve only lost about 10 pounds in 6 months and the side effects really, in my opinion, aren’t worth it. GI issues and heartburn like I’ve never had before. I don’t think 10 pounds is a good enough pay off and I’m considering trying monjourno or dropping it all together until some new ones come ot the market.

He asked me if I have been exercising and working out and you know what? I hated to tell him that I haven’t. I’m not going to get up in the morning to do it and while I used to work out at lunch, now my lunches are full of voice over work. The more I talked about it with him, the more and more I settled into the idea that I just have zero work/life balance.

Don’t get me wrong; this is not a brand new revelation. I’ve known this for years and years. Sometimes though, you have a conversation that wakes you out of your lull and renews your interest in trying to get closer to that work-life balance thing that is a healthy balance.

I don’t know how to achieve that but, I have some ideas. I told you all in a recent podcast that we are considering ((and probably will) bring on a partner group and investment group. When that happens, the soul sucking part of practice gets better. In fact, it goes away. No more HR, billing, collecting, and misery. Only patient treatment. No more keeping track of stats on my own. No more business bank account balancing. None of that.

That would provide me with some work-life balance. Also, I work 5 days a week and have since the beginning 25 years ago. Now, on the way I would be paid, if I can see the same amount of people in 3 days, I can just work 3 days. That would DEFINITELY give me some work-life balance.

Plus, I think I’ll have an opportunity to hire an associate in December that will take a little heat off of me. That would absolutely give me a better balance.

Just thinking out loud here, folks. But my thinking out loud sometimes speaks to others. These are the things I’m dealing with at the moment and it’s a big, transformational moment in my life. If you’re the praying type, I would ask for your prayers that I make the right decision for me and my family. I would appreciate it.

Item #1

The first one today is called “Patterns in Cancer Incidence Among People Younger Than 50 Years in the US, 2010 to 2019” by Benjamin Koh; Darren Jun Hao Tan; Cheng Han Ng, MBBS; et al and published in Jama Network and on August 16, 2023. Dayum. That’s hot.

Why They Did It

To characterize the patterns in the incidence of early-onset cancers in the US from 2010 to 2019 and provide granular data on the cancers with the fastest-growing incidence rates.

How They Did It

This population-based cohort study analyzed data from 17 National Cancer Institute Surveillance, Epidemiology, and End Results registries from January 1, 2010, to December 31, 2019.

Age-standardized incidence rates per 100 000 people were extracted for early-onset cancers, with rates age adjusted to the US standard population.

A total of 562,145 patients with early-onset cancer between 2010 and 2019 were identified and included.

Data were analyzed from October 16, 2022, to May 23, 2023.

What They Found

Among 562,145 patients aged 40-49 years; 351,120 with early-onset cancer, 4,565 were American Indian or Alaska Native, 54,876 were Asian or Pacific Islander, 61,048 were Black, 118,099 were Hispanic, 314,610 were White, and 8947 were of unknown race and/or ethnicity.

From 2010 to 2019, the age-standardized incidence rate of early-onset cancers increased overall and in female but decreased in male individuals. In contrast, the age-standardized incidence rate of cancers in individuals aged 50 years and older decreased over the study period

In 2019, the highest number of incident cases of early-onset cancer were in the breast. From 2010 to 2019, gastrointestinal cancers had the fastest-growing incidence rates among all early-onset cancer groups. Among gastrointestinal cancers, those with the fastest-growing incidence rates were in the appendix, intrahepatic bile duct, and pancreas

Wrap It Up

In this cohort study, the incidence rates of early-onset cancer increased from 2010 to 2019. Although breast cancer had the highest number of incident cases, gastrointestinal cancers had the fastest-growing incidence rates among all early-onset cancers. These data may be useful for the development of surveillance strategies and funding priorities.

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, “Body mass index and all-cause mortality in a 21^st century U.S. population: A National Health Interview Survey analysis” by Aayush Visaria and published in Plos One on July 5, 2023. Hot potato!

Why They Did It

Much of the data on BMI-mortality associations stem from 20^th century U.S. cohorts. The purpose of this study was to determine the association between BMI and mortality in a contemporary, nationally representative, 21^st century, U.S. adult population.

How They Did It

This was a retrospective cohort study of U.S. adults from the 1999–2018 National Health Interview Study (NHIS), linked to the National Death Index (NDI) through December 31^st, 2019.

BMI was calculated using self-reported height & weight and categorized into 9 groups.

We estimated risk of all-cause mortality using multivariable Cox proportional hazards regression, adjusting for covariates, accounting for the survey design, and performing subgroup analyses to reduce analytic bias.

What They Found

The study sample included 554,332 adults
Over a median follow-up of 9 years (IQR 5–14) and maximum follow-up of 20 years, there were 75,807 deaths.
The risk of all-cause mortality was similar across a wide range of BMI categories
These results persisted after restriction to healthy never-smokers and exclusion of subjects who died within the first two years of follow-up.
A 21–108% increased mortality risk was seen for BMI ≥30. Older adults showed no significant increase in mortality between BMI of 22.5 and 34.9, while in younger adults this lack of increase was limited to the BMI range of 22.5 to 27.4.

Wrap It Up

The risk of all-cause mortality was elevated by 21–108% among participants with BMI ≥30. BMI may not necessarily increase mortality independently of other risk factors in adults, especially older adults, with overweight BMI.

Further studies incorporating weight history, body composition, and morbidity outcomes are needed to fully characterize BMI-mortality associations.

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

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

Tweets by Chiro_Forward

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Vertebrogenic Pain & Fish Oil Benefit Claims

September 21, 2023 chiropracticforward 0:19:14 0 Comments

CF 296: Vertebrogenic Pain & Fish Oil Benefit Claims Today we’re going to talk about Vertebrogenic Pain & Fish Oil But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #296 Now if you missed last week’s episode , we talked about Two Surgeries, Two Outcomes & Cervical Artery Dissection and Spinal Manipulative Therapy. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Ugh, the dreaded September slowdown is upon me and the Tri-State Fair. We have a big fair here mid-to end of September every year and people literally take out small loans to take their families to this thing. Who does thtat? I don’t know. Not this family. Even if we were broke. But, I digress. The point being that September is always a challenging month for us and this year is no exception whatsoever. But, we know it’s going to be this way and we expect it so it’s not a surprise or terribley upsetting. It just is so we do the things we gotta do to deal with it. We take that extra time to market. I know that’s called reactive marketing but we have a constant online presence. Constant and consistent. We have email marketing and we have constant internal marketing strategies. It’s not like we only market when we’re slow. We just have MORE time to market when it’s slow. So, we will continue to broaden our footprint this month and see the fruits of our efforts in the next couple of weeks. Time is the same for us all but are you going to waste time? OR are you going to invest time? We choose to invest it. I invest my time in all aspects of my life. You’ll rarely find me sitting idle or just laying around the house with no purpose, goals or achievement happening. Is that healthy? Who knows? But I get a lot done annd I consistently have people asking me how I seem to get so much more done than everyone else?? How do I seem to have more hours in the day compared to others? Well, because I invest time instead of waste it. Item #1 This one is called, “Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain” by Conger et al published in Pain Medicine in August of 2022. https://doi.org/10.1093/pm/pnac081 Why They Did It The reasons we’re looking at this one is not to promote ablasions but to get us thinking a bit about vertobrogenic low back pain, endplates, sensitization, and all kinds of other stuff. Vertebrogenic low back pain (LBP) is a type of chronic LBP that is thought to originate from the vertebral endplates. The vertebral endplates are richly innervated by nociceptors, which are nerve endings that sense pain. When the vertebral endplates are damaged, the nociceptors can be activated, sending pain signals to the brain. The researchers say in t his paper that where we used to think that nerves would develop ingrowth into the cracks of a previously injured disc, this may not be an adequate explanation of disc pain. Specifically, they say, “Previously, it was thought that pathological neurovascular ingrowth penetrated into annular fissures, leading to increased sensitivity and nociception via the sinuvertebral nerve. However, more recent evidence appears to refute the occurrence of such neurovascular ingrowth in many cases.” I found that interesting and notable. The paper continues – Vertebral endplate damage can occur due to a variety of factors, including aging, disc degeneration, osteoarthritis, spinal injuries, and repetitive stress. The type of pain caused by vertebral endplate damage is often described as a dull, aching pain that is localized to the lower back. It may be aggravated by sitting or standing for long periods of time, and it may also radiate into the buttocks and legs. Once vertebrogenic pain has been diagnosed, there are a number of treatment options available. These options include physical therapy, medication, injections, and surgery. The current standard of care for vertebrogenic low back pain is intraosseous basivertebral nerve ablation (BVN RFA). This procedure has been shown to be effective in reducing pain and improving function in patients with Modic changes (MC1 or MC2) on MRI. The results of basivertebral nerve ablation appear to be durable, with improvements lasting for at least 2 to 5 years. Other treatments for vertebrogenic pain have been proposed, but there is less evidence to support their use. These treatments include extraosseous epiduroscopic basivertebral nerve ablation or bipolar RFA, intraosseous plasma rich growth factor, intraosseous injection of bioresorbable cement, and full endoscopic disc debridement surgery. Oral therapies for presumed low grade infection affecting the discovertebral complex are also controversial, but research is ongoing to determine which subpopulations of patients might benefit from this treatment. Finally, there is some evidence that paraspinal muscle quality may be associated with vertebrogenic pain, but it is not yet clear how treatments to address paraspinal muscle deficits might impact patients with this condition. Wrap It Up

Accumulated damage to the discovertebral complex may result in chemical and mechanical sensitization of endplate nocioceptors resulting in chronic vertebrogenic LBP.
Midline LBP, pain exacerbation by physical activity, sitting, and forward flexion are factors associated with treatment success after basivertebral nerve ablation
In appropriately selected patients, basivertebral nerve ablation results in substantial reduction in pain and disability in the majority of those treated at 12 months, with similar long term outcomes at 5 years.
The presence of MC1 or MC2 is currently the best radiographic indicator of vertebrogenic pain. Outcomes after basivertebral nerve ablation are not impacted by the volume of MC, location of MC, degree of disc degeneration, or presence/size of endplate defects. Patients with MC1 vs MC2 experience similar rates of success after basivertebral nerve ablation

Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 The last one today is called, “Health Claims and Doses of Fish Oil Supplements in the US” by Assadourian, et. Al. and published in JAMA Cardiology on August 23, 2023 and dayum it’s got sizzle for shizzle. Why They Did It One in 5 US adults older than 60 years takes fish oil supplements often for heart health despite multiple randomized clinical trials showing no data for cardiovascular benefit for supplement-range doses. Statements on the supplement labels may influence consumer beliefs about health benefits. The authors wanted to answer the questions, “What health claims are made on the labels of fish oil supplements, and what is the total daily dose of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) in commonly available fish oil supplements? How They Did It his cross-sectional study used data from labels of on-market fish oil (and nonfish ω-3 fatty acid) supplements obtained from the National Institutes of Health Dietary Supplement Label Database. The study was conducted and data analyzed from February to June 2022. The frequency and types of health claims made on fish oil labels and the organ system referenced were evaluated. The total daily doses of combined EPA and DHA were assessed for supplements from 16 leading manufacturers and retailers. What They Found

Across 2,819 unique fish oil supplements, 2082 (73.9%) made at least 1 health claim.
Of these, only 399 (19.2%) used an FDA-approved qualified health claim; the rest (1683 [80.8%]) made only structure/function claims (eg, “promotes heart health”).
Cardiovascular health claims were the most common (1747 [62.0%]).
Across 16 leading brands/manufacturers, 255 fish oil supplements were identified. Among these, substantial variability was found in the daily dose of EPA, DHA, and total EPA+DHA.
Only 24 of 255 supplements (9.4%) evaluated contained a daily dose of 2 g or more EPA+DHA.

Wrap It Up Results of this cross-sectional study suggest that the majority of fish oil supplement labels make health claims, usually in the form of structure/function claims, that imply a health benefit across a variety of organ systems despite a lack of trial data showing efficacy. Significant heterogeneity exists in the daily dose of EPA+DHA in available supplements, leading to potential variability in safety and efficacy between supplements. Increasing regulation of dietary supplement labeling may be needed to prevent consumer misinformation. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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

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

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Aaron Conger, Matthew Smuck, Eeric Truumees, Jeffrey C Lotz, Michael J DePalma, Zachary L McCormick, Vertebrogenic Pain: A Paradigm Shift in Diagnosis and Treatment of Axial Low Back Pain, Pain Medicine, Volume 23, Issue Supplement_2, August 2022, Pages S63–S71, https://doi.org/10.1093/pm/pnac081
Assadourian JN, Peterson ED, McDonald SA, Gupta A, Navar AM. Health Claims and Doses of Fish Oil Supplements in the US. JAMA Cardiol. Published online August 23, 2023. doi:10.1001/jamacardio.2023.2424

Nerve Pain Treated Naturally & The First Provider Seen Makes A Difference

August 28, 2023 chiropracticforward 0:19:37 0 Comments

CF 293: Nerve Pain Treated Naturally & The First Provider Seen Makes A Difference

Today we’re going to talk about Nerve Pain Treated Naturally & The First Provider Seen Makes A Difference

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 293

Now if you missed last week’s episode, we talked about Discs in Low back pain and unnecessary surgeries during covid. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

This week is like all others. Just going crazy to stay on top of everything going on in my life so we’ll probably cut it a little short this week.

I would say, back to school is always slow for us and it’s slow again this year. As expected. Every year I wonder if I peed on somebody’s dog and they told the whole town about it and now everyone’s mad at me and doesn’t want to come see me anymore.

Of course I only pee on cats so we know that’s not what’s going on here. It’s back to school, folks! It just happens. I can set my watch by it. It’s crazy.

So, I’m going to Savannah Georgia to watch a Savannah Bananas game and then driving to Charleston, SC for front row seats to see Train in concert. Train is one of my wifey’s favorite bands so it’ll be a good time and we love Savannah and Charleston. That’s if we don’t get blown away by the remnants of a hurricane that’s about to move in. We shall see.

For now though….let’s get to the research, shall we?

Item #1

The first on today is called “A comprehensive review on clinically proven natural products in the management of nerve pain, with mechanistic insights” bySanchita Dewanjee, Md Sohel, Md Shahadat Hossain, Farzana Ansari, Md Tofikul Islam, Farhana Sultana, Abdullah Al Mamun, Md Monirul Islam, Mohammad Nurul Amin and published in Heliyon and on April 14, 2023. Dayum. That’s hot.

Why They Did It

The study was designed to discuss the mechanistic role of several clinically proven natural products that have been shown to play a significant role against different nerve pain or neuropathic pain.

How They Did It

Information for this review article was salvaged using several accessible searching databases like SciVerse Scopus ® (Elsevier Properties S. A, USA), Web of Science® (Thomson Reuters, USA), and PubMed® (U.S. National Library of Medicine, USA) considering some search items like – nerve pain, natural products in pain/nerve pain management, clinically proven natural products in pain management, pain-reducing agents and so on.

What They Found

Our study reported the therapeutic efficacy of natural products and their possible mechanism against neuropathic pain in the human body.
Natural products widely used to treat neuropathic pain include comfrey root extract ointment, lavender oil, Rose Oil, aromatic essential oil, ginger oil, vitex agnus-castus, peganum oil, and ajwain 10%.
Some common pathways are involved in pain relief through sensory stimulation, enzymatic, anti-inflammatory, and pain-related receptor regulation.

Wrap It Up

The present study suggests that the mentioned natural products can be an appropriate choice for the treatment and management of neuropathic pain.

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, “First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization” by Christopher G Bise et al, and published in PubMed on 28 June 2023. Hot potato!

Why They Did It

Costs associated with low back pain (LBP) continue to rise.
Despite numerous clinical practice guidelines, the evaluation and treatments for LBP are variable and depend largely on the individual provider.
As yet, little attention has been given to the first choice of provider.
Early research indicates that the choice of first provider and the timing of interventions for LBP appear to influence utilization.
This study sought to examine the association between the first provider seen and utilization.

How They Did It

Using 2015-2018 data from a large insurer, this retrospective analysis focused on patients (29,806) seeking care for a new episode of LBP.
The study identified the first provider chosen and examined the following year of medical utilization.
Cox proportional hazards models were calculated using inverse probability weighting on propensity scores to evaluate the time to event and the relationship to the first choice of provider.

What They Found

The primary outcome was the timing and utilization of health care resources.
Total health care utilization was lowest in those who first sought care with chiropractic care or physical therapy.
Highest health care utilization was seen in those patients who chose the emergency department.

Wrap It Up

Overall, there appears to be an association between the first choice of provider and future health care utilization.
Chiropractic care and physical therapy provide nonpharmacologic and nonsurgical, guideline-based interventions.
Their participation appears related to a decrease in immediate and long-term utilization of health care resources.
This study expands the existing body of literature and provides a compelling case for the influence of the first provider on an acute episode of LBP.

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

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

Tweets by Chiro_Forward

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Discs In Low Back Pain & Unnecessary Surgeries Via COVID

August 25, 2023 chiropracticforward 0:18:26 0 Comments

CF 292: Discs In Low Back Pain & Unnecessary Surgeries Via COVID

Today we’re going to talk about Discs In Low Back Pain & Unnecessary Surgeries Via COVID

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 #292

Now if you missed last week’s episode, we talked about Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use . Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Isn’t it funny how things work sometimes? I had something odd happened recently here in the clinic. We found out that our acupuncturist was moving to a different chiropractor’s office. She’s been with us for about eight years. What she’s credentialed through me to see veterans through our VA system.

So the VA randomly called us one day inquiring on her moving to another office and when that is happening, etc. Well, it was news to us. So we reached out to the acupuncturist and she admitted that she had plans to move but had not shared them with us yet. Although Amarillo Texas is about 225,000 people, there are only 3 acupuncturists in the entire area. It’s just not that popular here.

Although, it is definitely gaining in popularity. So the prospects of us being able to bring on another acupuncturist quickly are very slim. However, we went ahead and reached out to the one we really wanted to work with us. I have a good relationship with her, but things have just not worked out to where we could’ve actually worked together before. It turns out that she was tired of her current situation and was interested in making a move.

So she came in for an interview, we talked, and she was on board. We started the credentialing process with the VA that very day, so, while it takes 90 days to get credentialed, at this point, we are already almost a month into the process. That should significantly shorten the waiting period for our veterans to switch to a new acupuncturist and soften the landing.

Oh, in the meantime, if our previous acupuncturist, had any plans of stealing our patients, and taking them to a new place, that is going to be hard for her to accomplish. She hast to get completely re-credentialed, and I promise you were ahead of her on getting that done. In addition, the veterans have to get authorization to see her and she hast to get credentialed before they can even start the process of getting authorized through her. Whereas here in my clinic the machine is already built. The gears are already oiled and greased, and we are at fine-tune the machine. I think there’s no doubt we are going to come out ahead on this transition.

One thing we all know is that the one constant in life is that things are always changing.

Many of us are going through changes with staff. I have 3 CA’s and that third spot. It’s just a constant turnover. I have another one that will start in two weeks. The last one lasted for about two weeks. The one before her lasted about three months. It’s been miserable but when we find the right one I think it will have been worth it anyway, that’s what’s on my mind this morning. Getting acupuncture back up and running and marketed, and getting another new staff member up and going.

It’s a constant churn and, as they say in the military, just embrace the suck and keep trucking. It all pays for your life and for the life of your family members. Might as well enjoy all of it that you can and embrace the parts you feel suck your soul and keep that part in the proper context.

Item #1

The first on today is called “Intervertebral disc degeneration and how it leads to low back pain” by Ashish D Diwan, James Melrose and published in Pub Med on Nov14 2022. Dayum. That’s hot.

Why They Did It

The purpose of this review was to evaluate data generated by animal models of intervertebral disc (IVD) degeneration published in the last decade.
The review aimed to highlight the valuable contributions of these animal models in identifying molecular events associated with pain generation.
IVD degeneration is a complex process contributing to spinal pain, and understanding the underlying mechanisms is crucial for developing effective therapeutic strategies to alleviate pain, promote disc repair and regeneration, and prevent associated neuropathic and nociceptive pain.

How They Did It

The researchers conducted a review of existing studies that employed animal models of IVD degeneration.
They likely searched relevant databases, academic journals, and publications from the past decade to gather a comprehensive dataset.

The selected studies would have used various animal models and experimental methods to induce IVD degeneration.

These animal models mimic certain aspects of human IVD degeneration, allowing researchers to study the molecular events and mechanisms involved in pain generation.

What They Found

Through their review, the researchers observed that in degenerated IVDs, there is nerve ingrowth and an increased number of nociceptors (pain-sensing neurons) and mechanoreceptors (sensors of mechanical stimuli).
The biomechanically incompetent and abnormally loaded degenerated IVDs experience increased mechanical stimulation, leading to heightened low back pain.
This finding helps establish a link between IVD degeneration and pain generation, shedding light on the complexity of the process.

The review also highlighted the potential of a specific factor called “growth and differentiation factor 6” in addressing IVD degeneration. Studies using this factor in IVD puncture and multi-level IVD degeneration models, along with a rat xenograft radiculopathy pain model, demonstrated its ability to prevent further deterioration in degenerate IVDs. The factor exhibited regenerative properties that promoted the recovery of normal IVD architectural functional organization and inhibited the generation of inflammatory mediators, which contribute to disc degeneration and low back pain.

Wrap It Up

The review of animal models of IVD degeneration provided valuable insights into the molecular events underlying pain generation in degenerate IVDs. It emphasized the importance of understanding the complex multifactorial process of IVD degeneration to identify potential therapeutic targets for pain relief and disc repair.

One promising candidate identified through the review was “growth and differentiation factor 6,” which showed considerable potential in preventing further deterioration of degenerate IVDs, promoting regeneration, and inhibiting the generation of inflammatory mediators.

The findings from these animal models suggest the need for human clinical trials with this compound to assess its efficacy in treating IVD degeneration and preventing low back pain generation in humans. Overall, this review underscores the significance of animal models in advancing our understanding of IVD degeneration and pain mechanisms, ultimately leading to improved treatment strategies for patients suffering from low back pain.

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, “100,000 older Americans got unnecessary surgeries during dangerous first year of COVID-19” by Aaron Toleos and published in Lown Institute on May 17, 2022. Hot potato!

Why They Did It

The Lown Institute conducted this analysis to shed light on the issue of overuse of medical procedures in American healthcare, particularly during the COVID-19 pandemic. The aim was to bring attention to the fact that even during a public health crisis, unnecessary procedures were still being performed on vulnerable patients, potentially exposing them to harm and wasting healthcare resources.

How They Did It

The analysis was based on Medicare claims data from January to December 2020. The Lown Institute used the 100% Medicare claims database to evaluate the volume of overuse for eight common low-value procedures. The specific procedures and criteria for overuse were determined based on the institute’s previously published research into the measurement of low-value care at hospitals.

What They Found

The Lown Institute found that a total of 106,474 unnecessary procedures were identified during the analyzed period. The most overused procedure by volume was coronary stents, with 45,176 procedures performed. Other procedures with high rates of overuse included vertebroplasty for osteoporosis, hysterectomy for benign disease, and spinal fusion for back pain.

The analysis also revealed that approximately one in five of these low-value procedures met the criteria for overuse across the country. Even some of the nation’s most well-regarded hospitals had rates of overuse above the national average. For example, all of the top 20 hospitals ranked by U.S. News had rates of coronary stent overuse above the national average, with four of them having rates at least double that.

Wrap It Up

The analysis conducted by the Lown Institute highlights the persistence of overuse of medical procedures in U.S. hospitals, even during a major public health crisis like the COVID-19 pandemic. Despite previous knowledge that certain procedures, such as coronary stents for stable coronary disease, are of limited clinical benefit, they continue to be performed at high rates. This raises concerns about patient safety, healthcare costs, and the need to address the issue of overuse in the American healthcare system. The findings call for greater attention to evidence-based practices and the promotion of appropriate and necessary medical interventions to ensure better patient outcomes and more efficient use of healthcare resources.

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

Social Media Links

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

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Tweets by Chiro_Forward

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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

Motor Control Stiffening & Spinal Manipulation And The Vertebral Artery

July 20, 2023 chiropracticforward 00:13:13 0 Comments

CF 289: Motor Control Stiffening & Spinal Manipulation And The Vertebral Artery

Today we’re going to talk about Motor Control Stiffening & Spinal Manipulation And The Vertebral Artery

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 #289

Now if you missed last week’s episode, we talked about COVID delayed surgeries and lumbar stenosis. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

What a day and what a week. In trying to keep up with the work/life balance thing, my wife and I took our 16 year old daughter to the Taylor Swift show up in Denver last weekend. From here in Amarillo, TX, that’s about a 7 hour drive. Not terrible overall and for a big portion of the drive you have mountains to look at so it’s all good.

We found an app called Autio that is co-owned by Kevin Costner. Along your drive, certain things are marked on the app and there are stories about the area you’re driving through that you can listen to while you’re driving through it. Pretty cool and definitely adds another layer to your drive if you’re a traveler like we are.

TSwift brough in 73,000 screaming fans and it was the second night of a 2-night stand there in Denver. That’s just unreal, honestly. The numbers and money are just staggering when you think about it.

Now, beyond that, we’re just ramping up some new marketing ideas, working on updating my stats, and getting ready to go to Alaska. We’re going on a cruise in a week and a half or so. If I can, I’m going to pre-record some episodes. If I just don’t have time to do that, you’ll be out of an episode for a week or two and we’ll pick it back up on my return. .

Most of you know how it goes. It’s tough to be gone and it’s even tougher to catch up when you return. But I’ll do my very best.

Let’s hop in.

Item #1

The first one today is called “Evidence for a general stiffening motor control pattern in neck pain: a cross sectional study” by Meisingset et. al. and published in BMC Musculoskeletal Disorders onMarch 17, 2015.

Why They Did It

Neck pain is associated with several alterations in neck motion and motor control. Previous studies have investigated single constructs of neck motor control, while few have applied a comprehensive set of tests to investigate cervical motor control. This comparative cross- sectional study aimed to investigate different motor control constructs in neck pain patients and healthy controls.

How They Did It

A total of 166 subjects participated in the study,
91 healthy controls (HC) and
75 neck pain patients (NP) with long-lasting moderate to severe neck pain.
Neck flexibility, proprioception, head steadiness, trajectory movement control, and postural sway were assessed using a 3D motion tracking system (Liberty).

What They Found

Neck flexibility was lower in neck pain patients compared to healthy controls, indicated by reduced cervical ROM and conjunct motion.
Movement velocity was slower in neck pain patients compared to healthy controls.
Tests of head steadiness showed a stiffer movement pattern in neck pain patients compared to healthy controls, indicated by lower head angular velocity.
Neck pain patients patients departed less from a predictable trajectory movement pattern (figure of eight) compared to healthy controls, but there was no difference for unpredictable movement patterns (the Fly test).
No differences were found for postural sway in standing with eyes open and eyes closed.
However, neck pain patients patients had significantly larger postural sway when standing on a balance pad.
Proprioception did not differ between the groups.
Largest effect sizes were found for neck and head steadiness.
Neck flexibility was the only construct that showed a significant association with current neck pain, while peak velocity was the only variable that showed a significant association with kinesiophobia.

Wrap It Up

Neck pain patients patients showed an overall stiffer and more rigid neck motor control pattern compared to healthy controls, indicated by lower neck flexibility, slower movement velocity, increased head steadiness and more rigid trajectory head motion patterns.
Only neck flexibility showed a significant association with clinical features in neck pain patients

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, “Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers” by Lindsay M. Gorrell,Andrew Sawatsky, W Brent Edwards & Walter Herzog and published in Taylor and Francis Online on 15 Nov 2022. Hot potato!

Why They Did It

The objective of this study was to measure VA length changes that occur during cervical spine manipulation and to compare these to the VA failure length.

How They Did It

Piezoelectric ultrasound crystals were implanted along the length of the VA (C1 to C7) and were used to measure length changes during cervical spine manipulation of seven un-embalmed, post-rigor human cadavers.

Arteries were then excised, and elongation from arbitrary in-situ head/neck positions to first force (0.1 N) was measured. Following this, VA were stretched (8.33 mm/s) to mechanical failure. Failure was defined as the instance when VA elongation resulted in a decrease in force.

What They Found

From arbitrary in-situ head/neck positions, the greatest average VA length change during spinal manipulation was 5.1%

From arbitrary in-situ head/neck positions, arteries were elongated on average 33.5% prior to first force occurrence and 51.3% to failure.

Average failure forces were 3.4 N

Wrap It Up

Measured in arbitrary in-situ head/neck positions, VA were slack. It appears that this slack must be taken up prior to VA experiencing tensile force.

During cervical spine manipulations (using cervical spine extension and rotation), arterial length changes remained below that slack length, suggesting that VA elongated but were not stretched during the manipulation.

However, in order to answer the question if cervical spine manipulation is safe from a mechanical perspective, the testing performed here needs to be repeated using a defined in-situ head/neck position and take into consideration other structures (e.g. carotid arteries).

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

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

Tweets by Chiro_Forward

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Meisingset I, Woodhouse A, Stensdotter AK, Stavdahl Ø, Lorås H, Gismervik S, Andresen H, Austreim K, Vasseljen O. Evidence for a general stiffening motor control pattern in neck pain: a cross sectional study. BMC Musculoskelet Disord. 2015 Mar 17;16:56. doi: 10.1186/s12891-015-0517-2. PMID: 25888215; PMCID: PMC4377005.

Lindsay M. Gorrell, Andrew Sawatsky, W Brent Edwards & Walter Herzog (2023) Vertebral arteries do not experience tensile force during manual cervical spine manipulation applied to human cadavers, Journal of Manual & Manipulative Therapy, 31:4, 261-269, DOI: 10.1080/10669817.2022.2148048

COVID-Delayed Surgeries & Lumbar Stenosis Research

July 13, 2023 chiropracticforward 00:17:40 0 Comments

CF 288: COVID-Delayed Surgeries & Lumbar Stenosis Research

Today we’re going to talk about COVID-Delayed Surgeries & Lumbar Stenosis Research

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 #289

Now if you missed last week’s episode, we talked about Mindfulness For Knee Replacement & The Use Of Tuina.

Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I’ll share with you all that I’ve been messing around a lot with AI and how it can make my life easier while saving me money. And it has.

What I’ve figured out so far:

I used to have to hire a virtual assistant off of Upwork to create my personal website blogs. I would always go in and take out the vitalist, philosophy stuff and make the blog mine but, for the bulk of the blogging, they would do it. Now, AI does it. I do the same process on my end but it doesn’t cost me nearly as much each week. In fact, the assistant, come to find out, was using AI and charging me as if they were the one creating it all. Now, I’ve cut out the middleman and saved money.
I was intimidated in the beginning, but I recently started experimenting with lots of AI image creation apps. I finally settled on one I really like and now, I can make unique, non-copyrighted images for my blogs, social media, etc. No more lame images off of Pixabay to find a non-licensed image anymore. I just make my own and, I have to admit, it’s kind of fun.

There is definitely a learning curve on AI right now but once you’ve crossed the threshold, it’s all downhill and life is good. I have some crude southern sayings to describe the easy life but I’ll save those for personal, one on one conversations if we ever meet in person.

So that’s what’s been on my radar lately.

Also, there is a group here in Texas that is buying percentages of practices. You still run it as you always have but they do the HR, billing and collections, AR, etc. All of the soul sucking parts of practice. No name change and the valuation and offering for 60% is more than fair.

That’s on my radar. We might do that. Life would smooth out if we did some of that. Keeping up with this machine without a dependable billing/collections dept is just a train wreck and hurts the heart pretty much every week.

As always, as we make our way through the mud and muck, I’ll be sure to keep you updated.

For now though, let’s get into the research, shall we?

Item #1

The first one today is called “Patients who delayed non-emergency surgeries during the pandemic are returning for care” by Beth Kutscher and published in LinkedIn on June 29, 2023. Dayum. That’s hot.

Why They Did It

The patients who postponed non-emergency surgeries during the pandemic are now seeking care, leading to an increase in surgical volume.

This has sparked a discussion about the necessity of these procedures. The motive behind studying the prevalence of unnecessary surgeries is to identify potential areas where healthcare resources and costs can be optimized.

How They Did It

The analysis involves studying the rates of surgical procedures and identifying cases that may be deemed unnecessary.
The Lown Institute conducted a controversial study that identified over 106,000 potentially unnecessary surgeries between March and December 2020.
However, the study’s methodology and conclusions were criticized by the American Hospital Association for having limitations and flaws. Other studies have also shown significant variations in surgical rates across countries and states, such as the high c-section rate in the United States and the discrepancy in lumbar fusion rates.

Vijay Yanamadala, a spine surgeon, conducted his own research on unnecessary lumbar spinal fusions, estimating that over 50% of such surgeries may be unnecessary. He also referenced the Lown Institute data, which suggests that back procedures, including vertebroplasty for osteoporosis and spinal fusion for back pain, contribute to about one-third of unnecessary surgeries.

Yanamadala wears two hats in this context, serving as a neurosurgeon and also as the chief medical officer for Sword Health, a company providing digital physical therapy.

What They Found

The Lown Institute’s study identified a large volume of potentially unnecessary procedures.
Yanamadala’s research specifically focused on lumbar spinal fusions and suggested that over 50% of them could be unnecessary.
Back procedures, including vertebroplasty and spinal fusion, were found to account for a significant portion of unnecessary surgeries.

Wrap It Up

The analysis of surgical procedures suggests that there is an issue with unnecessary surgeries in the healthcare system.
Factors contributing to unnecessary surgeries include poor compliance with physical therapy before surgery and the profit-driven nature of the U.S. healthcare system.
While elective surgeries are profitable for hospitals, there is a shortage of physical therapists, and certain specialties, such as neurosurgery, are more sought-after than non-surgical specialties like spinal cord injury fellowships.

The findings emphasize the need for a more balanced and patient-centered approach to surgical decision-making. Optimizing healthcare resources, improving compliance with non-surgical alternatives like physical therapy, and addressing the disparities in access to appropriate care are important steps toward reducing unnecessary surgeries and ensuring that patients receive the right care.

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 prospective study of non-surgical versus surgical treatment for lumbar spinal stenosis without instability” by Jung et al. and published in PubMed on August 17, 2020.

Why They Did It

This study compared non-surgical and surgical outcomes in surgical candidates for lumbar spinal stenosis (LSS).

How They Did It

Surgical candidates for stenosis were prospectively screened.
Patients were offered the option to be enrolled in a randomized cohort, an observational cohort, or not to participate.
Patient-reported outcomes were evaluated at baseline, and at 1, 3, 6, and 12 month
The primary outcomes were measures of pain and functional outcomes such as the Korean version of the Oswestry Disability Index (K-ODI), the EuroQol 5-Dimension instrument (EQ-5D), and 36-Item Short-Form Health Survey (SF-36).

What They Found

110 patients were enrolled in the randomized cohort and 37 patients in the observational cohort.

Among them, 97 patients received non-surgical treatment, and 50 patients underwent surgical treatment.

At 12 months, the non-surgical treatment group had less improvements in the primary outcome measures of back pain, leg pain, EQ-5D utility index and EQ-5D VAS.

Most SF-36 section parameters also showed less improvement in the non-surgical treatment group than in the surgical treatment group throughout the 12-month follow-up.

Wrap It Up

In stenosis patients without instability, non-surgical treatment resulted in less pain improvement and functional recovery through 1 year.

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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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

chiropractic forward

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