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CF 050: Chiropractic Care – Text Neck, Headaches, Migraines

CF 050: Chiropractic Care – Text Neck, Headaches, Migraines

Today we’re going to talk about headaches, migraines, neck pain, and our favorite topic here at the Chiropractic Forward Podcast, yes….we’ll talk about Chiropractic care. Specifically, chiropractic care for the headaches, migraines, and neck pain. 

Hold on though, make way, get in the Soul Train dance line because here’s that bumper music

Integrating Chiropractors

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have skidded all fast and furiously into Episode #50

Let’s talk a bit about the DACO program. For those that don’t know, that’s the Diplomate of American Chiropractic Orthopedists program I’m slowly trudging through. 

I say slowly. You have 3 years to finish. But, I’m a doer if you can’t tell. I’m a worker bee if you will. When I start something, I want to finish. I don’t like unfinished bidness. I don’t like things flapping out in the wind. I want to start it and then I want to finish it quickly and move on to the next thing. 

Getting 300 hours is never going to get done quickly. Especially when you are the sole doctor in a busy practice not getting home until 7 pm or even later sometimes. Such is my life. A curse and a blessing depending on the day and my outlook on that particular day. 

However, I believe I’m on a path to finish it up in about a year from when I started. Probably much sooner. For example, I knocked out 12 hours last week. That’s pretty solid but, we had a snow day and I took advantage of being stuck at home. 

I crawled down into my basement man cave, got in my blankie and jammies with an iPad on my belly, leaned the recliner back and got some education. 

So far, I have 40 hours of the 250 online hours done and 40 hours of the 50 live hours required. In total, I’m 80 hours into a 300-hour course. Rocking and rolling folks. Rocking and rolling. 

Some of the more recent courses I’ve completed were hip pain in children, joint hypermobility disorders, TMJ, and thoracic outlet syndrome. These courses are fascinating. 

The offer is there. If you need help getting started on yours, send me an email at dr.williams@chiropracticforward.com I’ll be glad to get you on your way. 

Speaking of getting in touch, I want to ask you to go to chiropracticforward.com and sign up for our newsletter. It makes everything easier. 

Now onto a discussion that took place on our Facebook page a couple of weeks ago that I thought was particularly interesting. 

I will put it in the show notes for you if you’d like to see the meme….funny word. My son loves it when we mispronounce it. You should try it with your kids if they’re old enough to get embarrassed by their parents.  

Anyway, the picture I posted was of a contemplative Kermit the Frog and it said, “Me when a patient tells me another chiropractor wanted 5 sets of x-rays over 9 months of treatment to correct something research doesn’t support.”

Now, let me set the stage here. The impetus for this was that one of my patients moved down to Georgia. Her daughter started having some headaches and pain so she went and got an MRI. 

The results of the MRI showed the issue to be out of the scope of chiropractic. Regardless, you guessed it, she got a recommendation for 5 sets of x-rays over 9 months of treatment. 

Absolute scare care riduculosity. 

Here’s where it got a little sticky. A colleague got on that post and expressed some dissatisfaction that I would post something like that. I guess he didn’t like my airing dirty laundry. Which is cool. I don’t mind at all but here’s what happened for me on the deal. 

I sat down and crafted a very PC response I think and in doing so, I had an opportunity to reflect on the podcast, the reason for it, and what we’ve done in just the past year. 

Here are some highlights that came to mind for me:

  1. You don’t make an omelet without cracking some eggs and I think some difference of opinion is to be expected and it’s something I just need to get used to. 
  2. I think I created this podcast to do whatever I could to move this profession forward. 
  3. Forward to me means providing research like we do every week but also to educate others, to suggest new research avenues, to encourage specialization and higher education, to push for integration, and to call out and discourage the behavior I feel holds us back from moving forward. 

If you aren’t active on our Facebook page, I’d encourage you to stop in and say, “Hi.” Tell us if you’re digging the podcast. Share some research you’ve found. Maybe give us a suggestion for a future podcast. We’re here. We also have a private Facebook group if you’d like to join the private group. 

OK, research for this week, here we go with paper #1

This one is called “Characteristics of Chiropractic Patients Being Treated For Chronic Low Back and Neck Pain[1].” The lead author is PM Herman and the paper was published in August of 2018 in the Journal of Manipulative Physiological Therapeutics. 

https://www.ncbi.nlm.nih.gov/pubmed/30121129

Get your marketing hat on for this one people. 

Why They Did It

Since chronic low back and neck pain are so prevalent, and since spinal manipulation is a common non-pharma treatment for them, the authors wanted to determine the characteristics of the type of patient that visits the chiropractor. 

How They Did It

  • They collected data from chiropractic patients in regard to regions and states, sites, providers and clinics, and patients. 
  • The data was collected through an iPad questionnaire given at the chosen sites. 
  • They had 518 chronic low back pain patients complete it while 347 chronic neck pain patients finished theirs. They also had 1159 do both. 

What They Found

  • Most of the sample were highly-educated
  • Most were non-hispanic
  • White females were the dominant demographic for race and gender
  • Few used narcotics
  • Avoiding surgery was the most important reason they chose chiropractic care 
  • Over 90% of the patients reported high satisfaction with their care

That should give you some good ideas when trying to figure out who you should be marketing to. I can lead the horse to water but I cannot show the snout into the pond and make the horse drink it up. 

Text Neck

I picked this one out because I saw a discussion on Facebook last week about Text Neck. The question posed was, isn’t text neck just a new term for an old problem? Is text neck just a scare tactic?

That was the general gist of the post. 

While I did not respond, I do have an opinion on text neck. I do not think it’s an old problem. I mean, let’s back up a bit. Poor posture is most certainly an age-old problem. No doubt about it. 

However, at no other point in our time in history that I’m aware of, have little bitty children all the way up to mid-aged and elderly people had a reason to be sitting in one spot for hours with their head flexed forward, bent down almost into their laps. It pains me to see some of the kids these days. 

My poor son. Not so much my daughter right now but my son….my goodness. That kid…I’ll look at him sometimes and he has somehow balled himself up into what I can only describe as something resembling a roly-poly or an armadillo. His head bent at 90 degrees looking at his phone in his lap. Basically, the epitome of text neck.

It must really suck being a chiropractor’s kid. I’ve taken pictures of it before when he wasn’t looking. As you probably know, you can draw on pictures on your phones. So I took that picture then drew big red marks exploding out of his neck. Then, while he’s sitting there on his phone, he gets the picture in a text. 

It’s awesome. You all should try it sometime if for no other reason than to give yourselves a laugh. 

Next Paper

This paper is called, “Cervical Proprioception in a Young Population Who Spend Long Periods on Mobile Devices: A 2-Group Comparative Observational Study” and it was published in the Journal of Manipulative and Physiological Therapeutics as well[2]. The lead author was Andrew Portelli and it was published in February of 2018. 

https://www.jmptonline.org/article/S0161-4754(17)30010-6/fulltext?elsca1=etoc&elsca2=email&elsca3=0161-4754_201802_41_2_&elsca4=Physical%20Medicine%20and%20Rehabilitation%7CHealth%20Professions

Why They Did It

The purpose of this study was to evaluate if young people with insidious-onset neck pain who spend long periods on mobile electronic devices (known as “text neck”) have impaired cervical proprioception and if this is related to time on devices.

What They Found

“The participants with text neck had a greater proprioceptive error during cervical flexion compared with controls. This could be related to neck pain and time spent on electronic devices.”

This message has been brought to you by an uncool parent of a teenager. 

Paper #3

This one is called, “Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial[3].” and it was published in Spine journal in February of 2018. 

https://www.ncbi.nlm.nih.gov/pubmed/29481979/

Why They Did It

The optimal number of visits for the care of cervicogenic headache with spinal manipulative therapy is unknown so the authors hoped to identify the dose-response relationship between visits and chronic headache outcomes…. and to evaluate the efficacy of chiropractic by comparison with a light-massage control.

What They Found

The authors’ conclusion was as follows, “There was a linear dose-response relationship between SMT visits and days with CGH. For the highest and most effective dose of 18 SMT visits, CGH days were reduced by half and about 3 more days per month than for the light-massage control.”

So, you guys and gals that want to take evidence-based to the extreme and get people out of your office in only 3 or 4 visits, you may not be hitting the number of visits that work the best. Everyone is different right? Everyone heals differently. Here we have 18 visits being the most effective for chronic cervicogenic headache. 

Good info to keep in mind. 

Integrating Chiropractors

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

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

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

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

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

That’s Chiropractic!

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

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

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

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About the author:

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

Bibliography

1. Herman PM, Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain. J Manipulative Physiol Ther, 2018.

2. Portelli A, Cervical Proprioception in a Young Population Who Spend Long Periods on Mobile Devices: A 2-Group Comparative Observational Study. J Manipulative Physiol Ther, 2018. 41(2): p. 123-128.

3. Haas M, Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine, 2018: p. S1529-9430.

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