chiropractic

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15)

CF 334: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15)…..it’s the final part of the series.  But first, here’s that sweet sweet bumper music  

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  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, smarts, personality, 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 resource for you and is 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. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • 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 #334 Now if you missed last week’s episode, we talked about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Up and down, peaks and valleys, getting hit and landing blows, riding the waves or gasping for air, whack-a-freaking-mole.  Slow week this week and last. Two weeks ago and May overall, we killed it. Absolutely killed it. Now, I’m wondering if we should just close the doors and call it a good career. We tried. Lol. 

Yes, that’s super dramatic.

No, we’re not closing up shop. Lol. But that’s how you get sometimes right? Damnit can’t it just be a set it and forget it thing? Well the answer is no. It cannot and will not. The competition is too great to rest solely on your reputation in the community. Yes, it helps but it’s not enough to stay where you want to be. It’s just not.  We all feel important I’m sure but here’s the brutal truth. People start to forget us the minute we go silent. You have to keep that pedal to the metal with the marketing, being involved in the community, constant weekly touches in the community, and telling your current active patients how much you appreciate referrals. They don’t always know, ya know?

So, market market market.  In separate news, I am re-engaging with the group I’ve mentioned in the past about purchasing 60% of the clinic, bringing in an associate or two, and having more time for voice-over work, real estate work, and medicolegal work in the chiropractic realm. 

If my plans are solid and actually happen…..and I have a track record of making things happen……in 2 years, I’ll have more and more time to dedicate to podcast hosting and painting and sculpting and all of the aspects of life outside of the clinic that truly feed my soul.  We’re working on it and so far, it’s looking good. It just takes time and I’ll keep you all updated as we go along. It may be something you want to consider as I go through it and come out the other side. 

Item #1

The last paper in our series is called, “The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial” by Zaworski et al and published in European Journal Of Physical Rehabilitative Medicine in April of 2021. Remember, the citations can be found at chiropracticforward.com under this episode. 

Zaworski K, Latosiewicz R. The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial. Eur J Phys Rehabil Med. 2021 Apr;57(2):280-287. doi: 10.23736/S1973-9087.21.06344-9. Epub 2021 Mar 2. PMID: 33650840.

Last reminder on this series. The WHO recommends spinal manipulative therapy at very low confidence. I’ve been doing this podcast every single week for over 7 years and the amount of research in favor of smt for everything but especially low back pain is honestly pretty staggering.

So, when I see the WHO recommend SMT, I’m like….well of course they do.  And then I see ‘at very low confidence’ which is the same level they recommended ultrasound, well, then I got miffed. I got ‘pressed’ as the kids say these days. Hundo P.  So I found all of the papers the WHO used to make the determination and we went through them one by one and this is the last one. 

Why They Did It

The aim of the study was to determine whether the use of combined therapy consisting of manual therapy and proprioceptive neuromuscular facilitation (PNF) is more effective than the use of manual therapy techniques, proprioceptive neuromuscular facilitation or traditional kinesiotherapy as single methods in the treatment of low back pain.

How They Did It

The setting was a Rehabilitation Department of Hospital in Parczew (Poland). The study was designed as four-arm randomized comparative controlled RCT and conducted on a group of 200 patients aged 27-55y. The patients were randomly divided into four 50-person groups:  1) group A – manual therapy;  2) B – proprioceptive neuromuscular facilitation;  3) C – manual therapy and proprioceptive neuromuscular facilitation; and  4) group D – traditional kinesiotherapy and control group.  Pain intensity was measured using VAS and Laitinen’s questionnaire.  Functional disability was assessed using Oswestry Disability Index (ODI) and Back Pain Functional Scale (BPFS).

What They Found

There was a statistically significant difference in pain reduction (VAS Scale) between Group C (4.8 points) and Group D (3.9 points).  In all the groups there was a statistically significant reduction in a degree of disability as measured by the ODI.  A level of functional capabilities increased significantly only in Group C (8.8 points) as compared to Group D (5.7 points).

Wrap It Up

All the evaluated methods caused pain reduction which lasted for at least 2 weeks after the end of treatment.  The degree of disability as measured by ODI lowered evenly in all groups.  Patients’ functional ability improved significantly in the group treated with combined manual therapy and proprioceptive neuromuscular facilitation as compared to the group of traditional kinesiotherapy.

OK, so there’s yet another paper the WHO used that’s in favor of SMT.  I’m going to try to do a very fast summary of what we’ve learned here, folks. 

For the record, I started this series on December 14, 2023 and today is June 10, 2024.

Yes, we’ve been at it for a while now. So, what DID we learn now that we’re at the end of our efforts? For starters, they cherry picked some pretty crappy papers. One was a pilot study. Why would you place the recommendation of a modality in part on a pilot study? Not sure about that.  Many of them were very small sample sizes. 

More strikingly though were the ages of these papers? Again, we cover new and fresh papers all of the time and low back pain specifically has been covered  and covered and covered again in the last 5 – 10 years and almost all papers have been in favor of SMT.  So why on Earth is the WHO sourcing and using old papers with mostly small sample sizes? I’m talking about papers from 1978, 1985, 1986, 1992, 2003, 2004, 2007, 2011, 2012, 2012 (pilot study), 2013, 2013. 

Yes there are some papers they used that were from 2020, 2019, 2017 or so. But I’d venture a guess that well over 60% of the papers they used were over 10-12 years old and some were as old as 35 years, 38 years, and up to 46 years old. What the holy hell? For real. Wrap your damn heads around that hot garbage.  Please tell me there’s an agenda to keep chiropractors in their place without telling me there’s and agenda to keep chiropractors in their place. It’s ponderous. 

The final score is:

    • In favor of SMT: 19
    • Undetermined: 5
    • Against: 4

So, you folks do what you will with the information. I don’t know that there’s anything that can be done. It’s the WHO out there doing WHO stuff but I’m telling your right now, them rating SMT at ‘very low confidence’ is incorrect in my opinion and I feel that our little experiment proves it beyond simply ‘my opinion’. 

Keep fighting my friends. Lots of work left to do!

Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world.

The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in 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!

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

 

Website https://www.chiropracticforward.com

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

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

Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic

CF 333: Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic Today we’re going to talk about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic 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!

Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  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, smarts, personality, 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 resource for you and is 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. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • 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 #333 Now if you missed last week’s episode, we talked about Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. Nothiing too special is going on with the clinic this week. We’re just doing our deal. Seeing patients. No big events last week and nothing too huge on the horizon other than the big Texas Chiropractic Association convention called ChiroTexpo goign on in Frisco, TX which is basically Dallas. That will be June 28-30 I believe and if you’re in TX or wish you were, come on and join us.  We’ve always got a great crown and would love to have you down there. Seminars are a great way to get that continuing education but an even better way to network and develop a little bit of influence. Why not? We sit around and we bitch about the state of our profession.

But are we doing anything at all to influence it? Are you a member of the ACA or your state association? If there are a bunch of subbies running your state association, instead of that being a turn-off, shouldn’t that be an amazing opportunity for you and some of your evidence-based friends to get involved and get yourselves in the seats of influence and control so that you can gently start to turn that air craft carrier the right direction? Instead of seeing the obstacle, see the opportunity. Ryan Holliday wrote a book called The Obstacle Is The Way. I highly recommend it.

I promise, when you walk into a board meeting and you realize that only 15-20 people in your entire state run the association, determine the speakers at your events, fight your fights and battles, etc….then you realize what kind of difference you can make. And I mean rather quickly if there’s a handful of you.  So, get it together, get involved, and make this profession respected the way the 2024 brand of chiropractic should be respected. Stop letting the loud-mouthed and angry subbies run the show. It’s your turn now.

Item #1

The first one this week is called “Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer A Systematic Review and Meta-Analysis” by Demb et al and published in JAMA Network Open on May 24, 2024. Aye, Chihuaua!! Es muy caliente! Remember, the citations can be found at chiropracticforward.com under this episode. 

Demb J, Kolb JM, Dounel J, et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(5):e2413157. doi:10.1001/jamanetworkopen.2024.13157

Why They Did It To report the frequency of presenting red flag signs and symptoms among individuals with early-onset colorectal cancer, to examine their association with early-onset colorectal cancer risk, and to measure variation in time to diagnosis from sign or symptom presentation.

How They Did It

  • PubMed/MEDLINE, Embase, CINAHL, and Web of Science were searched from database inception through May 2023.
  • Studies that reported on sign and symptom presentation or time from sign and symptom presentation to diagnosis for patients younger than age 50 years diagnosed with nonhereditary colorectal cancer were included.
  • Data extraction and quality assessment were performed independently in duplicate for all included studies using Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. 
  • Joanna Briggs Institute Critical Appraisal tools were used to measure risk of bias. Data on frequency of signs and symptoms were pooled using a random-effects model.
  • Outcomes of interest were pooled proportions of signs and symptoms in patients with early-onset colorectal cancer, estimates for association of signs and symptoms with early-onset colorectal cancer risk, and time from sign or symptom presentation to early-onset colorectal cancer diagnosis.

What They Found

  • Of the 12,859 unique articles initially retrieved, 81 studies with 24,908 126 patients younger than 50 years were included. 
  • The most common presenting signs and symptoms, reported by 78 included studies, were hematochezia, abdominal pain, and altered bowel habits. 
  • Hematochezia (is the passage of fresh blood through the anus, usually in or with stools), abdominal pain, and anemia were associated with higher early-onset colorectal cancer likelihood. 
  • Time from signs and symptoms presentation to early-onset colorectal cancer diagnosis was a mean of 6.4 months and a median of 4 months.

Wrap It Up

  • In this systematic review and meta-analysis of patients with early-onset colorectal cancer, nearly half of individuals presented with hematochezia and abdominal pain and one-quarter with altered bowel habits. 
  • Hematochezia was associated with at least 5-fold increased early-onset colorectal cancer risk. 
  • Delays in diagnosis of 4 to 6 months were common. 
  • These findings highlight the need to identify concerning early-onset colorectal cancer signs and symptoms and complete timely diagnostic workup, particularly for individuals without an alternative diagnosis or sign or symptom resolution.

Item #2

The second one is called, “Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data” by Trager et al and published in BMJ open in 

Trager RJ, Cupler ZA, Srinivasan R, et al Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data BMJ Open 2023;13:e073258. doi: 10.1136/bmjopen-2023-073258

Why They Did It

Radicular low back pain (rLBP) is often treated off-label with gabapentin or by chiropractors using chiropractic spinal manipulative therapy (CSMT). To date, no studies have examined the association between these interventions.  We hypothesised that adults under 50 years of age receiving CSMT for newly diagnosed rLBP would have reduced odds of receiving a gabapentin prescription over 1 year-follow-up.

How They Did It

Retrospective cohort study. Setting US network including linked medical records, medical claims and pharmacy claims of >122 million patients attending large healthcare organisations (TriNetX), queried 15 June 2023, yielding data from 2017 to 2023.

Participants Adults aged 18–49 were included at their first occurrence of rLBP diagnosis.  Exclusions were severe pathology, other spinal conditions, on-label gabapentin indications and gabapentin contraindications.  Propensity score matching controlled for variables associated with gabapentin use and receipt of prescription medication over the preceding year. Interventions Patients were divided into CSMT or usual medical care cohorts based on the care received on the index date of rLBP diagnosis. Primary and secondary outcome measures OR for gabapentin prescription.

What They Found

  • After propensity matching, there were 1635 patients per cohort. 
  • Gabapentin prescription over 1-year follow-up was significantly lower in the CSMT cohort compared with the usual medical care cohort, with an OR of 0.53. 
  • Sensitivity analyses revealed early divergence in cumulative incidence of prescription; and no significant between-cohort difference in a negative control outcome (gastrointestinal medication) suggesting adequate control for pharmacological care preference.

Wrap It Up

  • Our findings suggest that US adults receiving CSMT for newly diagnosed rLBP have significantly reduced odds of receiving a gabapentin prescription over 1-year follow-up compared with those receiving usual medical care. 
  • Results may not be generalisable and should be replicated in other healthcare settings and corroborated by a prospective study to reduce confounding.

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!

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 11)

CF 325: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 11) Today we’re going to talk about “The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 11)” But first, here’s that sweet sweet bumper music     Today we’re going to talk about Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider 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!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  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, smarts, personality, 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 resource for you and is 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. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • 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 #325 Now if you missed last week’s episode, we talked about Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I see the battle coming and I’m trying to build the walls. It’s tough to go from seeing 8-10 new VA patients every week down to seeing about 1 every 2 weeks. Plus they’re reducing their visits to acute conditions only when most of these folks are chronic. They’ve been hurting literally for decades for some of them.  So, yeah, the battle is approaching so I’m trying to build walls. Now, how do we do that? We stop being lazy about marketing and, I’m a Christian so I always believe that when one door is closed, another will open and the one that opens is usually better.  All big changes in my life and business has always been for the best. Even when I thought the changes were catastrophic. This one is inconvenient and it pisses me off a bit. I’d love to have a set it and forget it type of business but it’s just not and never will be.  It’s ups and downs every week so that’s what we’re doing. We’re riding the coaster and preparing for the decrease in our numbers that’s already here and that we know will continue to get worse before it levels off and before we get our marketing in full gear and get after it again before the VA started sending the vets to us.  Yep, fully engaged now. I’ll keep you updated.  I want to congratulate Dr. Steve Brown out in Gilbert, AZ on his new peer reviewed paper that came our recently. Steve is doing good work and trying to help chiropractors stay out of trouble on the smt stroke issue that we’re all having to deal with all of the time.  I’m putting the link to Dr. Brown’s paper right here in the show notes so go grab it and check it out. https://www.cureus.com/articles/239108-plausible-mechanisms-of-causation-of-immediate-stroke-by-cervical-spine-manipulation-a-narrative-review#!/ It may save your collective asses.  Now, due to this paper Steve has the predictable drivel coming from the philosophy wonks that have a stake in the game and that’s OK. He expects that. Heck he even might welcome it with a research-backed response of his own. But, if one looks deeper than the detractors seem to have the brain space to do, his paper pretty much protects us. If we read it, we can prevent dissections most times and, should a pt. Try to state we’re responsible for a VAD the next few days or weeks after an adjustment, his paper provides some protection.  Then, about the same week, we had a knucklehead present a case study called, “Myositis Ossificans Traumatica of Bilateral Sternocleidomastoid Muscles After Chiropractor Adjustment: A Case Report” by Felix et. Al in Cureus where they implied heavily that a chiropractic adjustment was the cause of the myositis ossificans.  I’m going to leave the link here in the show notes at chiropractiforward.com under episode 325.  https://www.cureus.com/articles/234594-myositis-ossificans-traumatica-of-bilateral-sternocleidomastoid-muscles-after-chiropractor-adjustment-a-case-report#!/  I hope you’ll go to the link, scroll down to the comments and watch Dr. Brown chime in and systematically tear this crap paper apart and watch the authors basically apologize and promise to make the necessary changes.  The moral of the story is this; research isn’t here to hold us back and tear us down. It’s here to defend us, make us better, and provide more and more validity as we increase our knowledge base. That’s why I’m here. That’s why Dr. Steve Brown and so many others are here.  One of the biggest hits I see our profession take online is that we’re all quacks because the profession was founded by a belief and a magnetic mystical healer. True as that may be, the medical field once had blood letting, leaches, and lobotomies.  Research pulled them together and out of the catacombs and research will and is doing the same for us as chiropractors. I promise when research came out proving blood letting useless, there were still those that had used blood letting for decades fighting the research, attacking and discrediting the research and researchers, and doing everything they could to clutch their pearls and maintain their box of safety.  All I can say is that flat Earthers will do flat earth stuff and you can’t tell or show them anything differently. Moon landing deniers…….good luck convincing them otherwise. When a certain dogma has taken over and defined one’s life, you can’t and won’t change it.  But that will never stop new thinking, research, and forward movement.  Item #1 We are continuing the series on why the hell the WHO would recommend SMT at very low confidence which, if you’ve been following along, is the same level of confidence they give ultrasound. Well that’s BS and I went and found all of the papers they used to make this determination and we’re going through each and every of them trying to form and impression of our own.  The first one today is called, “United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care” by UK BEAM Trial Team, published in British Medical Journal in December of 2004.  UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care. BMJ. 2004 Dec 11;329(7479):1377. doi: 10.1136/bmj.38282.669225.AE. Epub 2004 Nov 19. PMID: 15556955; PMCID: PMC535454. Remember, the citations can be found at chiropracticforward.com under this episode.  Why They Did It To estimate the effect of adding exercise classes, spinal manipulation delivered in National Health System or private premises, or manipulation followed by exercise to “best care” in general practice for patients consulting with back pain. How They Did It Pragmatic randomised trial with factorial design. Setting: 181 general practices in Medical Research Council General Practice Research Framework; 63 community settings around 14 centres across the United Kingdom. Participants: 1334 patients consulting their general practices about low back pain. Main outcome measures: Scores on the Roland Morris disability questionnaire at three and 12 months, adjusted for centre and baseline scores. What They Found
  • All groups improved over time. 
  • Exercise improved mean disability questionnaire scores at three months by 1.4 more than “best care.” 
  • For manipulation the additional improvement was 1.6 at 12 months. 
  • For manipulation followed by exercise the additional improvement was 1.9 at three months and 1.3 at 12 months. 
  • No significant differences in outcome occurred between manipulation in NHS premises and in private premises. 
  • No serious adverse events occurred.
Wrap It Up Relative to “best care” in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months. Item #2 The second one is called, “Effect of Spinal Manipulative and Mobilization Therapies in Young Adults With Mild to Moderate Chronic Low Back Pain: A Randomized Clinical Trial” by Thomas et. Al published in JAMA Network Open in August 2020 Thomas JS, Clark BC, Russ DW, et al. Effect of Spinal Manipulative and Mobilization Therapies in Young Adults With Mild to Moderate Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2020;3(8):e2012589. doi:10.1001/jamanetworkopen.2020.12589 Why They Did It Low back pain (LBP) is one of the most common reasons for seeking medical care. Manual therapy is a common treatment of LBP, yet few studies have directly compared the effectiveness of thrust (spinal manipulation) vs nonthrust (spinal mobilization) techniques. To evaluate the comparative effectiveness of spinal manipulation and spinal mobilization at reducing pain and disability compared with a placebo control group (sham cold laser) in a cohort of young adults with chronic LBP. How They Did It This single-blinded (investigator-blinded), placebo-controlled randomized clinical trial with 3 treatment groups was conducted at the Ohio Musculoskeletal and Neurological Institute at Ohio University from June 1, 2013, to August 31, 2017.  Of 4903 adult patients assessed for eligibility, 162 patients with chronic LBP qualified for randomization to 1 of 3 treatment groups.  Recruitment began on June 1, 2013, and the primary completion date was August 31, 2017.  Data were analyzed from September 1, 2017, to January 20, 2020. Participants received 6 treatment sessions of 
  1. spinal manipulation, 
  2. spinal mobilization, or 
  3. sham cold laser therapy (placebo) during a 3-week period.
What They Found Coprimary outcome measures were the change from baseline in Numerical Pain Rating Scale (NPRS) score over the last 7 days and the change in disability assessed with the Roland-Morris Disability Questionnaire 48 to 72 hours after completion of the 6 treatments. A total of 162 participants with chronic LBP were randomized.  Fifty-four participants were randomized to the spinal manipulation group, 54 to the spinal mobilization group, and 54 to the placebo group.  There were no significant group differences for sex, age, body mass index, duration of LBP symptoms, depression, fear avoidance, current pain, average pain over the last 7 days, and self-reported disability.  At the primary end point, there was no significant difference in change in pain scores between spinal manipulation and spinal mobilization, spinal manipulation and placebo, or spinal mobilization and placebo.  There was no significant difference in change in self-reported disability scores between spinal manipulation and spinal mobilization, spinal manipulation and placebo or spinal mobilization and placebo.   Wrap It Up In this randomized clinical trial, neither spinal manipulation nor spinal mobilization appeared to be effective treatments for mild to moderate chronic LBP 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.      Today we’re going to talk about Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider 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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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter 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      

Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider

CF 324: Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider

 

Today we’re going to talk about Cancer-Finding Blood Tests & Neck Pain Treatment Differs By Initial Provider 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!

Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spen ding your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, 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 resource for you and is 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. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • 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 #324 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 10).  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. Whack a mole Roller coaster of business Nothing is guaranteed. Nothing. Up and down up and down.  If you’re a follower of the podcast, you’ll know you’ve heard shows when I was riding high. Killing it. 20-25 new patients per week. 185-200 visits a week by myself. Then Periods of time like more recently when I have been seeing COVID era numbers and running low on funds while funding new clinic endeavors. Then, we start recovering from that and we’re on the way back up. Just in time for the local VA to hire themselves an acupuncturist and a chiropractor so many of our new patients and visits will begin to start to disappear.  Business ownership: it’s crazy man. But we’re on the ride and it’s time to stop being lazy. I’m a hustler in the best sense of the word. I know how to pivot and I know how to aim and direct money. I’ve wasted so much money in the past but I’ve made a hell of a lot too! So, to pivot. Pivot is in process. We’re still on the rollercoaster but, at 51 years old, I feel like my days of being in the craziest coasters are coming to an end and the days of being on a more stable, and older person appropriate coaster are just beginning. Stay tuned. You literally never know what’s going to happen around here from week to week.

 

Item #1 Our first one today is called, “”Questions Swirl Around Screening for Multiple Cancers With a Single Blood Test” by Rubin et. al. and published in JAMA on March 15, 2024

Remember, the citations can be found at chiropracticforward.com under this episode.

Rubin R. Questions Swirl Around Screening for Multiple Cancers With a Single Blood Test. JAMA. 2024;331(13):1077–1080. doi:10.1001/jama.2024.1018

 

New Blood Tests Promise Early Cancer Detection, But Experts Urge Caution Multiple cancer detection (MCD) blood tests are emerging as a potential way to catch cancer early. However, there’s significant uncertainty surrounding their benefits and drawbacks. What are MCD tests? These tests analyze blood for circulating tumor cells, DNA fragments, proteins, or other indicators suggesting cancer somewhere in the body. Unlike traditional cancer screenings (e.g., mammograms), MCD tests are not specific to one type of cancer and can potentially detect over 50 different cancers.

Pros:

  • May detect cancers not covered by existing screening methods.
  • Potentially leads to earlier diagnosis and treatment.
  • Easier and less invasive than traditional screenings.

Cons:

  • Tests are not yet FDA-approved and lack long-term data on effectiveness.
  • Positive results may lead to unnecessary anxiety and invasive follow-up procedures.
  • Tests might not detect slow-growing cancers or those unlikely to cause harm.
  • Unclear if early detection through MCD tests translates to lower cancer mortality.
  • High cost not currently covered by insurance.

Unanswered Questions:

  • Do MCD tests improve cancer survival rates?
  • Do they detect cancers best left untreated?
  • How should positive results be interpreted and followed up on?
  • Are physicians prepared to guide patients through MCD testing?

The Takeaway: While MCD tests hold promise, their true value remains unclear. Experts recommend waiting for more research before widespread adoption. The focus should be on establishing clear guidelines for appropriate use and interpreting test results.

 

Item #2

Our second paper today is called, “Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty” by Fenton et. al. and published in Spine Journal in October of 2023 and it’s all hot this week!

Fenton, Joshua J. MD, MPHa,b; Fang, Shao-You PhDb; Ray, Monika PhDb,c; Kennedy, John CCS, CDIPb; Padilla, Katrine MPPb; Amundson, Russell MDd; Elton, David DCd; Haldeman, Scott DC, MD, PhDe; Lisi, Anthony J. DCf; Sico, Jason MD, MHSf,g; Wayne, Peter M. PhDh; Romano, Patrick S. MD, MPHb,c. Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty. Spine 48(20):p 1409-1418, October 15, 2023. | DOI: 10.1097/BRS.0000000000004781

Why They Did It Initial provider specialty has been associated with distinct care patterns among patients with acute back pain; little is known about care patterns among patients with acute neck pain.. The authors wantedtTo compare utilization patterns for patients with new-onset neck pain by initial provider specialty.

How They Did It

  • Retrospective cohort study.
  • De-identified administrative claims and electronic health record data were derived from the Optum Labs Data Warehouse, which contains longitudinal health information on over 200M enrollees and patients representing a mixture of ages and geographical regions across the United States. 
  • Patients had outpatient visits for new-onset neck pain from October 1, 2016 to September 30, 2019, classified by initial provider specialty. 
  • Utilization was assessed during a 180-day follow-up period, including subsequent neck pain visits, diagnostic imaging, and therapeutic interventions.

What They Found

  • The cohort included 770,326 patients with new-onset neck pain visits. 
  • The most common initial provider specialty was chiropractor (45.2%), followed by primary care (33.4%). 
  • Initial provider specialty was strongly associated with the receipt of subsequent neck pain visits with the same provider specialty. 
  • Rates and types of diagnostic imaging and therapeutic interventions during follow-up also varied widely by initial provider specialty. 
  • While uncommon after initial visits with chiropractors (≤2%), CT, or MRI scans occurred in over 30% of patients with initial visits with emergency physicians, orthopedists, or neurologists. 
  • Similarly, 6.8% and 3.4% of patients initially seen by orthopedists received therapeutic injections and major surgery, respectively, compared with 0.4% and 0.1% of patients initially seen by a chiropractor.

Wrap It Up

Within a large national cohort, chiropractors were the initial provider for a plurality of patients with new-onset neck pain. Compared with patients initially seen by physician providers, patients treated initially by chiropractors or therapists received fewer and less costly imaging services and were less likely to receive invasive therapeutic interventions during follow-up. 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!

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Young Athletes With CTE & Catastrophizing, Fear Avoidance, and Pain

CF 322: Young Athletes With CTE & Catastrophizing, Fear Avoidance, and Pain

Today we’re going to talk about Young Athletes With CTE & Catastrophizing, Fear Avoidance, and Pain But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  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, smarts, personality, 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 resource for you and is 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. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • 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 #322 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 9).  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. I’m recording on a Monday and we have the big West Texas Conference coming up this Friday for the Texas Chiropractic Association. It’ll be in Lubbock, TX so about an hour and 45 minutes south of where I’m at here in Amarillo.  I’ve paid for our Parker intern, Dontae, to come with. I think it’s up to the older folks to get the younger folks engaged in our state associations. If you listen long enough, in every podcast, at the end, I say that the ACA and our state associations need bus in the leadership positions if this profession is ever going to continue gaining integration into the system as a whole. If we’re ever going to achieve 1st or 2nd referral status for a non-complicated msk issue, we damn well better start behaving like part of the team instead of part of a fringe cult from outer space. 

Here’s a thought, hey clinic owners and lead doctors with associates, if you don’t require your associates to be a part of their state associations, you are absolutely, undeniably part of the problem. It’s as much Your responsibility to bring them up correctly as it is theirs to start getting involved in their profession.  Oh, I’m getting fired up this morning, damnit!! I’ve held enough positions in the TCA at this point that I’ve lost count and ever since my first year of involvement, our membership has been the issue. We have about 25% of our licensed DCs in the state of TX as actual members in the TCA. So, if we have 6,500 DC in the state, then about 1600 or so are members. Not active members. Just dues-paying members.

Minimal effort members, you might say. 

Consider that the state of TX has around 70,000 physicians and the vast majority are required to be paying members of their predatory state association. The official name is Texas Medical Association but we call them the Evil Empire.  Tell me…..how in the hell are 1600 chiropractors, of which only about 50 are actually active, supposed to turn the tide or battle effectively against an Evil Empire of approximately 60,000 or more? Then throw in lead chiropractors and clinic owners that are sitting on their asses not giving a squirt one way or another and not showing their associates how to give back to their profession and how to protect their rights?

Come on…..it’s almost too ridiculous to even talk about. Why do we have to say this stuff?  it’s disappointing and astonishing.  I sat in a Board Of Directors meeting many years ago. It cost us money to be there and cost us money to be out of our clinics to be there. Fighting an uphill battle that the majority of the DCs in the state don’t care about. It’s self-defeating. But one of my colleagues and friends said, “If not us, then who?” And then it’s OK. Fight the battles nobody else is willing to fight.

Get in, impose your will. Make sure evidence-based, patient-centered practice models are at the forefront of your state association’s initiatives and influence and get the crazy aliens off of the stages at your states continuing education conferences. 

Literally, about 20 people run your associations at any point in time. Hop in. One person can make a world of difference.  Raise your hand. Send an email. Just show up and be there. 

Item #1 Our first one this week is called “Neuropathologic and Clinical Findings in Young Contact Sport Athletes Exposed to Repetitive Head Impacts” by McKee et. Al and published in JAMA Neurology on August 28, 2023 and that’s blisterin’ hot!! Remember, the citations can be found at chiropracticforward.com under this episode. 

McKee AC, Mez J, Abdolmohammadi B, et al. Neuropathologic and Clinical Findings in Young Contact Sport Athletes Exposed to Repetitive Head Impacts. JAMA Neurol. 2023;80(10):1037–1050. doi:10.1001/jamaneurol.2023.2907

Why They Did It Young contact sport athletes may be at risk for long-term neuropathologic disorders, including chronic traumatic encephalopathy (CTE). They wanted to characterize the neuropathologic and clinical symptoms of young brain donors who were contact sport athletes.

How They Did It This case series analyzes findings from 152 of 156 brain donors younger than 30 years identified through the Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) Brain Bank who donated their brains from February 1, 2008, to September 31, 2022.  Neuropathologic evaluations, retrospective telephone clinical assessments, and online questionnaires with informants were performed blinded. Data analysis was conducted between August 2021 and June 2023.

Exposures  Repetitive head impacts from contact sports.

Main Outcomes and Measures  Gross and microscopic neuropathologic assessment, including diagnosis of CTE, based on defined diagnostic criteria; and informant-reported athletic history and informant-completed scales that assess cognitive symptoms, mood disturbances, and neurobehavioral dysregulation.

What They Found Among the 152 deceased contact sports participants included in the study, CTE was diagnosed in 63 (median age, 26 years).  Of the 63 brain donors diagnosed with CTE, 60 were diagnosed with mild CTE (stages I or II).  Brain donors who had CTE were more likely to be older  Of the 63 athletes with CTE, 45 were men who played amateur sports, including American football, ice hockey, soccer, rugby, and wrestling; 1 woman with CTE played collegiate soccer.  For those who played football, duration of playing career was significantly longer in those with vs without CTE  Athletes with CTE had more ventricular dilatation, cavum septum pellucidum, thalamic notching, and perivascular pigment-laden macrophages in the frontal white matter than those without CTE. 

Cognitive and neurobehavioral symptoms were frequent among all brain donors.  Suicide was the most common cause of death, followed by unintentional overdose; there were no differences in cause of death or clinical symptoms based on CTE status.

Wrap It Up This case series found that young brain donors exposed to repetitive head impacts were highly symptomatic regardless of CTE status, and the causes of symptoms in this sample are likely multifactorial. 

Item #2 Our second one this week is called, “Changes in pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy mediate changes in pain intensity on disability in the treatment of chronic low back pain” by Ryum et al and published in Pain Reports in September of 2023 and it’s hot to the touch!

Ryum T, Stiles TC. Changes in pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy mediate changes in pain intensity on disability in the treatment of chronic low back pain. Pain Rep. 2023 Sep 13;8(5):e1092. doi: 10.1097/PR9.0000000000001092. PMID: 37719924; PMCID: PMC10501475.

Why They Did It Treatment of chronic low back pain (CLBP) based on the fear-avoidance model (FAM) has received support in randomized controlled trials, but few studies have examined treatment processes associated with treatment outcome.  This study examined changes in pain catastrophizing, fear-avoidance beliefs, and pain self-efficacy as mediators of the relation between changes in pain intensity and disability in exposure-based treatment of CLBP.

How They Did It Data from a randomized controlled trial with 2 treatment arms (which were the fear avoidance model with/without in-session exposure)  Change scores (pre to booster session) were computed for all variables, and the indirect effect of change in pain intensity on change in 3 measures of disability, through change in the proposed mediators, was tested in parallel mediation analyses.

What They Found Decreases in pain catastrophizing and fear-avoidance beliefs, as well as increases in pain self-efficacy, mediated a unique proportion of the relation between changes in pain intensity and disability, depending on the outcome measure.  The direct relation between changes in pain intensity and disability was absent when indirect effects were controlled.

Wrap It Up The results suggest that the way pain is interpreted (pain catastrophizing, fear-avoidance beliefs), as well as pain self-efficacy, are all more critical for reducing disability in exposure-based treatment of CLBP than symptom relief per se. You’ve been hearing this from you Ol’ Uncle Jeffro since about 2019 now. Since I went through the Diplomate of the Neuromusculoskeletal Medicine program. Which used to be called the DACO or the ortho diplomate.

It was the DACO when I started and changed in the middle of my education.  I wondered why but it became quickly apparent. There was as much Neuro in the process as there was ortho and yellow flags, upregulated CNS, fear avoidance and all kinds of Neuro tidbits were front stage. So, an ortho diplomate no longer adequately described what we were learning. 

Anyway, pay attention to this stuff. It will absolutely get your patients better when you understand 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!

Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website https://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 9)

CF 321: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 9)

Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 9) 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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Integrating Chiropractors

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  OK, we are back and you have found the Chiro ractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  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, smarts, personality, 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 resource for you and is 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. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • 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 #321 Now if you missed last week’s episode, we talked about PT For Sciatica & Laser For Neck Pain.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. I just got back from VO Atlanta, the world’s largest VoiceOver conference. I have to say that there are a lot of regular Joe’s like me walking about that place and in the industry but, oh my goodness….there are a lot of strange folks too as you might imagine.  A very diverse group and I’m not talking just about race. Just lots of different types of folks that the mainstream of our country wouldn’t recognize as being normal. I’ll just say it that way.  So, that was fun and useful and tiring. I’m glad I went but was glad to be back home. It’s a lot like going to chiropractic conferences.

Before I got involved in the Texas Chiropractic Association, I was a long\e wolf. I’d be out there on the fringe, not a member of the TCA, and almost proudly and defiantly uninvolved.  Compare and contrast that with me now. I’m a member of just about everything I can be a member of. Including the ACA, the TCA, FTCA, the MCM Mastermind, the Texas Orthopedic group, the national Orthopedic group, the national Forensics group and on and on and on.  My network then vs. now. I had a couple of folks I went to school with. Now, I have hundreds of trusted friends in the industry to learn from, ask questions, and bounce things off of.  There’s no comparison. The voice over thing reminds me of the fact that it’s not always the learning you get inside those classrooms that is the most valuable aspect of an industry conference.

Most of the time, it’s the one-on-one connections you make over dinner or over drinks and conversations you have with random folks throughout the weekend that pay the most dividends. Don’t get into conversations asking yourself, “what can I get from this person’ though. If you’re genuine and authentic and interested in others and what YOU can do for THEM, then it’s a natural instinct that they wonder what they can do for you in return.  That’s where the value of conferences comes in. It’s the network you build over years of going to these things that pay dividends. So, if you don’t see immediate ROI on the Monday you return, not to worry. Stick with it. Plant the seeds and reap the harvest down the road. 

Now remember we are continuing our series on why the WHO has designated spinal manipulative therapy at the level of very low confidence which is the same they designated ultrasound. I went and found all of the citations for all of the papers they used to make the determination. From what we’ve covered and from what I’m seeing, they haven’t used a lot of high-quality research to make the determination. This makes me wonder if there’s an agenda at the WHO to keep the man down. Keep the chiros in their place. Who knows? But it seems sus, as the kids say these days. 

Item #1 Our first paper this week is called, “Spinal manipulative therapy and exercise for older adults with Chronic Low Back Pain: a randomized clinical trial” by Schulz et. Al and published in Chiropractic Manual Therapy on May 15, 2019.  Remember, the citations can be found at chiropracticforward.com under this episode.  Schulz C, Evans R, Maiers M, Schulz K, Leininger B, Bronfort G. Spinal manipulative therapy and exercise for older adults with chronic low back pain: a randomized clinical trial. Chiropr Man Therap. 2019 May 15;27:21. doi: 10.1186/s12998-019-0243-1. PMID: 31114673; PMCID: PMC6518769.

Why They Did It Low back pain (LBP) is a common disabling condition in older adults which often limits physical function and diminishes quality of life.  Two clinical trials in older adults have shown spinal manipulative therapy (SMT) results in similar or small improvements relative to medical care; however, the effectiveness of adding SMT or rehabilitative exercise to home exercise is unclear.

How They Did It We conducted a randomized clinical trial assessing the comparative effectiveness of adding SMT or supervised rehabilitative exercise to home exercise in adults 65 or older with sub-acute or chronic LBP.  Treatments were provided over 12-weeks and self-report outcomes were collected at 4, 12, 26, and 52 weeks.  The primary outcome was pain severity.  Secondary outcomes included back disability, health status, medication use, satisfaction with care, and global improvement.  Linear mixed models were used to analyze outcomes.  The primary analysis included longitudinal outcomes in the short (week 4-12) and long-term (week 4-52).  An omnibus test assessing differences across all groups over the year was used to control for multiplicity.  Secondary analyses included outcomes at each time point and responder analyses.  This study was funded by the US Department of Health and Human Services, Health Resources and Services Administration.

What They Found 241 participants were randomized and 230 (95%) provided complete primary outcome data.  The primary analysis showed group differences in pain over the one-year were small and not statistically significant.  Pain severity was reduced by 30 to 40% after treatment in all 3 groups with the largest difference (eight percentage points) favoring SMT and home exercise over home exercise alone.  Group differences at other time points ranged from 0 to 6 percentage points with no consistent pattern favoring one treatment.  One-year post-treatment pain reductions diminished in all three groups.  Secondary self-report outcomes followed a similar pattern with no important group differences, except satisfaction with care, where the two combination groups were consistently superior to home exercise alone.

Wrap It Up Adding spinal manipulation or supervised rehabilitative exercise to home exercise alone does not appear to improve pain or disability in the short- or long-term for older adults with chronic low back pain, but did enhance satisfaction with care.

Item #2 The second paper today is called, “Manipulation does not add to the effect of extension exercises in chronic low-back pain (LBP). A randomized, controlled, double blind study” by Rasmussen et al published in Joint Bone and Spine in December of 2008.  Rasmussen J, Laetgaard J, Lindecrona AL, Qvistgaard E, Bliddal H. Manipulation does not add to the effect of extension exercises in chronic low-back pain (LBP). A randomized, controlled, double blind study. Joint Bone Spine. 2008 Dec;75(6):708-13. doi: 10.1016/j.jbspin.2007.12.011. Epub 2008 Nov 22. PMID: 19028434.

Why They Did It Both exercises and manipulation are recommended as basic therapy in back diseases, while a possible synergistic effect of these treatments have not been clarified.  This study was conducted to test a possible further effect of manipulation as adjunct to extension exercises for unspecific LBP.

How They Did It 72 patients with chronic LBP (mean 12 months) were examined by a specialist in manual medicine, who detected localized binding between the lumbar segments.  All patients were instructed in extension exercises, while randomized to either pretreatment with specific manipulation or control.  The patients were blinded to the manipulation, which was performed at the end of the manual examination, and repeated after two and four weeks.  The manipulator only knew the group of the particular patient just before manipulation by the end of the examination.  The primary end point was pain, measured by a visual analogue scale.

What They Found Pain in both back and leg decreased without differences between groups. Segmental binding of the low-back was associated with persisting clinical symptoms at four weeks.

Wrap It Up No additional effect was demonstrated of manipulation, when extension exercises were used as basic therapy. 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!

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

Website https://www.chiropracticforward.com

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

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

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

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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    

Pet Ownership And Cognitive Decline & PT Effectiveness

CF 312: Pet Ownership And Cognitive Decline & PT Effectiveness Today we’re going to talk about Pet Ownership And Cognitive Decline & PT Effectiveness 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!

Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  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, smarts, personality, 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 resource for you and is 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. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

 

On the personal end of things….. Alright, this was a crazy day. Where do we start? First, we had our new intern from Parker College start today. Welcome to the practice Donte. I’ll say he either picked the craziest day of days to start or he’s just bad luck.  Frist thing, it’s freezing outside and there are ice pellets coming out of the sky. It’s been pretty nice here in the Texas Panhandle until Donte’s first day with us. Now we’re just hoping no blizzard moves in with these 60 mph winds. 

Then, we one staffer out sick and then another got a call that her mother was having some health issues and she had to leave in a hurry so prayer for our work family. We’d appreciate your best wishes as well for her and her family.  Then we had a patient come in that was just a difficult one. It was our first from a PT so hey…..that’s cool as hell but this patient was a difficult one for sure.  There was more to the day that was challenging but I’m not going into the whole thing.

The point is, if Dontae was hoping to see an old guy navigate a day full of hurdles and land mines, he definitely got it.  It was a damn day and here’s hoping that the rest of the week is smooth sailing full of perfect patients and lots of learning for our new intern. 

Pro Tip, check out the C-sign. I was talking with one of my chiro buddies recently and he mentioned something about a patient with a low back and hip issue he had years ago. I asked if the patient had a C sign. My colleague wasn’t aware of the C-sign and I’ll admit that I wasn’t either until about 4 years ago when I went through the Ortho Diplomate. 

This is a Dr. Tim Bertlesman special for you. If they give you the C-sign, it’s the hip until you rule the hip out. That is an excellent rule of thumb and so easy to remember and bring back up because once you see and recognize the C-sign, you’ll be reminded immediately.  The C-sign is when a patient says, “It hurts right here.” And the have their thumb and index finger in a C shape and running the C along their iliac crest back and forth. Sometimes down into the inguinal area.  If you see that, assume it’s the hip until you rule it out with either orthos or imaging.  There’s your pro tip today.

Let’s get on with the episode. Since we’re going to have so many of the WHO and SMT and very low confidence episodes coming up, I’m going to split those up and just do them every other week to keep you invested and from getting bored with it.  You can thank Dr. Steven Brown from Gilber AZ for that. Lol. He said I seem obsessed with the topic.

He was joking of course but, while I’m not obsessed per se, I am definitely wondering; if we have as much research in our favor as we’ve covered for over 6 years now, how on Earth can the WHO have us at ‘very low confidence?’ Which is the same as ultrasound by the way.  I want to know. I’m figure a lot of you do as well. From our previous episodes on it, I see they’re using papers with low sample size and some that are definitely older studies to make that determination. But we’ll keep exploring. Just not this week. 

Item #1 Our first on ethis week is called, “How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis” by Dove, et. Al. and published in European Spine Journal on 29th of December 2022 and while it’s not piping hot, I haven’t gotten to use it in a bit so here ya go!! Remember citations to the papers can be found on our website at chiropracticforward.com and episode 312.  Dove, L., Jones, G., Kelsey, L. et al. How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. Eur Spine J 32, 517–533 (2023). https://doi.org/10.1007/s00586-022-07356-y

Why They Did It Physiotherapy interventions are prescribed as first-line treatment for people with sciatica; however, their effectiveness remains controversial.  The purpose of this systematic review was to establish the short-, medium- and long-term effectiveness of physiotherapy interventions compared to control interventions for people with clinically diagnosed sciatica

How They Did It It was a systematic review  Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Embase, PEDro, PubMed, Scopus and grey literature were searched from inception to January 2021.  Inclusion criteria were randomised controlled trials evaluating physiotherapy interventions compared to a control intervention in people with clinical or imaging diagnosis of sciatica.  Primary outcome measures were pain and disability.  Study selection and data extraction were performed by two independent reviewers with consensus reached by discussion or third-party arbitration if required.  Risk of bias was assessed independently by two reviewers  Three thousand nine hundred and fifty eight records were identified, of which 18 trials were included, with a total number of 2699 participants.  All trials had a high or unclear risk of bias. 

What They Found Meta-analysis of trials for the outcome of pain showed no difference in the short, medium or long term.  For disability there was no difference in the short, medium, or long term between physiotherapy and control interventions.  Subgroup analysis of studies comparing physiotherapy with minimal intervention favoured physiotherapy for pain at the long-term time points.  Large confidence intervals and high heterogeneity indicate substantial uncertainly surrounding these estimates.  Many trials evaluating physiotherapy intervention compared to substantial intervention did not use contemporary physiotherapy interventions.

Wrap It Up Based on currently available, mostly high risk of bias and highly heterogeneous data, there is inadequate evidence to make clinical recommendations on the effectiveness of physiotherapy interventions for people with clinically diagnosed sciatica.  Future studies should aim to reduce clinical heterogeneity and to use contemporary physiotherapy interventions.

Item #2 The last one today is called, “Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older” by Li et al and published in JAMA Network Open on December 26, 2023 and POW! That’s a hot one folks! Pet lovers listen up! Li Y, Wang W, Zhu L, et al. Pet Ownership, Living Alone, and Cognitive Decline Among Adults 50 Years and Older. JAMA Netw Open. 2023;6(12):e2349241. doi:10.1001/jamanetworkopen.2023.49241

Why They Did It Is pet ownership associated with cognitive decline in older adults, and how does pet ownership mitigate the association between living alone and the rate of cognitive decline? They wanted to explore the association of pet ownership with cognitive decline, the interaction between pet ownership and living alone, and the extent to which pet ownership mitigates the association between living alone and cognitive decline in older adults.

How They Did It This cohort study used data from waves 5 (June 2010 to July 2011) to 9 (from June 2018 to July 2019) in the English Longitudinal Study of Ageing.  Participants included adults 50 years and older.  Pet ownership and living alone in wave 5. Verbal memory and verbal fluency were assessed, and composite verbal cognition was further calculated. Of the 7945 participants included, the mean (SD) age was 66.3 (8.8) years, and 56.0% of the subjects were women.

What They Found Pet ownership was associated with slower rates of decline in composite verbal cognition, verbal memory, and verbal fluency.  Three-way interaction tests showed that living alone was a significant modifier in all 3 associations.  Stratified analyses showed that pet ownership was associated with slower rates of decline in composite verbal cognition, verbal memory, and verbal fluency among individuals living alone, but not among those living with others.  Joint association analyses showed no significant difference in rates of decline in composite verbal cognition, verbal memory, or verbal fluency between pet owners living alone and pet owners living with others.

Wrap It Up In this cohort study, pet ownership was associated with slower rates of decline in verbal memory and verbal fluency among older adults living alone, but not among those living with others, and pet ownership offset the associations between living alone and declining rates in verbal memory and verbal fluency.  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!

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Vertebrogenic Pain & Fish Oil Benefit Claims

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!

Chiropractic evidence-based products

Integrating Chiropractors

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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 #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!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter 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
  1. 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
  2. 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
       

Kids’ Screen Time & Physical Activity In Older Adults

CF 294: Kids’ Screen Time & Physical Activity In Older Adults

Today we’re going to talk about Kids’ Screen Time & Physical Activity In Older Adults

But first, heres 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!

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg
 

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 #294

Now if you missed last week’s episode, we talked about Nerve Pain Treated Naturally & The First Provider Seen Makes A Difference. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I just got back from a pretty incredible weekend with my wife. Our anniversary was a couple of weeks ago and her birthday was this last weekend so we kind of combined it all into a reason to have a trip. We went to Savannah, Georgia and Charleston South Carolina.

We flew out on Thursday to Savannah first. We went and saw the Savannah bananas play ball on Friday night and I just have to tell you if you don’t know anything about them just go to Facebook or TikTok. I think on TikTok they have 7.5 million followers which is more than any major league baseball team has. and they have that many followers for a reason. They are absolutely hilarious. It’s kind of like the Harlem Globetrotters of baseball.

And it wasn’t a three ring circus. It was a ten ring circus. And just a total blast from start to finish. If you get the chance, I highly recommend going to see the Savannah bananas. We did that and then kicked around Savannah for a day or so and then make the 2 1/2 hour drive over to Charleston on Saturday. Train is one of my wife’s favorite bands. Train happen to be playing in Charleston Saturday night. We were able to score some front row tickets and had a blast. They put on a really great show. And we spent the next day just kicking around Charleston on King Street. It was a great time.

Great weekend. I came back tired rather than recharged, but ready to get back into the swing of things today.

Today is a particularly exciting day because we. an intern from Parker college starting with us today. She’ll be with us through December 15. It’s always interesting to get a new intern. Are we gonna get along? Are they going to be dependable? Are they going to be fun to be around. Or are they just going to take up all your extra time?

In my experience, They are well worth it. And, anytime you get to be a positive influence on a young person, it’s time well spent. If you are not in any preceptor programs, or you don’t host any interns, I would encourage you to consider it. All right lots of stuff to do today so let’s go ahead and get into the research.

Item #1

 

The first on today is called Screen Time at Age 1 Year and Communication and Problem-Solving Developmental Delay at 2 and 4 Yearsby Takahashi,  et al and published in Jama Network and on August 21, 2023. Dayum. That’s hot.

Why They Did It

To examine the association between screen time exposure among children aged 1 year and 5 domains of developmental delay (communication, gross motor, fine motor, problem-solving, and personal and social skills) at age 2 and 4 years.

How They Did It

 

This cohort study was conducted under the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Pregnant women at 50 obstetric clinics and hospitals in the Miyagi and Iwate prefectures in Japan were recruited into the study between July 2013 and March 2017. The information was collected prospectively, and 7097 mother-child pairs were included in the analysis. Data analysis was performed on March 20, 2023.

What They Found

  • Of the 7097 children in this study, 3674 were boys (51.8%) and 3423 were girls (48.2%).
  • With regard to screen time exposure per day, 3440 children (48.5%) had l ess than 1 hour, 2095 (29.5%) had 1 to less than 2 hours, 1272 (17.9%) had 2 to less than 4 hours, and 290 (4.1%) had 4 or more hours.

  • Children’s screen time was associated with a higher risk of developmental delay at age 2 years in the communication, fine motor, problem-solving, and personal and social skills

  • Regarding risk of developmental delay at age 4 years, associations were identified in communication and problem-solving

Wrap It Up

 

In this study, greater screen time for children aged 1 year was associated with developmental delays in communication and problem-solving at ages 2 and 4 years.

 

These findings suggest that domains of developmental delay should be considered separately in future discussions on screen time and child development.

 

 

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 cant live without those products, send me an email and Ill 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, “Preventive Effect of an Intervention Program with Increased Physical Activity on the Development of Musculoskeletal Pain in Community-Dwelling Older Adults: A Randomized Controlled Trial” by Hirase, et. al. and published in Pain Medicine on November 2, 2022. warm potato!

Why They Did It

To examine whether compared with a program without increased physical activity, an intervention program with increased physical activity can prevent the development of musculoskeletal pain in community-dwelling older adults.

How They Did It

The exercise class consisted of weekly 60-min sessions over 24 weeks. The program to increase physical activity required the participants to record their daily step counts using pedometers.

The primary outcome was the development of musculoskeletal pain, and secondary outcomes were physical function, psychological status, cognitive function, and physical activity levels.

 

 

What They Found

Twenty-four weeks after the intervention, the intervention group had a significantly lower prevalence of musculoskeletal pain (12.8%) than the control group

A time-by-group interaction emerged for cognitive function and physical activity levels, both of which favored the intervention group.

The intervention group also showed greater improvement in psychological status 24  weeks after the intervention than the control group

Wrap It Up

The intervention program with increased physical activity prevented the development of musculoskeletal pain and improved cognitive function, physical activity levels, and psychological status more effectively than the program without increased physical activity. Our intervention program may be an effective pain prevention approach for older adults.

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!

Chiropractic evidence-based products

Integrating Chiropractors

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant 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….

Thats 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 cant 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

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

 

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

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

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

But first, heres 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!

Chiropractic evidence-based products

Integrating Chiropractors

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

 

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

 

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

 

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

 

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

 

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

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

 

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

 

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

 

On the personal end of things…..

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

 

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

 

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

 

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

 

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

 

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

 

Let’s do it.

 

 

 

Item #1

 

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

 

 

 

Why They Did It

 

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

 

 

How They Did It

 

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

 

 

What They Found

 

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

 

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

 

Wrap It Up

 

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

 

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

 

 

Before getting to the next one,

 

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

 

 

Item #2

 

Our last one this week is called, “Prenatal cannabis exposure associated with mental disorders in children that persist into early adolescence” by Nora D. Volkow, et al, and published in National Institutes of Health Post on September 12, 2022.

 

 

Why They Did It

 

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

 

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

 

How They Did It

 

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

 

 

What They Found

 

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

 

 

Wrap It Up

 

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

 

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

potentially affect brain development.

 

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

 

 

Store

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

 

 

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant 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….

 

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

 

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About the Author & Host

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