chiropractic

Fear Avoidance & Opioids and Neuro Changes With Cannabis Use In Adolescence

CF 199: Fear Avoidance & Opioids and Neuro Changes With Cannabis Use In Adolescence

Today we’re going to talk about fear avoidance behavior and opioids and we’ll talk about cannabis use in adolescence.  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

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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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

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

You have found yourself smack dab in the middle of Episode #199  Now if you missed last week’s episode, we talked about MRIs and Clinic Presentation & Surgery vs. Conservative Care For Discs. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things…..

I’m headed to Chicago on Wednesday. I’m going to the American College of Chiropractic Orthopedics conference out there. When you have completed the Forensics course work as I have, you go to the conference and take the final test.  I’m just gonna lay it out there; I haven’t studied. I hope my memory is amazing. More amazing than I think my 49-year-old noggin actually is. In real life. I’ve gotten so damn busy lately, I couldn’t study if I wanted to. So, we’re going to Chicago, we’re hanging out and learning good stuff, and then we’re keeping our fingers crossed that I’m able to kick the Ol clunky car into the driveway and bring the second Fellowship back home to the Williams Estate. Ultimately, if I don’t knock it out, I’m better than I was before.

Honestly, at the price point for this one after having done the Ortho Diplomate, it was a no-brainer.  Just the part of the course that was the AMA course on Impairment was useful. It’s pretty cool how they’ve quantified disability for basically anything and everything.

Crazy crazy

As mentioned, the recovery of the clinic numbers continues. I’m the only Chiro in the clinic and I had 33 new Chiro patients just last week alone. It’s a challenge. I’m probably going to have to be looking to hire an associate sooner rather than later if this stays the way it’s been in the last month. Funny how about 6 weeks ago I was frustrated with the lack of significant recovery from the COVID era numbers. Delta was on the spike. I didn’t see anything but a longer tunnel before we saw the light.  I’m by no means convinced it’s over. But numbers are going down now. And even in the middle of the delta spike, people here were done. 100% done. Restaurants have been full. No masks and no special distancing. Concerts. The whole thing.

Kids in school with no masks.

We had a spike for sure. It didn’t get as bad as the last spike. But bad enough to get everyone’s attention. I lost some folks I know during this last one. One of my buddies is in his fourth week in the hospital with it right now.  But business is back regardless and I’m pleased to see it. 

If you’ve been following along on the NP thing, still slow going. As is expected. Slow growing, slow to get our message heard. Just slow. But busier The hormone pellets have been amazing. We’re doing the IV therapy, PRP injection, trigger point injections, medical weight loss, COVID testing,…..it’s been interesting to get a peek into this world we’ve been essentially locked out of.  Sitting here today though, not one patient on his schedule so, we talk to our current patient load. We introduce our NP to everyone. We make them all aware that he’s here and we remove barriers. Barriers like ‘fear of the unknown by just introducing him. It’s a challenge but it’s one we are fully engaged in. Stay tuned. I’ll keep you updated on our progress. 

Item #1

Item 1 this week is called “Association of Cannabis Use During Adolescence With Neurodevelopment” by Albaugh et. al. (Albaugh MD 2021) and published in JAMA Psychiatry on June 16, 2021, and it’s ablaze!

Why They Did It

To what extent is cannabis use associated with magnetic resonance imaging–measured cerebral cortical thickness development during adolescence?

How They Did It

  • Cannabis use was assessed at baseline and 5-year follow-up with the European School Survey Project on Alcohol and Other Drugs. 
  • MRIs were done on each
  • The study evaluated 1598 MR images from 799 participants (450 female participants

What They Found

  • At a 5-year follow-up, cannabis use was negatively associated with thickness in the left prefrontal and right prefrontal cortices. 
  • There were no significant associations between lifetime cannabis use at 5-year follow-up and baseline cortical thickness, suggesting that the observed neuroanatomical differences did not precede initiation of cannabis use. 
  • Analysis revealed that thinning in the right prefrontal cortices, from baseline to follow-up, was associated with attentional impulsiveness at follow-up.

Wrap It Up

Results suggest that cannabis use during adolescence is associated with altered neurodevelopment, particularly in cortices rich in cannabinoid 1 receptors and undergoing the greatest age-related thickness change in middle to late adolescence.

Item #2

Number two today is called, “Anxiety and Fear Avoidance Beliefs and Behavior May Be Significant Risk Factors for Chronic Opioid Analgesic Therapy Reliance for Patients with Chronic Pain—Results from a Preliminary Study” by Silva et. al. (Marcelina Jasmine Silva 2021) and published in Pain Medicine in September of 2021 and it’s most certainly en Fuego on this day. 

Why They Did It

To describe differences between patients with chronic, non-cancer pain (CNCP) who were successfully able to cease full use of chronic opioid analgesic therapy (COAT), and those who reduced reliance on opioids,. How They Did It

  • A retrospective review of electronic medical records (EMR) data was organized for preliminary analysis.
  • It was a review of electronic medical records (EMR) data
  • 109 patients participated between October 2017 to December 2019

What They Found

  • Patients who were unsuccessful at opioid cessation reported significantly higher Fear Avoidance Beliefs Questionnaire (FAB) scores. 
  • Pain Catastrophizing Scale (PCS) scores showed a split pattern with unclear significance.

Wrap It Up

Results suggest that fear-avoidance beliefs and behavior play a significant role in refractory chronic opioid analgesic therapy reliance for patients with chronic non-cancer pain. We know this and you know this if you listen to this podcast with any regularity. We’ve covered it 100 times it seems. You should be having an ongoing conversation with your new patients about fear avoidance. 

A normal conversation that I have with new patients suffering from chronic pain sounds similar to this,

“Movement is healing. Motion is the lotion for the joints. Think about when someone has something as serious as surgery; they have them walking the halls that day or the next. Because movement is healing. 

Those that want a bottle of pills and some extra time to sit and wait for it to pass will be waiting longer and, sometimes, it never heals at all. Those that are getting back to their lives and working through the discomfort typically get better and have a better resolution of the injury. Know the difference between hurt and harm. When you’re injured, it can hurt getting back to the grind but that doesn’t mean it’s harmful. In fact, most of the time, hurt doesn’t mean harm.  Work through it and make it happen.  Most experts agree that pain lasting beyond 3 months is turning chronic and harder to treat. Taking control of chronic pain starts with understanding it so I’m going to give you an article I’ve written called Decoding Chronic Pain.

Please read it and we’ll talk about it on the next visit. In that article, there’s a recommendation for a book called “Back In Control” by David Hanscom, MD. He’s a fellow chronic pain sufferer and an orthopedic spinal surgeon. This book will give you some education and some techniques to help you with the cognitive aspect of pain, which my article addresses. You can throw acupuncture, massage, chiropractic, exercises, shot, and/or surgery at chronic pain but, many times, if you’re not also addressing the cognitive aspect of long-term pain, you likely won’t get where you want to be.

Are you familiar with the term ‘phantom limb pain’? How can a limb that is no longer attached and got burned up in an oven still hurt? It’s because they treated the peripheral source of the pain but did nothing to address the central, cognitive aspect of the issue. So the part of the brain that makes up the pain experience continues to make that pain experience happen. Even after it’s gone. That’s also why research has shown that when a chronic pain sufferer has absolutely perfect surgery for anything, they have a 60% chance of developing new chronic pain at the new site of insult or surgery. Because their pain-making mechanism is on high alert and uses pain as the protection mechanism. 

Part of improving and moving past it is to not avoid activities that you love and that feed your soul. If you start backing away from these activities, that’s called fear avoidance, and avoiding things can lead to deconditioning after only about 7 days for most. Not only that, but it takes a hell of a lot longer to re-condition.  So, fight back, move, hurt but work through it, and take control of this.  We’ll help you move, we’ll help work on balance, we’ll help with proprioception, we’ll help you discover what you’re still capable of doing. You do the exercises and move on your own at home.

Go for walks. Just move as much as you can.  Just know that you’re not stuck this way. Do you have any questions? OK, let’s get to work.”

Boom. That’s it.

Or something like that. Sometimes it’s shorter. Sometimes it’s longer and more involved. I’ve sat and talked to patients for an hour or more just to have them go and give me a 3 or 4-star review on Google because I didn’t get a good pop out of their back and they don’t feel any better after one visit. 

You know how it is.

That kind of stuff makes you want to stomp kittens and club baby seals but then there are those that you are able to save their lives on some level.

They’re the ones we’re here for so keep it all in the proper context and do the best you can every day.  Those are the ones that need us to be on top of our games.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to better it. 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 & disabilities and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

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

Contact

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

Connect

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

Website

Home

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TuneIn

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About the Author & Host

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

Bibliography

  • Albaugh MD, O.-G. J., Sidwell A, (2021). “Association of Cannabis Use During Adolescence With Neurodevelopment.” JAMA Psychiatry.
  • Marcelina Jasmine Silva, D., Zhanette Coffee, MSN, Chong Ho Yu, PhD, Marc O Martel, PhD (2021). “Anxiety and Fear Avoidance Beliefs and Behavior May Be Significant Risk Factors for Chronic Opioid Analgesic Therapy Reliance for Patients with Chronic Pain—Results from a Preliminary Study.” Pain Medicine 22: 2106-2116.

 

How Car Wrecks Contribute To Future Neck and Back Pain

CF 196: How Car Wrecks Contribute To Future Neck and Back Pain

Today we’re going to talk about How Car Wrecks Contribute To Future Neck and Back Pain. I have two different papers with what I thought were surprising conclusions in one way or another. Not only did I find themm a bit surprising but I don’t think the defense attorneys in PI cases will like either paper much. Just an assumption on my part. All of that coming up in this episode. 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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

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

You have found yourself smack dab in the middle of Episode #196 Now if you missed last week’s episode , we talked about Spinal Manipulative Therapy vs. Opioids and Young Elite Pitchers, Hips, and Elbow Pain. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things…..

We just ended our fourth week as an integrated practice and starting our fifth. It’s a struggle. I’m not going to lie. You see the money going out but you don’t see it coming in. That’s why, to pull this off, you need to be a busy Chiro and you need to have reserves in place.

Otherwise, it could be doomed. Unless you’re a hype machine. A marketing mastermind that fills the schedule before the integration even takes place. Let’s be honest, most of us just aren’t. I know the value of marketing. I know how to market on a fundamental level. But it’s hard. It’s hard to get your message out there and it’s hard to break through.

So, week one, maybe 4-5 appointments. Week two, maybe 18 appointments. Week 2 was about the same. Then last week was maybe only 8-9. So it’s up and down. We aren’t covering the salary but, we have reserves set back AND I’m fortunate enough to be busy.  The trick is just getting the message out and I feel like we’re doing that both externally as well as internally.

We have in-office brochures, flyers, and posters. Email marketing, social media, and all that good hoopla. It’s happening. We’re making it happen. 

In other news, I recovered from my five days in Washington DC. Geez. What a go-cation. It’s not the cost of taking a trip. It’s the cost of being gone. How much money you lose by not being in the office. That’s the real number and it just kills me!! So, I don’t think about it because I truly believe we need to be taking a trip once per quarter. You have to so you don’t lose your damn mind. It’s just a must.

Speaking of, I have a trip in just about three weeks to Chicago for business to finish off my Fellowship in Forensics. I’m looking forward to that and to networking with everyone involved with that whole side of the profession. Multiple streams of income folks. I do it inside the office as well as outside. Speaking, mentoring, authoring, medico-legal, Ortho fellowship, personal injury, family, triwest, acupuncture, massage, laser, esthetician, Texas Chiropractic Association, Texas Council of Chiropractic Orthopedists, Nurse Prac, and everything that falls under that.

That’s inside.

Outside is music, voice-over, art, real estate investing, and all kinds of other things I’m looking at.  What would it be like to just do a couple Of things?  Who knows? That’s just not me.  I make myself crazy but I honestly don’t know any other way. 

If you were thinking you could get into business for yourself and sit on the computer half the day fiddle assing on the computer, I got news. Your competition is out there getting Diplomates, certifications, and expertise to run circles around you.

Get busy.

Or wonder where all of those new patients are going since they don’t seem to be coming to see you.

Item #1

Alright, let’s hop in with our first one today called “Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis” by Nolet et. al. (Nolet PS 2019) and published in PM&R in November of 2019. In case you didn’t know, PM&R stands for physical medicine and rehabilitation. 

Why They Did It

They say in the abstract that neck injury resulting from a crash is associated with a high rate of chronicity. Prognosis studies indicate 50% of injured people continue to experience NP a year after the collision. This is difficult to interpret due to the high prevalence of NP in the general population. In other words, those that have not been in a car wreck still have neck pain, right? The stated goal of the authors here was to summarize the literature that has examined the association between a motor vehicle collision (MVC) related neck injury and future neck pain (NP) when compared to the population that has not been exposed to neck injury from a crash.

How They Did It

  • They performed a systematic review of the literature using five electronic databases, searching for risk studies on exposure to a car crash and future neck pain published from 1998 to 2018. 
  • The outcome of interest was future neck pain. 
  • Eligible risk studies were critically appraised using the modified Quality in Prognosis Studies (QUIPS) instrument. 
  • Eight articles were identified of which seven were of lower risk of bias. Six studies reported a positive association between a neck injury in an MVC and future NP compared to those without a neck injury in an MVC

What They Found

  • Pooled analysis of the six studies indicated an unadjusted relative risk of future neck pain in the car crash-exposed population with neck injury of 2.3, which equates to a 57% attributable risk to those having been in a car wreck. 
  • In two studies where exposed participants were either not injured or injury status was unknown, there was no increased risk of future neck pain

Wrap It Up

They wrap it up by saying, “There was a consistent positive association among studies that have examined the association between MVC-related neck injury and future neck pain. These findings are of potential interest to clinicians, insurers, patients, governmental agencies, and the courts.” I see personal injury patients. This is good info for their reports, their file, and their attorneys if they’re represented. 

 

Item #2 This one is called, “Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis” by Nolet, et. al.  (Paul S. Nolet 2020)and this one was published in Accident Analysis and Prevention in 2020.  It’s not that hot but I’m using it anyway just because I like it and cuz I say so….

Why They Did It The purpose of this study is to summarize the evidence for the association between exposure to a motor vehicle collision (MVC) and future low back pain (LBP).

How They Did It

  • A systematic search of five electronic databases from 1998 to 2019 was performed. 
  • Eligible studies describing exposure to a MVC and risk of future non-specific LBP were critically appraised using the Quality in Prognosis Studies (QUIPS) instrument. 
  • The search strategy yielded 1136 articles, three of which were found to be at low to medium risk of bias after critical appraisal. 

What They Found

  • All three studies reported a positive association between an acute injury in a MVC and future LBP. 
  • Pooled analysis of the results resulted in an unadjusted relative risk of future LBP in the MVC-exposed and injured population versus the non-exposed population of 2.7, which equates to a 63 % attributable risk under the exposed.

Wrap It Up

There was a consistent positive association in the critically reviewed literature that investigated the risk of future LBP following an acute MVC-related injury. For the patient with chronic low back pain who was initially injured in a MVC, more often than not (63 % of the time) the condition was caused by the MVC.  Thats a lot right, folks? Look, it’s obvious to say an injury was caused by a car wreck. It’s common as a chiropractor to hear patients tell you that their neck pain started with a car wreck they had 20 years before. We hear it all of the time.  But for reals, 57% for the neck and 63% of the back?

That’s solid and flies directly in the face of the other side of the courtroom when they try to tell jurors that the forces experienced in a low-speed impact are about the same as stepping off of a curb on the street. This is, by the way, one of the most ridiculous things I’ve ever heard in my entire life but an argument that they most certainly use periodically.  Fools!!!! The fools we must suffer in life!! I’m sure plenty of folks refer to me in the same manner. It is what it is. Let’s all just try to be the least of the fools…., if that makes any sense at all. 

Alright, that’s it.

Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus so get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

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

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

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 https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

Nolet PS, E. P., Kristman VL, Murnaghan K, Zeegers MP, Freeman MD (2019). “Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis.” PM R. 11(11): 1228-1239.  

Paul S. Nolet, P. C. E., Vicki L. Kristman, Kent Murnaghan, Maurice P. Zeegers, Michael D. Freeman (2020). “Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis.” Accid Anal and Prev 142.          

Spinal Manipulative Therapy Effectiveness & Chiropractic For Colic

CF 177: Spinal Manipulative Therapy Effectiveness & Chiropractic For Colic

Today we’re going to talk about manipulation effectiveness and we’ll talk about working on babies with colic. What’s the research say?

But first, here’s that sweet sweet bumper music

 

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #177

Now if you missed last week’s episode , we talked about car wreck research. It was part two of a two part little thing we did. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I have set the book launch date. It will be Tuesday, June the 8th. We will be releasing The Remarkable Truth About Chiropractic: A Unique Journey Into The Research on that date and I’ll be hoping that as many of you as want to, will consider being on my launch team. 

That means you download the book for free on launch day and you leave a great review on Amazon to help boost it’s exposure so that when I start charging for it, it’s up the relevant charts and I have a chance to get the message of evidence-based, patient-centered care to more and more people. Which is what it’s always been about in the first place. 

If you have connections with influencers, podcast hosts, TV hosts, radio, bloggers, or anyone like that, let me know and let me know if they’d be interested in an interview about the book. We want as much exposure as humanly possible on this deal. It’s not every day you get to release a book, now is it?

So, send me an email at [email protected] and tell me you want to be on the launch team. It’s that simple. 

As we have discussed, I am still going through the medical integration and hiring a nurse practitioner process. And it is now beginning to proceed a little more rapidly in the last week or so. Which is excellent news because I like to get things done and move to the next thing. I just got all of the paperwork and forward it over to our medical Director for his review and then we will proceed from there. 

While I am the first in my area to form one of these entities, I am hearing Word on the street that there are several others in the process as well so I need to put the foot down on the gas pedal. I know of two other chiropractors that are in the process right now in my area. One of them is a vitalist. 

So I’m trying to figure out how a chiropractic vitalist is offering medical services but whatever. Anyway it’s time to get this done and move on and be the first. There’s value to being the first one to do something. That’s what I plan on being

We have been taking this time of transition to get more familiar with our nurse practitioner. And fortunately I am more and more convinced that we have made the right decision. Outside of all of that rigmarole, we are just trying to get patients back in the door now that things are starting to cool off with the pandemic. It’s still a little odd. 

For example last week I I only saw approximately 130 patient for the whole week. Those numbers are down fairly significantly for me. However, we had around 23 new patients if I remember right. And this week is starting to look pretty good. It’s hard right now.

One week is up in the next week is down. I can’t quite explain it but we’re nowhere near where we were before the pandemic came along. If I’m being honest, it’s pretty damn frustrating. I’m not a patient person. I feel like I’ve waited over a year to get back to normal and now it’s time. Maybe I just need to take some Valium or something like that.

Since I don’t really have a lot more to share from the personal side of things, let’s just keep it short and jump right into the research.

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Item #1

This first one is called “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations” by Santilli et. al. [1] and published in Spine Journal in the March/April edition from 2006. Not hot at all. But still interesting when you have randomized, double-blind research.

Why They Did It

Acute back pain and sciatica are major sources of disability. Many medical interventions are available, including manipulations, with conflicting results. So the purpose was to assess the short- and long-term effects of spinal manipulations on acute back pain and sciatica with disc protrusion.

How They Did It

  • Randomized double-blind trial comparing active and simulated manipulations in rehabilitation medical centers in Rome and suburbs.
  • 102 ambulatory patients with at least moderate pain on a visual analog scale for local pain (VAS1) and/or radiating pain (VAS2).
  • Outcome measures took into account pain-free patients following treatment, quality of life, number of days on anti-inflammatories, drug prescriptions, pain scores, and disc protrusion reduction on follow up MRI
  • Manipulations or simulated manipulations were done 5 days per week by experienced chiropractors, with a number of sessions which depended on pain relief or up to a maximum of 20, using a rapid thrust technique.
  • Patients were assessed at admission and at 15, 30, 45, 90, and 180 days
  • A total of 64 men and 38 women aged 19-63 years were randomized to manipulations (53) or simulated manipulations (49). 

What They Found

  • Manipulations appeared more effective on the basis of the percentage of pain-free cases, number of days with pain, and number of days with moderate or severe pain
  • Patients receiving manipulations had lower mean VAS1
  • A significant interaction was found between therapeutic arm and time
  • There were no significant differences in quality of life and psychosocial scores

Wrap It Up

Active manipulations have more effect than simulated manipulations on pain relief for acute back pain and sciatica with disc protrusion.

Now, why include a paper from way back 15 years ago?? First, because it’s a solid paper and still has value and is still relevant. 

Secondly, because I’m seeing more and more chiropractors starting to diss or completely poo poo spinal manipulative therapy. We have the Airossti crew and then we have the exercise/rehab only crew. Which….shouldn’t they just have become PTs?? Seems more fitting to me. I didn’t want to be strictly an exercise coach. 

As with anything in life, there are extremes, aren’t there?? You have the vitalistic/philosophic extreme that embarrasses those of us in the profession trying to drag it forward and change it for the better. Then you have the evidence-based faction’s extreme aspect that are so evidence-based and evidence woke that they basically discount their own profession all together. The whole damn kit and caboodle!

So, let’s talk about it shall we?

I’ve beat up on vitalism quite a bit. Because it deserves it. You have the ones that are just embarrassing and then you have the ones like Nepute that have some legal challenges from what I hear. Then you have the fools talking about 99 patients and 9 new patients by himself all in 3 hours. Garbage. That’s stuff clowns do, folks. So, that end of it all goes without saying to most sensible people. 

But what about the extreme evidence-based crew? We’ve never talked about them before. Most because there’s been no reason until recently. 

Lately, they’ve gotten particularly vocal. There is a saying, “There is an art to disagreeing without being disagreeable.” Well, the extreme evidence-based people are, for me personally, becoming very disagreeable and extremely unlikable. 

Most are fresh out of school with little to zero experience in using spinal manipulative therapy so to turn around and bash those using SMT as their biggest tool in the toolbox is a little dumb. Is SMT everything? Of course not. But neither is exercise. Neither is only worrying about the cognitive aspect. Neither is acupuncture or massage or laser by themselves. Yet, while he makes fun of all of these, the American College of Physicians recommends them for low back pain. 

A good chiropractor should know when to mobilize and when to stabilize. I agree that chiropractors shouldn’t just use SMT all of the time no matter what. Ehlers-Danlos folks don’t need much SMT if any at all. Those having spinal instability, why would you use SMT on them when they need stabilization? I think you get my point. 

But again, it is not all about exercise either my friends. It is a multimodal approach. So to say that SMT doesn’t do all that much and all people need is to be moving is not accurate. 

And it falls on deaf ears and gets people riled up when done in a smartass, smug, and denigrating manner. When they’re making up cute little terms to label SMT docs into some sort of laughable crew, you’ve overstepped and have some things to learn. 

There are more and more of them lately but, the one particular person I have in mind with regard to the labeling, the kid….which is what he is….the kid is an online, virtual doc that has been out of school only a year or two. So, if he’s virtual only, makes sense that he is going to be an advocate of no SMT right? You can’t be an advocate of SMT but expect to make your living online only. 

So, even knowing his extreme business bias, he makes fun of people, pisses his colleagues off right and left, and seems to be trying to burn down the profession with all of us evidence-based SMT docs inside the building. 

For example, he has a video making fun of chiropractors in the instance that someone on a plane would ask if there are any doctors on the plane and a chiropractor would stand up. Making fun of his colleagues because they consider themselves doctors I guess. There’s no point to it other than being a smartass, getting clicks, and pissing off everyone in your profession. Making fun of the activator. No, I’m not an activator guy but is that really who you want to be?

Making fun of the idea of maintenance care while completely discounting anything that Andres Eklund has done over the past few years. 

Question #1 is why even be a chiropractor? Honestly. 

Look, I’ve been trying to change the profession for years. But not burn down the house. Let’s get more specialized Fellowships and Diplomates. Let’s get active in our state and national associations. Let’s follow researched guides. Let’s consume more and more research every day and every week. Basically, raise the damn game, folks. 

But to be out of school briefly, just to develop your online only bias, and then turn around and trash SMT while grouping them and labeling them with derogatory names…..

Big nope here. Not a fan. The fans say he’s a good dude… Blah blah blah.”

Tigers have stripes and I’ve seen these. Not just on him but others just like him. I don’t like the pattern. It’s not just one person. There are more and more of them lately. As if our profession doesn’t have a hard enough time moving past the vitalistic, philosophy part of the profession. 

Now we have these evidence woke knuckleheads on the complete other end. This kid is no better in my mind than the fools out in Oakland that we covered some time ago telling people they can reduce spinal degenerative bone spurs through 3 times per day for 3 weeks of adjusting. He’s no better. He’s certainly equally as arrogant. That’s a certainty. 

To be fair, and honest, and transparent, I haven’t watched all of his videos. Mostly because I can’t stomach that whole scene beyond the ten or so that I did watch. From what I watched though, I didn’t completely disagree with what he was saying. I really didn’t. Hell, I disagree with just about anything a vitalist says. I actually agreed with some of his sentiments.  

He’s completely wrong in some videos. He’s completely right in some videos. I think it’s OK to beat up on vitalists. Lol. But when you cherry pick and trash your entire profession collectively like is being done on a weekly basis, even when there is plenty of solid research to the contrary of what you are saying……well, you don’t look so smart. 

He’s disagreeing but he’s doing it in a way that is 100% disagreeable. For me anyway.

I guess I just don’t like feeling like I’m being made fun of. Not after the education I have gone through to do everything I can to be at the top of my game. And I don’t like my friends being made fun of either. Certainly not by a kid that cherry picks his research to confirm his bias while thinking he’s the smartest guy in the room. 

Some of the smartest people on the planet that I call friends are getting trashed almost weekly by people like this and it’s a shame. I have such a high amount of respect for some of my fellow Diplomates and I just don’t think it’s necessary to effect change. That’s it in a nutshell. 

Can you imagine being 20 something or early 30’s something and already having everything all figured out. How amazing that would truly be. What power he must have. Lol. 

He could spread a good message and move his profession in a positive direction in so many other ways. But he’s got those very specific stripes. He is who he is, the smartest guy in the room. There will be no changing these folks. Just like I don’t ever see the vitalistic side ever changing either. 

OK, enough

Item #2

Our second paper is called “The effect of chiropractic care on infantile colic: results from a single-blind randomised controlled trial” by Holm et. al. [2] and published in Chiropractic and Manual Therapies on April 19th 2021 sizzling…..foggin up my spectacles. 

Why They Did It

Chiropractic care is commonly used to treat infantile colic. However large trials with parental blinding are missing. Therefore, the purpose of this study is to evaluate the effect of chiropractic care on infantile colic.

How They Did It

  • It was a multicenter, single-blind randomized controlled trial conducted in four Danish chiropractic clinics, 2015–2019
  • Information was distributed in the maternity wards and by maternal and child health nurses. 
  • Children aged 2–14 weeks with unexplained excessive crying were recruited through home visits and randomized (1:1) to either chiropractic care or control group
  • Both groups attended the chiropractic clinic twice a week for 2 weeks.
  • The intervention group received chiropractic care, while the control group was not treated. 
  • The parents were not present in the treatment room and unaware of their child’s allocation.
  • The primary outcome was change in daily hours of crying before and after treatment.
  • Secondary outcomes were changes in hours of sleep, hours being awake and content, gastrointestinal symptoms, colic status and satisfaction.
  • All outcomes were based on parental diaries and a final questionnaire.

What They Found

  • Of 200 recruited children, 185 completed the trial
  • Duration of crying in the treatment group was reduced by 1.5 h compared with 1 h in the control group but when adjusted for baseline hours of crying, age and chiropractic clinic, the difference was not significant
  • The proportion obtaining a clinically important reduction of 1 h of crying was 63% in the treatment group and 47% in the control group

Wrap It Up

“Excessive crying was reduced by half an hour in favor of the group receiving chiropractic care compared with the control group, but not at a statistically significant level after adjustments. From a clinical perspective, the mean difference between the groups was small, but there were large individual differences, which emphasizes the need to investigate if subgroups of children, e.g. those with musculoskeletal problems, benefit more than others from chiropractic care.”

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

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

Store

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

 

 

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

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About the Author & Host

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

1. Santilli V, B.E., Finucci S,, Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J, 2006. 6(2): p. 131-7.

2. Holm LV, J.D., Christensen HW, Sondergaard J, Hestbaek L,, The effect of chiropractic care on infantile colic: results from a single-blind randomised controlled trial. Chiropr Man Therap, 2021. 29.

w/ Dr. Bobby Maybee – Everything Evidence-Based Chiropractic, Insight, Instruction, & Inspiration (Part One)

CF 161: w/ Dr. Bobby Maybee – Everything Evidence-Based Chiropractic, Insight, Instruction, & Inspiration (Part One)

Today we’re going to be joined by Dr. Bobby Maybee who is involved in so many things chiropractic but most notably he’s the leader of the Forward Thinking Chiropractic Alliance and co-founder of the Chiropractic Success Academy. This is going to be an excellent episode folks. Full of insight, instruction, and inspiration.  But first, here’s that sweet sweet bumper music.

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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

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

You have found yourself smack dab in the middle of Episode #161 Now if you missed last week’s episode , we talked about lumbar spinal fusion surgery. This was new, current, and very much in favor of conservative, non-pharmacological, nonsurgical care.. Keep up with the class.  On the personal end of things….. I’d like to hear how some of you are busier than normal or how some of you have only dropped off a bit during COVID. I wrapped up my stats from 2020 and it was a bit of a blood bath around my joint if I’m being honest and I’m always honest with you all. That’s they only way we move forward. Honesty.  So, let’s cover a few of the key stats. By the way, if you’re not keeping good stats and measuring all of your office metrics, I can’t tell you what a mistake it is that you’re making. My office turned around when I started accurately tracking my metrics. How can you know where you’re going or measure success in a quantifiable way if you’re not measuring it? As you’ll find out more and more in the coming months, I’m very big on keeping stats because it turned my office around. I know the value. Anyway, let’s get to some of my take-aways from my 2020 stats. 

  • One of the big kickers for me is that my new patients were down 36.1% from 2019. Yeah, that hurt like hell, folks. That’s in spite of picking up in our marketing efforts, posting and boosting about our cleaning and disinfecting efforts, and growing our social media following. Our area was hit hard with COVID. On the New York Times site, Amarillo, TX at different times and even recently has been #13 nationwide in areas hit the hardest. At one time, we were #2 on their list of the areas with the most new cases. People just did not feel comfortable going anywhere around here at different times during the year. Some times were more comfortable than others of course but overall….uncomfortable.
  • As a result of the new patient issue, my overall visit numbers suffered and were down 33.8%. So, we saw 33.8% less visits over the course of the year in 2020. When you consider the value of one visit in my office, well…..let’s just say that adds up to a considerable amount of income lost.
  • You’ll start to see a theme here when I tell you that my total services billed were down 36.6% and net services when we remove our write-offs sat at about 40% down. Ugh, right? But, we worked hard on our billing, of course. When you have extra time, you turn to billing and collections efforts. As a result, our total collections were only down 25.4%. Funny how that happens. 
  • We could go through a whole bunch of different metrics but I have an amazing guest today we need to get to. The most important stat is the final overall total. When we include all of the things that make us money like chiropractic, rehab, laser, decompression, acupuncture, massage, and on and on….when we combine it all, our total collections across the board were down 25.4% in 2020. While that’s a tough pill, I’m not alone. Many of you have had the same difficulties. Many of you have had it worse. And I’m sorry. It’s been difficult for us all. But the good news is that I think it’s lightening up and if improvement and progress makes us all feel good, it won’t take much to improve and show progress over 2020. Will it? I think not so here’s to all good things in 2021. Let’s get all of our practices back on track and help some folks get out of pain and avoid surgery. 

Now, without further adieu, let’s get to our guest today.  Today we are joined by the always interesting and talented Dr. Bobby Maybee hailing from the Pacific Northwest. Portland, Oregon to be exact. Dr. Maybee initially began the Forward-Thinking Chiropractic Alliance (FTCA) in 2014 as an attempt to change the landscape and conversation of the chiropractic profession of social media.   

Since then the FTCA has gone on to create evidence-based content in a grass roots nature.  This content is typically for the internet, and in an educational format through continuing education courses, and is staunchly evidence based.   Dr. Maybee hosts “Forward, The Podcast of the Forward-Thinking Chiropractic Alliance.”  As well, he was just elected Chair of the Oregon Board of Chiropractic Examiners Peer Review Committee, and is a member and supporter of the American Chiropractic Association.  

Dr. Maybee is a 2004 graduate of Western States Chiropractic College.  In his free time, he co manages a household of 5 children, 2 dogs Jett and Abbie, and a cat named Goober. And the best reason we can ever have to thank someone for something, Dr. Maybee is a veteran of the US Air Force which no doubt lends itself to him being such a good and effective leader. 

Welcome to the show Bobby, tell me how Portland is this morning.

How’s the weather? 

Introduction

  • Tell me your chiropractic story. Why chiropractic for you?
  • Tell me what got you to the place where you are the expert in the clinic that you are. What experiences or certifications built that person?
  • Tell me about your practice in Portland
  • With as many kiddos as you have and as many things as you’re involved in, what does a typical week look like for you.
  • How did the FTCA get started?
  • I see here and there online that some vitalists have really started to make the term ‘evidence-based’ a keyword, a trigger word, or a point of conterntion. Have you noticed that as well and how do you think a healthcare profession come to mock evidence and research?
  • What is your vision for the FTCA and what does the group to to move closer and closer to accomplishing them?
  • I was at the Forward 19 event in St Louis and really enjoyed it. Tell us about what goes into creating something like that? How do you pull it off?
  • Recently, I have been on a rant. I see vitalists say kooky stuff and I’m physically and mentally unable to ignore it. I have a recent episode on a guy that wants to teach other chiropractors how to treat 9 new patients and 99 established patients within three hours. Then I had an episode on the shake up of the WFC Research committee. As I mentioned in the episode, you were there in Berlin when it all started going sideways. Can you walk us through it all as far as you know it to be?
  • I think I’ve seen you vacillate on the topic of unity or not. Where do you stand on the whole deal? Is it possible the two sides can continue to live together? Or do you see groups like the Primary Spine Practitioner start to gain steam?
  • Tell us about the CSA that you and Dr. Kevin Christie have put together.

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Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     

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

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

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

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

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

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

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

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

Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

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

Three Year Anniversary Top Ten Countdown

CF 156: Three Year Anniversary Top Ten Countdown

It’s our THREE YEAR ANNIVERSARY episode!!! We’re going to cover our All-time Top Ten episodes spanning over our first three years on the air.  But first, here’s that sweet sweet bumper music

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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

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

You have found yourself smack dab in the middle of Episode #156 Now if you missed last week’s episode, we talked about the crazy and very suspicious shake-up with the research committee earlier this year at the World Federation of Chiropractic. Make sure you don’t miss that info. I believe it is vital for you as an evidence-based, patient-centered practitioner. Listen to it anyway because it’s important to keep up with the class. 

On the personal end of things…..

Well, no hate mail from last week’s episode or from the week before that when we highlighted a vitalist bragging about seeing 99 patients and 9 new patients in the span of 3 hours. Dammit, my eyes just about rolled out of my head yet again. It’s like every time I say that I gotta keep an eye on my eyes so I can keep them in my noggin. And, I have to step back a bit to keep from throwing up.  Not getting hate mail is a good thing.

Of course, there’s the very solid chance I’m simply speaking to an echo chamber here, and honestly, that’s OK too. I’d much rather be able to build this among my brethren without being molested by the ones that don’t agree with me.  The more like-minded folks we have listening, the better. The best thing I can say is to tell someone about us. I’m serious. I appreciate every single listen. But if all you do is listen and consume a free product, that’s not helpful in growing it and putting back into the thing you find value in. 

So, please. Tell someone about this podcast and the messages we convey every single week. Let’s build this message. Like I said in last week’s episode, this profession is in a battle. Not just between vitalists and evidence-based chiropractors but in a battle for integration, progress, and overall respect.  A battle for professional standardization. a battle over our research community. As I said last week, the ICA won the battle with the WFC research committee. They know there’s a battle. Now it’s time for evidence-based chiropractors to realize that fact and proceed accordingly. Yes, go read your research papers but then go and defend the evidence-based, patient-centered practice. Advocate for it.  Outside of that mess, things have been slower at the office. With this second spike, we’ve taken a step back. And it’s making my butt pucker a bit. I hate taking steps back. I like only progress. Only movement forward.

I’m seeing the number that I saw 5 or 6 years ago or more. Probably more. We are paying the bills but we’re not profiting right now. We’re just surviving. It can’t be over soon enough.  So that I don’t sound too spoiled; I understand I have it better than a lot of folks. Bar owners, full-time musicians, bartenders, servers, restaurant owners. That’s just for starters. I don’t know how these people survive without forgiveness plans and things like that. It’s insane where we are but I’d rather be sitting here in December than back in March, April, or May.  That’s for damn sure. As of the typing of this episode, the first vaccines are projected to be taken by Americans in about 5 days. Bring it on!! Let’s start getting life back to normal and then sit back and watch the comeback!

Before we get to our Top Ten list and before we get to our sponsor spot, I have to tell you, I’m about to give you a code for discounts on ChiroUp. People sometimes think ChiroUp is one thing or another but in all honestly, it’s a little too much to describe in one spot. It does A LOT!! It helps you implement rehab confidently. It writes reports to those in the medical community. It teaches you what exam protocols are appropriate for regions of the body. It teaches you how you should treat certain diagnoses. It does your report of findings for you. It gets you Google reviews. It tracks your patients’ progress after 30 days so you know how good you’re doing with your patients. It sends emails to your new patients full of recommendations, patient education, and videos of the exercises you recommended for them. It gives you marketing plans for different aspects of healthcare. And it does a hell of a lot more than that.  I could go into every single one of these topics and speak on each of them for half an hour but you’ll just have to trust me here. It is worth so much more than what ChiroUp charges. So, here’s the spot, take my code, use it, and then get better and love your life. You can thank Ol’ Uncle Jeffro later. 

CHIROUP ADVERTISEMENT

Just do it, folks. It’s worth every penny and much much more. It’s literally changed my practice from top to bottom for the better. There’s not another product out there I can say that about. 

Now, let’s get to our all-time 3rd anniversary top ten most listened to episodes, shall we? If you go to the show notes at chiropracticforward.com, find this episode….#156….and you scroll down through the transcription of the episode, you will find the links to each of these episodes so you don’t have to scroll through and find them on your own.

Number Ten Coming in at Number 10: Our 10th most listened to episode was episode #137. We had a special guest for that episode. Dr. Aric Frisina-Deyo and we talked about chiropractors treating in an FQHC setting and we talked about setting the bar high. Higher than chiropractors typically set the bar for themselves or their profession. This guest….wow. Young, bright, driven, and very very impressive. There’s absolutely a good reason that one had so many listeners.  https://www.chiropracticforward.com/2761-2/

Number Nine It’s nice to see this one still in the Top Ten after so much time has gone by. It’s called What’s Good In A Chiropractor. It was way way back in Episode 101. Keep in mind here that we’re now on #156. This episode is more than a year old now so it’s good to see that the principles I covered in this episode are still resonating with our listeners. In this episode I discussed some key characteristics I feel make up a good chiropractor. We talked about things like honesty, being evidence-based, networking, listening, your office presentation, and things of that nature. It’s excellent to see this stuff staying relevant and meaningful.  https://www.chiropracticforward.com/what-makes-a-good-chiropractor-9-characteristics/

Number Eight Number eight is called Kids Still Hurt, Manipulation For Lumbar Radiculopathy, & Lack of Attention On The Boards for Biopsychosocial Matters. Our listeners gobbled this one up. I think because we need current thinking and information on things like adjusting in the region where we know there’s radiculopathy. We need to understand that just because a person is a kid doesn’t mean they don’t hurt. This episode covered that very well, in fact. And the biopsychosocial aspect of pain has been a big big topic over the last couple of years. I think people are struggling to learn more and more about it and how it can help their patients.  https://www.chiropracticforward.com/cf-145-kids-still-hurt-manipulation-for-lumbar-radiculopathy-lack-of-attention-on-the-boards-for-biopsychosocial-matters/

Number Seven Our 7th most listened to episode was a more recent one with one of my very favorites, Dr. Katie Pohlman who will be on again in the very near future. And will hopefully be on our podcast about a hundred times beyond that. Hell, maybe she’ll just be my co-host eventually. Lol. Anyway, this episode was number 147 and was called New Research, Upcoming Research, And the Need For It All. Dr. Pohlman is the head of research at Parker University and you’re starting to see her name anywhere and everywhere with regard to chiropractic research. She is a star and I’m happy that Parker has hitched their wagon to her shooting star. This episode was full of thoughts on chiropractic research, what she’s currently working on, and where it’s all going.  https://www.chiropracticforward.com/w-dr-katie-pohlman-new-research-upcoming-research-and-the-need-for-it-all/

Number Six Our sixth most listened to episode was episode number 113 with my friend, Dr. William Lawson. This one was called Brand New Guidelines On Neck Pain Treatment. Dr. Lawson had a hand in the new paper we discussed and it was basically an entire episode walking you through new guidelines on treating neck pain. It’s one of my favorite episodes because it laid out very clearly what we should be doing, what we should be thinking, and how we should be approaching case management for neck pain. Very informative and Dr. Lawson is always on the top of his game. https://www.chiropracticforward.com/w-dr-william-larson-brand-new-guidelines-on-neck-pain-treatment/

Number Five Our 5th most listened to episode of all time is number 140 with Dr. Chris Howson. It was called Chiropractors In Hospitals and Drop Release. Not only does Dr. Howson work in an outpatient hospital setting in North Dakota, but Dr. Howson is also the inventor of a newer chiropractic tool on the market called the Drop Release. Pretty cool stuff and Dr. Howson knows his stuff, folks. If you want to know how to integrate into a hospital setting and want to know what it’s like, this is the episode for you. Plus we talk a bit about the drop release, what it’s for, and all the goodies. Plus a discount code you can use if interested.  https://www.chiropracticforward.com/cf-140-w-dr-chris-howson-chiropractors-in-hospitals-drop-release/

Number Four Our 4th most listened to episode is number 144 and is called Common Surgeries Aren’t Well-Researched & Chiropractic Wins Again.  This one was a stroll through a current paper that really spotlighted the fact that the most common musculoskeletal surgeries that we see being performed today don’t have much research behind them. Especially research that tested having the surgery vs. not having it at all. You’d think that research would have been done but sadly it hasn’t in almost every case. In fact, they looked at 6,735 studies and only 64….less than 1% of them….only 64 compared a surgical intervention to not having surgery at all. And, get this, of that 64 that actually did compare the two, only 9 of them were actually favorable to having the surgery. Go to episode 144 for more on that. It’s astonishing to me.  https://www.chiropracticforward.com/common-surgeries-arent-well-researched-chiropractic-wins-again/

Number Three Alright, we’re in the top three now. Our 3rd most listened to episode of all time is number 143 and is called Spinal Manipulation Has No Effect On Chronic Pain – Our Experts’ Rebuttal. This one dealt with a paper that came out recently in JAMA and it was not favorable at all to chiropractors or spinal manipulative therapy. This episode went through our own experts thoughts on the paper and how you can rebut any mention you might get from this down the road as you navigate your relationships within the medical community. Very interesting and extremely useful episode right here. This one can actually help protect your bottom line in the right situation.  https://www.chiropracticforward.com/new-paper-spinal-manipulation-has-no-effect-on-chronic-pain-our-experts-rebuttal/

Number Two Number 2 on our top ten list is episode number 142 and is called Nonoperative Disc Treatment, D3 for Depression, and The Biopsychosocial Part Of Chronic Pain. This one really spoke to chiropractors because it was loaded with research. Of course, most of our episodes are loaded with research but this one had a paper about treating discs without operation. Well, who the heck doesn’t want to do that? It was very comprehensive and showed how 97% of 269,713 patients were treated without surgery. Good good stuff. Things look worse and worse for musculoskeletal surgery these days honestly. And, again, this paper covered the biopsychosocial aspect of pain and that’s a popular topic these days. Something for everyone in this episode! https://www.chiropracticforward.com/nonoperative-disc-treatment-d3-for-depression-the-biopsychosocial-part-of-chronic-pain/

Number One And our number one most listened to episode of all time for our 3rd Anniversary is one that actually surprised me. It’s episode number 141 and is called Lancet Low Back Update & Movement Disorders Mean Pain. Now why this one got all of the listens? I have no idea. The Lancet is well-respected and should absolutely be paid attention to. I’m glad it’s getting all of the listens, to be honest. It was basically an update on the original Lancet series on low back pain that we covered way back when. It’s top-level research having relevance to our chiropractic community and I’m glad to see so many of you appreciating it and paying close attention to it. It’s important. It’s not the sexiest topic we cover so that’s why I found it a bit surprising but it’s a great episode to catch the number one spot for sure. Very deserving.  https://www.chiropracticforward.com/lancet-low-back-update-movement-disorders-mean-pain/

An episode or series of episodes that fell off of the top ten list just this year is still important and one worth giving honorable mention to. Episodes 13, 14, and 15 are called Debunked, The Odd Myth That Chiropractors Cause Strokes.  If you don’t know the research on this topic, please, for the love of everything, go listen to those three episodes starting with 13. It’s knowledge fuel and it’ll give you more confidence if you happen to lack it.  https://www.chiropracticforward.com/debunked-the-odd-myth-that-chiropractors-cause-strokes/

Alright, that’s it. We made it through all ten of the most listened to episodes in the three-year history of The Chiropractic Forward podcast. I want to truly thank you all from the bottom of my heart for listening and being a part of this little part of the world. For being a part of this podcast. When I’m sitting down to type out an episode, you are who I have in mind. I try to identify things I’m interested in but I also try to identify tough conversations that are not being had that desperately need to be talked through. 

We aren’t as big and as widely listened to as I’d like to be but we are growing steadily. If I can get you all on my team and talking about it and sharing episodes with your buddies and interacting in the private group, this thing can begin turning into even more of what I envisioned when I first started it.  With your help, we can get the message out on evidence-based, patient-centered practice.  Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. 

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

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

The Shake-Up With WFC’s Research Committee

CF 154: The Shake-Up With WFC’s Research Committee Today we’re going to talk about the research committee shake-up at the WFC. I’ve wondered for months now what exactly happened with shake-up and it hasn’t been easy to figure it out either. Who is to blame and what companies are to blame as well? We’ll get knee deep into it in this episode.  But first, here’s that sweet sweet bumper music

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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it.  You have found yourself smack dab in the middle of Episode #154 Now if you missed last week’s episode , we talked about how some chiropractors could be better and being careful which guru you’re going to place your faith in. Some are just absolute loons and only driven by profit, not results and not the patient.

The saying is, when you’re focused on the outcomes, you’ll never have to worry about the income. Make sure you don’t miss that info. Keep up with the class.  While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function

On the personal end of things…..

Chugging along. Making friends and influencing people. That’s how we do it here. Actually, that’s not true. I’m sure I got the vitalists all fired up last week and probably will this week as well. I’ll probably get some companies fired up too.  We’ll see. It doesn’t have a thing to do with anything chiropractic but I’ve mentioned a time or two here that I’m branching out and, as a retirement plan, I’m working on a little side gig in the voice over / voice artist industry. This stuff is fascinating y’all. It really is. 

So I went through the steps you’re supposed to go through in getting yourself all set up and now, here I am, I got a commercial demo done. If you’re just feeling goofy and bored, go to jeffwilliamsvoice.com and there’s a demo there you can listen to. Turns out I have the John Deere, Ford truck, eat this burger type of voice and I’m totally OK with that.  Anyway, after you get a demo, you start submitting to talent agencies around the world. Well, hell….I don’t have all day to spend on doing this stuff so I can only get a few per day and there are tons of them.

But, in just the first round or so of submissions, I already got signed up with a talent agent out in San Francisco and Los Angeles as well as interest from a talent agency in Barcelona Spain and potentially a marketing firm down in Dallas/Ft. Worth. . So….how damn cool is that? Maybe, one of these days, my side gig takes over my day job. I’m not holding my breath though. But, seriously, my buddy has done it for about 7 years and he’s making six figures. Can you imagine making a good 6 figure salary but no employees, no overhead, you can make that money in your basement in your underwear (sorry for the visual there), and you can do it from anywhere in the world as long as you have an internet connection?

Well, it’s a cool idea and a lot of folks get to do it that way. Who knows? It’s a lot of luck and all that stuff but I’ve never been one that was afraid to take chances or afraid to fall on my face.  Either way, it’s exciting and isn’t that what it’s about? Keeping life interesting and exciting? That reminds me, if you need a voice over for a youtube video, your podcast intro, or any commercial you’re doing, remember ol Uncle Jeffro here. I got you covered!

Item #1

Now, let’s get to spilling the tea shall we? I have to start by saying, I don’t love talking about this stuff. I don’t at all. It makes me uncomfortable. Mostly because some of my friends won’t like it. I work with a lot of chiropractors around the nation in different capacities and to be honest, while we work FOR the chiropractic profession, we don’t see eye to eye with each other on WHAT chiropractic is.  Still, they’re my friends. So what do I do? Do I just say nothing about things I know they won’t agree with? Or do I talk about it and give my view point on them?

Well, I have a podcast so I guess I talk about it. I could stay out of the messiness of our profession and avoid tough subjects all together I guess. But who ever changed anything by taking that sort of stance? That’s not really any kind of stance at all is it? You change things by standing up, somewhere, and supporting your convictions. So that’s where i’m at. I don’t like. I’m uncomfortable with it, honestly. But the show must go on.  Let’s start with what happened. Dr. Greg Kawchuk was the head of the World Federation of Chiropractic. I’m a fan of Dr. Kawchuk. so when I saw on Facebook or Twitter or somewhere that he resigned his post as head of the WFC research committee, it had me a bit miffed. Not only that but a lot of HUGE chiropractors on the committee left with him. Researchers on the level of Jan Hartvigsen for example. 

To be specific, those that resigned are

  • Greg Kawchuk DC PhD Canada – Chair
  • Simon French, PhD, MPH, BAppSc(Chiro) Australia
  • Iben Axén DC PhD Sweden
  • Jan Hartvigsen DC PhD Denmark
  • Martin Descarreaux DC, PhD Canada
  • Carolina Kolberg DC PhD Brazil

Every single one of these researchers has been in the episodes we have released. They are big time for our profession. The vitalists, unfortunately, have labeled them subluxation deniers. I label them scientists but….whatever.  I say tomato, they say dumb stuff. Their statement of resignation went like this, “Effective immediately, we (Greg Kawchuk (Chair), Iben Axen’, Martin Descarreaux, Simon French, Jan Hartvigsen, and Caroline Kolberg) resign from the World Federation of Chiropractic (WFC) Research Committee.

We no longer feel it is possible to function as independent academics in our roles on the committee. We urge the WFC to continue to promote the EPIC principles (Evidence-based, People-centered, Interprofessional and Collaborative), and to protect its core values from potential conflicts and outside influence. We wish the best for the WFC and our colleagues who serve on its Research Committee.” Now, it wasn’t all bad because they put Dr. Christine Goertz into the post as the head of the WFC committee and if you’re a listener here at the Chiropractic Forward evidence-based chiropractic podcast…..well then you know what a fan of Dr. Goertz we are. She’s a chiropractic treasure. 

But, when I first heard the news, as you can imagine, and as you probably felt when you heard, it was a bit concerning for our profession to lose so many high profile, top-level researchers at once. What’s that going to mean for our profession and why did this happen in the first place? I started paying attention. I started looking for information. What the heck happened? But nothing. Not only nothing on the story but nobody was talking about it either. Like….it was just another event that happened on just another day. No big deal. When, in reality, at least to research consumers such as myself, it was a huge deal! Why did this happen and what the hell is the story?

Well, I’m going to give away the ending here before we really dive in, I’m not 100% sure but at least now I have an idea. A generaly idea.  When I decided I was going to do this episode, I put it in our private Facebook group. We only have around 450 members approximately. Again, in case you don’t know, we have a public Chiropractic Forward page. That’s just to get the word out about the podcast and market the podcast.  Then we also have a Chiropractic Forward private group where we can share research papers, we can discuss amongst ourselves, and all that good stuff and we can do it privately. I encourage you all to join the private group.

Not if you’re a vitalist. That’s not the group for you. But if you’re evidence-based and patient-centered, then you’re a good fit.  Anyway, I posted in there that I wanted to do this episode and if anyone had the back story, please send me a private message about it. That I wanted to get it figured out and tell our audience. 

There was a lot of interest in the episode but nobody knew the story about what happened. I asked elsewhere. Nobody knew but everyone wanted to know. I even asked Dr. Kawchuk himself and he was tied up in a research project. Dangit.  Unfortunately, the research community’s lack of open communication on this matter has left this up to others to define the narrative. For example, when Googling up this story, I got an article by Matthew McCoy. The ever-so-nutsy vitalist out in Georgia. The townhall crier and huckster of woo. Yes, he’s one of them setting the narrative. 

Also, one of the top hits was by our global hater for the ages, Edzard Ernst. What a toolbag. Yes, our global hater sets the narrative on what is happening in the chiropractic world. But nothing from the evidence-based, patient-centered side of the profession. What in the hell is going on here, people? Why in the hell are you all sitting on your hands? Why are you not talking about this, writing about this, yelling about this, or at least pushing back on this? Are we spineless? No pun intended by the way. 

It’s just astonishing to me that so little is written about it and that the only information you can find on it is created by flat-earthers or by the apex of chiropractic haters.  Finally, one of my colleagues here in the U.S. contacted me through text and we set up a phone call. They gave me the story as well as they understood it and that’s what I’m going to give you. Thank you to this colleague for shedding as much light on this story as you could. I really do appreciate it and I’m pretty sure the rest of our audience does as well. 

If we are being fair, a small part of it appears to be Dr. Kawchuk’s fault, a very large part of it seems to fall on the vitalist, subluxation or nothing, rah rah rah crowd, and an even bigger aspect of the whole enchilada I believe can be directly pointed at the WFC’s corporate sponsors that backed the vitalist, subluxation is the only way crowd. I personally blame the companies. Without them bullying the WFC with sponsorship dollars, this wouldn’t have happened regardless of the rest of the dominoes that fell. 

Let’s back up a bit.  It sounds like it all begin in Berlin in 2019. Those of us paying attention know that it goes back much further than that though don’t we? Oh yeah, with the evidence-based, patient-centered model becoming more and more prevalent and moving the vitalists more and more to the fringe of the world, the louder the minority has become.  Still, it appears, Berlin 2019 at the WFC conference was the final straw. Dr. Greg Kawchuk, who again, I’m a fan of, was one of the speakers at the event. His presentation was not vitalist/subluxation friendly.

Word on the street is that his speech was met with cheers but was also met with water bottles being thrown up on the stage and antics like that. Because, you know….our profession is divided in two in case you’ve been hiding in a cave. So, cheers makes sense. I don’t know what makes the other side think it’s OK to throw stuff on the stage but who knows? Maybe that’s just a dumb little European quirk.  I had the opportunity to see almost the exact same speech at the Forward ’19 event in St. Louis a little over a year ago. I absolutely loved it. And, no….it was not subluxation friendly.  Here was the difference in the speech I saw in St. Louis and the one that was given in Berlin.

Dr. Kawchuk, it is suggested, made a quip during his speech that taking a child to a vitalistic chiropractor is similar to taking a child to a Catholic priest.  There are no recordings in existence of this version of the speech but I believe the basic gist of the comment was that if you’re willing to take your kid to a vitalist for 60+ visits, then you should leave your kids with a Catholic priest.  OK, let’s address this because this one comment is what the ICA hung their hat on so I think it’s a pivotal thing. I think it’s also why this part of the speech was dropped when I heard it in St. Louis.  It is my understanding, first of all, that Dr. Kawchuk wrote a letter of apology but it was perceived as having some “Yeah, but…” sentiment attached so maybe it didn’t come off as sincere as his detractors would want.

But here’s the thing, it wouldn’t have mattered how sincere the apology was, they found something to hang their hat on. They found an achilles heel and they weren’t going to let go of it. Regardless of what Greg said to them about it.  Can I just say that I’m a Christian and I’m used to getting made fun of by so many out there in the world. It almost doesn’t even affect me anymore. Notice I said ‘almost’.

Now, I’m not Catholic. But Catholics are Christians so, by association, I should be rather offended as well right? I suppose if I were of the easily offended mindset, I would be. But I’m not because I see it all for what it’s worth.  Number one: the Catholic church has had quite a well-chronicled issue in the past with priests and misconduct. I don’t know how you could argue with that and someone bringing it up has become VERY commonplace. That doesn’t make Greg’s comment any more out of place than the 100 other people I have seen mention or make fun of it on Facebook over the past 3-5 years. It’s become very common. Doesn’t make it right but it does make it common. 

Number Two: did that belong in this speech? Well, I wasn’t the speaker so how do I know. I know that I saw the same speech last year without the comment and it seemed very effective and very welcome to everyone that was in attendance. So, it appears it would have been just as good and ultimately less offensive to some.  Knowing what we now know, it doesn’t appear that it was a good choice to go with for that particular speech to that particular crowd. I would say that I enjoy a great and entertaining speech and the one I saw in St. Louis by Dr. Kawchuk was just that. It was actually pretty dang amazing.

I became an instant fan and hearing of the Catholic priest comment later on did nothing to dampen my fandom.  I suggest people lighten the hell up and quit being so damned dramatic. Water off a duck’s back. Oh my goodness, someone said something you didn’t like or agree with? Poor thing. Bless your heart.  So, Greg gave them something to hold onto and go on the attack with. OK. Do you think the ICA got irate over the priest comment? Or do you think they got irate because the speech was anti-vitalist, anti-subluxation?

Honestly….think about it. Let’s be smart. Which do you think it was? It should already be clear what I think it is.  So, the speech is made and the vitalists lose their damned minds and the ICA decides to deal with this travesty. Nobody but the higher ups over there know exactly how it all went down but, by all appearances, it looks like they started leaning on sponsors to pull support from the WFC until changes that the ICA deemed appropriate were made.  So, basically, the ICA decided to be a bully and start flexing on the playground.

They could read the tea leaves and with scientists like Kawchuk, Hartvigsen, and the others steering, the future wasn’t so bright for the ICA bullies so they started figuring out how to pull the purse strings. That’s what it looks like to me.  It looks like companies like ChiroHealth and Foot Levelers leaned on the WFC to remove Kawchuk. In advance of that, Greg just resigned. Then, the other top-level researchers resigned in solidarity and, I would imagine, in protest to what was happening. 

And I don’t blame them one bit.  Here’s the thing here; it is my opinion and the opinion of others that these vendors used our money that we paid them to bully the WFC at the urging of the ICA to oust Kawchuk. And it is my opinion that they used one sour comment to do it. When I feel pretty sure that they bullied the WFC simply because they didn’t like that the speech and the research committee seemed anti-subluxation. Here are the companies that pulled support simultaneously at this pivotal time for the WFC:

  • Standard Process
  • ChiroHealthUSA – USA
  • Chiro Diplomatic Corps
  • NCMIC – USA
  • National Chiropractic Council – USA
  • Koala Mattress – Australia
  • Life Chiropractic College West – USA
  • Life University – USA
  • Lloyd Table Inc – USA
  • Breakthrough Coaching – USA
  • Chiropractic Education Australia Ltd. – Australia
  • Da Vinci Labs – USA
  • Integrated Assessment Services Inc. – Canada
  • Japan Federation of Chiropractic Professionals – Japan
  • Mettler Electronics Corp. – USA
  • Tokyo College of Chiropractic (Formerly RMIT University) – Japan
  • Sidecar

It looks like vendors like ChiroHealth, Foot Levelers, and several others used the money we paid them, to then turn around and bully the WFC research committee because they gave a speech that was anti-subluxation. Used. Our. Money.  I repeated that for a reason. They use our money to get rid of the world’s biggest and best researchers because they didn’t like what they said.  On the other hand, these are the companies that continued to financially support and sponsor the WFC:

  • Palmer College of Chiropractic
  • Parker University
  • Logan Chiropractic College
  • New York Chiropractic College
  • Southern California University of Health Sciences
  • University of Bridgeport
  • University of Western States
  • National University of Health Sciences
  • Canadian Memorial Chiropractic College
  • Anglo European College of Chiropractic
  • Madrid College of Chiropractic
  • Nordisk Institute
  • Dynamic Chiropractic
  • The American Chiropractor
  • Chiropractic Economics

I would like to thank this group that chose to continue to support the WFC, thus continue to support research and science. Thank you for not being bullied by the ICA and the loud minority. Now, let’s be fair. Maybe it was just that times are tough. COVID has us all down. I know it’s got me down. Did they pull or reduce support for the WFC because of the ‘Rona? How are we to know? I don’t know. You don’t know either. But it seems pretty danged coordinated in conjunction with Dr. Kawchuk’s resignation doesn’t it? I mean….doesn’t it? It’s your choice to continue working with these companies but I’ll tell you this much, being evidence-based as I am….I will be second-guessing my commitment and participation with them going forward.

Honestly, how could you not? As my colleague so eloquently stated to me, “Their power is our power.” Again, nobody knows the exact motivation of these companies. I sure as hell don’t. I just know what it looks like.  What if enough of us contacted these companies and griped about this? We can collectively tell them we don’t approve of that sort of influence. We don’t approve of them using our money to bully our research community.

What if this were to serve as a rallying cry for activism over apathy? For a bunch of crappy stuff to take place, all it takes is for good people to just sit on their hands and do nothing.  This can be a rally cry for the WFC and Dr. Goertz, for the ACA, CARL, for the FTCA, and for this Chiropractic Forward Podcast. But, as my esteemed colleague said, there’s a cover charge to getting your voice heard and social media doesn’t quite cut it.  Now, how much of all of this was theater and how much was legitimate?

If Kawchuk was going to be let go because of the financial pressure by the ICA and these companies, was his resignation simply to keep the ICA from getting a win? It seems they reduce exposure by just going to their universities and doing their research there anyway. They’re not out front taking all of the heat and they’re still doing all of their research and all that anyway. Makes you wonder why anyone would want to be out front like that anyway, doesn’t it? I don’t think it was theater.

I think Greg got tired of dealing with the vitalist crap and said to hell with you people. I think the ICA bullied these companies and the WFC to push him out under the guise of a priest comment but really because they didn’t like the anti-subluxation sentiment of the research coming out of the WFC. And I think the companies did exactly what the ICA wanted them to do. So, I think the vitalists and subluxation people won at the end of the day.  It’s all looking like a bunch of stinky garbage on the part of the vitalists but, sometimes those unafraid to get down in the slop are the ones that win the battle. Doesn’t mean they win the war. Just the battle. 

Here’s what I believe. I believe right and truth win every single time. Eventually. So, let’s look at it from that perspective. There are mountains of papers supporting spinal manipulative therapy. There is a paucity as the researchers say….a paucity of solid, respectable research backing the vitalistic, subluxation theory that was generated in the late 1800’s. Here in 2020..it just hasn’t formulated into a solid, well-researched fact, folks. I’m sorry. Don’t punish the messenger.  Anecdotal evidence and charismatic gurus with guitars don’t make it true or make it right. 

Here’s something else I believe strongly, when you have people like McCoy and Edzard Ernst setting the narrative for our profession because we’re not willing to discuss something openly, well, then we’re just asking for it, folks. You either want a well-respected profession or you don’t.  Or, do you want a split all together? The Primary Spine Practitioner program through the University of Pittsburgh may be a good first step for some of you that are bent on the separation.  Can’t we all just get along? I don’t see it happening. I really don’t. I don’t see how our profession can be unified.

Vitalists refuse to follow or even notice solid research that doesn’t confirm their bias. Outright refuse. They insist it’s appropriate to see regular healthy people once per week for life.  Evidence says that’s not appropriate so, therefore, evidence-based chiropractors say it’s inappropriate and it gives us a bad name. So, what do you do about that? You can’t fix it. Evidence based folks can’t continue in a profession where part of the crowd makes them appear illegitimate.

Vitalists refuse to conform to any appearances of being evidence-based.  So, what’s the answer? You tell me. I don’t see a clear answer. I think it lies with the middle group that is neither evidence-based or vitalistic. They’re just out there making a living and getting through their days but are pretty much apathetic to either. When something happens that activates that group, I think that’s what will be the deciding factor on where this profession goes. 

I disagree with 99.9% of everything Edzard Ernst says but I agree with this comment wholeheartedly when he says, “In my view, the problem of the chiropractic profession is unsolvable. Giving up Palmer’s obsolete nonsense of vitalism, innate intelligence, subluxation, etc. is an essential precondition for joining the 21st century. Yet, doing so would abandon any identity chiropractors will ever have and render them physiotherapists in all but name, Neither solution bodes well for the future of the profession.”

I would say that he left out the fact that many PTs are now adding spinal manipulative therapy to their arsenal so maybe PTs are rendering themselves chiropractors rather than the other way around? I would also add to Ernst’s comment that a recent nationwide poll showed that people go to chiropractors to get rid of their pain. They do not go for wellness, vitalism, weekly visits, or innate intelligence talk.  In the comments of Ernst’s post a chiropractor chimed in and said that in his opinion, the profession has a better chance of providing a valuable healthcare service without the ICA members which make up only about 5% of the profession tagging along and raising a stink whenever someone challenges their model or views. 

Researchers should have the freedom to speak thei truth without fear of reprisal of companies that we essentially fund. It goes a hell of a lot deeper than a bad joke folks. It’s an attack on evidence-based chiropractic and an attack on the research community. And we’d better all start seeing it that way because now, the ICA has a win and you can believe they’ll be back for more. If these companies reduced or withheld funding to pressure the WFC based on the ICA’s pressure, we should let these companies know how we feel about it.  I see chiropractors going forward in the world treating pain, following current research, and current widely accepted guidelines. Guidelines that are based in the research literature. I see a profession that accepts a certain standard and a profession that hopefully begins to take policing its own seriously. 

Otherwise, we’ll continue to be the pimple on healthcare’s butt. And that’s the way I see it. And before anyone says it, I’ll say it first…no, I do not want to be a medical doctor. No desire at all. But being a chiropractor doesn’t mean that I have to blindly accept and promote a philosophy from the late 1800’s. They are not mutually exclusive. In any way. The adjustment is the cornerstone of my personal practice and the way I treat patients. It’s just not the end-all-be-all of what I do.  And all of this mess when we are at the precipice of actually breaking through in the healthcare industry. I’ve said it so many times on this podcast but there is no better time to be a chiropractor.

Y’all, it’s a perfect storm. The opioid crisis. The research backs every freaking thing we do OUTSIDE of the subluxation theory. Literallly everything we do.  Spinal manipulative therapy, exercise/rehab, low level laser, massage, acupuncture, balance and proprioceptive training, and things like that. Research backs it all up. It just can’t back up the subluxation stuff.  But we are at a point that we can actually get more patients in our doors if we are a respectable, evidence-based, patient-centered profession.  Again, you can disagree with me. You can cuss me. But you’ll always know where I stand and according to me, I stand for what’s right, I stand for the truth, ethics, morality, and I stand for patients and their right to be treated like respected individuals and not targets that have to be closed.

IF we can’t agree on that, then maybe you can at least respect me and respect the fact that I’m willing to make a stand for what I believe in. Because honestly, I don’t see a lot of folks standing up on this deal.   Maybe it’s just me. I would assume these things would be common sense. Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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 preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!
Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!
Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 
Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
Website https://www.chiropracticforward.com
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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Manipulation For Concussion, Sleep And Cognitive Decline, & Dementia Predictors And Prevention

CF 148: Manipulation For Concussion, Sleep And Cognitive Decline, & Dementia Predictors And Prevention

Today we’re going to talk about manipulation and concussion, sleep and cognitive decline, dementia predictors and prevention. 

But first, here’s that sweet sweet bumper music

Subscribe button 

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

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

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

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

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

Chiropractic’s Effect On Strength and More, Status of Muscle Relaxers, And The Best Recovery Posture

 

You have found yourself smack dab in the middle of Episode #148

Now if you missed last week’s episode , we were joined by Dr. Katie Pohlman, head of research at Parker University and the ACA Researcher of the Year for 2020. That right there is enough for you to just go and listen I think. What a great person and professional to have on our team. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function

On the personal end of things…..

On the personal side of things, it’s still looking up. I’m back to about 140-145/week. We started this Monday off with 7 new patients and 4 re-exams. As of right now, I’m writing this on a Monday. We already have 143 scheduled this week and that without today’s patients being all set up for Wednesday and Wednesday’s patients be re-booked on Friday so I’m looking to definitely have an up-week this week. 

If you listen regularly, I was at about 185-220 per week prior to COVID so, maybe we can make some strides this week toward getting back to some of the big numbers again. Maybe maybe. Fingers crossed. 

How are your numbers? I asked in our private group and will try to remember to share with you in next week’s episode. With me still being at about 80% or so, I’m curious if my experience is normal or not. If you want to jump into the private Chiropractic Forward group and comment on the thread, that’d be great or send me an email at [email protected] Either works just fine. 

Here’s a preview of something I’m working on. Many don’t know this but there was a big blow up at the World Federation of Chiropractic starting with the conference last year in Berlin. Now, just a month or so ago, several of the biggest baddest researchers we have in our profession left the WFC research committee and from an outsider looking in, it appears to be due to pressure from the ICA and the WFC sponsors. Sponsors that we evidence-based chiropractors use and sponsors that our money and business has given some teeth to. On the surface, it seems we have given them teeth to embolden the ICA and bully our top researchers. 

So, my goal is to compile as much information as I can in order to present what happened and why. I want to present it in a fair and well-balanced way looking only for the truth on the matter. I want to know which makes me suspect that you want to know as well. 

Everyone in the know has remained very hush hush on the matter and, if this is the vitalist side organizing sponsors that we use as well to bully the research community, then I want to know who I need to be doing business with and which businesses I may choose to find an alternative to. 

Be looking for that coming down the pike. I’m not trying to shake up the chiro world. I just want to know what happened and I may reconsider doing business with the businesses that made it happen. Because, again, on the surface, it seems our points of view on how the profession should proceed into the future are not in alignment. No pun intended. 

Outside of that, still so far so good around here. Just being smart and trying to stay healthy. Hell, I’m healthier now than I think I’ve ever been. I went back on Weight Watchers. It’s a program I was on about 8 years ago. I lost about 45-50 pounds without really much effort. I swore to the almighty I’d never put that weight back on again. Well…..I did. Lol. 

So, I’m back on the struggle bus but honestly, it’s not that bad. The program always made so much sense to me. It just teaches you how to eat what you’re surrounded by every day. Including fast food even. If you’re not familiar, based on height and weight, you’re assigned a point value. You’re allowed a certain number of points per day and overage points per week should you exceed those points. 

At the same time, foods are assigned point values and, once you are familiar with how much foods count against your daily points, you are able to make educated choices as to what is OK to eat and what just isn’t really worth eating. 

It’s a simple concept and I have to say, it works like crazy. I’ve lost over 15 pounds in about 3 weeks or so. 

Here’s to the next 45!!! Dammit. 

Alright, let’s get on with it this week. 

Item #1

This first one is called “Effectiveness of Osteopathic Manipulative Medicine vs Concussion Education in Treating Student Athletes With Acute Concussion Symptoms” by Yao et. al(Yao S 2020)., published in Journal of the American Osteopathic Association on August 7, 2020. Hot hot hot, it’s a lot hot! 

Why They Did It

The authors say that “current treatment options are limited and difficult to individualize. Osteopathic manipulative medicine (OMM) can aid musculoskeletal restrictions that can potentially improve concussion symptoms. Get that, they didn’t even say that they want to determine if it helps. They just straight up say osteopaths can help. Dammit. Chiropractors have to be more diplomatic in their research abstracts. 

As far as their objectives, more specifically, they said, “To assess concussion symptom number and severity in participants with concussion who received either OMM or an educational intervention.”

How They Did It

  • It was a randomized controlled trial 
  • Conducted at the New York Institute of Technology
  • Patients had concussion-like symptoms due to recent head injury within the previous 7 days
  • They were split randomly into two groups
  • One got manipulative therapy
  • The other group got concussion education intervention
  • They were assessed before and after with the Symptom Concussion Assessment Tool fifth edition

What They Found

  • 30 paticipants
  • The manipulation  group had significant decrease in symptom number and symptom severity compared with the concussion group

Wrap It Up

When used in the acute setting, OMM significantly decreased concussion symptom number and severity  compared with concussion education. This study demonstrates that integration of OMM using a physical examination-guided, individualized approach is safe and effective in the management of new-onset symptoms of uncomplicated concussions.

So let me just say this. Why in the H E double Hockey sticks does Osteopathic manipulation somehow trump chiropractic manipulation? Here’s your answer. It doesn’t if you see research validating osteo manipulation, then you just saw research validating chiropractic manipulation. Just because they got their outliers in line in a way that chiropractic has never even tried to do itself, doesn’t make their manipulation superior. At all. 

Adjusting Disc Herniations and Bulges

 

Item #2

This one is called “Association Between Sleep Duration and Cognitive Decline” by Ma, et. al(Ma Y 2020). and published in JAMA on September 21, 2020. My glasses just steamed up when I read that….because it’s that hot. 

Why They Did It

They wanted to answer the question, “What is the association between sleep duration and cognitive decline in the general aging population?”

How They Did It

  • This was a pooled cohort study 
  • Participants were 2 randomly enrolled cohorts comprising 28,756 individuals living in England and China
  • 50 years or older for the English
  • 45 years or older for the Chinese
  • Self-reported sleep duration per night according tro face-to-face interviews
  • Global cognitive z scores were calculatied 

Wrap It Up

They concluded that “an inverted U-shaped association between sleep duration and global cognitive decline was found, indicating that cognitive function should be monitored in individuals with insufficient (≤4 hours per night) or excessive (≥10 hours per night) sleep duration.” 

Item #3

This one is short, it’s an article in JAMA called “Nearly Half of Dementia Cases Could Be Prevented or Delayed” by Bridget Kuehn, published in JAMA on September 15, 2020. Fresh, sizzlin suckatash. 

Why They Did It

Basically, on this article, they’re covering the fact that there was a report in The Lancet back in 2017 identifying 9 preventable risk factors for dementia. They were….and still are:

  • Having little or no education
  • Hypertension
  • Untreated hearing impairment
  • Smoking
  • Obesity
  • Depression
  • Physical inactivity
  • Diabetes
  • Low social contact

This article is basically an update saying the emerging evidence suggests there are 3 more preventable dementia risk factors. They are:

  1. Head injuries
  2. Excessive alcohol consumption in midlife
  3. Air pollution exposure later in life. 

Some of the recommended steps to prevent dementia are as follows:

  • countries should provide primary and elementary education for all children,
  • take steps to prevent obesity and diabetes,
  • reduce air pollution 
  • reduce secondhand smoke exposure. 
  • programs to prevent people starting smoking, 
  • Prevent or treat hearing loss, and 
  • prevent head injuries,
  • encourage hearing aid use and smoking cessation. 
  • maintaining systolic blood pressure of 130 mm Hg or lower in midlife, 
  • limiting alcohol to fewer than 21 servings per week, and 
  • maintaining an active lifestyle.

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

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

 

 

Store

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

 

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

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About the Author & Host

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

Ma Y, L. L., Zheng F, (2020). “Association Between Sleep Duration and Cognitive Decline.” JAMA Open 3(9).

Yao S, Z. H., Angelo N, Leder A, Mancini J, (2020). “Effectiveness of Osteopathic Manipulative Medicine vs Concussion Education in Treating Student Athletes With Acute Concussion Symptoms.” J Am Osteopth Assoc

w/ Dr. Katie Pohlman – New Research, Upcoming Research, And the Need For It All

CF 147 w/ Dr. Katie Pohlman – New Research, Upcoming Research, And the Need For It All

Today we’re going to be joined by the one and only, research extraordinaire , Dr. Katie Pohlman. We’re going to talk about all kinds of research-related shenanigans so just you know that you are in the right place at the right time my friend.  But first, here’s that sweet sweet bumper music

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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #147.

Now if you missed last week’s episode , we talked about how chiropractic helped the VA cut opioid use among veterans and then we talked about diagnosing lumbar stenosis. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function

On the personal end of things…..

This week we have a guest you’ve heard me talk about plenty of times and I’m excited to have her with us so we won’t dwell on the my personal happenings too long here.   

First, we see numbers rising fairly significantly around my neck of the woods. Here in Texas, you can’t get anyone to take it seriously so we have folks walking around everywhere without a mask on. That tends to limit my interaction with people I don’t know. Of course, they’re required here in my clinic but going into a convenience store, that’s a different story. 

The last time I did that the clerk and myself were the only ones wearing them out of about 10 people. That’s a little distressing. To say the least. But, it is what it is. Darwinism is a real thing. Of course I don’t wish it on anyone and every loss is tragic. But there’s also the natural progression of Darwinism. Those that go by ‘heart’ and ‘opinion’ rather than science and self-preservation…..well, that’s a more dangerous course and I wish them all luck. In the end, regardless of how many get it, we’re looking at 98% of them coming through alright. No percentage guess on how many survive but suffer ongoing issues though. I haven’t heard numbers on that. 

Anyway, as far as the practice goes, we are clicking along and doing well. The new patient count is staying up there where it needs to be and the weekly visits will follow. Still around 145 last week though. I want to see that up around the 185 per week mark. Minimally. 

Then we can get back to paying down debt (aka school loans) and investing rather than paying the bills and surviving. Lol. lt’s good to pay the bills and survive but we should have bigger plans shouldn’t we? Investing and being debt free is key to the later part of life and it’s hard to do so when you’re down. 

Speaking of, I want to pass along some info to you guys and gals. I just finished up a book and decided I’d order 2 more off of Amazon to give out as gifts. The only other book I’ve ever done that with was one called The Easy Way To Quit Smoking by Alan Carr. I ordered several to loan out to my patients that are smokers. 

This book though was about investing. I have read financial books before but, if I’m being honest, getting into symbols and specifics and all…..it’s just not my forte. My wheelhouse exists elsewhere. Which sucks because being financially sound is key to all of our lives. 

Anyway, the book is called Quit Like A Millionaire by Kristy Shen and Bryce Leung. They’re a married couple with different last names. I don’t know. Young people these days do stuff different. Lol. Anyway, I am always skeptical about titles like that. Sure sure….quit like a millionaire. Riggghhhtttt. This book is different. When I said young people do things differently, these two really do. There are real, actionable steps here and I have to admit, even at 48 years old, I’m pretty jazzed about getting my numbers back up so I can jump in head first on some of these suggestions. 

They retired at 32 years old. She’s got the research and the numbers behind her and I’m impressed. If I can get started on it soon, I’ll talk about it and share my experiences with you as I go along. Until then, you might check her website at https://www.millennial-revolution.com/start-here/

Introduction

Enough of that, let’s get going with our guest today.  Welcome to the show, Dr. Pohlman. I appreciate you joining us today.

How are things at Parker University today?

Tell me why you became a chiropractor and then what it was that led you into the research side rather than the treatment side of the profession. 

Congratulations on being the ACA Researcher of the Year. Tell me, with all of the amazing researchers doing work in the profession right now, in your opinion, what made you the pick for the award this year. 

Let’s talk about your post at Parker University. Can you tell us about your day-to-day? For the research-minded listener out there in podcast land, what does the head of research at Parker do every day when you go into work?

I have a paper here that you were the lead author on called “Assessing Adverse Events After Chiropractic Care at a Chiropractic Teaching Clinic: An Active-Survellance Pilot Study” and published in the Journal of Manipulative and Physiological Therapeutics in August of 2020 so brand new stuff here(Pohlman K 2020). While unfamiliar with the other authors on the paper, I do recognize Dr. Greg Kawchuk. I got to see him speak last September in St. Louis at the Forward ’19 conference and wow….he’s an effective speaker to say the least. He’s a heavy hitter for sure. The stated objective here was to assess the feasibility of implementing an active-surveillance reporting system within a chiropractic teaching clinic and subsequently determining the frequency of adverse events after treatment is administered. Now pilot studies are basically the research before the research, right? So, what is down the road along these lines and why is this paper important to us?

Here is a quote from the conclusion of the paper that I think our listeners would find educational. You say, “Our preliminary findings identified that over 50% of patients had improved symptoms after a chiropractic encounter, whereas 8.9% of patients reported worsening symptoms and 5.0% reported new symptoms. Additionally, results from this study suggest that although most symptoms improve with care, there are symptoms that worsen or are new after care, which may not have been previously known to interns or practitioners.”

Another project you were an author on is called “Chiropractic Care of Adults With Postpartum-Related Low Back, Pelvic Girdle, or Combination Pain: A Systematic Review,” by yourself and Carol Ann Weiss et. al(Weiss C 2020). published again in the Journal of Manipulative and Physiological Therapeutics in again, August of 2020. It was a really busy August for you apparently! The objective of this one was to conduct a systematic review assessing the effectiveness of specific chiropractic care options commonly used for postpartum low back pain, pelvic girdle pain, or a combination of the two.  Can you lead us through the paper a little and talk about the abstract’s conclusion which says, “No treatment option was identified as having sufficient evidence to make a clear recommendation.”

The last paper I want to ask you about is one you were on that we covered way back in episode #68 and the paper was called “Change in young people’s spine pain following chiropractic care at a publicly funded healthcare facility in Canada.” It’s amazing how much wonderful research goes on in Canada, BTW. Anyway, it was published in Complementary Therapies in Clinical Practice in March of 2019(Manansala C 2019). This one was interesting to me because it highlighted the fact that spinal pain in young people has been established as a risk factor for pain later in their life. Basically, you all wanted to see how kids respond to chiropractic. I think most chiropractors find this to be obvious given our clinical observations but the conclusion of the paper was “the findings of th epresent study provide evidence that a pragmatic course of chiropractic care, including spinal manipulation, mobilization, soft tissue therapy, acupuncture, and other modalities within the chiropractic scope of practice are a viable conservative pain management treatment option for young people.” What can you tell me about this paper? Did you learn anything new that you didn’t already know going into it?

Do you ever get tired of having a new paper come out? Is it exciting every time?

When I was at Forward ’19, I heard about a program for the first time. I had never heard of CARL before. It turns out that you are very involved. Can you tell us what it is and why it’s important?

What are you and your crew working on now? What’s coming down the line and what big questions are you hoping to get answers to?

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

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

Store

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

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

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

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

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

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

Bibliography

  • Manansala C, P. S., Pohlman K, (2019). “Change in young people’s spine pain following chiropractic care at a publicly funded healthcare facility in Canada.” Complementary Therapies in Clinical Practice.
  • Pohlman K, F. M., Ndetan H, Hogg-Johnson S, Bodnar P, Kawchuk G, (2020). “Assessing Adverse Events After Chiropractic Care at a Chiropractic Teaching Clinic: An Active-Survellance Pilot Study.” J Man Physiol Ther.
  • Weiss C, P. K., Draper C, Silva-Oolup S, Stuber K, Hawk C, (2020). “Chiropractic Care of Adults With Postpartum-related Low Back, Pelvic Girdle, or Combination Pain: A Systematic Review.” J Man Physiol Ther.

 

Common Surgeries Aren’t Well-Researched & Chiropractic Wins Again

CF 144: Common Surgeries Aren’t Well-Researched & Chiropractic Wins Again Today we’re going to talk about how some of the most common musculoskeletal surgeries aren’t very well-researched and we’ll talk about how chiropractic performs when lined up with multidisciplinary treatment.  But first, here’s that sweet sweet bumper music  
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 kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 
  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!
Do it do it do it.  You have found yourself smack dab in the middle of Episode #144 Now if you missed last week’s episode, we talked about a new paper that came out in JAMA that said spinal manipulative therapy doesn’t work and what our research experts have to say about that and what my big mouth has to say about it. Make sure you don’t miss that info. Keep up with the class. There may come a time you need to take a stance on that.  While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.  Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper.  On the personal end of things….. I’m trudging through the designated doctor program here in Texas to assess the extent of the injury, return to work, and all of that fun fun stuff. I’m not even sure why I’m doing it. Just to have back up plans. I like multiple streams and I like options. If I get as busy as I was in 2019, I’ll never have the need for it. If it stays where I’m at – 75% of where I was, well it may be something I entertain.  Either way, will it make me a better doctor for personal injuries, work comp, and all patients in general? Hell yeah, it will. Even if I never use it for a DD exam, I’ll be a better doc after going through it. Guaranteed. Even if I don’t pass the damn test!! Which I hear is stupid and has nothing to do with the curriculum. Even if I fail the test, I’ll be better.  It is slowly cooling off here in the Texas Panhandle. While I realize we just went through the longest Spring and Summer known to mankind, I’m going to miss it. Despite all that went into making it the longest Spring and SUmmer ever….I’m going to miss the aspect of time slowing down, sitting on the back patio with my wife, dinner outside in the outdoor kitchen, swimming in the pool, and just being warm in general.  Oh, how I despise the cold weather. Lol. Here’s where you Northerners call me a pansy but….it’s like needles when the cold wind blows. I grew up a couple of hours north of where I live now and there was a difference in weather. At times, it would get bone-chilling cold growing up. I would take a shower in the morning before school, drive there and park, and walk into the school. My wet hair from showering would freeze before I got into the building. Now that’s cold, folks.  I grew up with that, yes, even in Texas. My hometown is called Perryton, TX and it’s only 7 miles from the tiny little strip of Oklahoma and it’s about 45 miles from Kansas. So, it’s not deep in the heart of Texas. It’s way up North.  My point is, I went to school down in Natchitoches, Louisiana, and then lived in Dallas for about 6 years before relocating back to the Texas Panhandle and Amarillo, TX.  Having not been in the cold cold for 8-10 years got me spoiled to the point that I can’t even tolerate cold weather anymore. At all. For any reason. It borderline pisses me off.  Everything dies, it’s cold, it’s windy, people are all yay about pumpkin spice crap, my bones ache a bit, and I’m bitchy 2/3 of the time.  I’m just warning you all, this is what you get to look forward to dealing with for the next 3-4 months. My whiny butt being all cold-weather fussy. But here’s the saving grace and the best thing since sliced bread; the remote start vehicle.  Yes, as any good Texan, I have a pickup and that dude has remote start with defrost and heated seats. You damn right. This is the ONE thing that has made Winter somewhat tolerable for me and, being a good Christian, I thank God and the car companies on the frigid mornings for blessing us all with such wonderous inventions like the remote start.  Now, I don’t want you North Dakota or Canadian friends of mine rolling your eyes too hard at me here. I’m sure you’d melt down here in TX in the Summers so…..we agree to play to our strengths and roll on down the road. Trust me, go through two-a-days in college in Louisiana and tell me how tough you are. Lol. Something you don’t see on TV when you watch football is the humidity. It’s REAL.  I went from three-a-days at one college playing football here in the Texas Panhandle to two-a-days in Louisiana. Not a problem by anyone in the Panhandle but in Lousiana, it looked like a battlefield with players dropping left and right with cramps and having to get IVs there on the practice field….it was insane. So, I’m cold intolerant but I can handle the other end of it. Don’t be too hard on me. Lol.  What does all of this have to do with chiropractic and research? Not a damn thing. Just a little bit of fun rambling and brain dump.  Let’s get on with the real reason we’re here. Item #1 This first one came to me from Dr. Craig Benton, one of my buddies, down in Lampasas, TX where it’s always a bit balmy almost year-round. It’s called “Integrating a multidisciplinary pain team and chiropractic care in a community health center: an observational study of managing chronic spinal pain” by Prater et. al(Prater C 2020). and published in Journal of Primary Care & Community Health on September 10th of 2020. Holy smokin scorchin’ blaze of newness! Look, y’all should know how I feel about chronic pain by now. This is right down my alley. Not a dark alley. No, one that’s lit up like an airport runway. Bright alley.  Why They Did It They say that chronic pain is one of the most common diseases in the US with the underserved population being most affected for obvious reasons. They say the underserved are at more risk of opioid misuse or overuse since they lack therapeutic access otherwise. For this reason, they are looking for other avenues to provide treatment to chronic pain sufferers.  How They Did It
  • This was a prospective observational pilot study
  • Held at a community health center
  • Measured the effectiveness of two interventions among the underserved population
  • The two interventions were 
  • Multidisciplinary team
  • Chiropractic care
  • The outcomes measured were pain and functional disability measured via the Pain Disability Questionnaire and reduction of opioid dosage at 6 and 12 months. 
  • 35 folks complete baseline and follow-up outcome measures from August 2018 to May 2020
Wrap It Up A key finding was quote, “Participants in the chiropractic team and those completing the study before COVID-19 were found to have significantly greater improvement at follow-up.” Well isn’t that sexy? Indeed.  “This observational study within a community health center resulted in improvement in spinal pain and disability with chiropractic care versus a multidisciplinary pain team. Offering similar services in primary care may help to address pain and disability, and hopefully limit external referrals, advanced imaging, and opioid prescriptions.” This was a pilot study with small sample size. Nothing to do backflips about but it’s a start down this path or thinking and learning so hopefully, we’ll see some very cool and very positive things for the chiropractic profession down the line if papers like this continue to come out. Before we get to the next paper, I want to tell you a little about this new tool on the market called Drop Release. I love new toys! If you’re into soft tissue work, then it’s your new best friend. Heck if you’re just into getting more range of motion in your patients, then it’s your new best friend. Drop Release uses fast stretch to stimulate the Golgi Tendon Organ reflex.  Which causes instant and dramatic muscle relaxation and can restore full ROM to restricted joints like shoulders and hips in seconds.   Picture a T bar with a built-in drop piece.  This greatly reduces the time needed for soft tissue treatment, leaving more time for other treatments per visit, or more patients per day.  Drop Release is like nothing else out there, and you almost gotta see it to understand, so check out the videos on the website. It’s inventor, Dr. Chris Howson, from the great state of North Dakota, is a listener and friend. He offered our listeners a great discount on his product. When you order, if you put in the code ‘HOTSTUFF’ all one word….as in hot stuff….coming up!! If you enter HOTSTUFF in the coupon code area, Dr. Howson will give you $50 off of your purchase. Go check Drop Release at droprelease.com and tell Dr. Howson I sent you. Item #2 I think I got this one from Dr. Craig Benton as well. Dr. Benton is a former guest of this podcast. Sounds like we need to have him back on. He’s my Allstar this week. Thank you, Dr. Benton. For keeping me in business and helping me keep everyone, including myself, educated.  This one is called, “Surgery for chronic musculoskeletal pain: the question of evidence” authored by Harris et. al(Harris IA 2020). and published in Pain Journal in September of 2020. Blisters!!! I got blisters on my fingers!!! You Beatles fans…..you’ll get it.  Why They Did It They say that globally, the most common reasons surgery is performed relate to the musculoskeletal system, and outside of injury, the most common reasons pertain to arthritis and back or neck pain. AKA – chronic pain. Yes, I love me some chronic pain people! Not suffering from it. Learning about it and treating it.  They say, “Although the surgical treatment of chronic pain generally relies on attributing pain to objective, often visible changes on imaging studies, the causes of chronic pain are more complex and are strongly influenced by psychosocial factors.” Things like Yellow Flags. Go look up yellow flags and Annie O’Connor’s book called World Of Pain please and thank you.  They say that surgeries like debridement of degenerative joints and things of that nature ignore the complexity of chronic pain. They look at surgery as purely mechanistic in nature with little to no involvement otherwise and the procedures often rely on observational evidence only, rather than rigorous, comparative trials.  In addition, they say that when the trials have actually been performed for these surgeries have been mostly subjective and measurements are usually not blinded to reduce the bias of the outcomes.  Do you want yourself or loved ones cut into when the procedure has not been thoroughly investigated, researched, and tested? Uh hell no. No thank you.  This paper was written to demonstrate that observational evidence is not adequate when you consider the costs and risks of surgical intervention. They advocate surgical procedures that should undergo randomized controlled trials with blinding and showing statistical and clinically important symptomatic improvement when compared to no surgery at all.  Wouldn’t you expect that they already do this???? Evidently not. At all, really.  Ultimately in this paper the goal here was to quantify what kind of support exists in the literature for some common procedures.  How They Did It
  • The first thing to do was identify the common procedures performed for chronic pain
  • Secondly, they had to identify the number of published RCTs comparing each procedure to a control group treated without that procedure
  • They did a search of the Cochrane Central Register of Controlled Trials
  • Each paper was reviewed by two independent authors
pastedGraphic.png What They Found
  • A very low proportion of the RCTs on the selected procedures compared the procedure to not performing the procedure. 64 from the more than 6,735 studies. Less than 1% if you’re keeping track. Is that not stunning? And infuriating?
  • Of those 64, only 9 were favorable to surgery. 
  • When considering individual surgical procedures, the majority of comparative trials did not favor surgery 
  • None of the studies using patient blinding for any procedure found it to be significantly better than not having the surgery at all. 
Wrap It Up We conclude that many common surgical procedures performed for musculoskeletal conditions causing chronic pain have not been subjected to randomized trials comparing them to not performing the procedure. Based on the observation that when such studies have been performed, only 14% (on average) showed a statistically significant and clinically important benefit to surgery; there is a need to produce such high-quality evidence to determine the effectiveness of many common surgical procedures.  Furthermore, the production of high-quality evidence should be a requirement before widespread implementation, funding or professional acceptance of such procedures, rather than the current practice of either performing trials after procedures have become commonplace, or not performing comparative trials at all.” Wouldn’t you like it in the year 2020, when we hear bragging about the amazing advances of medical wonders and technology, and sometimes rightfully so…..would you like it if these things that should go unsaid are actually done? Wouldn’t you like to know that your mom’s spinal surgery procedure was fully vetted? It was researched against not doing it at all? They haven’t done that? Seriously? Look, ever heard of phantom limb pain? Just in case, it’s where a limb is amputated. Cut off completely. Yet, it still hurts. Why the hell does something that is gone and no longer exists still hurt? It’s because chronic pain lives as much or more in the brain as it lives in a peripheral source.  So, if you go in and do surgery on arthritis for a chronic pain sufferer, what are the real chances that you got rid of that pain? How many people have arthritis that commonly doesn’t bother them much at all beyond the first 15 or so minutes after they wake up? The answer isn’t precise but it’s probably a hell of a lot if I’m placing bets.  Did you know that if a person has surgery and they’re in chronic pain syndrome that even if the surgery goes perfectly, they will still have a 60% chance of developing pain at the new site of surgery? That’s what happens when you have a sensitized or upregulated central nervous system. It’s on high alert and using pain to make your future decisions and to protect you. You have to turn the volume down on the central nervous system if you’re ever going to control the pain in the brain. It’s actually the MOST IMPORTANT aspect of treating chronic pain.  How many people get surgery when they don’t need it because the arthritis isn’t really the issue. When the issue actually lies withing the limbic system in the brain? To be fair, how many people get adjusted by the chiropractor a million times because they’re trying to pop out the pain? Hell, doing that a million times only deepens the issue.  Don’t get me wrong, there’s SMT benefit in regard to proprioceptive input, sensorimotor function, movement dysfunction, blood flow, and pain modulation but…..beyond a certain point, it will create instability and that will deepen the issue.  I tell new chronic patients that we treat this issue through a combined approach. They must be approaching the issue from a cognitive aspect simultaneously with my physical treatment as well as the exercise/rehab. If we have that comprehensive, three-pronged approach to their condition, we are going to stand a much better chance at getting this sucker under control.  If you’re adjusting and sending them out the door, that’s low-level and borderline ineffective at best. At the worst, with too many appointments, you compound the issue by adding spinal instability to the mix. Too many chiropractors and subluxation slayers just do not understand this concept. They think they’re being specific. The research is pretty clear. You’re adjusting segments at a time. Not one. You’re not that good.  Alright, that’s it. Y’all be safe. Keep changing the world and our profession from your little corner of the world. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   
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 subscribe 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
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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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography
  • Harris IA, S. V., Mittal R, Adie S, (2020). “Surgery for chronic musculoskeletal pain: the questions of evidence.” Pain 161(9): S95-S103.
  • Prater C, T. M., Battaglia P, (2020). “Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center: An Observational Study of Managing Chronic Spinal Pain.” Journal of Primary Care & Community Health.

w/ Dr. Chris Howson: Chiropractors In Hospitals & Drop Release

CF 140: w/ Dr. Chris Howson:  Chiropractors In Hospitals & Drop Release

Today we’re going to be joined by Dr. Chris Howson of the great state of North Dakota where we’ll be talking about chiropractic integration in a hospital setting as well as his new invention called Drop Release. 

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 making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

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

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

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

  • Like our Facebook page, 
  • Join our private Facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #140

Now if you missed last week’s episode , we talked about chiropractors affected by COVID, 2019 opioid overdoses, and insurnace compensation for chiropractic. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper. 

On the personal end of things…..

I am writing this on 8/17/20 which means I’m taking my son to college this afternoon for his freshman year. It’s my first kid to fly the coop and we’ll see how it goes. Many of you did this same thing years ago. Many of you don’t even have kids so I won’t dwell on it long. 

I’ll just say, especially to the young ones, there’s no time to waste. Whether it’s starting your own retirement account, starting your kids a college fund, or asking that girl on a date. There’s no time to waste because landmarks like I’m going through this week…..they arrive before you know it. Almost by surprise even. 

Before you know it, you’ll look up and you’ve been in business 20 years, your kids are graduating, you looking at retirement in the next 10-15 years and you don’t know exactly how it all happened. But it did and if you’re not a forethinker, it’ll punch you square in the nose and make your eyes cross. 

Just a word from your wise ol’ Uncle Jeffro. 

I don’t want to talk too much because we have a guest today. Before we welcome him, I want to do a proper introduction. 

  • 2004 graduate of Northwestern. 
  • Practicing in Grand Forks ND, 
  • has spent the last 9 years in an integrated practice setting. 
  • Has a strong background in sports and applies that “get em back on the field” mentality to all his patients.  
  • Member of FTCA, NDCA, and ACA.   
  • Currently pursuing the orthopedic diplomate.  
  • Inventor of the Drop Release.

Tell me a little bit about yourself and your family.

I always say that chiropractic isn’t something that immediately comes to mind when one is deciding what they want to be when they grow up. So how did you come to be a chiropractor?

Where did you go to school?

What in your background or your schooling best prepared you for your current practice setting? Did you have any mentors that were particularly impactful along the way?

We have talked at length on this podcast about integrating into the Federally Qualified Health Centers or FQHCs but your situation is a little bit different. Can you explain what you’re doing and how you got there? And how it’s different from an FQHC.

What kind of patient is your typical patient in the hospital setting? Are you just confined to acute low back or what? 

Have you had any issues or had to stand your ground when it came to those in the medical field that don’t necessarily love the chiropractic profession? 

Numbers

Do you see your model as something that can be repeated in TX, NC, CA, to Florida? And how? How could those interested start on the path you’re blazing up in ND?

Do you see your current way of practicing as your life long way or do you have plans to be in the private sector down the line?

So, we get along very well because we are both go getters and entrepreneurs. If people have been listening, lately, I’ve been giving them a code for a discount on a new little invention called Drop Release. You happen to be the inventor of Drop Release. I actually first met you in person at the Forward ’19 event in St. Louis when you were working your Drop Release exhibit booth. Tell us all how you came up with the idea. How did you take it from concept to reality? That’s the biggest hurdle most folks don’t get over. 

We might as well give them the code to save some money on Drop Release if they want one, don’t you think?

Thanks for joining us, Chris. I appreciate it. 

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

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

Key Takeaways

Store

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

Home

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

TuneIn

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About the Author & Host

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