chiropractor

Lumbar Stenosis

CF 230: Lumbar Stenosis

Today we’re going to talk about lumbar stenosis

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. 

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

You have found yourself smack dab in the middle of Episode #230

Now if you missed last week’s episode , we talked about T-sp Adjustments For Neck, Not Headache & Physical Activity In Children. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things…..

As I mentioned last week, I just finished the book called Who Not How by Dan Sullivan and another dude. Lol I can’t remember his name and don’t have time to look. Brad Hanby or something like that. Anyway, I’m on the hunt for an associate as a result. Great book and I know that with some help, not only will I have more time available to be a more effective clinic owner and doctor, but I’ll have the opportunity to grow the practice as well. It’ll be great. Give me a holler if interested in working in a busy evidence-based, patient -centered and medically integrated clinic that is making a difference int he Texas Panhandle. That’s us. 

Now, I’ve started reading a book recommended to me by Ben Fergus of the GRIP method fame and a fellow member of the MCM Mastermind you’ve heard me mention. This book is called Think Again by Adam Grant. It’s all about learning to search for the things you don’t really know and be willing to re-think your thoughts and stances on things. I’m still just getting into it a bit but it’s pretty alright and it’s teaching me some stuff. 

I also started a book by Gray Cook called The Business Of Movement I saw recommended by Jason Hulme recently in a Facebook group. It’s probably the Forward Thinking Chiropractic Alliance group if I’m guessing. Anyway, that one just came in the mail. Hell, I need an associate just so I’ll have time to read and get up to date. I also just joined an online class called Quadrant Analysis that I’m looking forward to diving into. 

So, I’m not perfect. Don’t follow everything I do. I could do better soap notes. I could do a lot of things better but….#1 our patients are 99% likely to refer us to their friends and family #2 ChiroUp tells me our clinic has about an 80% improvement rate for any and all conditions considered. #3 I’m 49, been in this sucker for 24 years, and I can’t wait to learn more and more. We can always learn more. We can always get better. We never know it all. If I ever find an associate that wants to come to the Texas Panhandle, that’ll be one of the first things I make sure they understand. If you ever stop learning, you’re either ignorant or you’re arrogant. Each is equally appalling. 

Boom, snap, pow, slap. 

Some of you may have seen a post by a ‘chiropractor’ …..I use the term loosely when referring to this dummy. She put on social medial recently the following, “An ovarian cyst is a functional gift from nature to make your more attractive and fertile after a traumatic loss. An enlarged prostate is a fit from nature to make you more potent after feeling degraded as a man. Tumors are not mistakes, they are purposeful adaptations.”

Bless her heart…. This little knucklehead is running around spouting this stuff and, yup you guessed it…is a chiropractor. I’m quoted in an article now saying she’s insane. Mostly because that’s my opinion and the only one I can think of that makes any sense with regard to a statement like that. 

I bring it up because you have to know these loony birds are out there soiling our names and our hard work. The people that listen regularly here are normal, educated, and hard working evidence based patient centered chiropractors out there changing the world and elevating this profession beyond quack BS that has held the profession back for so long. If however you stumbled upon this podcast and you believe stuff like this is plausible, please, don’t leave. Don’t go anywhere. 

Let me introduce you to evidence and research and sanity. 

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

Let’s get to it.

 

Item #1

This frist one is called “Diagnosis and Management of Lumbar Spinal Stenosis A Review” by Katz et. al. (Katz JN 2022) and published in JAMA on May 3, 2022, that was just like 3 weeks ago damn the heat….It burns

This is more of an article than a standard research paper so lets hit the high points with some relevant quotes from the report.

“Affects an estimated 103 million persons worldwide. Most are treated nonoperatively. Approximately 600 000 surgical procedures are performed in the US each year for lumbar spinal stenosis.”

The prevalence of the clinical syndrome of lumbar spinal stenosis in US adults is approximately 11% and increases with age.”

“The diagnosis can generally be made based on a clinical history of back and lower extremity pain that is provoked by lumbar extension, relieved by lumbar flexion, and confirmed with cross-sectional imaging, such as computed tomography or magnetic resonance imaging (MRI)”

More specifically, from my learning through the Neuromusculoskeletal diplomate program, a little clinic pearl here is the shopping cart sign. If they have to use a shopping cart to lean forward over in order to be able to walk through the grocery store, and sitting almost immediately alleviates the pain, there’s a great chance you have some stenosis on your hands. Pain on extension or extension/rotation can bolster the diagnosis. 

Then, on the MRI or CT, if you see the sedimentation sign where the nerve roots stay suspended in teh central canal rather than settling on the bottom of the canal due to gravity. You now have pretty convincing evidence of stenosis. 

“In a series of patients with lumbar spinal stenosis followed up for up to 3 years without operative intervention, approximately one-third of patients reported improvement, approximately 50% reported no change in symptoms, and approximately 10% to 20% of patients reported that their back pain, leg pain, and walking were worse.”

That makes a strong argument for no surgery doesn’t it? Look, most do fine with targeted exercise. There is a stenosis protocol in ChiroUp if you’re not usiing the program. While I am a ChiroUp devotee, I actually use the protocol and program from Dr. Carmen Amendolia. You can find all of his info at spinemobility.com It’s excellent and we see really good results using it. 

“Multiple clinical trials have studied manual therapy for spinal stenosis, including lumbar distraction mobilization, hip and sacroiliac joint mobilization, manual stretching, and muscle strengthening. In a clinical trial33 of 58 participants with lumbar spinal stenosis, 79% reported being at least somewhat better following a 6-week program that included manual therapy, treadmill walking, and strengthening and stretching exercises compared with 41% of patients randomized to the flexion exercise group.

The results were similar at 1 year. Schneider et al31 randomized 259 patients with lumbar spinal stenosis to 1 of 3 treatment groups: medications with or without epidural injections, manual therapy with individualized exercise, and group exercises. Participants randomized to manual therapy combined with individual exercises had improved their Zurich Claudication Questionnaire scores significantly more at the 2-month follow-up (mean difference, 2.0; 95% CI, 0.4 to 3.6) than did those randomized to medications with or without injections. Participants randomized to group exercises had similar improvement to those receiving medications and/or epidural injections (mean difference, −0.4; 95% CI, −2.1 to 1.3). The differences between groups were negligible at 6 months.”

“Epidural steroid injections may offer modest short-term pain relief but do not appear to last more than 3 weeks.”

“Long-term benefits of epidural steroid injections for lumbar spinal stenosis have not been demonstrated. Surgery appears effective in carefully selected patients with back, buttock, and lower extremity pain who do not improve with conservative management. “

 

Wrap Up

Lumbar spinal stenosis affects approximately 103 million people worldwide and 11% of older adults in the US. First-line therapy is activity modification, analgesia, and physical therapy. Long-term benefits from epidural steroid injections have not been established. Selected patients with continued pain and activity limitation may be candidates for decompressive surgery.

The key to remember about stenosis is that it isn’t necessarily the size of the hole rather what is happening to the structures going through the hole. If there is no realy inflammation or complication, stenosis patients may never know they have it. 

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

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

Store

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

 

 

 

 

 

 

 

The Message

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

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

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

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

 

Key Point:

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

That’s Chiropractic!

 

Contact

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

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

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

 

Connect

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

 

Website

Home

 

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

Bibliography

Katz JN, Z. Z., Mass H, Makhni MC, (2022). “Diagnosis and Management of Lumbar Spinal Stenosis: A Review.” JAMA 327(17): 1688-1699.

 

Cognitive Behavioral Therapy & Restless Leg Syndrome

CF 226: Cognitive Behavioral Therapy & Restless Leg Syndrome Today we’re going to talk about Cognitive Behavioral Therapy & Restless Leg Syndrome But first, here’s that sweet sweet bumper music

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

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 ma ke you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #226 Now if you missed last week’s episode , we talked about Pain And COVID & Images Can Mislead. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. As part of our MCM Mastermind call last week, it seems that everyone is starting to get busy once again. Which is refreshing. Omicron is settled down and deductibles are getting met once again.  Patients are coming back. Are we the only business that hasn’t gone up on prices this year? Gas, flights, travel of any kind, food, real estate, inflation…..everything has gone sky high. And I’m sitting here with the exact same pricing I’ve had for the last 5 or more years.  Last week, we talkied about getting hacked on FB. Yeah, it happened to me big time. BIG TIME. Facebook changed to this Meta thingy majig. So, I have created around 22 pages for various reasons. Philanthropy, business, clinic services, etc. Lots of stuff.  You may recall that I’ve been mentioning that I was running a targeted ad campaign. Since we are medically integrated, I started with the hormone pellets. I figured if I could get it to work for pellets, I could repeat the process with every service we offer.  So, I went and found a freelancer that does that. Hired them up and we were off and running. Well, he needed admin permissions on Facebook. I did not think that was a good idea but he’s not the first I’ve worked with and they all need this permission level for some reason. It’s honestly never made sense and I’ve never been comfortable with it.  But, since it’s pretty common, I did it. Well, I woke up last Monday to an email from him telling me to remove him from my Facebook because he’d been hacked. I went to do that but it was too late. I was already listed as an employee and two random names I’ve never seen were listed as the Admins.  So through hacking my paid ad person, they were able to hack my Meta and through hacking my Meta, they were now in control of 22 different pages of mine.  Excuse me for being crude here but that’ll make your butt strings pucker up, people. That’ll make you cuss in Spanish and kick baby bunnies.  Facebook support gave me a little hope. I got going with them, they understood the issue and said I’d hear back from them in 24-48 hrs. That was a Monday. Thursday rolled around and I still hadn’t heard anything from them so I started a new ticket with them. The new ticket dude knocked it out.  I was back in control of everything within about 2 hours. It’s odd; the hackers didn’t change anything on any of the 22 pages I run. They had 3 days minimum to mess everything up but they didn’t for some reason. I don’t know. It’s weird. But thank God they didn’t.  Now we’re back to normal, this Monday wasn’t a freak out butt puckering session and we’re good to go.  So let this be a lesson to you all. When you hire an ad person and they ask for admin permission, politely tell them, I’m sorry but I’ve been advised by my Ol’ Uncle Jeffro not to do that. You can get hacked through the back door like that and it doesn’t feel good. Not good at all.  Before we get to the research, we talked about pricing…..well, I’m guessing you are getting tired of getting paid peanuts for your good work?  Insurance pays maybe half. Medicare and Medicaid even less.  So how about full payment?  This comes with PI cases. How do you get these cases? You learn how the game is played. You learn the system. I recently connected with an attorney, Paul Samakow, a 41-year veteran attorney – he explains in detail what to do, how to do it, and how to have attorneys not only send you their clients, but how to assure they continue to send them over. His system is delivered to you in both written and video form – Samakow is actually pretty funny when you watch, he’s got a great personality – but his content and information are both spot on and serious, and will result in multiple referrals from attorneys if you follow his system. His system costs $997 and he guarantees satisfaction or your money back. Which is really a big deal for me and makes it easy to check this out.  Even if you only get one case, you’ve made at least 4 or 5 times the investment. Go to gettingpicases.com/cs That’s gettingpicases.com/cs One more time so you get it right:   gettingpicases.com/cs Alright onto the research Item #1 This first one is called, “Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care A Randomized Clinical Trial” by Wright et. al. (Wright JH 2022) and published on February 10, 2022. Ah….it’s hot and cozy.  First of all, before we dive in, we know chronic pain can lead to depression, anxiety, lack of sleep, and deeper pain. We also know that it goes the other way as well. Depression leads to deeper, more entrenched chronic pain, inactivity, anxiety and on and on.  That’s why the American College of Physicians has recommended Cognitive Behavioral Therapy as a first line treatment for back pain.  On another related note, chiropractors tend to think they can do everyhting. Y’all……CBT isn’t one of them. You can’t Google it and figure it out. It’s not in our scope. You have to find a specialist and refer it out. When you’re wondering if you can take care of it yourself……just don’t Why They Did It To evaluate whether computer-assisted CBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of it in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment. How They Did It
  • Randomized clinical trial 
  • included adult primary care patients from clinical practices at the University of Louisville who scored 
  • They were randomly assigned to computer-assisted CBT or treatment as usual for 12 weeks of active treatment. 
  • Follow-up assessments were conducted 3 and 6 months after treatment completion. 
  • The last follow-up assessment was conducted on January 30, 2020. 
  • The primary outcome measures were administered at baseline, 12 weeks, and 3 and 6 months after treatment completion.
What They Found
  • An intent-to-treat analysis found that computer-assisted CBT led to significantly greater improvement in outcome scores -cores than treatment as usual at posttreatment and 3 month and 6 month follow-up points. 
  • Posttreatment response and remission rates were also significantly higher for computer-assisted CBT than treatment as usual
Wrap It Up computer-assisted CBT was found to have significantly greater effects on depressive symptoms than treatment as usual in primary care patients with depression. Because the study population included people with lower income and lack of internet access who typically have been underrepresented or not included in earlier investigations of computer-assisted CBT, results suggest that this form of treatment can be acceptable and useful in diverse primary care settings.  Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.  Item #2 Our second one today is called “Current Evidence on Diagnostic Criteria, Relevant Outcome Measures, and Efficacy of Nonpharmacologic Therapy in the Management of Restless Legs Syndrome (RLS): A Scoping Review” by Guay et. al. (Guay A 2020) and pulblished in Journal of Manipulative and Physiological Therapeutics.  Why They Did It To outline the current evidence regarding the management of restless legs syndrome (RLS) with nonpharmacologic approaches.  How They Did It
  • Scoping review
  • The authors extracted data from the 24 admissible studies, that is, the ones about manual therapy, exercises, and alternative treatments for RLS
  • The Physiotherapy Evidence Database scale was used to rate the methodological quality of the included randomized controlled trials by 2 independent readers.
What They Found
  • In the 24 articles fulfilling the selection criteria, there was a consistent trend in the findings showing positive results in lowering RLS symptom severity. 
  • The efficacy of exercise, yoga, massage, acupuncture, traction straight leg raise, cryotherapy, pneumatic compression devices, whole-body vibration, transcranial and transcutaneous stimulation, and near-infrared lights showed different effects on RLS symptom severity, and the level of evidence was evaluated.
Wrap It Up Our results showed clinically significant effects for exercises, acupuncture, pneumatic compression devices, and near-infrared light. Short-lasting effects were identified with whole-body cryotherapy, repetitive transcranial stimulation, and transcutaneous stimulation. More studies are necessary to investigate efficacy of yoga, massage, traction straight leg raise, and whole-body vibration. No adverse effects were identified for moderate-intensity exercise, yoga, massage, and pneumatic compression devices. If I remember correctly, we did another episode that covered RLS and melatonin was a supplent that showed effectiveness. Google it and see if I’m right.  Alright….gotta go! Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.       

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography Guay A, H. M., O’Shaughnessy J, Descarreaux M, (2020). “Current Evidence on Diagnostic Criteria, Relevant Outcome Measures, and Efficacy of Nonpharmacologic Therapy in the Management of Restless Legs Syndrome (RLS): A Scoping Review.” J Man Physiol Ther 43(9): P930-941.   Wright JH, O. J., Eells TD, (2022). “Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care: A Randomized Clinical Trial.” JAMA Netw Open 5(2).          

The Complexity & Treatment of Chronic Pain

CF 224: The Complexity & Treatment of Chronic Pain Today we’re going to talk about manual therapy for chronic pain the complexities within.  But first, here’s that sweet sweet bumper music  

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

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

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

You have found yourself smack dab in the middle of Episode #224 Now if you missed last week’s episode , we talked about Kids’ Mental Status & Zero Calorie Drinks. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

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

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

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

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

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

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

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

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

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

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

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

That’s gettingpicases.com/cs

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

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

Item #1

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

Why They Did It

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

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

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

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

That was like Will Smith Rocking Chris Rock…..

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

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

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

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

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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  The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

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

Kids’ Mental Status & Zero Calorie Drinks

CF 223: Kids’ Mental Status & Zero Calorie Drinks Today we’re going to talk about the children, how are they doing lately? And then we’ll talk about whether low or no calorie beverages have any real use for us.  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 a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #223 Now if you missed last week’s episode, we talked about Forward Head Posture And Spinal Manipulative Therapy Effectiveness. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Let’s talk about marketing. I always share what I’m doing and how it’s working with you folks and while business is coming back, that’s just the natural flow. We expect to start getting busy again in March. I’m looking for marketing that moves the needle.  I’ve tried social media marketing campaigns that cost me in excess of $4500. For basically nothing. I might as well stuffed that money into my ears and lit it on fire and did a rain dance. It was useless.  Here’s something to know about me……I can be talked into just about anything.

I believe people and always look for the best in them. Or at least try to. So, yeah….I can either be talked into anything or, as is often the case, talk MYSELF into anything.  Here’s my life; I create all of our social media posts. I write my own blog every week. I record my own video and edit it every week for YouTube and Facebook. That’s in between 40+ patients a day and 20+ new patients per week and writing and recording a podcast, real estate, voice-over, and anything else in there including being a husband and a dad.  It’s time for some help and hopefully some effective help. 

I told you how I started with a new idea of lead magnets a few weeks ago. Not a lot happening there. As expected. I hoped…..but feared not much would come of it outside of an absence of my money. So far, it’s an absence of my money but I’m stubborn and not giving up just yet.  This lead magnet is for our testosterone hormone pellets. My thinking is that if it works for the pellets, then we will expand the concept and keep trucking with different products and services for the lead magnets. Still testing there and will update as needed.  I’m also starting with a new crew from England on social media marketing. I got the welcome packet today. My thinking is that my consultation payments for this medical integration are finished this month.

So that frees up some funds to put toward something else and there are not many things more important than marketing. So, I’m getting going with another group today to test them out and see how we can grow my stuff.  If it’s awesome, maybe I can make them a sponsor of the show and share them with you too. We’ll see.  A little tip from you Ol Uncle Jeffro, if you didn’t do it in January, do it now. Sit down with your key employee and go from month to month to plan out what you’re going to do for marketing.

What key events do you need to have a presence at, etc. Do you want to do a Mother’s Day promotion? What about a July 4th cookout at the office? That type of deal. When it’s planned, you don’t forget about it and it doesn’t sneak up on you.  Since I’m trying to delegate marketing more and more to my staff, I have the global marketing sheet but I also have started a weekly focus sheet.

So my marketing focus this week is to stress ‘no wait times for our NP, social media posts for the whole week, 2x/day, 1-2 videos for the week.  We’ll see, I think I have swimmers and not sinkers so we’ll see.  Continuing in the debacle of trying to find a front desk staffer, we have run into yet another snafu. This time we found a good one. Or so we thought. She worked with us for almost 2 full weeks. Then came St. Patty’s day. She ended up in a ditch running from the police and driving drunk at 2:00 am. She missed work the next day. Not because of a hangover but because she was in jail.  A little more research told us that she didn’t have custody of her kiddo because of 2 previous DWIs and this was her 3rd. So…..while you don’t want to be the one to compound someone’s suffering and misery, we had to cut ties. 

  1. If she lost custody of her kid because of drinking and still didn’t get the message, it’s going to be a long road
  2. If we’re missing work in the first 10 days because of jail, that’s just a bad omen of things to come
  3. If this is her 3rd DWI, she’s going to do jail time and we need an employee that is here and dependable. 
  4. If she miraculously doesn’t do jail time, she’ll be doing rehab, counseling, community services, court dates, and all that good stuff. And all of that equals time out of work. 

There are more reasons but that’s enough. We had to move on. I’ve always shied away from hiring friends because I just see that always going bad and it causing an awkward problem down the road. However, we started having one of our buddies come up to the office on a part-time basis to help us out on some overflow work and Holy guacamole….she’s insane good at the front desk stuff.  So….maybe we have a new front desk person after all. The saga continues and I’ll keep you updated. Stay tuned.  Alright to the research we go!

Item #1

This one is called “Five-Year Trends in US Children’s Health and Well-being, 2016-2020” by Lebrun-Harris et. al. (Lebrun-Harris LA 2022) and published in Jama Pediatrics on March 14, 2022. Holy fires of hell, it’s en Fuego!

Why They Did It

The authors say they aimed to examine recent trends in children’s health-related measures, including significant changes between 2019 and 2020 that might be attributed to the COVID-19 pandemic.

How They Did It

  • 174,551 children included in the study
  • Annual data were examined from the National Survey of Children’s Health (2016-2020), 
  • It was a population-based, nationally representative survey of randomly selected children. 

What They Found

  • Increased Anxiety
  • Increased depression
  • Decreases in daily physical activity
  • Decreases in parent or caregiver mental health
  • Decreases in coping with parenting demands

From 2019-2020 – the pandemic

  1. Increases in behavior or conduct problems
  2. Child care disruptions affecting parental employment
  3. Decreases in preventive healthcare visits
  4. increases in unmet health care needs, and 
  5. increases in the proportion of young children whose parents quit, declined, or changed jobs because of childcare problems.

Wrap It Up

Study findings point to several areas of concern that can inform future research, clinical care, policy decision-making, and programmatic investments to improve the health and well-being of children and their families. People have gone crazy. They were politically crazy and hating on each other prior to the pandemic. So let’s be honest here, shall we? But the pandemic deepened it and while technology is amazing and useful, social media has, in my opinion, destroyed the fabric of our society. Of love and understanding. Of mutual respect.  It’s allowed people to mouth off and insult each other from a distance saying things and in behaving in a manner that they would never behave like if the person they’re disrespecting were standing directly in front of them.  Anyway, kids are resilient but they’ve been affected too. Our world has gotten more stressful and it’s showing. 

Item #2

This second one is called, “Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-analysis” by McGlynn et. al. and published in JAMA Network Open on March 14, 2022. Schiza – Steamy

Why They Did It

There are concerns that low- and no-calorie sweetened beverages do not have established benefits, with major dietary guidelines recommending the use of water and not low- and no-calorie sweetened beverages to replace sugar-sweetened beverages. Whether low- and no-calorie sweetened beverages as a substitute can yield similar improvements in cardiometabolic risk factors vs water in their intended substitution for sugar-sweetened drinks is unclear. To assess the association of low- and no-calorie sweetened beverages with body weight and cardiometabolic risk factors in adults with and without diabetes.

How They Did It

  • Data were extracted and risk of bias was assessed by 2 independent reviewers
  • The primary outcome was body weight. Secondary outcomes were other measures of adiposity, glycemic control, blood lipids, blood pressure, measures of nonalcoholic fatty liver disease, and uric acid.
  • A total of 17 RCTs with 24 trial comparisons were included, involving 1733 adults

What They Found

I’m not going to tell you. Because it gets very technical and in the weeds as they say. You’ll start wandering off into the ether and thinking about things like….is there another word for Thesaurus? And if you were to choke a Smurf…..what color would they turn?

Wrap It Up

This systematic review and meta-analysis found that using low- and no-calorie sweetened beverages as an intended substitute for sugar-sweetened beverages was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution.  The evidence supports the use of low- and no-calorie sweetened beverages as an alternative replacement strategy over the moderate term in adults with overweight or obesity who are at risk for or have diabetes.

This is amazing because I’ve been off of sodas for a decade but recently discovered a new love for Coke Zero. My wife has been all over me about drinking them and now I can show her research that says maybe they’re not as bad as she thinks.  And at the end of the day, I take some satisfaction in being right. : ) Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

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

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

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

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 (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  Bibliography Lebrun-Harris LA, G. R., Kogan MD, Warren MD, (2022). “Five-Year Trends in US Children’s Health and Well-being, 2016-2020.” JAMA Pediatr.      

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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  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.          

Breathing Through The Pain, Need For Rehab, & Forward Head Posture And Shoulder Pain

CF 164: Breathing Through The Pain, Need For Rehab, & Forward Head Posture And Shoulder Pain

Today we’re going to talk about the impact of chiropractic care on opioid use and then we’ll talk about garbage marketing in the chiropractic profession. I go off a bit. I can’t help it. They make me nuts. 

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.  If this episode has a different type of sound quality when compared to previous episodes, my main computer died. It choked a little and held it’s belly and rolled around in agony for about a month and then…..sadly, it straight up and died. 

So, I have another ordered and in the meantime, I’m figuring out how to do this through my MacBook Pro. Where there’s a will, there’s a way. We’ll make it happen.  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 #164 Now if you missed last week’s episode, we talked about opioids and spinal pain and then we talked about vitalists’ scripts. That was about the point that I lost my mind momentarily. Because they make me crazy and all.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Wow, what a week I had last week, y’all. And I’m not talking in a good way. Oh hell no. This was one of those kick you in the face and in the backside. And when you’re falling to the ground, putting a boot in your ribs for good measure.  One word, two syllables. Day-um.  For patients that I’m comfortable with, it’s common for them to ask me how my day’s going and my go-to answer is usually something similar to, “Ah you know….pissing excellence. As usual. It becomes a habit after a while.” Yeah, not last week. I wasn’t the windshield. I was the bug. 

First thing’s first, on last Tuesday, my longest tenured employee and office manager turned in her resignation. Over 11 years, down the drain. She’s not just a staff member. She’s become my little buddy. She’s hilarious. She was also our marketing girl. Definitely a boot to the face. Pow.  But there are a lot of positives there as well. Being my longest employed staffer, she was also my highest paid so we will save a good chunk of money. We just need to make some adjustments on the marketing and things of that nature.  Then, on Wednesday, as mentioned previously, we joined the Wealthability program and we had a meeting with our new accountants they matched us with. They’re out in St. Louis. Well, they found that our previous CPA was wrong and now we have to pay a gob in taxes we weren’t expecting to pay. We can spread it out over an amount of time and it’s fixable but day-um…..

Come on man.

When you hire professionals, you expect a professional job that will prevent you from getting into trouble. Don’t you? That was a kick to the nether regions. Smack.  Then, later that afternoon, my main computer that has my entire life on it straight up died. Luckily, it had slowed a bit and I called my computer guy to come in and back it up so it can be replicated on another computer. Still, that computer won’t be here for 2 damn weeks.  Kick to the shin. Thunk. 

Then, two of my girls got the second vaccine shot and both got sicker than dogs. One missed work on Wednesday. Not that big of a deal. Just kind of sucked.  Then I got a visit from a connection that works in my Dad’s nursing home. She came to my house on Thursday night after work to tell me my Dad is being mistreated and is withering away.  Stomp to the noggin while I’m down. Snap.  There were some other little things here and there but you get the picture. Rough week. But we’re on the mend.

We’re heading the right direction this week I think. We have some good ideas and I think we are going to make some changes.  So, as a learning lesson, bad things can be used for an impetus to change course and go in a positive direction. For example, I’ve begun going down the path of fully integrating. I’m saving enough money with the departure of my manager that I can use that money toward integrating and hiring a nurse practitioner. 

This would fit my long term plan of being able to remove myself from my day to day practice. It’s a piece of the puzzle. The final piece of the puzzle would be hiring an associate. At that point, I believe my time begins to get freed up a bit.  Hopefully in five years, I’m mentoring my colleagues and teaching them how to accomplish what I’ve accomplished. I’m sharing wisdom with hungry evidence-based chiros and spreading the good news about evidence-based, patient-centered chiropractic care.  We’re going to get there.  In other news, last week wasn’t a total loss. You may have seen where the Texas Chiropractors, after a ten-year battle, put the smackdown on the Texas Medical Association. People’s elbow, Kabam!!

The biggest bully of bullies got slapped the hell around by the Texas Chiropractic Association and the Texas Board of Chiropractic Examiners at the Texas Supreme Court level.  Just briefly, the TMA had sued the TCA and the TBCE approximately 10 years ago over our right to perform the VONT testing. Also known as vestibulo-ocular nystagmus test. Then that morphed into attacking our rights to diagnose and our rights to treat the Neuromusculoskeletal system rather than just the musculoskeletal system. Seemingly silly little things but, if they had won, technically, we couldn’t treat anything having to do with ‘nerve’ and we couldn’t have diagnosed our own patients so we’d depend on referrals from medical professionals……and how do you think that would have turned out in the long run?

Not good for an chiropractor on the planet because other medical associations would have precedence and would have repeated the process. Those of us in leadership positions for the TCA have been well-aware for the last decade that if we lost this case, we would be the first domino and it would effect every other chiropractor.  We lost, then we lost the appeal, then the Texas Supreme Court gave us the win. And the Texas Medical Association, the most predatory state medical association in the United States, has to cover the court costs. Oh, and on top of that, they can suck it.  We are going to have an entire episode where I’ll be joined by my fellow TCA members. Folks that have been the deepest in the trenches on this case and know every in and out of the entire process.  It’s going to be a good one so keep a lookout for that one.  Alright, let’s get to the good stuff shall we?

Item #1

This first one is called, “Can Slow Deep Breathing Reduce Pain? An Experimental Study Exploring Mechanisms” by Jafari, et. al. (1) and published in the Journal Of Pain in September/October of 2020. It’s not a lot hot but hot enough!

Why They Did It

This study sought to investigate effects of instructed breathing patterns on experimental heat pain and to explore possible mechanisms of action

How They Did It

  • In a within-subject experimental design, 48 healthy volunteers performed 4 breathing patterns: 
      1. Unpaced breathing, 
      2. Paced breathing (PB) at the participant’s spontaneous breathing frequency, 
      3. Slow deep breathing at 6 breaths per minute with a high inspiration/expiration ratio (SDB-H), and 
      4. Slow deep breathing at 6 breaths per minute with a low inspiration/expiration ratio (SDB-L)
  • During presentation of each breathing pattern, participants received painful heat stimuli of 3 different temperatures and rated each stimulus on pain intensity
  • Respiration, heart rate, and blood pressure were recorded.

What They Found

Compared to unpaced breathing, participants reported less intense pain during each of the 3 instructed breathing patterns.

Wrap It Up

Slow deep breathing is more efficacious to attenuate pain when breathing is paced at a slow rhythm with an expiration that is long relative to inspiration, but the underlying mechanisms remain to be elucidated. Oh…..elucidated. That’s a $5 word for the research crew there. Congrats on elucidated, folks. 

CHIROUP ADVERTISEMENT

Item #2

This one is called, “Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019” by Cieza, et. al.  (2) and published in The Lancet on December 19, 2020. Smokin’, sizzlin’, steamy pot of chili pie.  I have learned, by the way, that Frito Pies are not an American thing.  It’s just mostly a Texan thing. I have eaten Frito pies my whole damn life and didn’t figure this factoid out until just a few years ago. I play Call Of Duty here and there on xbox.

I know….I’m a nerd but I’m a killing’ nerd on occasion! I can kill real people in a fake way right there with the best of them when I want to. And I have my glasses on. And I haven’t had any more than a few beers. Lol.  Anyway, I play with a dude from Louisville, KY and he’d never heard of Frito pies. Holy cow people. There are some things you need to get tuned into if you’re not from Texas. They are as follows:

    • Frito Pie
    • Fried Okra
    • Fried squash. 

Yes, all are terrible for you so…..as a priest told me at the bar back when I went to college in Louisiana and was asking him how this whole ‘priest being in a bar’ worked out….he said, “Everything in moderation, Brother.” We should probably get back to the paper, Y’all. 

Why They Did It

Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritized in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury.

How They Did It

To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability of 25 diseases, impairments, etc. 

What They Found

  • Globally, in 2019, 2.41 billion individuals had conditions that would benefit from rehabilitation, contributing to 310 million years of life lived with disability
  • This number had increased by 63% from 1990 to 2019
  • The disease area that contributed most to prevalence was musculoskeletal disorders with low back pain being the most prevalent condition in 134 of the 204 countries analyzed.

Wrap It Up

The authors wrap up their thoughts with this, “To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.”

I will add that the vitalists that think they can only adjust their way out of every damn condition or complaint need to get in the back of the line and just keep quiet. If you are going to be current rather than look like a dumb dumb, then you need to understand that a good, learned chiropractor knows that we do not only mobilize with adjustments, stretching, and things of that nature. But we also much know when to stabilize through strengthening activities.  If you’re just hitting the high spots on all of your patients, you need to be better and raise you game. Mr. Vitalist…..I’m talking to you. 

Item #3

The last one today is called, “Does forward head posture change subacromial space in active or passive arm elevation?” By Dehqan, et. al. (3) and published in the Journal of Manual and Manipulative Therapy on November 30, of 2020 and that’s about the right amount of hot Why They Did It Forward head posture (FHP) is one of the most common musculoskeletal disorders that appears to affect the shoulder joint through the shared muscles between the head and neck area and the shoulder girdle. The present study compared the acromiohumeral distance between individuals with normal head and neck alignment and those with moderate and severe FHP in active and passive arm elevation.

How They Did It

  • Based on the craniovertebral angle, 60 volunteers were selected and equally distributed among three groups, including group one with normal head and neck alignment, group two with moderate FHP and group three with severe FHP
  • The space between the humeral head and the acromion was measured in 10°, 45° and 60° of active and passive arm elevation as the acromiohumeral distance.

What They Found

  • The acromiohumeral distance was only different between the three groups at 45° arm elevation angle, and this difference was significant between groups one and three
  • In active and passive arm elevation, increased arm elevation angle reduced the subacromial space significantly
  • Also, in each arm elevation angle, the subacromial space differed significantly between the active and passive arm elevations.

Wrap It Up

They concluded, “The acromiohumeral distance was significantly lower in the severe FHP group than the group with normal head and neck alignment in the 45° active arm elevation angle, which could be due to the changed tension in tissues between active and passive arm elevation and also the maximum muscle activity in the 45° active arm elevation angle.”

Shoulder impingement folks.

I didn’t know anything about it until I went through he DACO program. Which is now the Neuromusculoskeletal Diplomate. It’s a real estate issue and when you have an upper cross type setup, forward head posture, you decrease the real estate.  Increase the real estate, decrease the issue in this sort of a setup.  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

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Bibliography

  1. Hassan Jafari, Ali Gholamrezaei, Mathijs Franssen, Lukas Van Oudenhove, Qasim Aziz, Omer Van den Bergh, Johan W.S. Vlaeyen, Ilse Van Diest, Can Slow Deep Breathing Reduce Pain? An Experimental Study Exploring Mechanisms, The Journal of Pain, Volume 21, Issues 9–10, 2020, 1018-1030
  2. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vox T, Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. 396 (10267), P2006-2017, December 19, 2020.
  3. Behdokht Dehqan, Cyrus Taghizadeh Delkhoush, Majid Mirmohammadkhani & Fatemeh Ehsani (2020) Does forward head posture change subacromial space in active or passive arm elevation?, Journal of Manual & Manipulative Therapy, DOI: 10.1080/10669817.2020.1854010

 

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

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  

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.

Website

Home

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

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https://player.fm/series/2291021

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

TuneIn

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow 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

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

  • 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.

 

Chiropractors Affected By COVID, 2019 Opioid Overdoses, Insurance Compensation For Chiropractic

CF 139: Chiropractors Affected By COVID, 2019 Opioid Overdoses, Insurance Compensation For Chiropractic

Today we’re going to talk about Chiropractors Affected By COVID, 2019 Opioid Overdoses, Insurance Compensation For Chiropractic

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. 

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 #139

Now if you missed last week’s episode , we talked about NSAIDs, cognitive behavioral therapy and vitalists ignoring stuff. 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…..

Personal means personal right? Well, I’m still working on getting the whole voice-over gig set up and rocking and rolling. What’s voice over you may ask? Well, the voices you hear on commercials, eLearning, promos, radio bumpers, and even cartoons and stuff like that. That’s voice overwork. 

Here’s my thought and I’ve said it here before; I don’t want to die in my office working on people when I’m 80. God bless those of you that love the daily grind so much that that’s your goal. It takes all sorts, doesn’t it? But that’s not me. I want to hire an associate and mentor them over the course of a certain amount of time and then sell my practice to them eventually. 

I’m a musician/singer/songwriter. I’m a sculptor. A portrait artist, furniture builder, and all kinds of other things. I love to travel as well. So, what kind of work could I do that would allow me some retirement income and can be done literally from anywhere in the world with an internet connection? Voice over of course. So, I started working on it once the Rona showed up. I’m taking some classes and building some skills and equipment and knowledge. 

The thought process is, if I start now, in 5 years it may be a very viable way to add to my weekly income in retirement. I have other things I’m looking at as well but this is the one I’m knee-deep in right now. 

I have friends that tell me they only get 24 hours in a day and I get more like 48. Lol. That’s not true of course but I do keep moving, keep thinking, keep working pretty much non-stop and move from one thing to another fairly quickly trying to multi-task and get it all done on some sort of time scale. 

I adhere to an old saying I try to always remember; time is just time. You’re either investing in it or you’re wasting it. I don’t like to waste time all that much. There’s always time to sit and relax here and there but, in general, I’m not much for wasting it. 

As far as business, we’re marketing like crazy. I’ve put more into marketing in the last 3 months than I have in the last three years and guess what…..80%. We’re still at about 80% of where I was and like I said last week, that’s my new normal and I’m done making myself crazy about it. I’ll take this extra time and I’ll continue to invest in it. 

So I’m anxious to see what happens. I have things working inside chiropractic. I have things working outside chiropractic. Let’s see which mud sticks to the wall. If any of it sticks at all, right? We never know but it’s exciting to be productive. It’s exciting to be creative. And it’s exciting to have the prospect of more income and more options as to your future. 

That’s where I’m at right now. I just turned 48. I  have less time in front than behind. I’m not getting younger so it’s time to step on the gas. And that’s what I’m doing. This pandemic crap isn’t going to last forever and I plan on sitting pretty in time to retire so let’s just get started right now shall we?

Item #1

Speaking of ‘pandemic crap’, here’s a paper called “The impact of COVID-19 on the chiropractic profession: a cross-sectional survey on opinions, professional changes, and personal hardships of US chiropractors” by Neff et. al(Neff S 2020). published in Chiropractic and Manual Therapies posted on 15 of July 2020 and dammit if that’s not hot then I don’t know what is, people. 

Now, before I get going on this one, I recognize three of the authors’ names from the Forward Thinking Chiropractic Alliance group on Facebook. Once again, if you’re considering yourself an evidence-based, patient-centered chiropractor rather than a vitalist, get in that group. You can learn a ton. Anyway, Shawn Neff, Rebecca Deyo who I’ve mentioned on this show before, and Annabelle MacAuley. All very smart, very talented doctors of chiropractic. 

Why They Did It

The research was conducted to collect self-reported data on how COVID-19 has affected U.S. doctors of chiropractic. I’m glad someone is paying attention to us and all. Honestly, chiropractors get the fat end of the bat don’t we? Who got PPE delivered to your office by the state back in April?

Yeah, me either. Anyway……

How They Did It

  • An electronic survey was sent to U.S. chiropractors nationwide via social media and email. 
  • The survey collected 
  • personal and practice demographic information, 
  • office protocols, 
  • changes made during COVID-19, 
  • chiropractic profession opinions/stances, 
  • information related to stress, and 
  • personal beliefs/opinions.
  • Data were analyzed using descriptive statistics.

What They Found

  • 750 U.S. chiropractors responded. 
  • Just over half of respondents reported moderate levels of stress, and 
  • Just over 30% reported severe levels due to a variety of reasons related to both personal and professional circumstances. 
  • The primary stressors were financial and business concerns. 
  • The highest stress levels were among employers responsible for others. 
  • A majority reported beliefs that the chiropractic profession should not advertise that spinal manipulation provides any immune system benefit. 
  • 13% of the respondents believed chiropractors should be marketing immune benefits during this time. 
  • A shift toward telehealth was reported, with 18% adding it to their services.

Wrap It Up

“Stress levels were high across the population. A range of opinions existed regarding spinal manipulation and immunity benefits. The majority reported there was not sufficient evidence to support such a belief; however, a group of respondents believed that chiropractors should be marketing immune-enhancing benefits to the population. A logical next step would be to study why such beliefs persist. This information may be useful in better understanding how chiropractors have experienced the global effects of COVID-19 across the United States.”

Adjusting Disc Herniations and Bulges

 

So…..if you want to know how many are vitalists and how many are evidence-based or, at minimum….agnostic….then doesn’t this give us some hints? A vitalist would claim to take the pressure off of nerves allowing the innate life force to better express itself rendering you immune to the disease. That sounds like about 13% of chiropractors surveyed. 

That tells me 87% call shenanigans on the rest of it. It’s been a while since I heard a number. We know its the minority but damnit they’re a loud minority, aren’t they? They’ve kept us right here without cultural authority for over 100 years at this point. 87% is pretty high though. Maybe it’s changing. 

I saw another recent survey where only a very small percentage of chiropractors were interested in learning more about chiropractic philosophy. I think it’s fine as a historical thing. Just not as something that keeps controlling our profession and keeps us at the bottom of the barrel. 

Love me or hate me, at least I’m honest and you know where I stand. 

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.

Getting Patients Returning, Shoulder Impingement, Cervical Manipulation, & X-rays and Neurodegenerative Disease

 

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

This second one is a report from CNN on opioids called “Drug overdose deaths jump in 2019 to nearly 71,000, a record high, CDC says” by Shelby Lin Erdman on July 16, 2020(Erdman 2020). Hot stuff….come on now. Make way people!

This was an article so we’ll be like a boat on the lake and just skip across the high spots. How about that?

  • Drug overdose deaths in the US jumped last year by about 4.8%. 
  • 2018 was slightly down from 2017
  • 2019 bumped back up to 71,000 overdose deaths. 
  • The former president of the American Medical Association, Dr. Patrice Harris, said the numbers show why it’s important to remove any obstacles to treatment for those addicted to drugs. While I think that’s worthy, I think it’s important to not that there should be no obstacles in place to see alternative practitioners in the first place when some of these folks presented with pain. The White House report in 2016 and The Lancet report on back pain both agreed there are obstacles in place preventing these kinds of patients from seeing chiropractors. 

Item #3

This one is called “Trends in Insurance Coverage for Complementary Health Care Services” by Whedon et. al(Whedon JM 2020). published in the Journal of Alternative and Complementary Medicine on July 7, 2020. The roof, the roof…it’s on fire. 

Why They Did It

Complementary health care professionals deliver a substantial component of clinical services in the United States, but insurance coverage for many such services may be inadequate. The objective of this project was to follow up on an earlier single-year study with an evaluation of trends in reimbursement for complementary health care services over a 7-year period.

How They Did It

  • The authors employed a retrospective serial cross-sectional design to analyze health insurance claims for services provided by licensed acupuncturists, chiropractors, and naturopaths in New Hampshire (NH) from 2011 to 2017. 
  • They restricted the analyses to claims in nonemergent outpatient settings for Current Procedural Terminology code 99213, which is one of the most commonly used clinical procedure codes across all specialties. 
  • They evaluated by year the likelihood of reimbursement, as compared with primary care physicians as the gold standard. 

What They Found

  • The total number of clinical services claimed was 
  • 26,725 for acupuncture, 
  • 8317 for naturopathic medicine, 
  • 2,539,144 for chiropractic, and 
  • 1,860,271 for primary care. 
  • Initially, the likelihood of reimbursement for naturopathic physicians was higher relative to primary care physicians but was lower from 2014 onward. 
  • Odds of reimbursement for both acupuncture and chiropractic claims remained lower throughout the study period. 
  • In 2017, as compared with primary care the likelihood of reimbursement was 
  • 77% lower for acupuncturists, 
  • 72% lower for chiropractors, and 
  • 64% lower for naturopaths.

Wrap It Up

“The likelihood of reimbursement for complementary health care services is significantly lower than that for primary care physicians in NH. Lack of insurance coverage may result in reduced patient access to such services.”

So when we talk about barriers to seeing safer, non-invasive practitioners, don’t tell me there are none. Don’t piss on my leg and tell me it’s raining. 

What was the Tommy Boy reference? You can get a good look at a t-bone by sticking your head up a bull’s ass but wouldn’t you rather take the butcher’s word for it? Or no…..it’s gotta be YOUR bull. Lol. Great movie. 

Anyway….buncha hullabaloo. Research and surveys are so clear and mostly consistent when they say spinal pain is so bad yet chiropractic is so good at treating it. Not only in terms of effectiveness but also in terms of patient satisfaction and even long term outcomes when compared to traditional treatment. The damn White House report a few years ago said there are barriers. The Lancet said it. I’ve seen it other places that aren’t coming to mind but it’s clear there are barriers in place set up by the stakeholders, the insurance gurus, the medical professionals….. All go 180 degrees from what the research tells them to do. 

And they keep going that way. It feels like it’s not turning around. At all. So…..shenanigans. I’m calling shenanigans. 

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. 

Subscribe Button

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

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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

  • Erdman, S. L. (2020) “Drug overdose deaths jump in 2019 to nearly 71,000, a record high, CDC says.” CNN.
  • Neff S, D. R., MacAuley A, Lawrence D, (2020). “The impact of COVID-19 on the chiropractic profession: a cross-sectional survey on opinions, professional changes, and personal hardships of U.S. chiropractors.” BMC Chiro Man Ther.
  • Whedon JM, e. a. (2020). “Trends in Insurance coverage for Complementary Health Care Services.” J Altern Complement Med.