chronic pain

Chronic Pain Central Sensitization & Patient Barriers To Physical Therapy

CF 316: Chronic Pain Central Sensitization & Patient Barriers To Physical Therapy Today we’re going to talk about Chronic Pain Central Sensitization & Patient Barriers To PT and, I would argue….chiropractic care. But first, here’s that sweet sweet bumper music    

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Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #316 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 6).  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Man, we’re going through some stuff at the office recently and it centers around collections. Remember when I said last week that practice is a big long game of whack-a-mole? Well, it’s a fact and what I’m currently dealing with is really a ‘death by a thousand cuts’ type of scenario with one glaringly large issue.  The bright neon sign issue right now is collections. We are billing appropriately but the checks aren’t showing up. We’ve had such a struggle with in-house billing in the past. We lost hundreds of thousands on that years ago so we’ve moved to off-site billers. We are now on our 4th, I believe.  I think we’re in the right spot with this one. However, in the transition, our collections have taken a nose dive and I mean a nose dive. As in, if we billed out $70k+, we had a collections of $28k. Right. Now, carry that out over 3 months with that kind of deficit, your resources that are meant to cover issues start to vanish fairly rapidly.  Remember, I have an overhead of $55k-$60k/month. I remember when I was younger and newer in practice. At the time, my overhead was about $25k. I was talking to an older chiro buddy of mine at a TX Chiro Assoc event and he told me his overhead was $45k/month. And he wasn’t integrated either. It blew me away. I couldn’t imagine having an overhead that high.  And…..well here we are. With 4 full time employees, a full-time NP, an acupuncturist, and 2 massage therapists…..it just sort of happens. All of the medical supplies….holy cow. That’s a pretty penny, folks. Massage supplies, acupuncture needles, 4,000 sq ft. Office, utilities…you get the point. It adds up fast and if you’re not cognizant of what’s up, it’ll get out of hand on you. That’s why I balance my own bank account each month. I know what’s coming in and what’s going out.  It’s why I know that we have a collections issue.  Remember we have death by a thousand cuts, right? Well, other issues of late are that we aren’t performing and charging for codes we could be. We’re letting cold laser patients walk out the door without doing laser. We’re letting exercise patients exit the building without doing their exerrcises. This is happening with patients that are covered under PI or on their insurance plan for rehab.  That’s just a training issue and we’re whacking that mole currently.  Another issue is that we’re still recovering from COVID on some level. In 2019, I had 220 more new patients over the course of that year than I had in 2023. What the hell? So, we’re whacking that mole by ramping up some marketing and website SEO efforts.  I have a call with the collection company today at lunch and I have addressed the other issues. Now, if we can get it happening on the collections, you’ll get to hear happy Jeff in future episodes. Yay!! Why do I share this stuff with you? I like to think this is not just a research article podcast. This is real life. If you know the struggles I’m dealing with and the successes I’m enjoying, you’re either going through the same and can learn, or you WILL be going through the same and can learn from my experiences.  Even when you’re riding the wave of success, things can short circuit and you have to always be paying attention so that you can catch it as quickly as possible so you can avoid disaster. After years of not having to give finances much consideration at all, it’s time to lean on some folks that owe the clinic money, lean on our biller a bit, get ourselves in order, and market.  Easy peasy right? I’ll keep you posted on our progress. Don’t cry for me, Argentina! You’ll be mad at me soon because I’ll be back to seeing 70+ new patients per month. Wait for it. When you’ve got my attention, you’ve got my attention and I have a tendency to really lean in and get focused. That’s where we are right now. While I don’t recommend it, it is a bit exhilerating. I’ll admit.  Item #1 Our first one today is called, “Nociplastic pain and central sensitization in patients with chronic pain conditions: a terminology update for clinicians” by Nijs et. Al. published in Brazillian Journal of Physical Therapy in May of 2023 and that’s hot enough! Remember, the citations can be found at chiropractscforward.com under this episode.  Nijs J, Malfliet A, Nishigami T. Nociplastic pain and central sensitization in patients with chronic pain conditions: a terminology update for clinicians. Braz J Phys Ther. 2023 May-Jun;27(3):100518. doi: 10.1016/j.bjpt.2023.100518. Epub 2023 Jun 14. PMID: 37348359; PMCID: PMC10314229. Why They Did It Acute pain has been tremendously beneficial throughout evolution as it enables us to identify potential harmful stimuli, and as it ensures we protect damaged tissue while it heals.  However, once evolved into a chronic state, its protective role diminishes with a wide range of negative and maladaptive sequelae that massively impact both the individual and society.  Neuroscientific research has significantly advanced our understanding about pain and chronic pain in particular, including the role of central (nervous system) sensitization in the generation and amplification of (persistent) pain experiences. This knowledge innovation created a massive implementation potential but also a challenge for clinicians to remain up-to-date in daily practice.  Particularly the variety of and rapid change in concepts and terminology used can be challenging for clinicians. For these reasons, this second part of the comprehensive pain management editorial series1 provides a terminology update regarding central sensitization and nociplastic pain in a clinically applicable way.  Essentially, central sensitization is the major underlying mechanism of nociplastic pain, which is a pain phenotype. To facilitate the understanding of the concept of central sensitization, it is crucial to understand that central sensitization is a homeostatic mechanism. This implies, similar to inflammation, that central sensitization is adaptive in the short term (e.g., in the days following surgery or following a motor vehicle accident). As such, it avoids further deterioration in acute pain situations.  However, central sensitization becomes maladaptive in the long term, with pain losing its protective value as commonly seen in patients with persistent pain (e.g., months after successful surgery or a motor vehicle accident).  In addition, central sensitization and inflammation – although physiologically very divert mechanisms – share many features, including the notion that multiple biomarkers together rather than a single gold standard are required for assuming its presence, the fact that they are both umbrella terms covering various clinical & biological presentations, that their clinical presentation varies substantially from patient to patient, and that they are both key mechanism in a wide variety of clinical conditions/diseases The presence of clinical features of central sensitization predicts poor treatment outcomes in patients with a variety of chronic pain conditions, at least when the treatment targets local tissues as the presumed source of nociception.  This applies to conservative interventions, but also to surgical interventions. These observations illustrate the need for early recognition of central sensitization in patients with chronic pain, in combination with tailored treatment. Item #2 Our last one today is called, “Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review”’ by Dickson et. Al. and published in Pain Medicine in February 2024 and that one’ll burn your damn eye brows off.  Cameron Dickson, Rutger M J de Zoete, Carolyn Berryman, Philip Weinstein, Kexun Kenneth Chen, Paul Rothmore, Patient-related barriers and enablers to the implementation of high-value physiotherapy for chronic pain: a systematic review, Pain Medicine, Volume 25, Issue 2, February 2024, Pages 104–115, https://doi.org/10.1093/pm/pnad134 Why They Did It To identify and synthesize patient-related barriers to… and enablers of ….the implementation of high-value physiotherapy (HVP) for chronic pain.  Furthermore, to review what patient-related interventions have been used to facilitate the implementation of high-value physiotherapy for chronic pain, as well as their efficacy. How They Did It The authors systematically searched the APA PsycInfo, Embase, CINAHL, Medline, Scopus, and PEDro databases for peer-reviewed studies (published in English) of adults with chronic pain.  They used the Theoretical Domains Framework of behavior change to synthesize identified themes relating to barriers and enablers. Outcomes from studies reporting on interventions were also qualitatively synthesized. What They Found
  • Fourteen studies reported on barriers and enablers, 8 of which related to exercise adherence. 
  • Themes common to barriers and enablers included perceived efficacy of treatment, interrelationship with the physiotherapist, exercise burden, and the patient’s understanding of exercise benefits. 
  • Other barriers included fear of movement, fragmented care, and cost. 
  • Ten studies explored interventions, 9 of which aimed to improve exercise adherence. 
  • Of these, evidence from 4 randomized controlled trials of technology-based interventions demonstrated improved exercise adherence among intervention groups compared with controls.
Wrap It Up
  • Patients with chronic pain experience barriers to high value PT, including their beliefs, the nature of their interaction with their physiotherapist, perceived treatment efficacy, and cost. 
  • Enablers include rapport with their physiotherapist, achievable exercises, and seamless cost-effective care. 
  • Technology-based interventions have demonstrated effectiveness at increasing exercise adherence. 
  • Our findings suggest that interventions seeking to enhance implementation of high value PT, need to consider the multifactorial barriers experienced by patients with chronic pain.
Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.       

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

Chiropractic evidence-based products

Integrating Chiropractors

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

Omnivorous vs Vegan & SMT For Chronic Neck Pain

CF 314: Omnivorous vs Vegan & SMT For Chronic Neck Pain Today we’re going to talk about Omnivorous vs Vegan & SMT For Chronic Neck Pain But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #314 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 5).  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Let’s start by giving Dr. Steven Brown out in Gilbert, AZ a shoutout. If you listened last week, we had a paper that was just the abstract. It was a paper that the WHO is using in part to help them formulate their opinion that SMT is recommended but at very low confidence.  The paper used orthopedic manual physical therapy, whatever the hell that is.  “The protocol consisted of accessory mobilizations (posteroanterior), traction of the lumbar region, mobilization with movement in the coxofemoral joint, and global techniques of neural mobilization of the lumbar spine. The duration of the orthopedic manual physical therapy was 20–25 minutes per session.”  Dr. Brown says, “They did not get actual lumbar spine, SI joint, or hip manipulation at all. Just 20-25 minutes of mobilization.” So, there you have it from one of last week’s papers. I think as we go through them, it’s getting clearer and clearer that the WHO may have an agenda. Which chiropractors expect, honestly. When you have MDs running the show, they’re going to be super slow to promote SMT to the MainStage for anything. Using papers like we’ve been seeing to make their determination is just, quizzical. For lack of a better word. It’s perplexing when we know there is more current and more impactful research in favor of SMT.  Moving on this week, I just got back from Jupiter, FL and the MCM Mastermind with Dr. Kevin Christie, Dr. Brett Winchester, Dr. Lindsey Mumma, and many more. Florida wasn’t warm. It was in the 50s and 60s but we were in a classroom most of the time anyway. We had some fine dining at The Woods, which is Tiger Woods’ restaurant. No Tiger sightings but none were expected. Lots of Bentleys, Mercedes, Lambos, and the like. It’s always a little crazy in Florida when you consider the amount of money strolling around those towns.  Lots of great discussions, lots of thoughts and plans. Now to have the time to organize the thoughts and take action on them. One fun one came from my little friend, Dr. Tiffany Armstrong from Iowa. Her and her husband have a great practice out there and are adding a gym to the mix. Fun fun.  She was talking about Storybrand and what are your Big 3? She said patients and clients can’t really keep up with more than three things. It got me to thinking and here’s what I came up with:
  1. Pain Relief
  2. Function, Stability, Strength
  3. Performance Care
That’s why you join a mastermind. That was a little comment on a discussion that we had in class. Nothing game changing but enough to give me some clarity and direction with some things I’ve been wanting to tweak and change. Imagine how many of those little comments and conversations we have over the weekend.  Lots of direction this morning outside of the. Podcast so I’m hopping into it  Item #1 Our first one today is called, “Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial” by Landry et. Al and published in JAMA Network Open November 30, 2023. Kapow! It’s hottern’ a teapot! Remember, the citations can be found at chiropractscforward.com under this episode.  Landry MJ, Ward CP, Cunanan KM, et al. Cardiometabolic Effects of Omnivorous vs Vegan Diets in Identical Twins: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(11):e2344457. doi:10.1001/jamanetworkopen.2023.44457 Why They Did It Increasing evidence suggests that, compared with an omnivorous diet, a vegan diet confers potential cardiovascular benefits from improved diet quality (ie, higher consumption of vegetables, legumes, fruits, whole grains, nuts, and seeds).  The researchers wanted to compare the effects of a healthy vegan vs healthy omnivorous diet on cardiometabolic measures during an 8-week intervention. How They Did It This single-center, population-based randomized clinical trial of 22 pairs of twins randomized participants to a vegan or omnivorous diet (1 twin per diet).  Participant enrollment began March 28, 2022, and continued through May 5, 2022.  The date of final follow-up data collection was July 20, 2022.  This 8-week, open-label, parallel, dietary randomized clinical trial compared the health impact of a vegan diet vs an omnivorous diet in identical twins.  Twin pairs were randomized to follow a healthy vegan diet or a healthy omnivorous diet for 8 weeks.  Diet-specific meals were provided via a meal delivery service from baseline through week 4, and from weeks 5 to 8 participants prepared their own diet-appropriate meals and snacks. The primary outcome was difference in low-density lipoprotein cholesterol concentration from baseline to end point (week 8).  Secondary outcome measures were changes in cardiometabolic factors, plasma vitamin B12 level, and body weight. Exploratory measures were adherence to study diets, ease or difficulty in following the diets, participant energy levels, and sense of well-being. A total of 22 pairs of twins What They Found After 8 weeks, compared with twins randomized to an omnivorous diet, the twins randomized to the vegan diet experienced significant mean (SD) decreases in low-density lipoprotein cholesterol concentration, fasting insulin level, and body weigh Wrap It Up In this randomized clinical trial of the cardiometabolic effects of omnivorous vs vegan diets in identical twins, the healthy vegan diet led to improved cardiometabolic outcomes compared with a healthy omnivorous diet.  Clinicians can consider this dietary approach as a healthy alternative for their patients. Item #2 OK, the last one this week is called, “A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain” by Liu et. Al. published in Complementary Therapies in Clinical Practice in August of 2023 and it’s just hot enough! Zhen Liu, Jiao Shi, Yubo Huang, Xingchen Zhou, Huazhi Huang, Hongjiao Wu, Lijiang Lv, Zhizhen Lv, A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain, Complementary Therapies in Clinical Practice, Volume 52, 2023, 101751, ISSN 1744-3881, https://doi.org/10.1016/j.ctcp.2023.101751. Why They Did It An increasing number of people suffer from chronic neck pain due to increased telecommuting. Manual therapy is considered a safe and less painful method and has been increasingly used to alleviate chronic neck pain.  However, there is controversy about the effectiveness of manipulation therapy on chronic neck pain.  Therefore, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effectiveness of manipulative therapy for chronic neck pain. How They Did It A search of the literature was conducted on seven databases from the establishment of the databases to May 2022.  This study included RCTs on chronic neck pain managed with manipulative therapy compared with sham, exercise, and other physical therapies.  The retrieved records were independently reviewed by two researchers.  Further, the methodological quality was evaluated using the PEDro scale.  The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment was used to evaluate the quality of the study results. Seventeen RCTs, including 1190 participants, were included in this meta-analysis. What They Found Manipulative therapy showed better results regarding pain intensity and neck disability than the control group.  Manipulative therapy was shown to relieve pain intensity and neck disability.  However, the studies had high heterogeneity, which could be explained by the type and control interventions.  In addition, there were no significant differences in adverse events between the intervention and the control groups. Wrap It Up Manipulative therapy reduces the degree of chronic neck pain and neck disabilities. Hurry, someone run and the the World Health Organization that we got a new paper to add to their crap recommendations…. More on the papers they’re using to recommend SMT at very low confidence in next week’s Part 6 of that series.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.       

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

Chiropractic evidence-based products

Integrating Chiropractors

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

Hip Pain And Corticosteroids & Chronic Pain After Spinal Surgery

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #303 Now if you missed last week’s episode , we talked about Spinal Manipulative Therapy And Bezodiazepines & Yanking Someone’s Head Off. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Back at it. You remember when I told you last week that I think we’re on a turnaround after having been out sick and then the next week having to spend half a week in Chicago for the Forensics conference? I think the trend is continuing.  I’m looking at 46 appointments today. That’s including 3 new patient exams, 2 PI intakes, and 3 re-exams. So it’s going to be a busy one today. I’ll be glad when the day wraps up at 6:00 pm this evening. Thursday is looking a little light but it’s 8:30 on a Monday morning right now. We have plenty of time to fill that day out in the next few days.  We had our first cold blast of the year and guess who’s not happy about it? This guy. This guy that love the Summer and green things and birds chirping and shiny happy people out running around and enjoying the warm weather. This guy.  In fact, cold weather and Winter basically piss me off a bit if I’m being honest. It’s terrible. Everything goes dormant, the clocks change so it’s dark before I even get off of work, the cold wind and wet rain and ice and snow…..I’m getting triggered just to talk about it honestly.  So, the point is, it’s a mental battle for me on some very low level. It’s in the background for sure but it’s a battle for me. I hate it and yet, I have to learn to live with it every year and just get through it. Maybe I’m dramatic about it. Sure. But don’t we have our challenges that work our mental state? We’re all different so I’m sure yours is likely different than mine in lots of cases.  Another thing that has been working my mental state is the lack of a good billing company. I tried to have in-house billing for years. I lost almost a million dollars over the course of 3 years because I trusted too much. She didn’t steal. She just didn’t re-submit when denied so once timely filing passes, you’re outta luck. Well, we were outta luck a bunch it seems and by the time I found it, it was pretty far gone.  A lot of beer will get you past something like that.  They don’t share these things with you when you’re going through school but there are some soul-sucking parts to being a clinic owner. What would it be like to just show up and go to work and go home without the worry and the fret of the HR part….the billing and collecting part? What would that all be like?? I don’t know but I’m moving down the path of finding that out. I’m working on a potential partial buyout in the next 6 months. And ya know what? I’m not even nervous about it. Because the business end of it isn’t my special skill. Not my special talent. It gives me loss of enjoyment.  So as I go down that path, I’ll be updating you. It may be something you’ll be interested in as well in the coming years. Especially if you’re 50-something and getting long in the tooth.  We shall see. To be continued.  Item #1 Our first one this week is called, “Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip” by Okie et. Al. and published in Journal of Bone Joint & Surgery on November 17, 2021.  Okike K, King RK, Merchant JC, Toney EA, Lee GY, Yoon HC. Rapidly Destructive Hip Disease Following Intra-Articular Corticosteroid Injection of the Hip. J Bone Joint Surg Am. 2021 Nov 17;103(22):2070-2079. doi: 10.2106/JBJS.20.02155. PMID: 34550909. Why They Did It While recent reports have suggested that hip corticosteroid injections can hasten joint degeneration, there are few published data on the topic. The purpose of the present study was to evaluate for an association between corticosteroid injection and rapidly destructive hip disease (RDHD) and to determine the rate of, and risk factors for, occurrence. How They Did It
  • This study was conducted in 2 parts. First, to assess for a potential association between hip corticosteroid injection and RDHD, a case-control analysis was performed. 
  • Patients who developed RDHD between 2013 and 2016 served as cases, whereas those who underwent total hip arthroplasty for diagnoses other than RDHD during the same period served as controls, and the exposure of interest was prior intra-articular hip corticosteroid injection. 
  • Second, in a retrospective cohort analysis, we analyzed all patients who received a fluoroscopically guided intra-articular hip corticosteroid injection at our institution from 2013 to 2016. 
  • The rate of post-injection RDHD was determined, and logistic regression was used to identify risk factors for occurrence.
What They Found
  • In the case-control analysis, hip corticosteroid injection was associated with the development of RDHD. 
  • There was evidence of a dose-response curve, with the risk of RDHD increasing with injection dosage as well as with the number of injections received. 
  • In the retrospective cohort analysis, the rate of post-injection RDHD was 5.4%. 
  • Cases of post-injection RDHD were diagnosed at an average of 5.1 months following injection and were characterized by rapidly progressive joint-space narrowing, osteolysis, and collapse of the femoral head.
Wrap It Up
  • This study documents an association between hip corticosteroid injection and RDHD. 
  • While the risk of RDHD following a single low-dose (≤40 mg) is low, the risk is higher following high-dose (≥80 mg) injection and multiple injections. 
  • These findings provide information that can be used to counsel patients about the risks associated with this common procedure. 
  • In addition, caution should be taken with intra-articular hip injections utilizing ≥80 mg of corticosteroid and multiple injections.
Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.  When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Our last one this week is called, “Prevalence of Chronic Pain After Spinal Surgery: A Systematic Review and Meta-Analysis” by Alshammari et. Al. and published in Cureus on July 13, 2023 and Damnit that’s sizzlin’ hot! Why They Did It Degenerative disc disease and low back pain are common challenges that persist even after a discectomy. However, characterizations and quantifications of these illnesses from the patients’ perspective are insufficient. We aimed to perform a systematic review of the literature and meta-analysis to determine the frequency of chronic pain after spinal surgery.  How They Did It
  • They searched all of the common libraries of research to retrieve articles describing the frequency of persistent back pain, reoccurring disc herniation, and undergoing another operation following primary lumbar discectomy. 
  • They excluded articles that did not disclose the proportion of patients who experienced ongoing back or leg pain for over six months after the operation. 
  • They included 16 studies evaluating 85,643 patients. 
What They Found The pooled prevalence of persistent pain was 14.97%  Wrap It Up With all advancements in technology and operation techniques, many patients (14.97%) still have failed back surgery syndrome. Appropriate preoperative communication and multidisciplinary and coordinated treatment strategies yielded the best results. I would argue that it’s actually higher than that. In a book that I highly recommend called Back In Control by spinal surgeon Dr. David Hanscum, he cites research showing that when surgery is performed on a patient with chronic pain syndrome, that person is 60% more likely to develop chronic pain at the new site of injury….the site of surgery. That’s when everything goes perfectly.  I have a friend that is a neurosurgeon in our market and he regularly tells his patient that spinal surgery is about a 50/50 chance of success or failure. I haven’t asked him for research on that but I’m passing the info along as it was passed to me.  Take it or leave it.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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

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  

Acupuncture For IBS & How Chronic Pain Develops

CF 284: Acupuncture For IBS & How Chronic Pain Develops

 

Today we’re going to talk about Acupuncture For IBS & How Chronic Pain Develops

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

 

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

 

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

 

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

 

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

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

 

You have found yourself smack dab in the middle of Episode #283.

 

Now if you missed last week’s episode, we talked about The Rate of Chronic Pain in the US & Adolescents And Cannabis Use. Make sure you don’t miss that info. Keep up with the class.

 

On the personal end of things…..

Welcome to this week, happy to have you and happy to be here. Numbers in the clinic are still coming back up a bit and I’m digging it.

 

Let’s talk about the difference in the providers in the medical world vs. our world for a sec. We are integrated here in my clinic. It’s me, a nurse practitioner, an acupuncturist, and 2-3 massage therapists depending on what day you’re asking.

 

Here’s what I have discovered. Those in the medical world are not entrepreneurial by general rule. They are used to going into a clinic and patients are there waiting on them. They treat and then they go home. So nurse pracs, PAs, and PTs are not out beating the streets.

 

So if you think you’re going to hire one of these providers and they’re going to be out and about helping your clinic grow, as a general rule, that is not going to happen. They’re show up and they’re going to learn fast and do a wonderful job. But they’re not going to build your practice by actively marketing. So don’t expect it.

 

I’ve seen acupuncturists build their clientele but not mine. Until the VA came on board, that was a barren wasteland for us and I couldn’t tell that there was any effort on that end of things.

 

Massage therapists…..if it’s theirs, they’ll build it. Some will push it a bit in their circles but it’s rare for them to be out beating the streets.

 

But chiropractors…..look guys and gals…..we are one of a freaking kind my friends. We, for the most part, are owners and marketers and builders and entrepreneurs. Not to mention driven and ambitious.

 

Some are too ambitious to be honest with you. Some want to make money and grow so badly to the detriment of their patients. So keep an eye on that. Don’t sell multilevel marketing to your patients. Don’t look like a street corner huckster. That’s not a good look folks.

 

So kudos on your entrepreneur game. Keep crushing it in an evidence-informed, patient centered way.

 

Crack Addicts: have you seen the new TV series on TLC yet? I believe it comes on on Wednesday nights. It’s Dr. Alessandra Colon somewhere in Florida. For me, there are some cringy things like in one episode she said, “The power is on!” after an adjustment. Well, that’s the vitalist saying and I’m just not a fan but that’s my baggage. The rest of the world probably knows nothing about that stuff.

 

She talks about alignment here and there and we evidence-informed chiros know that alignment isn’t really a thing but, for the most part, I’ll say that she’s doing a good job.

 

If her job is to walk the line between vitalists and the evidence-informed camps, then she’s doing a pretty good job. I think that the overall score is a net gain for chiropractic in general and we haven’t had a positive light shined on us like this in a long time. If ever. There is so much opportunity with this show for the profession. I hope she knows that and I hope continues to keep it between the lines. So far, I think I’m a fan.

 

Dr. Kevin Christie and the Mastermind. You’ve been hearing me talk about our Florida Mastermind for a couple of years now. Well, Dr. Kevin Christie has started a West Coast Mastermind. Their meetings will be in San Diego, Denver, Arizona, and Jackson Hole, Wyoming. Great locations and great learning, bonding, and networking. I cannot tell you how valuable the group has been for me and our Florida group.

 

I suggest you visit the link I’m putting in my show notes right here at this point in the text. Visit that link and get signed up. He only allows approximately 25 providers into each group so don’t sit around on your butt. Get it going.

 

https://www.modernchiropracticmarketing.com/mastermind-2024-west?mc_cid=03245907d3&mc_eid=8424d1275e

 

Alright, that’s it, let’s get into the research.

 

 

Item #1

 

The first one today is called “Acupuncture for the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome” by Ling-Yu Qi, MM; Jing-Wen Yang, PhD; Shi-Yan Yan, PhD and published in JAMA Network Open on December 29, 2022. Dayum. That’s hot.

 

 

 

Why They Did It

 

To preliminarily test the feasibility of using US Food and Drug Administration (FDA)–recommended end points to evaluate the efficacy of acupuncture in the treatment of IBS.

 

 

How They Did It

 

  • This pilot, multicenter randomized clinical trial was conducted in 4 tertiary hospitals in China from July 1, 2020, to March 31, 2021, and 14-week data collection was completed in March 2021.
  • Individuals with a diagnosis of IBS with diarrhea (IBS-D) were randomized to 1 of 3 groups, including 2 acupuncture groups

 

 

 

What They Found

 

  • Ninety patients were enrolled, with 30 patients in each group.
  • There were substantial improvements in the primary outcomes for all groups although the difference between them was not statistically significant

 

  • The response rates of adequate relief at week 4 were 64.3% in the specific acupoints group, 62.1% in the nonspecific acupoints group, and 55.2% in the nonspecific acupoints group

 

  • Adverse events were reported in 2 patients (6.7%) in the specific acupoints group and 3 patients (10%) in nonspecific acupoints or nonspecific acupoints group.

 

 

Wrap It Up

 

In this pilot randomized clinical trial, acupuncture in both the specific acupoints and nonspecific acupoints groups showed clinically meaningful improvement in IBS with diarrhea symptoms, although there were no significant differences among the 3 groups. These findings suggest that acupuncture is feasible and safe; a larger, sufficiently powered trial is needed to accurately assess efficacy.

 

 

Before getting to the next one,

 

Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.

 

When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.

 

 

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

 

 

 

 

Item #2

 

Our last one this week is called, “Mechanisms behind the Development of Chronic Low Back Pain and Its Neurodegenerative Features” by Abdullah Mosabbir published in Molecular and Cellular Mechanisms in Neurodegenerative Diseases on 28 December 2022. Hot potato!

 

 

Why They Did It

 

To understand and update the current state of knowledge of the pathophysiology of back pain in educating patients as well as guiding the development of novel therapeutics.

 

How They Did It

 

Many clinicians, caregivers and researchers aim to help educate patients about their pain and try to help them live a better quality of life despite their condition. This may include using strategies such as pain neuroscience education (PNE) and cognitive behavior therapy

 

What They Found

 

A systematic review and meta-analysis demonstrated that PNE can have a significant effect in reducing pain catastrophizing as well as kinesiophobia. This is highly beneficial in pain management, as reduced catastrophic thinking can help orient a person away from their pain and towards living their life, and reduced fear helps patients to be more open to active interventions like physical therapy and exercise.

 

 

Wrap It Up

 

  • cLBP is complex and there is no guarantee that treating its potential causes will cause the pain to go away. Therefore, rather than attempting to “cure” chronic pain, many clinicians, caretakers and researchers aim to help educate patients about their pain and try to help patients live a better quality of life, despite their condition. Understanding and updating our current state of knowledge of the pathophysiology of cLBP is important in educating patients as well as guiding the development of novel therapeutics.

 

  • The current understanding of the source of cLBP stems from damage to the ligamentous structures of the body due to prolonged poor posture, sub-failure injury, or major trauma. These contribute to abnormal forces acting on the spine, which leads to the degeneration of intervertebral discs and joints that directly or indirectly stimulate a painful sensation.

 

  • If these sensations persist, acute pain transitions to a chronic state that sustains the pain independent of the source of the initial damage. Once this occurs, further degeneration occurs in the spinal cord and brain, leading to peripheral sensitization, central sensitization, apoptosis of neurons and the reduction of grey matter in the brain. This ultimately can lead to cognitive impairment among cLBP patients.

 

 

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

 

 

Store

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

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

 

The Rate of Chronic Pain in the US & Adolescents And Cannabis Use

CF 283: The Rate of Chronic Pain in the US & Adolescents And Cannabis Use

 

Today we’re going to talk about The Rate of Chronic Pain in the US & Adolescents And Cannabis Use

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

 

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

 

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

 

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

 

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

 

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

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

 

You have found yourself smack dab in the middle of Episode #283

 

Now if you missed last week’s episode, we talked about new dietary ideas and how the doctor’s words matter. Make sure you don’t miss that info. Keep up with the class.

 

On the personal end of things…..

Summer is upon us and let’s talk about what happens in the Summer, you and your patients typically go places. When school is away, people tend to go out and play.

 

I’d be lying if I didn’t share that I have a little anxiety about it. Here’s why, if you listen regularly here, you know I’ve been a little slow this year and kind of hating life as a result. I’m very growth minded. Maybe life is just telling me to slow down, I don’t know. But, it’s looking like things are picking up. And what’s the quickest way to kill your momentum, yeah…..take days off. Of course.

 

With that being said, I have a trip to Boston in a couple of weeks. I’m only missing 2 days but it is what it is. My daughter was invited to a future medical professionals conference out there and you just have to go.

 

Then, we have an Alaskan cruise in late July early August. That’s a WEEK off and I’m so anxious about this.

 

Then in September, we have a front row seats for my wife’s favorite band on her birthday, it’s a Trane concert in Charleston, SC and the night before that, we’ll be at a Savannah Bananas game in Savannah, GA.

 

So here’s my thought process. In 10 years, I won’t remember the patients I saw in my clinic if I had stayed in town and not taken these trips. But I’ll always remember my daughter going to the conference in Boston. I’ll always remember the Alaskan cruise that we took. And I’ll always remember The Savannah/Charleston trip.

 

I guess my point is, we can experience only our clinic or we can experience life. Responsibly! You can’t abandon the responsibilities but life isn’t life if we’re not partaking in it. I’m all about my patients but I spent years and years so concerned about numbers that I lost sanity on some level. I’m still concerned about numbers.

 

Don’t get me wrong. I’m at 150 a week now instead of my usual 185-190 a week. That’s a solid hit folks but, I can hunker down and lose my mind about a practice that has shrunk a bit, or I can say it is what it is and I can keep on cooking but also stay busy living.

 

I’m going on my trips. My patients are going to go on their trips too. I’m going to freak out about being gone a little bit. It’s just going to happen. It’s going to be really slow when I get back and you know what? It’s going to be OK because my clinic has a reputation and the patients will continue to come.

 

So, if you’re where I’m at and you have some anxiety about taking trips with your family and enjoying your people, get your butt out fo the clinic and enjoy yourself. We only get one spin on the Earth. Let’s do it and let’s not worry about it.

 

 

 

Item #1

 

The first one today is called Nondisordered Cannabis Use Among US Adolescents” by Ryan S. Sultan et al and published in JAMA Network Open on May 3, 2023. Dayum. That’s hot.

 

 

 

Why They Did It

 

To describe the prevalence and demographics of nondisordered cannabis use and to compare associations of cannabis use with adverse psychosocial events among adolescents with no cannabis use, of nondisordered cannabis use, and cannabis use disorder.

 

How They Did It

 

This cross-sectional study used a nationally representative sample derived from the 2015 to 2019 National Survey on Drug Use and Health. Participants were adolescents aged 12 to 17 years, separated into 3 distinct groups: nonuse (no recent cannabis use), of nondisordered cannabis use (recent cannabis use below diagnostic threshold), and cannabis use disorder.

 

Analysis was conducted from January to May 2022.

 

 

What They Found

 

  • The 68 263 respondents) included in the analysis represented an estimated yearly mean of 25 million US adolescents during 2015 to 2019.
  • Among respondents, 1675 adolescents had cannabis use disorder, 6971 adolescents had of nondisordered cannabis use, and 59 617 adolescents reported nonuse.
  • Compared with nonusers, individuals with of nondisordered cannabis use had approximately 2 to 4 times greater odds of all adverse psychosocial events examined, including major depression, suicidal ideation, slower thoughts, difficulty concentrating, truancy, low grade point average, arrest, fighting, and aggression.
  • Prevalence of adverse psychosocial events was greatest for adolescents with cannabis use disorder, followed by of nondisordered cannabis use, then nonuse

 

 

Wrap It Up

 

In this cross-sectional study of US adolescents, past-year of nondisordered cannabis use was approximately 4 times as prevalent as past-year cannabis use disorder. A stepwise gradient association was observed for odds of adverse psychosocial events between adolescent of nondisordered cannabis use and cannabis use disorder. In the context of US normalization of cannabis use, prospective research into of nondisordered cannabis use is necessary.

 

 

Before getting to the next one,

 

Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.

 

When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.

 

 

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

 

 

 

 

Item #2

 

Our last one this week is called, “Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020” by Richard L. Nahin, MPH; Termeh Feinberg, MPH; Flavia P. Kapos, DDS, M; et al published in JAMA Network Open on May 16, 2023. Hot potato!

 

 

Why They Did It

 

To estimate rates of chronic pain and high-impact chronic pain (HICP) incidence and persistence in US adults across demographic groups.

 

How They Did It

 

  • This cohort study examined a nationally representative cohort with 1 year of follow-up.
  • Data from the 2019-2020 National Health Interview Survey (NHIS) Longitudinal Cohort were used to assess the incidence rates of chronic pain across demographic groups.

 

  • The cohort was created using random cluster probability sampling of noninstitutionalized civilian US adults 18 years or older in 2019.

 

  • Of the 19 081, the final analytic sample of 10 415 adults also participated in the 2020 NHIS. Data were analyzed from January 2022 to March 2023.

 

What They Found

 

  • Among 10 415 participants included in the analytic sample, 51.7% were female, 54.0% were aged 18 to 49 years, 72.6% were White, 84.5%were non-Hispanic or non-Latino, and 70.5% were not college graduates.

 

  • Among pain-free adults in 2019, incidence rates of chronic pain and high-impact chronic pain in 2020 were 52.4 and 12.0 cases per 1000 PY, respectively.

 

  • The rates of persistent chronic pain and persistent high-impact chronic pain in 2020 were 462.0 and 361.2 cases per 1000 PY, respectively.

 

Wrap It Up

 

In this cohort study, the incidence of chronic pain was high compared with other chronic diseases. These results emphasize the high disease burden of chronic pain in the US adult population and the need for early management of pain before it becomes chronic.

 

 

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

 

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

 

 

Store

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

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

 

New Dietary Ideas & The Doctor’s Words Matter

CF 282: New Dietary Ideas & The Doctor’s Words Matter

Today we’re going to talk about new dietary ideas and the doctor’s words matter.

But first, heres that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

 

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

 

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

 

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

 

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

 

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

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

 

You have found yourself smack dab in the middle of Episode #282

 

Now if you missed last week’s episode, we were joined by Dr. Lindsay Mumma and talked about clinical excellence and pelvic floors.

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

 

On the personal end of things…..

What’s going on in my world these days? It’s interesting always. To say the least.

 

The biggest on our radars at the moment are three things actually.

  1. We have always leased our space and I would love to own the property for obvious reasons. But prices are just ridiculous, honestly. So it’s been a challenge when we’re looking at property. We still have one year on our current lease but just had this building come open that is looking pretty good both size-wise and price-wise. So it has to be looked at. We know our current space is going to go up in a year and our monthly nut on the building will probably be about the same so, why not? But there’s still the process of moving everything, the IT stuff, the making it all work stuff, setting up a clinic/gym hybrid and all that gobbled gook. Geez. It’s daunting.
  2. The second thing we’re looking at is hiring an associate. But can both of these be done at the same time? Hiring an associate and moving into a new building. I don’t think they can be done simultaneously without putting us in a precarious position financially. The extra info on that thought is that it doesn’t seem to matter because associates are getting out of school and they’re going to work for a franchise and aren’t really doing associate-ships anymore. Every chiro I know out in the world that is looking for an associate tells me they’re not to be found and in the last 7 months or so that I’ve been looking, they’re exactly right. Plus, living in Amarillo, TX isn’t as appealing as living in Dallas or Houston or wherever. A person has to almost be from the Texas Panhandle to see my job offering as a blessing. So, if the associate situation continues the way it is, it’ll be no question. We’ll just move into the new building. Lol.
  3. The third thing is that there is a company out of the Houston, TX area that is an investment gropu and they’re buying 60% of practices that qualify within their metrics and they take over all of the soul-crushing parts of your clinic. They do the HR, the billing, and the collecting. The clinics keep their name and nobody but the owner and the staff will ever even know that part of the practice was sold. Dentists have been doing this model for years. Clinic owners make a solid salary and make their 40% commission. They can bill on the medical E&M scale and get paid at a higher level than we could on our own DC codes so the same work for more money. Plus they help bring in medical if you want and they help bring in PT if you want. And they’ll help bring in associates as well. My colleagues working with the company tell me they’re working less and making more and it was the best decision they ever made. So, I’m looking at seriously. With a little side eye but the wife is on board, which is the most important thing. I just need to get the price I’m looking for. Then we shall see.

 

So, there are 3 biggies that are weighing me down because not a one of those are small decisions. They’re actually monumental decisions and they’re all sitting on my plate currently. I’ll let you know how it unfolds as it unfolds.

 

Stay tuned. For now, let’s dive into the research.

 

 

Item #1

 

The first one today is called “Dietary recommendations for cardiovascular health challenged by new evidence on saturated fatty acids’ effects on LDL-C and Lp(a) levels” by Dr. Chinta Sidharthan and published in News Medical Life Sciences on May 15, 2023. Dayum. That’s hot.

 

 

 

Why They Did It

 

The study was conducted to investigate the effects of dietary modifications on cardiovascular health, specifically focusing on the impact of reducing saturated fatty acid intake on lipid profiles and the risk of cardiovascular diseases.

 

 

How They Did It

 

  • The research on the relationship between dietary modifications, lipoprotein A, and cardiovascular disease risk is based on a review of existing scientific literature and studies.

 

  • The research involved analyzing and synthesizing data from multiple studies that investigated the effects of dietary modifications, particularly the reduction of saturated fatty acids, on lipoprotein A and LDL-C levels.

 

  • To assess the impact of dietary modifications on lipoprotein A and LDL-C levels, the researchers collected and analyzed data from participants, including their dietary intake, lipoprotein A and LDL-C levels, and potentially other relevant markers or risk factors for cardiovascular disease. Statistical was performed to determine the associations between different variables and to assess the significance of the findings.

 

 

 

What They Found

 

  • Despite the lack of data for conclusive inferences, it appears that the risk of cardiovascular disease depends on a relative balance between the levels of the two lipoproteins — LDL-C and lipoprotein A — and the baseline values of both in each individual.

 

  • Furthermore, while reducing cardiovascular risk due to high LDL-C levels through the modulation of saturated fatty acid intake remains important, the clinical LDL-C measurements also include the cholesterol component from lipoprotein A.

 

 

Wrap It Up

 

  • Overall, the evidence indicated that the standard recommendations for a heart-healthy diet which includes reduced consumption of saturated fatty acids, might have a negative impact by increasing the lipoprotein A levels despite lowering the LDL-C levels.

 

  • Since dietary changes are the most prevalent non-pharmacological form of disease prevention, tailored recommendations for dietary changes after considering individual lipid profiles might be required.

 

  • Furthermore, additional cardiac health markers such as lipoprotein A cholesterol content are necessary to assess cardiovascular disease risk accurately.

 

 

Before getting to the next one,

 

Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.

 

When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.

 

 

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

 

 

 

 

Item #2

 

Our last one this week is called, The enduring impact of what clinicians say to people with low back pain” by Ben Darlow, Anthony Dowell, G David Baxter, Fiona Mathieson, Meredith Perry, Sarah Dean published in PubMed on December 11, 2013. Hot potato!

 

 

Why They Did It

 

The purpose of this study was to explore the formation and impact of attitudes and beliefs among people experiencing acute and chronic low back pain.

 

How They Did It

 

Semistructured qualitative interviews were conducted with 12 participants with acute low back pain (less than 6 weeks’ duration) and 11 participants with chronic low back pain (more than 3 months’ duration) from 1 geographical region within New Zealand. Data were analyzed using an Interpretive Description framework.

 

 

What They Found

 

  • Participants’ underlying beliefs about low back pain were influenced by a range of sources. Participants experiencing acute low back pain faced considerable uncertainty and consequently sought more information and understanding.

 

  • Although participants searched the Internet and looked to family and friends, health care professionals had the strongest influence upon their attitudes and beliefs. Clinicians influenced their patients’ understanding of the source and meaning of symptoms, as well as their prognostic expectations. Such information and advice could continue to influence the beliefs of patients for many years.

 

  • Many messages from clinicians were interpreted as meaning the back needed to be protected.

 

  • These messages could result in increased vigilance, worry, guilt when adherence was inadequate, or frustration when protection strategies failed.

 

  • Clinicians could also provide reassurance, which increased confidence, and advice, which positively influenced the approach to movement and activity.

 

 

Wrap It Up

 

Health care professionals have a considerable and enduring influence upon the attitudes and beliefs of people with low back pain. It is important that this opportunity is used to positively influence attitudes and beliefs.

 

When a patient is standing on the ledge of chronic pain, we can push them in or pull them back literally based on what we say and how we behave. If you make a big deal out of ddd, they’re gone, echoing as they fall into the pit. If you tell them that everyone has ddd at some point and usually zero pain associated with it, you start pulling them back. Certainly after you encourage them to move, go for a walk, hurt doesn’t mean harm, and you get some pain free movement wins through your treatment and exercises…..well then we’re having two completely different outcomes altogether now, aren’t we?

 

Be smart with your words and your behavior. It’ll make you look like you’re up on your research and education and it’ll make all the difference in the world in your patients.

 

 

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

 

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

 

 

Store

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

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

 

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

 

Spinal Stabilization For Chronic Pain & Dry Needling

CF 274: Spinal Stabilization For Chronic Pain & Dry Needling

 

Today we’re going to talk about a dry needling and we talk about spinal stabilization for chronic back pain.

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

  You have found yourself smack dab in the middle of Episode #274   Now if you missed last week’s episode, we talked about SMT and Fibromyalgia as well as SMT and adverse events. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things….. Today has been a little bit of a whirlwind. In fact the last month or so has been a bit of a whirlwind. I started with a new company called BlueIQ that some of you will be familiar with.   What an incredibly powerful tool! Full of functions I’ll never use but full of functions that I will use as well. I have no affiliation with them. Just sharing my experience. My colleague uses them and loves them so I thought I’d give it a try. I’m a bit of a stats nerd after all. Anyway, this thing is like $150/month.  

I don’t like my overhead getting any higher than it already is so I went and found things I could cut to make the room. That, honestly, wasn’t very hard to do. I should do more of that, by the way.   I’ve had two onboarding calls with them so far and I’m just blown away at all of the cool things it can do as far as tracking my business through implementing with my EHR so it’s up to date. Every hour it updates actually so it’s current to the hour.   I always know my stats. Right where I’m at. It sets goals for me and even has a page for team meetings where we can go over our KPIs easily and quickly.   I’m kind of blown away by them honestly.

So, super excited about BlueIQ right now.   Other than that, just trying to maintain some momentum with clinic numbers. We blew back up and have now kind of slowed again. We were back up to my comfortable 180 or so visits per week. Now, back down to about 150 or so last week.  

Just keeping an eye on that and keeping an eye on the newer front desk staff to make sure we’re booking correctly and all that good stuff. Just watching. That’s something that’s on my radar basically.   Just got back from the voice over conference in Atlanta last week and headed off to Florida at the end of this month for my quarterly Mastermind meeting with Dr. Kevin Christie and crew.   Lots of stuff happening all at once. Such is life and, since it’s a little crazy at the moment, I’mma jump right into the research so let’s do it!  

 

Item #1   The first on today is called, “Immediate Effects of Dry Needing or Manual Pressure Release of Upper Trapezius Trigger Points on Muscle Activity During the Craniocervical Flexion Test in People with Chronic Neck Pain: A Randomized Clinical Trial” by Jorge Rodríguez-Jiménez, PT, MSc and published in Pain Medicine on 18 February 2022. Dayum. That’s hot.    

Why They Did It   To compare the effects of dry needling or manual pressure release on an active trigger point in the upper trapezius on craniocervical flexion test performance, pressure pain thresholds, and cervical range of motion in chronic neck pain.    

How They Did It  

  • Subjects were randomized to receive dry needling (n = 25) or manual trigger point pressure release (n = 25) on upper trapezius active trigger points.
  • Surface electromyography from the upper trapezius, splenius capitis, sternocleidomastoid, and scalene muscles during performance of the craniocervical flexion test was assessed before and immediately after the intervention as the primary outcome. Neck pain intensity, range of motion, and pressure pain thresholds were the secondary outcomes.

    What They Found  

  • A decrease in sternocleidomastoid activity at all stages of the craniocervical flexion test (time effect, P < 0.001) was found in both groups after the interventions, with no significant between-group difference.
  • Pressure pain thresholds measured over the cervical spine and second metacarpal increased after dry needling when compared with manual trigger point pressure release (P < 0.05). Pain intensity decreased immediately after both treatments with moderate to large effect sizes, whereas cervical range of motion increased for both groups but with small effect sizes.

 

Wrap It Up  

A single session of dry needling or manual pressure release over upper trapezius active trigger points promotes limited effects on muscle performance during the craniocervical flexion test, pressure pain thresholds, and cervical range of motion in patients with chronic neck pain.   Before getting to the next one,  

Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.   When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.   I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.  

Item #2   Our last one this week is called, “Effectiveness of Spinal Stabilization Exercises on Movement Performance in Adults with Chronic Low Back Pain” by Khalid Alkhathami and published in PubMed on 1st Feburary 2023. Hot potato!  

Why They Did It   The purpose of this study was to determine the effects of spinal stabilization exercises (SSEs) on movement performance, pain intensity, and disability level in adults with chronic low back pain (CLBP).  

How They Did It  

  • Forty participants, 20 in each group, with CLBP were recruited and randomly allocated into one of two interventions: spinal stabilization exercises and general exercises (GEs).
  • All participants received their assigned intervention under supervision one to two times per week for the first four weeks and then were asked to continue their program at home for another four weeks.
  • Outcome measures were collected at baseline, two weeks, four weeks, and eight weeks, including the Functional Movement Screen (FMSTM), Numeric Pain Rating Scale (NPRS), and Modified Oswestry Low Back Pain Disability Questionnaire (OSW) scores.

  What They Found  

  • There was a significant interaction for the Functional Movement Screen  scores (p = 0.016), but not for the Numeric Pain Rating Scale and Modified Oswestry Low Back Pain Disability Questionnaire scores.
  • Post hoc analysis showed significant between-group differences between baseline and four weeks (p = 0.005) and between baseline and eight weeks (p = 0.026) favor spinal stabilization exercises over general exercises.
  • Further, the results demonstrated that all participants, regardless of group, had significant improvements in movement performance, pain intensity, and disability level over time.

 

Wrap It Up  

The results of the study favor spinal stabilization exercises over general exercises in improving movement performance for individuals with CLBP, specifically after four weeks of the supervised spinal stabilization exercises program.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.  

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

Website https://www.chiropracticforward.com  

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

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

Twitter https://twitter.com/Chiro_Forward  

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

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

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

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

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

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

Bibliography  

  • Rodríguez-Jiménez J. Immediate Effects of Dry Needing or Manual Pressure Release of Upper Trapezius Trigger Points on Muscle Activity During the Craniocervical Flexion Test in People with Chronic Neck Pain: A Randomized Clinical Trial. Pain Medicine. 2022 Feb 18:pabc018. doi: 10.1093/pm/pabc018. PMID: 34902236

 

  • Alkhathami K, Alshehre Y, Brizzolara K, Weber M, Wang-Price S. Effectiveness of Spinal Stabilization Exercises on Movement Performance in Adults with Chronic Low Back Pain. Int J Sports Phys Ther. 2023 Feb 1;18(1):169-172. doi: 10.26603/001c.68024. PMID: 36793568; PMCID: PMC9897033.

 

SMT And Fibromyalgia & SMT And Adverse Events

CF 273: SMT And Fibromyalgia & SMT And Adverse Events

Today we’re going to talk about SMT And Fibromyalgia & SMT And Adverse Events

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  You have found yourself smack dab in the middle of Episode #273   Now if you missed last week’s episode, we talked about Postpartum VAD and Pregnancy CAD. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things….. If you listened in on the pod last week, I mentioned I’d be heading to VOAtlanta, the nation’s largest voice over conference. I done did it and it was fun. It’s so much like chiro conferences it’s amazing. Except on a larger scale. Not that many tend to go to DC conferences. There were over 1,000 voice actors at this thing. Tons. Lots of classes, lots of teachers, lots of people. Every freaking where.   It dawned on me; every profession has its big dogs and it’s peasants. In the vo world, I’m not royalty. I’m a peasant trying to figure out how to be royalty. Lol. In the chiro world, I’m probably middle management I suppose. Definitely not a peasant but not considered royalty either.   I think it comes down to notoriety and nationally, the big dogs are just better known.

This means they made the moves, made the connections, built the network, put themselves out there, and then began reaping the rewards.   I imagine even the tiddlywinks circuit has its big dogs and its peasants. I don’t know. I just find it so interesting on some level.   I think if you want authority or notoriety, I think the base it’s built on is notoriety. Which means you have to do things that make you remarkable and…..notorious. In a positive way, of course.   That means being active in your state and national association.

That means doing something other people would be interested in. I wrote a book. I host a podcast and Facebook group. I speak and present when the opportunities arise, and I network through my Mastermind and throughout the profession.   That’s got me to upper to middle management I suppose. I’m also considering putting some courses together as well to continue helping colleagues and this profession.   What are you doing every day and every year to consistently be 10% better?   Are you networking? Or are you an introvert? Believe it or not, I’m a bit of an introvert. I’m great once I’m engaged in conversation but starting the conversation isn’t something I excel at, to be honest. But, I learned a fun little tactic from a fellow VO in Atlanta this weekend.

He said, “If you see a casting director or agent you’re really wanting to talk to but don’t know how, just compliment them. People love compliments.”   Nice jacket, those shoes are amazing, man…..what I’d give for a watch like that…..blah blah blah. You get what I’m saying. I watched him do it to a casting director. She walked by and he said “Can I just say real quick that you are just a ray of sunshine and I really enjoyed the info you shared in your session.” She ate it up! Lol.   Anyway, I don’t know where I’m going with this other than to say, if you want to be a big dog in whatever industry you are in, get to work marketing yourself and don’t wait for someone else to do it for you. Notoriety doesn’t happen on its own. You have to manifest it.   So get out there an start manifesting it everywhere.    

Item #1   The first on today is called, “Effectiveness of spinal manipulation in addition to pharmacological treatment in fibromyalgia: A blinded randomized trial” by Bugra Ince and published in National Library of Medicine on Jan 25, 2023. Dayum. That’s hot.       Why They Did It   To investigate the effectiveness of spinal manipulation in addition to pharmacological treatment in patients with fibromyalgia.     How They Did It  

  • A single-center, randomized, and placebo-controlled trial with three parallel arms SETTING: Outpatient clinics at a tertiary health care facility. Female patients aged 18-55 years receiving pharmacological treatment.
  • Spinal manipulation, sham manipulation, and control groups. Patients in the spinal manipulation group received high-velocity low-amplitude manipulation treatment twice a week for 3 weeks.
  • Patients in the sham group received an application that was very similar to the active treatment but was not expected to have any real therapeutic effect. Patients in the control group continued to receive pharmacological therapy.

            What They Found  

  • Sixty patients with a mean age of 41.7 years (SD = 8.0) were enrolled in the study. A mixed-design repeated analysis of covariance was used to test the data.
  • At 1 month after randomization, pain scores did not differ between groups. At 3 months after randomization, the spinal manipulation group had a significantly lower pain score (adjusted mean = 4.3 cm, SE: 0.4) than the control group (adjusted mean = 6.8 cm, SE: 0.4) and the sham manipulation group (adjusted mean = 5.7 cm, SE: 0.4).
  • PPT did not differ between groups at any time point. FIQR, WPI, and FSS showed some improvement 1 or 3 months after randomization in favor of the spinal manipulation group.

    Wrap It Up   Spinal manipulation used in addition to pharmacological treatment in young/middle-aged female patients with fibromyalgia could be an effective treatment for pain, disease severity, and functionality.       Before getting to the next one,   Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.   When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.     I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.    

Item #2   Our last one this week is called, “A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy” by Eric Chun-Pu Chu and published in Scientific Reports on 23 January 2023. Hot potato!     Why They Did It  

  • This study examined the incidence and severity of adverse events (AEs) of patients receiving chiropractic spinal manipulative therapy (SMT), with the hypothesis that < 1 per 100,000 SMT sessions results in a grade ≥ 3 (severe) AE.
  • A secondary objective was to examine independent predictors of grade ≥ 3 AEs.

    How They Did It   Data originated from 30 affiliated chiropractic clinics with 38 chiropractors (New York Chiropractic & Physiotherapy Center, EC Healthcare, Hong Kong). These clinics are integrated into a larger healthcare organization, including several medical specialties and imaging and laboratory testing centers that utilize a shared medical records system.    

 

What They Found   The authors had 85% agreement of independent AE grades, with six of 39 cases having discrepant scores. All discrepant scores were either graded “1” or “2” and ultimately were resolved via mutual discussion.    

Wrap It Up  

  • This current study, which retrospectively studied a large dataset from integrated chiropractic clinics in Hong Kong, found that severe AEs potentially occurring in relation to SMT were rare, yielding an incidence of 0.21 per 100,000 SMT sessions. No AEs were identified that were life-threatening or resulted in death.
  • The sample size of 39 AEs across 960,140 SMT sessions in 54,846 patients was insufficient to identify independent predictors of severe AEs. Further research on this topic is needed, possibly via a practice-based research network which could increase the sample size and allow for such analysis.

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 
Chu, E. C. P., Lin, L. W., Lee, Y. C., & Lin, J. C. (2023). A retrospective analysis of the incidence of severe adverse events among recipients of chiropractic spinal manipulative therapy. Scientific Reports, 13(1), 2484. doi: 10.1038/s41598-022-10584-0

Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain

 

CF 267: Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain

 

Today we’re going to talk about Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

You have found yourself smack dab in the middle of Episode #267   Now if you missed last week’s episode, we talked about Risk/Reward For Low Back Pain Treatments & Chiropractors In An Interprofessional Practice Setting. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Alright, my life is starting to stabilize a bit, me thinks. Which you’re all going to enjoy because I’ve spent a few months complaining about my numbers being down.   I think that’s starting to take care of itself. I’ve told you my tiger of a wife jumped into attack mode when we lost 3 out of our 4 employees. Not only did she cover the front desk, she dove into all of the financials like she hasn’t done in a coupld of years and found all kinds of stuff that needed attention.   That girl’s has been pulling 12-14 hour days for over two weeks now and…..thank goodness…..the new front desk staffer started today!! So the wifey has to get her trained up and, now that she knows what wasn’t getting attention, she’ll move to that part of the practice and it’s about to be amazing.  

My point being, everything happens for a reason. Sometimes when the house gets cleaned, even when unintentional, it’s a good thing. Lots of things have come to light. Lots of things not known or realized have a spotlight on them. We have fresh energy, fresh eyes, and are able to re-establish our culture, intention, and vibe.   I didn’t share fully with this audience how dire things really were for us but, in short, we lost 3 of our 4 full timers within a two week time span and the last one that quit didn’t give us a two-week notice so that was particularly tough. I found out she was quitting on a Friday and Monday morning, I had 50 patients set up. Wow.   Not only that but the one remaining full timer we had had only been with us for about 3 months and was still getting her feet wet. Absolute insanity. I’ve never been stuck like that before.  

To say that this was an ass-puckering experience is to understate the freak out.   But again, having a wife as a secret weapon was the gamechanger. Get your spouse or partner trained and up to speed in case of emergency. Please. It saved us.   But, let’s say you don’t have that luxury. OK, it’ll be tougher if it ever happens to you. However, it’ll still be for the best. My clinic is getting back to being busy because those three were besties and they had subconsciously checked out. I’d never ever think that at least two of them would ever hurt us intentionally. But, when you start turning your attention to another job opportunity, your current obligations are going to suffer. It’s just a fact.   Anyway, upward and onward. This has been difficult here and there but, overall, not as bad as expected and now that we are on the other side of the tunnel, it was worth it. If something similar happens to you, be grateful for the message and the experience and get to work. The sun will shine again.  

Item #1  

The first on today is called, “Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain” by Yoni K. Ashar, PhD and published in JAMA Psychiatry on September 29, 2021. Dayum. That’s hot.     Why They Did It   To test whether a psychological treatment (pain reprocessing therapy [PRT]) aiming to shift patients’ beliefs about the causes and threat value of pain provides substantial and durable pain relief from primary CBP and to investigate treatment mechanisms.  

How They Did It  

  • Participants randomized to PRT participated in 1 telehealth session with a physician and 8 psychological treatment sessions over 4 weeks.
  • Treatment aimed to help patients reconceptualize their pain as due to non-dangerous brain activity rather than peripheral tissue injury, using a combination of cognitive, somatic, and exposure-based techniques.
  • Participants randomized to placebo received an open-label subcutaneous saline injection in the back; participants randomized to usual care continued their routine, ongoing care.

  What They Found  

  • In this randomized clinical trial, 33 of 50 participants (66%) randomized to 4 weeks of pain reprocessing therapy were pain-free or nearly pain-free at posttreatment, compared with 10 of 51 participants (20%) randomized to placebo and 5 of 50 participants (10%) randomized to usual care, with gains largely maintained through 1-year follow-up.
  • Treatment effects on pain were mediated by reduced beliefs that pain indicates tissue damage, and longitudinal functional magnetic resonance imaging showed reduced prefrontal responses to evoked back pain and increased resting prefrontal-somatosensory connectivity in patients randomized to treatment relative to patients randomized to placebo or usual care.

 

Wrap It Up  

Psychological treatment centered on changing patients’ beliefs about the causes and threat value of pain may provide substantial and durable pain relief for people with CBP.  

Before getting to the next one,   Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.   When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.     I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.  

Item #2  

Our last one this week is called, “Meditation-Based Therapy for Chronic Low Back Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials” by Ting-Han Lin, MD and published in Pain Medicine on 10, October 2022. Hot potato!    

Why They Did It  

They wanted to know the applicability of meditation-based therapies for CLBP management. Meditation-based therapies constitute an alternative treatment with high potential for widespread availability.    

How They Did It  

  • They performed a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy of meditation-based therapies for CLBP management.
  • The primary outcomes were pain intensity, quality of life, and pain-related disability; the secondary outcomes were the experienced distress or anxiety and pain bothersomeness in the patients.
  • The PubMed, Embase, and Cochrane databases were searched for studies published from the databases’ inception dates until July 2021, without language restrictions.

    What They Found  

  • We reviewed 12 randomized controlled trials with 1,153 patients. In 10 trials, meditation-based therapies significantly reduced the CLBP pain intensity compared with nonmeditation therapies (standardized mean difference [SMD] −0.27, 95% confidence interval [CI] = −0.43 to −0.12, P = 0.0006).
  • In seven trials, meditation-based therapies also significantly reduced CLBP bothersomeness compared with nonmeditation therapies (SMD −0.21, 95% CI = −0.34 to −0.08, P = 0.002). In three trials, meditation-based therapies significantly improved patient quality of life compared with nonmeditation therapies (SMD 0.27, 95% CI = 0.17 to 0.37, P < 0.00001).

 

Wrap It Up  

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

Key Point:

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

Contact

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

Connect

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

Website https://www.chiropracticforward.com  

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

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

Twitter https://twitter.com/Chiro_Forward  

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

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

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

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

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

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

Bibliography

  • Ashar YK, G. A., Schubiner H, (2022). “Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial.” JAMA Psychiatry 79(1): 13-23.  
  • Ting-Han Lin, M., Ka-Wai Tam, PhD,, Yu-Ling Yang, PT, Tsan-Hon Liou, PhD, Tzu-Herng Hsu, MD, Chi-Lun Rau, PhD, (2022). “Meditation-Based Therapy for Chronic Low Back Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Pain Medicine 23(10): 1800-1811.    

Upregulated Central Nervous System & Shared Decision Making With The Patient

CF 245: Upregulated Central Nervous System & Shared Decision Making With The Patient Today we’re going to talk about Upregulated Central Nervous System & Shared Decision Making With The Patient. But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   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 excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #245 Now if you missed last week’s episode , we talked about Recognizing Cervical Artery Dissection. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Things are clicking along pretty normally for a chaotic clinic. Today, let’s talk a little about your relationships with your employees before we get to the research.  Everyone has different styles of owning or managing their clinics and staff. Mine has always been to treat them like family. Honestly, we spend more time with our staff than we do with our own families. So why not have friendly and almost family-like relationships with them? Why the hell not? I don’t want awkward forced relationships with the people I’m with every day all day. I want fun, happy, and friendly relationships. With people I look forward to seeing every day. 

My staff is hilarious and we have a lot of fun together. 

I’ll give you a little story as an example. My office manager is getting married in September. Probably about the time this episode goes live. She had her wedding shower on August 13th at her mother’s house. It wasn’t the regular boring old wedding shower. They had drinks, men and women, cornhole, and beer pong in the back yard…..you get the picture. Pretty much my entire staff of 12 or 13 was there. Which is nice. They feel like family to an extent. That’ll warm your heart, right? Well, I’m of the age that beer pong wasn’t ‘a thing’ in my college years. We played simple games like quarters or something like that. Anyway, I went to the wedding shower. My wife actually helped host it and run it all. She made a huge table full of charcuterie items and it was just all very well done. 

So that’s point #1; she felt close enough to us to not only want us at her wedding shower but to have my wife help host it.  Then, after gifts were opened and a few filtered out, everyone moved to the backyard and played cornhole and beer pong. My office manager made me be her teammate for a game of beer pong. Now, I told her I can’t play with drinks because I was driving so I just sipped on one beer while we played.  Turns out, I actually have a little talent for beer pong. We won the first game against her fiancee and Boom! Instant respectability amongst the kiddos. 

So, point #2; when your staff likes you and wants you to participate in aspects of their personal life, I say you just do it.  You build friendship, loyalty, camaraderie, and trust the more you just say, “Yes.” Play beer pong. Even when you don’t want to or don’t know how to play it. It’ll pay off in the long run.  If you feel differently, let me know. Send me an email at dr.williams@chiropracticforward.com I want your opinion so I can share with the collective. 

OK, on to the research. 

 

Item #1

Our first one is called “Does shared decision making results in better health related outcomes for individuals with painful musculoskeletal disorders? A systematic review” by Christopher et. al. (Yannick Tousignant-Laflamme 2017) published in the Journal of Manual and Manipulative Therapy in 2017. 

Why They Did It

Shared Decision-Making (SDM) is a dynamic process by which the health care professional and the patient influence each other in making health-related choices or decisions. SDM is strongly embedded in today’s health care approaches and is advocated as an ideal model since it renders individuals more control over the health care they choose to receive, and has been shown to improve patient outcomes. The goal of this systematic review was to investigate the added value of SDM on clinical health-related outcomes in patients with a variety of musculoskeletal conditions.

How They Did It

PubMed and CINAHL. To be considered for review, the study had to meet all the following criteria: (1) prospective studies that involved treatment decision-making;  (2) randomized controlled trial design;  (3) involving patients faced with having to make a treatment decision;  (4) comparing SDM with a control intervention and  (5) including one or more of the following outcome measures: well-being, costs, health-related pain or disability measures, or quality of life.

What They Found

We did not find a single study that looked at the true effect of SDM on patient-reported outcomes in a population with musculoskeletal pain.

Wrap It Up

For the management of painful musculoskeletal conditions, in the light of the current evidence (none), we estimate that it would be wise to explore the effectiveness of SDM before forcing its large-scale implementation in rehabilitation. Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.

Item #2

The last one is called, “Mechanisms of chronic pain – key considerations for appropriate physical therapy management” by Courtney et. al. (Carol A. Courtney 2017) and published in the Journal of Manual and Manipulative Therapy in March of 2017.  Rather than a full-blown research project, this one is more of an informational article with some future direction. 

They say the following: “In the last decades, knowledge of nociceptive pain mechanisms has expanded rapidly. The use of quantitative sensory testing has provided evidence that peripheral and central sensitization mechanisms play a relevant role in localized and widespread chronic pain syndromes.  In fact, almost any patient suffering from a chronic pain condition will demonstrate impairments in the central nervous system. In addition, it is accepted that pain is associated with different types of trigger factors including social, physiological, and psychological.  This rationale has provoked a change in the understanding of potential mechanisms of manual therapies, changing from a biomechanical/medical viewpoint, to a neurophysiological/nociceptive viewpoint. 

Therefore, interventions for patients with chronic pain should be applied based on current knowledge of nociceptive mechanisms since determining potential drivers of the sensitization process is critical for effective management.  The current paper reviews mechanisms of chronic pain from a clinical and neurophysiological point of view and summarizes key messages for clinicians for proper management of individuals with chronic pain.”

Now, I don’t know exactly where you’ve been hearing this since 2019. Oh, wait, yes I do. Here!

 

You’ve been hearing it here and research is catching up.  I didn’t invent this stuff, of course. And I’m no smarter than everyone else. I just happened to take the course for the Diplomate of the International Academy of Neuromusculoskeletal Medicine and was taught by Drs. Anthony Nicholson and Matthew Long in that course and THEY are on the cutting edge.  They are the reason I’ve been preaching this stuff for so long now. They’re the reason my patients get better at the rate they do. 

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Message

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

Key Point:

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

Contact

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

Connect

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

Website 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

Carol A. Courtney, C. F.-d.-l.-P. S. B. (2017). “Mechanisms of chronic pain – key considerations for appropriate physical therapy management.” Journal of Manual & Manipulative Therapy 25(3): 118-127.  

Yannick Tousignant-Laflamme, S. C., Derek Clewley, Leila Ledbetter, Christian Jaeger Cook & Chad E Cook, (2017). “Does shared decision making results in better health related outcomes for individuals with painful musculoskeletal disorders? A systematic review.” Journal of Manual & Manipulative Therapy 25(3): 144-150.