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Jeff Williams - evidence-based chiropractor

Discs In Low Back Pain & Unnecessary Surgeries Via COVID

August 25, 2023 chiropracticforward 0:18:26 0 Comments

CF 292: Discs In Low Back Pain & Unnecessary Surgeries Via COVID

Today we’re going to talk about Discs In Low Back Pain & Unnecessary Surgeries Via COVID

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

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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 #292

Now if you missed last week’s episode, we talked about Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use . Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Isn’t it funny how things work sometimes? I had something odd happened recently here in the clinic. We found out that our acupuncturist was moving to a different chiropractor’s office. She’s been with us for about eight years. What she’s credentialed through me to see veterans through our VA system.

So the VA randomly called us one day inquiring on her moving to another office and when that is happening, etc. Well, it was news to us. So we reached out to the acupuncturist and she admitted that she had plans to move but had not shared them with us yet. Although Amarillo Texas is about 225,000 people, there are only 3 acupuncturists in the entire area. It’s just not that popular here.

Although, it is definitely gaining in popularity. So the prospects of us being able to bring on another acupuncturist quickly are very slim. However, we went ahead and reached out to the one we really wanted to work with us. I have a good relationship with her, but things have just not worked out to where we could’ve actually worked together before. It turns out that she was tired of her current situation and was interested in making a move.

So she came in for an interview, we talked, and she was on board. We started the credentialing process with the VA that very day, so, while it takes 90 days to get credentialed, at this point, we are already almost a month into the process. That should significantly shorten the waiting period for our veterans to switch to a new acupuncturist and soften the landing.

Oh, in the meantime, if our previous acupuncturist, had any plans of stealing our patients, and taking them to a new place, that is going to be hard for her to accomplish. She hast to get completely re-credentialed, and I promise you were ahead of her on getting that done. In addition, the veterans have to get authorization to see her and she hast to get credentialed before they can even start the process of getting authorized through her. Whereas here in my clinic the machine is already built. The gears are already oiled and greased, and we are at fine-tune the machine. I think there’s no doubt we are going to come out ahead on this transition.

One thing we all know is that the one constant in life is that things are always changing.

Many of us are going through changes with staff. I have 3 CA’s and that third spot. It’s just a constant turnover. I have another one that will start in two weeks. The last one lasted for about two weeks. The one before her lasted about three months. It’s been miserable but when we find the right one I think it will have been worth it anyway, that’s what’s on my mind this morning. Getting acupuncture back up and running and marketed, and getting another new staff member up and going.

It’s a constant churn and, as they say in the military, just embrace the suck and keep trucking. It all pays for your life and for the life of your family members. Might as well enjoy all of it that you can and embrace the parts you feel suck your soul and keep that part in the proper context.

Item #1

The first on today is called “Intervertebral disc degeneration and how it leads to low back pain” by Ashish D Diwan, James Melrose and published in Pub Med on Nov14 2022. Dayum. That’s hot.

Why They Did It

The purpose of this review was to evaluate data generated by animal models of intervertebral disc (IVD) degeneration published in the last decade.
The review aimed to highlight the valuable contributions of these animal models in identifying molecular events associated with pain generation.
IVD degeneration is a complex process contributing to spinal pain, and understanding the underlying mechanisms is crucial for developing effective therapeutic strategies to alleviate pain, promote disc repair and regeneration, and prevent associated neuropathic and nociceptive pain.

How They Did It

The researchers conducted a review of existing studies that employed animal models of IVD degeneration.
They likely searched relevant databases, academic journals, and publications from the past decade to gather a comprehensive dataset.

The selected studies would have used various animal models and experimental methods to induce IVD degeneration.

These animal models mimic certain aspects of human IVD degeneration, allowing researchers to study the molecular events and mechanisms involved in pain generation.

What They Found

Through their review, the researchers observed that in degenerated IVDs, there is nerve ingrowth and an increased number of nociceptors (pain-sensing neurons) and mechanoreceptors (sensors of mechanical stimuli).
The biomechanically incompetent and abnormally loaded degenerated IVDs experience increased mechanical stimulation, leading to heightened low back pain.
This finding helps establish a link between IVD degeneration and pain generation, shedding light on the complexity of the process.

The review also highlighted the potential of a specific factor called “growth and differentiation factor 6” in addressing IVD degeneration. Studies using this factor in IVD puncture and multi-level IVD degeneration models, along with a rat xenograft radiculopathy pain model, demonstrated its ability to prevent further deterioration in degenerate IVDs. The factor exhibited regenerative properties that promoted the recovery of normal IVD architectural functional organization and inhibited the generation of inflammatory mediators, which contribute to disc degeneration and low back pain.

Wrap It Up

The review of animal models of IVD degeneration provided valuable insights into the molecular events underlying pain generation in degenerate IVDs. It emphasized the importance of understanding the complex multifactorial process of IVD degeneration to identify potential therapeutic targets for pain relief and disc repair.

One promising candidate identified through the review was “growth and differentiation factor 6,” which showed considerable potential in preventing further deterioration of degenerate IVDs, promoting regeneration, and inhibiting the generation of inflammatory mediators.

The findings from these animal models suggest the need for human clinical trials with this compound to assess its efficacy in treating IVD degeneration and preventing low back pain generation in humans. Overall, this review underscores the significance of animal models in advancing our understanding of IVD degeneration and pain mechanisms, ultimately leading to improved treatment strategies for patients suffering from low back 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 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, “100,000 older Americans got unnecessary surgeries during dangerous first year of COVID-19” by Aaron Toleos and published in Lown Institute on May 17, 2022. Hot potato!

Why They Did It

The Lown Institute conducted this analysis to shed light on the issue of overuse of medical procedures in American healthcare, particularly during the COVID-19 pandemic. The aim was to bring attention to the fact that even during a public health crisis, unnecessary procedures were still being performed on vulnerable patients, potentially exposing them to harm and wasting healthcare resources.

How They Did It

The analysis was based on Medicare claims data from January to December 2020. The Lown Institute used the 100% Medicare claims database to evaluate the volume of overuse for eight common low-value procedures. The specific procedures and criteria for overuse were determined based on the institute’s previously published research into the measurement of low-value care at hospitals.

What They Found

The Lown Institute found that a total of 106,474 unnecessary procedures were identified during the analyzed period. The most overused procedure by volume was coronary stents, with 45,176 procedures performed. Other procedures with high rates of overuse included vertebroplasty for osteoporosis, hysterectomy for benign disease, and spinal fusion for back pain.

The analysis also revealed that approximately one in five of these low-value procedures met the criteria for overuse across the country. Even some of the nation’s most well-regarded hospitals had rates of overuse above the national average. For example, all of the top 20 hospitals ranked by U.S. News had rates of coronary stent overuse above the national average, with four of them having rates at least double that.

Wrap It Up

The analysis conducted by the Lown Institute highlights the persistence of overuse of medical procedures in U.S. hospitals, even during a major public health crisis like the COVID-19 pandemic. Despite previous knowledge that certain procedures, such as coronary stents for stable coronary disease, are of limited clinical benefit, they continue to be performed at high rates. This raises concerns about patient safety, healthcare costs, and the need to address the issue of overuse in the American healthcare system. The findings call for greater attention to evidence-based practices and the promotion of appropriate and necessary medical interventions to ensure better patient outcomes and more efficient use of healthcare resources.

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!

The Message

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

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

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

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

Key Point:

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

That‘s Chiropractic!

Contact

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

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

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

Connect

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

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (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

COVID-Delayed Surgeries & Lumbar Stenosis Research

July 13, 2023 chiropracticforward 00:17:40 0 Comments

CF 288: COVID-Delayed Surgeries & Lumbar Stenosis Research

Today we’re going to talk about COVID-Delayed Surgeries & Lumbar Stenosis Research

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!

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.

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 #289

Now if you missed last week’s episode, we talked about Mindfulness For Knee Replacement & The Use Of Tuina.

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

On the personal end of things…..

I’ll share with you all that I’ve been messing around a lot with AI and how it can make my life easier while saving me money. And it has.

What I’ve figured out so far:

I used to have to hire a virtual assistant off of Upwork to create my personal website blogs. I would always go in and take out the vitalist, philosophy stuff and make the blog mine but, for the bulk of the blogging, they would do it. Now, AI does it. I do the same process on my end but it doesn’t cost me nearly as much each week. In fact, the assistant, come to find out, was using AI and charging me as if they were the one creating it all. Now, I’ve cut out the middleman and saved money.
I was intimidated in the beginning, but I recently started experimenting with lots of AI image creation apps. I finally settled on one I really like and now, I can make unique, non-copyrighted images for my blogs, social media, etc. No more lame images off of Pixabay to find a non-licensed image anymore. I just make my own and, I have to admit, it’s kind of fun.

There is definitely a learning curve on AI right now but once you’ve crossed the threshold, it’s all downhill and life is good. I have some crude southern sayings to describe the easy life but I’ll save those for personal, one on one conversations if we ever meet in person.

So that’s what’s been on my radar lately.

Also, there is a group here in Texas that is buying percentages of practices. You still run it as you always have but they do the HR, billing and collections, AR, etc. All of the soul sucking parts of practice. No name change and the valuation and offering for 60% is more than fair.

That’s on my radar. We might do that. Life would smooth out if we did some of that. Keeping up with this machine without a dependable billing/collections dept is just a train wreck and hurts the heart pretty much every week.

As always, as we make our way through the mud and muck, I’ll be sure to keep you updated.

For now though, let’s get into the research, shall we?

Item #1

The first one today is called “Patients who delayed non-emergency surgeries during the pandemic are returning for care” by Beth Kutscher and published in LinkedIn on June 29, 2023. Dayum. That’s hot.

Why They Did It

The patients who postponed non-emergency surgeries during the pandemic are now seeking care, leading to an increase in surgical volume.

This has sparked a discussion about the necessity of these procedures. The motive behind studying the prevalence of unnecessary surgeries is to identify potential areas where healthcare resources and costs can be optimized.

How They Did It

The analysis involves studying the rates of surgical procedures and identifying cases that may be deemed unnecessary.
The Lown Institute conducted a controversial study that identified over 106,000 potentially unnecessary surgeries between March and December 2020.
However, the study’s methodology and conclusions were criticized by the American Hospital Association for having limitations and flaws. Other studies have also shown significant variations in surgical rates across countries and states, such as the high c-section rate in the United States and the discrepancy in lumbar fusion rates.

Vijay Yanamadala, a spine surgeon, conducted his own research on unnecessary lumbar spinal fusions, estimating that over 50% of such surgeries may be unnecessary. He also referenced the Lown Institute data, which suggests that back procedures, including vertebroplasty for osteoporosis and spinal fusion for back pain, contribute to about one-third of unnecessary surgeries.

Yanamadala wears two hats in this context, serving as a neurosurgeon and also as the chief medical officer for Sword Health, a company providing digital physical therapy.

What They Found

The Lown Institute’s study identified a large volume of potentially unnecessary procedures.
Yanamadala’s research specifically focused on lumbar spinal fusions and suggested that over 50% of them could be unnecessary.
Back procedures, including vertebroplasty and spinal fusion, were found to account for a significant portion of unnecessary surgeries.

Wrap It Up

The analysis of surgical procedures suggests that there is an issue with unnecessary surgeries in the healthcare system.
Factors contributing to unnecessary surgeries include poor compliance with physical therapy before surgery and the profit-driven nature of the U.S. healthcare system.
While elective surgeries are profitable for hospitals, there is a shortage of physical therapists, and certain specialties, such as neurosurgery, are more sought-after than non-surgical specialties like spinal cord injury fellowships.

The findings emphasize the need for a more balanced and patient-centered approach to surgical decision-making. Optimizing healthcare resources, improving compliance with non-surgical alternatives like physical therapy, and addressing the disparities in access to appropriate care are important steps toward reducing unnecessary surgeries and ensuring that patients receive the right care.

Before getting to the next one,

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.

Item #2

Our last one this week is called, “A prospective study of non-surgical versus surgical treatment for lumbar spinal stenosis without instability” by Jung et al. and published in PubMed on August 17, 2020.

Why They Did It

This study compared non-surgical and surgical outcomes in surgical candidates for lumbar spinal stenosis (LSS).

How They Did It

Surgical candidates for stenosis were prospectively screened.
Patients were offered the option to be enrolled in a randomized cohort, an observational cohort, or not to participate.
Patient-reported outcomes were evaluated at baseline, and at 1, 3, 6, and 12 month
The primary outcomes were measures of pain and functional outcomes such as the Korean version of the Oswestry Disability Index (K-ODI), the EuroQol 5-Dimension instrument (EQ-5D), and 36-Item Short-Form Health Survey (SF-36).

What They Found

110 patients were enrolled in the randomized cohort and 37 patients in the observational cohort.

Among them, 97 patients received non-surgical treatment, and 50 patients underwent surgical treatment.

At 12 months, the non-surgical treatment group had less improvements in the primary outcome measures of back pain, leg pain, EQ-5D utility index and EQ-5D VAS.

Most SF-36 section parameters also showed less improvement in the non-surgical treatment group than in the surgical treatment group throughout the 12-month follow-up.

Wrap It Up

In stenosis patients without instability, non-surgical treatment resulted in less pain improvement and functional recovery through 1 year.

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!

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.

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.

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

Tweets by 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

Pain And COVID & Images Can Mislead

April 20, 2022 chiropracticforward 0:14:17 0 Comments

CF 225: Pain And COVID & Images Can Mislead Today we’re going to talk about Pain and COVID & how in the hands of the wrong practitioner, Imaging Can Mislead 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!

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

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

You have found yourself smack dab in the middle of Episode #225 Now if you missed last week’s episode , we talked about The Complexity & Treatment of Chronic Pain. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. What a damn day folks. What a way to start a Monday. I get to work and have a message to remove the permissions on my page for one of the folks I have helping me with my ad campaign on Facebook. Turns out he got hacked. Which means everyone he has permission with on social media got hacked as well! Including me. Unreal. So I showed up on a Monday going one direction with a ton of focuse. Next thing you know, I’m headed in teh complete opposite direction afraid I’m going to lose every bit of everything that makes up my professional online presence. Including my Chiropractic Forward page and Insta. My Creek Stone Integrated Medical, my voice over page, my art page…..everything. I have a botu 22 pages for various things. Furniture building, bands I’ve been in, charity groups, etc. So, that’s stressful as hell. For that very reason, I’m cutting it short and getting straight to the research. I’ll let you all know how it turns out next week. Before the research though, I have a gift for you! I’m going to turn you on to a system I recently came acros that can result in your getting tons of PI cases from attorneys. Getting these referrals can be done because it’s how I built my practice in the early days. Paul Samakow, a veteran personal injury attorney, put this system together. An attorney telling your how to talk to attorneys – he knows what attorneys want to hear – inviting them to lunch isn’t effective marketing these days. His system, is delivered to you in both written and video form, and really hits the mark. Over 25 concepts on how you can not only get attorneys to refer to you, but endear yourself to them. Samakow’s system costs $997 and he guarantees satisfaction or your money back. Which is always a big deal. That guarantee makes a difference for me. You should check it out. Even if you only get one case, you’ve made at least 4 or 5 times the investment. Trust me, I get, on average, about $2500-$3500 per settled case minimum. Lots of time much more than that. Go to gettingpicases.com/cs That’s gettingpicases.com/cs One more time so you get it right: gettingpicases.com/cs Item #1 The first one this week is called, “Manifestations of Pain During the COVID-19 Pandemic Portrayed on Social Media: A Cross-Sectional Study” by D’Souza et. al. (Ryan S D’Souza 2022) and published in Pain Medicine in 2022 holy smokes it’s hot. Why They Did It Pain is an often overlooked and underappreciated manifestation during the COVID-19 pandemic. Several permutations of pain should be considered, including: 1) acute pain related to viral infection, 2) exacerbation of preexisting chronic pain, and 3) new-onset pain from post-COVID syndrome. Preexisting chronic pain may worsen, potentially because of lack of health care access, worsening of psychological well-being, unavailability of medications, and other stressors A unique category includes patients without any history of chronic pain who developed persistent pain after recovery from COVID-19 infection [1]. This fits within a syndrome known as “post–acute COVID-19 syndrome” which describes patients who experience persistent symptoms beyond 4 weeks after the onset of COVID-19 symptoms I have been seeing this A LOT! Patients who suffer from pain may not be well informed and may turn to publicly available sources for their information needs, especially during the pandemic when in-person health care was less accessible [2]. With the omnipresence of social media and popular broadcast sites, these platforms should be considered vital in disseminating information on COVID-19 [3,4]. Thus, our objectives were 1) to view videos on the YouTube platform as a source of information on pain during the COVID-19 pandemic, 2) to report on their content on the location, type, and chronicity of pain symptoms, 3) to report the overall goal and target audience of the videos, and 4) to critically appraise video quality. Given the novelty of this topic, we hypothesized that the quality of videos would be low and there would be a paucity of videos published by professional societies. Second, we compared video characteristics between low- and high-quality videos and hypothesized that lower-quality videos would more likely be produced by independent users. How They Did It

It was a cross-sectional study
They sampled videos on YouTube from March 2020 to March 2021 that had to do with COVID-related pain
The authors queried the YouTube platform (www.youtube.com) with the keywords “COVID-19 pain,” “chronic pain after COVID-19,” and “pain related to COVID-19” from March 11, 2020, to March 1, 2021, using the “relevance” filter.
The authors restricted each search to the first 50 videos, yielding 150 videos screened.

Wrap It Up Our findings highlight that musculoskeletal/nociceptive pain in the back and extremities and visceral pain in the abdomen and chest are the most commonly reported pain types. Not surprisingly, the intended audience was patients, with an overall objective to educate on pain symptoms in most videos. This information is important, as it provides patients an explanation of the various pain generators in the body and the expected type of pain quality. The general public may be unaware that COVID-19 infection, a disease primarily having pulmonary and cardiovascular manifestations, can actually cause painful symptoms, even in seemingly disparate areas such as the eyes or genitourinary system. However, only a minority of videos (15%) provided education on pain management. Thus, clinicians should consider focusing time on educating patients on treatment options, as publicly available sources are lacking in this component. Item #2 Thsi one is called “Systematic literature review of imaging features of spinal degeneration in asymptomatic populations” by Brinjikji et. al. (Brinjikji W 2015) and published in AJNR in 2015. Why They Did It

They say in the abstract that degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain.
They sought to estimate the prevalence, by age, of common degenerative spine conditions by performing a systematic review studying the prevalence of spine degeneration on imaging in asymptomatic individuals.

How They Did It

We performed a systematic review of articles reporting the prevalence of imaging findings (CT or MR imaging) in asymptomatic individuals from published English literature through April 2014.
Two reviewers evaluated each manuscript. We selected age groupings by decade (20, 30, 40, 50, 60, 70, 80 years), determining age-specific prevalence estimates.

What They Found

Thirty-three articles reporting imaging findings for 3,110 asymptomatic individuals met our study inclusion criteria.
The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals.
Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age.
Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age.
The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age.

Wrap It Up

Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age.
Many imaging-based degenerative features are likely part of normal aging and unassociated with pain.
These imaging findings must be interpreted in the context of the patient’s clinical condition.

Don’t see it on an. Image and immediately assume that’s the issue. Phantom Limb pain exists in chronic pain conditions so why can’t low back pain be a phantom back pain? Take a long hard look at the biopsychosocial part of things. If you cannot line up the cliinical patient with the image, don’t make a big deal out of the findings because it’s likely meaningless. 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!

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 Tweets by 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 Brinjikji W, L. P., Comstock B, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner JA, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG (2015). “Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.” AJNR Am J Neuroradiol 36(4): 811-816. Ryan S D’Souza, M., Anthony E Kilgore, Shawn D’Souza (2022). “Manifestations of Pain During the COVID-19 Pandemic Portrayed on Social Media: A Cross-Sectional Study,.” Pain Medicine 23(2): 229-233.

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

August 20, 2020 chiropracticforward 00:27:47 0 Comments

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

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

But first, here’s that sweet sweet bumper music

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

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

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

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

Do it do it do it.

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

You have found yourself smack dab in the middle of Episode #139

Now if you missed last week’s episode , we talked about NSAIDs, cognitive behavioral therapy and vitalists ignoring stuff. Make sure you don’t miss that info. Keep up with the class.

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

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

On the personal end of things…..

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

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

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

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

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

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

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

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

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

Item #1

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

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

Why They Did It

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

Yeah, me either. Anyway……

How They Did It

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

What They Found

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

Wrap It Up

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

Adjusting Disc Herniations and Bulges

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

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

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

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

Before we get to the next paper, I want to tell you a little about this new tool on the market called Drop Release. I love new toys! If you’re into soft tissue work, then it’s your new best friend. Heck if you’re just into getting more range of motion in your patients, then it’s your new best friend.

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

Drop Release uses fast stretch to stimulate the Golgi Tendon Organ reflex. Which causes instant and dramatic muscle relaxation and can restore full ROM to restricted joints like shoulders and hips in seconds.

Picture a T bar with a built-in drop piece. This greatly reduces the time needed for soft tissue treatment, leaving more time for other treatments per visit, or more patients per day. Drop Release is like nothing else out there, and you almost gotta see it to understand, so check out the videos on the website.

It’s inventor, Dr. Chris Howson, from the great state of North Dakota, is a listener and friend. He offered our listeners a great discount on his product. When you order, if you put in the code ‘HOTSTUFF’ all one word….as in hot stuff….coming up!! If you enter HOTSTUFF in the coupon code area, Dr. Howson will give you $50 off of your purchase.

Go check Drop Release at droprelease.com and tell Dr. Howson I sent you.

Item #2

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

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

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

Item #3

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

Why They Did It

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

How They Did It

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

What They Found

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

Wrap It Up

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

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

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

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

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

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

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

Key Takeaways

Store

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

Subscribe Button

The Message

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

Connect

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

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TuneIn

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About the Author & Host

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

Bibliography

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

No Immunity Boosting Benefit, Coconut Oil Fails, and Screen Time & Autism

May 21, 2020 chiropracticforward 00:19:33 0 Comments

CF 126: No Immunity Boosting Benefit, Coconut Oil Fails, and Screen Time & Autism Today we’re going to talk about Immune boosting via spinal manipulative therapy, we’ll talk about coconut oil and it’s a mirage, and we’ll talk about autism and screen time. It’s a good one today folks! But first, here’s that sweet sweet bumper music

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

Do it do it do it. You have found yourself smack dab in the middle of Episode #126 Now if you missed last week’s episode, we talked about current knowledge on making a robust low back pain diagnosis. Make sure you don’t miss that info. Keep up with the class. While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper. On the personal end of things….. We’re still hanging in there. For me personally, I shut down in the beginning for two weeks. Completely shut down. Some stayed open the whole time and never made a lot of changes. So at this point, understandably, they’re ahead as far as getting their patient base back to 100%. For me, I’m more around 65%-70% of my normal load. While the entrepreneur in me is not real happy with that, the business owner that was needing to take a breath and breathe a little bit is happy about it. At this point, it is what it is. Literally. There’s only so much we have control over. I am a saver by nature. I started a multi-account system years ago that socks money away for different purposes. I have about 7 or 8 different accounts that I move money to at the end of each week. So, fortunately, I don’t take loans. Other than student loans and house loans, I don’t get into much debt at all. That only goes so far and I’m not willing to drain it all just to keep employees when I don’t have enough business but, if things continue to go well and we see the numbers coming back to a more normal state and then hopefully stabilize, I don’t believe I’ll have to do anything like drain accounts or let employees go. I love my staff and I’ll fight for them. But I won’t go broke for anyone. Except maybe my kids or my mom. So far so good. This crap has a time limit. We won’t be stuck with it like this forever. Maybe longer than we want but not forever. One foot in front of the other, one day at a time. We’ll get there. Item #1 Let’s start out easy today. This one is called “Association of Early-life social and digital media experiences with the development of autism spectrum disorder-like symptoms” by Karen Heffler, et. al. (Heffler K 2020) and published in JAMA on April 20, 2020 and that’s a hot one folks. Why They Did It They wanted to answer the question, “Are screen media exposure and social and demographic factors associated with the risk for autism spectrum disorder on a modified checklist for autism in toddlers at 2 years of age? How They Did It

Data for this cohort study were derived from the National Children’s Study,
A total of 2152 children were enrolled at birth from October 1, 2010, to October 31, 2012.
Data were analyzed from December 1, 2017, to December 3, 2019.
Caregivers reported whether the child viewed television and/or videos (yes or no) at 12 months of age, hours of viewing at 18 months of age, time spent by the caregiver reading to the child (number of days per week compared with daily) at 12 months of age, and frequency of playing with the child (daily or less than daily) at 12 months of age
Prematurity, maternal age at birth, child sex, household income, race/ethnicity, and caregiver English-language status were included in analysis.

Wrap It Up “This cohort study found greater screen exposure and less caregiver-child play early in life to be associated with later ASD-like symptoms. Further research is needed to evaluate experiential factors for potential risk or protective effects in ASD.” Basically, “Less screen exposure and more parent-child play at 12 months of age were associated with fewer ASD–like symptoms at 2 years of age” Before we get to the next item this week, I did a thing Being an evidence-informed practitioner can present a set of problems at times. Mostly problems with regard to patient volume because we don’t typically treat patients with long-term recommendations. So we see them come and go depending on if they hurt or not. It can lead to lulls, disappointment, and boredom if there’s not a steady stream of new patients coming through your pearly gates each and every month. I have taken various courses over the years at Udemy so when I decided to create a course, I immediately thought Udemy would be a good place to start. While I’m still building the course and adding content every week, it’s live and ready to go for those interested in getting started. I’m putting the link to the course at this point in the show notes. You can go to chiropracticforward.com, go to Episodes and find this episode and just scroll till you find it. https://www.udemy.com/course/marketing-evidence-based-chiropractic/?referralCode=36A4D91C66B48300360B Over the last two years or so, I’ve averaged almost 80 new patients every month as a solo practitioner. If you’re interested, I created, basically, my playbook for marketing and my thoughts on each topic or technique. I also have created downloads, checklists, and examples to show what my stuff looks like. Just go to udemy.com and do a search on Marketing An Evidence-Based Chiropractic Practice and check it out. It will grow and expand in the coming months and if you get just one patient from the ideas shared in it, it paid for itself. Now imagine if you get a bunch….well then it’s priceless. udemy.com and the course is called Marketing and Evidence-based Chiropractic Practice. Item #2 Item #2 is called “Coconut Oil’s Health Halo A Mirae, Clinical Trials Suggest” by Jennifer Abbasi (Abassi J 2020)and published in JAMA on April 8, 2020….hot cakes, smokin’ hotcakes. This one is an article so let’s just get to the highlights. She starts by saying that clinical trials don’t support the public’s positive perception of coconut oil. She points to a study that was published in Circulation that found coconut oil actually increases low-density lipoprotein cholesterol (which is the bad kind of cholesterol) and offers no benefit for weight, blood glucose, or inflammation markers. She says coconut oil has been marketed as a miracle for about a decade and a 2016 New York Times survey showed 72% of Americans consider it a health product. This while on 37% of nutritionists felt it was beneficial when compared to other oils. What they’ve learned more recently include:

Compared to nontropical vegetable oils, coconut oil significantly increased total cholesterol.
Coconut oil did not significantly affect triglycerides or markers of glycemia, inflammation, and body fat compared with others
Researchers calculated that coconut oil use could translate to a 6% increase risk of major vascular events and a 5.4% increase in teh risk of coronary heart disease mortality.

There’s much more to the article so I encourage you to find it and read it if you’re interested in coconut oil but in summary: Coconut oil should not be viewed as a healthy oil for cardiovascular disease risk reduction and limiting coconut oil consumption because of its high saturated fat content is warranted and it offers no proven health benefits compared to other cooking oils and seems detrimental on important blood lipids. As such, the prudent approach would be to avoid it in comparison to other cooking oils” Item #3 Alright here’s we arrive at the main event. This brand new article coming out on May 4, 2020….there’s a serious amount of sizzle on this sucker and not just because it’s brand new but also because a large number of chiropractors are going to call shenanigans on it. The topic of chiropractors helping boost immune function through spinal manipulative therapy has been such a hot topic on social media since this pandemic started that I won’t get on and read a general chiropractic group and it’s posts. I won’t do it. My eyes start rolling out of my damn head so why intentionally punish myself? Honestly. This article is called “A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity” and is authored by the biggest of the big chiropractic researchers that include Pierre Cote, Andre Bussieres, JD Cassidy….hello stroke research…Jan Hartvigsen, Greg Kawchuk, Charlotte Leboeuf-Yde, Silvano Mior, Michael Schneider and more than 140 signatories. It was published in Chiropractic and Manual Therapies just a week or so ago as I mentioned. Background – As I said this pandemic has made chiropractors lose their minds. Including myself, if I’m being honest. Not about the immune system. But about safety and keeping myself and my people and patients safe. Anyway, they say that during this time, the ICA posted reports claiming that chiropractic care can impact the immune system. These claims aren’t in line with the WHO and the World Federation of Chiropractic. The researchers reviewed the two reports posted by the ICA on their website on March 20th and the 28th. They explored the method used to develop the claim that SMT can boost the immune system and they discuss the scientific merit of the claim. They go on to explain why the claim lacks scientific credibility and is dangerous to the public. Get this; over 150 researchers from 11 countries reviewed and endorsed this article and response. Some of the more notable quotes include: Advancing extraordinary claims without providing extraordinary evidence should raise significant concerns about the scientific validity of the ICA’s position. In their reports, the ICA claims that individuals who received chiropractic care during the 1918 Spanish flu pandemic were 51 to 91 times less likely to die than those who were treated by medical doctors. These effect sizes are too large to be trustworthy and are a red flag of pseudoscience because extraordinary claims require extraordinary evidence. Using data from a 100-year-old non-published, non-randomized controlled trial to suggest that chiropractic adjustments reduce mortality from the flu is scientifically and socially irresponsible. We consider that proclaiming the benefits of chiropractic adjustment/spinal manipulation on immunity during a pandemic is plainly irresponsible and demonstrates a lack of understanding of science, the coronavirus pandemic, and public health risks. By only citing basic science experiments, the ICA appears to have overlooked the WHO guidance on implementation research, which clearly states that basic science experiments do not provide relevant justification for the implementation of a health intervention We call on the ICA to explain why it does not adhere to internationally accepted standards of research implementation but instead rely on unconnected basic science studies when linking chiropractic care to immune system function. Pseudoscience has the potential to mislead and misinform at any time; even more so in the midst of a pandemic when the public is vulnerable. The current coronavirus pandemic demands that we act responsibly by adopting sound public health practices as recommended Their conclusion is that, in the ICA reports, they provided no valid clinical scientific evidence that chiropractic care can impact the immune system. Not only that but they call on political and regulatory forces to hold accountable those making the claims. Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. Key Takeaways Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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

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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by 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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger Bibliography Abassi J (2020). “Coconut Oil’s Health Halo a Mirage, Clinical Trials Suggest.” JAMA 323(16): 1540-1541. Heffler K, S. D., Subedi K, (2020). “Association of Early-Life Social and Digital Media Experiences With Development of Autism Spectrum Disorder-Like Symptoms.” JAMA Pediatr.

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