evidence based

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 3)

CF 310: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 3) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 3) But first, here’s that sweet sweet bumper music  

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

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Integrating Chiropractors

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OK, we are back and you have found the 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 #310 Now if you missed last week’s episode, we talked about the same thing we’ll be covering this week but that was part 2 and we are about to get going with part 3 so hold your shorts.  Go back and listen to last week’s when you have time because you need to Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, Christmas was yesterday so I just have the holiday hangover today basically. Not from alcohol. I didn’t drink a drop yesterday. Just the activity, the family, the food, and the goign from here to there. Everything involved with a big holiday.  It’s been a tough year for me and my family. We are still recovering from a key passing in our family last year. The ripples were felt all year this year as well. An incredible amount of staff turnover, the like of I’ve never seen in 26 years of practice. And so much more. It was a tough one. While I know a new year makes no real difference, I’m hoping to put 2023 to bed and move to a positive, optimistic, properous 2024 full of more peace for me and my family.  After Chritmas……I’m tired. My normal bed time is around 1:00 am. Last night I was in bed and asleep by about 10:30. When I’m out that early, you know I had all I wanted. Maybe I’m just getting old.  This goes for young, mid, and old…..what are your practice plans?/ what’s the end game? Are you aiming to die in your office still working on patients? Which is fine. It’s just the question that needs to be answered. We get out of college and we start working. Day after day. Many times without thinking of the endgame which, when we’re younger, we don’t think will ever actually happen because we are, of course, indestructible.  Well, my friends, take it from your ol’ Uncle Jeffro, the day does indeed come for all of us. The chiropractor that made me want to be a chiropractor, Dr. Jerry Whitehead from Perryton, TX, just passed away. Sad but true. So what’s the end game? My advice…..build it to sell it. Maybe not in the next 5 years. Maybe not in the next 25 years. But if you build it to sell it, when you’re ready, you have a sell-able product with systems and staff in place to continue what you started.  Imagine an investor or another chiropractor that has it all laid out before them and all they have to do is sign on the line and it’s theirs.  So, my plan for example, is to get an associate in place. Then get another associate in place so there is redundancy. If one leaves us, the remaining one is there to train the next. I want to pay them in a way that the thought of leaving here and having to start their own thing just makes them want to puke. I got that idea from another very successful chiro.  Open up the books, show them your overhead and let them know how hard it is to run the show. Then pay them enough that the thought of giving up that money and having to be in control of all of that stress and management just makes them sick to their stomach.  Then, work into a management position. Also, if you haven’t named your practice yet, don’t do ‘Last Name Chiropractic’. What if I named mine Williams Chiropractic and someone named Bradburn bought it? Well now they have to completely re-brand or keep a name that’s not even theirs. We are Creek Stone for a reason. I like the imagery of the name but it’s also non-descript so anyone can buy it and comfortably continue building the brand.  I try to continuously strike a balance between building trust in me and my name with my community but also let the brand be the marketer instead of having my name and face on every bit of marketing. The less my name and face is in all of the branding, the easier it is for someone else to buy it and not have to overcome the transition of going from my name and face to theirs. If the brand is strong, it will stand on its own instead of depending on my name and image. Also, start thinking now, “What is your exit number?” Assuming you will exit at some point. I have a number in mind for me to have all bills covered, all debts paid, and have plenty fo retirement. With VoiceOver, that number has been significantly reduced by the way. Side gigs that can carry into and sustain retirement are pretty damn nice. We have airbnbs and VoiceOver helping us out on the deal.  I have a plan that I set into motion around 3 years ago and it’s really been paying off so, if all of the pieces fit together, I can ideally be in at least partial retirement by 55 or 56 I think. I hope.  My mom says thats too early. That I’m not old enough to retire. I responded to her, “Who the heck told you that?” Probably some corporation that needs their workers to stay in place into their late 60’s. I’ve workd hard since I was 14. I’m 51. I’m a musician, singer/songwriter, sculptor, painter, futrniture builder, voice actor, landlord, husband, and dad. I’m not wanting to retire. I just want to retire from every day, all day patient care. That’s all.  Anyway, if we were to make New Year’s resolutions, mine would be that my plan keeps taking shape and my financial future keeps going in the right direction to gain more and more freedom of my time. Time is not replaceable and we’re either wasting it or we are investing it. Time cannot be purchased so I’m doing everyhting I can to make the most of what time I have left.  Some thoughts for you with this new year coming up on us.  Item #1 Our first one this week is on the WHO’s list and it’s called, “Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans: A Prospective, Randomized, Placebo-Controlled Trial” by Dougherty et. Al. and was published in Geriatric Orthopedic Surgical Rehabiliation in December of 2014.  Citations are in the show notes.  Dougherty PE, Karuza J, Dunn AS, Savino D, Katz P. Spinal Manipulative Therapy for Chronic Lower Back Pain in Older Veterans: A Prospective, Randomized, Placebo-Controlled Trial. Geriatr Orthop Surg Rehabil. 2014 Dec;5(4):154-64. doi: 10.1177/2151458514544956. PMID: 26246937; PMCID: PMC4252156. Why They Did It Chronic lower back pain (CLBP) is problematic in older veterans. Spinal manipulative therapy (SMT) is commonly utilized for CLBP in older adults, yet there are few randomized placebo-controlled trials evaluating SMT. How They Did It The purpose of the study was to compare the effectiveness of SMT to a sham intervention on pain (VAS, SF-36), disability (Oswestry Disability Index), and physical function (SF-36 subscale, Timed Up and Go) by performing a randomized placebo-controlled trial at 2 Veteran Affairs Clinics. What They Found
  • Older veterans (≥ 65 years of age) who were naive to chiropractic were recruited. 
  • A total of 136 were included in the study with 69 being randomly assigned to SMT and 67 to sham intervention. 
  • Patients were treated 2 times per week for 4 weeks (which is roughly the Clinical Compass guides for chronic pain) assessing outcomes at baseline, 5, and 12 weeks postbaseline. 
  • Both groups demonstrated significant decrease in pain and disability at 5 and 12 weeks. 
  • At 12 weeks, there was no significant difference in pain and a statistically significant decline in disability scores in the SMT group when compared to the sham intervention group. 
Wrap It Up
  • The SMT did not result in greater improvement in pain when compared to our sham intervention; however, SMT did demonstrate a slightly greater improvement in disability at 12 weeks. 
  • The fact that patients in both groups showed improvements suggests the presence of a nonspecific therapeutic effect.
This was in 2014. I think we could makes some educated guesses here in almost 2024 that that could be do to SMT affecting and supporting functional movement, proprioceptive input, and encouragement as far as activity. This could go toward what you’ve heard me mention with regard to Reframe the conversation. Reprogramming basically.  As a side note, after being in this thing 26 years, It’s really hard for me to imagine no difference in the pain levels. Even if just short term. I find it odd but the sample size is honestly small here.  Who knows? But there it is and this is one of the papers the WHO used to recommend SMT but at very low level of confidence.  Item #2 Our last one today is called, “The effect of spinal manipulation on brain neurometabolites in chronic nonspecific low back pain patients: a randomized clinical trial” by Didehdar et. Al. and published in Irish Journal of Medical Science in May of 2020.  Didehdar D, Kamali F, Yoosefinejad AK, Lotfi M. The effect of spinal manipulation on brain neurometabolites in chronic nonspecific low back pain patients: a randomized clinical trial. Ir J Med Sci. 2020 May;189(2):543-550. doi: 10.1007/s11845-019-02140-2. Epub 2019 Nov 26. PMID: 31773541. Why They Did It In patients with chronic nonspecific low back pain (NCLBP), brain function changes due to the neuroplastic changes in different regions. They aimed to evaluate the brain metabolite changes after spinal manipulation, using proton magnetic resonance spectroscopy How They Did It In the current study, 25 patients with chronic nonspecific low back pain aged 20-50 years were enrolled.  Patients were randomly assigned to lumbopelvic manipulation or sham.  Patients were evaluated before and 5 weeks after treatment by the Numerical Rating Scale (NRS), the Oswestry Disability Index (ODI), and proton magnetic resonance spectroscopy What They Found After treatment, severity of pain and functional disability were significantly reduced in the treatment group vs. sham group  After treatment, N-acetyl aspartate (NAA) in thalamus, insula, dorsolateral prefrontal cortex (DLPFC) regions, as well as choline (Cho) in the thalamus, insula, and somatosensory cortex (SSC) regions, had increased significantly in the treatment group compared with the sham group.  A significant increase was further observed in N-acetyl aspartate in thalamus, anterior cingulate cortex (ACC), and somatosensory cortex regions Also, a significant increase was observed in glutamate and glutamine levels of thalamus.  There was no significant difference in terms of brain metabolites at baseline and after treatment  in the sham group. Wrap It Up In the patient with low back pain, spinal manipulation affects the central nervous system and changes the brain metabolites. Consequently, pain and functional disability are reduced. Nice. I’m not going to pretend to be a Neuro wonk but that’s nice.  There is a response when things are done to us. Of course. I see this come up with the insistence that adjustments improve the immune system. OK, but for how long? And is the improvement about the same is getting hit in the butt with a 2×4?  I don’t know the answers to those questions by the way. But, until we do, it’s probably not responsible to advertise that spinal manipulative therapy increases the immune system. If I see an ad that says, “Come in and get you adjustment to ward off COVID and flu,” my face is going to split and my eyes will roll out of my head. Because……just….no. Don’t do it please.  That was a slight tangent so let’s just stop here.  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
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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 2)

CF 309: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 2) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 2) 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 #309 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 1).  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Hey crew, this week, we’re just kind of gearing up for Christmas because that’s a big deal. We have Christmas on a Monday this year so that’s nice and tidy, right. We don’t have to decide if we’re taking off Christmas Eve or not. It’s pretty simple this year.  I have a short story about something that we went through last week here in the clinic. It jusst takes one person to really throw a monkey wrench into your week.  I’ll start by saying, “Thank God I can’t prescribe medication.” Those folks have a whole extra layer of crap they have to deal with I’m sure. If you’re fresh faced and new in practice, here’s your warning, there are awful people out there in the world that just want to steal your joy for no damn reason at all. I’m better now but one of them stole mine last week. I had a patient that laid off of work. On their own. Not doctor-ordered. On the day before they decided to return to work, they came into the clinic. They told me they were only really in my clinic for their appointment to get a doctor’s note.  Fine, I’m happy to see patients and I’m happy to write a note that the patient came to see me that day. Not a big deal. Pretty much every day normal stuff.  The next day, the person starts harassing our front desk staffer about writing a note for them covering the days spent at home prior to their visit to our clinic.  The person expected us to falsify our records and create treatment dates for them pretending they were being seen in our office. Dates they were not seen in our office. THAT’S NUTS. And immoral. And unethical. And should be embarrassing for them to even ask, much less expect and DEMAND, an office to do for them.  They said I should be their advocate because I’m their doctor. If you  or your patients ever thought a provider was supposed to be the patients’ advocate, get that out of your head. As you likely know, we are taught specifically, especially in the medicolegal area of healthcare, that we are NOT our patients’ advocates.  We are objective care givers only. Besides that, advocating is one thing. Out and out lying and falsifying records is quite another.  When the patients was told that we cannot do that, the threats started. I received an email from this person telling me that online reviews are powerful tools and that they are going to let everyone know our clinic did them wrong and make sure anyone that reads it will never come to my clinic.  Really??  Using the threat of online reviews to extort a falsified doctor’s note so they don’t get into trouble at work because of their own actions?  This person, who works for a big government outfit, who has probably never took a chance and built anything on their own. Who has never laid awake at night worrying about their business. Who has never poured piles of money, blood, sweat, and tears into building their own brand and reputation. Who. Has never employeed 14 people and was responsible for feeding their families.  This type of person is going to try to tear us down because we wouldn’t lie for them.   You cannot make this stuff up. After not getting the note they demanded, they did go ahead and leave the revenge review. We got us a 1-star out of the deal.  We healthcare people cannot put people like this on blast due to HIPAA so…..we just sort of have to take it on the chin. It’s not the first time I’ve had a patient leave a completely false review but this one is the first one like this. No doubt.  I have the emails and the threats. I reported the review to Yelp as false, libelous, and disparaging with the review service. Of course, Yelp doing Yelp stuff and being absolutely worthless, decided to keep the review. So…..I responded. While the reviewer just used his first name and an initial for the last, I went ahead and addressed him by his full last name. If he’s putting me on blast for no reason, I’m putting him on blast for real. Let’s get the cockroach into the daylight.  After addressing him by his full name, my public response was as follows,  “The first thing I would like to clear up with you that has been taught to healthcare providers through the years, is that healthcare providers are absolutely NOT advocates for patients. We cannot be advocates for our patients. We are objective caregivers. Nothing more. So you can forget that talking point. Secondly, for you to ask a healthcare provider of any type to misrepresent your treatment dates, is quite honestly shocking. We offered, and were more than happy to write you a note for the day that you were seen in our clinic. That is very customary and very appropriate. We would have even been happy to include in the note that any issue experienced was supposedly ongoing. Furthermore, we would have even been happy to leave out any part about only being in the office to get a doctors note.  But we cannot, and will not pretend that we treated you on dates that we did not treat you. For you to demand that from us is quite honestly embarrassingly entitled of you. I understand that you being out of work for some amount of time might cause you issues with your supervisor. While we hate hearing that, we at Creek Stone shoulder zero responsibility in the matter and should have NEVER been expected to play a part in it in any way. You threatened to leave us a terrible review if we refused to lie for you. That will not be tolerated. In your threat to us, you claim that Yelp is a powerful tool. We absolutely understand that. While, we obviously could not prevent you from leaving us a libelous, disparaging, and legally actionable review in an attempt  to prevent others from seeking care with us, we want to be clear, direct, and factual in our response. This review is nothing more than a legally actionable revenge review and we suggest you remove it immediately.  Having a staff of 12 working at our clinic, and caring dearly about each one of them and their loved ones, I guess I’ll never quite understand why someone like you would try to affect our way of providing for our families. Especially when your discipline issue is your own fault.” So, I get an email that night saying that he was never asking me to falsify anything and that he would be fine with a note stating that I saw him on the date I saw him and mention that he stated that it started 3 days previous to the visit. Which would be an honest recounting of the visit I had with him. I have no problem with that.  He even said he’d be happy to leave me a great review. Lol.  OK, now we’re getting somewhere. I told him I have plenty of great reviews. There’s no need for that. I’m happy to provide a note recounting the encounter truthfully and honestly but I would apprecaite him removing the 1-star review. He was happy to do that and I was happy to provide an accurate note for his visit.  One more joy robber vanquished.  This person said they’ll never step foot in my clinic again. What a blessing. As you get busier, you get to choose who you will and who you will not do business with. I will not do business with people like this.  What’s the moral? JUST BE KIND TO OTHERS. You don’t know what others deal with. Be ethical. Be generous. If you did something wrong, take responsibility for your own actions. Thast goes for provider and patient Most importantly, don’t try to tear others down based on the faults in your own actions or behavior. I tell our staff that when we have a bad one…..just remember all of the amazing, loving, and kind patients that we have all day every day.  I had to take my own advice on this one.  I hope the grinch takes their presents from under the tree. Item #1 Our first one continuing from part one from last week is called, “Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trial with adaptive allocation” by Bronfort, et al and published in Annals of Internal Medicine in September 16, 2014. Remember; citations are in the show notes at chiropracticforward.com Bronfort G, Hondras MA, Schulz CA, Evans RL, Long CR, Grimm R. Spinal manipulation and home exercise with advice for subacute and chronic back-related leg pain: a trial with adaptive allocation. Ann Intern Med. 2014 Sep 16;161(6):381-91. doi: 10.7326/M14-0006. PMID: 25222385.  Why They Did It Back-related leg pain (BRLP) is often disabling and costly, and there is a paucity of research to guide its management. The researchers wanted to determine whether spinal manipulative therapy (SMT) plus home exercise and advice (HEA) compared with home exercise and advice alone reduces leg pain in the short and long term in adults with Back-related leg pain. How They Did It
  • Controlled pragmatic trial with allocation by minimization conducted from 2007 to 2011. 
  • Research centers (Minnesota and Iowa).
  • Persons aged 21 years or older with Back-related leg pain for least 4 weeks.
  • 12 weeks of SMT plus home exercise and advice or home exercise and advice alone.
  • The primary outcome was patient-rated Back-related leg pain at 12 and 52 weeks. 
  • Secondary outcomes were self-reported low back pain, disability, global improvement, satisfaction, medication use, and general health status at 12 and 52 weeks. .
  • Blinded objective tests were done at 12 weeks.
  • Of the 192 enrolled patients, 191 (99%) provided follow-up data at 12 weeks and 179 (93%) at 52 weeks. 
What They Found
  • For leg pain, SMT plus home exercise and advice had a clinically important advantage over home exercise and advice at 12 weeks but not at 52 weeks. 
  • Nearly all secondary outcomes improved more with SMT plus home exercise and advice at 12 weeks, but only global improvement, satisfaction, and medication use had sustained improvements at 52 weeks. 
  • No serious treatment-related adverse events or deaths occurred.
Wrap It Up For patients with Back-related leg pain, SMT plus home exercise and advice was more effective than home exercise and advice alone after 12 weeks, but the benefit was sustained only for some secondary outcomes at 52 weeks. Item #2 The last one this week is called, “Effect of spinal manipulative therapy on mechanical pain sensitivity in patients with chronic nonspecific low back pain: a pilot randomized, controlled trial” by Bond et al and published in Journal of Manual Manipulative therapy in February of 2020. Right before the world took a dump on itself with the COVID pandemic.  Bond BM, Kinslow CD, Yoder AW, Liu W. Effect of spinal manipulative therapy on mechanical pain sensitivity in patients with chronic nonspecific low back pain: a pilot randomized, controlled trial. J Man Manip Ther. 2020 Feb;28(1):15-27. doi: 10.1080/10669817.2019.1572986. Epub 2019 Mar 5. PMID: 30935324; PMCID: PMC7006726. Why They Did It The long-term goal of our study is to improve the understanding of the biological mechanisms associated with spinal manipulative therapy (SMT) in low back pain How They Did It
  • This project involved a pilot randomized, blinded clinical trial of 3-week SMT in chronic nonspecific low back pain (CNSLBP) patients. 
  • They recruited 29 participants and randomly assigned them into either a SMT or sham SMT group. 
  • Pre- and postintervention, they quantified the effect of SMT on clinical outcomes (Numeric Pain Rating Scale and Oswestry Disability Index) and pressure pain threshold at local (lumbar spine), regional (lower extremity), and remote (upper extremity) anatomical sites.
What They Found
  • The researchers observed a significant main effect for time signifying reduced hypersensitivity (increased pressure pain threshold) at local and regional locations at 3 weeks. 
  • Furthermore, they found significant main effects of time indicating improvements in pain and disability from baseline among all participants regardless of intervention. 
  • However, no between-group differences were observed in pressure pain threshold, clinical pain, or disability between the SMT and sham SMT groups over 3 weeks.
Wrap It Up After 3 weeks of SMT or sham SMT in chronic nonspecific low back pain patients, we found hypoalgesia at local and remote sites along with improved pain and low back-related disability 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
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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (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      

Kids’ Screen Time & Physical Activity In Older Adults

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

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

But first, heres that sweet sweet bumper music

   

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #294

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

On the personal end of things…..

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

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

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

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

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

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

Item #1

 

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

Why They Did It

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

How They Did It

 

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

What They Found

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

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

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

Wrap It Up

 

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

 

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

 

 

Before getting to the next one,

 

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

 

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

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

Item #2

Our last one this week is called, “Preventive Effect of an Intervention Program with Increased Physical Activity on the Development of Musculoskeletal Pain in Community-Dwelling Older Adults: A Randomized Controlled Trial” by Hirase, et. al. and published in Pain Medicine on November 2, 2022. warm potato!

Why They Did It

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

How They Did It

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

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

 

 

What They Found

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

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

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

Wrap It Up

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

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

 

Store

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

   

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

Chiropractic evidence-based products

Integrating Chiropractors

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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

 

Headaches In Kids & Multiple Myeloma Research

CF 290: Headaches In Kids & Multiple Myeloma Research

 

Today we’re going to talk about Headaches In Kids & Multiple Myeloma 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!

Chiropractic evidence-based products

Integrating Chiropractors

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

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

 

OK, we are back and you have found the Chiropractic Forward Podcast where we are 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 #290

 

Now if you missed last week’s episode, we talked about motor control stiffening and spinal manipulation and the vertebral artery. Make sure you don’t miss that info. Keep up with the class.

 

On the personal end of things…..

Hey, hey, everyone! Welcome – we’ve got a rather interesting topic to dive into, and it’s a bit personal, I must admit.

 

You see, in the world of chiropractic, we have our colleagues we love and then we have the ones we love to gripe about. But what happens when a fellow chiropractor goes completely off the rails and starts attacking others not only professionally, but personally as well? Strap in, folks, because today we’re talking about hate and about handling professional turbulence and keeping your cool in the face of what I perceive to be a sheer craziness.

 

So, picture this – there I am one night at home, minding my own business after a long hard day at work, scrolling on Facebook when I get tagged in a post. It’s brought to my attention out of nowhere that another chiropractor that will go unnamed here, got some hurt feelings by something I said somewhere in almost 300 podcast episodes and posted a hit piece on me that was full of absolute vitriol and hate. It was disgusting. Especially from someone that wants desperately to be a leader for the profession.

 

Certainly considering that I’ve never met the dude in my life. Never shared an email exchange, text, wave, no contact in my 25 years of being in the profession. These really seemed to be some hurt feelings here. This guy decided to unleash a barrage of attacks directly on me that came out of left field because I have never, nor will I ever, attack him, or one of his sycophants, directly by name, place, or person.

 

When I have ever discussed anti-vitalism, it’s in broad terms with no names or identifying factors. That’s intentional. I think it’s important to talk about ideas and why I support them or do not support them or why the evidence supports them or does not support them. But I have never found value in the idea of going after someone by name directly. That’s rude, hateful, it doesn’t demonstrate leadership, and it’s not the way I want to handle things personally.

 

This particular person doesn’t like when someone doesn’t support his brand of chiropractic. If someone says something against it, that person, so it seems, must be destroyed. There are lots of examples in his tabloid. It’s like he woke up and thought, “You know what would be a great idea? I’d like to try ruining someone’s reputation and potentially their license because they don’t agree with me!”

 

Regardless of the work people have put into their careers. Trust me, I’m not the first nor will I be the last to suffer these attacks from this tabloid. This person is on a mission that he thinks is vital at all costs. Regardless.

Now, I’m all for spirited debates and discussions within our profession. It’s healthy, it keeps us sharp, and ultimately benefits our patients and the profession. But attacking someone personally and professionally? Come on, man! We’re supposed to be helping people live better lives and making better doctors of chiropractic, not creating chaos! I mean honestly, it’s astonishing the depths that he went on this deal.

 

I’ve had my moments of frustration, just like anyone else. But I firmly believe that the best way to handle situations like these is with grace and professionalism. Let’s face it, we’re human – emotions can run high. But when someone goes “off the rails” as I like to put it, well, that’s a whole other level of… shall we say, “interesting.”

 

So, what did I do in the face of this unprovoked direct attack? Well, I took a step back, breathed deeply, and reminded myself why I got into this field in the first place. It’s all about helping people lead healthier, happier lives. And if I let someone else’s negativity derail me, then I’m not doing justice to my calling. Then, I called my lawyer who, after reading it, simply couldn’t believe someone would have the gall to write that hit piece but then recommended I let it go for now unless I suffer a personal or professional loss.

 

Because, without one single doubt, several points made at my cost in the hit piece were taken out of context and sensationalized for shock value and to, in my opinion, do nothing more than make me look like a fool and try to discredit me at every turn and on every level. And trust me, there are plenty of our colleagues that are sycophants of this guy that will think just that and believe every word. For example, it was claimed that I advertised I was the best chiropractor in Amarillo when you cannot advertise superiority. Even included a screenshot of a video I posted. But failed to mention that the video was announcing that I was voted Best Chiropractor in Amarillo. Two years in a row as a matter of fact. An accomplishment I’m very proud of.

 

Which I am more than able to post about winning. As many times as I damn well want to post about it. That context was absent from the hit job. When things are deliberately taken out of context and sensationalized in such a manner to attack and result in a personal or professional loss…..well then…legally…..the game changes, doesn’t it?

 

Getting back to it….It’s not always easy to maintain composure when you’re faced with such attacks. But I realized that responding in kind would only perpetuate the negativity. So, I’m choosing a different path – I’ve continued to focus on my patients, on my podcast, on my leadership duties, and on improving myself and my message. I do not plan on having a tick for tat running discussion going on this. He done his damage and I suspect it’ll end right there. I certainly recommend that it does.

 

As they say, ultimately, the best revenge is success. While this unnamed individual may be busy spewing negativity and trying to destroy anyone that disagrees with his brand of chiropractic, I’m busy promoting my brand of chiropractic without the personal and direct attacks on my colleagues. It seems like the ones that want to convince others that they aren’t somehow crazy and maniacal, are always the ones out there doing the crazy things. The crazy things that just go to prove everyone’s point.

 

So, what’s the takeaway from all of this? Well, first and foremost, keep your cool when faced with attacks, whether they’re personal or professional. Do what you can to get effective counsel and rise above the chaos and stay true to yourself and your purpose. I know who I am and I know damn well what I stand for – as do any of you who listen regularly or know me personally. And, Hey….I’m a big boy. Literally and figuratively. I can take it and I suppose if you’re going to take a stance and fight for the things you believe in, you have to be ready for the punches from the trolls. I wasn’t expecting it. But I am now.

 

And secondly, let’s all remember that in the grand scheme of things, we’re here to make a positive impact on the world, not engage in hate or destroying someone personally just because we happen to not agree with them. It’s shameful, desperate, and embarrassing. Hate is going to hate and we can’t change that so we might as well get busy living and doing what we can to be a positive change and a positive force for those around us that love us and have faith in our ideas and in our leadership.

 

 

Item #1

 

The first on today is called “Potential effect modifiers for treatment with chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7–14 years: development of and results from a secondary analysis of a randomised clinical trial” by Susanne Lynge, Werner Vach, Kristina Boe Dissing & Lise Hestbaek and published in Chiropractic & Manual Therapies and on 11 July 2023. Dayum. That’s hot.

 

Why They Did It

 

A recent randomized controlled trial (RCT) investigating the effect of chiropractic manipulation in 199 children aged 7–14 years with recurrent headaches demonstrated a significant reduction of number of days with headache and a better global perceived effect (GPE) in the chiropractic manipulation group compared to a sham manipulation group. However, potential modifiers for the effectiveness of chiropractic manipulation of children with recurrent headaches have never been identified.

 

The present study is a secondary analysis of data from that RCT and will investigate potential effect modifiers for the benefit of chiropractic manipulation for children with headache.

 

How They Did It

 

Sixteen potential effect modifiers were identified from the literature and a summary index was prespecified based on clinical experience. Relevant variables were extracted from baseline questionnaires, and outcomes were obtained by means of short text messages. The modifying effect of the candidate variables was assessed by fitting interaction models to the data of the RCT. In addition, an attempt to define a new summary index was made.

 

 

What They Found

 

The prespecified index showed no modifying effect. Four single variables demonstrated a treatment effect difference of more than 1 day with headache per week between the lower and the upper end of the spectrum: intensity of headache (p = 0.122), Frequency of headache (p = 0.031), sleep duration (p = 0.243), and Socioeconomic status (p = 0.082).

 

Five variables had a treatment effect difference of more than 0.7 points on the GPE scale between the lower and the upper end of the spectrum: Frequency of headache (p = 0.056),

Sport activity (p = 0.110),

Sleep duration (p = 0.080),

History of neck pain (p = 0.011), and

 Headache in the family (0.050).

 

A new summary index could be constructed giving highest weight to History of neck pain and Headache in the family and Frequency of headache. The index suggests a difference of about 1 point in GPE between low and high values of the index.

 

 

Wrap It Up

 

Chiropractic manipulation offers a moderate benefit for a broad spectrum of children. However, it cannot be excluded that specific headache characteristics, family factors, or a history of neck pain may modify the effect. This question must be addressed in future studies.

 

 

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, “An experimental treatment developed at Israel’s Hadassah-University Medical Center has a 90% success rate at bringing patients with multiple myeloma into remission.” by Judy Siegel-Itzkovich and published in The Jerusalem Post on MAY 29, 2023. Hot potato!

 

Why They Did It

 

The researchers and medical professionals at Hadassah-University Medical Center in Jerusalem’s Ein Kerem developed the innovative treatment for multiple myeloma cancer because it is a significant medical challenge. Multiple myeloma is the second-most common hematological disease and has long been considered incurable, with a poor life expectancy for patients. The motivation behind this research was to find a groundbreaking solution that could improve the prognosis and quality of life for patients suffering from this type of cancer.

 

How They Did It

 

The treatment is based on genetic engineering technology known as CAR-T (Chimeric Antigen Receptor T-Cell Therapy). The process involves the following steps:

 

Apheresis: Blood components are collected from the patient, and the T cells (active cells in the immune system that can fight tumors) are isolated.

 

Genetic Engineering: A genetic segment that encodes a receptor against cancer cells is added to the T cells using a virus.

 

Injection: The engineered T cells are then injected back into the patient’s body.

 

Targeting and Destruction: The engineered T cells target the tumors and destroy the cancer.

 

 

What They Found

 

According to the article, more than 90% of the 74 patients treated at Hadassah with the CAR-T therapy went into complete remission. This represents a highly successful response rate and a significant improvement in the prognosis for patients with multiple myeloma. The treatment also showed minimal side effects, making it even more promising for patients’ well-being.

 

 

Wrap It Up

 

The researchers and medical professionals at Hadassah-University Medical Center have achieved an unprecedented breakthrough in the treatment of multiple myeloma cancer using CAR-T therapy. This innovative approach, based on genetic engineering technology, has shown remarkable success in achieving complete remission for the majority of patients treated.

 

The treatment offers hope to those suffering from a disease that was once considered incurable, greatly improving their life expectancy and quality of life. Moreover, by significantly reducing the cost of the treatment, Hadassah has made it more affordable and accessible to a larger number of patients in Israel and around the world.

 

The success of this treatment could pave the way for the development of future treatments using CAR T cells for other types of cancer as well. The researchers’ efforts represent a major achievement in the field of oncology and immunotherapy, with the potential to revolutionize cancer treatment worldwide.

 

 

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 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

COVID-Delayed Surgeries & Lumbar Stenosis Research

CF 288: COVID-Delayed Surgeries & Lumbar Stenosis Research

 

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

 

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 #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:

  1. 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.
  2. 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,

 

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 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!

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

 

 

w/ Dr. Lindsay Mumma – Excellence in Practice & Pelvic Floors. Oh How They Suck

CF 281: w/ Dr. Lindsay Mumma – Excellence in Practice & Pelvic Floors. Oh How They Suck Today we’re going to be joined by the amazing breath of fresh air called Dr. Lindsey Mumma. A force to be reckoned with, and an interview you’re going to absolutely love. But first, here’s that sweet sweet bumper music    

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

Chiropractic evidence-based products

Integrating Chiropractors

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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-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 chiropracticforward.com

You have found yourself smack dab in the middle of Episode #281 Now if you missed last week’s episode , we talked about Catastrophizing and Proprioception. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I don’t want to take up a lot of time on personal happenings. I want to save as much time as I can for our force-to-be-reckoned with cool super guest. So, let’s just hop in and let me tell you all about her.  Dr. Lindsay Mumma is the owner of Triangle Chiropractic and Rehabilitation Center in Raleigh, NC,  Triangle is a multidisciplinary practice she opened in 2012 after graduating from Palmer College of Chiropractic with the Clinical Excellence Award. And I’m sure you’ll agree soon that she is indeed excellent, my friends.  She teaches for the Motion Palpation Institute and moveMentors. Her private practice focuses on rehabilitative chiropractic care across the lifespan and with a specific focus on prenatal and postpartum health.  She is a wife, mother to two boys, she’s a speaker, a life enthusiast, and author of The Trimester Series, the best-selling book Your Pelvic Floor Sucks, and the Top 50 in Health Substack publication Dr. Lindsay Mumma’s Newsletter.  So, pretty good start, right? I think I spent my first 11-12 years playing music and being crazy. Lol.  Welcome Dr. Mumma who will remain, Lindsay the rest of this podcast if that’s OK with you  The first thing I want to know is…..why chiropractic? What got you interested in the more evidence-based side of our profession rather than the more vitalistic approach many of us were taught years ago? We are going to talk about your new book specificaly but first, tell me about the Trimester Series and about your newsletter.  I saw you hanging out with Brett Winchester recently on Facebook. I guess he and some others came to your clinic and did a workshop? Let’s talk about that insance genius and the visit. So, let’s get to your latest big huge achievement. You recently published your best seller called ‘Your Pelvic Floor Sucks’ which is a genius title for lots of reasons but tell me….why is a chiropractor the best person to be addressing pelvic floor dysfunction? How long did it take you to write the book? Did you use ChatGPT to help you get it done? Are female practitioners better suited for these types of conversations with patients? What’s the hardest part about improving pelvic floor function? Do you find that these patients are more motivated than your regular Joe off the street considering the symptoms? Or are they still difficult to get to exercise? If someone reads your book, will they actually be able to make themselves better, or do they need to work with someone in person? What is on the horizon for Dr. Super Mumma? What do you have cooking up? You are my favorite witch. Lol. In Tampa at our masterrmind meeting, you let drink beer and old fashioneds all night but when I was going upstairs to go to bed I was trying to buy myself a coke zero in the lobby and you were having none of it, sister. You made me get water and then put some vitamin powder witchy concoction in it. Which actually turned out to be rather yummy so all was good but that brings us to the question.  Why are you so witchy? 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. 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  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  

Catastrophizing and Proprioception

CF 280: Catastrophizing and Proprioception

Today we’re going to talk about catastrophizing and we’ll talk about proprioception in chronic low back pain patients as well.

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 y  our 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 #280   Now if you missed last week’s episode, we talked about Newer Information On Nonsurgical Spinal Decompression Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Things seem to be humming along nicely around my clinic, other than still needing a good, solid, driven associate. But, it is what it is and that’s OK. The right on will come along when they’re supposed to come along. And we’ll take good care of them when they do.  

In other news, I’m still digging on BlueIQ.

I buy a lot of goofy crap and have bought goofy things and services over the years. Always trying to get that competitive advantage.   Some of the more solid investments I’ve made over the years have been ChiroUp, ReviewWave, being in Dr. Kevin Christie’s Mastermind group, and then I think BlueIQ. I think.

I’m still evaluating and using it but I think I really really like it.  

Stats right from my phone if I want them and they’re updated every hour from my EHR, well hell yes. Please and thank you. Thank you, may I have another.  

Also big in the clinic now is that we’ve been using a software called SignPresenter. Now think about it; I have an integrated clinic and that means I have a crap ton of services when you combine all providers.

Well, I got to thinking, why the hell don’t I have a TV in our lobby with all of our services being splashed across the screen and across the brains of all of the people that come through our doors?

Why am I being a dummy?   So I started a little research and came across SignPresenter and signed up muy pronto. There’s a small learning curve on the thing but I think I bout got it handled.   I’ve started making my own graphics, videos, etc, and can now showcase things on it for our lobby-dwelling folks.

Including QR codes for landing pages and more information and things like that.   I think it matters. Our front desk pro, Elexis, tells me that people will just stand in front of the TV watching it. Lol. So that’s a good thing. Can’t be bad!! I’ll let you know how that goes but early signs say that it’s a big, big win.  

OK, enough of the ramblings, let’s get ot the research.    

Item #1  

The first one today is called “Widespread Proprioceptive Acuity Impairment in Chronic Back Pain: A Cross-sectional Study” by Matthias Poesl MSc, Gabriela F. Carvalho Ph.D., Waclaw M. Adamczyk Ph.D., Beate Schüßler MSc, Michael Richter Ph.D., Kerstin Luedtke Ph.D., Tibor M. Szikszay Ph.D. and published in Science Direct on 17 March 2023. Dayum. That’s hot.  

Why They Did It  

To investigate whether proprioceptive accuracy measured with the Joint Position Sense (JPS) in patients with chronic neck and low back pain is impaired exclusively in affected areas or also in distant areas, not affected by pain.  

How They Did It  

  • Patients with chronic neck pain, patients with chronic low back pain, and age- and sex-matched asymptomatic control subjects.
  • One hundred and thirty-three patients with chronic neck and back pain were recruited.
  • Among them, 33 did not meet the inclusion and exclusion criteria or decided not to participate in the study.
  • In total, 30 patients with CLBP, 30 patients with CNP, and 30 pain-free control participants were included.
  • No significant differences were found between all 3 groups regarding sociodemographic and between both patient groups regarding disease-related characteristics.

  What They Found  

  • Both patients with chronic neck pain and patients with chronic low back pain differed significantly from asymptomatic controls in the Joint Position Sense of the cervical spine, lumbar spine and ankle joint, regardless of the painful area.
  • No difference was shown between patient groups.
  • An association of the Joint Position Sense with clinical characteristics, however, could not be shown.

 

Wrap It Up  

These results suggest widespread impairment of proprioceptive accuracy in patients with chronic and low back pain and a role for central sensorimotor processes in musculoskeletal pain conditions.    

 

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, “Level of pain catastrophizing determines if patients with long-standing subacromial impingement benefit from more resistance exercise: predefined secondary analyses from a pragmatic randomized controlled trial (the SExSI Trial)” by Mikkel Bek Clausen, Michael Skovdal, Thomas Graven-Nielsen, Thomas Bandholm, Karl Bang Christensen, Kristian Thorborg and published in British Journal Of Sports Medicine on March 10, 2023. Steamy stack of simmering sausage!  

Why They Did It

The primary aim was to investigate the effectiveness of adding more resistance exercise to usual care on pain mechanisms (including temporal summation, conditioned pain modulation and local pain sensitivity) and pain catastrophizing in people with subacromial impingement at 16 weeks follow-up. Second, to investigate the modifying effect of pain mechanisms and pain catastrophizing on the interventions’ effectiveness in improving shoulder strength and disability  

How They Did It

  • 200 consecutive patients were randomly allocated to usual exercise-based care or the same plus additional elastic band exercise to increase total exercise dose.

 

  • Completed add-on exercise dose was captured using an elastic band sensor. Outcome measures recorded at baseline, 5 weeks, 10 weeks and 16 (primary end point) weeks included temporal summation of pain (TSP) and conditioned pain modulation assessed at the lower leg, pressure pain threshold at the deltoid muscle (PPT-deltoid), pain catastrophizing and the Shoulder Pain and Disability Index.

  What They Found  

  • Additional elastic band exercise was not superior to usual exercise-based care in improving pain mechanisms or pain catastrophizing after 16 weeks.

 

  • Interaction analyses showed that pain catastrophizing (median split) modified the effectiveness of additional exerciseswith superior results in the additional exercise group compared with the usual care group in patients with less pain catastrophizing.

 

Wrap It Up  

Additional resistance exercise added to usual care was not superior to usual care alone in improving pain mechanisms or pain catastrophizing. Additional exercise was, however, superior in improving self-reported disability in patients with lower levels of pain catastrophizing at baseline. 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 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

 

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YouTube

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TuneIn

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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

 

 

Children, Activity, and Depression and Axially Loaded MRIs

CF 269: Children, Activity, and Depression and Axially Loaded MRIs

Today we’re going to talk about Children, Activity, and Depression and Axially Loaded MRIs

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 #269   Now if you missed last week’s episode, we talked about Postoperative Acupuncture & Activity And Depression.  Make sure you don’t miss that info. Keep up with the class.   On the personal end of things….. This week has started out gangbusters, folks. 47 on the schedule and that’s just me. We have the nurse practitioner kicking, the massage therapists doing their thing, we have the acupuncturist banging ‘em out, and a full, brand new team, as most of you know…..and they’re learning and getting up to speed quickly.   They’re much quicker with everything they do every day. The new front desk staffer is phenomenal and really catching on. She’s the real deal so, things are smelling pretty darn rosey around Creek Stone folks.   Isn’t that a lot better than me fussing about being slow. Let’s hope my upward swing maintains so I don’t have to go back into gripey mode.   Now, things I’m doing lately. I’m experimenting a lot with ChatGPT. If you’re not familiar, you might give it a look-see. It’s a game changer for those like me that are highly involved in their own content creation, blogs, articles, marketing, and things of that nature. It’s scary but for now, scary in a good way and is saving me literally 3-6 hours every single week and saving lots of money as well.   Need an article, have ChatGPT get the base coat of the painting laid down for you while you come in and do the touch-ups. Need a meeting outline? ChatGPT. How about ideas for social media postings? Yep, ChatGPT. It’s remarkable.   Think about it; I have several things happening in my daily. Chiropractic Forward is a small part of my life.  This ChatGPT is helping me get a lot of stuff lined out and I’m pretty excited about it.   So check it out. Remember, you heard it from your ol’ Uncle Jeffro first.   Let’s dive in.     Item #1   The first on today is called, “Physical Activity Interventions to Alleviate Depressive Symptoms in Children and Adolescents” by Francesco Recchia and published in Jamapediatrics on January 3, 2023. Dayum. That’s hot.     Why They Did It   To determine the association of physical activity interventions with depressive symptoms in children and adolescents.   How They Did It   A random-effects meta-analysis using Hedges g was performed. Heterogeneity, risk of bias, and publication bias were assessed independently by multiple reviewers. Meta-regressions and sensitivity analyses were conducted to substantiate the overall results. The study followed the PRISMA reporting guideline.   PubMed, CINAHL, PsycINFO, EMBASE, and SPORTDiscus were searched from inception to February 2022 for relevant studies written in English, Chinese, or Italian.     What They Found  
  • Twenty-one studies involving 2441 participants (1148 [47.0%] boys; 1293 [53.0%] girls; mean [SD] age, 14 [3] years) were included.
  • Meta-analysis of the postintervention differences revealed that physical activity interventions were associated with a reduction in depressive symptoms compared with the control condition (g = −0.29; 95% CI, −0.47 to −0.10; P = .004).
  • Analysis of the follow-up outcomes in 4 studies revealed no differences between the physical activity and control groups (g = −0.39; 95% CI, −1.01 to 0.24; P = .14).
  • Moderate study heterogeneity was detected (Q = 53.92; df = 20; P < .001; I2 = 62.9% [95% CI, 40.7%-76.8%]). The primary moderator analysis accounting for total physical activity volume, study design, participant health status, and allocation and/or assessment concealment did not moderate the main treatment effect. Secondary analyses demonstrated that intervention (ie, <12 weeks in duration, 3 times per week, unsupervised) and participant characteristics (ie, aged ≥13 years, with a mental illness and/or depression diagnosis) may influence the overall treatment effect.
  Wrap It Up   Physical activity interventions may be used to reduce depressive symptoms in children and adolescents. Greater reductions in depressive symptoms were derived from participants older than 13 years and with a mental illness and/or depression diagnosis. The association with physical activity parameters such as frequency, duration, and supervision of the sessions remains unclear and needs further investigation.   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, “Magnetic Resonance Imaging Evaluation of Biomechanical Effects of Axial Loading on the Lumbar Spine” by Adnan Sehic and published in PubMed on 2022 30 Dec. Hot potato!     Why They Did It   The aim of this study is to determine the significance of alMRI in detecting the morphologic changes of the lumbar spine caused by axial loading and to compare it with conventional MRI images of the lumbar spine without loading.   How They Did It  
  • The study was conducted as a prospective, descriptive clinical trial.
  • Imaging was performed with a MRI 1.5 T in the head-first supine position. Imaging was performed in two acts: without load and under load. Loading for alMRI was performed with the DynaWell L-Spine device.
  • The onset of loading was 10 minutes before the start of alMRI. The loading continued throughout the imaging procedure.
    What They Found   After evaluating the changes in the height and size of the lumbar disks, the size of the DSCA, and the narrowing of the intervertebral foramina significant differences were found between the images before and after axial loading.   Wrap It Up   alMRI provides information on morphological changes of all segments of the lumbar spine. This data represents significant information that can lead to more accurate and effective treatment of LBP.     Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.   Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

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

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

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

Key Point:

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

Thats Chiropractic!

Contact

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

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

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

Connect

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

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 Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids

CF 253: Spinal Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids Today we’re going to talk about Spinal Cord Stimulators vs. Placebo & we’ll talk about Low Back pain, Chiropractic, And Opioids 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 #253 Now if you missed last week’s episode, we talked about High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter?. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Alright, if you’ve heard me fussing my face off about being slow for like oh I don’t know…..the last 8 freaking weeks or so….then you’ll be glad to hear that I have 43 on the schedule today with 5 new patients. That’s more like it.  That’s 5 new patients, one consultation, and 3 re-exams. So….they’re  coming back slowly.

Where the hell did they go in the first place? Who knows? But I talked to my buddy, Tyce Hergert down in Southlake, TX and he’s been slow as hell too. Until just last week. He thinks it’s the economy, inflation, back to school kicked it off, and then we have a big election that makes people a bit pulled back and financially more aware.  Who knows, but it makes sense. Maybe it was a perfect storm kind of thing but I know I’m ready to get back to business and running around like my ass is on fire unable to keep up. Then you get to hear me fuss about that. Lol. It’s a cycle. 

Why can’t it ever just sit right there in teh perfect pocket where you’re seeing just the right number of patients and are right where you want to be as far as being busy during the work week? Yeah, that’s a pipe dream. Never happening.  I’ll tell you this though, I’d rather be running around here with my ass on fire, changing people’s lives, and making money along the way rather than sitting here wondering who I made mad and moping around like a whipped dog. Lol.  So, for this week…we’re back toward the top of the mountain. 

Just real quick on a side gig kind of thought process. I have people asking me all of the time how I started getting into real estate. I want to help you guys. I read a book that’s in the Rick Dad Poor Dad umbrella that’s called Tax Free Wealth by Tom Wheelright.  It started talking about how you can pay lower to zero taxes by buying real estate. Well that got me to listening to the Bigger Pockets podcast and taking their webinars. Then I started delving into the niches of real estate. I decided for lots of reasons that Short Term Rentals, or STRs made the most money and the most sense. 

That led to a podcast and a book by Avery Carl called Short Term Rental, Long Term Wealth. They also have a private Facebook group that I’m a member of.  In case you don’t know, STR is what an Airbnb or VRBO property is. Short term rental like 3-5 days or so vs. a year long lease.  Trust me; people a hell of a lot dumber than you are making a ton on real estate. Here are the ways you make money on real estate:

  1. Cashflow – You have a profitable property so you make monthly cashflow. On average, our STR in Lubbock, TX profits about $2,000/month. That’s above and beyond our overhead on the house. 
  2. Appreciation – You never buy property planning on appreciation. However, assuming it’s not in a terrible neighborhood, it usually appreciates. Which is money in your pocket when, or it, you sell. 
  3. Equity – Other people are buying your property for you. They are kind enough to buy down the payment and buy your equity in the property. Meaning, because of them paying you every month, you own more and more of your own property. 
  4. Taxes – There are multiple ways that real estate benefits your taxes and I’ll leave that up to a CPA since I am not one but in general;
    1. With STRs, you can count your losses and depreciate everything on the real estate side, including the curtains to bring down your tax burden in your chiropractic clinic and try to get your tax burden down to zero for the year. 
    2. The write offs. You can write off all of the furnishings and everything that fits the real estate realm. Including meals where you sit and talk to your business partner (your wife and kids) about your properties. 

Not to mention that if you buy an STR in a place you like to visit, you have a place to stay whenever you need it! Also, if the STR is more than 90 miles from your primary residence, you can qualify for a vacation home loan and only pay 10% down instead of the traditional 20% down.

That makes a million dollar home near or on the beach a hell of a lot more do-able for most of us.  I’ll give you all a bit of a tip, you don’t have to go into these things blindly. Go to airdna.co and go down to the Rentalizer link on the left of your screen. Once there, put in any address, including your home address, and see what it might make as an STR. You may be surprised! It’s not a fool proof silver bullet but can give you some ideas. Also, don’t pay a 20% management fee. It takes me literally 15 minutes per week per property to manage.

Don’t lose 20% of your profit. You can do it yourself. Use guesty.com for the property management software and combine that with pricelabs.com for automatic and appropriate pricing from week to week and then……let er rip!!! Thank me later, fools! If you have any questions, join our private Chiropractic Forward Facebook group and start a post in there. I’d be happy to help if I have the answer. If I don’t, I can find it.  Let’s get started with the research shall we?

Item #1

The first on today is called “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial” by Hara et. al. (Hara S 2022) and published in JAMA on October 18, of 2022 and that’s some hot steamy salsa right there. 

Why They Did It The use of spinal cord stimulation for chronic pain after lumbar spine surgery is increasing, yet rigorous evidence of its efficacy is lacking. The authors wanted to investigate the efficacy of spinal cord burst stimulation, which involves the placement of an implantable pulse generator connected to electrodes with leads that travel into the epidural space posterior to the spinal cord dorsal columns, in patients with chronic radiculopathy after surgery for degenerative lumbar spine disorders.

How They Did It

  • It was a placebo-controlled randomized clinical trial
  • 50 patients were in the study
  • Done at St. Olavs Univer. Hospital in Norway
  • Conducted from 2018 – 2021
  • Patients underwent two 3-month periods with spinal cord burst stimulation and two 3-month periods with placebo stimulation in a randomized order. Which seems like they gave it a good solid chance to work to me
  • Burst stimulation consisted of closely spaced, high-frequency electrical stimuli delivered to the spinal cord. 
  • The stimulus consisted of a 40-Hz burst mode of constant-current stimuli with 4 spikes per burst and an amplitude corresponding to 50% to 70% of the paresthesia perception threshold.
  • The primary outcome was difference in change from baseline in the self-reported Oswestry Disability Index

What They Found

The mean changes in ODI score were −10.6 points for the burst stimulation periods and −9.3 points for the placebo stimulation periods None of the pre-specified secondary outcomes showed a significant difference.  Nine patients experienced adverse events, including 4 who required surgical revision of the implanted system.

Wrap It Up

The concluded, “Among patients with chronic radicular pain after lumbar spine surgery, spinal cord burst stimulation, compared with placebo stimulation, after placement of a spinal cord stimulator resulted in no significant difference in the change from baseline in self-reported back pain–related disability.” So…..chronic pain…..if you’re a regular listener, you know me and chronic pain. I love learning and talking about it. You can’t solve a problem through burst stimulation that is as much entrenched in the brain as it may be in a physical sense. 

You can blast it and blast it and until you treat the centralized portion, you’re pissing up a rope, as they say in Texas.  If you don’t have a clue what I’m talking about, start going through this podcast listening to anything on chronic pain, get a book by David Hanscum called Back In Control, and dive into the biopsychosocial aspect of pain. That’ll get you started. 

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

This second one I got from my buddy Dr. Craig Benton down in Lampassas, TX quite a while ago. Thank you Craig. It’s called “Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids” by Whedon et. Al. (Whedon JM 2018) and published in Journal of Alternative and Complementary Medicine in June of 2018. 

Why They Did It They say, “Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications.”

How They Did It

  • The authors used a retrospective cohort design to analyze health insurance claims data.
  • The data source was the all payer claims database administered by the State of New Hampshire. 
  • The study population was 18-99 year olds, enrolled in a health plan, with at least two clinical office visits within 90 days for a primary diagnosis of low-back pain. 
  • The authors excluded those with a diagnosis of cancer.
  • The authors measured likelihood of opioid prescription fill among recipients of services delivered by doctors of chiropractic compared with non-recipients. 
  • They also compared the cohorts with regard to rates of prescription fills for opioids and associated charges.

What They Found

The adjusted likelihood of filling a prescription for an opioid analgesic was 55% lower among recipients compared with non-recipients.  Average charges per person for opioid prescriptions were also significantly lower among recipients.

Wrap It Up

They concluded, “Among New Hampshire adults with office visits for non-cancer low-back pain, the likelihood of filling a prescription for an opioid analgesic was significantly lower for recipients of services delivered by doctors of chiropractic compared with non-recipients. The underlying cause of this correlation remains unknown, indicating the need for further investigation.” 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

  • Hara S, A. H., Solheim O, (2022). “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial.” JAMA 328(15): 1506-1514.  
  • Whedon JM, e. a. (2018). “Association Between Utilization of Chiropractic Services for Treatment of Low Bac k Pain and Risk of Adverse Drug Events.” J Manipulative Physiol Ther 17(30): 30136-30137.      

Benzodiazepines and Mirror Therapy

CF 238: Benzodiazepines and Mirror Therapy  In today’s episode, we cover Benzopdiazapines and Mirror Therapy  But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

You have found yourself smack dab in the middle of Episode #238 Now if you missed last week’s episode , we talked about Chronic Pain and current thinking. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I usually type up the podcast ideas and outline on a Monday. Well, we were off this Monday for July 4th so I’m short a day this week which means that this personal happenings part of the podcast has to be short so I can make everything happen in this short week.  So here we go. I’m still on the hunt for an associate chiropractor. One who is a go-getter determined to be successful.

One that understands they can go to work for the Joint and get paid more currently. In the now and here. But there will be a cap and they will not be able to exceed that cap. One that understands that there is no cap with me. The more they bring in and grow the clinic and themselves, the more I want to take good care of them. Plain and simple. If that’s you, email me at creekstonecare@gmail.com.

I want to get to know you. 

I am getting ready and looking forward to being in Sarasota with the Florida MCM Mastermind for the weekend of July 22nd. It’s a good time of networking with my fellow mastermind people and helping each other build our businesses. Hell yeah. I thrive in masterminds. Even if I don’t necessarily have the time to implement everything I want to implement. I get inspiration, ideas, and actionable steps I can take almost immediately most of the time.  Lots of little tips and tricks and I learn as much or more from the Mastermind members outside of the classroom at the hotel bar as I learn in the classroom. If you’re interested in joining, send me a message, and let’s get you connected with Dr. Kevin Christie and hopefully get you plugged into the group ASAP. I mean really, we’re meeting in Sarasota on July 22nd and there’s still room for you but in November, we’re meeting a Playa Largo in Key Largo, FL. Everyone’s bringing their family too so you know you don’t want to miss that one. Reach out and let me help you get plugged in.  You have to be grossing $350,000 per year and growth-minded to play so holla.  Let’s get started today. 

Item #1

Our first one today is called “Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA” by Trager et. al. (Trager RJ 2022) and was published in BMJ Open on June 13, 2022. The sizzle…..it’s hot

Why They Did It

Although chiropractic spinal manipulative therapy (CSMT) and prescription benzodiazepines are common treatments for radicular low back pain (rLBP), no research has examined the relationship between these interventions.  We hypothesize that utilization of CSMT for newly diagnosed radicular LBP is associated with reduced odds of benzodiazepine prescription through 12 months’ follow-up.

How They Did It Retrospective cohort study. National, multicentre 73-million-patient electronic health records-based network (TriNetX) in the USA 2003 – 2021

What They Found

  • Odds of receiving a benzodiazepine prescription were significantly lower in the CSMT cohort over all follow-up windows prematching and postmatching (p<0.0001). 
  • Sensitivity analysis suggested a patient preference to avoid prescription medications did not explain the study findings.

Wrap It Up

  • These findings suggest that receiving CSMT for newly diagnosed rLBP is associated with reduced odds of receiving a benzodiazepine prescription during follow-up. 
  • These results provide real-world evidence of practice guideline-concordance among patients entering this care pathway. 
  • Benzodiazepine prescription for rLBP should be further examined in a randomized trial including patients receiving chiropractic or usual medical care, to reduce residual confounding.

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

Item #2

The last one today is called “3D augmented reality mirror visual feedback therapy applied to the treatment of persistent, unilateral upper extremity neuropathic pain: a preliminary study” by Mouraux et. Al. (Dominique Mouraux) and published in the Journal of Manual and Manipulative Therapy in 2017.

Why They Did It

The authors assessed whether or not pain relief could be achieved with a new system that combines 3D augmented reality system (3DARS) and the principles of mirror visual feedback.

How They Did It

Twenty-two patients between 18 and 75 years of age  All of whom suffered of chronic neuropathic pain.  Each patient performed five 3DARS sessions treatment of 20 mins spread over a period of one week.  The following pain parameters were assessed: 

  1. visual analogic scale after each treatment session 
  2. McGill pain scale and DN4 questionnaire were completed before the first session and 24 h after the last session.

What They Found

  • The mean improvement of VAS per session was 29%. 
  • There was an immediate session effect demonstrating a systematic improvement in pain between the beginning and the end of each session. 
  • They noted that this pain reduction was partially preserved until the next session. 
  • If we compare the pain level at baseline and 24 h after the last session, there was a significant decrease of pain of 37%. 
  • There was a significant decrease on the McGill Pain Questionnaire and DN4 questionnaire.

Wrap It Up

Our results indicate that 3DARS induced a significant pain decrease for patients who presented chronic neuropathic pain in a unilateral upper extremity.  While further research is necessary before definitive conclusions can be drawn, clinicians could implement the approach as a preparatory adjunct for providing temporary pain relief aimed at enhancing chronic pain patients’ tolerance of manual therapy and exercise intervention.

You can decide how well-related this is BUT, with phantom limb pain, in addition to cognitive behavioral therapy, they have treated using mirror therapy. 

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

Key Point:

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

Contact

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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