evidence-based

Postpartum VAD and Pregnancy CAD

CF 272: Postpartum VAD and Pregnancy CAD

 

Today we’re going to talk about postpartum VAD and pregnancy CAD.

 

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 #272   Now if you missed last week’s episode , we talked about outdoor play, screen time, and the impact of exercise. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Last week was Spring Break so we were a little slower than I like last week but understandable. Everyone is enjoying their kiddos being out of school and taking them on trips. I guess I’ll just move on and get over it.   It’s a big week for me. I’m headed to Atlanta on Thursday for a big voiceover conference called VOAtlanta. It’s actually the largest voice conference in the US from what I’m told.   If you’ve been to a chiropractic conference, then I can tell you, it’s very similar but big. You go keynote speeches. You sit in classes and do all that good stuff. Meet, mix, network. But they have X-sessions, which are really interesting.   An x-session is taught by an expert in whatever that session has to do with. It’s a 3-hour intensive where you really dial down into that subject.

So one may be eLearning, one may be commercial reads, or one may be the best way to win auditions.   That’s what’s on tap for this weekend. It seems more and more voiceover stuff is taking over my weekends and, to be honest, my weekly lunches.   I have too many side gigs and too many interests. I want to be the highest level at everything I do. Of course, that’s not possible is it? Nobody can be an expert at everything.   I’ll never be the smartest, most capable chiropractor. I’ll never be the busiest vo, or the best real estate investor, or the best painter or sculptor or musician or whatever else I have my fingers in.   So we have to be OK with be pretty darn good, don’t we? My point is, we are hard on ourselves many times.

With imposter syndrome and all of the things that go into business and our psyches, it’s difficult to believe that we are where we are and we are on a level that lots of people with they were on. We doubt ourselves instead of lifting ourselves up. I’m the worst.   I’m a tweener right now. Lol. I just made that word up by the way. I’m between. I have a successful clinic, thank the good Lord. And I have a successful voiceover career that is starting up. So, I’m between. I’m a tweener. That’s where I’m busy as hell at the one thing that I want to transition out of.   Don’t get me wrong. I love being a chiropractor and I love solving the puzzles of my patients. But I’m past the every day, day to day, hands on treatment part of it. It’s time for a younger and hungrier associate or two to come in and rock that part out.   At the same time here, I’m building for my future.

How do you retire from day to day patient care and transition into having more freedom of time, freedom of money, and freedom of place? For me, that’s voice over and real estate investing.

These can be done from anywhere at any time. But those have to mature to be able to take over my healthcare provider income. Or at least supplement it once I withdraw from daily care.   In the meantime, one is already built and busy. The other two are building and getting busy. So when both are combined and considered, well I’m busier than a one legged man in an ass kicking contest.   I think where I’m going with all of this is to make sure you have your plan. I’m 50. Some say that’s young. Especially when I spent the first 8 years or so of having my chiro license being a full-time musician. I gave everyone else a head start on me.

But I feel I’m running behind. I see chiros, many in my mastermind group, ahead of me in being able to withdraw from daily patient care and being able to have multiple locations and things like that.   So, what’s your plan? Just work like a mule your whole life and die in your clinic seeing patients at 80 years old? There’s nothing wrong with that by the way. Some love that idea. I have other things I really want to do and accomplish.

How do I get there?

How do you get there?  

Start thinking big and beyond your current positions. Start at the end and work backwards. What is your ultimate goal and what’s it going to take to get there financially, emotionally, risk-wise, etc.? Also, like voiceover and real estate is for me, what are your fail safes in case things don’t unfold perfectly. Because you know they rarely do.   Just start thinking about it regardless of your age. It’s never too early to plan it out and go down that path. Does it take 5 clinics and you just started your first one? Not too early to start considering what it’ll take to get another up and running in the next 3-5 years, and then on and on.   Start thinking, planning, and using some strategery.   Alright, lets get into the research.        

Item #1   The first on today is called, “Postpartum vertebral artery dissection: case report and review of the literature” by Nicholas T. Manasewitsch and published in Thrombosis Journal on 29 October 2020.    

Why They Did It   To determine the hypertensive disorders of pregnancy associated with vascular complications, including ischemic stroke and cervical artery dissection and vertebral artery dissection (VAD).  

How They Did It   A 31-year-old Hispanic woman presented 10 days postpartum with a one-day history of vertigo, nausea, vomiting, and frontal headache. The patient’s pregnancy course had been complicated by preeclampsia, chorioamnionitis, and iron-deficiency anemia, and her delivery was complicated by acute hemorrhage. Physical examination was significant for left leg ataxia.    

What They Found  

  • Laboratory studies showed marked thrombocytosis. Emergent computed tomography (CT) scan of the head was obtained and revealed a left cerebellar ischemic large vessel stroke. Subsequent CT angiography of the head and neck showed a left VAD.
  • Based on correlation of the clinical history and laboratory and imaging findings, a diagnosis of vertebral artery dissection secondary to reactive (secondary) thrombocytosis from overlapping iron-deficiency anemia and acute hemorrhage was established. The patient was started on a heparin infusion and experienced significant improvement after a four-day hospitalization.

 

Wrap It Up   VAD is a rare but important cause of neurologic symptoms in the postpartum period and should be considered in the differential diagnosis for women who present with headache and/or vertigo. Women aged 30 years or older and those with a history of a hypertensive disorder of pregnancy are at particularly high risk. Prompt diagnosis and management of VAD is essential to ensure favorable outcomes.   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, “Pregnancy Linked to Risk of Postpartum Cervical Artery Dissection” by Kurt Samson, MS and published in American Academy of Neurology on August 20, 2020.    

Why They Did It   To provide a possible explanation for why pregnancy is a risk factor for stroke.    

How They Did It  

  • The researchers analyzed data from emergency departments and acute care hospitals in New York and Florida between 2005-2015 and identified 826 women with cervical artery dissection and 826 matched controls, between the ages of 12 and 42 years, who had been hospitalized for renal colic.
  • The subjects were matched for age, race, insurance, income, and state of residence, with pregnancy defined as labor and delivery within 90 days before or six months after the index visit. The researchers then compared the risk of cervical artery dissection during pregnancy versus the same time period one year later.

 

What They Found   Pregnancy was twice as common among 826 women with cervical artery dissection compared with the controls, with heightened risk limited to the postpartum period. Postpartum events occurred an average of 21 days after hospital discharge, and 45 percent of women with postpartum cervical artery dissection had hypertensive disorders of pregnancy at the time of their dissection diagnosis.      

Wrap It Up   New types of headaches, including face or neck pain, should be taken seriously, especially in the weeks just after pregnancy. While migraines, especially if similar to prior migraines, are the most common causes of headaches, new headaches or new types of headaches require prompt medical attention to be considered treatable issues.    

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

 

 

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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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 #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

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

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

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

The Message

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

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

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

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

Key Point:

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

Thats Chiropractic!

Contact

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

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

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

Connect

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

Website

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Low Back Surgery & White Rice And Your Heart

CF 263: Low Back Surgery & White Rice And Your Heart

Today we’re going to talk about spinal surgery for low back pain & white rice and your heart.

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

  You have found yourself smack dab in the middle of Episode #263   Now if you missed last week’s episode, we talked about physical and psychological factors in low back pain and we talked about the prevalence of long-term low back pain after symptomatic lumbar disc herniation. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Let’s talk about employees and my situation shall we? After I get through this short story, if you thought you were in a crappy spot, you may change your mind and feel blessed while feeling sorry for your Ol’ Uncle Jeffro here in Amarillo, TX.   So, many of you know, this has been a challenging time for me. We started slowing down here in the clinic in September and not intentionally, by the way. Then lost my mother in law at the end of September. Then got a subpoena to testify in a court case that a family member is involved in. That added to our general level of stress for sure. Then started having some staffing issues.  

My office manager decided to leave to open her own day care. About the same time, my second most important office member got a job offer to run a urgent care type facility. All the while, my numbers have been down from about 185 appointments per week down to about 135 or so per week. 50 less per week means 200 fewer per month. It’s a hit man. Especially when you carry that through for an entire quarter; September through December.  

Especially when you consider I’m also funding starting a nurse practitioner from scratch.   Then during this time we opened our second short term rental Airbnb house and fully furnished that sucker and worked on it day in and day out. Throw Thanksgiving, Christmas, and New Year’s in on all that and you’re starting to get the picture of what it’s been like around here.  

So, we got one replacement hired and so far, she’s out-freaking-standing! The second replacement, after we hired her a little over 2 weeks ago, decided she just wouldn’t show up for her first day of work today. So, back to the drawing board while the girl that would be training her…..well her last day is in 4 days so, yeah.   Oh, and I almost forgot, one of my best staff members on my spa side of the business has been having marital problems and had to take a 2-week vacation to work that out.  

Then I have two others that I had to give hefty raises to in order to keep them. It’s been a time folks, a real real time.   I do not understand employees right now. Especially the ones that get hired and don’t show up for work on Day 1. That’s TWICE in the last month that we hired someone that did not show up for their first day. What is wrong with people right now?   I hope you’re having more luck with employees right now than I am.   Here’s the thing though, screw it! We’re still getting up and showing up for our staff, for each other, and for our patients. Pain doesn’t disappear because we’re having problems in our personal and/or professional lives. Surgeons are still doing unnecessary surgery that we can prevent regardless of our problems.  

If I have to go down to one employee for a while, we’ll figure it out. My wife will answer the phones and set appointments and I’ll bust my tail in the back office until we find another game-changing team that’s ready to make a difference for our patients. The mission is stead and unchanged. We will provide world class care to the population of my area. Period.   I promise, I’m not going to gripe on every episode because you won’t stick around but part of my point in sharing with you is:

  1. To let you know that if you’re having issues, you’re not alone. A lot of business owners are having staffing issues.
  2. If I’m going through it and find the way out, you can copy that. Or at least copy my attitude and stay strong through the valleys so you can enjoy the peaks when they come back around.

 

Item #1

The first on today is called, “The role of spinal surgery in the treatment of low back pain”by Lachlan Evans and published in Medical Journal of Australia on 12 December 2022. Dayum. That’s hot.

 

Why They Did It   Low back pain (LBP) is common, increasingly prevalent and the leading cause of lost productivity worldwide. Most LBP is generated by non‐specific degenerative changes affecting the bone and soft tissue of the spine, with congenital and acquired deformity, infection, malignancy and trauma comprising a much smaller cohort.  

 

How They Did It  

  • This narrative review focused on studies of any design involving adult patients (aged ≥ 18 years) with axial pain affecting the region of the lumbar spine. We acknowledge the myriad aetiologies of axial LBP and the corollary that treatment strategies must address the underlying cause and, as such, are similarly diverse.

 

  • Studies on neurogenic claudication or radiculopathy treated with surgery were excluded as were those evaluating patients with significant structural abnormalities such as spondylolisthesis and fractures.

 

  • Studies reporting spinal cord stimulation, radiofrequency ablation or percutaneous administration of epidural analgesia were also considered beyond the scope of our discussion.

 

  • They performed an electronic search of the MEDLINE database for articles published from 1 January 1991 to 31 December 2021, without restriction of language. Theyemployed the following search strategy: “lower back pain OR lumbar back pain” AND “surg* OR operati*”. Articles were not excluded based on study design. The study quality was assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.

 

What They Found  

  • Acute LBP is frequently self‐resolving, but recurrence is common, and a significant proportion of patients will develop chronic pain. This transition is perpetuated by anatomical, biological, psychological and social factors.

 

  • Chronic LBP should be managed with a holistic biopsychosocial approach of generally non‐surgical measures.

 

  • Spinal surgery has a role in alleviating radicular pain and disability resulting from neural compression, or where back pain relates to cancer, infection, or gross instability.

 

  • Spinal surgery for all other forms of back pain is unsupported by clinical data, and the broader evidence base for spinal surgery in the management of LBP is poor and suggests it is ineffective. Emerging areas of interest include selection of a minority of patients who may benefit from surgery based on spinal sagittal alignment and/or nuclear medicine scans, but an evidence base is absent.

      Wrap It Up

  • The increasing burden of LBP presents a significant challenge to health care systems throughout the world. Its management should be overseen by primary care physicians and centred upon a holistic biopsychosocial approach of generally non‐surgical interventions.
  • Even though spinal surgery does have a role in alleviating symptoms of radiculopathy or neurogenic claudication, or in circumstances where back pain is related to cancer, infection or gross instability, its role in the management of degenerative LBP is not supported by the studies currently available.

 

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, “White rice and pasta are just as bad for your heart as candy” by Caitlin Tilley and published in Dailymail on October 3rd, 2022. Hot potato!    

 

Why They Did It  

They examined the risk of heart disease among people whose diets were high in refined grains compared to whole grains.    

How They Did It  

  • The study looked at 1,168 healthy patients and compared them to 1,369 patients with coronary artery disease.

 

  • Participants answered a food frequency questionnaire to determine how often they ate whole and refined grains.

 

What They Found  

  • They found those who ate refined grains – processed to give them a finer texture and longer shelf life – were more likely to develop coronary artery disease in middle-age.
  • They found that a diet that includes consuming high amount of unhealthy and refined grains can be considered similar to consuming a diet containing a lot of unhealthy sugars and oils

 

Wrap It Up  

As more studies demonstrate an increase in refined grains consumption globally, as well as the impact on overall health, it is important that we find ways to encourage and educate people on the benefits of whole grain consumption.     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.      

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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  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

Lachlan Evans, T. O. D., Andrew Morokoff and Katharine Drummond, (2022). “The role of spinal surgery in the treatment of low back pain.” Med J Aust II.  

Tilley C (2022). “White rice and pasta are just as bad for your heart as CANDY, study suggests.” DailyMail.      

Nonpharmacologic Treatment In The ER & Spinal Manipulative Therapy For Non-musculoskeletal Conditions

CF 255: Nonpharmacologic Treatment In The ER & Spinal Manipulative Therapy For Non-musculoskeletal Conditions Today we’re going to talk about Nonpharmacologic Treatment In The ER & Spinal Manipulative Therapy For Non-musculoskeletal Conditions 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. 

I want to get to this before getting to the research and even some more real estate investing talk this week.

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.

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 #255 Now if you missed last week’s episode , we talked about Gluteal Tendinopathy. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I have a short week this week so I’m preparing to go to Key Largo to be with my MCM Florida Mastermind group. I went to the website and saw that 2023 is sold out for the group. I have to say, it’s really an impressive group, folks. I tried to get you all in. Lol.  We will be at this amazing place I recommend you check out someday. It’s in Key Largo and it’s called Playa Largo. It’s a resort and spa with restaurants and all of the comforts. It’s just wonderful and I can’t wait to go back. It’s a Monday now and by Thursday, afternoon, assuming the weather cooperates, we’ll be on the beach. 

In other news, I’m curious, on the previous episode, #254, I covered my experience with real estate investing and gave, what I hope, is really interesting and really useful information on investing in short term rentals. Go listen if you’re interested and you missed it.  What makes me think about that this week is that we have a first home. We bought it back in 2006 I believe. Very nice neighborhood. The house is 100 years old and I needed something newer and more current.  When we moved to our current house about 5 years ago, we kept it as a rental just for giggles.

This was before we got serious about real estate. We were just hoping to make a few hundred a month and have someone else buy our equity. Which is exactly what happened.  Fast forward and this year, we re-financed it to get a gob of money out to invest in a short term rental elsewhere. Well, a couple of months ago, we decided, you know what? Why don’t we just sell it to get it off our books so we can qualify for a hefty loan on something more tropical than Amarillo, TX. So we listed it.  Guess what? As our luck holds steady, the real estate market takes a dump about a week or two before we got it ready and listed. So now we can’t sell it for it’s appraisal price. 

Now, here’s the beauty of real estate. There are lots of options!!

  1. Take a bath and cut the price so deep that we lose money but get rid of the house. 
  2. Keep it as a long term rental
  3. Make it a short term rental

If you listened last week, then you probably already know the answer. Instead of taking a $15k-20k hit by cutting the price to sell it, we can take that money and furnish the house and make it a short term rental. So that’s what we’re doing.

I was at the house last night putting together a queen size bed with a trundle while my wife hung curtains.  We went to a site called airdna.co and using their Rentalizer tool, we evaluated the potential of that specific address and BAM…..it was a no-brainer.  So we are off and running.

One last note, if you go Airbnb and you get a property manager, you’re a sucker! They want 20% of your profits when, once set up, it’ll take you literally 15 minutes per week per listing to self-manage.  Go back to last week’s episode and listen but you can manage an STR in Florida from AZ with no problem. You need a wireless thermostat, a wireless Schlage Encode deadbolt, Ring cameras, a maintenance person, a lawn person, and a good cleaner. That’s it. Happy investing.

Now, onto the research.  Item #1 The first one is called “The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature” by Cote et. al. (Côté P 2021) and published in Chiropractic Manual Therapeutics on February 17th of 2021 and goes a lil sumpin’ like this. 

Why They Did It

A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial.

They say, We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders.

How They Did It

The Global Summit took place on September 14-15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence.

What They Found

We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review.  Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. 

Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report.

Wrap It Up

Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders.  We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function.  Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.

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

Item #2

Our last one today is called “Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis” by Sakamoto et. Al. (Sakamoto JT 2018) and published in Academy of Emergency Medicine in March of 2018. 

Why They Did It

Pain is a common complaint in the emergency department (ED). Its management currently depends heavily on pharmacologic treatment, but evidence suggests that nonpharmacologic interventions may be beneficial. The purpose of this systematic review and meta-analysis was to assess whether nonpharmacologic interventions in the ED are effective in reducing pain.

How They Did It

We conducted a systematic review of the literature on all types of nonpharmacologic interventions in the ED with pain reduction as an outcome. We performed a qualitative summary of all studies meeting inclusion criteria and meta-analysis of randomized controlled studies measuring postintervention changes in pain. Interventions were divided by type into five categories for more focused subanalyses.

What They Found

Fifty-six studies met inclusion criteria for summary analysis. The most studied interventions were acupuncture (10 studies) and physical therapy (six studies). The type of pain most studied was musculoskeletal pain (34 studies). Most (42 studies) reported at least one improved outcome after intervention. Of these, 23 studies reported significantly reduced pain compared to control, 24 studies showed no difference, and nine studies had no control group. Meta-analysis included 22 qualifying randomized controlled trials and had a global standardized mean difference of -0.46 (95% confidence interval = -0.66 to -0.27) in favor of nonpharmacologic interventions for reducing pain.

Wrap It Up

Nonpharmacologic interventions are often effective in reducing pain in the ED. However, most existing studies are small, warranting further investigation into their use for optimizing ED pain management. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

Côté P, H. J., Axén I, Leboeuf-Yde C, Corso M, Shearer H, Wong J, Marchand AA, Cassidy JD, French S, Kawchuk GN, Mior S, Poulsen E, Srbely J, Ammendolia C, Blanchette MA, Busse JW, Bussières A, Cancelliere C, Christensen HW, De Carvalho D, De Luca K, Du Rose A, Eklund A, Engel R, Goncalves G, Hebert J, Hincapié CA, Hondras M, Kimpton A, Lauridsen HH, Innes S, Meyer AL, Newell D, O’Neill S, Pagé I, Passmore S, Perle SM, Quon J, Rezai M, Stupar M, Swain M, Vitiello A, Weber K, Young KJ, Yu H (2021). “The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.” Chiropr Man Therap 29(1): 8.  

Sakamoto JT, W. H., Vissoci JRN, Eucker SA (2018). “Are Nonpharmacologic Pain Interventions Effective at Reducing Pain in Adult Patients Visiting the Emergency Department? A Systematic Review and Meta-analysis.” Acad Emerg Med.  

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

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YouTube

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

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https://player.fm/series/2291021

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 Inflammatory Response’s Effect On Chronic Pain & The Entry Point For Low Back Pain

CF 235: The Inflammatory Response’s Effect On Chronic Pain & The Entry Point For Low Back Pain Today we’re going to talk about the inflammatory response’s protection from chronic pain, which is fascinating.. and we’ll talk about where patients should be starting their journey for low back pain.  But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

  • Go to Amazon and check out my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for 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 your 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 #235 Now if you missed last week’s episode, we talked about Chiropractic saving Medicare patients money and adverse events and a better position for preventing strokes when adjusting the neck. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

I had a big weekend in Frisco, Tx. If you don’t know where Frisco, TX is, it is basically North East Dallas. It’s the home of the Dallas Cowboys training facility. It’s where all of the people you hear about moving to Texas are moving to. The place has growth that is just almost unreal.  They have to be continually building high schools and highways because they can hardly keep up with their growing population.  Anyway, it was the location of the Texas Chiropractic Association’s annual state convention, which is called ChiroTexpo. 

This year, I was asked to teach a 2-hour course. My course is called Chronic Pain And The Up-regulated Central Nervous System. Those of you that are regular listeners here are probably familiar with some of what I cover in the course. My main goal for attendees of my course is more responsible in managing of their patients and more responsible in communicating with them.  I’m trying to kill the habits some have of catastrophizing imaging findings and scaring patients into a ton of treatment by using harmful words, phrases, and analogies.  I had a patient last week whose primary told her that her spine was like a dry twig from osteoporosis.

Seriously?

The daughter was scared to death and the patient didn’t want to move an inch because she had a picture in her mind that her spine was going to start splintering. How awful.  But, you get what I’m saying. I’m trying to use guidelines and research to show why words matter and how we can help solve more chronic pain patients’ issues through good communication and broad management protocols.  So there. Good times in the metroplex.  I got to meet a lot of folks and hang out with some buddies. I got to see Mike Massey from Tennessee. He was speaking on Mastering Medicare. I got to hang out with Jay Greenstein and have some dinner and drinks. He was in town speaking on technology in the profession.

Excellent as always.

I hung out and had dinner with Brandon Steele, his wife and daughter, and my other good friend Craig Benton from Lampasas Texas. I also spent plenty of time with my regular TCA family, Tyce Hergert, Devin Pettiet, Max Vige, Bill Lawson, the new President of the TCA and Todd Whitehead, the new Secretary/Treasurer of the TCA, and always a favorite, Stephen Foster who is the President of Texas Chiropractic College. What a wonderful individual. TCC is fortunate to have him at the helm. 

These connections are important to me and I value them greatly.  I also got to meet a couple of fellow speakers and get to know them better. Kristi Hudson from ChiroHealthUSA out in Mississippi. She’s just got amazing good vibes and energy. You can tell when people are good at heart and she’s great. I also met Dr. Cindy Howard, a functional medicine mastermind, ninja, and Jedi. She’s just simply a force to be reckoned with. Very impressive, excellent attitude, and a new connection I’m excited to have made. 

On top of all of that, I won an award at the awards gala. I won the Executive Director’s award which is amazing and quite an honor.  So, overall, it was a great weekend. I’m recovering from all of the festivities but it was well worth it and I’m looking forward to the next one.  Again, it’s mid-June 2022 and I’m still looking for a chiropractor to come in here and treat in my clinic and grow my clinic. If interested, send me an email and a CV to creekstonecare@gmail.com please.

I want to get to know you. But, understand, I’m a go-getter. You’ll need to be as well. But for the right person, this might be the place you’ll want to spend the rest of your career. 

Alright, let’s dive in. But before we do, let’s pay some bills real quick. 

Doctors:  I’ve been telling you about a system that once obtained will help you get more  PI cases.  This system was created by an attorney who exclusively handles accident cases. He got tired of lame approaches by doctors wanting his referrals, so he created this system to teach you how to get the attention and then the love of PI attorneys.  You know these cases are the GOLD of our business.  Very few no-shows, full payment … not health insurance caps or Medicare or Medicaid. Go to: http://www.gettingpicases.com/cs Over 500 doctors nationwide are now using this system…. don’t be left out…  improve your practice, gain free time because of the added income you’ll realize, and appreciate that the attorney, Paul Samakow, is still offering a 100% Money Back Guarantee …  if you give his ideas a fair shake and it doesn’t work, he’ll refund your money…  you have nothing to lose here…

Go to:  http://www.gettingpicases.com/cs

Item #1

The first one is called “Acute inflammatory response via neutrophil activation protects against the development of chronic pain” by Parisien et. al. (Parisien M 2022) and published in Science Translational Medicine on May 11 of 2022 and it’s a hot potato, coming through. 

Why They Did It

They say, “The transition from acute to chronic pain is critically important but not well understood. Here, we investigated the pathophysiological mechanisms underlying the transition from acute to chronic low back pain” On a quick side note, there is the suggestion that neuroplasticity may partially explain the slip from acute to chronic. Isn’t it an interesting thought; tissue has a healing time? If we can get the pain to cease after healing occurs, thus preventing the slip from acute to chronic….imagine how much time, money, and suffering we save the system. Low back pain is the leading cause of disability globally and I would venture a guess that the vast majority of that pain is not acute. It’s chronic. 

How They Did It

  • They performed the transcriptome-wide analysis in peripheral immune cells of 98 participants with acute LBP, followed for 3 months.
  • Transcriptomic changes were compared between patients whose LBP was resolved at 3 months with those whose LBP persisted

What They Found

  • They found thousands of dynamic transcriptional changes over 3 months in LBP participants with resolved pain but none in those with persistent pain. 
  • Transient neutrophil-driven up-regulation of inflammatory responses was protective against the transition to chronic pain. 
  • In mouse pain assays, early treatment with a steroid or NSAID also led to prolonged pain despite being analgesic in the short term; such a prolongation was not observed with other analgesics. 
  • Depletion of neutrophils delayed resolution of pain in mice, whereas peripheral injection of neutrophils themselves prevented the development of long-lasting pain induced by an anti-inflammatory drug.

Wrap It Up

Analysis of pain trajectories of human subjects reporting acute back pain in the UK Biobank identified elevated risk of pain persistence for subjects taking NSAIDs. Thus, despite analgesic efficacy at early time points, the management of acute inflammation may be counterproductive for long-term outcomes of LBP sufferers. You can’t tell me that’s not somewhat exciting. I also read an article last week asking if we’re close to curing cancer and, based on some more recent results from the immunotherapy strategies they’re using and studying, they’re optimistic that an end for a lot of cancers may be in sight. 

That’s worth having some excitement over. If we can cure cancer and figure out how to prevent pain from slipping into chronic pain…..damn. Imagine how our world changes. Almost immediately. I’m a dreamer and I’m dreaming right now. What a party that’ll be if they can get it done.  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 live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase.

Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #2

The last one today is called, “Where to start? A two-stage residual inclusion approach to estimating the influence of the initial provider on health care utilization and costs for low back pain in the US” by Harwood et. al.   (Harwood 2022)and published in BMC Health Services Research on May 23, 2022 and that’s hotter than Texas in June and July.  For real, folks. It was already hitting 105 and 108 in Amarillo and Dallas this last weekend. That’s nuts. 

Why They Did It

Diagnostic testing and treatment recommendations can vary when medical care is sought by individuals for low back pain (LBP), leading to variation in quality and costs of care. We examine how the first provider seen by an individual at initial diagnosis of LBP influences downstream utilization and costs.

How They Did It

  • They used national private health insurance claims data on  3,799,593 individuals, 
  • Subjects were individuals aged 18 or older 
  • They were retrospectively assigned to cohorts based on the first provider seen for their low back pain
  • They excluded those with back pain, serious conditions, or opioid script in the 6 months prior to the study
  • Outcome measures included imaging, back surgery rates, hospitalization rates, emergency department visits, early- and long-term opioid use, and costs (out-of-pocket and total costs of care). 

What They Found

  • Cost and utilization varied considerably based on the first provider seen by the patient. 
  • The frequency of early opioid prescription was significantly lower when care began with an acupuncturist or chiropractor, and highest for those who began with an emergency medicine physician or advanced practice registered nurse (APRN). 
  • Long-term opioid prescriptions were low across most providers except physical medicine and rehabilitation physicians and APRNs. 
  • The frequency and time to serious illness varied little across providers. 
  • The total cost of care was lowest when starting with a chiropractor ($5093) or primary care physician ($5660), and highest when starting with an orthopedist ($9434) or acupuncturist ($9205).

Wrap It Up

The first provider seen by individuals with LBP was associated with large differences in health care utilization, opioid prescriptions, and cost while there were no differences in delays in diagnosis of serious illness. Frequency and time to serious illness varied little across providers and the total cost of care was the lowest when starting with a chiropractor.  Superhero sounds engaged. 

 

Boom, snap, slap, kachow, frickin’ face chop. 

So why in the holy mother of common sense are we not being flooded with pain patients coming from the medical community? How is it possible? We keep seeing papers just like this. This just happens to be the newest one. We’ve seen multitudes of this same result.  Evidence-based and patient-centered chiropractic saves money, get patients equal or better outcomes, patients are more satisfied with chiropractic care, and we save the patient and the system money. 

That’s it, the end of the story. It’s time for a profession that acts as they stand on the shoulders of mother evidence and research….like the medical profession, for example….. to begin paying attention to its own damn research and making it mandatory for spinal and joint pain patients to go to an evidence-based, patient-centered chiropractor first for 2 weeks before they even think of making a different move.  If they’re not doing that, they’re 100% ignoring just about every bit of research I’ve seen on this topic in the past 10 years.

Dr. Christine Goertz once told me that it takes on average 18 years for research to filter down to the everyday provider in the field.  So…..just like 8 more years before our offices are inundated, right? That is if they don’t cure chronic pain first.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. 

Store

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

Key Point:

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

Connect

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

Harwood, K. J., Pines, J.M., Andrilla, C.H.A., (2022). “Where to start? A two stage residual inclusion approach to estimating influence of the initial provider on health care utilization and costs for low back pain in the US.” BMC Health Serv Res 22(694).  

Parisien M, L. L., Dagostino C, (2022). “Acute inflammatory response via neutrophil activation protects against the development of chronic pain.” SCIENCE TRANSLATIONAL MEDICINE 14(644).    

w/ Dr. Chris Chippendale – Evidence-Based, Patient-Centered Communication

CF 232: w/ Dr. Chris Chippendale – Evidence-Based, Patient-Centered Communication Today we’re going to be joined by Dr. Chris Chippendale all the way from the UK. Dr. Chippendale is highly accomplished and I’m looking forward to hearing what he has to share with us with regard to his experience training chiropractors, tutoring, lecturing, and promoting evidence-based, patient-centered, ethical practice. That fits in perfectly with our brand of chiropractic.  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 #232 Now if you missed last week’s episode , we talked about Adjustments For Scoliosis & Importance Of Pain Perceptions.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

My attention has been diverted. And I’m getting weary of not being able to focus, problem-solve, and grow.  Do any of us have time?

Do you have all of the time you want? I remember in the early days, I’d answer the phone. I’d make appointments and cancellations and reschedule appointments all in a paper spiral appointment book with a pencil and an eraser.  One of the long-time patients that have been with me since I was a baby chiropractor came to see me last week and we were reminiscing. He said I even played the guitar and sang him a song when he came in.  While I’m still not above that sort of behavior should patients truly and sincerely ask, I can’t remember ever doing that more than a couple of times in 24 years.

But, I must have been bored. 

I had plenty of time to sit around and play SimCity or something like that. I had plenty of time back then to be a traveling musician and call radio DJs and book my band all over the Southwest US.  Looking back today, I had all the time in the world and didn’t realize it. In one way or another, I felt pretty busy all of this time I guess. I don’t remember being particularly bored much. I guess it’s just perspective. Who knows? There was a lot of excitement because I was young and the future was wide open. I was traveling with a band from Friday through Sunday every single weekend so a lot when into that. I don’t know.

But, I definitely had a lot more time then than I do now. Whether I knew it or not.  Now, I’m super busy. 25 new patients per week as a solo doc on top of about 650 or more appointments per month will keep you a bit tied up. At some point, not yet, but at some point, patient care starts to suffer. For that reason, I’m going to hire an associate. If you are evidence-based, patient-centered, self-motivated, and ready to step in and help us grow, I’m ready to talk to you. Contact me at creekstonecare@gmail.com.

I want to get to know more about you. 

Alright, we have a guest so I don’t want to waste any more time.

Let’s get to it with Dr. Chris Chippendale. 

Dr. Chippendale helps clinicians get better results through honest, ethical, and effective communication. He’s been training DCs since 2013, both with the Royal College of Chiropractors Specialist Pain Faculty, and independent seminars throughout the United Kingdom.

Dr. Chippendale has spoken internationally on communication skills and patient-centered care and he’s currently the Lead Graduate Tutor for the Royal College and provides communication training for all UK Chiropractic graduates as part of their Post Registration Training Scheme.

He’s also a guest lecturer at London South Bank University and recently collaborated with the Royal College in the development of their new Communication Practice Standards. In 2017 he launched Patient-Centered Training to provide more educational opportunities for colleagues. Since then he’s gone on to train hundreds of DCs to effectively connect and build trust with their patients.

In 2021 he launched The Happy Patient Project, an all-new online program to help successful chiropractors level up their patient management skills. Welcome to the podcast Chris, we’ve been trying to find a spot that works for you and works for me and finally…..here we are.

How are you doing? Tell me about your life. What does a day for Dr. Chippendale look like?

What are the main differences, from what you can tell, between the American brand of chiropractic and the UK brand of chiropractic?

What qualities do you think patients are looking for in their doctor?

Just like politics or everything else in life, there are extremes and there are middles and there are normals and there are crazies. There are vitalists that most of us would like to kick while there are extremes of the evidence-based camp that need to take a long walk off of a short pier. With that in mind, where do you think Evidence-Based DCs drop the ball when it comes to patient management?

How do you go about adapting your communication to different types of patients?

What are some of the biggest myths in the profession when it comes to building a successful and ethical practice?

What makes you different from all the other practice management gurus?

I have heard that the UK has a friend of chiropractic in Prince Charles. Is that right or wrong and does it matter?

I see you posting fairly regularly in the Forward Thinking Chiropractic Alliance Facebook group and can’t think of one post that I didn’t agree with. Tell me about your Patient-Centered Training and then tell me about The Happy Patient Project. 

We all want to make a living and do profitable things but, thinking beyond that, what is your vision and hope for the chiropractic profession and how do you see yourself fitting into that?

Tell everyone how to get hold of you if they identify with you and are interested in getting to know you better and want to get connected with you. 

Alright, that’s it. Keep on keepin’ on.

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

Store

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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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    

Exercise For Depression & Manipulation For Tendinopathy

CF 228: Exercise For Depression & Manipulation For Tendinopathy Today we’re going to talk about Exercise For Depression & Manipulation For Tendinopathy 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 anrd 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 #228 Now if you missed last week’s episode , we talked about nerve flossing carpal tunnel and we talked about catastrophizing. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things….. I just got back from the MCM Mastermind that was started by Dr. Kevin Christie. This group is just outstanding y’all. I mean honestly, Dr. Mark King of the Motion Palpation Institute is a member. How do you beat that?? Dr. Jay Greenstein of Kaizenovate and Kaizo care clinics in Washington DC. Dr. Ben Fergus of the GRIP method. Seriously. THE Dr. Brett Winchester is joining us at the next one. You can’t make this stuff up. 

One theme we discussed a lot this weekend was The Front Stage and Back Stage Systems in your practice. Strategic Coach was kind enough to be our guest presenter and they rocked it.  Another theme I kept on bringing up was whatever you can have a vision on and take consistent action on, will happen for you.  BUT YOU MUST HAVE BOTH VISION AND ACTION. 

In our Mastermind Group we have: 

    • A Doc who takes one week off per month 
    • A Doc who lives in a different state than 
    • where is practice is located 
    • At least 5 practices clear well over 1M in revenue (and they are high quality of evidence informed care) 
    • One that is exiting patient care in the Fall
    • A Doc who is building a short term rental business – that’s me! 
    • All Docs who no matter their accomplishements and the size of their practices…..they are still pushing the envelope and humble enough to come to each meeting with a Beginner’s mind. Eager to learn and eager to share thier knowledge and experience. 

Remember, it’s not HOW….it’s WHO.

Who do you know that can help you get where you want to be? I know 14 others right now in this group.  What would you love to have in 5 years that is big? Our group has top chiros from North Carolina, Texas, Florida, Connecticut, Missouri, Montana, Ohio, Maryland, Minnesota, Alabama, and Illinois.  We meet four times a year to raise our games. World class care through a mastermind and collaboration of some of the best in the country. To be the best, it makes sense to learn from the best. It’s pretty exciting! 

Next meeting is in July in Sarasota.  I’m already making plans. I believe Dr. Christie is interested in growing the group by about 5 or so more seats. If you’re interested, let Dr. Christie know. Send him and email to drkchristie@gmail.com 

Before we get to the research, we all know that the number one type of case that we want is a personal injury case – they are gold because the clients are more compliant, and we get paid at rates far above insurance or Medicare or Medicaid. The patient’s attorney tells them to go for treatment as doing so enhances their legal case and gets them more money. The problem is, how do we get PI cases?  Attorneys don’t generally respond to your invitation for lunch. And let’s face it, they’re a tough bunch. I have the answer. An attorney I know has put together a system, that is both in written and video form, that shares how to approach attorneys and get them to send their PI clients to you. This is the real deal. Attorney Paul Samakow’s system costs $997 and he guarantees satisfaction or your money back. You have to check this out.  Even if you only get one case, you’ve made at least 4 or 5 times the investment.

Go to gettingpicases.com/cs

That’s gettingpicases.com/cs

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

Item #1

This first one is called, “Association Between Physical Activity and Risk of Depression A Systematic Review and Meta-analysis” by Pearce et. al. (Pearce M 2022) and published in Jama Psychiatry on April 13, 2022 – Dayumm that’s fresh and hot. 

Why They Did It

To systematically review and meta-analyze the dose-response association between physical activity and incident depression from published prospective studies of adults.

How They Did It

PubMed, SCOPUS, Web of Science, PsycINFO, and the reference lists of systematic reviews retrieved by a systematic search up to December 11, 2020

What They Found

  • Fifteen studies comprising 191,130 participants and 2,110,588 person-years were included. 
  • Heterogeneity was large and significant. 
  • Those accumulating HALF the recommended volume of physical activity had 18% lower risk of depression. 
  • Adults accumulating the recommended volume of 8.8 marginal metabolic equivalent task hours per week had 25% lower risk with diminishing potential benefits and higher uncertainty observed beyond that exposure level. 

Wrap It Up

This systematic review and meta-analysis of associations between physical activity and depression suggest significant mental health benefits from being physically active, even at levels below the public health recommendations. Health practitioners should therefore encourage any increase in physical activity to improve mental health.

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

Item #2

The last one today is called, “”The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review” by Savva et. al. (Savva C 2021) and was published in the Journal of Manual and Manipulative Therapy in 2021 – aye chi wa wa. Steamy. 

Why They Did It

To summarize the available literature with regards to the potential analgesic effect and mechanism of joint mobilization and manipulation in tendinopathy. 

What They Found

  • The effect of these techniques in rotator cuff tendinopathy and lateral elbow tendinopathy, applied alone, compared to a placebo intervention or along with other interventions has been reported in some randomized controlled trials which have been scrutinized in systematic reviews. 
  • Literature in other tendinopathies such as medial elbow tendinopathy, de Quervain’s disease and Achilles tendinopathy is limited since the analgesic effect of these techniques has been identified in few case series and reports. 
  • Therefore, the low methodological quality renders caution in the generalization of findings in clinical practice. 
  • Studies on the analgesic mechanism of these techniques highlight the activation of the descending inhibitory pain mechanism and sympathoexcitation although this area needs further investigation.

Wrap It Up

Study suggests that joint mobilization and manipulation may be a potential contributor in the management of tendinopathy as a pre-conditioning process prior to formal exercise loading rehabilitation or other proven effective treatment approaches. 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

Pearce M, G. L., Abbas A, (2022). “Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis.” JAMA Psychiatry.  

Savva C, K. C., Korakakis V, Efstathiou M, (2021). “The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review.” J Man Manip Ther 29(5): 276-287.    

Nerve Flossing Carpal Tunnel & Catastrophizing

CF 227: Nerve Flossing Carpal Tunnel & Catastrophizing Today we’re going to talk about Nerve Flossing Carpal Tunnel & Catastrophizing 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 #227 Now if you missed last week’s episode , we talked about Cognitive Behavioral Therapy & Restless Leg Syndrome. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things…..

Well if you listened to me last week, then you heard me struggling through an episode. My voice was a straight up mess, I felt pretty dang rough, and really just wanted to be at home in my bed. That business went on for a few more days. I finally figured out that I had COVID. What the hell. Isn’t COVID over? Apparently not.  At this point, I’m 8 days out from the first day I felt crummy. I just have a stuffy nose and coughing some stuff out of my chest here and there but doing pretty good overall.  I’m just glad I got the omicron brand rather than the DeltaVID or the OG-VID I was beginning to think I was immune.

I had an employee that had the antibodies but never got sick. I figured that was me. I guess not. So, I should be good to go with the Rona for like six months before I get it again. Lol So last week was a bust and I have a short week this week as I head to Florida to meet my buddies in St Augustine fir the MCM Mastermind that Kevin Christie began.  It’s an outstanding group of providers. I don’t know if there are any seats left in the group but if you’d like to join the group, gimme a holler.

The next trip and meeting is July 22 in Sarasota. Let’s get to it. Before we do though, I recently connected with a dude.  we all know that the number one type of case that we want is a personal injury case – they are gold because the clients are more compliant, and we get paid at rates far above insurance or Medicare or Medicaid. The patient’s attorney tells them to go for treatment as doing so enhances their legal case and gets them more money. That’s on their end of it but we know less medical providers will accept their cases and they need treatment. And we can help. 

The problem is, how do we get PI cases?  Attorneys don’t generally respond to your invitation for lunch. And let’s face it, they’re a touch bunch. I have the answer. An attorney I know has put together a system, that is both in written and video form, that shares how to approach attorneys and get them to send their PI clients to you. This is the real deal. Attorney Paul Samakow’s system costs $997 and he guarantees satisfaction or your money back. You have to check this out.  Even if you only get one case, you’ve made at least 4 or 5 times the investment. Go to gettingpicases.com/cs That’s gettingpicases.com/cs One more time so you get it right:   gettingpicases.com/cs 

Item #1

The first one is called “Peripheral and Central Adaptations After a Median Nerve Neruomobilization Program Completed by Individuals With Carpal Tunnel Syndrome: An Exploratory mechanistic Study using Musculoskeletal Ultrasound Imaging and Transcranial Magnetic Stimulation” by Paquette et. al. (Paquette P 2020) and published in the Journal Of Manipulative and Physiological Therapeutics on August of 2020. It’s just steamy….not too enfuego on this day.  Why They Did It The authors say, “This exploratory and mechanistic study aims to evaluate the potential peripheral and central adaptations that may result in individuals with CTS who have completed a neuromobilization program.” How They Did It

  • Fourteen individuals with CTS were evaluated 
  • Evaluation were before and 1 week after the completion of a 4-week neuromobilization program that incorporated median nerve sliding exercises. 
  • Pain and upper limb functional abilities were assessed using standardized questionnaires. 
  • The biological integrity and mechanical properties of the median nerve and the corticospinal excitability were quantified using musculoskeletal ultrasound imaging and transcranial magnetic stimulation, respectively.

What They Found

  • Upon completion of the program, participants reported both large and moderate improvements in pain and upper limb functional abilities, respectively. 
  • The biological integrity and mechanical properties of the median nerve remained unchanged, whereas a small significant increase in corticospinal excitability was observed.

Wrap It Up The proposed neuromobilization program appears promising to improve pain and upper limb functional abilities in individuals with CTS. These improvements may be preferentially mediated via central, rather than peripheral, adaptations. Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.

Item #2

The last one today is called, “Pain Catastrophizing and Pain Self-Efficacy Mediate Interdisciplinary Pain Rehabilitation Program Outcomes at Posttreatment and Follow-Up” by Schumann et. al. (Matthew E Schumann 2021) and published in Pain Medicine in September of 2021 and THAT one is enfuego today. 

Why They Did It

“To prospectively evaluate interdisciplinary pain rehabilitation outcomes, as well as to evaluate the mediating effects of both pain catastrophizing and pain self-efficacy on outcome.”

How They Did It

  • 315 patients with chronic pain participated
  • They completed a 3-week interdisciplinary pain rehabilitation program. 
  • Pain severity, pain interference, pain catastrophizing, pain self-efficacy, quality of life, depressive symptom questionnaires, and measures of physical performance were assessed before and after treatment. 
  • Follow-up questionnaires were returned by 163 participants. 
  • Effect size and reliable change analyses were conducted from pre- to posttreatment and from pretreatment to 6-month follow-up. 
  • Mediation analyses were conducted to determine the mediating effect of pain catastrophizing and pain self-efficacy on pain outcome.

What They Found

  • Significant improvements from pre- to posttreatment in pain outcomes were observed, and more than 80% evidenced a reliable change in at least one pain-relevant measure. 
  • Pain catastrophizing and pain self-efficacy mediated the relationship between changes in pain outcomes.

Wrap It Up

Interdisciplinary pain rehabilitation is an effective treatment, and decreasing pain catastrophizing and increasing pain self-efficacy can influence maintenance of treatment gains. So when you’re managing your words and managing the patients’ yellow flags as much as you’re managing the bio aspect of the condition, then you’re on the right track.  If you only manage the bio part and ignore the psychosocial parts, you only get 1/3 of the equation and potentially only 1/3 of the improvement.

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

 

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

Bibliography

Matthew E Schumann, P., Brandon J Coombes, PhD, Keith E Gascho, Jr., Jennifer R Geske, Mary C McDermott, APRN, CNP, DNP, MS, Eleshia J Morrison, PhD, Andrea L Reynolds, PT, Jessica L Bernau, RN, Wesley P Gilliam, PhD, (2021). “Pain Catastrophizing and Pain Self-Efficacy Mediate Interdisciplinary Pain Rehabilitation Program Outcomes at Posttreatment and Follow-Up.” Pain Med 23(4): 697-706.  

Paquette P, H. J., Gagnon D, (2020). “Peripheral and Central Adaptations After a Median Nerve Neuromobilization Program Completed by Individuals With Carpal Tunnel Syndrome: An Exploratory Mechanistic Study Using Musculoskeletal Ultrasound Imaging and Transcranial Magnetic Stimulation.” J Man Physiol Ther 43(6): P566-578.