evidence-based

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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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

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

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

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

The Message

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

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

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

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

Website 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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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

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

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

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

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

The Message

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

Key Point:

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

Connect

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

Website 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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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/

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https://player.fm/series/2291021

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

TuneIn

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

About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (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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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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This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

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

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

  • 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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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.    

Cognitive Behavioral Therapy & Restless Leg Syndrome

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Complexity & Treatment of Chronic Pain

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

On the personal end of things…..

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

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

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

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

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

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

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

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

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

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

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

That’s gettingpicases.com/cs

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

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

Item #1

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

Why They Did It

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

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

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

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

That was like Will Smith Rocking Chris Rock…..

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

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

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

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

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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  The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

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

Kids’ Mental Status & Zero Calorie Drinks

CF 223: Kids’ Mental Status & Zero Calorie Drinks Today we’re going to talk about the children, how are they doing lately? And then we’ll talk about whether low or no calorie beverages have any real use for us.  But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

On the personal end of things…..

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

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

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

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

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

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

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

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

Item #1

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

Why They Did It

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

How They Did It

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

What They Found

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

From 2019-2020 – the pandemic

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

Wrap It Up

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

Item #2

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

Why They Did It

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

How They Did It

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

What They Found

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

Wrap It Up

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

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

Key Point:

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

Contact

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  Bibliography Lebrun-Harris LA, G. R., Kogan MD, Warren MD, (2022). “Five-Year Trends in US Children’s Health and Well-being, 2016-2020.” JAMA Pediatr.