evidence-informed chiropractic podcast

Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic

CF 333: Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic Today we’re going to talk about Colo-Rectal Cancer Recognition & Less Gabapentin With 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!

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #333 Now if you missed last week’s episode, we talked about Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. Nothiing too special is going on with the clinic this week. We’re just doing our deal. Seeing patients. No big events last week and nothing too huge on the horizon other than the big Texas Chiropractic Association convention called ChiroTexpo goign on in Frisco, TX which is basically Dallas. That will be June 28-30 I believe and if you’re in TX or wish you were, come on and join us.  We’ve always got a great crown and would love to have you down there. Seminars are a great way to get that continuing education but an even better way to network and develop a little bit of influence. Why not? We sit around and we bitch about the state of our profession.

But are we doing anything at all to influence it? Are you a member of the ACA or your state association? If there are a bunch of subbies running your state association, instead of that being a turn-off, shouldn’t that be an amazing opportunity for you and some of your evidence-based friends to get involved and get yourselves in the seats of influence and control so that you can gently start to turn that air craft carrier the right direction? Instead of seeing the obstacle, see the opportunity. Ryan Holliday wrote a book called The Obstacle Is The Way. I highly recommend it.

I promise, when you walk into a board meeting and you realize that only 15-20 people in your entire state run the association, determine the speakers at your events, fight your fights and battles, etc….then you realize what kind of difference you can make. And I mean rather quickly if there’s a handful of you.  So, get it together, get involved, and make this profession respected the way the 2024 brand of chiropractic should be respected. Stop letting the loud-mouthed and angry subbies run the show. It’s your turn now.

Item #1

The first one this week is called “Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer A Systematic Review and Meta-Analysis” by Demb et al and published in JAMA Network Open on May 24, 2024. Aye, Chihuaua!! Es muy caliente! Remember, the citations can be found at chiropracticforward.com under this episode. 

Demb J, Kolb JM, Dounel J, et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(5):e2413157. doi:10.1001/jamanetworkopen.2024.13157

Why They Did It To report the frequency of presenting red flag signs and symptoms among individuals with early-onset colorectal cancer, to examine their association with early-onset colorectal cancer risk, and to measure variation in time to diagnosis from sign or symptom presentation.

How They Did It

  • PubMed/MEDLINE, Embase, CINAHL, and Web of Science were searched from database inception through May 2023.
  • Studies that reported on sign and symptom presentation or time from sign and symptom presentation to diagnosis for patients younger than age 50 years diagnosed with nonhereditary colorectal cancer were included.
  • Data extraction and quality assessment were performed independently in duplicate for all included studies using Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. 
  • Joanna Briggs Institute Critical Appraisal tools were used to measure risk of bias. Data on frequency of signs and symptoms were pooled using a random-effects model.
  • Outcomes of interest were pooled proportions of signs and symptoms in patients with early-onset colorectal cancer, estimates for association of signs and symptoms with early-onset colorectal cancer risk, and time from sign or symptom presentation to early-onset colorectal cancer diagnosis.

What They Found

  • Of the 12,859 unique articles initially retrieved, 81 studies with 24,908 126 patients younger than 50 years were included. 
  • The most common presenting signs and symptoms, reported by 78 included studies, were hematochezia, abdominal pain, and altered bowel habits. 
  • Hematochezia (is the passage of fresh blood through the anus, usually in or with stools), abdominal pain, and anemia were associated with higher early-onset colorectal cancer likelihood. 
  • Time from signs and symptoms presentation to early-onset colorectal cancer diagnosis was a mean of 6.4 months and a median of 4 months.

Wrap It Up

  • In this systematic review and meta-analysis of patients with early-onset colorectal cancer, nearly half of individuals presented with hematochezia and abdominal pain and one-quarter with altered bowel habits. 
  • Hematochezia was associated with at least 5-fold increased early-onset colorectal cancer risk. 
  • Delays in diagnosis of 4 to 6 months were common. 
  • These findings highlight the need to identify concerning early-onset colorectal cancer signs and symptoms and complete timely diagnostic workup, particularly for individuals without an alternative diagnosis or sign or symptom resolution.

Item #2

The second one is called, “Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data” by Trager et al and published in BMJ open in 

Trager RJ, Cupler ZA, Srinivasan R, et al Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data BMJ Open 2023;13:e073258. doi: 10.1136/bmjopen-2023-073258

Why They Did It

Radicular low back pain (rLBP) is often treated off-label with gabapentin or by chiropractors using chiropractic spinal manipulative therapy (CSMT). To date, no studies have examined the association between these interventions.  We hypothesised that adults under 50 years of age receiving CSMT for newly diagnosed rLBP would have reduced odds of receiving a gabapentin prescription over 1 year-follow-up.

How They Did It

Retrospective cohort study. Setting US network including linked medical records, medical claims and pharmacy claims of >122 million patients attending large healthcare organisations (TriNetX), queried 15 June 2023, yielding data from 2017 to 2023.

Participants Adults aged 18–49 were included at their first occurrence of rLBP diagnosis.  Exclusions were severe pathology, other spinal conditions, on-label gabapentin indications and gabapentin contraindications.  Propensity score matching controlled for variables associated with gabapentin use and receipt of prescription medication over the preceding year. Interventions Patients were divided into CSMT or usual medical care cohorts based on the care received on the index date of rLBP diagnosis. Primary and secondary outcome measures OR for gabapentin prescription.

What They Found

  • After propensity matching, there were 1635 patients per cohort. 
  • Gabapentin prescription over 1-year follow-up was significantly lower in the CSMT cohort compared with the usual medical care cohort, with an OR of 0.53. 
  • Sensitivity analyses revealed early divergence in cumulative incidence of prescription; and no significant between-cohort difference in a negative control outcome (gastrointestinal medication) suggesting adequate control for pharmacological care preference.

Wrap It Up

  • Our findings suggest that US adults receiving CSMT for newly diagnosed rLBP have significantly reduced odds of receiving a gabapentin prescription over 1-year follow-up compared with those receiving usual medical care. 
  • Results may not be generalisable and should be replicated in other healthcare settings and corroborated by a prospective study to reduce confounding.

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

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13)

CF 329: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #329 Now if you missed last week’s episode, we talked about current tendinopathy thoughts and chiropractic vs. medical costs.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Well the week is already starting off with a bang and not in a great way either. First thing this morning, I found out one of my employee’s was abused by her ex over the weekend. Broke into her house, prevented her from leaving, and beat her while the 4-year-old was in the house. For a whole weekend.  You should see the girl’s leg. It’s insane. 

So, as an employer, what do you do? Believe it or not, this isn’t the first time we’ve had our go around with crap heads like this. I don’t understand some boys. I say boys because they’re not men. Men respect, support, and boost up women. They don’t do what this guy has been doing.  I can tell you what we do. We are pulling out all the stops to get this girl all of the help our area non-profits have to offer. We’re getting her a protective order.

We’re getting her housing. We’re getting her as far from danger as we can as quickly as we can.  I’ve put my staff on notice about this guy. He’s already called the office today, by the way. They all know his name and what he looks like and my cop friend says call 911 if he shows his face.  I have protection here should it come to that but it won’t.

This guy just likes to beat up and try to control and intimidate women that lack the confidence and support to do something about it. 

Well, she’s got that now and I think he’s going to have a hard time ever doing something like this again.  I tell you this because most of you listening are probably clinic owners yourself. In 26 years in practice, something similar with regards to being hyper aware of an individual that could come to the clinic, has happened maybe 3-5 times or so.

Once or twice it was a unstable patients. The other times, it’s been spouses, all male, all in need of hard-learned lessons. 

It’s stressful. It makes everyone in the office anxious. Being a business owner is hard and some things like this we just cannot control. But we can be aware and we can be vigilant. We can help our team mate make the best decisions and we can do our part to try to make sure she’s protected to the very best of our ability.  Like I said, my entire staff knows the plan, knows what he drives, knows his name, and knows exactly what he looks like. 

It’s a journey and this week is just a little different from our regular journey. But, we’re making it happen, getting patients better while our team helps walk her through this. 

Alright, on with the research. We are continuing our series we are doing every other week where we are trying to figure out what brand of crack the WHO was smoking when they chose and used citations to deem spinal manipulative therapy as being effective at ‘very low confidence’ recently. Two of those papers are covered in this episode. 

Item #1

Our first one today is called, “Short term trial of chiropractic adjustments for the relief of chronic low back pain“ by Waagen et al and published in Manual Medicine in 1986. This one is so old that it can hardly be found.

Literally, I had search and search Remember, the citations can be found at chiropracticforward.com under this episode. 

Waagen GN et al. Short term trial of chiropractic adjustments for the relief of chronic low back pain. Manual Med. 1986;2:63-67.

A double-blind study of the efficacy of spinal adjustive therapy delivered by chiropractors was designed and implemented at the clinic of a chiropractic college.  Nineteen patients with low back pain completed a nominal two-week period of treatment.  Nine patients in the experimental group received a series of chiropractic ‘adjustments’, while ten control patients received a comparable series of manual interventions.  Experimental patients had significantly more relief from pain than control patients immediately after being treated as measured on a 10 cm visual analogue scale.  After two weeks of treatments the experimental patients as a group exhibited significant overall pain relief, whereas improvement of patients in the control group was not significant.  Using a global index for the objective measurements of change in spinal mobility it was also concluded that experimental patients improved significantly compared to control patients  Because of the small sample size the results reported must be considered preliminary.  Modification in the research design from other trials studying manipulative therapy included the use of chiropractic adjustments as the form of manipulation, use of a realistic manual control treatment and use of a global index as an outcome measure.  So yes….it’s in our favor but….it’s a tiny sample size and it’s 38 years old. So why is the WHO using it? 

Item #2

Your second one this week is called, “Short-term usual chiropractic care for spinal pain: a randomized controlled trial” by Walker et al and published in Spine Journal 11 years ago back in 2013. 

Walker B.F et al. Short-term usual chiropractic care for spinal pain: a randomized controlled trial. Spine (Phila Pa). 2013;38(24):2071-2078. doi: 10.1097/01.brs.0000435032.73187.c7.

Why They Did It

The authors wanted to establish the short-term effectiveness of chiropractic therapy for spinal pain compared with a sham intervention and explore the predictors of chiropractic treatment satisfaction. Chiropractic treatment is widely used for spinal pain. However, a lack of sound evidence precludes conclusions about the effectiveness of chiropractic for spinal pain.

How They Did It

  • Participants were adults experiencing spinal pain, randomized to receive 2 treatments of chiropractic or sham therapy. 
  • Participants and outcome assessors were blinded to group allocation. 
  • Primary outcomes at 2 weeks were NRS and Functional Rating Index). 
  • Secondary outcomes were global change, minimum acceptable outcome, and treatment satisfaction. 
  • Treatment effects were estimated with linear mixed models for the primary outcomes. 
  • And they used logistic regression to identify differences in the secondary outcomes and explore for predictors of treatment satisfaction.

What They Found

  • One hundred eighty three participants were recruited and included in the analyses. 
  • Participants receiving chiropractic therapy reported greater improvements in pain, physical function, and were more likely to experience global improvement and treatment satisfaction. 
  • There was no between-group difference in achieving a minimally acceptable outcome. 
  • Awareness of treatment assignment and achieving minimally important improvement in pain intensity were associated with chiropractic treatment satisfaction.

Wrap It Up

Short-term chiropractic treatment was superior to sham; however, treatment effects were not clinically important. Awareness of treatment assignment and clinically important reductions in pain were associated with chiropractic treatment satisfaction

Alright, another puzzling episode of why does the WHO include garbage crap papers to decide if spinal manipulation is effective? I maintain that there is an agenda of some sorts that is bias against chiropractic. 

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        

The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 6)

CF 315: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 6)

Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 6).

If you’ve been following along, and I hope you have…The WHO updated their recommendations recently for pain. Spinal maniuplative therapy was include so we’re on the menu. But, they rated SMT at very low confidence, which is the same as what they rated ultrasound. So, in the eyes of the WHO, smt may be about as effective as ultrasound. Yeah, we’re call BS so we are going through each paper they used to make this determination and they all, except for a few, are old, outdated, and pretty much stink. We’ll talk about it…. 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 giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. 

 

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #315 Now if you missed last week’s episode, we talked about Omnivorous vs Vegan and SMT For Chronic Neck Pain.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Another day, another dollar by friends. Here we are at the end of January 2024 and if all works well and if you’re an insurance or hybrid clinic, then you know that you’ve been a little slower because the deductibles re-set in January for the most part and people don’t like to spend their own money.  But, about a month or so is as long as many of them ever want to go without going to the chiropractor and that’s OK.

The point being that hybrid clinics like mine should start seeing increased numbers in February. It may be mid to late February but we should see us start getting busier for sure.  In the meantime, I’ve started focusing more and more on marketing. I feel like I’m pretty dangerous when I have the time to be. Right now, I have the time to be. I used to sit around brainstorming ideas for marketing, memes, content, and all that entails. Then I’d create my own original stuff and post it.  I haven’t done that in forever it seems but here lately, and unfortunately, I’ve had some extra time to give those things attention again. I like a challenge and so I’m on it. I’ve targeted the demographics I want targeted.

The ones I think that the economy and who happens to be the President will have no control over economically. We’ve re-newed our efforts in getting our message to these people.  In addition, we’ve re-newed our efforts in our public outreach. Face to face, person to person outreach. Dan Kennedy says, YCDBSOYA, You can’t do business sitting on your ass. You’re moving forward or falling behind. You’re the window or the bug. You either make things happen in your life or you sit around wonder what the hell just happened.  So that’s what’s up with Creek Stone on this Monday, January 29th.

I have 35 on the schedule when I typically have 45. You carry that out throughout the week, that’s 50 less per week which is 200 less appointments per month. That’s unacceptable.  I’ve had less new patients lately as well. I think my Google SEO has dimished since going with a very reputable company a few years ago so we switched it up and went with a new website company that I know gets results. That’s brand new.  I also got to looking at our new patients demographics and it looks like we’re seeing fewer VA patients recently. That’s worth investigating and diving into.  If you’re not doing these thing regularly, might get on it. It’s whack-a-mole folks. You can never hit the auto-pilot button and sit back and just do the work if you’re the owner. It’s a constant battle. Enjoy the great times and ride that wave. When things start popping up out of nowhere, dig in, have some grit, and wait for that next wave.  Alright, here we go with the research today. 

Item #1

The first one today is called, “Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial” by Krekoukias, et al., published in 2017 in the Journal of Manual Manipulative Therapy.  Remember, the citations can be found at chiropractscforward.com under this episode.  Krekoukias G, Gelalis ID, Xenakis T, Gioftsos G, Dimitriadis Z, Sakellari V. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. J Man Manip Ther. 2017 May;25(2):66-73. doi: 10.1080/10669817.2016.1184435. Epub 2016 Jun 23. PMID: 28559665; PMCID: PMC5430451.

Why They Did It The authors wanted to examine the efficacy of spinal mobilization in subjects with low back pain (LBP) and associated spinal disk degeneration.

How They Did It Seventy-five subjects suffering from chronic LBP were randomly allocated into 3 groups of 25 subjects.  Each group received five treatment sessions with the first group receiving manual therapy (MT) (spinal mobilization), the second a sham treatment, and the third conventional physiotherapy (CP) (stretching exercises, transcutaneous electrical nerve stimulation, and massage).  Subjects were assessed for their pain intensity using the numerical pain rating scale and for their self-reported disability using the Oswestry and Roland-Morris Questionnaire at baseline and after the completion of the five treatment sessions.

What They Found Paired t-tests showed a significant improvement for all outcome measures in the manual therapy and conventional physiotherapy group.  Analysis of covariance revealed that the manual therapy group had significant improvement in all outcome measures in comparison with the sham and conventional physiotherapy group, whereas no significant difference was observed between the sham and conventional physiotherapy group

Wrap It Up Manual Therapy is preferable to conventional physiotherapy in order to reduce the pain intensity and disability in subjects with chronic LBP and associated disk degeneration.  The findings of this study may lead to the establishment of spinal mobilization as one of the most preferable approaches for the management of LBP due to disk degeneration.

Item #2 The last one is, “The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. A randomized clinical trial” by Koes published in Spine journal in 1992 and they’re using 1992 to make this determination in 2024 because there’s no better and more current  Koes BW, Bouter LM, van Mameren H, Essers AH, Verstegen GM, Hofhuizen DM, Houben JP, Knipschild PG. The effectiveness of manual therapy, physiotherapy, and treatment by the general practitioner for nonspecific back and neck complaints. A randomized clinical trial. Spine (Phila Pa 1976). 1992 Jan;17(1):28-35. doi: 10.1097/00007632-199201000-00005. PMID: 1531552.

Why They Did It As you see in the title of the paper, the plan was to test the effectgiveness of manual therapy, physiotherapy, and treatment by a general practitioner on back and neck pain

How They Did It It was a randomized controlled trial The effectiveness of manual therapy, physiotherapy, continued treatment by the general practitioner, and placebo therapy (detuned ultrasound and detuned short-wave diathermy) were compared for 256 patients with nonspecific back and neck complaints lasting for at least 6 weeks. The principle outcome measures were severity of the main complaint, global perceived effect, pain, and functional status. These are presented for 3, 6, and 12 weeks follow-up. 

What They Found Both physiotherapy and manual therapy decreased the severity of complaints more and had a higher global perceived effect compared to continued treatment by the general practitioner.  Differences in effectiveness between physiotherapy and manual therapy could not be shown. 

Wrap It Up A substantial part of the effect of manual therapy and physiotherapy appeared to be due to nonspecific (placebo) effects. From 1992 – Placebo seems to be why smt appears to be effective. We know that placebo can and should play a part in a patient’s recovery. And we can leverage placebo in our favor too. Placebo has a bad name for some reason. In the biopsychosocial construct we should be using to our advantage all of the time.  Encouraging and positive words, little pain free wins….these things play a part in neuroplasticity and moving it in our direction and moving the patient away from chronic pain. 

That doesn’t mean that smt is placebo only and there have been plenty of papers shwoing the effectiveness of SMT beyond placebo in teh last 10 years or more. This paper is liteerally 32 years old. What in the holy hell are they using this paper for in 2024? I can’t explain it.  To be fair, I suppose the Gate Theory from the 1960s is still relevant so why can’t this paper still be relevant, right?/

But I’d argue that the Gate Theory is gamechanging big stuff. This paper, in my opinion, isn’t in the same ball park with regard to impact and effectiveness. As knowledge base expands, more recent and more relevant knowledge replaces outdated knowledge. This paper should be replaced and not be relevant when recommending SMT for treatment.  My two cents.  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

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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    

Sciatica & Mental Stimulation And Dementia

CF 307: Sciatica & Mental Stimulation And Dementia Today we’re going to talk about Sciatica & Mental Stimulation And Dementia But first, here’s that sweet sweet bumper music

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

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Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are 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 #307 Now if you missed last week’s episode , we talked about Pain Neuroscience Education & Cannabis And Bipolar Disorder. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I just got back from Colorado Springs yesterday. Many of you know that I do voice over projects in my spare time. Whatever that is. I don’t really have spare time these days. But, I flew from Amarillo, TX, to Las Vegas, then to Colorado Springs…..how dumb is that? I hae to do that same path on the way home too.  I was doing live announcing for a Redline Cheer and Dance competition. The season is here and I’ll be hopping all over to these competitions and meeting all kinds of new people. It’s always interesting and mostly fun. It can be a bit of a grind but it’s mostly fun. The traveling, hotels, and meals…..I always enjoy them. New experiences keep you jazzed. And you can’t hardly beat the view from anywhere in CS.  The week after Thanksgiving was slow. I just didn’t have a good week last week and that can get in your brain if you allow it to. I don’t like being slow and I don’t like what it does to morale. I like a good low grade excited buzz in the office. Not a subdued and draggy feeling. Which is what last week was.  Today is Monday and I have 45 on my schedule so that’s an improvement and I’ll take it. I’m a motivated dude. I need to move forward at all times. Any set back kind of pisses me off and gives me the grumps.  But, as a leader, you can be honest with your manager. But you have to put on the front for the rest of your staff. You can tell you manager, hey, I’m struggling with finances this week and this provider or that provider in the clinic isn’t quite covering their overhead. That gives me anxiety and we need to pay attention to that. Or whatever. Hey manager, I don’t have the extra funds to replace this equipment, let’s figure out a work around until we do. Something like that. You can have those conversations with your manager because that’s why they’re there. Or, it’s supposed to be why anyway.  But when it comes to the rest of the office, you need to have that front on that everything is great, we’re working through a couple of challenges but nothing you’ve never seen, and it’s time to rock n roll. Don’t let them see you sweat. It’s not good for them or for you.  Fake it till you make it. It’s never on autopilot folks. It’s always changing and you have to keep dodging punches and swinging every single day.  So, let’s get to it so I can go back to swinging some punches around here. Metaphorically, of course.  Item #1 Our first one today is called, “I Am Worried I Have Sciatica—What Do I Need to Know?” By Zhang et. Al. and published in JAMA Internal Medicine on November 12, 2023 and Aye crumb! Es muy caliente, mi amigos! Zhang GY, Incze MA. I Am Worried I Have Sciatica—What Do I Need to Know? JAMA Intern Med. Published online November 13, 2023. doi:10.1001/jamainternmed.2023.5990. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2811335 This is more of an article instead of a research project so let’s hit the highlights. 
  • They say, “Sciatica is a type of pain that is caused by irritation of the sciatic nerve. This nerve travels from the low back down the legs. Sciatica most commonly happens when a disk in your spine gets damaged or worn out and presses on the sciatic nerve.”
  • The pain can be sharp and aching. It is often accompanied by numbness, tingling, or shooting pain down the back of one leg. Rarely, sciatica can cause muscle weakness, like having difficulty lifting your foot.
  • A medical professional can usually diagnose sciatica by asking about your symptoms and doing a physical examination. For most people, blood tests and imaging such as x-ray or magnetic resonance imaging are not necessary. If you have had cancer, spine infections, or injection drug use; have a new fever; cannot feel your groin area; cannot control going to the bathroom; have trouble urinating; or your leg feels weak, you should see a medical professional right away.
  • Most people with sciatica fully recover without any treatment. About one-third of people with sciatica recover within 2 weeks, and three-fourths of people feel better within 3 months. It is hard to predict who will get better and who will still feel pain. Sciatica can come and go. If your sciatica lasts more than 12 weeks, it is a good idea to get reevaluated by a health care professional.
  • There are many ways to treat pain related to sciatica. Anti-inflammatory drugs like ibuprofen or naproxen may provide modest, short-term relief. Acetaminophen (Tylenol) can also be helpful for pain. Other prescribed medications such as muscle relaxers, steroids, opioids (eg, tramadol, oxycodone), and gabapentin are not proven to help, and some may have dangerous side effects. Talk with your doctor about what medications are best for you. Maintaining gentle physical activity (eg, walking, light housework) as tolerated is important for recovery. A physical therapist can help to coach you on specific exercises to speed up the recovery process. There is no strong evidence that treatments like back adjustments (eg, from chiropractors), gentle spine stretching (called lumbar traction), or acupuncture work. Doctors sometimes give injections of steroid or numbing medications near the spine to help with pain. These might help relieve pain for a short time, but they do not help to heal sciatica.
  • If treatments like physical therapy and pain medications do not help after 4 months, surgery may improve symptoms for some people. But there is a chance that the pain may return even after surgery. Most surgeries for sciatica use small cuts and special tools to remove the damaged part of the spinal disk. This can relieve pressure on the sciatic nerve. Recovery time from sciatica surgery varies among people but generally takes 6 to 12 weeks. While surgery can help, it has risks, including nerve damage and infection.
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 Last one today is called, “Lifestyle Enrichment in Later Life and Its Association With Dementia Risk” by Wu et al. and published in JAMA Network Open on July 14, 2023 and that’s a steamy stack something good! Wu Z, Pandigama DH, Wrigglesworth J, et al. Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. JAMA Netw Open. 2023;6(7):e2323690. doi:10.1001/jamanetworkopen.2023.23690 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807256?guestAccessKey=eaeccd11-7338-417d-a1b5-70481ff42466&utm_content=weekly_highlights&utm_term=072323&utm_source=silverchair&utm_campaign=jama_network&cmp=1&utm_medium=email Why They Did It Lifestyles enriched with socially and mentally stimulating activities in older age may help build cognitive reserve and reduce dementia risk. Objective  To investigate the association of leisure activities and social networks with dementia risk among older individuals. How They Did It
  • It was a longitudinal prospective cohort study 
  • Used population-based data from the ASPREE Longitudinal Study of Older Persons (ALSOP) for March 1, 2010, to November 30, 2020. 
  • Community-dwelling individuals in Australia aged 70 years or older who were generally healthy and without major cognitive impairment at enrollment were recruited study 
  • A total of 19 measures of leisure activities and social networks assessed at baseline were classified using exploratory factor analysis.
  • Dementia was adjudicated by an international expert panel according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. 
  • Cox proportional hazards regression examined dementia risk over 10 years, adjusting for education, socioeconomic status, and a range of health-related factors.
  • This study included 10,318 participants. Their median age was 73.8 years at baseline, more than half (52.6%) were women, and most self-identified as White
What They Found
  • In adjusted analyses, more frequent engagement in adult literacy activities (eg, writing letters or journaling, using a computer, and taking education classes) and in active mental activities (eg, playing games, cards, or chess and doing crosswords or puzzles) was associated with an 11.0% and a 9.0% lower risk of dementia, respectively. 
  • To a lesser extent, engagement in creative artistic activities (craftwork, woodwork, or metalwork and painting or drawing) and in passive mental activities (reading books, newspapers, or magazines; watching television; and listening to music or the radio) was also associated with reduced dementia risk. 
  • In contrast, interpersonal networks, social activities, and external outings were not associated with dementia risk in this sample.
Wrap It Up These results suggest that engagement in adult literacy, creative art, and active and passive mental activities may help reduce dementia risk in late life.  In addition, these findings may guide policies for geriatric care and interventions targeting dementia prevention for older adults. So, it appears that working the brain keeps the brain working. Basically.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     

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

Chiropractic evidence-based products

Integrating Chiropractors

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

Over Manipulation Syndrome

CF 305: Over Manipulation Syndrome

Today we’re going to talk about Over Manipulation 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 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 #305 Now if you missed last week’s episode , we talked about  Interesting Thoughts On Low Back & Degenerative Cervical Myelopathy. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I skipped last week because I was at the MCM Mastermind. Dr. Kevin Chritstie’s group that I’m a part of. We met in Orlando. What a great trip. The kids went with us and I did the Mastermind meeting and then had a day and a half to hit Disney and hit it we did.  We killed ourselves trying to see everything. While that’s impossible, we did see a lot and had a great time. The Harry Potter stuff at Universal is legit folks. Crazy. The Star Wars stuff at Hollywood Studios is incredible. And the Avatar stuff at Animal Kingdom is cool as hell. I’m just saying.  I’ll add that we went about 10 years ago and I hated it. I hated all of it. This time, for whatever reason, was better. I didn’t absolutely hate it. I actually enjoyed most of it. Maybe because the kids are older and don’t have to be watched. Maybe I just knew more about what to expect. I’m not sure. But it was a good time had.  On the Mastermind…..I got some good tidbits and nuggets out of it and had a great time reconnecting with my tribe. These are my people and I can’t tell you how much we enjoy each other. We learn as much from each other at the bar or eating together than we learn from our speakers.  Our Mastermind is full but Dr. Christie started another Mastermind that has openings. If you are at all interested, I cna’t encouurage you enough to email Dr. Christie at drkchristie@gmail.com and see if you can sneak into his new group. Next year they’ll be meeting in San Diego, Denver, Phoenix, and Jackson Hole, Wyoming. All great places to hang out, learn, and network.  Alright, Happy Thanksgiving. Let’s hop into the research.  Item #1 This isn’t really a research paper we’re going to cover here. This is more a conglomeration to demonstrate something I’ve gotten a lot of push back on in private conversations with other chiropractors over the years. Let me start by saying that I Donn’t want to take money out of Chiros’ pockets. The evidence based folks should be mostly fine with what I’m going to talk about today because they’re not doing crazy stuff.  The more non-evidence based folks aren’t going to like this discussion at all. All I can say is that when someone making the right decision affects their financial status, well, you just never know what you’re going to get.  First thing….I’m not about to advocate not adjusting your patients. The adjustment is the cornerstone of my practice for more than 25 years. What we’re going to talk about, over manipulation syndrome or spinal instability, was never for any reason in any shape, form, or fashion on my radar screen before getting the Neuromusculoskeletal medicine diplomate and diving into ChiroUp.  Let’s start with a personal story. I went to the chiropractor first when I was hurt as a freshman in high school. I was hurt badly and nobody else helped me. After months of pain, my mom took me to the local chiro and in two weeks you’d never know I was hurt.  That’s why I ended up becoming a chiropractor in the first place. While that experience was life changing, it also led to my buddy and I being all cool and popping our own necks all of the time. It was hard to do at first. I really had to use both hands and really crank on it to get that pop noise we all covet so much.  But then, after some time of constantly self-adjusting my neck, it got easier. And easier, and easier. To the point that I could just turn my neck and it would pop incidentally for no reason at all. And if I didn’t pop it, it would get irritated and feel like it needed to pop all of the time.  I had created instability by self-adjusting all of the time.  Our spine wants to be stiff and solid without that extra movement. But I had created extra movement consistently enough that I had loosened all of those tiny muscles and connective tissues. As a compensation, because our spine wants stiffness and stability, the larger postural muscles stiffened up to try to make up for all of those tiny ones that went lax and lazy.  So, that sets up a neck that is stiff but hypermobile. You can share this with all of your self-adjustors if you like.  Anyway, that brings up two thoughts:
  1. When you have an older person, discs degenerate, connective tissue gets loosened through manual labor, people have had injuries, or something issues like Elhers Danlos have started to aggravate…..hypermobility starts to take hold
  2. When you have patients that have been going to chiropractors repeatedly over the years, you can create hypermobility where there was none. Like my time self-adjusting. I’m not talking about responsible and appropriate adjusting like you do with a limited, condition focused treatment plan. I’m talking about, “I need to see you once a week for the rest of your life to treat your immune system and help you avoid cancer.” Or, I need to see you 76 times and 10 sets of x-rays this year to make sure you have the right, perfect degree curvature in your neck. As common sense would dictate, this is probably going to be more common with more aggressive adjusters. 
I’ll tell you that I’m out on the cliff a bit on this topic if I’m being honest. When you go searching, you’ll find Over Manipulation Syndrome. But, it’s not a huge topic with 100’s of articles.  One of them is at hur911injurycenters.com, probably not a chiro friendly page if I’m just guessing. They say, “Over-manipulation syndrome can be caused through self-manipulation as well as through high-velocity adjustments from a chiropractor. If you or a chiropractor have over-manipulated a joint through high-velocity treatments, you might experience damage to the ligament structures. This damage can lead to joint instability and worsening of hypermobility.” One I found is by Dr. Mark Saracino, a Board Certified Chiropractic Neurologist from Pennsylvania. I will put the link to his thoughts in the show notes for you.  Dr. Saracino starts out with a funny/not so funny joke, ““How many Chiropractors does it take to change a light bulb?” Answer: “Just one, but it takes 56 visits!”  https://drsaracino.com/PDFs/INFO/TooManyChiropracticVisits.pdf He says, “To my knowledge, no studies have shown that manipulations, once a month or more, are harmful. Just as dependencies on unnecessary drugs and surgeries should be avoided, patients should not become dependent on frequent manipulations- no more than 6 per year to the same spinal bone. Spinal manipulation is an important, but small part of a chiropractic neurologist’s treatment capabilities. It should be employed as infrequently as possible.” I want to go on record here and disagree with him on that point. If he thinks that 6 adjustments with exercises are going to get some of the veterans I see from the VA out of pain after suffering for 40 years…..well, trust me…..6 adjustments Ain’t gettin it done. He’s got a bias. He’s being a proponent of all of the magic outside of an adjustment that a chiropractic neurologist can perform. So I just disagree on that one point.  But I do agree with the point of avoiding unnecessary consistent and frequent adjustments.  To further clarify, there are some suffering from high impact chronic pain, which is chronic pain with an associated disability. They will never be free of pain and seem to only do well seeing a chiropractor every other week or so on a pain management basis. Then, there is a group called Caring Medical in Florida. They also have a bias. They specialize in prolotherapy to tighten lax ligaments. So, it makes sense they’re going to highlight Over Manipulation Syndrome. That doesn’t make them wrong. But I’m being honest as I can be on this. They have a bias and it should be noted.  I’ll put the link in the show notes as well.  https://www.caringmedical.com/prolotherapy-news/manipulation-syndrome-oms/#:~:text=Over-manipulation syndrome is a,or manipulation by a practitioner. Ross Hauser, MD says from the top of the article, “Over-manipulation syndrome is a condition characterized by chronic pain of the joints or vertebrae from instability due to ligament laxity that is caused by excessive self-manipulation or manipulation by a practitioner.”  To keep from pissing everyone off, he says, “In our opinion, a good chiropractic or osteopathic physician is an invaluable asset to a person’s health and care. Many cases of chronic pain, headaches and health ailments can be resolved with manipulation. Yes, overly aggressive spinal manipulation can be the cause of spinal instability, but when done correctly it can cause immediate (or quick) relief of symptoms.” And more to the point I’m making, “We see a large number of hypermobility cases where the patients present with a history of excessive chiropractic manipulations. A short course of manipulation to relieve pain or tension is understandable. However, patients who sign up for long-term chiropractic packages that include thrusting manipulations often find themselves even more unstable after the treatment course. Good chiropractors treat each patient individually and conservatively.” I agree. Reminder – I’m not advocating not adjusting your patients. The adjustment is the cornerstone of my practice for more than 25 years. I’m not advocating only adjusting your patients 6 times per year.  What I am advocating AGAINST….is long, extended, ongoing, maybe never ending treatment protocols to try to treat pain. When what you may be actually doing is causing a greater problem called instability and hypermobility by over manipulating and loosening the structures that hold the spine tight.  How much is too much? Who the hell knows? Certainly not me. Everyone is different, different ages, different work loads, different injuries throughout the years, different chiropractors over the years, etc.  But if all you’re doing is identifying ‘subluxations’ and knocking down the high spots without also considering instability or hypermobility, then you’re at risk of doing your patients and injustice and potentially making them actually worse.  If they already have hypermobility, what good are more adjustments and mobility really going to do for that particular area of their spine? Not much in my opinion. Why not think outside of the box a little and try stabilizing and strengthening the spot instead of mobilizing it? For neck instability, try a contraption called The Iron Neck. It’s great at strengthening the neck in a 360 degree way. It’s outstanding and I’m not sure there is a better strategy out there for neck stability.  For low back instability, we use McGill’s Big Three and add Dead Bug which is also ChiroUp’s protocol for L-sp instability.  If you don’t know how to look for and test for spinal instability, one of the clues for the low back is that it hurts to roll over in bed. Also, sometimes these people bend over to grab something and get a ‘catch’ or a ‘locked up’ back when trying to stand up from that position. They kind of have to work out of it to finally stand up.  With the low back, you can have a patient prone on their stomach. If it hurts when you palpate the l-sp facets, have them do a ‘superman’ position with their legs straight and lifted backward off of the table. If you palpate again while they’re in that position and it feel better, then you are likely looking at a instability patient. When you stabilize that region and palpate it and it feels better, the back is telling you it has too much mobilization and needs stabilization instead.  Simple sudden movements can hurt as well. The Space Mountain ride fired up the instability in my neck last week. It jerked me around on the roller coaster when it was dark and I couldn’t brace or see what was in front of me.  So there you have it. I’ve had some of the smartest chiros in the evidence-based realm tell me I’m crazy. That chiropractors absolutely cannot create spinal instability. I know that for so many, it’s a completely new thought process but I ask that you seriously give it consideration.  How is it that self-adjustors, like I once was, can create instability from adjusting too much but a chiropractor somehow cannot? I’ll also share that I have no bias on this deal. In fact, advocating against constant, frequent, adjusting does me no good whatsoever considering the adjustment is the literal cornerstone of my clinic. I have zero bias. I just follow research, I read, I observe, I talk to others, and I have personal experience and I’m telling you flat out – some patients will do better with strengthening and stabilization because they’re already got too much mobilization and the wrong chiropractor can potentially be the cause of that hypermobilization.  Convince me I’m wrong at dr.williams@chiropracticforward.com. I’d love to hear your thoughts on this topic. I think it’s important.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as  it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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

Chiropractic evidence-based products

Integrating Chiropractors

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

Interesting Thoughts On Low Back & Degenerative Cervical Myelopathy

CF 304: Interesting Thoughts On Low Back & Degenerative Cervical Myelopathy Today we’re going to talk about Interesting Thoughts On Low Back & Degenerative Cervical Myelopathy But first, here’s that sweet sweet bumper music    

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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 #304 Now if you missed last week’s episode , we talked about Hip Pain And Corticosteroids & Chronic Pain After Spinal Surgery. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. We’re going to go quickly today. I have only a three day week this week because the fam and I are headed to Orlando this week for my Mastermind meeting If you do not recall, I’m in Dr Kevin Christie’s group and there are about 25 of us. We meet once per quarter and this will be our last one of the year. It’s always good to get around people that are doing big things. I’d say I’m probably somewhere in the middle of the group. Some are doing bigger things that I am and some are not. Some are right where Imm at but in a different way.  The point is I can learn from each of them and they can learn from me. That’s the essence of a mastermind group I suppose. Dr Christie has started a second Mastermind group now and this one is more for those in the western parts of the USA. I highly recommend listening to him on his Modern Chiropractic Mastery podcast and connecting with him either through email or through his Facebook group if the same name Masterminds are valuable. I don’t take trips once per quarter taking time out if my clinic for small silly stuff. This is big and you should be a part of it if you can be.  Next, poaching employees from other chiropractors in your area. General business tip: I’ve had a local chiropractor go after and poach two of my providers (acupuncture & massage) in less than two months. The tip is, don’t be a douchebag. Hire and train your own damn people, folks. I had invested years into each of these two people and helped them build their clientele and they were VERY well treated and paid.  Which I feel is mostly on them. That doesn’t mean I don’t need to look into our own setup to try to understand how they could do what they did. However, not just one, but two in less than two months……that’s dirty and has me hoppin’ mad. We came out on top big time on the acupuncturist. Without a doubt. The same will happen with the LMT. He just doesn’t know it yet. I’m happy he got the acupuncturist. It solved a big problem for me. Our new one is better and easier to do business with. I’m actually OK with him getting that particular LMT. I still have two others.  All parties involved over there are going to learn some lessons from each other. It’s not really about the individuals. It’s about the principle. I’ve never gone after my colleagues’ staff and never would. In fact, I’ve had MULTIPLE opportunities to poach others’ staff and told them I could not hire them because of my relationship with their boss. So, if you like making enemies out of your colleagues, going after their staff is a perfect way to do it. Item #1 OK, this first one this week is called “The mediating effect of social functioning on the relationship between catastrophizing and pain among patients with chronic low back pain” by Papianou et. Al. and published in Pain Medicine in November 2023. Schiza!! It’s muy caliente, my friends. Three languages in six words. Pow.  Citation is in the show notes, folks Lauren N Papianou, Jenna M Wilson, Robert R Edwards, Christine B Sieberg, Samantha M Meints, The mediating effect of social functioning on the relationship between catastrophizing and pain among patients with chronic low back pain, Pain Medicine, Volume 24, Issue 11, November 2023, Pages 1244–1250, https://doi.org/10.1093/pm/pnad093 Why They Did It
  • Pain catastrophizing can be characterized as an interpersonal form of coping used to elicit support or empathy from others. Despite intentions of increasing support, catastrophizing can impair social functioning. 
  • While considerable work has addressed the relationship between catastrophizing and pain, limited empirical work has examined this relationship within a social context. 
  • First, we examined the role of catastrophizing as a potential contributor to group differences (chronic low back pain [cLBP] vs pain-free controls) in social functioning. 
  • Then they conducted a follow-up, exploratory analysis to examine the relationships between catastrophizing, social functioning, and pain within the subgroup of participants with cLBP.
What They Found
  • Participants with cLBP reported higher levels of pain, impaired social functioning, and higher catastrophizing compared to pain-free controls. 
  • Catastrophizing partially mediated the group difference in impaired social functioning. 
  • Additionally, social functioning mediated the association between higher catastrophizing and greater pain within the subgroup of cLBP participants.
Wrap It Up
  • We showed that impaired social functioning was driving the relationship between higher pain catastrophizing and worse pain among participants with cLBP. 
  • Interventions, such as cognitive behavioral therapy, should address catastrophizing in individuals with cLBP, while simultaneously improving social functioning.
Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.  When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Our last one this week is called, “The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy – A Systematic review and Meta-analysis” by Jiang et. Al. and published in Global Spine Journal in 2023 and that’s hot enough to be some hot stuff.  Jiang Z, Davies B, Zipser C, et al. The value of Clinical signs in the diagnosis of Degenerative Cervical Myelopathy – A Systematic review and Meta-analysis. Global Spine Journal. 2023;0(0). doi:10.1177/21925682231209869 Why They Did It
  • Delayed diagnosis of degenerative cervical myelopathy (DCM) is likely due to a combination of its subtle symptoms, incomplete neurological assessments by clinicians and a lack of public and professional awareness. Diagnostic criteria for degenerative cervical myelopathy will likely facilitate earlier referral for definitive management.
  • They wanted to determine (i) the diagnostic accuracy of various clinical signs and (ii) the association between clinical signs and disease severity in degenerative cervical myelopathy?
How They Did It
  • A search was performed to identify studies on adult patients that evaluated the diagnostic accuracy of a clinical sign used for diagnosing degenerative cervical myelopathy. 
  • Studies were also included if they assessed the association between the presence of a clinical sign and disease severity. 
  • The QUADAS-2 tool was used to evaluate the risk of bias of individual studies.
What They Found
  • This review identified eleven studies that used a control group to evaluate the diagnostic accuracy of various signs. 
  • An additional 61 articles reported on the frequency of clinical signs in a cohort of degenerative cervical myelopathy patients. 
  • The most sensitive clinical tests for diagnosing DCM were the Tromner and hyperreflexia, whereas the most specific tests were the Babinski, Tromner, clonus and inverted supinator sign. 
  • Five studies evaluated the association between the presence of various clinical signs and disease severity. 
  • There was no definite association between Hoffmann sign, Babinski sign or hyperreflexia and disease severity.
Wrap It Up The presence of clinical signs suggesting spinal cord compression should encourage health care professionals to pursue further investigation, such as neuroimaging to either confirm or refute a diagnosis of DCM. I’ll put some links to the tests at this point in the show notes at chiropracticforward.com Remember, it’s episode 304 Tromner Sign https://www.grepmed.com/images/7323/clinical-video-neurology-reflex-sign Inverted Supinator Sign   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.       

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

 

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

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

 

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

 

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

 

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

 

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

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

 

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

 

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

 

On the personal end of things…..

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

 

 

Item #1

 

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

 

 

 

Why They Did It

 

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

 

How They Did It

 

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

 

Analysis was conducted from January to May 2022.

 

 

What They Found

 

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

 

 

Wrap It Up

 

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

 

 

Before getting to the next one,

 

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

 

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

 

 

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

 

 

 

 

Item #2

 

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

 

 

Why They Did It

 

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

 

How They Did It

 

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

 

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

 

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

 

What They Found

 

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

 

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

 

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

 

Wrap It Up

 

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

 

 

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

 

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

 

 

Store

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

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

 

Catastrophizing and Proprioception

CF 280: Catastrophizing and Proprioception

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

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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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 y  our time with us learning together.   Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com   If you haven’t yet I have a few things you should do.

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

 

You have found yourself smack dab in the middle of Episode #280   Now if you missed last week’s episode, we talked about Newer Information On Nonsurgical Spinal Decompression Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

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

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

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

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

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

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

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

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

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

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

Item #1  

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

Why They Did It  

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

How They Did It  

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

  What They Found  

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

 

Wrap It Up  

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

 

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

 

Item #2   Our last one this week is called, “Level of pain catastrophizing determines if patients with long-standing subacromial impingement benefit from more resistance exercise: predefined secondary analyses from a pragmatic randomized controlled trial (the SExSI Trial)” by Mikkel Bek Clausen, Michael Skovdal, Thomas Graven-Nielsen, Thomas Bandholm, Karl Bang Christensen, Kristian Thorborg and published in British Journal Of Sports Medicine on March 10, 2023. Steamy stack of simmering sausage!  

Why They Did It

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

How They Did It

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

 

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

  What They Found  

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

 

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

 

Wrap It Up  

Additional resistance exercise added to usual care was not superior to usual care alone in improving pain mechanisms or pain catastrophizing. Additional exercise was, however, superior in improving self-reported disability in patients with lower levels of pain catastrophizing at baseline. Alright, that’s it. Keep on keepin’ on.

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

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

Store

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

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

The Message

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

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

 

SMT and The Low Back & How Much Exercise Is Actually Needed

CF 278: SMT and The Low Back & How Much Exercise Is Actually Needed

 

Today we’re going to talk about SMT and The Low Back & How Much Exercise Is Actually Needed

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  You have found yourself smack dab in the middle of Episode 278   Now if you missed last week’s episode, we talked about the safety of SMT in the cervical spine and we talked about Chiropractors’ beliefs around the need for x-rays. That one was surprising given the fact that it’s now 2023. Make sure you don’t miss that info. Keep up with the class.  

 

On the personal end of things…..

First thing’s first, yours truly voiced the Elvis character in a video game that just came out on Xbox and Playstation. It’s called God of Rock and the company that released it is called Modus.   If you’re a gamer and you like fighting games, go google up god of rock by Modus and see what you think. The Elvis character is named King and yep, that’s my voice. Even the grunts and groans, the punches and the taking damage. All of it. Crazy. Life. I lead, folks. Just insane but blessed too.   It’s warming up outside for most of us. At least here in the South it is. You Yankees feel free to correct me if you like. I can handle your ridicule.   It got me to thinking, with it getting warmer outside now, how does that affect your marketing efforts? Here’s what I’m thinking; what do we do more of when it warms up/

  • We do more yard work
  • Runners run more
  • Bikers bike more
  • Hikers hike
  • You’ve got Summer baseball, basketball, and whatnot.
  • Some of you will have rowing, waterskiing, and watersports. Note – that wouldn’t be Amarillo, TX just in case you’re wondering.

  The point being that your marketing might shift a bit to make sure you’re talking to the people that are out there putting their bodies under more stress than they have in the last 6 or so months.   So, go do all of the stuff. Build it this Summer  

Item #1   The first on today is called “Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomized controlled trials” by Sidney M Rubinstein, Annemarie de Zoete, Marienke van Middelkoop, Willem J J Assendelft, Michiel R de Boer, Maurits W van Tulder and published in PubMed on March 13 2019.    

Why They Did It  

To assess the benefits and harms of spinal manipulative therapy (SMT) for the treatment of chronic low back pain.    

 

How They Did It  

  • Two reviewers independently selected studies, extracted data, and assessed risk of bias and quality of the evidence.
  • The effect of SMT was compared with recommended therapies, non-recommended therapies, sham (placebo) SMT, and SMT as an adjuvant therapy.
  • Main outcomes were pain and back specific functional status, examined as mean differences and standardized mean differences (SMD), respectively. Outcomes were examined at 1, 6, and 12 months. Quality of evidence was assessed using GRADE. A random effects model was used and statistical heterogeneity explored.

  What They Found  

  • 47 randomised controlled trials including a total of 9211 participants were identified, who were on average middle aged (35-60 years).

 

  • Most trials compared SMT with recommended therapies. Moderate quality evidence suggested that SMT has similar effects to other recommended therapies for short term pain relief (mean difference -3.17, 95% confidence interval -7.85 to 1.51) and a small, clinically better improvement in function (SMD -0.25, 95% confidence interval -0.41 to -0.09).

 

  • High quality evidence suggested that compared with non-recommended therapies SMT results in small, not clinically better effects for short term pain relief (mean difference -7.48, -11.50 to -3.47) and small to moderate clinically better improvement in function (SMD -0.41, -0.67 to -0.15). In general, these results were similar for the intermediate and long term outcomes as were the effects of SMT as an adjuvant therapy.

 

  • Evidence for sham SMT was low to very low quality; therefore these effects should be considered uncertain. Statistical heterogeneity could not be explained.

 

  • About half of the studies examined adverse and serious adverse events, but in most of these it was unclear how and whether these events were registered systematically. Most of the observed adverse events were musculoskeletal related, transient in nature, and of mild to moderate severity.

 

  • One study with a low risk of selection bias and powered to examine risk (n=183) found no increased risk of an adverse event (relative risk 1.24, 95% confidence interval 0.85 to 1.81) or duration of the event (1.13, 0.59 to 2.18) compared with sham SMT. In one study, the Data Safety Monitoring Board judged one serious adverse event to be possibly related to SMT.

 

Wrap It Up  

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

Item #2   Our last one this week is called, “How much exercise is needed to live longer” by Sara Berg, MS and published in American Medical Association on March 16, 2018.  

Why They Did It   To know many minutes of moderate or vigorous physical activity are needed to lower the risk of premature mortality.  

How They Did It   From two large prospective U.S. cohorts, 116,221 adults self-reported leisure-time physical activity—defined as exercise that is not done at work—through a validated questionnaire. The questionnaire was repeated up to 15 times over the course of 30 years.    

What They Found  

  • The study found that those who worked out two to four times beyond the minimum physical activity recommendations had a lower risk of death from cardiovascular disease.

 

  • Those who worked out two to four times above the moderate physical activity recommendations—about 300 to 599 minutes each week—saw the most benefit.

 

  • Participants had a 26% to 31% lower all-cause mortality while 28% to 38% had lower cardiovascular mortality. On top of that, 25% to 27% experienced lower non-cardiovascular mortality.

 

Wrap It Up   Adults who worked out two to four times more than the vigorous physical activity recommendations—about 150 to 299 minutes per week—were found to have 21% to 23% lower all-cause mortality, according to the study. They were also reported to have 27% to 33% lower cardiovascular mortality and 19% lower non-cardiovascular mortality.     Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.  

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

 

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

 

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

 

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

 

Key Point:

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

 

Thats Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

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

 

TuneIn

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About the Author & Host

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

 

Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain

 

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

 

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

 

But first, heres that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

On the personal end of things…..

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

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

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

Item #1  

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

How They Did It  

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

  What They Found  

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

 

Wrap It Up  

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

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

Item #2  

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

Why They Did It  

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

How They Did It  

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

    What They Found  

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

 

Wrap It Up  

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

 

The Message

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

Key Point:

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

Contact

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

Connect

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

Website https://www.chiropracticforward.com  

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

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

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

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

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

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

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

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

Bibliography

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