Over Manipulation Syndrome

November 22, 2023 chiropracticforward 0:29:34 0 Comments

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!

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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:

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
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!

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

Home

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Jeff Williams - evidence-based chiropractor

Interesting Thoughts On Low Back & Degenerative Cervical Myelopathy

November 8, 2023 chiropracticforward 0:16:19 0 Comments

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

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, 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!

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

Home

Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

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

June 8, 2023 chiropracticforward 00:20:35 0 Comments

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, here‘s that sweet sweet bumper music

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

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

We’re the fun kind of research. Not the stuffy, high-brow, 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 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, “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!

The Message

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

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

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

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

Key Point:

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

That‘s Chiropractic!

Contact

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

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

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

Connect

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

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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

Catastrophizing and Proprioception

May 18, 2023 chiropracticforward 00:17:07 0 Comments

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, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, 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 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, “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!

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

Home

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

Tweets by Chiro_Forward

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

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

May 4, 2023 chiropracticforward 00:14:10 0 Comments

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, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, 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 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, “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!

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

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https://player.fm/series/2291021

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

TuneIn

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

About the Author & Host

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

Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain

February 16, 2023 chiropracticforward 00:16:13 1 Comment

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, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, 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 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, “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!

The Message

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

Key Point:

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

Contact

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

Connect

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

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.

5 Year Chiropractic Forward Roundup and All Time Top Ten Episodes

December 22, 2022 chiropracticforward 00:20:15 0 Comments

CF 260: 5 Year Chiropractic Forward Roundup and All Time Top Ten Episodes

Today we’re going to talk about our 5 Year Roundup and we highlight the All Time Top Ten Episodes But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, 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 #260 Now if you missed last week’s episode , we talked about Cervical Curvature & Lumbar MRI Findings In Asymptomatics – New Stuff. Make sure you don’t miss that info. Keep up with the class. 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.

On the personal end of things….. We’re not going to do a lot of personal stuff on this show. I want to first just thank those of you that have been listeners of this show. I probably over share sometimes about what’s going on with me or with my clinic. Because of that, those of you that are long-time listeners know a lot about me. Thanks for putting up with me and coming along on this ride with me. You’ve been with me through key staff changes and huge practice changes. You’ve been with me through adding a nurse practitioner and integrating my entire practice medically. You’ve been with me through the ‘I’m so busy I can’t keep up’ stages to the ‘I can’t figure out why I’m so slow’ stages. That’s one I’m climbing out of right now as we speak. The reason I share so much about what I’m doing or going through is

It’s cathartic. It makes me feel better to talk about it. It’s like a weekly journal and if you’re familiar with journaling, it’s helpful mentally and effective.
I know that if I’m going through it and I figure it out, then somebody else is going through it and my experience will help guide them. If you are not going through it currently, there’s a damn good chance you eventually will go through it and my experience will set you up to be able to handle it better.

So, thank you. I continue to be blessed by all of you. I’m glad you find value in what I share. I hope somewhere along the way, I have helped you to be better than you were before. That’s the daily goal for me as well as for you. We’re in it together.

Now, onto the All Time Top Ten most listened to episodes of the Chiropractic Forward podcast.

There were some surprises for me on this one. As I cover these, I’ll also leave the links to them in the show notes so you can easily go listen should you have interest.

10. Our tenth place episode is episode #114 which was titled

Ten Keys to Practice Success –

This one has been piling up the listens since February 11, 2020. Yep, right before the RONA came to town to wreak havoc. https://www.chiropracticforward.com/ten-keys-to-chiropractic-success/ I covered a wide range of the ten keys to my success and broke them down for you. Evidently, you and your buddies found value in it. And that makes me feel warm and fuzzy inside my belly.

9. Our ninth place goes to episode #189 where we were joined by the one and only Dr. Brett Winchester. One of the smartest and funniest human beings I think I’ve ever met in my life. Humble and amazing, Brett makes you proud to be a chiropractor and through Dr. Kevin Christie’s Florida Mastermind group, has become a friend of mine. One I greatly value. On the episode, Brett talked about Chiropractic Excellence, Inspiration, & Being The Best Evidence-informed Chiropractor You Can Be. It is definitely worth your time.

https://www.chiropracticforward.com/w-dr-brett-winchester-chiropractic-excellence-inspiration-being-the-best-evidence-informed-chiropractor-you-can-be/

8. Our 8th most popular episode goes to episode #139 and was called Chiropractors Affected By COVID, 2019 Opioid Overdoses, Insurance Compensation For Chiropractic. It went live on August 20, 2020 so, still in the pandemic but after a Spring and Summer of the COVID mess and we talked about some research on how it affected us as a profession, we went over fresh at the time opioid overdose info, and then we talked about how insurance companies reimburse us. You probably already know that part. You’re living it! Lol. https://www.chiropracticforward.com/chiropractors-affected-by-covid-2019-opioid-overdoses-insurance-compensation-for-chiropractic/ 7.

Coming in at #7 is episode #113 where we were joined by the current Texas Chiropractic Association President himself, the head hombre, The Illustrious Potentate from Austin, TX, Dr. William Lawson where we covered a paper he played a part in that covered new and updated guidelines on treating cervical pain. https://www.chiropracticforward.com/w-dr-william-larson-brand-new-guidelines-on-neck-pain-treatment/

6. At #6 we have episode #142. In this one, we covered treatment for nonoperative discs, we talked about supplementing Vitamin D3 for depression and what the research says, and we covered the bio psychosocial part of chronic pain. This one is my kind of episode. The bioqsychosocial aspect is something I just find to be fascinating and intriguing. I’m glad you all seemed to find it interesting as well. https://www.chiropracticforward.com/nonoperative-disc-treatment-d3-for-depression-the-biopsychosocial-part-of-chronic-pain/

5. Number 5 this year is episode #136 and it was called ‘Chiropractic’s Effect On Strength and More, Status Of Muscle Relaxers, And The Best Recovery Posture.’ This episode is a pretty standard run of the mill episode. It doesn’t have any of my real estate golden nuggets hidden within….nothing special but everyone likes it so hell yeah. I’ll take it. This one showed how to best recover your breath after exercise, how opioids are still bad, and how active-duty military personnel receiving chiropractic care exhibited improved strength and endurance, as well as reduced LBP intensity and disability, compared with a wait-list control. https://www.chiropracticforward.com/cf-136-chiropractics-effect-on-strength-and-more-status-of-muscle-relaxers-and-the-best-recovery-posture/

4. Still in the top Five since August of 2020, it’s episode #141 called “Lancet Low Back Update & movement Disorders Mean Pain” This one has been one of the top episodes since it was first released and has stayed there. This one covers an update The Lancet released. An update on the huge low back series they came out with originally around 2016/2017 if I recall correctly. We covered the original series here on the podcast toward the very beginning of Chiropractic Forward existence. https://www.chiropracticforward.com/lancet-low-back-update-movement-disorders-mean-pain/

3. Our 3rd most listened to episode is #143 called ‘New Paper: Spinal Manipulation Has No Effect On Chronic Pain – Our Experts Rebuttal’. Basically, some no so flattering research came out trying to prove that spinal manipulative therapy was basically useless. For this episode, I contacted several of our profession’s experts and we gave our own rebuttal to this paper right here on the podcast. The exact conclusion of the paper we talked about said, ““In this randomized clinical trial, neither spinal manipulation nor spinal mobilization appeared to be effective treatments for mild to moderate chronic LBP.” Well, who the hell can say that? Seriously. After all of the papers in support of SMT for chronic low back, someone’s going to pop out with that? Nope. So we talked about it and met it head on. https://www.chiropracticforward.com/new-paper-spinal-manipulation-has-no-effect-on-chronic-pain-our-experts-rebuttal/

2. Hitting number two all time is episode #140 with my buddy, Dr. Chris Howson of the Great State of North Dakota. We talked about Chiropractors In Hospitals & Drop Release. He should know because he is in a hospital-run outpatient clinic and is well-integrated in the medical community. He also invented the Drop Release so of course we talked about that and how he uses it. I use the hell out of mine now too! https://www.chiropracticforward.com/cf-140-w-dr-chris-howson-chiropractors-in-hospitals-drop-release/

Coming in this year at the Number One spot for the most listened to podcast episode in the history of this show is episode #137. In this episode I was joined by Dr. Aric Frisina-Deyo and we talked about Chiropractors In An FQHC Setting & Setting The Bar High Early On. This episode, of course, was excellent and Aric is one of the more impressive individuals you’ll ever meet in our profession. Congratulations to Dr. Frisina-Deyo on being #1.

Alright. That was fun. It’s always cool to go back and re-visit some of these episodes once a year and see what is resonating with our listeners. It’s interesting. Out of the top ten, only four of them included a guest. Also, you’d think the one with did where we were joined by Dr. Stu McGill would be in the top ten somewhere…..but not at all. Dr. McGill came in around #14 all time. We have been fortunate enough to be joined by not only Stu but Dr. William Morgan, Dr. Katie Pohlman, Dr. Christine Goertz, Dr. Tyce Hergert, Dr. Kris Anderson, Dr. Jay Greenstein, Dr. Kevin Christie and the list goes on and on and on. If you are still new to the podcast, I hope you’ll spend some time going back through some of the episodes that peak your interest.

We’ve had a good run so far and, for now, I plan to continue it as long as it’s fun and as long as you listen. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.

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

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

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

The Message

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

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

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

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

Website 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

Gluteal Tendinopathy – You Don’t Know What You Don’t Know

November 9, 2022 chiropracticforward 00:18:14 0 Comments

CF 254: Gluteal Tendinopathy – You Don’t Know What You Don’t Know Today we’re going to talk about Gluteal Tendinopathy – You Don’t Know What You Don’t Know But first, here’s that sweet sweet bumper music

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

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, 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 #254. Now if you missed last week’s episode, we talked about Spinal Cord Stimulators vs. Placebo & we talked about Low Back pain, Chiropractic, And Opioids. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

You may have heard me talk about it a time or two but I’m really impreessed with a contraption that we have in our office. When I bought mine it was only the third purchased in Texas. Texas is a big place, folks! One had been sold to a research lab, one had been sold to a Physical Therapy outfit, and then mine. Definitely we’ve been ahead of the curve. When I have a car crash patient or a chronic pain patient, we can run the BESS test and the mCTSIB tests to test for concussion and proprioception. Not just test proprioception but train it as well. Balance training, rehab training, movement evaluation, and excellent shoulder rehab as well. It’s called the ISO Free by Tecnobody and it’s cool and it makes me different from the rest of my colleagues by giving us capabilities nobody else has. Check out these products and see what you think.

Go to https://www.tecnobody.com/en/products. Once you decide you have to have more information, email me at creekstonecare@gmail.com and I’ll hook you up with the people that can get you a deal on it. This week I’m really starting to look forward to a little trip we’ve been planning for a while. Remember, you should take a solid trip about once per quarter. It’s the only way to preserve your sanity. You have to get out of your office and spend time on your loves or risk losing your mind completely. Our trip this go around is part of Dr. Kevin Christie’s Florida Mastermind. We are all meeting in the Florida Keys. Key Largo to be specific. Which is the first Key south of the mainland.

Kevin picked this resort because my wife and I went there in February 2020. Just one month before the pandemic set in on the world. People were just starting to think seriously about masks and all of that stuff back then. It was a blast and this resort called Playa Largo was the bees knees. Massages every day, drinks poured in cored pineapples on the beach at sunset, ,dining on the beach and being served funny umbrella drinks as you lounge in the hammock reading Stu McGill’s Back Mechanic book was amazing. Check it out.

Just Google up Playa Largo and see what you find. It’ll make you consider Key Largo instead of Key West. So that’s coming up November 11-13 or somewhere around there. We’re taking my daughter with us and I believe all other Mastermind members are bringing wife and kiddos so it should be a really special time of bonding, swapping ideas, and growth. Speaking of growth, you’ve been hearing me fuss about being slow. We’re still slower than I want but it looks to be picking up a bit. Just in time to go to Key largo, right?

I have anxiety about it but I’m going and I’m not letting business worry me or stress me out. I have to compartmentalize that stuff and step away from it. Which I am.

What do you have coming up that you’re looking forward to? I talked about the Tecnobody products earlier. Are you using anything new and cool? I’d love to hear about it and check it out. I love new gadgets that get patients better! Email me at dr.williams@chiropracticforward.com and tell me all about it. Let’s hop into the research

Item #1

Let’s talk about Gluteal Tendinopathy, shall we. My friends at ChiroUp recently put out an awesome rundown of GT through their email list. Check the show notes for the link to their rundown on it at this poin in the show notes. https://chiroup.com/blog/what-is-the-most-common-cause-of-hip-pain After going through the Ortho Diplomate, GT has been on my radar and it’s amazing. Once you know to look for it, you’re going to find it EVERYWHERE!

Literally everywhere.

You just don’t know what you don’t know and I didn’t know before the Ortho Diplomate. First, Why do people get it? They say it’s from excessive tension or compression of the area. Secondly, what does it look like? GT is lateral hip pain and is tendinopathy of the glute medius or minimus. It hurts to walk but very tellingly, it hurts to lay on that side because of the compression but it also hurts to lay on the other side because we always stretch the leg over the other one so there is tension on the area. Pain on going up and down stairs for sure. One of our patients could barely get into and out of their RV and she was unhappy.

Also, there is usually significant pain on palpation of the area. You can get their attention very quickly by poking around on it. Current thinking is away from bursitis and more toward GT. If bursitis is present, it’s probably more a symptom of GT. This thinking is fresh enough that I found myself in a pissing match with an ortho surgeon about whether it’s bursitis or it’s GT.

We’re always going to have less authority than the ortho in this case so, I told the patient what the research shows and said that ultimately, the terminology doesn’t matter because it will be treated the same. That worked out fine. Try to avoid pissing matches on GT because it’s just not widely known about right now. Orthos are injecting corticosteroids into the hip joints of these GT patients and they’re stunned that it has no effectiveness. That’s because the problem isn’t in the joint. It’s in the connection on the posterior aspect of the greater trochanter. How do we test for it and treat it?

Hip Lag Sign
FaberEx
Palpation

What I do in my office is I use the Drop Release, which was invented by my friend, Dr. Chris Howson of the Great State of North Dakota, to beat it up just a little bit. I use regular SMT to make sure things are moving well. Then I recommend they do some cold laser on the insertion to work down some inflammation. We combine that with targeted rehab exercises from ChiroUp. We have also combined my side with trigger point injections from our Nurse Practitioner.

It has been an awesome combination for us here at my clinic and we are helping these people get past GT a lot faster. Recent research is showing, that PRP injections at the site show promise in helping chronic GT recover quickly as well. That’s exciting because we do PRP here at my clinic! I have the luxury of those not responding to the trigger points and my help to also try PRP now. So, let’s cover that paper briefly before wrapping up for this week’s episode. It’s called “The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection” by Fitzpatrick et. al. (Fitzpatrick J 2018) and published in the American Journal of Sports Medicine and was published on January 2, 2018.

Why They Did It

There would be no difference in the modified Harris Hip Score (mHHS) between a single platelet-rich plasma (PRP) injection compared with a corticosteroid injection in the treatment of gluteal tendinopathy.

How They Did It

Randomized controlled trial;
There were 228 consecutive patients referred with gluteal tendinopathy who were screened to enroll 80 participants;
Participants were randomized (1:1) to receive either a blinded glucocorticoid or PRP injection intratendinously under ultrasound guidance.
A pain and functional assessment was performed using the mHHS questionnaire at 0, 2, 6, and 12 weeks and the patient acceptable symptom state (PASS) and minimal clinically important difference (MCID) at 12 weeks.
Participants had a mean age of 60 years, a ratio of female to male of 9:1, and mean duration of symptoms of >14 months.

What They Found

Pain and function showed no difference at 2 weeks or 6 weeks
The mean mHHS was significantly improved at 12 weeks in the PRP group compared with the corticosteroid group

Wrap It Up

Patients with chronic gluteal tendinopathy for greater than 4 months, diagnosed with both clinical and radiological examinations, achieved greater clinical improvement at 12 weeks when treated with a single PRP injection than those treated with a single corticosteroid injection Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

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

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

The Message

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

Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

Website 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 https://traffic.libsyn.com/chiropracticforward/CF_-_Ep._254.mp3

Bibliography Fitzpatrick J, B. M., O’Donnell J, McCrory PR, Zheng MH, (2018). “The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection.” Am J Sports Med 46(4): 9336-9939.

Recognizing Cervical Artery Dissection

September 1, 2022 chiropracticforward 00:16:05 0 Comments

CF 244: Recognizing Cervical Artery Dissection Today we’re going to talk about Recognizing Cervical Artery Dissection But first, here’s that sweet sweet bumper music

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

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

Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent education for you AND your patients. It saves you time in 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 #244 Now if you missed last week’s episode , we talked about Chiropractic Adjustments To Avoid Other Procedures & we talked about Male Vets With Chronic Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Well, I just turned the big 50 people. It hurt a little. I’m not going to lie. I’ve always been one to really value and enjoy being young. I didn’t just go through it without appreciating my abilities and what I could do and accomplish. I loved being an athlete and running and all of that good stuff. They say it’s just a number but that number is engrained in my joints and I feel it. Part of it is a weight thing.

Being 6’ 4” and 275 or so isn’t great for joints of the body so I’m on it. We’ll get that down. I’m determined. So, 50 is blah for me but it’s over and it’s onward ho. I have too many irons in the file to be worrying about birthdays and all of that stuff.

Business is pretty solid for back-to-school. It’s pretty steady. Which is surprising. I’m changing up some marketing in the near future and will share some of my experience on that. I’m a little nervous to dive more into marketing because if I’m honest, I’m at capacity as it is. I saw 27 new patients last week. Just me. We had a total of about 180 visits and that’s just about as much as I can do. But with the type of marketing, we’re going to be trying, we’ll be more likely to only get the patients in here that we want to work with that are already fully committed and motivated. We shall see. But for now, let’s get on with the research. We have some fun ones this week.

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

Item #1

This first and only one this week is getting some attention due to a recent artery dissection suffered by a woman in Georgia. Unfortunate for sure. I don’t know the particulars so we won’t go into that specifically but, when things like this happen, we start seeing more and more about the chiropractors cause stroke thing. Typically, this isn’t true and there is a lot of research backing that up. I want to cover an article today that just came out called, “How to Recognize A Cervical Artery Dissection’ by James Demetrious, DC, DABCO (DABCO 2022) and published in PostGrad DC on July 18, 2022. Kaplowy!

That’s hot!

Since this is an article, we’ll dispense with the traditional format and hit the high notes. The arrticle highlights an excellent paper that came out not long ago that we covered here on the podcast. It’s by Chaibi et al (Chaibi A 2018) and was in the Annals of Medicine in 2019. In their paper, they cited high-quality research that affirms

Manual therapy doesn’t no result in an increased risk of CAD
There is no strong evidence that manual therapy provokes CAD.

Chaibi and Russell cite high-quality research to support these conclusions:

The rarity of CAD also makes the provision of epidemiological evidence challenging.
However, several extensive cohort studies and meta-analyses have found no excess risk of CAD resulting in secondary ischaemic stroke for chiropractic SMT compared to primary care. [2, 3, 4]
Similarly, retrospective cohort studies have reported no association with traumatic injury to the head or neck after SMT for neuromusculoskeletal pain.
Studies have disproven any misconception about whether SMT strains exceed failure strains.
No changes in blood flow or velocity in the VA of healthy young male adults were found in various head positions and during a cervical SMT.
Thus, these studies support the evidence of spontaneous causality or minimally suggest very low risk for serious AEs following SMT.

For my office, I try my best to minimize the risk to as close to zero as possible. If there is a young person in the office with unilateral neck pain for no reason, especially combined with a severe headache, they’re getting the inquisition, folks. I’m a research nerd and through my years of doing this podcast, I have compiled 19 questions that I feel can give us the best possible screen for CAD. Feel free to use them for yourself. They are as follows:

Is there any difference in upper arm strength from side to side?
Is there pain or numbness in one side of the face?
Can the patient raise both eyebrows equally?
Is there any difference in the size of the pupils?
Does the patient have an even smile?
Is the tongue straight when you have the patient stick it out?
Do they have a mostly even grip bilaterally?
Can they perform a resisted shoulder shrug evenly bilaterally?
Do you have a head pain or headache that developed suddenly and can be sharp or throbbing?
Do you have a headache that is worse when laying down?
Do you have difficulty speaking or swallowing?
Do you have any visual abnormalities?
Do you have unsteadiness or lack of coordination beyond what you consider normal?
Are you having any recent onset hiccups?
Are you having any hearing loss or pulsing tinnitus?
Are you having any nausea or vomiting?
Signs of nystagmus?
Any other neurological symptoms?
Do they have any light-headedness or fainting, disorientation, unexplained anxiety, disturbances in the ears, tremors, or sweating?

Now, if after all of those questions, you have accurately documented this complaint and should have a good direction forward. Most of the time, after the screen, I’m comfortable moving on. I’ve done my due diligence. However, I’m sure I’ve lost some patients over the years because if some of these are answered yes with no clear explanation for them, they’re getting an MR-A or a CT-A or I’m not working on them. Plain and simple. I tell them my first job is to do no harm. My second job is to make them better. Most appreciate it and are happy to do the imaging.

So, there you go. If you’d like more information on why chiropractors are almost never solely responsible for CAD, I put together a very comprehensive and, I think, entertaining rundown of the information and I did it in various forms so that you could get the info however you like. I put it in a blog on my website at chiropracticforward.com. The blog is called Debunked; The Odd Myth That Chiropractors Cause Strokes. The link can be found in the show notes right here at this point in the episode. https://www.chiropracticforward.com/blog-post/debunked-the-odd-myth-that-chiropractors-cause-strokes-revisited/

I also have it in video form on YouTube with the same title And just to be sure you could get the information in your preferred format, I made podcast episodes covering the same information in depth. The episodes of this podcast are Episodes 13, 14, and 15

I invite you to dive in a bit so you can be on top of it all.

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

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

Chaibi A, R. M. (2018). “A risk-benefit assessment strategy to exclude cervical artery dissection in spinal manual-therapy: A comprehensive review.” Annals of Medicine.
DABCO, J. D. D. (2022). “How to Recognize a Cervical Artery Dissection?” PostGradDC.

You Are What You Eat & Screen Time For Kids

July 7, 2022 chiropracticforward 0:17:16 0 Comments

CF 236: You Are What You Eat & Screen Time For Kids Today we’re going to talk about what you eat and mental health and we’ll talk about screen time for kids. But first, here’s that sweet sweet bumper music

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

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

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

You have found yourself smack dab in the middle of Episode #236 Now if you missed last week’s episode , we talked about about the inflammatory response’s protection from chronic pain, which is fascinating.. and we talked about where patients should be starting their journey for low back pain. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. Struggles and challenges in my personal space. See if you recognize any of my struggles in your life and clinic. Some are so busy they can’t see straight. I have to say that the last few weeks have been a bit slow for me compared to where I normally am, numberswise. I typically will see 180+ appointments per week, 23 or so NP per week included in that number, and around 650 or so total appointments per month by myself. Lately, it’s more like 145 or so per week. In my mind, it’s the economy. It’s gas prices. It’s uncertainty. I keep good stats and this is just not normal for me. I didn’t make anyone in town mad. I didn’t go out and kick the mayor’s dog or anything. My name and reputation hasn’t changed. We’re good. So why the slow down? COVID isn’t really around to take the blame this time. And, in the past, any time there’s been a slow down, it’s either back to school in August or it’s the holidays. So, outside of those factors what else is working people’s brains these days? Uncertainty. The inability to afford extras because of the price of food and gas and real estate and vehicles and everything else y ou can think of. I cannot wait until the post-COVID wreck finally settles and life starts to click normally once again. No more excuses about inflation, gas, supply chains, price gouging, or anything else. Just normal life. I can’t wait. In the meantime, I’m still looking for an associate. I’m a go getter. I’m a do-er. If you are too and you need a great place to work, be mentored, and maybe even buy out one of these days, email me at creekstonecare@gmail.com, I want to start a conversation with you. Before we get ot the research, I’ve been telling you about a system that once obtained will help you get more PI cases. This system was created by an attorney who exclusively handles accident cases. He got tired of lame approaches by doctors wanting his referrals, so he created this system to teach you how to get the attention and then the love of PI attorneys. You know these cases are the GOLD of our business. Very few no-shows, full payment … not health insurance caps or Medicare or Medicaid. Go to: http://www.gettingpicases.com/cs Over 500 doctors nationwide are now using this system…. don’t be left out… improve your practice, gain free time because of the added income you’ll realize, and appreciate that the attorney, Paul Samakow, is still offering a 100% Money Back Guarantee … if you give his ideas a fair shake and it doesn’t work, he’ll refund your money… you have nothing to lose here… Go to: http://www.gettingpicases.com/cs Item #1 This first one is an article that covers a paper. The article is called “Your mental health may depend on what’s in your diet” by the staff (Staff 2021) at Study Finds. It was published in September of 2021 and that’s just steamy enough! It’s an article so here is the summary of the info within:

“There is increasing evidence that diet plays a major role in improving mental health, but everyone is talking about a healthy diet,” says Lina Begdache, an assistant professor of health and wellness studies and co-author of the study
There is not one healthy diet that will work for everyone. There is not one fix
Results indicated that eating breakfast daily, getting moderate exercise frequently, and keeping fast food and caffeine consumption down improved the mental health of young women. In mature women, the same applied with the addition of high consumption of fruits daily.
In young men, daily exercise coupled with dairy and meat consumption increased mental health, along with a low intake of fast food and caffeine. The same applied to mature men with an additional intake of nuts daily.
“I have found it in my multiple studies so far, that men are less likely to be affected by diet than women are. As long as they eat a slightly healthy diet they will have good mental well-being. It’s only when they consume mostly fast food that we start seeing mental distress,”
“Women, on the other hand, really need to be consuming a whole spectrum of healthy food and doing exercise in order to have positive mental well-being. These two things are important for mental well-being in women across age groups.”

Interesting stuff there. Food for thought…..pun intended. See what I did there? And….you’re welcome Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later. Item #2 The last one today is called “Association Between Screen Time Trajectory and Early Childhood Development in Children in China” by Zhao et. al. (Zhao J 2022) and published in JAMA Pediatrics on June 6, 2022. Aye yaye….muy caliente! Why They Did It Screen time has become an integral part of children’s daily lives. Nevertheless, the developmental consequences of screen exposure in young children remain unclear. The authors wanted to investigate the screen time trajectory from 6 months to 72 months of age and its association with children’s development at age 72 months in a prospective birth cohort. That’s 6 years old for those that don’t like brain math. Basically – Is early screen exposure associated with children’s cognitive, language, and social-emotional development? How They Did It

Women in Shanghai were recruited for this cohort study.
Their children were followed up at 6, 9, 12, 18, 24, 36, 48, and 72 months of age.
Children’s screen time was classified into 3 groups at age 6 months:
continued low (ie, stable amount of screen time),
late increasing (ie, sharp increase in screen time at age 36 months), and
early increasing (ie, large amount of screen time in early stages that remained stable after age 36 months).
Cognitive development was assessed by specially trained research staff in a research clinic.
Of 262 eligible mother-offspring pairs, 152 dyads had complete data regarding all variables of interest and were included in the analyses.
Data were analyzed from September 2019 to November 2021.

Wrap It Up The findings of this study suggest that both the duration and the onset of screen exposure matters in terms of children’s cognitive and social-emotional development. It found that excessive screen time in early years was associated with poor cognitive and social-emotional development. This finding may be helpful in encouraging awareness among parents of the importance of onset and duration of children’s screen time. Parents…..listen up. I wished I had this information when I was a young parent. I think some of the stuff we did would be 180 degrees different. No doubt in my mind. And for those of you that don’t understand on Facebook how research like this is chiropractic, you don’t get it and probalby never will. We are a profession. Not a spinal manipulative therapy modality. We are a profession and kids mental health and development is as much a part of the health and well being of our patients as is low back pain. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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

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

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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – 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 Staff (2021). “Your mental health may depend on what’s in your diet.” StudyFinds. Zhao J, Y. Z., Sun X, (2022). “Association Between Screen Time Trajectory and Early Childhood Development in Children in China.” JAMA Pediatr.

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