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American Academy of Family Physicians Warming To Chiropractic For Chronic Pain & Evidence Behind Supplements

CF 111: American Academy of Family Physicians Warming To Chiropractic For Chronic Pain & Evidence Behind Supplements

Today we’re going to talk about how the American Family Physicians may be warming up to chiropractic for chronic pain and what supplements actually have some evidence behind them.

But first, here’s that sweet sweet bumper music


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

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

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

  • Like our facebook page, 
  • Join our private facebook group and interact, and then 
  • go review our podcast on iTunes and other podcast platforms. 
  • We also have an evidence-based brochure and poster store at chiropracticforward.com
  • While you’re there, join our weekly email newsletter. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #111

Now if you missed last week’s episode , we talked about Dry Needling vs. Massage and even more importantly, we talked about the topic of “What is your exit number?”. What are you looking to get out of it all in the end? I feel like there were points made in there that could really get you to contemplating and thinking going forward. So, make sure you don’t miss that info. Keep up with the class. 

That reminds me, did you know that you can use our website as quite a resource? I do it all of the time. If you think I can keep every one of these papers in my noggin and pull them out of my brain files on demand, that’s a big nope. But I can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever I want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

On the personal end of things…..

Rinse and repeat man, rinse and repeat. If you’re friends with me on Facebook, then you know life has been crazy and there’s no slow down in site. 

Some really positive stuff happening though too. For example, I was interviewed for two different articles in Chiropractic Economics recently. They published an article called “Chiropractic for prevention: the latest research on maintenance care” by Michele Wojciechowski. Michele used my comments exclusively in this article and that’s just a big honor. 

I remember when I was new in practice. I remember reading articles in Dynamic Chiropractic and Chiropractic Economics and thinking that would be cool to be in that one of these days. Now…..now…I’ve been fortunate enough to be in Reader’s Digest, on the ACA Blog a couple of times, and now Chiropractic Economics. It’s pretty damn exciting and it’s an honor. 

Thank you Michele for finding value in my comments and sharing them with everyone else. I’ll leave a link to that article at this point in the show notes if you’re interested in giving it a read through. 

Other than that, my family and I took a quick ski-cation to Red River, New Mexico. If you haven’t been, look it up. Here’s why we like Red River, First thing, it’s close. For a Texan to be able to just drive about 4 hours and be in the mountains, that’s pretty exciting. 

Next thing, it’s just gorgeous. And, the ski slope comes right down into the town so you don’t have to drive out to a mountain which is nice. 

Let’s talk about why I retired from skiing myself though shall we? This may make you think a bit about some of the stuff you do in your offtime. Maybe it won’t but it’s important to think about things which is the whole point of me bringing it up.

I used to ski a lot back in high school and junior high. I was pretty decent at it too. Then I went off to play football and be a college kid. Well, Louisiana for a bit and Dallas for a bit…..those areas aren’t very conducive to learning to snow ski. It’s too damn far. Especially when you’re still a kid and broke as hell. Skiing just doesn’t happen at that point in life unless you have parents taking you. I didn’t.

So then you start life and you’re building a business and there’s never time to go then either. 

Well by the time I got back around to going skiing again, I hadn’t done it in about 20 years give or take. So, i got a private coach for a morning just to get me back on that bicycle and rocking and rolling again. I have to tell you, it was hard as hell!! It was NOT like riding a bike. Nothing at all like it as a matter of fact!!

But, I took it slow, I didn’t fall at all, and was fairly happy with my progress over the weekend. HOWEVER, I got to thinking when I got home. I went back to work and had about 45 patients that next day. What if I had twisted a knee, broken and elbow, or dislocated a shoulder while I was skiing? What would I have done?

You know this sounds stupid when you say it but, “They call them accidents because you don’t plan them.” But you can avoid them sometimes. I got to thinking long and hard enough about the risk vs. rewards for continuing to ski and……honestly, on paper, it wasn’t worth the risk. 

So, I retired. Maybe if I had an associate. Maybe I could make more sense of it but, the truth is, I don’t have an associate. It’s just me although I’m thinking of hiring one just as soon as it makes sense. Anyway. I took the kids skiing while the wifey and myself enjoyed the mountains, some brewskis, and some playoff football games. 

What are you involved in as far as physical activity outside of your practice that puts you at risk and puts your ability to earn a living at risk? Do you have disability insurance? Life insurance? Long term care insurance? I have all of that. Do you need it?

Start thinking about these things. Certainly, the more successful you get and the busier your practice gets. Risking an injury just might not be worth it at some point. 

Before we dive into the reason we’re here, it’s good to support the people that support evidence-informed practitioners. Well, ChiroUp certainly does just that. 

If you don’t take advantage of the deal I’m about to offer you, I think you just might be crazy.

Regular listeners know I’ve used ChiroUp for well over a year now. I’m going to tell you want it is and then share a way to do a FREE TRIAL and, if you sign up, only pay $99/month for the first six months. So listen up!

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, activities of daily living, & for their exercises. 

This saves you so much time – no more explaining & re-explaining your patient’s care because they have access to it right there at their fingertips. 

You can be confident that your patients are getting the best possible care because the reports and exercises are populated based on what the literature recommends and isn’t that reassuring? All of that work has been done FOR you by people that are deep into the research. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice.

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL and, to sweeten the deal, you can use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super saver code is Williams99.

Item #1

Let’s start with this one from American Family Physician. I got this one from one of my amazing colleagues, Dr. Craig Benton down in Lampasas, TX. It’s called “Nonpharmacologic therapies can improve chronic pain outcomes” authored by Michael Devitt and was published in American Academy of Family Physicians on January 15, 2020(Devitt M 2020). Damn it’s hot…..

Not a research paper but more of an article in their publication but has plenty to do with chiropractic. 

They set the stage here by pointing out that chronic pain is something that can cause people to go to extreme measures just to get the pain to go away. Or at least lighten up. They say this includes potentially harmful behaviors like drug and alcohol misuse and/or abuse. 

Then this article in the American Family Physicians journal starts to highlight and promote the nonpharmacologic treatment modalities that are available to family physicians. Honestly, did you think you’d ever see the day? Ever? The battle isn’t over by any stretch of the imagination but research is gradually, inch by inch, turning the tide. 

They say these modalities include simple methods like massage and heat as well as more complex therapy like acupuncture and chiropractic manipulation. They called us ‘complex’ and I’m taking that as a compliment. Lol. What we do can damn sure be complex. 

They say that these nonpharma strategies aren’t only effective for decreasing pain and improving function, but can also be effective for reducing longer-term adverse effects such as substance use disorders and suicide attempts. THAT’S A BIG DAMN DEAL. 

In fact, I got one word, two syllables….day-um. 

One researcher, the lead author from an active-duty US Army service study said “Chronic pain is associated with adverse outcomes such as substance use and suicidal thoughts and behavior,” said Esther Meerwijk, Ph.D., M.S.N., a statistician at the VA Palo Alto Health Care System in California. She added, “It made sense that if nondrug treatments are good at managing pain, their effect would go beyond only pain relief. However, I was surprised that the results of our analyses held, despite our attempts to prove them wrong.”

Despite our attempts to prove them wrong! Haven’t they been trying to prove us wrong for generations now? Lol. I always say that with all of the powers against us, if we were wrong, if we were ineffective, we would have been wiped out years ago. 

In one of her projects, they reviewed the records of more than 275,000 active-duty service members reporting chronic pain.

They combed through their files to determine whether they had received any of 13 nonpharmacologic therapies after their deployment. Those therapies were acupuncture or dry needling, biofeedback, chiropractic care, cold laser therapy, exercise therapy, lumbar supports, massage, osteopathic spinal manipulation, other physical therapy, superficial heat, traction, transcutaneous electrical nerve stimulation, and ultrasonography. 

After crunching all of the numbers and outcomes here’s what they came up with:

Specifically, service members who received nonpharmacologic therapies were

  • 8% less likely to experience new-onset alcohol and/or drug use disorders;
  • 12% less likely to experience suicidal ideation;
  • 17% less likely to experience a self-inflicted injury, including attempted suicide;
  • 18% less likely to intentionally poison themselves with opioids, related narcotics, barbiturates or sedatives; and
  • 35% less likely to accidentally poison themselves with the same types of drugs.

The researchers acknowledged several limitations in their research. For example, although most nonpharmacologic therapies were provided after service members were diagnosed with chronic pain, the authors could not determine whether those nonpharmacologic therapies were used specifically to treat that pain.

In the news release, Meerwijk also explained that her team did not study the effects of individual nonpharmacologic therapies.

“We treated them as one,” she said. “Most likely, only some of the therapies that we included are responsible for the effect that we reported, whereas others may have had no effect at all, assuming there’s no other variable that explains our findings.”

Despite these limits, the authors expressed confidence in their research methods and findings.

“Our results suggest that (nonpharmacologic therapies) provided to active-duty service members with chronic pain may reduce their odds of long-term adverse outcomes,” they concluded in the study. “Given known associations of these adverse outcomes with morbidity and mortality, providing (nonpharmacologic therapies) to service members with chronic pain could potentially save lives.”

I’ve been hearing this crashing tidal wave coming. It’s not here yet. But the roar is approaching and it sounds like sweet sweet music to me ears. 

Item #2

I’m going to do everything I can to boil this sucker down and strip it to the bare bones without it getting too long or boring. This one is called “Evidence-based supplements for the enhancement of the athletic performance” by Peeling, et. al(Peeling P 2017). and published in the International Journal of Sport Nutrition and Exercise Metabolism in 2017. 

The authors wanted to put together a review focusing on the available evidence based for performance supplements commonly used in sports and summarizing the when’s and the how’s around their uses.

The ysay there is robust evidence that the following supplements can enhance sports performance when used according to established protocols. 

So let’s motor through this like poop through a goose, shall we?

  1. Caffeine -There exists a lengthy research history on caffeine supplementation across a range of performance protocols, including endurance-based situations, resistance training exercise, short-term supramaximal efforts, and/or repeat-sprint tasks. Reported benefits of caffeine include benefits include adenosine receptor antagonism, increased endorphin release, enhanced neuromuscular function, improved vigilance and alertness, and a reduced perception of exertion during exercise. Low to moderate doses of caffeine (∼3–6 mg/kg BM), consumed 60 min pre exercise, appear to have the most consistent positive outcomes on sports performance in research situations, although a variety of other protocols (as mentioned above) also appear beneficial, and are practiced in real-life. Of note, athletes who intend to use caffeine as a performance aid should trial their strategies during training or minor competitions, in order to fine-tune a protocol that achieves benefits with minimal side effects.
  2. Creatine – widely-researched supplement, with creatine monohydrate (CM) being the most common form used. Creatine loading can acutely enhance the performance of sports involving repeated high-intensity exercise (e.g., team sports), as well as the chronic outcomes of training programs based on these characteristics (e.g., resistance or interval training), leading to greater gains in lean mass and muscular strength and power. When accepted creatine monohydrate supplementation protocols are followed, the expected increase in intramuscular creatine stores is likely to enhance lean mass, maximal power/strength, and the performance of single and repeated bouts of short-term, high-intensity exercise.
  3. Nitrate –  The authors say Nitrate is a popular supplement initially found to improve oxygen uptake kinetics during prolonged submaximal exercise. Great sources are Leafy green and root vegetables (i.e., spinach, rocket, celery, beetroot, etc.
  4. Beta-Alanine – The paper says this is one of the immediate defenses against the accumulation of protons in the contracting musculature during exercise. I can also tell you that this is just something I never nerded out on. Lol. Not my cup of tea but I like to offer something for everyone here at the Chiropractic Forward Podcast. They say it can improve tolerance for maximal exercise bouts lasting 30 s to 10 min and provide small yet significant benefits in both continuous and intermittent exercise tests. Basically, it’s used in order to augment high-intensity exercise performance ranging from 30 s to 10 min in duration.
  5. Sodium Bicarbonate – benefits are generally seen in short-term, high-intensity sprints lasting ∼60 s in duration, with a diminishing return as the effort duration exceeds ∼10 min. However, greater benefits may be realized (>8% improvement) with a greater number of repeated sprint bouts

Go to our show notes at chiropracticforward.com if you’d like to get dosing information and all the little technical tidbits. It’s really interesting. Even to an orthopedic guy like me although, its technical enough to make my eyes glaze over as well. 

There are several others listed in the paper as well but the authors point out that the evidence for their effectiveness is much less clear. They are Sodium citrate, Phosphates, and Carnitine.

Even though that stuff is not my cup of tea, it’s good to know, it’s good to have as a reference, and it’s good to pass on to you because many of you actually do nerd out on that stuff and thank God for that. That means I can call people like you and ask what the hell. On the other hand, if it’s something I nerd out on like orthopedics, you can call me and say what the hell?

Store

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

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The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Devitt M (2020). “Nonpharmacologic Therapies Can Improve Chronic Pain Outcomes Reductions in Drug Misuse, Suicide Attempts Reported.” AAFP.

Peeling P, B. M., Paul S, (2017). “Evidence-based supplements for the enhancement of athletic performance.” IntJ sport Nutrition Exercise Metabolism 28(2): 178-187.

Forward ’19, Decompression Research, Curveball or Pitch Count?

CF 094: Forward ’19, Decompression Research, Curveball or Pitch Count?

Today we’re going to talk about my Forward ’19 experience, we’ll talk about decompression research, and we’ll cover some new research on whether it’s the curveball or the pitch count that injures young players on the baseball diamond. 

But first, here’s that sweet sweet bumper music 

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have rattled and rolled into Episode #94

Now if you missed last week’s episode on the bigger the disc the better and what early improvement in treatment tells you, make sure you don’t miss that info. Every episode offers some good take-aways so make sure you’re up to date and not falling behind the rest. 

I like to look at this podcast as an ongoing, fun way of learning and making each other just a little bit better every week so don’t just hop in for one episode. Stack them up one after another and, before you know it, you’re going to start retaining the info and you’re going to start recalling something we talked about down the road when you’re interacting with a patient and they ask you a question. 

You’ll see. Even though I’m the host, it happens to me. Someone will ask me a question and I’ll remember an episode we did on that topic and BOOM!! Pow!! There it is, the answer comes to me. Pretty cool. 

Forward ’19 – For you newbies here you’re probably wondering what the hell Forward ’19 is. A quick rundown is that it is a yearly seminar/conference that was born from an online Facebook group called the Forward Thinking Chiropractic Alliance aka FTCA. They have a website as well. 

The group is very much evidence-based or evidence-informed. Whichever is your preferred verbiage. The group has about 7800 or so doctors in it and they are interacting on a daily basis mostly to try and make each other better. Overall, it’s a good group. I’ve heard people griping because they see griping here and there in the group but, in general, it’s a very positive, very smart, and very helpful group. I encourage you joining it if you’re a doctor or student. 

Anyway, Forward 19 – What an event. The group puts on several events through the year but this is the key event put on by the FTCA every year. This is year #2. It was in St Louis at the campus of Logan Chiropractic College.

First thing is, holy smokes what a campus man. I bet they pay a fortune just to mow the grass. Just wow. The landscaping, the tower in the middle, and Purcer Center where it was all held. Just gorgeous. Having gone to Parker, that was the Chiro campus I’d been on and don’t get me wrong, Parker is impressive. I’d say Logan most definitely is as well. Kudos.

Speakers:

Gray Cook SFMA – SFMA stands for Selective Functional Movement Assessment – I have to admit that this was my first exposure to Gray Cook but it won’t be my last. I had heard of SFMA but was not all that familiar with it. I really enjoyed his talk and some of the concepts he puts forward. I can’t wait until I get through with my Diplomate program – hopefully in November – so that I can dive into Gray Cook’s stuff and just keep building on the knowledge pile. 

Greg Kawchuk – He is the Research Chair for the World Federation of Chiropractic. 

So, outside of the FTCA, I had little knowledge of Greg Kawchuk. But, Greg gave a speech at the World Federation of Chiropractic last year in Berlin that got some people a little fussy and some people elated. It definitely got the attention of chiropractors around the world to say the least. He gave the same speech last weekend in St. Louis and it had people on the edge of their seats. 

Backing up a bit, Greg is a dynamic speaker. One of the more humorous and engaging speakers I’ve seen in maybe forever. He’s immediately like-able and that make for a good speech from the top. The talk was all about putting the ACT back in Chiropractic. A play on the way the philosophy guys use the TOR and the TIC garbage. You know….the principled vs. un-principled hoohah. 

I happened to think that evidence-informed docs are the principled ones and if you need more info on why I think that, just go back about 3-4 episodes and listen to my podcast on the topic of Closing Patients. A principled, ethical person doesn’t carry themselves in that manner and the philosophy folks are much more likely to be out there closing patients than offering responsible treatment plans that are based on commonly accepted guidelines. In my experience at least. It’s always made me a bit hot under the collar when someone asks whether another chiropractor is principled or not. 

Makes me want to principle them in the forehead…..with a mighty slap. 

Anyway, putting the ACT back in chiropractic: he asked what are we doing right now? What are you doing right now to move the needle forward? To bring chiropractic into this current century we are in? He suggests we do a lot of sciencing and consume at least 1 science per day and I agree with him. 

Hell, here at the Chiropractic Forward podcast, we distribute about 3-4 sciences per episode so we almost got you covered for the whole week if you’re a regular listener. 

I think the part of his presentation that some took exception to was the part where he feels the evidence group may, at some point, consider a divorce from the philosophy geared group. He said it may not be an official divorce but could be very much a divorce in the way we act, carry ourselves, communicate with our patients, and things of that nature. 

He says, at the end of the day, it could be something similar to….. we went out for a pack of smokes and…..just never came back. 

Now, as you sit in your car or truck or your office hearing me say that, you can take that all in as you will. I’m going to tell you that, as a doctor that considers himself very much on the research end of things and very little on the philosophy end of it, and as a doctor that does everything he can to be ethical, honest, and all that…..it is so hard to sit and hear patients talking to me about being forced to sign of on a contract for thousands of dollars for a year long schedule for umpteen visits based on a curve correction that research suggests isn’t that big of a deal. 

It’s hard to hear about the knuckleheads in Oakland claiming they can reverse degenerative spurring by seeing someone 3x/per day for 3 weeks. It’s hard to watch Mr. man bun top not from the coffee house talking about fixing kids with no research to back his claims. 

It’s hard to hear about chiropractors scaring the crap out of patients with x-rays and convincing them that they are somehow damaged and in a dire circumstance unless they undergo 60 visits and another 3 sets of x-rays….

These are just a few of the stories. There are so so so many of them and at some point, I just don’t want to be associated with that anymore. At all. If that’s not understandable and that makes no sense to you and that makes you mad at me, well….I’d say I’m sorry but I’m just….I’m just not. 

Even though I don’t smoke in the physical meaning of the word, I think I went out for a pack of smokes and never came back about 15 years ago. 

Christine Goertz – If you are a regular listener of our podcast, you know Dr. Goertz has been on our show before and you know I’m a nerdy fan of her and her contribution to our profession. Any chance to listen to Dr. Goertz is a chance that should be seized upon. She’s a giant in our industry. 

Annie O’Connor – World Of Hurt – OK, I’m admitting something again. I wasn’t familiar with Annie O’Connor. Annie is fun and vivacious and really another very dynamic speaker but she is full of knowledge nuggets. The kind that you can really put to use. She spoke on how words can harm so how key communication can be for some patients. She talked about yellow flags and she talked about classifying pain patients so that we can help them with more efficiency. You can believe that World Of Hurt is on my reading list after Forward ’19. 

Greg Friedman – documentation  documentation. Greg is Greg. Smart, laid back, fun, and just likable immediately. It was great to get to meet him in person and share a good discussion prior to his documentation class. He’s full of excellent information and not just on documentation so, if you get a chance and you need the hours, search out a class. He’s flying all over the nation every weekend. 

Mike Massey – he shared teaching duties with Greg on the documentation class. He told me he’s a listener of our podcast and he’s an active member of the FTCA so I’ve been a fan of his for a while now. It’s always a cool deal to put the online world into a 3D context and it was sure nice to meet Dr. Massey. Hopefully next time I’ll get to sit and speak a while with him. I think our personalities probably match up pretty closely from what I can tell. 

Some of the others I got to see and speak with are Brandon Steele

Kevin Christie

Jon Morrison

Robert Jones, President Of The ACA was there the whole weekend sitting in on the classes himself. What a super guy.

Budweiser tour

Meeting people

Kris Anderson

Chris Howson

Rob Pape

Bobby Maybee

Bobby Mozafari

Mike Massey

Greg Friedman

Dale Thompson

Kevin Christie

Anne Maurer

My biggest regret is that I didn’t get any real one on one time with very many of these folks but That’s OK. All’s well.

If I didn’t come up and speak with you but you saw me there, please don’t take it personally, believe it or not, I have a bit of a shy streak. Once I’ve had a conversation with someone, it’s all good. But, if I don’t know you yet….ugh….I have a podcast. I was a traveling musicians for 7 years. Why would a guy like me be shy at all? Yeah I don’t know. I’m in control in those other situations. Maybe it’s when I’m not in control or I’m a newbie….who knows?

Anyway, if you ever see me at an event, regardless of the event, please come say hi. I’d love to meet you.

We are about to get to our two articles. One is new research on traction/decompression information for low back discs and the other is on young baseball pitchers and how the curveball isn’t the culprit. 

First though, we have backed off and rather than having two show sponsors, we have one and it’s a company you all know how much I love. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99

Item #1

The first article today is called “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis” by Cheng, et. al(Cheng Y 2019). and published in Clinical Rehabilitation in August 28, 2019. Smoking hot folks. Stand back. Watch your eyebrows!

First thing, recognize in the title there, this is a systematic review and meta-analysis. That’s at the top of the research pyramid. 

Why They Did It

To evaluate the effectiveness of traction in improving low back pain, functional outcome, and disk morphology in patients with herniated intervertebral disks.

How They Did It

  • They did a big time search PubMed, Scopus, Embase, and the Cochrane Library and they did this search from the earliest record all the way up to July 2019. 
  • They included RCTs that involved adult patients with low back pain associated with herniated disc confirmed by MRI or CT
  • RCTs that compared lumbar traction to sham or no traction
  • RCTs that provided quantitative measurements of pain and function before and after intervention. 
  • The initial search came up with 3,015 records which they whittled down to 7 involving 403 patients.

What They Found

Compared to the control group, the patients that had traction showed significantly greater improvements in pain and function in the short term

The differences were not significant enough to support the long-term effects on pain and function, nor the effects on herniated disc size. 

Wrap It Up

Compared with sham or no traction, lumbar traction exhibited significantly more pain reduction and functional improvements in the short term, but not in the long term. There is insufficient evidence to support the effect of lumbar traction on herniated disk size reduction.

Here’s where I’m at on that. I use decompression. I just need to know more about this study. Did they do simple traction? Did they do a cycling pull phase from a pull to a rest phase? How much weight was the pull? How long did they do each treatment and how many treatments did they do?

There’s also patient preference and clinical experience factoring into using decompression.

Reading down through this sucker, it’s just too varied to make any assumptions. The intervention programs differed among the studies from 10 sessions to 60. The treatment protocols varied from 2 weeks to 10 weeks. Some of the studies included had no information on the weight of the pull while a handful went up to 50% of the body weight. Some of the studies used continued traction while others had intermittent traction. Some even used self-suspended, inversion table type traction. 

Are you getting a whiff of what I’m dumping here? 

Out of the 7 studies they included, only 2 measure the disc height and one measured the disc ratio. 

Overall, when you read through the paper, these authors freely admit, this is a tough one but they wanted to start somewhere. They suggest several ways to go forward and say that there are a couple of studies out there that show a trend toward long-term decompression reducing the size of a disc herniation but no longer papers have been done to investigate it. 

It’s anecdotal as hell but I’m going to go ahead and anecdote the hell of you. Right to your face. Or….to your ears as it may be. I’ve been doing decompression for about 7 years and I’ve yet to see anything as effective. Including exercises, McKenzie, all of it. In some cases, it has absolutely amazed me. But, like I said, that is anecdotal but I hope some of these really super smart researchers out there in the profession start to dial down into it and figure it out. Mostly because I know it works. I’ve just seen it too many times. 

Item #2

This last item is called “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers” by Oliver et. al(Oliver G 2019). and was published in Journal of Pediatric Orthopedics in September of 2019. Wait, it’s September of 2019 right now right? Steaming pile of fresh knowledge nuggets, big platter, sizzling. 

Why They Did It

The purpose of this study was to examine differences in pelvis, torso, and upper extremity pitching mechanics and muscle activations between the fastball, change-up, and curveball pitches in youth baseball pitchers following a simulated game.

How They did It

  • 14 youth baseball pitchers with no history of injury were included
  • All major muscles and mechanics were measured
  • The pitchers were instructed to throw with max effort during a simulated game that provided random game situations
  • They were limited to 85 pitches
  • Data from 3 fastballs, curveballs, and change-ups thrown in the first and last innings were selected for analysis

Wrap it up

The principle findings of this study revealed that pitching to the age-restricted pitch count limit did not result in altered pitching mechanics or muscle activations, and no differences occurred between the 3 pitches. These results support previous research that indicate the curveball pitch is no more dangerous for youth than the other pitches commonly thrown. This is supported by the pitcher’s ability to maintain a proper arm slot during all 3 pitches and indicates that they are obtaining the spin on the ball from their grip and not by altering upper extremity mechanics.

So….it is not the curveball it seems but, rather, it’s the pitch count in young pitchers, it’s treating them like professionals when they’re still developing, it’s that they tend to play only one sport aka specialize, and that they need to be treated like developing children and human beings rather than the Dad’s lost glory or a future paycheck for the whole family. 

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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The Message

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

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

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

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 or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

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

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

  • Cheng Y, H. C., Lin Y, (2019). “The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis.” Clin Rehabil.
  • Oliver G, P. H., Henning L, (2019). “Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers.” J Pediatr Orthop 39(8): 387-393.

The History of Chiropractic (Do You Know What You Think You Know?)

CF 092: The History of Chiropractic (Do You Know What You Think You Know?)

Today we’re going to talk about the history of spinal manipulative therapy and the history of chiropractic. 

But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun and accessible while we make you and your patients better all the way around. Welcome, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have collapsed into Episode #92

Now i you missed last week’s episode on the 10,000 Steps Myth, the neuro aspect of an adjustment, and sodas kill, make sure you don’t miss that info. 

Keep up with your colleagues and listen. Also, don’t miss Episode #13. I systematically debunk the myth that we chiropractors cause strokes. I’m not having it, y’all. It’s just not reality and I show you how to fight the myth. 

Also, a few episodes back we talked about Closing Patients and my opinion on that. It may not be what you think it is. 

This week has been more of just catching up. My new schedule I mentioned last week either has my world screwed epically or it’s working beautifully. Lol. Time will only tell but I’m pretty confident we’re doing just fine. 

If you missed last week, I talked about implementing a firmer policy of having patient time and new patient/paper time. 

Since doing that, we have been a bit lighter on the schedule that in recent weeks past but I am getting so much more done right now and it feels good. I have more energy at the end of the day. And doesn’t it feel good to feel good?

It’s cool. For now. If it gets much lighter on the schedule, I’ll hit the WTF? Button and switch gears. WTF….that stands for Why The Face right?Lol. 

Kidding!! I know what it means but I run a mostly clean business here!! But, the point was….. I’m not worried at all right now. 

We are about to get to all things History here but I saw an interesting thing on Facebook this week and it made me want to punt a kitten. I thought I’d share. 

I was on Facebook and saw a couple of knuckleheads coming live from a coffee house. They do it once a week. Doesn’t sound too miserable just yet, does it? It’s actually a decent idea. Get the coffee shop in on it and Facebook live it once a week from the coffee shop talking about certain issues and what your solution to the certain issues might be. Maybe take questions from the crowd there too. Not a bad idea honestly.

Hell, I’d do that myself. Problem is that I’m too damn busy to do it and I’m not a morning person so I’m not getting up early enough to do it before work. Just forget it. Freaking forget it. 

These guys are there at like 10 am on a specific day and I’m like….why aren’t you at work working on people in your work place where people work at 10 am on a work day? Lol. 

They say build it and they will come and Maybe they haven’t built it just yet so the crowds are not coming just yet. I don’t know. Maybe they just make this coffee shop thing a priority for now and choose to not be working on a work day. Either way, one day the one dude wore a cap in the video and the next week he wore a tight little top knot man bun. 

YESSSS I’m old. Yess I think it looks unprofessional. Yes…it makes me crazy like so many other things of his generation tend to do,  and yes…..I’d rather take a kick in the nuggets than to allow someone that looks and talks like him work on me or my kid. 

But…..Yes….there’s a chiropractor for everyone so…..what the hell do I know. Look the way you want I suppose. I’ve heard they have chiros in Florida and California that dress in flip flops and shorts so….when it Rome I guess. 

Here’s my deal, they target kids and parents. Nothing wrong with that. But, they are busy talking about kids that can’t concentrate at school and how there’s just a disconnect in what God meant them to be capable of and what they are currently doing and, if the parents just bring them in to the chiropractor, these guys can help the kids make the connection back and lead that kiddo to the awesome shining light of a life that God intended for them. 

Ummmm…..no you can’t. Is that judgy? Yup. Sorry, whether you admit it or not, we make snap judgements of each other. Rightly or wrongly. IT’s a fact of life. My snap judgement is…..son of a mother. Son of a motherless goat. 

There are so many great chiropractors engaged in research, engaged in diplomat programs. Engaged in taking themselves and this profession to the next level. And this crap trashes all of it. Chunks it all in to the garbage immediately. 

 They chunk it in the garage with their ‘truth’. You hear that crap all of the time now. Speak YOUR truth. We all have our own truth. When did that start exactly? There’s the truth and that’s it. There’s not your truth, my truth, my dog’s truth, some talking head on TV’s truth…..none of it. There is only THE truth. 

And the truth is I’ve seen nothing convincing about this sort of stuff. Absolutely 100% nothing to the level allowing people to get on Facebook touting the ability in a voice that says “You’re great parents. You’re doing everything for your kiddo and we know that. You just need the right kind of help.” Srsly? I you could just get the parents on your brogram…..err…I mean program. 

Come on bruh. Bro. Broseph, I can see it now, they sell brotein shakes at their office and it’s part of the brogram that Billbro Baggins and his buddy Chillbro Swaggins put together after a night of hitting the hookah. 

Show me the support for chiropractors resolving ADHD, autism, and all of that other stuff they claim to help with. Show me it in systematic trials. Maybe randomized controlled trials. Hell, just something peer reviewed and published in a reputable journal? 

But DON’T show me a damn case study or pilot study. Don’t do it or I’ll name you publicly. Lol. I can’t handle people that think case studies hold up to proper scrutiny. They do not. They’re interesting and, for the most part, that’s it. 

They could be doing these in business suits and ties and start spouting unsupported claims like this and they would still look like space cadets claiming they have been to the moon, looked back at Earth, and it is indeed flat despite all evidence to the contrary. Seriously. Srsly. 

I can’t stand this sort of gibberish. It’s a waste of time and talent. 

I’m getting to Item #1 in just a second but we can’t get started without mentioning the sponsor of the first half of our show, 

Let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that actually saves you money. Instead of spending money on cable TV or looping a DVD over and over in your lobby, the bite-sized videos are specifically made to inform your patients about the importance of chiropractic, healthy living, and to encourage referrals while, at the same time, presenting the benefits of all of the different products and services that you offer. Specific to your office.

That’s right. It works by using a tailor-fit video playlist that only promotes the products and services offered in your specific practice. Not only that but the videos are updated automatically on a weekly basis so there’s no need to manually update your playlist AND you don’t have to learn any complicated software. You get to just set it and forget it. And don’t we busy doctors need just that?

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions. That’s CFP19, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription.

Go visit GoChiroMedia.com to check out the demo reels and get started on your free trial.

Item #1

Now we know a little about our more recent history like chiropractors used to go to jail for treating patients. We know that the AMA has wanted us banished form Earth since our inceptions. Most chiropractors know this stuff. And you should know this stuff. 

But, I remember Dr. Anthony Nicholson, on one of his guest spots with us, I remember him mentioning that spinal manipulative therapy was actually one of the mainstays of treatment before the explosion of the physician/medical complex. I honestly did not know that. 

So, when I stumbled across this paper called “A History fo Manipulative Therapy.” I started reading. It was written by Erlan Pettman(Pettman E 2007) who is actually a PT and published in the Journal of Manual Manipulative Therapeutics in 2007, Old man river…..it’s an oldie but goodie, people. 

So, the author is a PT and this is basically his devotion to getting spinal manipulative therapy under the scope of physical therapists. Or to get more PTs to utilize it. I don’t know but, he says that the earliest reference to its use is in 400 BC back in Europe. 

Interestingly, he says that spinal manipulative therapy rose simultaneously in cultures from Indonesia, Hawaii, Japan, China and India, to Central Asia, Mexico, Nepal, Russia, and Norway. All things I did not know. He also mentions that historical reference to Greece show the first direct evidence of its use and that it was well-established at the 400 BC mark so certainly predated that time going even further back. 

Get this: Hippocrates who lived from 460-385 BC and who is referred to as the father of medicine….you know….the whole hippocratic oath thing….anyway, even back then he wrote a book on joints and described using spinal manipulative therapy. He even noted that the treatment should be followed by exercises. That’s sort of being ahead of ones time wouldn’t you agree?

This is such an interesting paper that I do hope you’ll check it out. I’m linking it in the show notes right here at this point in the text of the podcast. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565620/

While it’s very interesting, it is also very long and you’re not going to stick with me through it. There’s enough here that I may need to do an entire episode just on this paper because it’s THAT fascinating. 

Briefly, he says that as common as spinal manipulative therapy was throughout the origins of mankind, it appears that physicians and surgeons began to abandon the acceptance of it in the 18th century. Though he can’t say exactly why, he offers that it could conceivably be from using the technique for the wrong candidate or potentially the perceived danger in manipulating a spine weakened by tuberculosis which was ravaging the population at that time. 

So that’s where the downturn started for spinal manipulative therapy and, as he says, by the 19th century, a significant part of the medical establishment has a true disdain for bonesetters and their practices. 

While there were many throwing the proverbial poo at spinal manipulative therapy, there were others with the power to recognize the obvious. Robert Jones, the founder of British Orthopaedics, wrote, “We should mend our ways rather than abuse the unqualified. Dramatic success in their hands should cause us to enquire as to the reason. It is not wise or dignified to waste time denouncing their mistakes, for we cannot hide the fact that their successes are our failures” INDEED Mr. Jones. Indeed….

Were you told that DD Palmer invented chiropractic? Of course you were. I was too. And, in as far as ‘chiropractic’ is an industry or a profession, he did. But, he did not invent the idea of ‘bonesetting’ through some magical discovery. At least it doesn’t appear that way in this article. 

The author talks about Andrew Taylor Still. Still was also a magnetic healer. He suffered from chronic headache and took note one day. He had fallen asleep with his neck wedged between the roots of an oak tree. Upon waking, he had no more headaches. From there he began conceiving a theory about health and how it could only be maintained and, therefore, disease defeated, through normal function of the musculoskeletal system. This was all in 1874. Still went on to create the practice of Osteopathy. Did you know that Still’s practice was only about a day’s drive from DD Palmer’s town?

An astute listener will see the parallels of where osteopathy WAS and originated very similar to where chiropractic was and originated. And very astute listeners will make note of where osteopathy is now and where some in the chiropractic profession wish to keep us…..right back where we started. No progress. No learning. No breakthroughs. Nothing. It’s dumbfounding to say the least. 

The author also talks about DD Palmer in the article. How could you not? He says that he was not the first to use the word subluxation nor was he the first to describe the use of the spinous and transverse processes as levers to adjust said subluxation. Those honors go to Johannes Hieronymi, William and Daniel Griffen, and Edward Harrison. 

Did you know that in the 1920’s chiropractic was on life support but that the GI Bill after WWII was what enabled returning soldiers to go to chiropractic college and really bolster the numbers? I didn’t know that. Pretty cool. 

Also of particular note is that in 1958, the National New from the National Chiropractic Association warned about the rising numbers of PT’s training in manipulative procedures. So…..that’s been a thing for a long time it seems. Lol. 

Just a fascinating read for us chiropractors. Go give it a look see and see what you think. I’d love to hear your impressions. Email me at dr.williams@chiropracticforward.com and let me know what you thought. 

It’s good to support the people that support you don’t you think? Well, ChiroUp certainly supports evidence-based practices. 

If you’re a regular listener of our podcast, you know I used it since about June of 2018. Let me tell you about it. 

ChiroUp is changing the way we practice by simplifying patient education and here’s what I mean: 

In a matter of seconds, you can send condition-specific reports to your patients with recommendations for treatment, for their activities of daily living, & for their exercises. 

You can see how this saves you time – no more explaining & re-explaining your patient’s care, because they have access to it at their fingertips. 

You can be confident that your patients are getting the best possible care, because the reports are populated based on what the literature recommends and isn’t that re-assuring? All of that work has been done FOR you. 

There are more than 1000 providers worldwide using ChiroUp to empower their treatments, patients, & practice – Including myself! **Short testimony**

If you don’t know what it’s all about or you’d like to check it out, do yourself a favor and go to Chiroup.com today to get started with your FREE TRIAL – Use code Williams99 to pay only $99/month for your first 6 months

That’s ChiroUp.com and super double secret code Williams99.

Store

Part of making your life easier is having the right patient education tools in your office. Tools that educate based on solid, researched information. We offer you that. It’s done for you. We are taking pre-orders right now for our brand new, evidence-based office brochures available at chiropracticforward.com. Just click the STORE link at the top right of the home page and you’ll be off and running. Just shoot me an email at dr.williams@chiropracticforward.com if something is out of sorts or isn’t working correctly. 

If you’re like me, you get tired of answering the same old questions. Well, these brochures make great ways of educating while saving yourself time and breath. They’re also great for putting in take-home folders. 

Go check them out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? We won’t spam you. Just one email per week to remind you when the new episode comes out. That’s it. 

Chiropractic evidence-based products
Integrating Chiropractors
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The History of Chiropractic (Do You Know What You Think You Know?)

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 instead of chemical treatments like pills and shots.

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

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

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 or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

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

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Pettman E (2007). “A History of Manipulative Therapy.” J Man Manip Ther 15(3): 165-174.

w/ Dr. John Van Tassel – (Part Two) Florida State Athletics, Mentoring, & Life/Work Balance

CF 083: w/ Dr. John Van Tassel – Florida State Athletics, Mentoring, & Life/Work Balance

Today we’re going to continue talking with our guest, Dr. John Van Tassell. This is part two of our interview so, if you’ve yet to listen to part one, stop now and go back one week and start there. You don’t want to miss the sage-like wisdom of this amazing chiropractic ambassador.  You are absolutely going to love listening to Dr. Van Tassel talk about Division I college sports, mentoring, and a good healthy life/work balance.

Before we get going with part two, here’s that Miami Vice-like bumper music

Chiropractic evidence-based products
Integrating Chiropractors
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OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have twisted and shouted your way right into Episode #83. When you have a guest from Florida, you think of gators and snakes. And Pablo Escobar and Miami Vice but we try to not get too under the table here on the Chiropractic Forward Podcast. 

Before we hop into the episode, let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that will eliminate the need for running cable TV or the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living, encourage referrals, and present the benefits of all the different products and services you offer.

It works by using a tailored-fit video playlist that will only promote the products and services available at your practice, and the videos are replaced automatically on a weekly basis. There’s no need to manually update your playlist or learn any complicated software. You truly can set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription. 

So visit GoChiroMedia.com (that’s g-o-c-h-i-r-o-m-e-d-i-a-.com) to check out the demo reels, and to get started on your free trial. Take you practice to the next level with GoChiroTV.

Introduction

We’re here to advocate for chiropractic while we also make your life easier using research and some good solid common sense and smart talk. 

Go check our evidence-based brochures out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? 

How about the previous two episodes we did with Dr. Anthony Nicholson on Chronic pain? That was basically a mini-masterclass folks. I hope you know that. If you know nothing of any substance about chronic pain, the previous two episodes are your starting points. 

You have to listen to me here. Just go listen. Thank me later. He is the Niagara Falls of knowledge nuggets folks. 

In personal happenings, my family experienced some unpleasantness this past weekend. My 7 year old blue European Great Dane passed away. We got the Euro Dane because they are supposed to be heartier than their American Dane counterparts. 

They think she developed some sort of tumor that zapped her weight, had her dehydrated, and just unable to walk or do anything. Not cool. It was the opposite of anything fun but, she’s not suffering and that’s the best you can ask for on that sort of deal. 

Now on to our special guest today. INTRODUCTION

He is a heck of a communicator. Any discussion I have seen him take part in on the Forward Thinking Chiropractic Alliance Facebook page….he’s the most thorough, most sensible, most sage-like if you will. I’ve even sent him patients all the way from where I sit here in Amarillo, TX. 

He’s the Yoda of chiropractors and I love reading his stories. If someone asks him a question, he doesn’t respond with a paragraph. He sits down and really thinks about it, considers it at length, and then responds with about a 5 paragraph guidance manual and I love it. 

Not to mention the fact that he’s one of the most accomplished you’ll find in any group anywhere. 

All of that is personal experience and fine and dandy but how about we give him an official introduction?

  • Graduating from Logan College of Chiropractic, Dr. John Van Tassel has been a chiropractor since 1991 and is the owner of Athletic and Family Chiropractic in Tallahassee, Florida. 
  • He has been an adjunct professor at Tallahassee Community College and Florida State University. 
  • He has been the FCA Sports Council Doctor of the Year
  • The ProSport Chiropractic Doctor of the Year for the Southeast Region
  • And has been a contributing author in various publications

What really gets one’s attention about Dr. Van Tassel is that he is the team chiropractor for the Florida State Seminoles. A perennial powerhouse of anything athletic in the SEC. 

We’re going to talk about all of it and you’re going to be fascinated so here we go. 

Let’s welcome to the show, the pride of Tallahassee, Dr. John Van Tassel. Thank you so much for taking the time out of your schedule to be with us today. 

Let’s start with a little humor. The first thing I want to know is…..what in the heck is up with Florida? There was even a Facebook game going around for a while where you just Google your birthday and the words “Florida man…” Lol. Are Floridians just inherently crazy?

Tell me….we all have a story that got us where we are. I always like to ask this question because chiropractic is a bit of a niche choice when choosing a career. What was your story toward being a chiropractor?

Now I noticed you’re originally from North Carolina. Why the move to Tallahassee. 

We became acquainted either through the evidence based chiropractic group or the forward thinking chiropractic alliance group. I can’t remember which but one of them for sure. They’re great groups. You’ll find people that are bull-headed that it’s their way or they scoff at you but that’s with any group really. Mostly….overall….they’re very friendly, very helpful, and very giving people. Giving of their experience and information as well as giving with their assistance should you need something. 

I always encourage anyone that considers themselves on the evidence-informed spectrum of the profession to join both groups. I learn SOMETHING from each of them just about every week. 

With that being said, I think you’ll agree that you are one of the more active members of the FTCA. Tell me about how you got involved with the Forward Thinking Chiropractic Alliance and what keeps you coming back daily.

One of the things that obviously sets you apart from the run-of-the-mill chiropractor is your involvement with Florida State. Let’s start at the beginning and just talk about that for a bit. How did you get started with a D-I program? Was it a specific certification that moved you in that direction? What’s it like day to day, month to month, and year to year? And has it morphed through the years? 

In our preparation for this episode, you mentioned that you enjoy mentoring younger practitioners. With that in mind, what advice do you feel is vital for someone just starting out trying to open or build their own practice?

Continuing with the mentoring theme, what do you find to be the important aspects of maintaining a healthy work/life balance?

You seem to have a unique ability to recall things. For example, I can’t remember what I had for lunch yesterday but you can recall happenings and conversations from 20 years ago. 

I really think, and I believe most of the FTCA members would agree, that you have the best stories and should probably be working on your first book by now. 

With that in mind, can you re-tell the one you shared yesterday about the carpal tunnel patient that went to the GP who basically told her you didn’t know what you were talking about?

Now, the reason I asked for that one specifically, is because you’re in an arena where you commonly interact with other practitioners from the medical field. Are you experiencing this sort of bias against chiropractic in that world as well? Why do you think MD’s still don’t understand what it is that we do?

One of my favorite stories of your was about your Wall of Fame down your hallway. I’m sure there are plenty of recognizable names on that but your favorite is Mrs. Jones. Someone nobody outside of your practice and her personal circle would know. Is that a story you would mind sharing with us?

I want to close with this because this may be something that people can really use as the key takeaway from our time together today. 

I was reading one of your posts that went like this, “I was just thinking about something while A plumber unclogs my system at the house. I tell people, patients and students and athletes mostly, that desire and passion and determination are key. But it’s our habits that get us where we are going. We accomplish goals by developing habits.”

Now, I don’t know how a plumber brings to mind things like goals and habits but, I couldn’t agree more. What would you say are your core habits that have made the difference in your career?

You have slithered right into Episode #82. When you have a guest from Florida, you think of gators and snakes. And Pablo Escobar and Miami Vice but we try to not get too under the table here on the Chiropractic Forward Podcast. 

Before we hop into the episode, let’s talk about GoChiroTV. GoChiroTV is a patient education system for your office that will eliminate the need for running cable TV or the same DVDs over and over again in your waiting room. The bite-sized videos are specifically made to inform your patients about the importance of chiropractic and healthy living, encourage referrals, and present the benefits of all the different products and services you offer.

It works by using a tailored-fit video playlist that will only promote the products and services available at your practice, and the videos are replaced automatically on a weekly basis. There’s no need to manually update your playlist or learn any complicated software. You truly can set it and forget it.

Listeners of the Chiropractic Forward Podcast can use the promo code CFP19 at checkout to get 15% off all subscriptions, which also comes with a 45-day free trial to see if it’s right for your practice. Your discounted rate will be locked in for as long as you have a subscription. 

So visit GoChiroMedia.com (that’s g-o-c-h-i-r-o-m-e-d-i-a-.com) to check out the demo reels, and to get started on your free trial. Take you practice to the next level with GoChiroTV.

Introduction

We’re here to advocate for chiropractic while we also make your life easier using research and some good solid common sense and smart talk. 

Go check our evidence-based brochures out at chiropracticforward.com under the store link. While you’re there, sign up for the newsletter won’t you? 

How about the previous two episodes we did with Dr. Anthony Nicholson on Chronic pain? That was basically a mini-masterclass folks. I hope you know that. If you know nothing of any substance about chronic pain, the previous two episodes are your starting points. 

You have to listen to me here. Just go listen. Thank me later. He is the Niagara Falls of knowledge nuggets folks. 

In personal happenings, my family experienced some unpleasantness this past weekend. My 7 year old blue European Great Dane passed away. We got the Euro Dane because they are supposed to be heartier than their American Dane counterparts. 

They think she developed some sort of tumor that zapped her weight, had her dehydrated, and just unable to walk or do anything. Not cool. It was the opposite of anything fun but, she’s not suffering and that’s the best you can ask for on that sort of deal. 

Now on to our special guest today. INTRODUCTION

He is a heck of a communicator. Any discussion I have seen him take part in on the Forward Thinking Chiropractic Alliance Facebook page….he’s the most thorough, most sensible, most sage-like if you will. I’ve even sent him patients all the way from where I sit here in Amarillo, TX. 

He’s the Yoda of chiropractors and I love reading his stories. If someone asks him a question, he doesn’t respond with a paragraph. He sits down and really thinks about it, considers it at length, and then responds with about a 5 paragraph guidance manual and I love it. 

Not to mention the fact that he’s one of the most accomplished you’ll find in any group anywhere. 

All of that is personal experience and fine and dandy but how about we give him an official introduction?

  • Graduating from Logan College of Chiropractic, Dr. John Van Tassel has been a chiropractor since 1991 and is the owner of Athletic and Family Chiropractic in Tallahassee, Florida. 
  • He has been an adjunct professor at Tallahassee Community College and Florida State University. 
  • He has been the FCA Sports Council Doctor of the Year
  • The ProSport Chiropractic Doctor of the Year for the Southeast Region
  • And has been a contributing author in various publications

What really gets one’s attention about Dr. Van Tassel is that he is the team chiropractor for the Florida State Seminoles. A perennial powerhouse of anything athletic in the SEC. 

We’re going to talk about all of it and you’re going to be fascinated so here we go. 

Let’s welcome to the show, the pride of Tallahassee, Dr. John Van Tassel. Thank you so much for taking the time out of your schedule to be with us today. 

Let’s start with a little humor. The first thing I want to know is…..what in the heck is up with Florida? There was even a Facebook game going around for a while where you just Google your birthday and the words “Florida man…” Lol. Are Floridians just inherently crazy?

Tell me….we all have a story that got us where we are. I always like to ask this question because chiropractic is a bit of a niche choice when choosing a career. What was your story toward being a chiropractor?

Now I noticed you’re originally from North Carolina. Why the move to Tallahassee. 

We became acquainted either through the evidence based chiropractic group or the forward thinking chiropractic alliance group. I can’t remember which but one of them for sure. They’re great groups. You’ll find people that are bull-headed that it’s their way or they scoff at you but that’s with any group really. Mostly….overall….they’re very friendly, very helpful, and very giving people. Giving of their experience and information as well as giving with their assistance should you need something. 

I always encourage anyone that considers themselves on the evidence-informed spectrum of the profession to join both groups. I learn SOMETHING from each of them just about every week. 

With that being said, I think you’ll agree that you are one of the more active members of the FTCA. Tell me about how you got involved with the Forward Thinking Chiropractic Alliance and what keeps you coming back daily.

One of the things that obviously sets you apart from the run-of-the-mill chiropractor is your involvement with Florida State. Let’s start at the beginning and just talk about that for a bit. How did you get started with a D-I program? Was it a specific certification that moved you in that direction? What’s it like day to day, month to month, and year to year? And has it morphed through the years? 

In our preparation for this episode, you mentioned that you enjoy mentoring younger practitioners. With that in mind, what advice do you feel is vital for someone just starting out trying to open or build their own practice?

Continuing with the mentoring theme, what do you find to be the important aspects of maintaining a healthy work/life balance?

You seem to have a unique ability to recall things. For example, I can’t remember what I had for lunch yesterday but you can recall happenings and conversations from 20 years ago. 

I really think, and I believe most of the FTCA members would agree, that you have the best stories and should probably be working on your first book by now. 

With that in mind, can you re-tell the one you shared yesterday about the carpal tunnel patient that went to the GP who basically told her you didn’t know what you were talking about?

Now, the reason I asked for that one specifically, is because you’re in an arena where you commonly interact with other practitioners from the medical field. Are you experiencing this sort of bias against chiropractic in that world as well? Why do you think MD’s still don’t understand what it is that we do?

One of my favorite stories of your was about your Wall of Fame down your hallway. I’m sure there are plenty of recognizable names on that but your favorite is Mrs. Jones. Someone nobody outside of your practice and her personal circle would know. Is that a story you would mind sharing with us?

I want to close with this because this may be something that people can really use as the key takeaway from our time together today. 

I was reading one of your posts that went like this, “I was just thinking about something while A plumber unclogs my system at the house. I tell people, patients and students and athletes mostly, that desire and passion and determination are key. But it’s our habits that get us where we are going. We accomplish goals by developing habits.”

Now, I don’t know how a plumber brings to mind things like goals and habits but, I couldn’t agree more. What would you say are your core habits that have made the difference in your career?

Chiropractic evidence-based products

Integrating Chiropractors
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The Message

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The Message

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

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

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

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 or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

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

Chiropractic Forward Podcast Facebook GROUP

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Twitter

YouTube

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

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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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

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 instead of chemical treatments like pills and shots.

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

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point:

Patients should have the guarantee of having the best treatment offering the least harm.

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 or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

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

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

CF 050: Chiropractic Care – Text Neck, Headaches, Migraines

CF 050: Chiropractic Care – Text Neck, Headaches, Migraines

Today we’re going to talk about headaches, migraines, neck pain, and our favorite topic here at the Chiropractic Forward Podcast, yes….we’ll talk about Chiropractic care. Specifically, chiropractic care for the headaches, migraines, and neck pain. 

Hold on though, make way, get in the Soul Train dance line because here’s that bumper music

Integrating Chiropractors

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

You have skidded all fast and furiously into Episode #50

Let’s talk a bit about the DACO program. For those that don’t know, that’s the Diplomate of American Chiropractic Orthopedists program I’m slowly trudging through. 

I say slowly. You have 3 years to finish. But, I’m a doer if you can’t tell. I’m a worker bee if you will. When I start something, I want to finish. I don’t like unfinished bidness. I don’t like things flapping out in the wind. I want to start it and then I want to finish it quickly and move on to the next thing. 

Getting 300 hours is never going to get done quickly. Especially when you are the sole doctor in a busy practice not getting home until 7 pm or even later sometimes. Such is my life. A curse and a blessing depending on the day and my outlook on that particular day. 

However, I believe I’m on a path to finish it up in about a year from when I started. Probably much sooner. For example, I knocked out 12 hours last week. That’s pretty solid but, we had a snow day and I took advantage of being stuck at home. 

I crawled down into my basement man cave, got in my blankie and jammies with an iPad on my belly, leaned the recliner back and got some education. 

So far, I have 40 hours of the 250 online hours done and 40 hours of the 50 live hours required. In total, I’m 80 hours into a 300-hour course. Rocking and rolling folks. Rocking and rolling. 

Some of the more recent courses I’ve completed were hip pain in children, joint hypermobility disorders, TMJ, and thoracic outlet syndrome. These courses are fascinating. 

The offer is there. If you need help getting started on yours, send me an email at dr.williams@chiropracticforward.com I’ll be glad to get you on your way. 

Speaking of getting in touch, I want to ask you to go to chiropracticforward.com and sign up for our newsletter. It makes everything easier. 

Now onto a discussion that took place on our Facebook page a couple of weeks ago that I thought was particularly interesting. 

I will put it in the show notes for you if you’d like to see the meme….funny word. My son loves it when we mispronounce it. You should try it with your kids if they’re old enough to get embarrassed by their parents.  

Anyway, the picture I posted was of a contemplative Kermit the Frog and it said, “Me when a patient tells me another chiropractor wanted 5 sets of x-rays over 9 months of treatment to correct something research doesn’t support.”

Now, let me set the stage here. The impetus for this was that one of my patients moved down to Georgia. Her daughter started having some headaches and pain so she went and got an MRI. 

The results of the MRI showed the issue to be out of the scope of chiropractic. Regardless, you guessed it, she got a recommendation for 5 sets of x-rays over 9 months of treatment. 

Absolute scare care riduculosity. 

Here’s where it got a little sticky. A colleague got on that post and expressed some dissatisfaction that I would post something like that. I guess he didn’t like my airing dirty laundry. Which is cool. I don’t mind at all but here’s what happened for me on the deal. 

I sat down and crafted a very PC response I think and in doing so, I had an opportunity to reflect on the podcast, the reason for it, and what we’ve done in just the past year. 

Here are some highlights that came to mind for me:

  1. You don’t make an omelet without cracking some eggs and I think some difference of opinion is to be expected and it’s something I just need to get used to. 
  2. I think I created this podcast to do whatever I could to move this profession forward. 
  3. Forward to me means providing research like we do every week but also to educate others, to suggest new research avenues, to encourage specialization and higher education, to push for integration, and to call out and discourage the behavior I feel holds us back from moving forward. 

If you aren’t active on our Facebook page, I’d encourage you to stop in and say, “Hi.” Tell us if you’re digging the podcast. Share some research you’ve found. Maybe give us a suggestion for a future podcast. We’re here. We also have a private Facebook group if you’d like to join the private group. 

OK, research for this week, here we go with paper #1

This one is called “Characteristics of Chiropractic Patients Being Treated For Chronic Low Back and Neck Pain[1].” The lead author is PM Herman and the paper was published in August of 2018 in the Journal of Manipulative Physiological Therapeutics. 

https://www.ncbi.nlm.nih.gov/pubmed/30121129

Get your marketing hat on for this one people. 

Why They Did It

Since chronic low back and neck pain are so prevalent, and since spinal manipulation is a common non-pharma treatment for them, the authors wanted to determine the characteristics of the type of patient that visits the chiropractor. 

How They Did It

  • They collected data from chiropractic patients in regard to regions and states, sites, providers and clinics, and patients. 
  • The data was collected through an iPad questionnaire given at the chosen sites. 
  • They had 518 chronic low back pain patients complete it while 347 chronic neck pain patients finished theirs. They also had 1159 do both. 

What They Found

  • Most of the sample were highly-educated
  • Most were non-hispanic
  • White females were the dominant demographic for race and gender
  • Few used narcotics
  • Avoiding surgery was the most important reason they chose chiropractic care 
  • Over 90% of the patients reported high satisfaction with their care

That should give you some good ideas when trying to figure out who you should be marketing to. I can lead the horse to water but I cannot show the snout into the pond and make the horse drink it up. 

Text Neck

I picked this one out because I saw a discussion on Facebook last week about Text Neck. The question posed was, isn’t text neck just a new term for an old problem? Is text neck just a scare tactic?

That was the general gist of the post. 

While I did not respond, I do have an opinion on text neck. I do not think it’s an old problem. I mean, let’s back up a bit. Poor posture is most certainly an age-old problem. No doubt about it. 

However, at no other point in our time in history that I’m aware of, have little bitty children all the way up to mid-aged and elderly people had a reason to be sitting in one spot for hours with their head flexed forward, bent down almost into their laps. It pains me to see some of the kids these days. 

My poor son. Not so much my daughter right now but my son….my goodness. That kid…I’ll look at him sometimes and he has somehow balled himself up into what I can only describe as something resembling a roly-poly or an armadillo. His head bent at 90 degrees looking at his phone in his lap. Basically, the epitome of text neck.

It must really suck being a chiropractor’s kid. I’ve taken pictures of it before when he wasn’t looking. As you probably know, you can draw on pictures on your phones. So I took that picture then drew big red marks exploding out of his neck. Then, while he’s sitting there on his phone, he gets the picture in a text. 

It’s awesome. You all should try it sometime if for no other reason than to give yourselves a laugh. 

Next Paper

This paper is called, “Cervical Proprioception in a Young Population Who Spend Long Periods on Mobile Devices: A 2-Group Comparative Observational Study” and it was published in the Journal of Manipulative and Physiological Therapeutics as well[2]. The lead author was Andrew Portelli and it was published in February of 2018. 

https://www.jmptonline.org/article/S0161-4754(17)30010-6/fulltext?elsca1=etoc&elsca2=email&elsca3=0161-4754_201802_41_2_&elsca4=Physical%20Medicine%20and%20Rehabilitation%7CHealth%20Professions

Why They Did It

The purpose of this study was to evaluate if young people with insidious-onset neck pain who spend long periods on mobile electronic devices (known as “text neck”) have impaired cervical proprioception and if this is related to time on devices.

What They Found

“The participants with text neck had a greater proprioceptive error during cervical flexion compared with controls. This could be related to neck pain and time spent on electronic devices.”

This message has been brought to you by an uncool parent of a teenager. 

Paper #3

This one is called, “Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial[3].” and it was published in Spine journal in February of 2018. 

https://www.ncbi.nlm.nih.gov/pubmed/29481979/

Why They Did It

The optimal number of visits for the care of cervicogenic headache with spinal manipulative therapy is unknown so the authors hoped to identify the dose-response relationship between visits and chronic headache outcomes…. and to evaluate the efficacy of chiropractic by comparison with a light-massage control.

What They Found

The authors’ conclusion was as follows, “There was a linear dose-response relationship between SMT visits and days with CGH. For the highest and most effective dose of 18 SMT visits, CGH days were reduced by half and about 3 more days per month than for the light-massage control.”

So, you guys and gals that want to take evidence-based to the extreme and get people out of your office in only 3 or 4 visits, you may not be hitting the number of visits that work the best. Everyone is different right? Everyone heals differently. Here we have 18 visits being the most effective for chronic cervicogenic headache. 

Good info to keep in mind. 

Integrating Chiropractors

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 instead of chemical treatments like pills and shots.

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

Chiropractic care is safe and cost-effective. It can decrease instances of surgery & disability. Chiropractors normally do this through conservative, non-surgical means with minimal time requirements or hassle to the patient. 

And, if the patient develops a “preventative” mindset going forward from initial recovery, chiropractors can likely keep it that way while raising the general, overall level of health of the patient!

Key Point: Patients should have the guarantee of having the best treatment offering the least harm.

That’s Chiropractic!

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Help us get to the top of podcasts in our industry. That’s how we get the message out. 

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

http://www.chiropracticforward.com

Social Media Links

Chiropractic Forward Podcast Facebook GROUP

Twitter

YouTube

iTunes

Player FM Link

Stitcher:

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About the author:

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

1. Herman PM, Characteristics of Chiropractic Patients Being Treated for Chronic Low Back and Neck Pain. J Manipulative Physiol Ther, 2018.

2. Portelli A, Cervical Proprioception in a Young Population Who Spend Long Periods on Mobile Devices: A 2-Group Comparative Observational Study. J Manipulative Physiol Ther, 2018. 41(2): p. 123-128.

3. Haas M, Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine, 2018: p. S1529-9430.

CF 012: Proven Means To Treat Neck Pain

CF 033: Did You Need Proof That Chiropractors Help Headaches?

CF 005: Valuable & Reliable Expert Advice On Clinical Guides For Your Practice

 

 

CF 011: With Dr. Tyce Hergert: It’s Here. New Guides For Low Back Pain That Medical Doctors Are Ignoring

This week, we are talking about acute and non-acute low back pain. What are current healthcare guidelines? Why does it matter to chiropractic patients and non-chiropractic patients and are those in the medical field getting (and implementing) the information?

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast where we talk about issues related to health, chiropractic, evidence, and research and how those things all fit into a comprehensive approach for treating different conditions. Thank you for taking time out of your day to give us a listen. I know your time is valuable and I will always try hard to fill our time with valuable content.

We’re going to have more fun this week than stepping on a nail. Which I have done.

Before we dive in, it was so nice we had to do it twice. What am I talking about? I’m talking about bringing on Tyce. Tyce Hergert that is down in Southlake, TX. Owner and operator of Chiropractic Care Center of Southlake as well as Southlake Physical Medicine where he oversees an integrated practice. Dr. Hergert is also the immediate former President of the Texas Chiropractic Association so now he can say what he really thinks. He was the big cheese, the illustrious potentate of chiropractic in Texas.

Although it’s highly unlikely, should you enjoy what Tyce shares with us here today, go and listen to his other guest spot which can be found in Episode #6. You can find episode #6 at the following link:

CF 006: With Dr. Tyce Hergert: Astounding Expert Information On Immediate Headache Relief

Welcome to the show Tyce. Nice to have you back.

I would say that a chiropractor would be completely oblivious to not understand that Chiropractic is considered to be on the fringe of healthcare by many to most in the medical field. It’s just a fact and chiropractors deal with this daily. We Chiropractors are used to feeling like the black sheep of the healthcare family off in a corner keeping all to ourselves.

In other articles, podcasts, and videos of mine, you’ll notice I have covered the Wilk vs. AMA case. I’ve covered the Doctored film by Jeff Hayes spotlighting mistreatment of chiropractors. I’ve also covered current attacks on Texas Chiropractors by the Texas Medical Association. It is all very well-documented at this point.

Chiropractic is currently undergoing an amazing renaissance. This is due to a couple of key factors. The first being the need to develop non-pharmacological treatment recommendations in the midst of a national opioid addiction crisis. A crisis that has killed thousands and thousands in the last several years. The second reason being the body of high-quality research that is consistently coming to light almost every month showing the effectiveness of Chiropractic and evidence-based chiropractors.

Do you feel this renaissance, Tyce, or is it just me living inside my head?

With all of the new information and new healthcare laws emerging, the questions going forward SHOULD be, “Is the medical field and is the insurance industry listening and implementing?” We shall see. So far, the answer is, “Absolutely not.” In fact, it’s almost defiant.

Is that an accurate statement Tyce? You’re my checks and balance guy on everything.

Let’s begin with the most glaring denial of Federal Law by the insurance companies right now. It has to do with Section 2706 of the Patient Protection and Affordable Care Act. Also commonly known as “Obamacare.” Section 2706 of the PPACA is entitled the nondiscrimination In Health Care section of the Federal Law and is intended to keep insurance companies and health plans from keeping chiropractors and the services they provide out of the system.

It reads as follows, “A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.”

On the American Chiropractic Association’s FAQ site for 2706, they state, “It is important to understand that Section 2706 and its assurance of non-discrimination in terms of participation and coverage requires that doctors of chiropractic not be discriminated against in the provision of any “essential benefit” that is within their scope of practice.”

Here’s the rub on 2706: part of its purpose is to reimburse chiropractors performing the same services under their scope and license at the same level financially as any other profession that provides that service.

For instance, under the PPACA Section 2706 Federal Law, chiropractors are to be paid the exact same for an 99203 exam code as a doctor of medicine or osteopathy is paid.

Would you agree with that assessment Dr. Hergert? Is this your understanding of the law?

Plain and simple. This is not happening. With so many chiropractors now integrating their practices with medical directors, physician assistants, nurse practitioners, and physical therapists like Dr. Hergert has in Southlake, it’s painfully clear that doctors of chiropractic are being discriminated against when it comes to reimbursements for the same codes performed.

In fact, chiropractors are integrating with these other professions just so that they can finally GET the reimbursements that the other practitioners are allowed! It is madness and clearly violates Section 2706 of PPACA.

Dr. Hergert, you are a great resource here since you’re in the middle of the two professions. What is your experience on this?

Tyce: The carriers will come right out and tell you they don’t think they have to play by this rule.

Also, there is violation of the law if an insurer does something such as applying caps on specific services provided by one healthcare provider whereas the cap does not apply to another type of provider. It is my understanding that United Healthcare has moved to a $65 visit cap on chiropractic care here in Texas.

Am I misinformed here Tyce? Does United Healthcare only put caps on Chiropractors or are they capping services with all providers?
Tyce: That gets very frustrating for those patients with a $50-70 copay.

It is the American Chiropractic Association’s opinion that a violation exists if the insurer or plan denies specific forms of care that is otherwise covered if it is a chiropractor providing the service and it is within their scope and licensing. I would suggest that a medical doctor probably gets services such as non-surgical decompression covered under insurance but chiropractors are routinely denied coverage.

Are there any better examples of this disparity, Tyce, since I don’t know any medical doctors that have their patients perform decompression?

There is a possible violation of Federal Law when Chiropractors are denied inclusion into a plan or group purely based on the profession. For example, it is my understanding that FirstCare won’t cover Chiropractic. Is that a violation of 2706?

Is that a violation? I suppose I could offer an opinion if I were a lawyer. I’m not sure why exactly other providers are allowed coverage while chiropractors are left out in the cold. Here is a great example though that I’m aware of here locally. there is a local insurance network that will remained un-named that charges $200 per year for chiropractors to be included for coverage however, medical professionals pay nothing to be included. Could that be a violation of the nondiscrimination law? I would say it smells a little fishy.

In my opinion, Federal Law is being violated all over the place in regards to Section 2706 of PPACA. I’m not sure how it can be perceived any other way.

What can you add here Tyce that I may have left out?
Tyce: What this means for patients is you can’t use that shiny new insurance policy that is costing you more than a $250k house payment would. You have to fork over the more money to pay for your chiropractic care.

Moving on from Section 2706…..I love talking about the New Recommendations For Acute and Chronic Low Back Pain.
It is becoming more and more aggravating that we chiropractors are not seeing a flood of acute and chronic low back pain patients. If you read my articles, watch my videos, or listen to my podcast with any regularity, you have no doubt been informed several times over of these new recommendations which, at this point aren’t that new anymore. They have been around for about a year now.

It is my opinion that no long-held beliefs or protocols will change if new information isn’t continually pounded and yelled about from the top of the roofs with megaphones. In marketing, experts have said that it takes a target 7 times of being exposed to information before it is finally received and, hopefully, acted upon.

I know that the medical field has NOT been exposed to this information at least 7 times because of two factors:
1. I have spoken to several medical practitioners here locally and not a single one of them has heard of or were aware of these new recommendations.
2. I am not seeing an incredible, overwhelming influx of acute and chronic low back pain new patients coming through my doors as a result of medical referrals.

Tyce, are you seeing an incredible influx of new low back patients from the medical field these days?

Is this willful disregard for the changing recommendations and a “clinging on” to old dogmatic beliefs passed down from the AMA years ago? I think some of it most certainly is.

Is it that a few bad seeds in the Chiropractic profession are giving the rest of us a bad image? I would say some of it most certainly is.

What I think it is mostly based on, however, is the fact that medical professionals are busy, they’re stressed, and many times over-worked and they simply don’t always have the time or opportunity to stay completely up on every new recommendation or updated protocol.

What do you think about it, Tyce?
Tyce: “You’re not down with, what you’re not up on.” Most don’t know. They didn’t get this info in school, and the pharma reps aren’t out spreading the good news.

With that being said, let’s be clear; the issues of low back pain, its economic impact, and the national opioid epidemic crisis in America combine to make these new recommendations that much more important.

Let’s start with the American College of Physicians. Remember, the American College of Physicians was proven in the Wilk vs. AMA case to have played a part in collaborating with the AMA in an attempt to rid the Earth of Chiropractic. I think that’s important to note as we go through the information because the ACP is historically known as a detractor or the chiropractic profession to put it mildly.

In response to the opioid epidemic gripping the nation currently, the American College of Physicians developed new recommendations for treating acute and chronic low back pain.

Why They Did It
• The American College of Physicians developed this guideline in order to provide updated recommendations on treatment of low back pain.
• With these recommendations, the ACP hoped to influence clinicians AND patients to make the correct decision for care in acute, subacute, or chronic low back pain conditions.

How They Did It
• They based their recommendations on a systematic review of randomized controlled trials and other systematic reviews.
• The research they reviewed included those papers available through April of 2015.
• The research included only those on noninvasive pharmacologic and nonpharmacologic treatments.

What They Found
• Recommendation #1: patients with subacute or acute low back pain should seek nonpharmacologic treatments such as Chiropractic, Massage, Acupuncture, and superficial heat BEFORE resorting to non-steroidal anti-inflammatories such as Ibuprofen, Tylenol, Aleve, etc… (Graded as a strong recommendation)
• Recommendation #2: patients with chronic low back pain should seek nonpharmacologic treatments such as Chiropractic, Exercise/Rehabilitation, Acupuncture, & Cold Laser Therapy BEFORE resorting to non-steroidal anti-inflammatories such as Ibuprofen, Tylenol, Aleve, etc… (Graded as a strong recommendation)
• Recommendation #3: In patients with chronic low back pain that have had no relief from nonpharmacological means, the first line of treatment would consist of NSAIDs like Aleve, Tylenol, Ibuprofen, etc.. As a second-line treatment, the clinician may consider tramadol or duloxetine. Opioids would be a last option and only if all other treatments have been exhausted and failed and even then with lengthy discussion with the patient in regards to the risks and benefits of using opioids. (Graded as weak recommendation)

Let’s recap: in February of 2017, the American College of Physicians, historically a Chiropractic profession detractor and attacker, now recommends Chiropractic as a first-line treatment for acute and chronic low back pain.

Dr. Hergert, does that make you feel warm and fuzzy inside because it does me?

Next, let us discuss the American Medical Association. If you thought the American College of Physicians was guilty of Chiropractic-hating, the American Medical Association is, or was, “Pablo Escobar” or the “El Chapo” of the attacks on the Chiropractic profession. The “El Jefe” of the Chiropractic haters, and the group that not only sat in the driver’s seat but also OWNED the entire truck of destruction back before Wilk vs. AMA came along. I believe I have been watching too much Netflix.

As a side note, I have realized that I have a wife, a daughter, and an all female staff at my office and…..I’m not the El Chapo or El Jefe of really anything. My son and I just walk around following orders pretty much. Tyce, you’re married with two daughters right?

On April 11, 2017, the Journal of the American Medical Association published a study on their website titled “Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain Systematic Review and Meta-analysis,” authored by Neil Page, MD et. al. In the format of this research paper, they refer to chiropractic treatment as spinal manipulative treatment or SMT. But, because spinal manipulative therapy is what we chiropractors do the most and what we are most identified with, I’m replacing the term “SMT” with “chiropractic adjustment.”

Is that fair, Tyce? I think it’s fair.

Why They Did It
Considering that spinal manipulation, or the chiropractic adjustment, is a treatment option for acute low back pain, and that acute low back pain is one of the most common reasons for visits to the doctor’s office, the authors wanted to systematically review the studies that have been done in the past dealing with the effectiveness as well as the harms of chiropractic adjustments in the treatment of acute low back pain.

How They Did It
• The researchers used searches of MEDLINE, Cochrane Database of Systematic Reviews, EMBASE, and Current Nursing and Allied Health Literature.
• The search spanned 6 years from January 2011 through February 2017 for randomized controlled trials of adults with low back pain comparing spinal manipulative therapy with no treatment or with alternative treatments.
• The accepted papers also had to measure pain or functional outcomes for up to 6 weeks.
• The data extraction was done in duplicate.
• The quality of the study was assessed through use of the Cochrane Back and Neck Risk of Bias tool.
• Finally, the evidence was assessed using the GRADE criteria which stands for Grading of Recommendations Assessment, Development, and Evaluation.
• 26 eligible randomized controlled trials were identified and accepted

What They Found
• 15 of the RCTs, totaling 1699 patients, showed moderate-quality evidence that chiropractic adjustments had a statistically significant association with improvements in PAIN.
• 12 of the RCTs, totaling 1381 patients, showed moderate-quality evidence that chiropractic adjustments have a statistically significant association with improvements in FUNCTION.
• NO RCTs reported any serious harms or adverse event as a result of undergoing chiropractic adjustments.
• There were only minor events reported like some increased pain, muscle stiffness, and headache in roughly 50%-67% of those treated in the large case series. I would be interested to hear more about this statement by the authors. That is not what we commonly see in our practice. Sometimes, if the patient is new and is not accustomed to chiropractic adjustments, they may experience some soreness or stiffness the next day which is to be expected following a change in the body.
• I want to be as thorough as I can here….Tyce, do you see 50%-67% minor harms in your daily practice?

Wrap It Up
In true AMA fashion, instead of just coming out and saying, “Chiropractic adjustments showed moderate quality evidence for effectiveness in pain as well as in function,” the authors instead stated in conclusion, “Among patients with acute low back pain, spinal manipulative therapy was associated with modest improvements in pain and function at up to 6 weeks, with transient minor musculoskeletal harms. However, heterogeneity in study results was large.” Heterogeneity is defined as, “The quality or state of being diverse in character or content.” In my opinion, this is to give themselves and “out” by implying there was not enough focus to the RCTs to truly state their findings as fact.

Nonetheless, when the AMA comes even remotely close to endorsing anything having to do with Chiropractic, I’ll take it. And so should those in the medical field that commonly come in contact with those seeking help for their acute and chronic low back pain.

So…….We Should Be All Set For Success Now Right? Maybe they’re about to open up a chiropractic low back pain wing of the hospital, right?

That is what you’ think but there is new information from the White House that this simply is not the case despite the obvious ramifications. You can find the link in the show notes but on page 57 of The President’s Commission On Combating Drug Addiction and The Opioid Crisis report, the authors say, “A key contributor to the opioid epidemic has been the excess prescribing of opioids for common pain complaints and for postsurgical pain. Although in some conditions, behavioral programs, acupuncture, chiropractic, surgery, as well as FDA-approved multimodal pain strategies have been proven to reduce the use of opioids, while providing effective pain management, current CMS reimbursement policies, as well as health insurance providers and other payers, create barriers to the adoption of these strategies.” This is straight from the White House.

At the bottom of page 57, you will also see that it says, “The Commission recommends CMS review and modify rate-setting policies that discourage the use of non-opioid treatments for pain, such as certain bundled payments that make alternative treatment options cost prohibitive for hospitals and doctors, particularly those options for treating immediate post-surgical pain.”

What say you Tyce?
Tyce: You mean like a specialist copay for chiro care and a lower copay for primary care? Or covering surgery 100% and NOT covering non-surgical means.

Essentially, the United States Government is admitting there is professional discrimination at the highest levels…..hello Medicare and Health Insurance plans….I’m talking to you….this discrimination creates barriers to doing the smart thing.

The smart thing is seeing a chiropractor for your back pain. The “Big Guys” (AKA: American College of Physicians and the American Medical Association) recommend it and the government says policies are in place to prevent patients from following those recommendations.

In addition, policies that discriminate against chiropractic or chiropractors run in violation of Section 2706 of PPACA. It comes full circle.
I know you have something good to say here Tyce…

Tyce: The beautiful thing we get to see in our office, since we have both medicine and chiropractic working together, is the end of the story…people getting off the mind altering drugs, healing, and getting their lives back. All we do is follow these simple guidelines.

I have a question to pose to the entire Chiropractic profession: How in the heck do we deal with this?

It has to be through either the legislature at the state and federal levels or it has to be through the legal system. A guarantee I feel comfortable making is that the insurance companies won’t begin enforcing it on their own.

Mobilization and unification of the Chiropractic profession is probably where it starts.

Some steps toward that end include:
• Join or get involved with your state association. They’re the only ones effectively fighting for you and your rights on the state level.
• Join or get involved with your national association. They’re the only ones effectively fighting for you and your rights on the national level.
• If possible, build relationships with your state and national legislators.
• Donate to all of the above in the largest amounts you are comfortable with.
• Tell your friends and your colleagues about what is going on and help them get involved if they’re so inclined.
• Follow the news of your industry closely and stay knowledgeable about your profession. Both the good AND the bad.

Tyce, you have served for years and you’re still serving your profession. What you got on this?
Tyce: “Be part of the solution. You don’t have to dedicate 24/7 to the crusade….but you could do a little more. Right?”

A Chiropractic profession that is unified and playing offense instead of defense is powerful and is one of the worst nightmares of some folks I know out there in the world. Personally, as a side note, I like to see people like that squirm just a little don’t you? It just feels good. Makes what’s left of my hair stand up.

So won’t you consider helping if you haven’t before? If you don’t know where to start, email me at dr.williams@chiropracticforward.com and I will help you get on your way.

Tyce, I want to thank you for taking the time to come on the podcast and share your genius with us. With our history, I’m sure that Chiropractic Forward podcast listeners can count on your being a guest many many times. And, the next time will be the third time and I can say something like, “It was so nice, we had to do it thrice, with Tyce….or something stupid but entertaining like that.” Thanks for joining us today.

When Chiropractic is at its best, you cannot beat the risk vs reward ratio.

Did you know that research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, in comparison to the traditional medical model, patients get good or excellent results with Chiropractic? Chiropractic care is safe, more cost-effective, it decreases your chances of having surgery, and it reduces your chances of becoming disabled. We do this conservatively and non-surgically. In addition, we can do it with minimal time requirements and minimal hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward from initial recovery, we can likely keep it that way while raising the general, overall level of health!

Please feel free to send us an email at dr dot williams at chiropracticforward.com and let us know what you think or what suggestions you may have for us for future episodes. If you love what you hear, be sure to check out www.chiropracticforward.com. As this podcast builds, so will the website as we add more content, educational products, and a little further down the road, webinars, seminars, and speaking dates as they get added.

 

In the meantime, here are some of our recent podcasts that may be of interest:

CF 012: Proven Means To Treat Neck Pain

CF 008: With Dr. Craig Benton – Brand New Information Based on Results Chiropractic Proven Effective For Low Back Pain

CF 010: Surprise Unique Information Shows Chiropractic May Work On The Brain Too

 

 

 

 

We cannot wait to connect again with you next week. From Creek Stone here in Amarillo, TX, home of the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

References and Source Material
1. https://www.amarillochiropractor.com/startling-medical-professional-attacks-chiropractic/
2. https://www.amarillochiropractor.com/healthcare-in-texas-the-battle-against-a-monopoly-a-true-story-about-david-goliath-3/
3. https://www.whitehouse.gov/sites/whitehouse.gov/files/images/The%20Underestimated%20Cost%20of%20the%20Opioid%20Crisis.pdf
4. https://www.acatoday.org/Portals/60/Docs/Advocacy%20and%20Reimbursement/2706/2706-FAQs.pdf?ver=2015-12-23-125425-503
5. https://annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice
6. https://jamanetwork.com/journals/jama/article-abstract/2616395?widget=personalizedcontent&previousarticle=2616379
7. https://www.whitehouse.gov/sites/whitehouse.gov/files/images/Final_Report_Draft_11-3-2017.pdf

 

CF 007: Awesome Alternatives To High Blood Pressure Treatment

In today’s podcast, we are going to talk about high blood pressure, what happens, how many people it affects, and what we may be able to do to help it. Today is all about high blood pressure and I’m going to admit to you….in researching for this week’s podcast, even I learned new things about high blood pressure and I’m betting you will too. If you love what you hear, be sure to check out www.chiropracticforward.com. As this podcast builds, so will the website as we add more content, educational products, and a little further down the road, webinars, seminars, and speaking dates as they get added.

Welcome to the podcast today, Dr. Jeff Williams here with Creek Stone here in Amarillo, TX and I’m your host for the Chiropractic Forward podcast where we talk about issues related to health, chiropractic, evidence, and research and how those things all fit into a comprehensive approach for treating different conditions. Thank you for taking time out of your day to give us a listen. I know your time is valuable and I will always try hard to fill our time with valuable content.

You have fallen head first into episode #7 this week and I want to welcome you. We are going to have more fun that headbutting an i-beam..which I actually did on accident one time when I was a kid. I was running away from someone while playing tag and was looking over my shoulder wrhen smack…now I have a scare on the side of my noggin 35-40 years later. This is how I am certain we will have more fun with this episode.

Speaking of fun, with this being a brand new podcast, I can’t tell you how much fun it is to check the stats of the show and see people tuning in and finding value in our ideas and in information we have to share with you.

I think it is responsible to start off with a disclaimer: I am not a cardiologist. I am a research-minded, evidence-based Doctor of Chiropractic that has seen a jillion people with high blood pressure throughout a 20-year career. The ideas and discussion to follow will be based on information derived from the Centers for Disease Control and Prevention, from the American Heart Institute, and from information shared through Dr. Stephen Sinatra of New York, who is a cardiologist and founder of the New England Heart Center. Ultimately, your blood pressure and heart health is something your primary practitioner and/or cardiologist should be monitoring consistently. Our intent here is not to “treat” anyone through the internet but to simply raise awareness and encourage you to pay attention and take steps to protect yourself if needed. Do not simply depend on information from the internet or Dr. Google as I call it. If you are suffering from high blood pressure (or think you might be) make an appointment with your primary today.

Now that we’ve taken care of that, let’s get going with an easy definition of high blood pressure. According to the American Heart Association, high blood pressure is when your blood pressure, the force of the blood flowing through your blood vessels, is consistently too high.

I want to tell you all why, at times, I should have high blood pressure. It’s because I have a teenager. Yes, I have a 15 year old high school kid and he’s why. Lol. Not really, as far as teenagers go, he could be soooo much worse. Other than his need to be right conflicting with my need to be right, he’s a sweetheart.

Other reasons may be a busted pipe in the pool house when we had a major freeze. I know I know…first world problems… I happen to be the owner of a european great dane…..enough said. That girl can tear some stuff up when she gets bored.

I also have a huge Leonberger dog. Look it up. They’re beautiful but the hair…I’m telling you, it’s a job to stay clean. I could make cushions out of the amount of hair that dog generates.

The animals at my house at this point would include two dogs, a cat (not my choice), two guineas, and two turtles..and that doesn’t even include my 10 year old daughter and my teenage son… I probably have some mice too if I’m guessing right.

Not to mention I’m an actively practicing chiropractor running a busy practice and all of the stressors that come with it. Own your own business they said, be your own boss they said….you’ll be able to do whatever you want. Heck, I don’t have time to think twice and I certainly don’t have a lot of time to sit around and generate content. I’m busy humpin it and making a living. I’m not out on the lecture circuit just yet and having dinner and a drink in the hotel bar. Lol. I’m at work all day every day. I have stress people!! That’s all I’m saying.

But seriously, I have actually been very fortunate and have not had to battle with high blood pressure yet. Thank the good Lord. I am just lucky I think.

From personal experience in treating patients, I have seen new patients having blood pressure counts of 200 over 110 before and they had NO IDEA their blood pressure was high. What does a chiropractor do in that instance? You may get different ideas from different chiropractors but I can tell you what THIS chiropractor does in those cases. I send them either directly to their primary practitioner or the urgent care, whichever they prefer. I won’t touch them as far as chiropractic treatment until the blood pressure is under control.

There is research we will discuss in a minute showing chiropractic is effective in controlling high blood pressure but I will not be the one trying to get it down when it is at that level. I’ll be the one trying to help once it’s normalized. That is simply my opinion and the way I choose to go about things in my practice. As I said, other chiropractors likely have other opinions and protocols.

Next, let’s discuss some high blood pressure facts from the Centers for Disease Control & Prevention that you may not already know about concerning WHO is commonly affected:

  • Did you know that about 75 million Americans suffer from high blood pressure? That’s about a third of the population. Another way of saying that is that 1 in every 3 people have high blood pressure. 
  • Unfortunately, only about half of the people with high blood pressure have the condition under control.
  • About 11 million adults in America have high blood pressure and don’t even know it.
  • High blood pressure costs America around $46 Billion every year when you account for the cost of health care services, medications, and days out of work.
  • High blood pressure affects women about as much as it affects men overall but under the age of 45, more men are affected. Over the age of 65, more women have the condition.
  • When we look at race, more black people have high blood pressure than do whites and Hispanics, and of the black people having it, more women are affected than men.
  • Women having high blood pressure that then become pregnant are more likely to have complications.
  • Uncontrolled high blood pressure during the midlife phase (45-65) seems to be linked to higher risks of dementia later in life.

Here are some of those random facts that you may be able to use in a game of Trivial Pursuit somewhere down the line:

  • Did you know that too little salt can contribute to high blood pressure? We commonly associate an excess of salt with high blood pressure but too little is an issue as well. According to Dr. Stephen Sinatra, a cardiologist from New York, it seems a good mix is keeping more than 1.8 grams of salt a day in your body while keeping sodium below 2.8 mg/day while keeping a close eye on hidden salts that can be found in canned soups, pickles, salted nuts, etc.
  • Potassium plays a part in healthy blood pressure so it’s likely a good idea to foods like eggplant, squash, bananas, coconut water, and baked potatoes.
  • It’s a good idea to have the blood pressure taken in both arms since the numbers are often different from one arm to the other.
  • Cardio is great but weight training can RAISE blood pressure. If you like to lift weights but suffer from high blood pressure, it would probably be a great idea to lift much lighter with higher reps in an attempt to bring down those numbers.

Now let’s talk about some of the causes of high blood pressure in patients:

  • Emotional stress
  • Being overweight
  • Environmental toxins
  • Smoking
  • Lack of exercise
  • Too much salt as well as too little salt
  • More than one or two drinks of alcohol per day.
  • Age
  • Genetics

What risks do you run when leaving your high blood pressure untreated or uncontrolled? As unpleasant as it may be to discuss, it can be as serious as you may have imagined. Here are the potential outcomes of untreated high blood pressure:

  • The CDC states that over 360,000 U.S. citizens died of high blood pressure in 2013 which totals about 1,000 deaths every single day.
  • High blood pressure increases your risk of having a heart attack, of having a stroke, of having long-lasting heart failure, and of having kidney disease.

Here’s brand new and very interesting research paper I wanted to take the time to discuss. It’s by AP Wong and is titled “Review: Beyond conventional therapies: Complementary and alternative medicine in the management of hypertension: An evidence-based review(1).”

Why They Did It

The authors state that high blood pressure is responsible for about 12.8% of all deaths globally. Considering that staggering fact, the World Health Organization has targeted a 25% reduction in high blood pressure by the year 2025 and has encouraged more evidence and research into non-conventional methods of controlling high blood pressure.

How They Did It

  • The authors of the paper had two main objectives

1. Describe the therapeutic modalities commonly used in treating high blood pressure.

2. Review the current level of evidence that has been attained for each.

  • The researchers used a search from 2005-2013 of the databses MEDLINE, The Cochrane Library, PUBMED, and EMBASE.
  • 23 papers were found and accepted.
  • Modalities identified in the 23 papers were fish oil, qigong, yoga, coenzyme Q10, melatonin, meditation, vitamin D, vitamin C, monounsaturated fatty acids, dietary amino-acids, chiropractic, osteopathy, folate, inorganic nitrate, beetroot juice, beetroot bread, magnesium, and L-arginine.

What They Found

The following therapies had weak to no evidence for effectiveness in treating high blood pressure:

  • Fish oil
  • Yoga
  • Vitamin D
  • Monounsaturated fatty acid
  • Dietary amino-acids
  • Osteopathy

The following therapies showed significant reduction in blood pressure:

  • Chiropractic
  • Magnesium
  • Qigong
  • Melatonin
  • Meditation
  • Vitamin C
  • Folate
  • Inorganic nitrate
  • Beetroot juice
  • L-arginine

Coenzyme Q10 has differing results. Some studies showed it had weak to no effectiveness while other studies showed it to have significant effect on the reduction of high blood pressure.

Wrap It Up

In a quote from the authors conclusion, they said, “Results from this review suggest that certain non-conventional therapies may be effective in treating hypertension and improving cardiac function and therefore considered as part of an evidence-based approach.”

With all of the information combined from the articles used as source material, including the research paper, the Alternative means of treating high blood pressure may include:

  • CHIROPRACTIC – we will talk more about this in just a moment
  • Coenzyme Q10 – More discussion on Coenzyme Q10 later.
  • Magnesium
  • Ribose
  • L-arginine
  • RestricT carbohydrates
  • Use olive oil – consider adopting the use of the Mediterranean Pan-Asian diet which is a non-inflammatory diet.
  • Cutting sugar out of your diet is crucial for those suffering from high blood pressure.
  • Less alcohol is best but a glass of wine a day has shown benefits.
  • No processed juices from the grocery store. They’re packed full of useless and damaging sugars.
  • Exercise protocols
  • Lose weight – only a five pound reduction can make a difference
  • Stop smoking!
  • Qigong
  • Melatonin
  • Meditation
  • Vitamin C
  • Folate
  • Inorganic nitrate
  • Beetroot juice

Besides this study, there are several other suggesting Chiropractic plays an important role in reducing or controlling blood pressure.

In one from 1988 by Yates, et. al. called “Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial,” they showed how anxiety and blood pressure were significantly reduced following chiropractic treatment(2).

In another very interesting study through the University of Chicago Medicine from March 14, 2007, and led by George Bakris, MD (director of the hypertension center at the University of Chicago Medical Center, researchers did the following:

  • They took 50 Chicago-area citizens having high blood pressure.
  • All had misaligned C1 vertebrae measured on x-ray
  • They were randomly divided into a treatment group consisting of a chiropractic adjustment and a sham group where no treatment was actually performed.
  • The participants were assessed at the beginning of treatment, after the chiropractic adjustment, and at the end of eight weeks.

What They Found

The authors stated that the improvement in blood pressure for both systolic and diastolic were similar to that seen when giving patients two different blood pressure medications at the same time. Not only that, but the reduction in the blood pressure continued in the eighth week!

Wow!!!

When Chiropractic is at its best, you cannot beat the risk vs reward ratio. Plain and simple. Spinal pain is a mechanical pain and responds better to mechanical treatment rather than chemical treatment such as pain killers, muscle relaxants, and anti-inflammatories.

Just another reason to call a chiropractor TODAY!

Research and clinical experience shows that, in about 80%-90% of headaches, neck, and back pain, in comparison to the traditional medical model, patients get good or excellent results with Chiropractic. Chiropractic care is safe, more cost-effective, it decreases your chances of having surgery, and it reduces your chances of becoming disabled. We do this conservatively and non-surgically. In addition, we can do it with minimal time requirements and minimal hassle on the part of the patient. And, if the patient develops a “preventative” mindset going forward from initial recovery, we can likely keep it that way while raising the general, overall level of health!

Please feel free to send us an email at dr.williams@chiropracticforward.com and let us

know what you think or if you have any suggestions for future episodes. And remember

to help us spread the word by sharing our podcast with your colleagues, your friends,

and your family.

From Creek Stone in Amarillo, TX and the flight deck of the Chiropractic Forward

podcast, this is Dr. Jeff Williams saying upward, onward, & forward.

Research Citations

(1) Wong AP, et al. “Review: Beyond conventional therapies: Complementary and alternative medicine in the management of hypertension: An evidence-based review.” Pak J Pharm Sci. 2018 Jan;31(1):237-244.

https://www.ncbi.nlm.nih.gov/m/pubmed/29348109/

(2) Yates RG, et. al. “Effects of chiropractic treatment on blood pressure and anxiety: a randomized, controlled trial.” J Manip Physical Ther. 1988 Dec;11(6):484-8.

https://www.ncbi.nlm.nih.gov/pubmed/3075649

(3) Bakris, G. Journal of Human Hypertension, advance online publication, March 2, 2007. Grassi, G. Journal of Human Hypertension, advance online publication, January 25, 2007.George Bakris, MD, director, hypertension center, University of Chicago. Marshall Dickholtz Sr., DC, Chiropractic Health Center, Chicago.

http://www.uchospitals.edu/news/2007/20070314-atlas.html

Other Source Material:

https://www.cdc.gov/bloodpressure/facts.htm

https://www.cdc.gov/features/highbloodpressure/index.html

https://www.heart.org/HEARTORG/Conditions/HighBloodPressure/GettheFactsAboutHighBloodPressure/The-Facts-About-High-Blood-Pressure_UCM_002050_Article.jsp#.WmYUYyOZNBw

https://www.drsinatra.com/6-surprising-blood-pressure-facts-everyone-should-know