low back pain

Jeff Williams - evidence-based chiropractor

Discs In Low Back Pain & Unnecessary Surgeries Via COVID

August 25, 2023 chiropracticforward COVID-19, Disc Herniations, Low Back Pain, Surgery 0:18:26 0 Comments

CF 292: Discs In Low Back Pain & Unnecessary Surgeries Via COVID

Today we’re going to talk about Discs In Low Back Pain & Unnecessary Surgeries Via COVID

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

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

You have found yourself smack dab in the middle of Episode #292

Now if you missed last week’s episode, we talked about Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use . Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Isn’t it funny how things work sometimes? I had something odd happened recently here in the clinic. We found out that our acupuncturist was moving to a different chiropractor’s office. She’s been with us for about eight years. What she’s credentialed through me to see veterans through our VA system.

So the VA randomly called us one day inquiring on her moving to another office and when that is happening, etc. Well, it was news to us. So we reached out to the acupuncturist and she admitted that she had plans to move but had not shared them with us yet. Although Amarillo Texas is about 225,000 people, there are only 3 acupuncturists in the entire area. It’s just not that popular here.

Although, it is definitely gaining in popularity. So the prospects of us being able to bring on another acupuncturist quickly are very slim. However, we went ahead and reached out to the one we really wanted to work with us. I have a good relationship with her, but things have just not worked out to where we could’ve actually worked together before. It turns out that she was tired of her current situation and was interested in making a move.

So she came in for an interview, we talked, and she was on board. We started the credentialing process with the VA that very day, so, while it takes 90 days to get credentialed, at this point, we are already almost a month into the process. That should significantly shorten the waiting period for our veterans to switch to a new acupuncturist and soften the landing.

Oh, in the meantime, if our previous acupuncturist, had any plans of stealing our patients, and taking them to a new place, that is going to be hard for her to accomplish. She hast to get completely re-credentialed, and I promise you were ahead of her on getting that done. In addition, the veterans have to get authorization to see her and she hast to get credentialed before they can even start the process of getting authorized through her. Whereas here in my clinic the machine is already built. The gears are already oiled and greased, and we are at fine-tune the machine. I think there’s no doubt we are going to come out ahead on this transition.

One thing we all know is that the one constant in life is that things are always changing.

Many of us are going through changes with staff. I have 3 CA’s and that third spot. It’s just a constant turnover. I have another one that will start in two weeks. The last one lasted for about two weeks. The one before her lasted about three months. It’s been miserable but when we find the right one I think it will have been worth it anyway, that’s what’s on my mind this morning. Getting acupuncture back up and running and marketed, and getting another new staff member up and going.

It’s a constant churn and, as they say in the military, just embrace the suck and keep trucking. It all pays for your life and for the life of your family members. Might as well enjoy all of it that you can and embrace the parts you feel suck your soul and keep that part in the proper context.

Item #1

 

The first on today is called “Intervertebral disc degeneration and how it leads to low back pain” by Ashish D Diwan, James Melrose and published in Pub Med on Nov14 2022. Dayum. That’s hot.

Why They Did It

  • The purpose of this review was to evaluate data generated by animal models of intervertebral disc (IVD) degeneration published in the last decade.
  • The review aimed to highlight the valuable contributions of these animal models in identifying molecular events associated with pain generation.
  • IVD degeneration is a complex process contributing to spinal pain, and understanding the underlying mechanisms is crucial for developing effective therapeutic strategies to alleviate pain, promote disc repair and regeneration, and prevent associated neuropathic and nociceptive pain.

How They Did It

 

  • The researchers conducted a review of existing studies that employed animal models of IVD degeneration.
  • They likely searched relevant databases, academic journals, and publications from the past decade to gather a comprehensive dataset.

  • The selected studies would have used various animal models and experimental methods to induce IVD degeneration.

  • These animal models mimic certain aspects of human IVD degeneration, allowing researchers to study the molecular events and mechanisms involved in pain generation.

What They Found

  • Through their review, the researchers observed that in degenerated IVDs, there is nerve ingrowth and an increased number of nociceptors (pain-sensing neurons) and mechanoreceptors (sensors of mechanical stimuli).
  • The biomechanically incompetent and abnormally loaded degenerated IVDs experience increased mechanical stimulation, leading to heightened low back pain.
  • This finding helps establish a link between IVD degeneration and pain generation, shedding light on the complexity of the process.

  • The review also highlighted the potential of a specific factor called “growth and differentiation factor 6” in addressing IVD degeneration. Studies using this factor in IVD puncture and multi-level IVD degeneration models, along with a rat xenograft radiculopathy pain model, demonstrated its ability to prevent further deterioration in degenerate IVDs. The factor exhibited regenerative properties that promoted the recovery of normal IVD architectural functional organization and inhibited the generation of inflammatory mediators, which contribute to disc degeneration and low back pain.

Wrap It Up

 

  • The review of animal models of IVD degeneration provided valuable insights into the molecular events underlying pain generation in degenerate IVDs. It emphasized the importance of understanding the complex multifactorial process of IVD degeneration to identify potential therapeutic targets for pain relief and disc repair.

 

  • One promising candidate identified through the review was “growth and differentiation factor 6,” which showed considerable potential in preventing further deterioration of degenerate IVDs, promoting regeneration, and inhibiting the generation of inflammatory mediators.

 

  • The findings from these animal models suggest the need for human clinical trials with this compound to assess its efficacy in treating IVD degeneration and preventing low back pain generation in humans. Overall, this review underscores the significance of animal models in advancing our understanding of IVD degeneration and pain mechanisms, ultimately leading to improved treatment strategies for patients suffering from low back pain.

 

Before getting to the next one,

 

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

 

When you decide you can‘t live without those products, send me an email and I‘ll give you the hookup. They will 100% differentiate your clinic from your competitors.

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

Item #2

Our last one this week is called, “100,000 older Americans got unnecessary surgeries during dangerous first year of COVID-19” by Aaron Toleos and published in Lown Institute on May 17, 2022. Hot potato!

Why They Did It

The Lown Institute conducted this analysis to shed light on the issue of overuse of medical procedures in American healthcare, particularly during the COVID-19 pandemic. The aim was to bring attention to the fact that even during a public health crisis, unnecessary procedures were still being performed on vulnerable patients, potentially exposing them to harm and wasting healthcare resources.

How They Did It

The analysis was based on Medicare claims data from January to December 2020. The Lown Institute used the 100% Medicare claims database to evaluate the volume of overuse for eight common low-value procedures. The specific procedures and criteria for overuse were determined based on the institute’s previously published research into the measurement of low-value care at hospitals.

 

 

What They Found

  • The Lown Institute found that a total of 106,474 unnecessary procedures were identified during the analyzed period. The most overused procedure by volume was coronary stents, with 45,176 procedures performed. Other procedures with high rates of overuse included vertebroplasty for osteoporosis, hysterectomy for benign disease, and spinal fusion for back pain.

  • The analysis also revealed that approximately one in five of these low-value procedures met the criteria for overuse across the country. Even some of the nation’s most well-regarded hospitals had rates of overuse above the national average. For example, all of the top 20 hospitals ranked by U.S. News had rates of coronary stent overuse above the national average, with four of them having rates at least double that.

 

Wrap It Up

The analysis conducted by the Lown Institute highlights the persistence of overuse of medical procedures in U.S. hospitals, even during a major public health crisis like the COVID-19 pandemic. Despite previous knowledge that certain procedures, such as coronary stents for stable coronary disease, are of limited clinical benefit, they continue to be performed at high rates. This raises concerns about patient safety, healthcare costs, and the need to address the issue of overuse in the American healthcare system. The findings call for greater attention to evidence-based practices and the promotion of appropriate and necessary medical interventions to ensure better patient outcomes and more efficient use of healthcare resources.

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

 

Store

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

 

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

The Message

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

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

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

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

 

Key Point:

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

That‘s Chiropractic!

Contact

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

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

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

Connect

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

Website

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Jeff Williams - evidence-based chiropractor

New Dietary Ideas & The Doctor’s Words Matter

June 1, 2023 chiropracticforward Catastrophizing, Chronic Pain, Diet 00:20:07 0 Comments

CF 282: New Dietary Ideas & The Doctor’s Words Matter

Today we’re going to talk about new dietary ideas and the doctor’s words matter.

But first, here‘s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

 

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

 

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

 

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

 

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

 

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

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

 

You have found yourself smack dab in the middle of Episode #282

 

Now if you missed last week’s episode, we were joined by Dr. Lindsay Mumma and talked about clinical excellence and pelvic floors.

Make sure you don’t miss that info. Keep up with the class.

 

On the personal end of things…..

What’s going on in my world these days? It’s interesting always. To say the least.

 

The biggest on our radars at the moment are three things actually.

  1. We have always leased our space and I would love to own the property for obvious reasons. But prices are just ridiculous, honestly. So it’s been a challenge when we’re looking at property. We still have one year on our current lease but just had this building come open that is looking pretty good both size-wise and price-wise. So it has to be looked at. We know our current space is going to go up in a year and our monthly nut on the building will probably be about the same so, why not? But there’s still the process of moving everything, the IT stuff, the making it all work stuff, setting up a clinic/gym hybrid and all that gobbled gook. Geez. It’s daunting.
  2. The second thing we’re looking at is hiring an associate. But can both of these be done at the same time? Hiring an associate and moving into a new building. I don’t think they can be done simultaneously without putting us in a precarious position financially. The extra info on that thought is that it doesn’t seem to matter because associates are getting out of school and they’re going to work for a franchise and aren’t really doing associate-ships anymore. Every chiro I know out in the world that is looking for an associate tells me they’re not to be found and in the last 7 months or so that I’ve been looking, they’re exactly right. Plus, living in Amarillo, TX isn’t as appealing as living in Dallas or Houston or wherever. A person has to almost be from the Texas Panhandle to see my job offering as a blessing. So, if the associate situation continues the way it is, it’ll be no question. We’ll just move into the new building. Lol.
  3. The third thing is that there is a company out of the Houston, TX area that is an investment gropu and they’re buying 60% of practices that qualify within their metrics and they take over all of the soul-crushing parts of your clinic. They do the HR, the billing, and the collecting. The clinics keep their name and nobody but the owner and the staff will ever even know that part of the practice was sold. Dentists have been doing this model for years. Clinic owners make a solid salary and make their 40% commission. They can bill on the medical E&M scale and get paid at a higher level than we could on our own DC codes so the same work for more money. Plus they help bring in medical if you want and they help bring in PT if you want. And they’ll help bring in associates as well. My colleagues working with the company tell me they’re working less and making more and it was the best decision they ever made. So, I’m looking at seriously. With a little side eye but the wife is on board, which is the most important thing. I just need to get the price I’m looking for. Then we shall see.

 

So, there are 3 biggies that are weighing me down because not a one of those are small decisions. They’re actually monumental decisions and they’re all sitting on my plate currently. I’ll let you know how it unfolds as it unfolds.

 

Stay tuned. For now, let’s dive into the research.

 

 

Item #1

 

The first one today is called “Dietary recommendations for cardiovascular health challenged by new evidence on saturated fatty acids’ effects on LDL-C and Lp(a) levels” by Dr. Chinta Sidharthan and published in News Medical Life Sciences on May 15, 2023. Dayum. That’s hot.

 

 

 

Why They Did It

 

The study was conducted to investigate the effects of dietary modifications on cardiovascular health, specifically focusing on the impact of reducing saturated fatty acid intake on lipid profiles and the risk of cardiovascular diseases.

 

 

How They Did It

 

  • The research on the relationship between dietary modifications, lipoprotein A, and cardiovascular disease risk is based on a review of existing scientific literature and studies.

 

  • The research involved analyzing and synthesizing data from multiple studies that investigated the effects of dietary modifications, particularly the reduction of saturated fatty acids, on lipoprotein A and LDL-C levels.

 

  • To assess the impact of dietary modifications on lipoprotein A and LDL-C levels, the researchers collected and analyzed data from participants, including their dietary intake, lipoprotein A and LDL-C levels, and potentially other relevant markers or risk factors for cardiovascular disease. Statistical was performed to determine the associations between different variables and to assess the significance of the findings.

 

 

 

What They Found

 

  • Despite the lack of data for conclusive inferences, it appears that the risk of cardiovascular disease depends on a relative balance between the levels of the two lipoproteins — LDL-C and lipoprotein A — and the baseline values of both in each individual.

 

  • Furthermore, while reducing cardiovascular risk due to high LDL-C levels through the modulation of saturated fatty acid intake remains important, the clinical LDL-C measurements also include the cholesterol component from lipoprotein A.

 

 

Wrap It Up

 

  • Overall, the evidence indicated that the standard recommendations for a heart-healthy diet which includes reduced consumption of saturated fatty acids, might have a negative impact by increasing the lipoprotein A levels despite lowering the LDL-C levels.

 

  • Since dietary changes are the most prevalent non-pharmacological form of disease prevention, tailored recommendations for dietary changes after considering individual lipid profiles might be required.

 

  • Furthermore, additional cardiac health markers such as lipoprotein A cholesterol content are necessary to assess cardiovascular disease risk accurately.

 

 

Before getting to the next one,

 

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

 

When you decide you can‘t live without those products, send me an email and I‘ll give you the hookup. They will 100% differentiate your clinic from your competitors.

 

 

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

 

 

 

 

Item #2

 

Our last one this week is called, “ The enduring impact of what clinicians say to people with low back pain” by Ben Darlow, Anthony Dowell, G David Baxter, Fiona Mathieson, Meredith Perry, Sarah Dean published in PubMed on December 11, 2013. Hot potato!

 

 

Why They Did It

 

The purpose of this study was to explore the formation and impact of attitudes and beliefs among people experiencing acute and chronic low back pain.

 

How They Did It

 

Semistructured qualitative interviews were conducted with 12 participants with acute low back pain (less than 6 weeks’ duration) and 11 participants with chronic low back pain (more than 3 months’ duration) from 1 geographical region within New Zealand. Data were analyzed using an Interpretive Description framework.

 

 

What They Found

 

  • Participants’ underlying beliefs about low back pain were influenced by a range of sources. Participants experiencing acute low back pain faced considerable uncertainty and consequently sought more information and understanding.

 

  • Although participants searched the Internet and looked to family and friends, health care professionals had the strongest influence upon their attitudes and beliefs. Clinicians influenced their patients’ understanding of the source and meaning of symptoms, as well as their prognostic expectations. Such information and advice could continue to influence the beliefs of patients for many years.

 

  • Many messages from clinicians were interpreted as meaning the back needed to be protected.

 

  • These messages could result in increased vigilance, worry, guilt when adherence was inadequate, or frustration when protection strategies failed.

 

  • Clinicians could also provide reassurance, which increased confidence, and advice, which positively influenced the approach to movement and activity.

 

 

Wrap It Up

 

Health care professionals have a considerable and enduring influence upon the attitudes and beliefs of people with low back pain. It is important that this opportunity is used to positively influence attitudes and beliefs.

 

When a patient is standing on the ledge of chronic pain, we can push them in or pull them back literally based on what we say and how we behave. If you make a big deal out of ddd, they’re gone, echoing as they fall into the pit. If you tell them that everyone has ddd at some point and usually zero pain associated with it, you start pulling them back. Certainly after you encourage them to move, go for a walk, hurt doesn’t mean harm, and you get some pain free movement wins through your treatment and exercises…..well then we’re having two completely different outcomes altogether now, aren’t we?

 

Be smart with your words and your behavior. It’ll make you look like you’re up on your research and education and it’ll make all the difference in the world in your patients.

 

 

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

 

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

 

 

Store

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

 

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

 

The Message

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

 

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

 

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

 

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

 

Key Point:

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

 

That‘s Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

Social Media Links

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

 

Chiropractic Forward Podcast Facebook GROUP

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

 

Twitter

 

YouTube

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

 

iTunes

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

 

Player FM Link

https://player.fm/series/2291021

 

Stitcher:

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

 

TuneIn

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

 

About the Author & Host

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

 

 

Jeff Williams - evidence-based chiropractor

Subacromial Dry Needling & Lumbar Discs With Stenosis Present

April 19, 2023 chiropracticforward Dry Needling, Stenosis 0:17:04 0 Comments

CF 276: Subacromial Dry Needling & Lumbar Discs With Stenosis Present

Today we’re going to talk about Subacromial Dry Needling & Lumbar Discs With Stenosis Present

But first, here’s that sweet sweet bumper music

   

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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  OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.   We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers.   I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.   Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com   If you haven’t yet I have a few things you should do.
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
  • Then go Like our Chiropractic Forward Facebook page,
  • Join our private Chiropractic Forward Facebook group, and then
  • Review our podcast on whatever platform you’re listening to
  • Last thing real quick, we also have an evidence-based brochure and poster store at com
  You have found yourself smack dab in the middle of Episode #276   Now if you missed last week’s episode , we talked about Remote Myofascial Release & Manual Versus Instrumental Spinal Manipulation. Make sure you don’t miss that info. Keep up with the class.   On the personal end of things….. As we speak, I’m getting ready to meet my friends from the MCM Florida Mastermind this coming weekend. Now, I’m a couple of weeks ahead on these podcast episodes for most of you so by the time you hear this one, it’ll have come and gone but that’s what’s happening right now.   What the hell is the MCM Mastermind you might ask? Well, Dr. Kevin Christie of the Modern Chiropractic Marketing podcast put it all together a couple of years ago. It started out at about 15 of us from around the country and I think we’re up to about 24 right now. Pretty capped out I believe. Kevin doesn’t want it any bigger than that but listen up!!   He has talked about starting a West Coast mastermind as well. A separate sister group. They won’t be the OGs like our Florida group or anything but just as important…..as far as they know. : )   Anyway, it’s a very unique and very professionally run and organized thing. Lots of masterminds are thrown together a little willy nilly but Kevin, through his work with Strategic Coach, has this down to a science. The education and the speakers are always top notch, the networking and bonding opportunities are ideal for the exchange of ideas and inspiration, and it’s a damn good reason to get out of your clinic and experience something besides those walls.   Plus, Kevin has some pretty talented connections. Our members include Brett Winchester, Mark King of MPI, Jay Greenstein, Ben Fergus, and lots lots more. Also, you get perspectives from a range of areas of the country. For example, our members are from
  • Texas
  • Alabama
  • Florida
  • North Carolina
  • Montana
  • Ohio
  • Connecticut
  • Illinois
  • Missouri
  • New Jersey
  And I probably missed a few states but you get the idea. It’s a pretty cool thing to be a part of and I value the incredible connections I’ve made over the last two years.   Whether it’s one of Kevin Christie’s masterminds or it’s another you come across, I highly encourage you hop into one….or form your own. You’ll thank yourself.   In addition, I’m lining up my stuff for the big 100 Men Who Give A Damn event tonight. I’ve talked about this on the podcast before but we have to be in the community. You must. You can’t do business sitting on your ass in the words of Dan Kennedy so get out and go and do.   One of the easiest and best ways to do that is through setting up your own 100 Men Who Give A Damn. Although I’d just go ahead and drop the Men from it and say 100 Who Give A Damn because when the wives come, the men spend more so let’s get all inclusive and get everyone there.   You don’t have to do much. I asked 3-4 folks to help me and I picked them from different areas of the community and different industries for a wider net. One being internet, website, etc.   We got a site up and were off and running. You have one event per quarter. Most businesses are happy to donate their space for charitable events.   No membership, no committees or regular meetings. Low maintenance way to have your very own philanthropic group.   Check out our site at www.100menamarillo.com and ask me any questions at creekstonecare@gmail.com I’m happy to help you get up and running if interested.   No paper work or anything. Just start.       Item #1   The first on today is called, “Dry Needling for Subacromial Pain Syndrome: A Systematic Review with Meta-Analysis” by David Griswold and published in Pain Medicine on 26 August 2022. Dayum. That’s hot.     Why They Did It   The authors of this systematic review with meta-analysis evaluated the evidence for the effectiveness of various applications of dry needling (DN) combined with other conservative treatments for subacromial pain syndrome (SAPS).     How They Did It  
  • Six databases (PubMED, CINAHL, Biosis, Web of Science, SPORTDiscus, and Cochrane Central Register of Controlled Trials) were searched after the study had been registered in PROSPERO.
  • The authors included randomized clinical trials investigating the clinical effects of DN in combination with other conservative interventions for SAPS.
  • Outcomes included pain and disability.
    What They Found  
  • Eight studies were selected. All eight studies involving 10 comparisons were included in the analyses (N = 538). A random-effects model was used to analyze between-group effects.
  • Dry needling performed in combination with other conservative interventions produced favorable outcomes at all time points for pain and disability.
  Wrap It Up   The meta-analysis suggests that various applications of DN performed with other conservative interventions are more effective than conservative treatment alone for reducing pain and disability in patients with SAPS. Direct-comparison studies are needed to determine whether one application of DN is superior to another.     Before getting to the next one,   Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.   When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.     I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.   Item #2   Our last one this week is called, “Conservative Treatments for Lumbar Disc Herniation at L3-4 or L4-5 Were More Likely to Fail When Ipsilateral Foraminal Stenosis Was Present at the Caudally Adjacent Segment” by Shuchen Ding and published in PubMed on 14 February 2023. Hot potato!   Why They Did It   To prove conservative treatments are important in lumbar disc herniation (LDH), but predictors for poor outcomes are unclear.   How They Did It  
  • Consecutive patients with unilateral single-level LDH at L3-4 or L4-5 were enrolled. Baseline clinical data were collected, and lumbar spine magnetic resonance imaging was evaluated.
  • Foraminal stenosis was evaluated using Lee’s approach and further categorized as absence (grade 0 and 1) or presence (grade 2 or 3).
  • Each patient underwent conservative treatments (oral meloxicam and dexamethasone, corset, back extension exercise, physiotherapy, and manual therapy) for 6 weeks.
  • Conservative treatments were defined as failed if a patient underwent surgery within 6 weeks or reported poor recovery at 6-week follow-up.
  • Multivariate logistic regressions were used to examine the associations of failed conservative treatments with baseline characteristics and magnetic resonance imaging findings.
  What They Found  
  • The study included 222 patients (mean age 45.5 ± 9.8 years). Of patients, 48 (21.6%) had concurrent ipsilateral foraminal stenosis at the caudal segment, and conservative treatments failed in 39 (17.6%).
  • At baseline, patients with LDH and caudal foraminal stenosis were older (50.79 ± 6.14 years vs. 44.10 ± 10.13 years, P < 0.001), had greater leg pain (7.06 ± 1.17 vs. 6.39 ± 1.40, P = 0.003), and had a higher rate of positive straight leg raising test (54.2% vs. 33.3%, P = 0.008) than patients without caudal foraminal stenosis.
  • In multivariate regression, failure of conservative treatments was associated with positive straight leg raising test (odds ratio 2.26, P = 0.046), and caudal foraminal stenosis (odds ratio 3.20, P = 0.007).
  Wrap It Up   In the presence of caudal foraminal stenosis and positive SLR test, conservative treatments were more likely to fail in patients with LDH.     Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.   Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

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

Connect

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

Website

Social Media Links

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

Chiropractic Forward Podcast Facebook GROUP

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

Twitter

YouTube

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

iTunes

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

Player FM Link

https://player.fm/series/2291021

Stitcher:

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

TuneIn

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

About the Author & Host

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

Jeff Williams - evidence-based chiropractor

Pain Reprocessing Therapy & Meditation-Based Therapy For Chronic Pain

February 16, 2023 chiropracticforward CBT, Chronic Pain, Cognitive Behavioral Therapy 00:16:13 1 Comment

 

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

 

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

 

But first, here’s that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

On the personal end of things…..

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

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

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

Item #1  

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

How They Did It  

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

  What They Found  

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

 

Wrap It Up  

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

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

Item #2  

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

Why They Did It  

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

How They Did It  

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

    What They Found  

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

 

Wrap It Up  

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

 

The Message

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

Key Point:

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

Contact

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

Connect

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

Website https://www.chiropracticforward.com  

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

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

Twitter https://twitter.com/Chiro_Forward  

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

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

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

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

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

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

Bibliography

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

Risk/Reward For Low Back Pain Treatments & Chiropractors In An Interprofessional Practice Setting

February 9, 2023 chiropracticforward Integration, Low Back Pain 00:17:20 0 Comments

CF 266: Risk/Reward For Low Back Pain Treatments & Chiropractors In An Interprofessional Practice Setting

Today we’re going to talk about Risk/Reward For Low Back Pain Treatments & Chiropractors In An Interprofessional Practice Setting

 

But first, here’s that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

  You have found yourself smack dab in the middle of Episode #266   Now if you missed last week’s episode , we talked about where to adjust and the types of adjustments that were most beneficial. Make sure you don’t miss that info. Keep up with the class.   On the personal end of things…..

Man oh man…..we’ve been having such an interesting time around these parts. If you’ve been listening along with me, I lost 3 of my 4 full time employees within only a 2 week span. That’s almost like starting completely over. Stressful, kind of shock and awe type of thing.   But, turns out, if you have a spouse or partner that knows the front desk and has the flexibility in their work schedule to put other things on the back burner and come in and help you turn it around, then that’s freaking gold, people. Listen to the words exiting my piehole. “Make sure your significant other knows how to run the front desk, bill, verify insurance, and put in charges.   Without this, we would have been in terrible shape. My wife is my failsafe. She’s fierce when backed into a corner as well. So, when we kind of feel on the defensive, BAM!

Mama bear comes out and makes it happen.

And she has. She’s the gamechanger.   In case you haven’t followed along, we lost all 3 within 2 weeks. The first two both gave us one month notice. The last one, our front desk staffer, gave us no notice at all. Just up and quit. Thanks to my wife, we were up and running on day one and haven’t missed a beat. In fact, we’ve already grown our weekly visits. Just two weeks in with a new front desk that cares and is knocking it out for us.  

Turns out, my low numbers all this Fall and Winter weren’t bad marketing and all that. It was that the simple jobs or booking and re-booking weren’t being tended to the way we asked. That didn’t just fall on the shoulders of one person. It was several. Now that we’ve started from scratch, our systems are being re-implemented and it’s making a difference quickly.   Now you get to not hear about it anymore very soon. I’m only sharing with you so that, should you go through some of the stuff I’ve dealt with recently, you’ll have a broader knowledge base to make corrections from. When you’d increased your marketing yet the numbers remain low, it’s probably internal. Not external.  

I’m 50 and still learning lessons.  

During the Fall 2022 Slowdown ….that’s what it will forever be referred to by the way….the Fall 2022 Slowdown…..we brought Darcy Sullivan of Propel on board to get our website SEO enpoint and dialed in. If I’m going to have a slowdown, it’s not going to be because of being cheap and not taking care of the #1 source of referrals….which is Google.  

So I brought Darcy on and did the package where they basically do the whole thing for me because, let’s be honest, I don’t have the time nor the expertise for it.   We’ve gone through the process and now she’s updated my website and we’re ready to see what happens with the Google machine. Between Darcy at Propel and my wife handling front desk duties until she gets the new staffer trained up….I’m in a no-lose situation my friends.   I’m looking forward to reporting back on how well Darcy’s crew does for us.   Now, let’s get going with the research, shall we?          

Item #1  

The first on today is called, “Benefits and harms of treatments for chronic non-specific low back pain without radiculopathy: Systematic review and meta-analysis” by Ronald J. Feise and published in The Spinal Journal on November 15, 2022. Dayum. That’s hot.    

Why They Did It  

The aim of this review was to compare the benefits and harms of treatments for the management of chronic low back pain without radiculopathy and to report the findings in a format that facilitates direct comparison (Benefit-Harm Scale: level 1 to 7).    

How They Did It  

  • This was a registered systematic review and meta-analysis of randomized controlled trials. I
  • nterventions included non-pharmacological (acupuncture, spinal manipulation), pharmacological and invasive treatments compared to placebo.
  • Best evidence criteria were used. Two independent reviewers conducted eligibility assessment, data extraction and quality appraisal.

    What They Found  

  • The search retrieved 17,362 records.
  • Three studies provided data on the benefits of interventions, and 30 provided data on harms.
  • Studies included interventions of acupuncture (n=8); manipulation (n=2); pharmacological therapies (n=9), including NSAIDs and opioid analgesics; surgery (n=8); and epidural corticosteroid injections (n=3).
  • Acupuncture and manipulation were effective in reducing pain intensity compared to sham.
  • The benefit of the other interventions was scored as uncertain due to not being effective, statistical heterogeneity preventing pooling of effect sizes, or the absence of relevant trials.
  • The lowest risks were for acupuncture, spinal manipulation, NSAIDs, combination ingredient opioids, and steroid injections, while they were higher risks for single ingredient opioid analgesics (level 4) and surgery (level 6).

    Wrap It Up  

  • There is uncertainty about the benefits and harms of all the interventions reviewed due to the lack of trials conducted in patients with chronic non-specific low back pain without radiculopathy.
  • From the limited trials conducted, non-pharmacological interventions of acupuncture and spinal manipulation provide safer benefits than pharmacological or invasive interventions.
  • There were high harms ratings for opioids and surgery.

    Before getting to the next one,   Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.   When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.    

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

Item #2  

Our last one this week is called, “Chiropractors in interprofessional practice settings: a narrative review exploring context, outcomes, barriers and facilitators” by Corrie Myburgh and published in Biomed central on 16 December 2022. Hot potato!    

Why They Did It  

To determine the added value of interprofessional interventions over existing mono-professional practice, elucidation of specific health care issues, service delivery contexts and benefits of combining multiple service provider is required.  

How They Did It  

  • A search of relevant databases was performed
  • The search was conducted in October 2021.
  • Two reviewers independently screened the articles. In case of disagreement consensus was reached through discussion.
  • An article was included if it described interprofessional practice including a chiropractor and outcome measurements relating to interprofessional service delivery were reported.
  • In particular, articles were included if they had peer-reviewed scientific content in the form of journal articles, book chapters, and conference proceedings

    Wrap It Up  

  • Very limited evidence from which to judge the value of interprofessional practice interventions involving chiropractors is currently available. Exploratory studies have outlined issues relating to feasibility and potential value of interprofessional practice initiatives across at least four domains of practice.
  • However, only one study was identified with the specifically stated purpose of investigating an interprofessional practice practice intervention for a particular health care issue; this being low back pain in older patients.
  • The discourse relating to interprofessional practice involving chiropractors appears to be at an early stage of development and further studies conducted specifically to evaluate interprofessional practice solutions for specific health care issues are urgently required.

So, we need some research. We want to be part of the team so let’s prove that we can provide value and be a valuable member of the team.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.  

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

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

 

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

 

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

 

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

 

Key Point:

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

 

That’s Chiropractic!

 

Contact

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

 

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

 

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

 

Connect

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

 

Website

 

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Chiropractic Forward Podcast Facebook GROUP

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

 

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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

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About the Author & Host

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

Jeff Williams - evidence-based chiropractor

Early Diagnosis Of Spondylolysis and Clinical Guides For Low Back Pain

January 30, 2023 chiropracticforward Low Back Pain, Spondylolysis 00:19:16 0 Comments

CF 264: Early Diagnosis Of Spondylolysis and Clinical Guides For Low Back Pain

Today we’re going to talk about potential early diagnosis of spondylolysis as well as clinical guides on low back pain treatment. But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

  You have found yourself smack dab in the middle of Episode #264   Now if you missed last week’s episode, we talked about spinal surgery for low back pain & white rice and your heart. Make sure you don’t miss that info. Keep up with the class.  

On the personal end of things…..

Man, life is crazy. I think we’re just given what we’re supposed to have at the time we need it. I don’t really know what that means but let’s put it this way; in my personal clinic, I was overwhelmed to a point I had no idea how to keep up. September came and boom, I’ve been down 150-200 visits per month for the entire Fall.  

I’m a Christian so, is it a God thing that when I’m about to pull my hair out, the bottom feels like it drops out and we take a step back?? Who knows? Not me. But Voice over has picked up. So income is steady. Not up or down. Just different sources. It’s weird.   I spent this last weekend playing a singer-songwriter showcase on Saturday night here in Amarillo and then flying to Dallas and back to Amarillo on Sunday to emcee a cheer and dance competition. I got paid very well for both of them. It was outstanding.

Getting paid well for doing things you love doing is pretty refreshing.   Don’t get me wrong; I love working with patients. But when it’s just you and you’ve got 190-200 appointments per week, staffing issues, billing issues, decreased reimbursements, blah blah blah….well that can take away from you job and life enjoyment. I realize I’m preaching to the choir here but you see what I mean.   Still, with the clinic, it looks like it’s coming back around a little in the last 2 weeks or so. We’ll see.

I’m still working with Darcy Sullivan at Propel but still very new to the journey with her so no real wow results yet. It’s a process and I’ll keep you updated.   Also this week, I’m headed to Ft. Lauderdale as part of my MCM Florida Mastermind group. It’s always a great time connecting with this group and with it being a new year, we’ve grown by about 6 or 7 members so more people to solve our problems and more people we can all learn from and, in turn, teach.   I’ll let you know how Ft. Lauderdale goes and if we get into any shenanigans!    

Item #1

Our first one is called “Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021”, and is a clinical practice guidelines published in the Journal of Orthopaedic and Sports Physical Therapy in October of 2021.

This one is a full blown huge article on PT recommendations for 2021. It’s always a year behind and all. So we’re going to just hit some of the interesting points that work for chiropractors too.   They say that providers may use exercise training interventions, including trunk muscle strengthening and endurance and specific trunk muscle activation, to reduce pain and disability in patients with acute LBP with leg pain.   For chronic pain, they say providers should use exercise training interventions, including trunk muscle strengthening and endurance, multimodal exercise interventions, specific trunk muscle activation exercise, aerobic exercise, aquatic exercise, and general exercise.  

Here’s one I found particularly interesting, “Physical therapists should use thrust or nonthrust joint mobilization to reduce pain and disability in patients with acute LBP.”   The hell you say! All these years PTs have been making fun of chiros. Now they’re recommending SMTs. Let’s be fair to the medical world though. They’re not making fun of movement, smt, and strengthening chiros.

They’re making fun of vitalists. And who can blame them?  

They also said, “Physical therapists may use massage or soft tissue mobilization for short-term pain relief in patients with acute LBP.”   Again, we’ve been doing this stuff for-ev-er. Welcome to the party PTs!   You’ll never believe the recommendations for chronic low back pain, that right….” Physical therapists should use thrust or nonthrust joint mobilization to reduce pain and disability in patients with chronic LBP and with chronic pain with associated leg pain.”  

They go on to add massage and soft tissue manipulation as well as dry needling and nerve flossing as well as even mechanical traction   So, two things here:

  1. If you for some reason didn’t feel validated today, feel validated. If you are evidence-informed, you are doing the right stuff and you have been forever and ever regardless of what people from the medical side have said about you over the years. Buncha freaking Chads and Karens showing their asses.
  2. PTs are going to put you out of business because they’re doing everything we’re doing including our one thing, spinal manipulative therapy. Not only are they doing what we do, but they have more cultural authority in the medical community, they are the MDs’ first referral, and they get paid more for it all. Unless we ban together, run the garbage out of our profession, police our own, and move this profession in the direction of evidence-informed, patient-centered care models. Otherwise, bend over and kiss your ass goodbye.

    Before getting to the next one,   Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.   When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.    

I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.   Item #2

#2 today is called, “Lateral bending differentiates early-stage spondylolysis from nonspecific low back pain in adolescents“ by Sugiura et. Al and published in Musculoskeletal Science and Practice in April of 2022 and it’s still a steamy pile of hot stuff.

  Why They Did It Early-stage spondylolysis (ESS) is one of the common causes of acute low back pain (LBP) in adolescents. Although accurate diagnosis of Early-stage spondylolysisis important for providing appropriate treatment, differentiating Early-stage spondylolysis from other low back disorders is difficult by physical signs alone. They wanted to elucidate the most common characteristic, namely, motion-provoking LBP, in patients with Early-stage spondylolysis.

How They Did It

  • We included and categorized adolescents with acute LBP (<1 month) into the Early-stage spondylolysis and nonspecific LBP groups based on magnetic resonance imaging (MRI) findings.
  • Patients were evaluated using a visual analog scale (VAS), Oswestry Disability Index (ODI), and degree of pain using a numerical rating scale (NRS) provoked by hyperextension, hyperflexion, right and left rotations, and lateral bending in standing position

  What They Found

  • The mean scores for VAS and ODI and NRS of each test were compared between groups
  • The Early-stage spondylolysis group had a significantly greater number of LBP cases provoked by lateral bending than the NS-LBP group.

  Wrap It Up  

Our results indicate that lateral bending is the greatest motion-provoking characteristic of LBP in patients with Early-stage spondylolysis.      

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

Website https://www.chiropracticforward.com  

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

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

Twitter https://twitter.com/Chiro_Forward  

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

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

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

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

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

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

Bibliography

  • George S, F. J., Silfies S, Schneider M, (2021). “Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021.” J Ortho Sports Phys Ther 51(11): CPG1-CPG60.  
  • Sugiura S, A. Y., Toyooka T, Shiga T, Takato O, Ishizaki T, Omori Y, Takata A, Kiguchi Y, Tsukioka A, Okamoto Y, Matsushita Y, Inage K, Ohtori S, Nishikawa S (2022). “Lateral bending differentiates early-stage spondylolysis from nonspecific low back pain in adolescents.” Musculoskelet Sci Pract 58.      
Jeff Williams - evidence-based chiropractor

Low Back Surgery & White Rice And Your Heart

January 17, 2023 chiropracticforward Low Back Pain, Nutrition 00:17:50 0 Comments

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

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

But first, here’s that sweet sweet bumper music

 

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

On the personal end of things…..

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

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

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

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

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

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

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

 

Item #1

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

 

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

 

How They Did It  

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

 

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

 

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

 

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

 

What They Found  

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

 

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

 

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

 

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

      Wrap It Up

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

 

Before getting to the next one,   Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.   When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.    

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

 

Item #2   Our last one this week is called, “White rice and pasta are just as bad for your heart as candy” by Caitlin Tilley and published in Dailymail on October 3rd, 2022. Hot potato!    

 

Why They Did It  

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

How They Did It  

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

 

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

 

What They Found  

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

 

Wrap It Up  

As more studies demonstrate an increase in refined grains consumption globally, as well as the impact on overall health, it is important that we find ways to encourage and educate people on the benefits of whole grain consumption.     Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.   Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      

But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

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

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

Website https://www.chiropracticforward.com  

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

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

Twitter https://twitter.com/Chiro_Forward  

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

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

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

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

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

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

 

Bibliography

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

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

Jeff Williams - evidence-based chiropractor

Spinal Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids

November 3, 2022 chiropracticforward Low Back Pain, Opioids, Pain, Placebo 00:23:35 0 Comments

CF 253: Spinal Cord Stimulator vs. Placebo & Low Back Pain, Chiropractic, And Opioids Today we’re going to talk about Spinal Cord Stimulators vs. Placebo & we’ll talk about Low Back pain, Chiropractic, And Opioids But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

You have found yourself smack dab in the middle of Episode #253 Now if you missed last week’s episode, we talked about High Blood Pressure And Cognitive Decline & Does The Popping Noise Matter?. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Alright, if you’ve heard me fussing my face off about being slow for like oh I don’t know…..the last 8 freaking weeks or so….then you’ll be glad to hear that I have 43 on the schedule today with 5 new patients. That’s more like it.  That’s 5 new patients, one consultation, and 3 re-exams. So….they’re  coming back slowly.

Where the hell did they go in the first place? Who knows? But I talked to my buddy, Tyce Hergert down in Southlake, TX and he’s been slow as hell too. Until just last week. He thinks it’s the economy, inflation, back to school kicked it off, and then we have a big election that makes people a bit pulled back and financially more aware.  Who knows, but it makes sense. Maybe it was a perfect storm kind of thing but I know I’m ready to get back to business and running around like my ass is on fire unable to keep up. Then you get to hear me fuss about that. Lol. It’s a cycle. 

Why can’t it ever just sit right there in teh perfect pocket where you’re seeing just the right number of patients and are right where you want to be as far as being busy during the work week? Yeah, that’s a pipe dream. Never happening.  I’ll tell you this though, I’d rather be running around here with my ass on fire, changing people’s lives, and making money along the way rather than sitting here wondering who I made mad and moping around like a whipped dog. Lol.  So, for this week…we’re back toward the top of the mountain. 

Just real quick on a side gig kind of thought process. I have people asking me all of the time how I started getting into real estate. I want to help you guys. I read a book that’s in the Rick Dad Poor Dad umbrella that’s called Tax Free Wealth by Tom Wheelright.  It started talking about how you can pay lower to zero taxes by buying real estate. Well that got me to listening to the Bigger Pockets podcast and taking their webinars. Then I started delving into the niches of real estate. I decided for lots of reasons that Short Term Rentals, or STRs made the most money and the most sense. 

That led to a podcast and a book by Avery Carl called Short Term Rental, Long Term Wealth. They also have a private Facebook group that I’m a member of.  In case you don’t know, STR is what an Airbnb or VRBO property is. Short term rental like 3-5 days or so vs. a year long lease.  Trust me; people a hell of a lot dumber than you are making a ton on real estate. Here are the ways you make money on real estate:

  1. Cashflow – You have a profitable property so you make monthly cashflow. On average, our STR in Lubbock, TX profits about $2,000/month. That’s above and beyond our overhead on the house. 
  2. Appreciation – You never buy property planning on appreciation. However, assuming it’s not in a terrible neighborhood, it usually appreciates. Which is money in your pocket when, or it, you sell. 
  3. Equity – Other people are buying your property for you. They are kind enough to buy down the payment and buy your equity in the property. Meaning, because of them paying you every month, you own more and more of your own property. 
  4. Taxes – There are multiple ways that real estate benefits your taxes and I’ll leave that up to a CPA since I am not one but in general;
    1. With STRs, you can count your losses and depreciate everything on the real estate side, including the curtains to bring down your tax burden in your chiropractic clinic and try to get your tax burden down to zero for the year. 
    2. The write offs. You can write off all of the furnishings and everything that fits the real estate realm. Including meals where you sit and talk to your business partner (your wife and kids) about your properties. 

Not to mention that if you buy an STR in a place you like to visit, you have a place to stay whenever you need it! Also, if the STR is more than 90 miles from your primary residence, you can qualify for a vacation home loan and only pay 10% down instead of the traditional 20% down.

That makes a million dollar home near or on the beach a hell of a lot more do-able for most of us.  I’ll give you all a bit of a tip, you don’t have to go into these things blindly. Go to airdna.co and go down to the Rentalizer link on the left of your screen. Once there, put in any address, including your home address, and see what it might make as an STR. You may be surprised! It’s not a fool proof silver bullet but can give you some ideas. Also, don’t pay a 20% management fee. It takes me literally 15 minutes per week per property to manage.

Don’t lose 20% of your profit. You can do it yourself. Use guesty.com for the property management software and combine that with pricelabs.com for automatic and appropriate pricing from week to week and then……let er rip!!! Thank me later, fools! If you have any questions, join our private Chiropractic Forward Facebook group and start a post in there. I’d be happy to help if I have the answer. If I don’t, I can find it.  Let’s get started with the research shall we?

Item #1

The first on today is called “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial” by Hara et. al. (Hara S 2022) and published in JAMA on October 18, of 2022 and that’s some hot steamy salsa right there. 

Why They Did It The use of spinal cord stimulation for chronic pain after lumbar spine surgery is increasing, yet rigorous evidence of its efficacy is lacking. The authors wanted to investigate the efficacy of spinal cord burst stimulation, which involves the placement of an implantable pulse generator connected to electrodes with leads that travel into the epidural space posterior to the spinal cord dorsal columns, in patients with chronic radiculopathy after surgery for degenerative lumbar spine disorders.

How They Did It

  • It was a placebo-controlled randomized clinical trial
  • 50 patients were in the study
  • Done at St. Olavs Univer. Hospital in Norway
  • Conducted from 2018 – 2021
  • Patients underwent two 3-month periods with spinal cord burst stimulation and two 3-month periods with placebo stimulation in a randomized order. Which seems like they gave it a good solid chance to work to me
  • Burst stimulation consisted of closely spaced, high-frequency electrical stimuli delivered to the spinal cord. 
  • The stimulus consisted of a 40-Hz burst mode of constant-current stimuli with 4 spikes per burst and an amplitude corresponding to 50% to 70% of the paresthesia perception threshold.
  • The primary outcome was difference in change from baseline in the self-reported Oswestry Disability Index

What They Found

The mean changes in ODI score were −10.6 points for the burst stimulation periods and −9.3 points for the placebo stimulation periods None of the pre-specified secondary outcomes showed a significant difference.  Nine patients experienced adverse events, including 4 who required surgical revision of the implanted system.

Wrap It Up

The concluded, “Among patients with chronic radicular pain after lumbar spine surgery, spinal cord burst stimulation, compared with placebo stimulation, after placement of a spinal cord stimulator resulted in no significant difference in the change from baseline in self-reported back pain–related disability.” So…..chronic pain…..if you’re a regular listener, you know me and chronic pain. I love learning and talking about it. You can’t solve a problem through burst stimulation that is as much entrenched in the brain as it may be in a physical sense. 

You can blast it and blast it and until you treat the centralized portion, you’re pissing up a rope, as they say in Texas.  If you don’t have a clue what I’m talking about, start going through this podcast listening to anything on chronic pain, get a book by David Hanscum called Back In Control, and dive into the biopsychosocial aspect of pain. That’ll get you started. 

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

Item #2

This second one I got from my buddy Dr. Craig Benton down in Lampassas, TX quite a while ago. Thank you Craig. It’s called “Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids” by Whedon et. Al. (Whedon JM 2018) and published in Journal of Alternative and Complementary Medicine in June of 2018. 

Why They Did It They say, “Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications.”

How They Did It

  • The authors used a retrospective cohort design to analyze health insurance claims data.
  • The data source was the all payer claims database administered by the State of New Hampshire. 
  • The study population was 18-99 year olds, enrolled in a health plan, with at least two clinical office visits within 90 days for a primary diagnosis of low-back pain. 
  • The authors excluded those with a diagnosis of cancer.
  • The authors measured likelihood of opioid prescription fill among recipients of services delivered by doctors of chiropractic compared with non-recipients. 
  • They also compared the cohorts with regard to rates of prescription fills for opioids and associated charges.

What They Found

The adjusted likelihood of filling a prescription for an opioid analgesic was 55% lower among recipients compared with non-recipients.  Average charges per person for opioid prescriptions were also significantly lower among recipients.

Wrap It Up

They concluded, “Among New Hampshire adults with office visits for non-cancer low-back pain, the likelihood of filling a prescription for an opioid analgesic was significantly lower for recipients of services delivered by doctors of chiropractic compared with non-recipients. The underlying cause of this correlation remains unknown, indicating the need for further investigation.” Alright, that’s it. Keep on keepin’ on.

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

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

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

The Message

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

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

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

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

Website https://www.chiropracticforward.com

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

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

Twitter https://twitter.com/Chiro_Forward

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

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

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

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

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

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

Bibliography

  • Hara S, A. H., Solheim O, (2022). “Effect of Spinal Cord Burst Stimulation vs Placebo Stimulation on Disability in Patients With Chronic Radicular Pain After Lumbar Spine Surgery: A Randomized Clinical Trial.” JAMA 328(15): 1506-1514.  
  • Whedon JM, e. a. (2018). “Association Between Utilization of Chiropractic Services for Treatment of Low Bac k Pain and Risk of Adverse Drug Events.” J Manipulative Physiol Ther 17(30): 30136-30137.      
Jeff Williams - evidence-based chiropractor

Chiropractic Adjustments For The Cervical Spine Really Work & Lumbar Radiculopathy Treatment

November 24, 2021 chiropracticforward Chiropractic Research, Low Back Pain, Neck Pain, Radiculopathy 00:19:25 0 Comments

CF 205: Chiropractic Adjustments For The Cervical Spine Really Work & Lumbar Radiculopathy Treatment Today we’re going to talk about research backing the use of spinal manipulative therapy for neck pain. A systematic review and meta-analysis even! Big stuff. Then we’ll talk about treatment for lumbar radiculopathy. What extra tips can you pick up? But first, here’s that sweet sweet bumper music  

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

Chiropractic evidence-based products

Integrating Chiropractors

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

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

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

You have found yourself smack dab in the middle of Episode #205 Now if you missed last week’s episode, we talked about The Case Of The Disappearing Disc & Vitamin D And Back Pain. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Alright, we got some stuff shaking folks. So, let’s talk about it. First thing, Drake leaving. Who the hell is Drake you might ask? Well, that’s our Parker university intern that’s been with us since last August. We’re spoiled as hell having Drake with us these days. We’re going to miss his help and honestly, he’s just a good guy. We’ll miss him personally as well.  Yes, I tried to hire him but not everyone wants to move to Amarillo so getting associates in this area can be a bit of a challenge. So I’m saying it, if you want to come to Amarillo, you’re always more than welcome to send me a resume at dr.williams@chiropracticforward.com and I’m happy to take a look. 

We have fun. We get people better. And life is good.  I mentioned a couple of weeks ago that we had a turnover and we’d be having a new front desk staffer coming on board. Well, this is the week and here we go. We may have gotten lucky on this one people. 

First, we hire off of Indeed. I’m sure they think I’m a bit of a prick but I use the assessment tools. They have to fill out a couple of assessments that test their knowledge. One is on EHR, another is general office procedure and stuff like that. Well, so many of them just go down the line clicking jobs and submitting without understanding that the assessments weed that out. If they don’t take the time to fill out the assessments, they didn’t care enough about the job to read about it. Which means I don’t care enough about them to waste my time learning more about them. So I move right past them. 

This girl has worked for an urgent care and only looked elsewhere because they didn’t have a full-time position like she needed. My friends actually work at the urgent care and vouched for her. We have the ones we’re interested in come in for a working interview. All of the staff agreed she was the clear choice both in experience as well as in personality.  Our office culture is one defined by fun. We jump scare each other. We laugh. We kid. We are always appropriate but there are times we could be more professional but….again…we have fun. And Our patients love it.

They commonly comment in our Google Reviews about how they love that everyone is so happy, having fun, and enjoying their work.  It’s easy when you have the crew I have. We do work. We work hard. Some days suck. Some days fly by. But think about it, we spend more time with our staff than we spend with our own families for the most part. Right? So why not having fun? Why not have a sense of family, of belonging, and a sense of being a team? Why not? So we’ll be making a new teammate this week. She’s going to be amazing. I just have a feeling. 

Also, I believe it was last week we discussed side gigs.  I mentioned my recent success in the voice over industry and that I’ve been schooling up on real estate investing and all that good stuff. I mentioned that I planned on parlaying that voice over success into real estate investments.  Well, I’ve been analyzing houses and I’ve been learning about remote management of short-term rentals and the pros and cons vs having a long-term rental and all of that good stuff.  Well, I identified 9 properties down in Lubbock TX. Lubbock is about an hour and a half to the south of Amarillo. It’s the home of Texas Tech and Buddy Holly. It’s also where one of my kids goes to college. It’s also the place where my other kid who is currently an 8th grader will likely go if I haven’t retired and moved to Florida when she goes to college. 

Lots of football games, basketball games, baseball games….lots of visits to the medical school there in town….lots of big-name concerts. It’s all good news for having a short-term rental.

Go back and listen to last week’s episode if you want to know why short-term rentals make more sense for tax reasons than other investments right now.  Anyway, I found 9 houses that my wife went to look at last week. She made an offer on one and, once we refi our rental house here in Amarillo, we’ll be able to pull out about $150,000 to put on 1-2 others. One of which is a flip we think we can profit $30k in about three months if there are no surprises or hiccups.  So…..I’m a fact finder. I’ve been finding facts for about a year now. Watching YouTubes. Taking little classes. Listening to podcasts. Reading books. Meeting people and building a small network. So, we’re on it. We’re excited. We’re pumped. We’re busy as hell. 

It’s kind of crazy the faith I have in my wife’s decisions. In lots of ways, she’s the smartest person I believe I’ve ever met. Our first house we bought together, I was on the road traveling with my band somewhere down in south Texas when she made an offer on it. I’d never even seen the house. 

The one I live in now, I actually saw and agreed on. 

The 2-3 down in Lubbock, I haven’t seen either. But I’m buying them. Lol. It’s crazy but she’s a hell of a teammate on this stuff and her vision of what she can do with a house has blown me away. She has some serious skills and I can’t wait to see what happens when she puts them to use on these investments. 

OK, on to the first paper.  Spinal Manipulative Therapy for Acute Neck Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials – PubMed

Item #1

The first one is called “Spinal Manipulative Therapy for Acute Neck Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials” by Chaibi et. al. (Chaibi A 2021) and published in the Journal of Clinical Medicine in October 2021 and that’s got some smoke on it! Let me say that I’ve been yelling for some research on the effectiveness of SMT for neck pain for 4 years here on this podcast. I’ve talked to different researchers about it. They said they couldn’t get funding for it. Now, here we are with a small step for a chiropractor but a giant leap for chiropractor-kind…..or something like that. 

Why They Did It

Acute neck pain is common and usually managed by medication and/or manual therapy. General practitioners (GPs) hesitate to refer to manual therapy due to uncertainty about the effectiveness and adverse events (AEs); 

How They Did It

  • To review original randomized controlled trials (RCTs) assessing the effect of spinal manipulative therapy (SMT) for acute neck pain. 
  • Data extraction was done in duplicate and formulated in tables. 
  • Quality and evidence were assessed using the Cochrane Back and Neck (CBN) Risk of Bias tool and the (GRADE) criteria
  • Six studies were included. 

What They Found

  • The overall pooled effect size for neck pain was very large -1.37 (95% CI, -2.41, -0.34), favoring treatments with SMT compared with controls. 
  • They had a single study that showed that SMT was statistically significantly better than medicine (30 mg ketorolac im.) one day post-treatment. 
  • Minor transient adverse events reported included increased pain and headache, while no serious adverse events were reported

Wrap It Up

SMT alone or in combination with other modalities was effective for patients with acute neck pain. However, limited quantity and quality, pragmatic design, and high heterogeneity limit our findings. So, once again, researchers….please listen. We have enough information on the low back. We know we knock it out of the park on low back pain. Even our haters mostly know we kill it on low back pain. Those douches over at sciencebasedmedicine.whatever mostly admit we’re good on low back pain. And trust me, if you change their damn minds, you’re on to something.  So, let’s expand to the neck, please. Pretty please? Dr. Goertz, Dr. Pohlman, Drs influential with Chiropractic Compass, can we please continue down this path of exploring our effectiveness and low risk for adverse events in the neck because honestly, THIS clinically is what is holding us back. 

Professionally, it’s the vitalists in our profession. But clinically, it’s the perception that we do harm when treating the neck. Can we do harm? Well hell yes we can. Do we commonly do harm and are we likely or probable to do harm? Oh hell no. Why would you ask such a dumb question?

 

Item #2

https://pubmed.ncbi.nlm.nih.gov/30521781/

This one is called “The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial” by Satpute et. al. (Satpute K 2019) and published in Archives of Physical Medicine and Rehabilitation on December 3rd of 2018. It’s mushy…not solidified but not as warm as we like. 

Why They Did It

To evaluate the effect of spinal mobilization with leg movement (SMWLM) on low back and leg pain intensity, disability, pain centralization, and patient satisfaction in participants with lumbar radiculopathy.

How They Did It

  • A double-blind randomized controlled trial.
  • The setting was in a General hospital.
  • 60 adults with the mean age of 44 years old were included
  • They were al diagnosed with subacute lumbar radiculopathy
  • They were randomly allocated to receive spinal mobilization with leg movement  exercise and electrotherapy or exercise and electrotherapy alone. 
  • All participants received 6 sessions over 2 weeks.
  • The primary outcomes were leg pain intensity and Oswestry Disability Index score. Secondary variables were low back pain intensity, global rating of change (GROC), straight leg raise (SLR), and lumbar range of motion (ROM)
  • Variables were evaluated blind at baseline, post-intervention, and at 3 and 6 months of follow-up

What They Found

  • Significant and clinically meaningful improvement occurred in all outcome variables. 
  • At 2 weeks the spinal mobilization with leg movement group had significantly greater improvement than the control group in leg pain and disability. 
  • Similarly, at 6 months, the spinal mobilization with leg movement group had significantly greater improvement than the control group in leg pain and disability. 
  • The spinal mobilization with leg movement group also reported greater improvement in the global rating of change and in SLR range of motion.

Wrap It Up In patients with lumbar radiculopathy, the addition of spinal mobilization with leg movement provided significantly improved benefits in leg and back pain, disability, SLR ROM, and patient satisfaction in the short and long term. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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

Chiropractic evidence-based products

Integrating Chiropractors

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  The Message

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

Key Point:

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

Contact

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

Connect

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

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About the Author & Host

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

Bibliography

  • Chaibi A, S. K., Russell MB (2021). “Spinal Manipulative Therapy for Acute Neck Pain: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.” J Clin Med 10(21): 5011.
  • Satpute K, H. T., Bisen R, Lokhande P, (2019). “The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial.” Arch Phys Med Rehabil 100(5): 828-836.  
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Low Back Disability and Research on Osteoarthritis

April 22, 2021 chiropracticforward Low Back Pain, Osteoarthritis 0:17:49 0 Comments
CF 174: Low Back Disability and Research on Osteoarthritis Today we’re going to talk about the global impact of low back disability and what the numbers look like in 2017 vs. 1990. Has it gotten better or worse? I bet you have a good guess if you’re a regular here. We’ll also talk about new research on treatment for osteoarthritis. Stick around.  But first, here’s that sweet sweet bumper music.
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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow 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. 
You have found yourself smack dab in the middle of Episode #174 Now if you missed last week’s episode, we talked about nutrition to control pain, CBT and CFT, and TMJ, and 2020 deaths. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I’ve been working working working. The clinic is finally getting busy. It’s nice but it also presents an obvious challenge with getting all of the other stuff I do in a timely manner.  Monday, I write and record the podcast. How busy are your Mondays? I saw 58 patients last Monday. I have about 50 today. You can see the problem. But we’re getting it done between patients.  Tuesdays, I write and post a blog to my personal page. Then I record the video for my clinic’s YouTube page. If you ever want to watch any of those, it’s under Creek Stone Integrated Care. Lots of good stuff over there I hope. I believe most of you would enjoy and maybe learn something over there.  But, to write, post, and record a video in one day can be a challenge on top of everything else. But, it’s a priority. It has to be if you’re going to be competitive in the marketplace. It has to be.  Wednesdays are the weekly email and then on to all of the extra stuff I do like book editing, gathering content for social media, voice-over marketing, medical integration, and all of the stuff that goes into life.  I finally broke down and hired a virtual assistant from Pakistan for voice-over leads. I have one in India for a couple of my websites. I’m looking for more ways to farm out my responsibilities so that I can do everything possible to free up more and more time. At the end of the day, there are just some things that can’t be farmed out. You can’t have blogs and videos farmed out.  Can you imagine if I tried to farm out this podcast? It wouldn’t be me and wouldn’t be something I’m happy with. So, we’ll try to figure out the other things that can be handled remotely and go down that path.  I am going through the marketing and publishing process on this new book of mine. It’s written. It’s getting formatted and all of the ducks are in getting line. That’s a cool thing I’m really looking forward to seeing that get out there in the ether and seeing what happens with it.  And finally, we are about 3 days away from officially hiring a nurse practitioner. Pretty excited. Pretty nervous about everything starting to get very real for us on that end of things. It’s not 100% real until you make that hire. Then it’s pedal to the metal, full speed.  As always, I’ll continue to keep you all updated on the process for those interested and following along.  Item #1 Let’s start with our first paper called “Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017” by Wu et. al. [1] and published in the Annals of Translational Medicine in March of 2020 and that’s just hot enough! Why They Did It Low back pain (LBP) is a common musculoskeletal problem globally. Updating the prevalence and burden of LBP is important for researchers and policy makers. This paper presents, compares and contextualizes the global prevalence and years lived with disability (YLDs) of LBP by age, sex and region, from 1990 to 2017. How They Did It
  • Data were extracted from Global Burden of Disease, Injuries, and Risk Factors Study) 2017 Study. 
  • Age, sex and region-specific analyses were conducted to estimate the global prevalence and years lived with disability of LBP, with the uncertainty intervals (UIs).
What They Found
  • The prevalent numbers of people with LBP at any one point in time in 1990 was 377.5 million, and this increased to 577.0 million in 2017.
  • Age-standardized prevalence of LBP was higher in females than males.
  • LBP prevalence increased with age, and peaked around the ages of 80 to 89 years, and then decreased slightly.
  • Global years lived with disability were 42.5 million in 1990 and increased by 52.7% to 64.9 million in 2017
  • Years lived with disability were also higher in females than males and increased initially with age; they peaked at 35-39 years of age in 1990, before decreasing, whereas in 2017, they peaked at 45-49 years of age, before decreasing.
We have so many of the answers in a good, evidence-based, patient-centered chiropractic or integrated clinic. The more of this stuff…..this information….they publish, the more I believe the medical complex is forced to look at the higher functioning chiropractors. They just have to. Eventually. I hope.  CHIROUP ADVERTISEMENT Item #2 This second and final paper this week is called “Pain-related behavior is associated with increased joint innervation, ipsilateral dorsal horn gliosis, and dorsal root ganglia activating transcription factor 3 expression in a rat ankle joint model of osteoarthritis” by Bourassa et. al. [2] and published in Pain Reports in October 2020, still steamy Why They Did It They say, “Osteoarthritis (OA)-associated pain is often poorly managed, as our understanding of the underlying pain mechanisms remains limited. The known variability from patient to patient in pain control could be a consequence of a neuropathic component in OA.” First, what is monoiodoacetate? Also known as MIA. Well, MIA is an inhibitor of glyceraldehyde-3-phosphate, which disrupts cellular glycolysis, which in turn leads to eventual cell death. Knowing this, the MIA model has become a standard for modeling joint disruption in OA in rats and mice.  The model, which is easier to perform in the rat, involves injection of MIA into a knee joint that induces rapid pain-like responses in the ipsilateral limb, the level of which can be controlled by injection of different doses.  How They Did It They used a rat MIA model of the ankle joint to study the time-course of the development of pain-related behavior and pathological changes in the joint, dorsal root ganglia (DRG), and spinal cord, and to investigate drug treatments effects. What They Found
  • Mechanical hypersensitivity and loss of mobility (as assessed by treadmill) were detected from 4 weeks after MIA
  • Pain from cold stimulus was detected from 5 weeks
  • Through histology and imaging, they confirmed significant cartilage and bone degeneration at 5 and 10 weeks
  • They detected increased nociceptive fiber innervation in the subchondral bone and synovium at 5 and 10 weeks. 
  • Sympathetic blockade at 5 weeks reduced pain-related behavior.
  • At 5 weeks, they observed, ipsilaterally only, dorsal root ganglion neurons expressing anti-activating transcription factor 3, a neuronal stress marker.
Wrap It Up Besides a detailed time-course of pathology in this OA model, we show evidence of contributions of the sympathetic nervous system and dorsal horn glia to pain mechanisms. In addition, late activating transcription factor 3 expression in the dorsal root ganglia that coincides with these changes provides evidence in support of a neuropathic component in OA pain. Further down in the conclusion of the paper, the authors say, “We also observed that the pharmacological suppression of sympathetic fiber function, microglia reactivity, and astrocyte function led to mild ameliorations of pain-related behavior. Taken together, our data reinforced the concept that multiple factors are contributing to pain in OA. We believe that further investigation of a neuropathic phenotype in OA pain has important implications for the development of therapeutic approaches.” Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com. 
Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography 1. Wu A, M.L., Zheng X, Huang J,, Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med, 2020. 8(6). 2. Bourassa V, D.H., Yousefpour N, Fitzcharles MA,, Pain-related behavior is associated with increased joint innervation, ipsilateral dorsal horn gliosis, and dorsal root ganglia activating transcription factor 3 expression in a rat ankle joint model of osteoarthritis. Pain Reports, 2020. 5(5): p. e846.