mri

MRI’s and Clinic Presentation & Surgery vs. Conservative Care For Discs

CF 198: MRI’s and Clinic Presentation & Surgery vs. Conservative Care For Discs Today we’re going to talk about surgery vs. conservative treatment for discs and we’ll talk about MRI findings and clinical pain.  But first, here’s that sweet sweet bumper music    

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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 an invaluable resource for your patient education and for you. It can save you time in putting talks together or just staying current on research. It’s categorized into sections so that the information is easy to find and it’s written in a way that is easy to understand for practitioner as well as patient. You have to check it out. 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 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 #198 Now if you missed last week’s episode , we talked about Extruded Discs – Surgery or No Surgery? Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, we went with ReviewWave and I have to say it’s overall been a very positive experience. Except for this one thing. Today, we showed up for work and we have it set to where new patients can pick their schedule and make the appointment themselves. Within certain parameters, of course. Well. Something’s wonky because we showed up at work and, instead of the 6 or 7 new patients we expected today, we now have 10 new patients and 4 re-exams on top of our regular load of established patients.  As you can imagine, this presents a certain set of difficulties. Especially when my exam takes 20 minutes minimum and more typically takes about 30-40 minutes per new patients. So, we’re forced to step on the gas a touch. We’ll get through it and we’ll do a good job but, being too busy is as bad as not being busy enough in some ways.  Patients like to know they’re going to a provider that a lot of other folks go to and find value in. But, when it looks like you’re running them through like cattle and your one on one time is 30-45 seconds rather than a couple of minutes or more….they notice it and I don’t care what the vitalistic philosophy wonk gurus in the profession try to convince you, patients don’t like that.  They feel it and sense it and they don’t like it. I don’t like it. I don’t like people waiting on me. I don’t like making a bad first impression. I don’t like to be rushed any more than I normally am.  More than anything, I don’t want to fall into quantity over quality. I always want quality here. And never forsake it in the search for quantity. That’ll get us nowhere that we want to go.  So, this part of the show will be short, we will survive and do a good job regardless of time constraints, and we have a call scheduled with ReviewWave to remedy the issue.  When you get too busy to fit them in, create a waiting list, hire help, or raise your pricing to thin the herd. Just a little tip from your Ol’ Uncle Jeffro.  Let’s dive in Item #1 The first one is called “Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study” by Gugliotta et. al.(Gugliotta M 2016)and published in BMJ Open, that is the British Medical Journal for the peasants in the crowd. It’s a joke! Anyway, it was published in December of 2016 and it goes a lil sumpin like dis…. Why They Did It We sought to compare short-term and long-term effectiveness of surgical and conservative treatment in sciatica symptom severity and quality of life in patients with lumbar disc herniation in a routine clinical setting. How They Did It
  • It was a prospective cohort study of a routine clinical practice registry consisting of 370 patients. 
  • Outcome measures were the North American Spine Society questionnaire and the 36-Item Short-Form Health Survey to assess patient-reported back pain, physical function, neurogenic symptoms and quality of life. 
  • Primary outcomes were back pain at 6 and 12 weeks. 
  • Standard open discectomy was assessed versus conservative interventions at 6, 12, 52 and 104 weeks. 
What They Found
  • Surgical treatment patients reported less back pain at 6 weeks than those receiving conservative therapy, were more likely to report ≥50% decrease in back pain symptoms from baseline to 6 weeks and reported less physical function disability at 52 weeks. 
  • The other assessments showed minimal between-group differences with CIs, including the null effect.
Wrap It Up Compared with conservative therapy, surgical treatment provided faster relief from back pain symptoms in patients with lumbar disc herniation, but did not show a benefit over conservative treatment in midterm and long-term follow-up. So, bad for conservative interventions in the short term. Good in the long term. When they spread it out and look long term, there’s minimal difference. So, why risk it in the first place. The rate that low back surgeries must be re-done is too high to risk it. They estimate that around 40% of back surgeries fail.  Yeah, I’m good as long as I don’t have cauda equine or progressive neurological deficits. You keep your full dose of surgery. I’ll have none on this day! So, long-term, minimal difference,…..well then we’re going with no surgery any time it’s appropriate and makes sense.  CHIROUP ADVERTISEMENT Item #2 Alright, the last paper we have today is called, “Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-Based Cohort Study” by Kasch et. al. (Kasch R 2021) and published in Spine Journal.  Why They Did It The authors wanted to examine associations between common lumbar degenerative changes observed on MRI and present or future low back pain.  How They Did It
  • Participants from a population-based cohort study were imaged at study entry,
  • LBP status measured at baseline and 6-year follow-up. 
  • MRI scans were reported for the presence of a range of MRI findings. 
  • LBP status was measured on a 0-10 scale. 
What They Found
  • MRI findings were present in persons with and without back pain at baseline. 
  • Higher proportions were found in older age groups. 
  • 76.4% of participants had a least one MRI finding and 8.3% had 5 or more different MRI findings. 
  • Most MRI findings were slightly more common in those with LBP and pain severity was slightly higher in those with MRI findings
  • In the longitudinal analyses we found most MRI findings were not associated with future LBP-severity regardless of the presence or absence of baseline pain. 
  • Compared to zero MRI findings, having multiple MRI findings (≥5) was associated with mildly greater pain-severity at baseline and greater increase in pain-severity over 6 years in those pain free at baseline, but not in those with baseline pain
Wrap It Up Our study shows that the MRI degenerative findings we examined, individually or in combination, do not have clinically important associations with LBP, with almost all effects less than one unit on a 0-10 pain scale Meaning, quit catastrophizing MRI findings. Quit telling 40 year olds they have the backs of 85 year olds. Quit pushing them into the chronic pain pit because you don’t know schiza from shinola and you’re too damn lazy to take the time and energy to get some smarts beyond what you learned in chiropractic college.  Slap pow pop kazow!! 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 so get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   

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

Chiropractic evidence-based products

Integrating Chiropractors

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The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website
Home
Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger   Bibliography Gugliotta M, d. C. B., Dabis E, Theiler R, Jüni P, Reichenbach S, Landolt H, Hasler P. (2016). “Surgical versus conservative treatment for lumbar disc herniation: a prospective cohort study.” BMJ Open 6(12).   Kasch R, T. J., Hancock MJ, Maher CG, Otto M, Nell C, Reichwein N, Bülow R, Chenot JF, Hofer A, Wassilew G, Schmidt CO (2021). “Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-Based Cohort Study.” Spine (Phila Pa 1976).        

The Fate Of An OxyContin Producer & The Outdated Use of MRI Diagnosing Cervical Dysfunction

CF 150: The Fate Of An OxyContin Producer & The Outdated Use of MRI Diagnosing Cervical Dysfunction  Today we’re going to talk about the outdated use of MRI to diagnose cervical dysfunction and then the fate of an oxycontin producer.   But first, here’s that sweet sweet bumper music

Chiropractic evidence-based products

Integrating Chiropractors

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

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

Do it do it do it. 

CF 013: DEBUNKED: The Odd Myth That Chiropractors Cause Strokes (Part 1 of 3)

 

You have found yourself smack dab in the middle of Episode #150 Now if you missed last week’s episode, we talked about the costs of preventable disease, and then we’ll talk about whole-body vibration for function and bone mineral density in postmenopausal, osteoporotic women. Make sure you don’t miss that info. Keep up with the class.  While we’re on the topic of being smart, did you know that you can use our website as a resource?

Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function

On the personal end of things…..

On the personal side of things, it’s an alright week. Nothing too crazy other than the rise in the Rona around the nation. We got my biggest week last week since Rona hit us. We had 170 visits last week. Still down from my average of 182 pre-Rona but way up from an average of 135-145 post-Rona.

So progress. Then this week, we’re having three days of snow, ice, and sleet. So….it’s a Texas Two-Step. Two steps forward and one step back. Patience is a virtue. Blah. Such is life.

I thought I’d share a recent experience with you all in an effort to let you know you’re not alone, we can’t make them all happy, and how I handled it.

So last weekend I got an email. It wasn’t positive. In fact, it was a bit combative. Let’s just say it wasn’t flattering. Now, I’d like to be fair to myself here. In 22+ years, I’ve had conflict or whatever you want to call it….let’s call it miscommunication. I’ve had a miscommunication with patients only 3-4 times. Five if I’m pushing it. But this goes to serve as an example, you’re never too old or in practice too long to be above being questioned. In fact, in today’s culture of disrespecting ‘experts’ for lack of a better word, questioning authority, and an overall culture of lacking mutual respect…..well, I think it makes sense that we’re all more likely to have some miscommunication issues here and there. 

Then, online reviews throw a whole other kink into the plan, doesn’t it? So, due to respect for this person and HIPAA, I will be very vague here but in general, this person had significant cervical disc radiculopathy. Sometimes you make a diagnosis and you’re not 100% sure but you’re heading that direction. Not with this one. There was no doubt. They were very upset. Crying. Nauseous. Not feeling well and rating the pain at a 7 out of 10 on the VAS scale. 

We tried some over-the-door traction but it really made the person nauseous so that was out. I tried some retraction/extension exercises and started them on nerve gliding exercises to try to make some headway.  The second treatment comes and we are able to do a little more. Now they’re rating it at a 4 out of 10. Looks like we’re on easy street right? We got this!!

We did very light decompression and the patient said it felt good and they were doing better.  OK. Whew. Another one on the road to avoiding surgery.  Not so fast. For whatever reason, this patient never showed up again. I don’t always think about my patients but I did think about this one because they were so severe on day one. I wondered how they were doing and why I never saw them again. 

Well, this weekend’s email answered that for me. There’s no need to read the whole email just because there’s no need but the sentiment of it was that I had a conversation with them that they characterized as saying that anxiety was causing the pain and that I told them I couldn’t help them. What they took from the conversation was that I should have ordered an MRI on day one basically, that I blamed mental and emotional issues on the part of the patient for their pain and they felt that was unprofessional and uneducated. And potentially ego-driven on top of all of that. They mentioned they sought out an MRI, went to a neurosurgeon, and had a two-level fusion, and are on the road to recovery with the help of PT.

https://www.chiropracticforward.com/giving-maintenance-care-dry-needling-and-vitalism/

 

Oh….you know I’m always honest with you folks because honestly, that’s not flattering stuff. Nobody wants to look into themselves and say, “Does this person have a point? Where did I go wrong and how can I prevent that from happening again with someone else? But here’s the truth, I literally don’t recall that conversation whatsoever. I have a thousand different conversations every week. But I know me. I’ve never in my life told a patient that they have mental or emotional problems and those are the source of their pain. Nor have I ever insinuated that anxiety is the pain source when it’s clear as a bell that it’s radiculopathy secondary to a disc issue. My staff has heard me repeat the same discussions, the same lines, and the same jokes day after day, month after month and they’ll be the first to tell you I’ve never said anything of the sort. 

So, flummoxed as I have been, I slept on that email for the rest of the weekend thinking about it. The last thing you want to do is respond out of anger. You definitely don’t want to respond out of a defensive posture. Especially when you’re reasonably sure you did nothing uneducated or ego-driven. A response like that will only make us look more unprofessional than they already think we are and maybe even potentially provoke. 

So, in short, I did not address the ego comment because I felt it was unnecessary. I’ll just take my lumps on that one. I mentioned how happy I was to hear from them and hear they are recovering. I genuinely was glad. Even if the email was less than flattering.  At least they got some aspect of a resolution. Even if I wasn’t the end solution. I don’t feel there’s any ego on my part in that sentiment. 

I explained that we typically do a trial treatment of a week or two before deciding on advanced imaging and that would have definitely been in the considerations had we treated beyond two appointments. That’s appropriate. Some can make an argument that there was radiculopathy so we could have gotten an MRI on day one. But, if we’re honest, how many patients do you have that have radiculopathies that you are able to clear fairly quickly without resorting to an MRI? My guess is quite a few because that’s my experience. We just don’t have to get very many. But again, we have to have the chance to find out, right?

I discussed briefly that I am very much on top of current research and thinking with regards to pain and neuromusculoskeletal issues and may have been assessing yellow flags. I discussed briefly what the biopsychosocial aspect of treatment entails these days but didn’t want to dwell on it much. Mostly because I never felt it was anxiety, mental, emotional driven thing to start with. It was clearly a disc. But I hope the mention somehow rebuts the idea that I need more education. 

I offered that as a potential reason we may have had some miscommunication.  I also mentioned that there have been very few patients over the years that I would just straight up tell them “I can’t help you.” I told them that I’m typically one of the most stubborn practitioners and will hold on until it’s crystal clear I’m not helping. That, for me, has never happened after only two visits.  In a nutshell, I said that being patient-centered, evidence-based, and having high patient satisfaction was the most important thing to me and that I don’t recall the exact conversation or the wording but that I can learn from the email and can use it to make me better at my job and that I appreciated them taking the time to share their thoughts with me. 

In the end, I was glad to hear about them feeling better and I apologized for any miscommunication on my end.  While that sounds like a very long email, it wasn’t and I took the time to make sure it was hopefully as eloquent as a guy like myself can generate. Without arrogance, ego, combativeness, or being defensive. But WITH being caring, being professional, and being thoughtful. 

Even though it may not be reciprocated, I respect this person and I DO hope they are feeling better. And, whether we feel like these things are our fault or whether we think we did anything wrong or not, we can ALWAYS always learn from stuff like this. We can always be better. I can promise you, I learned to not be lackadaisical when it comes to speaking to patients about central nervous system upregulation or sensitization. Or when discussing the biopsychosocial aspect of pain. 

People don’t know what we know about that stuff and we shouldn’t assume that it’s an easy topic and everyone ‘gets it.’ Or will get it. I really cannot explain what happened there but, I do know it made me step back and think through it though. It made me check my communication. 

Again, I don’t tell you all this stuff because I love it or love to talk about it. I don’t tell you all my patient numbers weekly because I love it. I share this stuff with you because what is happening with me is real. It’s real life. And if it’s happening to me, then it IS happening to many of you. And if it’s not currently happening to you, it CAN or WILL and you may learn from me.  Not as a mentor per se but as that Ol’ Uncle Jeffro.

Alright, enough with the stress talk. Geez. Not very often at all. Maybe once every 5 years or so but when it happens……geesh. I take it personally, I take it home, I dwell on it, and I’m not too proud to admit that it affects me.

I care.

I truly do.

If you get anything from this podcast and all of these episodes, it should be that I care. I care about chiropractic patients, our profession, ethics, morals, professionalism, education, and doing it the right way. 

I care. 

Item #1 Let’s start out with this article that was in CNN Business last week. It’s an article by Chris Isidore called, “OxyContin maker to plead guilty to federal criminal charges, pay $8 billion, and will close the company”(Isidore 2020). It was published on October 21, 2020, it’s cold as hell in Texas but that….that’s hot.  The highlights of the article are that Purdue Pharma, the maker of OxyContin, has agreed to plead guilty and to pay more than $8 billion. Not only pay $8 billion but to also close down the company.  What? Yeah, they say the money will go to opioid treatment and abatement programs. “Purdue Pharma actively thwarted the United States’ efforts to ensure compliance and prevent diversion,” said Drug Enforcement Administration Assistant Administrator Tim McDermott. “The devastating ripple effect of Purdue’s actions left lives lost and others addicted.” They say, “The company doesn’t have $8 billion in cash available to pay the fines. So Purdue will be dissolved as part of the settlement, and its assets will be used to create a new “public benefit company” controlled by a trust or similar entity designed for the benefit of the American public.

Adjusting Disc Herniations and Bulges

 

The Justice Department said it will function entirely in the public interest rather than to maximize profits. Its future earnings will go to paying the fines and penalties, which in turn will be used to combat the opioid crisis.” Maybe it’s just me but that sounds Big Brother as hell to me. Don’t get me wrong, pharma companies, in many instances, are of the devil but to dissolve them, then recreate them and they be basically government run? I don’t know about all that but to me, that’s what this sounds a bit like. 

They go on to say, “That new company will continue to produce painkillers such as OxyContin, as well as drugs to deal with opioid overdose. “The company, which filed for bankruptcy in 2019, pleaded guilty to violating federal anti-kickback laws, as it paid doctors ostensibly to write more opioid prescriptions.” What a-holes. Paid doctors to write more opioid prescriptions. And what a-hole of a doctor do you have to be to take payment to write addicting prescriptions in the first damn place? Honestly.  Meanwhile, we recently crossed the 450,000 dead mark.

Dead from opioid-related overdoses. All the while we evidence-based chiropractors sit and watch stuff we could help treat just spiral out of control. We’re sitting on the bench waiting for the coach to put us in the game but we just rarely get our number called.  If they want to make surgeons the quarterback of the football team, at least we could be the running back or tight end or something. Geez.

We could be a key part of the pain team and research has told the stakeholders several times. But nope. We’re stuck riding the pine.  A little further down in the article, my worries are actually hit on when they say, “So some states are objecting to the settlement. Twenty-five state attorneys general wrote to US Attorney General William Barr last week arguing against the plan to create a government-controlled company out of the assets of Purdue Pharma, arguing that the government should not be in the business of selling OxyContin.”

And I agree with the 25 state attorneys general. That, to me, is not what American was built on.  Again, don’t get me wrong, I’m all about punishing the hell out of a corrupt and evil company like Purdue Pharma. I’m even all about putting them out of business. Hell, the Statler family that runs this business pulled $10 billion out of the company and placed into family trusts before filing bankruptcy. It’s a bad group of people. Lop they’re damn heads off if you think they deserve it…..OK, maybe not to that extent but you get my point. 

But, putting a company out of business and then stepping in as the government to take it over and run it…..no. I don’t like it. But that’s just me. 

CHIROUP ADVERTISEMENT

Item #2

Alright, my last one today is called “Twenty years of ‘insanity’ in diagnosing underlying clinically relevant cervical dysfunction using traditional MRI” by Anton Bowden(Bowden 2018) and published in the Journal of Spine Surgery in September of 2018 and it goes a little sumpin’ like dis. 

Why They Did It

Bowden starts by saying “Studies dating back several decades have failed to show a strong correlation between abnormal MRI scans of the intervertebral discs and clinical symptoms. Which you know if you’ve been following along. This is part of why the patient I mentioned earlier was mad at me for not immediately ordering an MRI. 

He continues, “The recently published 20-year prospective longitudinal study of cervical spine disc degeneration” by Daimon et al.(Daimon K 2019), is perhaps the strongest confirmation to date affirming that intervertebral discs naturally degenerate with age, and that evidence of degeneration alone is insufficient information with which to make a conclusion regarding the root cause of a patient’s symptoms.” We have covered that paper here on the Chiropractic Forward Podcast before.   They discuss the study at length saying, “Daimon et al. found that while MRI signal intensity longitudinally decreases across all cervical disc levels, there is a peak in structural degeneration that occurs at the C5–C6 level, with C4–C5 and C3–C4 having progressively lower degeneration rates. Since the C5–C6 level also corresponds with the highest flexion-extension range of motion of the cervical spine, a mechanical component of the degeneration process appears to be highlighted by the study.

Common Surgeries Aren’t Well-Researched & Chiropractic Wins Again

 

Once the C5–C6 level has been destabilized due to degeneration, sequential acceleration of degeneration at adjacent levels was observed. This insight has relevance to current discussions regarding adjacent-segment disease subsequent to arthrodesis and arthroplasty. The authors also observed that 95% of subjects experienced degenerative progression over the 20-year study period, while only 67% developed clinical symptoms. This observation lends strength to the argument that trying to fight all forms of disc degeneration is an insolvable fight against nature, at least for the foreseeable future.” I was happy to see him mention this, “As a biomechanist, I would be remiss to point out that imaging alone is missing fundamental information regarding the dynamic function of the spine. Spines that look very similar while lying down in the MRI may move very differently while going about activities of daily living—and the consequences can be dramatic for mechanical loading and pain in the discs and adjacent spinal structures “  Here on the show in some of the earlier episodes, we covered the fact that discs that show little to no issues in the supine position can look very different when seated or standing.

Significantly different as a matter of fact. The research has been done on this yet I’ve had discussions with two separate radiologists and both of them guessed there would be little to no change in the disc with position change.  That’s just not the case, is it? I’m happy to see this author recognize the fact.  Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world.

Keep taking care of yourself 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 preventativly 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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Bibliography

  • Bowden, A. (2018). “Twenty years of ‘insanity’ in diagnosing underlying clinically relevant cervical dysfunction using traditional MRI.” J Spine Surg 4(3).
  • Daimon K, F. H., Nishiwaki Y, (2019). “A 20-year prospective longitudinal MRI study on cervical spine after whiplash injury: Follow-up of a cross-sectional study.” J Ortho Science 24(4): 579-583.
  • Isidore, C. (2020) “OxyContin maker to plead guilty to federal criminal charges, pay $8 billion, and will close the company.” CNN Business.