neck pain

w/ Dr. William Lawson – Brand New Guidelines On Neck Pain Treatment

CF 113: w/ Dr. William Lawson –  Brand New Guidelines On Neck Pain Treatment

Today we’re going to be joined by Dr. William Lawson to talk about some brand new guidelines that came out in December regarding neck pain and the treatment of neck pain for chiropractors. Be sure and listen so you’re up on the latest and you’re not doing it wrong!

But first, here’s that sweet sweet bumper music

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. 

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Do it do it do it. 

You have found yourself smack dab in the middle of Episode #113

Now if you missed last week’s episode, we talked about what effect lifestyle might have on dementia and we talked about whether or not the feeling of having a stiff back actually means that you have a stiff back. 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 to find whatever you want quickly and easily. 

I swear to you, I see chiropractors always asking about research papers and what research is there on this or that. I want to yell at the top of my lungs to go and check my damn website. But, you don’t want to look like you’re self-serving and pumping your own tires so…..I say nothing. It IS called social media for a reason. It’s not called to get online and sell your stuff to everyone all the time. So I don’t. 

With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

It just makes sense to be but hell, I used it all of the time because I can’t remember everything off the top of my head. I’m old now. My brain doesn’t brain like that anymore. 

On the personal end of things…..

Guys and girls…..you wouldn’t believe me if I told you. That’s if you’ve been listening regularly over the last 3 months. Now, remember, there’s a two-week delay on these podcasts so keep that in mind but, yesterday afternoon my step-dad went to the ER with heart issues. He’s 80 and he’s the one that had the appendectomy on Christmas day. 

Keep in mind that my biological dad is still in a nursing home at 76 years old after he suffered a stroke back on November 9th. 

Lots of other stuff is going on with other members of my family as well but those are the biggies for now. 

Anyway, it looks like he’ll be getting a heart cath today. I’ll keep you updated. 

On the bright side, I got my certificate to get in a big fancy frame. It’s the one that says I’m a Diplomate of the International Academy of Neuromusculoskeletal Medicine and I have to be honest, I remember being brand new in practice and really admiring the fact that some would go to the lengths of getting a Diplomate. 

I never considered that I would ever be one to do it though. When I got out of college, I didn’t want to see another book or class. I would say I was a bit of a lazy student back in the college days. I learned better from studying notes than I learned from listening to some boring teacher drones on and on day after day. 

Other than the lab classes, it was torture for me. I learn better by having words in front of me and studying them over and over. That’s why the school was so damn difficult for me. Especially histology. Lordy lordy. We had a 98-year-old with a monotone voice teaching us histology at Parker in Dallas. Can you imagine a more dry subject and it was taught by the driest person with the dry-est delivery. Hell no, folks. Hell no. If I had them, I would have given up the nuclear codes just to get him to shut up. It was awful. 

Anyway, the thought of my undergoing another 2-year course of study to get a Diplomate just wasn’t on the radar. And it stayed that way for about 20 years. Until one day. One day I was walking through the exhibit hall at ChiroTexpo ’18 in Dallas, TX and I met one Dr. Tim Bertelsman. He was pumping the tires on ChiroUp. BTW, if you want to go to chiroup.com and sign up with the code Williams99, you can get the first six months for only $99/month. You won’t regret it. 

Anyway, once he went through all of the amazing stuff that ChiroUp can do for me and my patients, he looked up at me…..I’m a pretty tall dude….and he said I should come to his lecture on back pain later that day. He said that it counts as 10 hours toward the 50 live hours needed toward the Orthopedic Diplomate. He said very confidently, “Come check it out. You’ll like it. You’ll stay.”

He got a chuckle out of me on that. I had other things I wanted to do for the weekend. Ten hours in a classroom wasn’t in the plans. Hell, being in TCA leadership, I already get about 40 or more hours a year anyway. 

Plus, The Diplomate was not on my radar so that didn’t mean anything to me but I was intrigued by the idea of focusing my knowledge and thoughts on the low back so I made sure I sat in on his class. At least for a bit just to check it out. 

Well, it’s obvious at this point, but I sat through the whole weekend. Dr. Bertelsman just nailed it. He’s engaging and interesting and extremely knowledgeable. He’s a star on the speaking circuit. 

So, I finished that class and thought, if that information was so good, what could I learn from the next one and on and on? Plus, I’d already knocked out 10 of the 50 live hours. Makes sense to at least look at it as a possibility. 

The more I looked at it, the more I realized that the Academy, Dr. James Lehman with the University of Bridgeport, and the Australian group with Dr. Anthony Nicholson and Dr. Matthew Long called Chiropractic Development International have all really really gone to great lengths to make getting that Diplomate easily accessible. They are working together to create a new culture of chiropractors. Chiropractic practitioners that are on a different level – a different plane from your regular run of the mill general chiropractor. 

I would have to say they have done just that. With only 5 live hour weekends required over the course of a year and half to 2 years, and the ability to take all of the other 250 hours in the comfort of you home…..well, it made sense. I get a ton of hours every year anyway so….why not?

I put the pedal to the metal and got the hours knocked out in about 6 months and spent the rest of my time just studying and reviewing the material. It worked out. Here we are, about the frame a certificate. 

The point is, it’s more convenient than it’s ever been and you can and should do it. If for now other reason than to be the best in your community at assessing, diagnosing, and treating. I mean really, who the hell doesn’t want that?

We are joined on the podcast today by the doctor that made it more convenient for folks in Texas to take on the Diplomate program.  Dr. William Lawson is our guest today. 

Dr. Lawson is located down in Austin, TX

He has a diplomate in Chiropractic Orthopedics as well as a Diplomate in Integrative Medicine college of pain management. 

He has a masters degree in Health Care Administration

He is certified in acupuncture

He is heavily involved in the Texas Chiropractic Association

He is an Air Force veteran

He does Designated Doctor work as well as medicolegal work

Let’s welcome Dr. William Lawson to the show. Thanks for taking some time out to come on the show today, Bill. Welcome!

This is actually your second time on The Chiropractic Forward show. The last time was September 27, of 2018 and it was episode #41. Here we are in episode 113 so it’s been a bit. Tell me what all has been going on in the life of Dr. Lawson since then

A quick review at chiropracticforward.com tells me that the last time you were on, we spent the episode discussing research targetting the cervical region. I remember fussing because we have so much research-based around the lumbar region and low back pain but nothing near as robust for the cervical region. Then, you got involved in research paper having to do with neck pain and treatment. Tell us how that came about and tell us what part you played in it. What was your contribution to it? 

So it turns out, all I have to do is raise a fuss to get neck pain some attention and voila…..here we are. : )

I noticed in the Acknowledgements section, some of our other friends were also involved in contributing. Drs Kris Anderson up in North Dakota, Dr. Craig Benton in Lampasas, TX, your name of course, and Dr. Dean Smith who is active with the Evidence-Based Chiropractor group. It looks like an excellent group. 

Let’s go ahead and give it this paper the Chiropractic Forward treatment if that’s OK

This paper you were involved in is called “Best-Practice Recommendations for Chiropractic Management of Patients With Neck Pain” authored by Wayne Whalen, Ronald Farabaugh, Cheryl Hawk and a slew of others. It was published in the Journal of Manipulative and Physiological Therapeutics on December 20, 2019 – Hot potato…

Why They Did It

Dr. Lawson, since you were involved in it, walk us through their reasoning for doing the paper if you will. 

How They Did It

I must admit to only reading the abstract so far so lead us a little deeper into how they go about formulating these guidelines and recommendations?

For those that don’t know or don’t really get deep into research, can you give us a layman’s explanation of what exactly a Delphi Panel is?

What They Found/Wrap Up

Tell us what they came up with. At the end of the day and after all of the effort, what do we have going forward?

(This is a good point to go beyond the abstract and cover the 16 points made in the Best-Practice Recommendations For Chiropractic Management of Neck Pain section of the paper)

  1. Begin care management with a thorough history.
  2. Follow the history with a condition-specific examination. It is the duty of the provider to perform an examination consistent with the complexity of the case, based initially on history, which includes the mechanism of injury.
  3. Evaluate patients with complaints of neck pain for potentially serious red flags.
  4. Consider referral for diagnostic imaging or other studies based on established clinical practice guidelines (see “Diagnostic Imaging” later).
  5. Develop a care plan based on history and examination. The care plan includes appropriate diagnostic tests. Sometimes referred to as a report of findings, the history, examination findings, plan of care, and prognosis should be reviewed with the patient through a process of shared decision-making and with their consent to proceed obtained.17
  6. Document factors that may delay recovery. (Yellow Flags?)
  7. Develop a working diagnosis and, when clinically indicated, consider differential diagnoses.
  8. Reassure the patient regarding the generally benign nature of minor neck pain and encourage activity and movement. With moderate to severe neck pain, emphasize the importance of treatment plan compliance.
  9. Determine whether to (a) manage the patient exclusively, (b) co-manage, or (c) refer to another provider.
  10. Begin treatment with a brief trial of care, 6 to 12 visits, followed by evaluation for treatment effectiveness. The initial trial is not the same as a limit or cap on care.
  11. Evaluate the patient briefly during each encounter, pre- and post-treatment. Conduct a more focused condition-specific evaluation after each benchmark in the treatment plan. Examples: Every 6 to 12 visits, or in 30-60-90-day intervals.
  12. Some patients’ responses to treatment may not follow a predictable pattern, or they may not respond. In this case, consider a modification to the treatment plan that may include, but may not be limited to (a) change in technique and/or modality, (b) referral to another provider within the same discipline for a second opinion, (c) referral to another provider outside the discipline for a second opinion and consideration of other treatment approaches, or (d) referral for diagnostic tests (eg, X-ray, magnetic resonance imaging [MRI], computed tomography scan, neurodiagnostic or blood studies)
  13. Refer patients with new or worsening symptoms or evidence of psychological issues to providers with expertise in those areas (eg, behavioral health).
  14. Determine at each visit and/or evaluation if the patient is improving, is worsening, or has plateaued, and discharge if appropriate.
  15. Encourage and provide home and self-care approaches.
  16. Document the history, clinical examination, treatments performed, the rationale for and response to care, and any referrals.

In the paper, just after the section we just covered, they recognize that not all patients recover fully. Unfortunately, we’re all well-aware. Tell me a bit about what they have to say about that. 

For patients who have reached MTB, the question then becomes: What is the best course of care to help control the ongoing pain? In general, patients unable to reach full recovery fall into one of these categories:

  • 1. No physician/provider intervention is necessary. The patient has residual minor neck pain but can manage it with self-care strategies: ice, nonsteroidal anti-inflammatory drugs, home-based exercise.
    2.
    Physician/provider intervention is necessary in periodic episodes of care. The patient experiences pain that exceeds his or her ability to self-manage and must return for care in an episodic fashion.
    3.
    Physician/provider intervention is necessary on an ongoing basis. The patient experiences pain that exceeds his or her ability to self-manage, and in the absence of care the condition deteriorates. These patients often benefit from 1 to 2 visits per month to providers of nonpharmacologic conservative care who use spinal manipulation, to be reevaluated every 6 to 12 visits.

Now, I have been seeing this paper being shared and discussed all over the Forward Thinking Chiropractic Alliance Facebook page as well as the Evidence-based Chiropractor Facebook group. Those are all very like-minded docs in there and we all love practice guidelines, the idea of professional standardization, a certain level of standards within that construct, and those sorts of things. 

So it’s no surprise that a paper putting guidelines into the profession is well-accepted by those groups. I wonder if you’ve seen or noticed any thoughts or opinions elsewhere? Basically, what is the paper’s reception as far as the rest of the profession is concerned? Or do you know? A lot of chiropractors don’t know a thing about research or new research and may not even know it exists. 

Let’s start wrapping it up a bit, do we have any more research papers you’re contributing to? What is next on your horizon? 

Thanks for coming on the show this week


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

CF 051: Necks, Integrity of the Cervical Spine, and the CDC on Opioids

CF 051: Necks, Integrity of the Cervical Spine, and the CDC on Opioids

Today we’re going to talk about the reliability of clinical tests assessing the cervical spine, what is happening when adjusting a neck as far as the integrity of the cervical spine, and what the CDC says about opioids. It’s all fascinating all the time here at the Chiropractic Forward Podcast 

But first, here’s that bumper music

Integrating Chiropractors

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

You have drifted all slow and gently into Episode #51

DACO

As has become the tradition, let’s talk a bit about the DACO program. DACO stands for Diplomate of American Chiropractic Orthopedist. Trudging along. I’m up to I believe 84 of the required 300. Classes this last week were on frozen shoulder, piriformis syndrome, Important aspects of lumbar MRI, and inguinal pain. 

This stuff is just invaluable, folks. I’m an organizational freak but at the end of each course, I’ll make myself a quick sheet that I can reference when something like that comes through the door. I think making these little quick sheets will really help to get some of the more rare or difficult cases figured out quickly. 

I’ve already put the lumbar differential diagnosis sheet to use a few times as well as the dizziness quick sheet I created. I have shared several times here that I don’t sit around a lot either at work or at home. I’m a busy bee. 

Vacation & Hobbies

Going on vacation, don’t even try to take me to a beach. If my wife wants to go to the beach, that’s all her. I’ll tag along and I’ll check in on her out there reading a book from time to time but, for the most part, I’ll be off doing, seeing, and experiencing. The ability to sit still and just relax…..that’s an ability I did not receive in this lifetime. 

As a result, I make live edge furniture. Go to Facebook and look up Amarillo live edge and custom furniture. I am a sculpture and charcoal artist. Go back to Facebook now and look up River Horse Art Gallery. I’m in the process of teaching myself to paint right now too. I also am a singer/songwriter. Go back to Facebook once again. Yes, once again and look up Flying Elbows Perspective.

Crazy name indeed. 

So, here’s the point. It’s not to brag or pump my tires. The point is that this is how important I’ve found the DACO program to be. While I haven’t completely put everything else on hold, the DACO has taken priority of my time. One reason is that I want to motor through it quickly and efficiently. The next reason would be that I’ll be the only DACO in all of Texas West of the Dallas/Ft. Worth metroplex. 

What does that get me? Maybe a pat on the back. Maybe a part time or full-time gig on staff at an FQHC. As we have mentioned in previous episodes, there are reports of DCs on FQHC staffs making as little as $120/visit up to $300/visit on even Medicaid visits. Unbelievable. But you have a better shot at getting into the system when you are specialized AKA – a Diplomate. 

Just a part of making us all better. You guys and gals need to be looking at this stuff. 

Before we hop into the papers for the week, I want to ask you to go to chiropracticforward.com and sign up for our newsletter. I think I have some pretty cool stuff coming down the pike you’ll be interested in. That’s in you enjoy evidence-based education.

Now, here we go with some vital information that we think can build confidence and improve your practice which will improve your life overall.

Paper #1

The first paper here is called “Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1—A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration” It was done my Madege Lemurnier et. al. and published in the European Spine Journal in September 2017[1]. 

Why They Did It

With a title as long as that one, what the heck are they doing here? They say they were hoping to determine the reliability of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. 

How They Did It

They updated the systematic review of the 2000-2010 Bone and Joint Decade Task Forst on Neck Pain and Associated Disorders. 

They searched the literature for studies on the reliability and validity of Doppler velocimetry to evaluate the cervical arteries. 

They had two independent evaluators look through it all

What They Found

  • Preliminary evidence showed that the extension-rotation test may be reliable and has adequate validity to rule out pain arising from facet joint. Or rule in I suppose. Just in case you are unaware of the cervical extension-rotation test, it’s exactly as it sounds. Have the patient extend and then rotate toward the side you’re testing. When you combine this maneuver with palpation you can typically get a good idea of whether the patient is suffering from a facet issue. You need to know that this test is also effective in sniffing out a low back facet issue as well. Lumbar extension and then rotation can give you some good clues sometimes.
  • The evidence suggests variable reliability and preliminary validity for the evaluation of cervical radiculopathy including neurological examination (manual motor testing, dermatomal sensory testing, deep tendon reflexes, and pathological reflex testing), Spurling’s and the upper limb neurodynamic tests.
  • No evidence found for doppler velocimetry. 

Wrap It Up

Little evidence exists to support the use of clinical tests to evaluate the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We found preliminary evidence to support the use of the extension–rotation test, neurological examination, Spurling’s and the upper limb neurodynamic tests.

Paper#2

On to our second paper. This one is called “Intervertebral kinematics of the cervical spine before, during, and after high-velocity low-amplitude manipulation” and appeared in Spine Journal in August of 2018 and was authored by Dr. William J. Anderst, et. al[2].

Why They Did It

Since cervical manipulation is such a common intervention for neck pain, the authors wanted to characterize the forces involved and the facet gapping that takes place during manipulation. 

How They Did It

It was a laboratory-based prospective observational study

It included 12 patients 

Each patient had acute mechanical neck pain

One of the outcome measurements was the neck pain rating scale (NPRS)

Other measurements were taken for amount and rate of cervical facet joint gapping 

What They Found

The authors concluded, “This study is the first to measure facet gapping during cervical manipulation on live humans. The results demonstrate that target and adjacent motion segments undergo facet joint gapping during manipulation and that intervertebral ROM is increased in all three planes of motion after manipulation. The results suggest that clinical and functional improvement after manipulation may occur as a result of small increases in intervertebral ROM across multiple motion segments.”

Pretty cool stuff. 

Paper #3

Our last paper for this episode is called, “CDC: Drug overdoses hit new record.” It’s an article on thehill.com written by Nathaniel Weixel and was published on August 15th of this year, 2018[3]. 

The article leads off saying that 72,000 Americans died from drug overdoses in 2017 and that’s based on information provided by the Centers for Disease Control and Prevention. That is a new record folks and we have our friends in the medical realm to thank for it. 

Who’s To Blame?

Now, that, of course, doesn’t mean pharmacists and medical doctors are bad and there was a mass conspiracy to cause this deal. But it does mean that SOME of them are bad. SOME doctors are doing time in an orange outfit right now because they knew better but the dollar was mightier than common sense and common decency. 

There were pharmacies dispensing 100x more than their population could ever consume but they want to not refer to us and talk about the integrity of the cervical spine. That kind of crap is what got us here.

But, it’s also what has brought chiropractors from the shadows into the light. When you have the mess the medical field has created, then you have to start looking for the non-pharma solutions and we are it. 

Comparison

72,000 deaths. You ever heard of the Vietnam War? Of course, you have. We all have. Some either remember or have seen what a big deal it was. The deaths, the protests, the loss. I’ve been to the Vietnam Wall in Washington DC several times. It’s profound. It’s stunning to see all of those names. 

Just to compare, the total number of those lost in Vietnam stands at 58,220. Now keep in mind, that takes into account deaths from as early as 1956 all the way up to as late as 2006 and comes from Defense Casualty Analysis System Extract Files from The Vietnam Conflict Extract Data File. 

I did my homework. I’m not giving you fake numbers here. 

Essentially, 13,780 more deaths happened because of opioids, In just one year. In just 2017. That doesn’t even begin to scratch the surface when you start totaling up 2016, 2015, and further back. Unbelievable isn’t it? 

If we look at it, 2014 had 28,647 deaths, 2015 had 33,100 deaths, 2016 saw 63,632 deaths…..and then 72,000 in 2017. 

I’m guessing you can see the trend. Hell yes, it’s an epidemic.

The Math

I’ll do the math for you because I love you and I’m glad you’re here and I don’t want you to have to think too hard while you’re giving me your time. Over the last 4 years, that’s approximately 200,000 opioid-related deaths. 197,379 to be more specific. 

The genie seems to be out of the bottle.

While we can’t put the genie back in, we can offer solutions for the future. Many of those addicted to opioids became addicted due to spinal surgery. Many of those surgeries were unnecessary. One paper I reviewed showed that approximately 5% of lumbar fusions are necessary making about 95% of the unnecessary. Yeah….95%. 

The Answer

We have the answer people. The American College of Physicians, The White House, The Lancet, 2 papers in JAMA, Consumer Report surveys, The Joint Commission, The FDA…..seriously, there is not one reason that we aren’t inundated by spinal pain referrals at this very moment. No reason at all. It actually makes me mad as hell that we are not. 

Exactly what the hell does it take to make general practitioners, neurosurgeons, orthopedic surgeons, nurse practitioners, and physician assistants understand that an evidence-based chiropractor is best situated to help these people as a first-line therapy?

Integrating Chiropractors

The Message

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

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

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

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

Key Point:

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

That’s Chiropractic!

Contact

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

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

Connect

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

Website

http://www.chiropracticforward.com

Social Media Links

Chiropractic Forward Podcast Facebook GROUP

Twitter

YouTube

iTunes

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Stitcher:

TuneIn

About the Author and Host:

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

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

CF 012: Proven Means To Treat Neck Pain

CF 041: w/ Dr. William Lawson – Research For Neck Pain

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

 

 

 

Bibliography

1. Lemeunier N, Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1—A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration. Euro Spine J, 2017. 26(9): p. 2225-2241.

2. Anderst W, Intervertebral kinematics of the cervical spine before, during, and after high-velocity low-amplitude manipulation. Spine (Phila Pa 1976), 2018. 0(0).

3. Weixel N. CDC: Drug overdoses hit new record. The Hill 2018  5 August 2018]; Available from: https://thehill.com/policy/healthcare/401961-cdc-drug-overdoses-hit-new-high-in-2017.