podcast

Exercise For Depression & Manipulation For Tendinopathy

CF 228: Exercise For Depression & Manipulation For Tendinopathy Today we’re going to talk about Exercise For Depression & Manipulation For Tendinopathy 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 anrd you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

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

You have found yourself smack dab in the middle of Episode #228 Now if you missed last week’s episode , we talked about nerve flossing carpal tunnel and we talked about catastrophizing. Make sure you don’t miss that info. Keep up with the class. 

 

On the personal end of things….. I just got back from the MCM Mastermind that was started by Dr. Kevin Christie. This group is just outstanding y’all. I mean honestly, Dr. Mark King of the Motion Palpation Institute is a member. How do you beat that?? Dr. Jay Greenstein of Kaizenovate and Kaizo care clinics in Washington DC. Dr. Ben Fergus of the GRIP method. Seriously. THE Dr. Brett Winchester is joining us at the next one. You can’t make this stuff up. 

One theme we discussed a lot this weekend was The Front Stage and Back Stage Systems in your practice. Strategic Coach was kind enough to be our guest presenter and they rocked it.  Another theme I kept on bringing up was whatever you can have a vision on and take consistent action on, will happen for you.  BUT YOU MUST HAVE BOTH VISION AND ACTION. 

In our Mastermind Group we have: 

    • A Doc who takes one week off per month 
    • A Doc who lives in a different state than 
    • where is practice is located 
    • At least 5 practices clear well over 1M in revenue (and they are high quality of evidence informed care) 
    • One that is exiting patient care in the Fall
    • A Doc who is building a short term rental business – that’s me! 
    • All Docs who no matter their accomplishements and the size of their practices…..they are still pushing the envelope and humble enough to come to each meeting with a Beginner’s mind. Eager to learn and eager to share thier knowledge and experience. 

Remember, it’s not HOW….it’s WHO.

Who do you know that can help you get where you want to be? I know 14 others right now in this group.  What would you love to have in 5 years that is big? Our group has top chiros from North Carolina, Texas, Florida, Connecticut, Missouri, Montana, Ohio, Maryland, Minnesota, Alabama, and Illinois.  We meet four times a year to raise our games. World class care through a mastermind and collaboration of some of the best in the country. To be the best, it makes sense to learn from the best. It’s pretty exciting! 

Next meeting is in July in Sarasota.  I’m already making plans. I believe Dr. Christie is interested in growing the group by about 5 or so more seats. If you’re interested, let Dr. Christie know. Send him and email to [email protected] 

Before we get to the research, we all know that the number one type of case that we want is a personal injury case – they are gold because the clients are more compliant, and we get paid at rates far above insurance or Medicare or Medicaid. The patient’s attorney tells them to go for treatment as doing so enhances their legal case and gets them more money. The problem is, how do we get PI cases?  Attorneys don’t generally respond to your invitation for lunch. And let’s face it, they’re a tough bunch. I have the answer. An attorney I know has put together a system, that is both in written and video form, that shares how to approach attorneys and get them to send their PI clients to you. This is the real deal. Attorney Paul Samakow’s system costs $997 and he guarantees satisfaction or your money back. You have to check this out.  Even if you only get one case, you’ve made at least 4 or 5 times the investment.

Go to gettingpicases.com/cs

That’s gettingpicases.com/cs

One more time so you get it right:   gettingpicases.com/cs

Item #1

This first one is called, “Association Between Physical Activity and Risk of Depression A Systematic Review and Meta-analysis” by Pearce et. al. (Pearce M 2022) and published in Jama Psychiatry on April 13, 2022 – Dayumm that’s fresh and hot. 

Why They Did It

To systematically review and meta-analyze the dose-response association between physical activity and incident depression from published prospective studies of adults.

How They Did It

PubMed, SCOPUS, Web of Science, PsycINFO, and the reference lists of systematic reviews retrieved by a systematic search up to December 11, 2020

What They Found

  • Fifteen studies comprising 191,130 participants and 2,110,588 person-years were included. 
  • Heterogeneity was large and significant. 
  • Those accumulating HALF the recommended volume of physical activity had 18% lower risk of depression. 
  • Adults accumulating the recommended volume of 8.8 marginal metabolic equivalent task hours per week had 25% lower risk with diminishing potential benefits and higher uncertainty observed beyond that exposure level. 

Wrap It Up

This systematic review and meta-analysis of associations between physical activity and depression suggest significant mental health benefits from being physically active, even at levels below the public health recommendations. Health practitioners should therefore encourage any increase in physical activity to improve mental health.

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

Item #2

The last one today is called, “”The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review” by Savva et. al. (Savva C 2021) and was published in the Journal of Manual and Manipulative Therapy in 2021 – aye chi wa wa. Steamy. 

Why They Did It

To summarize the available literature with regards to the potential analgesic effect and mechanism of joint mobilization and manipulation in tendinopathy. 

What They Found

  • The effect of these techniques in rotator cuff tendinopathy and lateral elbow tendinopathy, applied alone, compared to a placebo intervention or along with other interventions has been reported in some randomized controlled trials which have been scrutinized in systematic reviews. 
  • Literature in other tendinopathies such as medial elbow tendinopathy, de Quervain’s disease and Achilles tendinopathy is limited since the analgesic effect of these techniques has been identified in few case series and reports. 
  • Therefore, the low methodological quality renders caution in the generalization of findings in clinical practice. 
  • Studies on the analgesic mechanism of these techniques highlight the activation of the descending inhibitory pain mechanism and sympathoexcitation although this area needs further investigation.

Wrap It Up

Study suggests that joint mobilization and manipulation may be a potential contributor in the management of tendinopathy as a pre-conditioning process prior to formal exercise loading rehabilitation or other proven effective treatment approaches. 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 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

Pearce M, G. L., Abbas A, (2022). “Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis.” JAMA Psychiatry.  

Savva C, K. C., Korakakis V, Efstathiou M, (2021). “The analgesic effect of joint mobilization and manipulation in tendinopathy: a narrative review.” J Man Manip Ther 29(5): 276-287.    

Cognitive Behavioral Therapy & Restless Leg Syndrome

CF 226: Cognitive Behavioral Therapy & Restless Leg Syndrome Today we’re going to talk about Cognitive Behavioral Therapy & Restless Leg Syndrome But first, here’s that sweet sweet bumper music

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

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 ma ke you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Facebook page, 
  • Join our private Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #226 Now if you missed last week’s episode , we talked about Pain And COVID & Images Can Mislead. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. As part of our MCM Mastermind call last week, it seems that everyone is starting to get busy once again. Which is refreshing. Omicron is settled down and deductibles are getting met once again.  Patients are coming back. Are we the only business that hasn’t gone up on prices this year? Gas, flights, travel of any kind, food, real estate, inflation…..everything has gone sky high. And I’m sitting here with the exact same pricing I’ve had for the last 5 or more years.  Last week, we talkied about getting hacked on FB. Yeah, it happened to me big time. BIG TIME. Facebook changed to this Meta thingy majig. So, I have created around 22 pages for various reasons. Philanthropy, business, clinic services, etc. Lots of stuff.  You may recall that I’ve been mentioning that I was running a targeted ad campaign. Since we are medically integrated, I started with the hormone pellets. I figured if I could get it to work for pellets, I could repeat the process with every service we offer.  So, I went and found a freelancer that does that. Hired them up and we were off and running. Well, he needed admin permissions on Facebook. I did not think that was a good idea but he’s not the first I’ve worked with and they all need this permission level for some reason. It’s honestly never made sense and I’ve never been comfortable with it.  But, since it’s pretty common, I did it. Well, I woke up last Monday to an email from him telling me to remove him from my Facebook because he’d been hacked. I went to do that but it was too late. I was already listed as an employee and two random names I’ve never seen were listed as the Admins.  So through hacking my paid ad person, they were able to hack my Meta and through hacking my Meta, they were now in control of 22 different pages of mine.  Excuse me for being crude here but that’ll make your butt strings pucker up, people. That’ll make you cuss in Spanish and kick baby bunnies.  Facebook support gave me a little hope. I got going with them, they understood the issue and said I’d hear back from them in 24-48 hrs. That was a Monday. Thursday rolled around and I still hadn’t heard anything from them so I started a new ticket with them. The new ticket dude knocked it out.  I was back in control of everything within about 2 hours. It’s odd; the hackers didn’t change anything on any of the 22 pages I run. They had 3 days minimum to mess everything up but they didn’t for some reason. I don’t know. It’s weird. But thank God they didn’t.  Now we’re back to normal, this Monday wasn’t a freak out butt puckering session and we’re good to go.  So let this be a lesson to you all. When you hire an ad person and they ask for admin permission, politely tell them, I’m sorry but I’ve been advised by my Ol’ Uncle Jeffro not to do that. You can get hacked through the back door like that and it doesn’t feel good. Not good at all.  Before we get to the research, we talked about pricing…..well, I’m guessing you are getting tired of getting paid peanuts for your good work?  Insurance pays maybe half. Medicare and Medicaid even less.  So how about full payment?  This comes with PI cases. How do you get these cases? You learn how the game is played. You learn the system. I recently connected with an attorney, Paul Samakow, a 41-year veteran attorney – he explains in detail what to do, how to do it, and how to have attorneys not only send you their clients, but how to assure they continue to send them over. His system is delivered to you in both written and video form – Samakow is actually pretty funny when you watch, he’s got a great personality – but his content and information are both spot on and serious, and will result in multiple referrals from attorneys if you follow his system. His system costs $997 and he guarantees satisfaction or your money back. Which is really a big deal for me and makes it easy to check this out.  Even if you only get one case, you’ve made at least 4 or 5 times the investment. Go to gettingpicases.com/cs That’s gettingpicases.com/cs One more time so you get it right:   gettingpicases.com/cs Alright onto the research Item #1 This first one is called, “Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care A Randomized Clinical Trial” by Wright et. al. (Wright JH 2022) and published on February 10, 2022. Ah….it’s hot and cozy.  First of all, before we dive in, we know chronic pain can lead to depression, anxiety, lack of sleep, and deeper pain. We also know that it goes the other way as well. Depression leads to deeper, more entrenched chronic pain, inactivity, anxiety and on and on.  That’s why the American College of Physicians has recommended Cognitive Behavioral Therapy as a first line treatment for back pain.  On another related note, chiropractors tend to think they can do everyhting. Y’all……CBT isn’t one of them. You can’t Google it and figure it out. It’s not in our scope. You have to find a specialist and refer it out. When you’re wondering if you can take care of it yourself……just don’t Why They Did It To evaluate whether computer-assisted CBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of it in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment. How They Did It
  • Randomized clinical trial 
  • included adult primary care patients from clinical practices at the University of Louisville who scored 
  • They were randomly assigned to computer-assisted CBT or treatment as usual for 12 weeks of active treatment. 
  • Follow-up assessments were conducted 3 and 6 months after treatment completion. 
  • The last follow-up assessment was conducted on January 30, 2020. 
  • The primary outcome measures were administered at baseline, 12 weeks, and 3 and 6 months after treatment completion.
What They Found
  • An intent-to-treat analysis found that computer-assisted CBT led to significantly greater improvement in outcome scores -cores than treatment as usual at posttreatment and 3 month and 6 month follow-up points. 
  • Posttreatment response and remission rates were also significantly higher for computer-assisted CBT than treatment as usual
Wrap It Up computer-assisted CBT was found to have significantly greater effects on depressive symptoms than treatment as usual in primary care patients with depression. Because the study population included people with lower income and lack of internet access who typically have been underrepresented or not included in earlier investigations of computer-assisted CBT, results suggest that this form of treatment can be acceptable and useful in diverse primary care settings.  Before getting to the next one, I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! It’s live again. Use the code HOTSTUFF upon purchase at droprelease.com to get $50 off your purchase. Y’all, it makes a world of difference. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. My patients love it and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Hear me now and believe me later.  Item #2 Our second one today is called “Current Evidence on Diagnostic Criteria, Relevant Outcome Measures, and Efficacy of Nonpharmacologic Therapy in the Management of Restless Legs Syndrome (RLS): A Scoping Review” by Guay et. al. (Guay A 2020) and pulblished in Journal of Manipulative and Physiological Therapeutics.  Why They Did It To outline the current evidence regarding the management of restless legs syndrome (RLS) with nonpharmacologic approaches.  How They Did It
  • Scoping review
  • The authors extracted data from the 24 admissible studies, that is, the ones about manual therapy, exercises, and alternative treatments for RLS
  • The Physiotherapy Evidence Database scale was used to rate the methodological quality of the included randomized controlled trials by 2 independent readers.
What They Found
  • In the 24 articles fulfilling the selection criteria, there was a consistent trend in the findings showing positive results in lowering RLS symptom severity. 
  • The efficacy of exercise, yoga, massage, acupuncture, traction straight leg raise, cryotherapy, pneumatic compression devices, whole-body vibration, transcranial and transcutaneous stimulation, and near-infrared lights showed different effects on RLS symptom severity, and the level of evidence was evaluated.
Wrap It Up Our results showed clinically significant effects for exercises, acupuncture, pneumatic compression devices, and near-infrared light. Short-lasting effects were identified with whole-body cryotherapy, repetitive transcranial stimulation, and transcutaneous stimulation. More studies are necessary to investigate efficacy of yoga, massage, traction straight leg raise, and whole-body vibration. No adverse effects were identified for moderate-intensity exercise, yoga, massage, and pneumatic compression devices. If I remember correctly, we did another episode that covered RLS and melatonin was a supplent that showed effectiveness. Google it and see if I’m right.  Alright….gotta go! 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
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 (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 Guay A, H. M., O’Shaughnessy J, Descarreaux M, (2020). “Current Evidence on Diagnostic Criteria, Relevant Outcome Measures, and Efficacy of Nonpharmacologic Therapy in the Management of Restless Legs Syndrome (RLS): A Scoping Review.” J Man Physiol Ther 43(9): P930-941.   Wright JH, O. J., Eells TD, (2022). “Effect of Computer-Assisted Cognitive Behavior Therapy vs Usual Care on Depression Among Adults in Primary Care: A Randomized Clinical Trial.” JAMA Netw Open 5(2).          

Kids’ Mental Status & Zero Calorie Drinks

CF 223: Kids’ Mental Status & Zero Calorie Drinks Today we’re going to talk about the children, how are they doing lately? And then we’ll talk about whether low or no calorie beverages have any real use for us.  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 
  • 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 #223 Now if you missed last week’s episode, we talked about Forward Head Posture And Spinal Manipulative Therapy Effectiveness. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Let’s talk about marketing. I always share what I’m doing and how it’s working with you folks and while business is coming back, that’s just the natural flow. We expect to start getting busy again in March. I’m looking for marketing that moves the needle.  I’ve tried social media marketing campaigns that cost me in excess of $4500. For basically nothing. I might as well stuffed that money into my ears and lit it on fire and did a rain dance. It was useless.  Here’s something to know about me……I can be talked into just about anything.

I believe people and always look for the best in them. Or at least try to. So, yeah….I can either be talked into anything or, as is often the case, talk MYSELF into anything.  Here’s my life; I create all of our social media posts. I write my own blog every week. I record my own video and edit it every week for YouTube and Facebook. That’s in between 40+ patients a day and 20+ new patients per week and writing and recording a podcast, real estate, voice-over, and anything else in there including being a husband and a dad.  It’s time for some help and hopefully some effective help. 

I told you how I started with a new idea of lead magnets a few weeks ago. Not a lot happening there. As expected. I hoped…..but feared not much would come of it outside of an absence of my money. So far, it’s an absence of my money but I’m stubborn and not giving up just yet.  This lead magnet is for our testosterone hormone pellets. My thinking is that if it works for the pellets, then we will expand the concept and keep trucking with different products and services for the lead magnets. Still testing there and will update as needed.  I’m also starting with a new crew from England on social media marketing. I got the welcome packet today. My thinking is that my consultation payments for this medical integration are finished this month.

So that frees up some funds to put toward something else and there are not many things more important than marketing. So, I’m getting going with another group today to test them out and see how we can grow my stuff.  If it’s awesome, maybe I can make them a sponsor of the show and share them with you too. We’ll see.  A little tip from you Ol Uncle Jeffro, if you didn’t do it in January, do it now. Sit down with your key employee and go from month to month to plan out what you’re going to do for marketing.

What key events do you need to have a presence at, etc. Do you want to do a Mother’s Day promotion? What about a July 4th cookout at the office? That type of deal. When it’s planned, you don’t forget about it and it doesn’t sneak up on you.  Since I’m trying to delegate marketing more and more to my staff, I have the global marketing sheet but I also have started a weekly focus sheet.

So my marketing focus this week is to stress ‘no wait times for our NP, social media posts for the whole week, 2x/day, 1-2 videos for the week.  We’ll see, I think I have swimmers and not sinkers so we’ll see.  Continuing in the debacle of trying to find a front desk staffer, we have run into yet another snafu. This time we found a good one. Or so we thought. She worked with us for almost 2 full weeks. Then came St. Patty’s day. She ended up in a ditch running from the police and driving drunk at 2:00 am. She missed work the next day. Not because of a hangover but because she was in jail.  A little more research told us that she didn’t have custody of her kiddo because of 2 previous DWIs and this was her 3rd. So…..while you don’t want to be the one to compound someone’s suffering and misery, we had to cut ties. 

  1. If she lost custody of her kid because of drinking and still didn’t get the message, it’s going to be a long road
  2. If we’re missing work in the first 10 days because of jail, that’s just a bad omen of things to come
  3. If this is her 3rd DWI, she’s going to do jail time and we need an employee that is here and dependable. 
  4. If she miraculously doesn’t do jail time, she’ll be doing rehab, counseling, community services, court dates, and all that good stuff. And all of that equals time out of work. 

There are more reasons but that’s enough. We had to move on. I’ve always shied away from hiring friends because I just see that always going bad and it causing an awkward problem down the road. However, we started having one of our buddies come up to the office on a part-time basis to help us out on some overflow work and Holy guacamole….she’s insane good at the front desk stuff.  So….maybe we have a new front desk person after all. The saga continues and I’ll keep you updated. Stay tuned.  Alright to the research we go!

Item #1

This one is called “Five-Year Trends in US Children’s Health and Well-being, 2016-2020” by Lebrun-Harris et. al. (Lebrun-Harris LA 2022) and published in Jama Pediatrics on March 14, 2022. Holy fires of hell, it’s en Fuego!

Why They Did It

The authors say they aimed to examine recent trends in children’s health-related measures, including significant changes between 2019 and 2020 that might be attributed to the COVID-19 pandemic.

How They Did It

  • 174,551 children included in the study
  • Annual data were examined from the National Survey of Children’s Health (2016-2020), 
  • It was a population-based, nationally representative survey of randomly selected children. 

What They Found

  • Increased Anxiety
  • Increased depression
  • Decreases in daily physical activity
  • Decreases in parent or caregiver mental health
  • Decreases in coping with parenting demands

From 2019-2020 – the pandemic

  1. Increases in behavior or conduct problems
  2. Child care disruptions affecting parental employment
  3. Decreases in preventive healthcare visits
  4. increases in unmet health care needs, and 
  5. increases in the proportion of young children whose parents quit, declined, or changed jobs because of childcare problems.

Wrap It Up

Study findings point to several areas of concern that can inform future research, clinical care, policy decision-making, and programmatic investments to improve the health and well-being of children and their families. People have gone crazy. They were politically crazy and hating on each other prior to the pandemic. So let’s be honest here, shall we? But the pandemic deepened it and while technology is amazing and useful, social media has, in my opinion, destroyed the fabric of our society. Of love and understanding. Of mutual respect.  It’s allowed people to mouth off and insult each other from a distance saying things and in behaving in a manner that they would never behave like if the person they’re disrespecting were standing directly in front of them.  Anyway, kids are resilient but they’ve been affected too. Our world has gotten more stressful and it’s showing. 

Item #2

This second one is called, “Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-analysis” by McGlynn et. al. and published in JAMA Network Open on March 14, 2022. Schiza – Steamy

Why They Did It

There are concerns that low- and no-calorie sweetened beverages do not have established benefits, with major dietary guidelines recommending the use of water and not low- and no-calorie sweetened beverages to replace sugar-sweetened beverages. Whether low- and no-calorie sweetened beverages as a substitute can yield similar improvements in cardiometabolic risk factors vs water in their intended substitution for sugar-sweetened drinks is unclear. To assess the association of low- and no-calorie sweetened beverages with body weight and cardiometabolic risk factors in adults with and without diabetes.

How They Did It

  • Data were extracted and risk of bias was assessed by 2 independent reviewers
  • The primary outcome was body weight. Secondary outcomes were other measures of adiposity, glycemic control, blood lipids, blood pressure, measures of nonalcoholic fatty liver disease, and uric acid.
  • A total of 17 RCTs with 24 trial comparisons were included, involving 1733 adults

What They Found

I’m not going to tell you. Because it gets very technical and in the weeds as they say. You’ll start wandering off into the ether and thinking about things like….is there another word for Thesaurus? And if you were to choke a Smurf…..what color would they turn?

Wrap It Up

This systematic review and meta-analysis found that using low- and no-calorie sweetened beverages as an intended substitute for sugar-sweetened beverages was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution.  The evidence supports the use of low- and no-calorie sweetened beverages as an alternative replacement strategy over the moderate term in adults with overweight or obesity who are at risk for or have diabetes.

This is amazing because I’ve been off of sodas for a decade but recently discovered a new love for Coke Zero. My wife has been all over me about drinking them and now I can show her research that says maybe they’re not as bad as she thinks.  And at the end of the day, I take some satisfaction in being right. : ) 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.

Website

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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 Lebrun-Harris LA, G. R., Kogan MD, Warren MD, (2022). “Five-Year Trends in US Children’s Health and Well-being, 2016-2020.” JAMA Pediatr.      

Working Class Rising Death Rates & Nutrition Affects Chronic Pain

CF 179: Working Class Rising Death Rates & Nutrition Affects Chronic Pain Today we’re going to talk about the fact that there are rising death rates among folks that are of working-class age. Not just the elderly. Why is that happening? Then we’ll talk about diet and chronic pain.  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. 
You have found yourself smack dab in the middle of Episode #179 Now if you missed last week’s episode , we talked about  whether chiropractors cause disc herniations or not and we talked about how family doctors still aren’t getting the message. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. This medical integration thing is about to take off. Wee ahve the contracts all drawn up, questions answered, and ready to get them all signed.  New EIN, new credentialing for me and the NP, and full steam ahead. Did you know that I have to re-credential under the new entity as well? What a pain in the backside, right? Hell yeah it is. I’m OK referring patients back and forth within the same group. You start to run into risk of getting in trouble with the Stark, anti-kickback laws when you are referring patients back and forth across different entities.  So, yeah….there’s that. I won’t bore you with the particulars but it’s definitely a ride we’re on and it’s go time.  Everything I’ve seen and experienced thus far tells me that we’re in a good spot and things are proceeding fairly smoothly. Slowly but smoothly. Next will be credentialing and that will slow everything down for a couple of months but that’s probably a good thing I’m guessing.  I’m fortunate to have a genius for a wife that understands a lot of the legal end of things that I’m just not talented at. Plus we have an attorney in Austin that literally wrote the integration law that has set it all up for us. And we have Dr. Tyce Hergert with Southlake Physical Medicine consulting us so we have a talented and very smart team.  Surrounding yourself with good people is the first step to success. We can’t be expected to be the smartest expert on everything that we encounter in our personal or professional lives. We need good people in our lives and our network. Good and talented people who have the right kind of heart for our style.  That’s exactly what I have right now so I’m very confident going forward. I don’t take big risks. I take measured, smart risks. That’s exactly where I’m at.  Alright, busy busy this week so let’s get scooting with this episode.  Item #1 This one called “High and Rising Working-Age Mortality in the US. A Report From the National Academy of Sciences, Engineering, and Medicine” by Mullan Harris, et. al. [1] published in JAMA on May 10, 2021. Servin em up steamy and saucy.  Why They Did It They say, “Life expectancy has increased in the US and in the world for the past century. In 2010, life expectancy plateaued in the US while continuing to increase in other high-income nations. In the US, life expectancy declined for 3 consecutive years (2015-2017) due primarily to an increase in mortality among working-age adults (those aged 25-64 years).1 Although the increase in mortality was first described among White middle-aged adults, mortality is now increasing among young and middle-aged adults and in all racial groups. This increase in premature death, claiming lives during the prime working ages, has important implications for individuals, families, communities, employers, and the nation.” They found that average working-age mortality rates decreased after 2010 in 16 high-income countries but increased in the US. Three causes of death were identified as chiefly responsible: (1) drug poisoning and alcohol-induced causes, (2) suicide, and (3) cardiometabolic diseases. The first category includes mortality from mental and behavioral disorders, which often involve drugs or alcohol. Cardiometabolic diseases include endocrine, nutritional, and metabolic diseases (eg, diabetes, obesity); hypertensive heart disease; and ischemic heart disease and other diseases of the circulatory system (eg, arrhythmia, cardiomyopathy, heart failure). Drug and alcohol use were the largest contributors to increasing mortality among working-age adults, accounting for 8% (an estimated 1.3 million) of deaths in this population between 1990 and 2017 (an average of 44 869 per year). The increase was largest among White male adults and older Black male adults. They go on. They say, “The drug crisis was the product of 2 influences: an increase in access to legal and illegal drugs and the vulnerability of certain populations. The licensing of OxyContin in 1996, subsequent flooding of the market with prescribed opioids, and waves of highly potent heroin and fentanyl that coincided with growing demand for these substances have been described as a perfect storm.3 The drug supply expanded with limited government oversight, substantial marketing by the pharmaceutical industry, and overprescribing by physicians.” With regards to Suicide, they say, “Suicide, which accounted for 569 099 deaths among working-age adults during 1990-2017 (an average of 20 325 per year), increased primarily among White adults, especially White men, and in less populated, rural areas. Few studies have established a cause for this trend. Economic stresses are a possibility; suicide is associated with economic downturns, wage stagnation, weak health care safety nets, and foreclosures.4 Another potential contributing factor is declining social support from churches, civic organizations, and families. Such social supports, which protect against self-harm, have declined in recent decades, especially among lower-educated White adults. Easier access to firearms is associated with increased suicide rates; however, the greater increase in nonfirearm suicides during this period suggests other causes. Other risk factors for suicide include mental illness, comorbid conditions, disability, and substance use.” With regard to cardiometabolic disease they say, “Cardiometabolic diseases caused more than an estimated 4.8 million deaths among working-age adults during 1990-2017 (an average of 173 062 per year). The largest relative increases in cardiometabolic mortality occurred among younger adults (aged 24-44 years) in all racial/ethnic groups, White men and women, Black men (in recent decades), and those living in rural areas. Cardiometabolic mortality rates increased after 2010 for 2 reasons: (1) mortality from endocrine, nutritional, and metabolic diseases and hypertensive heart disease generally increased during 1990-2017 and (2) after a period of substantial reductions in mortality from ischemic heart disease and other circulatory diseases from the 1970s onward, progress stalled after 2010.” “The report discusses 3 explanations for this trend. First, the most important was the increased prevalence of obesity and its cardiometabolic consequences. Obesity rates increased in the early 1980s as a period-based phenomenon that affected the entire population, but the related cardiometabolic consequences occurred in a cohort fashion; younger cohorts born in the 1970s-1990s experienced obesogenic environments their entire lives, whereas exposure in older cohorts was limited to older ages.5 As a result, many young adults are entering their work lives with a high prevalence of chronic diseases associated with obesity. “ “The recent increase in mortality among working-age adults shows no signs of receding. Obesity rates are unrelenting, drug- and alcohol-related deaths and suicide rates, already high among working-age adults, increased during the COVID-19 pandemic” So what does all of that mean? Well, it means we are providers and we need to know this stuff and be aware of it. We need to be able to refer to specialists when we see the signs of drug or alcohol abuse, suicidal tendencies, or nutritional concerns.  It’s not just a, “‘hey he should get his crap together while he still can.” It’s a little more immediate than that I think .  CHIROUP ADVERTISEMENT Item #2 Item 2 today is called “Dietary Interventions Are Beneficial for Patients with Chronic Pain: A Systematic Review with Meta-Analysis”” by Field et. al. [2] published in Pain Medicine on November 17, 2020 and that’s a bit roasty.  Why They Did It The standard Western diet is high in processed hyperpalatable foods that displace nutrient-dense whole foods, leading to inflammation and oxidative stress. There is limited research on how these adverse metabolic drivers may be associated with maladaptive neuroplasticity seen in chronic pain and whether this could be attenuated by a targeted nutritional approach. The aim of this study was to review the evidence for whole-food dietary interventions in chronic pain management. How They Did It
  • A structured search of eight databases was performed up to December 2019.
  • A meta-analysis was performed in Review Manager.
  • Forty-three studies reporting on 48 chronic pain groups receiving a whole-food dietary intervention were identified
What They Found
  • A visual analog scale was the most commonly reported pain outcome measure, with 17 groups reporting a clinically objective improvement
  • Twenty-seven studies reported significant improvement on secondary metabolic measures.
  • Twenty-five groups were included in a meta-analysis that showed a significant finding for the effect of diet on pain reduction when grouped by diet type or chronic pain type.
Wrap It Up There is an overall positive effect of whole-food diets on pain, with no single diet standing out in effectiveness. This suggests that commonalities among approaches (e.g., diet quality, nutrient density, weight loss) may all be involved in modulating pain physiology   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. Harris KM, W.S., Gaskin DJ,, High and Rising Working-Age Mortality in the US: A Report From the National Academy of Sciences, Engineering, and Medicine. JAMA, 2021. 2. Rowena Field, M.P., Fereshteh Pourkazemi, PhD, Jessica Turton, Kieron Rooney PhD,, Dietary Interventions Are Beneficial for Patients with Chronic Pain: A Systematic Review with Meta-Analysis. Pain Med, 2020. 22(3): p. 694-714.

Do Chiropractors Cause Disc Herniations & Family Doctors Still Don’t Get It

CF 178: Do Chiropractors Cause Disc Herniations & Family Doctors Still Don’t Get It

Today we’re going to talk about if chiropractors cause lumbar disc herniations and how primary doctors still don’t understand guidelines that are 4 years old at this point.

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.
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 #178

Now if you missed last week’s episode, we talked about spinal manipulative therapy effectiveness and chiropractic for colic. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..
It’s dragging. Don’t think for a second that you’re going to set up a medical entity in just a week or so. Lol. Goodness gracious. I went through my orthopedic diplomate in 6 months for a reason. It’s not because I’m smarter than anyone else or that I have more extra time than anyone else. Far from it.
I went through it so quickly because I hate stuff just lingering out in the ether unfinished or waiting or on hold or whatever. It drives me crazy to have unfinished ideas or projects. Literally crazy.
So, this new growth thing is making me crazy because it’s still not tied up and we’re in a holding pattern until the papers are signed and we are credentialing. Which we aren’t doing just yet.

But, I think we’re close.

My book will be launching on Tuesday, June the 8th. Be looking for it, y’all! I’m beyond excited about it!

Business is slowly picking back up. Texas is wide open at this point. Its rarer to see someone wearing a mask than it is to see those not wearing masks. Concerts have returned. Crowds have returned. And Texas had the second slowest growth of COVID last month. What does that say exactly?? Hell if I know. But I see the University of Massachusetts penalizing kids for not wearing masks off-campus and I see Texas with little COVID growth yet we’re wide open with basically no masks.

Who’s right? To me, it looks like Texas and states like Texas are right at this point in time. All of the lockdowns were important and needed and effective. Now, it appears to be time to loosen up considerably and proceed with less fear and more science.

I’m not an expert in that field. But there has to be some science coming out of what’s happening and the differences between states still locked down and states that are wide open. Between kids that have been going to school since August of 2020 and kids that just started a week or two ago because their schools have been closed all year.

It’s all interesting. That’s for sure. As for me, in my area, the sense of a return to the old normal is refreshing. In a city area of about 270,000 people, we added 19 new cases yesterday. Again, I’m 100% honest when I tell you there are basically zero masks to be seen with 100% capacity everywhere you go.

You be the judge.

Item #1
This first one is called “Chiropractic care and risk for acute lumbar disc herniation: a population-based self-controlled case series study”’ by Hincapie et. al. [1] and published in European Spine in July of 2018.

Why They Did It
“Our objective was to investigate the association between chiropractic care and acute lumbar disc herniation with early surgical intervention, and contrast this with the association between primary care physician care and acute lumbar disc herniation with early surgery.”

How They Did It
195 cases of acute lumbar disc herniation with early surgery (within 8 weeks) were identified in a population of more than 100 million person-years.
Self-controlled case series design and population-based healthcare databases in Ontario, Canada
They investigated all adults with acute lumbar disc herniation requiring emergency department (ED) visit and early surgical intervention from April 1994 to December 2004.
The relative incidence of acute lumbar disc herniation with early surgery in exposed periods after chiropractic visits relative to unexposed periods was estimated within individuals, and
compared with the relative incidence of acute lumbar disc herniation with early surgery following primary care physician visits.

What They Found
Strong positive associations were found between acute lumbar disc herniation and both chiropractic and primary care physician visits.
The risk for acute lumbar disc herniation with early surgery associated with chiropractic visits was no higher than the risk associated with primary care physician visits.

Wrap It Up
“Both chiropractic and primary medical care were associated with an increased risk for acute lumbar disc herniation requiring ED visit and early surgery. Our analysis suggests that patients with prodromal back pain from a developing disc herniation likely seek healthcare from both chiropractors and primary care physicians before full clinical expression of acute lumbar disc herniation. We found no evidence of excess risk for acute lumbar disc herniation with early surgery associated with chiropractic compared with primary medical care.”

CHIROUP ADVERTISEMENT

Item #2
The last one today is called “Initial Management of Acute and Chronic Low Back Pain: Responses from Brief Interviews of Primary Care Providers” by Roseen et. al. [2] and published in the Journal of Alternative and Complementary Medicine in March of 2021 and we got a hot one folks!

Why They Did It
They say, “In April 2017, the American College of Physicians (ACP) published a clinical practice guideline for low back pain (LBP) [3] recommending nonpharmacologic treatments as first-line therapy for acute, subacute, and chronic LBP.”

Listeners of this Chiropractic Forward Podcast know this because I have been riding that horse nonstop since it came out. I mention damn near every single episode.

The objective here is “To assess primary care provider (PCP)-reported initial treatment recommendations for LBP following guideline release. “

How They Did It
Cross-sectional structured interviews.
Interviews were completed between December 2017 and March 2018.
Convenience sample of 72 primary care providers from 3 community-based outpatient clinics in high- or low-income neighborhoods.
The PCPs were interviewed about their familiarity with the ACP guideline, and how they initially manage patients with acute/subacute and chronic LBP.
PCPs were also asked about their comfort in referring patients to nonpharmacologic treatment providers, and about barriers to referring.

What They Found
Of 72 participating PCPs, over three-fourths indicated being familiar with the ACP guideline
For acute LBP, PCPs typically provided advice to stay active and pharmacologic management (97%; primarily nonsteroidal anti-inflammatory drugs).
For chronic LBP, PCPs were more likely to recommend nonpharmacologic treatments than for acute LBP
The most common nonpharmacologic treatments recommended for chronic LBP were physical therapy (78%), chiropractic care (21%), massage therapy (18%), and acupuncture (17%)
The cost of nonpharmacologic treatments was perceived as a barrier.
However, PCPs working in low-income neighborhood clinics were as likely to recommend nonpharmacologic approaches as those from high-income neighborhood clinics.

Wrap It Up
“While most PCPs indicated they were familiar with the ACP guideline for LBP, nonpharmacologic treatments were not recommended for patients with acute symptoms. Further dissemination and implementation of the ACP guideline are needed.”

So, what’s it going to take? Well, for one, the more fringe and crazy part of our profession needs to cut their crap. No, I don’t want to be a medical doctor or I would have gone to med school.

What I DO want is to be a respected part of an integrated healthcare team. Like it or not, the PCP is the gatekeeper and if the PCPs trust us, we get more patients, and at the end of the day, aren’t more patients the name of the game? Come on, of course, it is.

If our profession moves into the year 2021 instead of 1896 or whatever year Palmer got the idea from the osteopaths, then we can move forward with becoming a part of the community. Rather than separate and distinct. I do like not being under the state medical boards and all that good stuff. That’s necessary while there’s still such a divide.

But we can become more and more of the team if we stop thee more fringe assertions and ideas. Nepute, to my understanding, the chiro out in St. Louis…..the dude that has been, in my view, an absolute lunatic all over social media, is the first person getting nailed under the new covid laws and just happens to be a chiropractor.

Not a good look. In my opinion, he’s done chiropractors zero favors and really bruised us up quite a bit. Why in the hell would a PCP…….or a circus worker…or anyone else in the damn world…..see someone like NePuke and associate them with all other chiropractors and decide they’ll never send a patient or a friend to whackos like chiropractors?

Raise the game folks. Raise the game. Get current. Get smart. Make sure you’re sciencing once or twice per day. It’s not hard to do. Get a Diplomate. Specialize. Raise the game

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.

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
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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. Hincapie C, Chiropractic care and risk for acute lumbar disc herniation: a population-based self-controlled case series study. European Spine Journal, 2018. 27(7): p. 1526-1537.
2. Roseen EJ, C.F., Atlas SJ, Mehta DH,, Initial Management of Acute and Chronic Low Back Pain: Responses from Brief Interviews of Primary Care Providers. J Altern Complement Med, 2021. 27(S1): p. S106-S114.
3. Qaseem A, Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med, 2017. 4(166): p. 514-530.

Car Crashes And Awesome Research To Go Along With It

CF 175: Car Crashes And Awesome Research To Go Along With It Today we’re going to talk about car wreck research and it’s pretty cool. Especially if you treat PI patients and you ever find yourself testifying. I’m going to give you a couple of caveman clubs that you can use to figuratively bash a rabid attorney with.  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. 

You have found yourself smack dab in the middle of Episode #175 Now if you missed last week’s episode , we talked about ow back disability and osteoarthritis research. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

We hired a nurse practitioner. I have to say that there are so many scary talented and scary smart people out there in the world, folks. We got to meet several of them while going through the interview process. If everyone comes out of school highly trained, it’s hard to use that as a measuring stick.  So, I fell back to my core need; which was to hire a good person. It wouldn’t be helpful to hire someone that would come in and feel superior to everyone else in the office. It wouldn’t be helpful to hire someone highly trained but they don’t treat my staff with respect and even love. That would kill office culture dead in its tracks and I like my office culture. 

I tease my staff. I tease my patients. They tease me back. I love the atmosphere. I don’t want to hire a stick in the mud. So I didn’t. When it comes down to it, you can train everything that needs to be trained. But you can’t make a miserable person a good person. You can’t make an introvert an extrovert. You can’t make someone that has a sense of entitlement into someone that is full of gratitude.  You just can’t do it. I think the one we hired is the closest of all that we interviewed to me and who I am and how I carry myself.

He’s new so there won’t be any bad habits. He’s eager to learn. I love that. I’m afraid I’m not the best teacher but we’re going to do it anyway! So, that’s my big news this week, the NP is on and this train is rolling down the tracks now.  Now, I’m going to tell you that here in Texas, masks are no longer mandated. Not even in the schools. So, as you might imagine, if COVID were still a huge concern here, there would be people piling up in the hospitals.

There aren’t. In fact, your hospital load just continues to dwindle. We are in an area of about 275,000 people or so. And the last number I saw last week was that we added 15 new cases that day.  That’s with kids going to school and interacting with each other. In BIG schools. When you go to a restaurant, the places are packed with people. I’m telling you, here in Texas, there is no ‘new normal’. There is the old normal.

You’d never even know that anything was ever different for a year, honestly.  Yet, numbers are continuing to go down. So, why are other states back on the rise? What does it all mean? Has Texas reached herd immunity through infections and vaccines? Maybe. Texas has been a problem state for COVID for months until more recently.  I don’t know all of the answers. But what I feel is that the states that are still on serious lockdown are doing their population an injustice when you compare them to Texas. If their kids aren’t in school, they should be. They’re doing more damage than good from what I can tell. At this point anyway. 

Trust me, I’ve been all about being safe and smart and taking care of each other. Especially those most at risk. But, at this point, everyone that wants to be vaccinated in my area is vaccinated. At this point, in my state, if you get sick, it’s because you chose to risk it. Plain and simple.  Alright, let’s dive in. But first, I want to drop in a word about our amazing sponsors and give you a way to save a little money. 

CHIROUP ADVERTISEMENT

This podcast episode was inspired by a recent episode of the Chiropractic Science podcast hosted by Dean Smith. His guest was Dr. Michael Freeman who I’ll talk about here in just a minute. These papers are papers they talked about on that episode so, if you want it from the horse’s mouth, go over to Chiropractic Science and find the recent episode with Dr. Michael Freeman and hit play. Then come back here and get my take on it. 

Item #1

This one is called “Is Acceleration a Valid Proxy for Injury Risk in Minimal Damage Traffic Crashes? A Comparative Review of Volunteer, ADL and Real-World Studies” by Nolet, et. al. (Nolet PS 2021) published in International Journal of Environmental Research and Public Health in March of 2021 and I can’t even….wouldn’t even try to touch it…..

Why They Did It

Let me preface this by saying that Dr. Michael Freeman is an author on this paper and he’s just a phenomenal asset to chiropractic, health in general, and personal injury research. If you aren’t familiar with Dr. Freeman, we’re talking about the fact that he’s a DC, an MD, and Ph.D. and a whole bunch of other stuff one single person has any business being.  Also on this paper is Dr. Art Croft. I have the advanced certification through Dr. Croft’s SPINE Institute in San Diego and I have to tell you that he’s one of the most impressive individuals I’ve ever personally met.  In the paper, they say, “Injury claims associated with minimal damage rear impact traffic crashes are often defended using a “biomechanical approach,” in which the occupant forces of the crash are compared to the forces of activities of daily living (ADLs), resulting in the conclusion that the risk of injury from the crash is the same as for ADLs.” 

To put that in me and you talk…..what they’re saying is that it’s common in court for attorneys to say that being in a 5mph low-speed rear impact is similar in force to just stepping off of a sidewalk curb. Or some other ridiculous analogy like that.  They go on to say, “The purpose of the present investigation is to evaluate the scientific validity of the central operating premise of the biomechanical approach to injury causation; that occupant acceleration is a scientifically valid proxy for injury risk.”

To put that in me and you talk…..they just want to see if common every day events are truly like a low-speed rear impact car wreck. 

How They Did It

  • Data were abstracted, pooled, and compared from three categories of published literature: 
      1. Volunteer rear-impact crash testing studies, 
      2. ADL studies, and 
      3. Observational studies of real-world rear impacts. 
    • We compared the occupant accelerations of minimal or no damage (i.e., 3 to 11 kph speed change or “delta-V”) (2 mph up to 7 mph. ) rear-impact crash tests to the accelerations described in 6 of the most commonly reported ADLs in the reviewed studies. 
    • As a final step, the injury risk observed in real-world crashes was compared to the results of the pooled crash test and ADL analyses, controlling for delta-V.
    • OK in me and you speak, Delta V just means the change in speed that was experienced. Anytime you are in a wreck, you essentially go from one speed to another in a millisecond. That’s not conceptually, that’s literally. Delta V helps to describe that change in speed. 

What They Found

  • The results of the analyses indicated that average peak acceleration forces observed at the head during rear impact crash tests were typically at least several times greater than average forces observed during activities of daily living.
  • In contrast, the injury risk of real-world minimal damage rear impact crashes was estimated to be at least 2000 times greater than for any activities of daily living. So defense attorneys can stick that in their hat and smoke it up twice.

Wrap It Up

The results of our analysis indicate that the principle underlying the biomechanical injury causation approach, that occupant acceleration is a proxy for injury risk, is scientifically invalid. The biomechanical approach to injury causation in minimal damage crashes invariably results in the vast underestimation of the actual risk of such crashes and should be discontinued as it is a scientifically invalid practice. That also seems like a mic drop if the attorney pulls it out and uses it in a case. And should be appropriately accompanied by superhero comic noises like

Slap! Pow! Snap! Kazaam! Fwaaaap!! I love it.

Item #2

Item #2 is called “Estimating the number of traffic crash-related cervical spine injuries in the United States; An analysis and comparison of national crash and hospital data” by Michael Freeman and Wendy Leith (Freeman MD 2020) and published in Accident Analysis And Prevention in July of 2020 and that’s still got some steam to it. 

Why They Did It

In the intro, they say, “Cervical spine injury is a common result of traffic crashes, and such injuries range in severity from minor (i.e. sprain/strain) to moderate (intervertebral disk derangement) to serious and greater (fractures, dislocations, and spinal cord injuries). There are currently no reliable estimates of the number of crash-related spine injuries occurring in the US annually, although several publications have used national crash injury samples as a basis for estimating the frequency of both cervical and lumbar spinal disk injuries occurring in lower speed rear impact crashes.”

In me and you speak, they’re saying that many defense attorneys want to use estimates on neck injury and severity prevalence from national databases but it doesn’t make sense to do it that way and you can’t use these databases as a proper defense in a court case.  They say the purpose is, “To develop a reliable estimate of the number of various types of cervical spine injuries occurring in the US by comparing data from national crash injury to national hospital emergency departments and inpatient samples.”

Well, that makes sense to me….let’s see how it came out. 

How They Did It

Comparative cross-sectional METHODS: Cervical spine injury data were accessed, analyzed, and compared from 3 national databases; the 

    1. National Automotive Sampling System-Crashworthiness Data System (NASS-CDS), 
    2. Nationwide Emergency Department Sample (NEDS), and the 
    3. Nationwide Inpatient Sample (NIS).

What They Found

  • It is estimated that there are approximately 869,000 traffic crash-related cervical spine injuries seen in hospitals in the US annually, including around 
      • 841,000 sprain/strain (whiplash) injuries, 
      • 2800 spinal disk injuries, 
      • 23,500 fractures, 
      • 2800 spinal cord injuries, and 
      • 1500 dislocations.
  • Because of highly restrictive inclusion criteria for both crash and injury types, as well as a very small sample size, the NASS-CDS underestimated all types of crash-related cervical spine injuries seen in US hospital emergency departments by 84 %
  • The injury type with the largest degree of underestimation in the NASS-CDS was cervical disk injuries, which were estimated at an 88 % lower frequency than in the Nationwide Emergency Department Sample
  • National insurance claim data, which include cases of cervical disk injury diagnosed both in and outside of the ED, indicate that the Nationwide Emergency Department Sample likely undercounts cervical disk injuries by 92 %, and thus the NASS-CDS correspondingly undercounts such injuries by 99 % or more.

Do you see why it’s so good to have people like Dr. Michael Freeman and Dr. Art Croft on our side? Holy smokes. Who else is out there putting attorneys in their place like these folks have done for years?

Wrap It Up

They end it by saying “Because of a limited sample size and restrictive criteria for both crash and injury inclusion, the NASS-CDS cannot be used to estimate the number of crash-related spinal injuries of any type or severity in the US. The most inappropriate use of the database is for estimating the number of spinal injuries resulting from low-speed rear impact collisions, as the NASS-CDS samples fewer than 1 in 100,000 of the cervical spine injuries of any type occurring in low-speed rear impact collisions.” Smack, Kowapow, Thunk! As I said, I love this kind of research. I remember Dr. Croft speaking about being an expert and attorneys starting to come at him and how he was able to just draw them out into deeper water before putting ‘em under!! I love it. 

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 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

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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

Freeman MD, L. W. (2020). “Estimating the number of traffic crash-related cervical spine injuries in the United States; An analysis and comparison of national crash and hospital data.” Accid Anal Prev 142(105571).  

Nolet PS, N. L., Kristman VL, Croft AC, Zeegers MP, Freeman MD, (2021). “Is Acceleration a Valid Proxy for Injury Risk in Minimal Damage Traffic Crashes? A Comparative Review of Volunteer, ADL and Real-World Studies.” Int J Environ Res Public Health 18(6): 2901.      

Useless Research & Insulin or Inflammation

CF 172: Useless Research & Insulin or Inflammation Today we’re going to talk about how I treat my staff, we’ll talk about insulin vs. inflammation, and we’ll talk about some trash research that came out in JAMA recently that you may wind up being confronted with at some point so listen up.  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. 

You have found yourself smack dab in the middle of Episode #172 Now if you missed last week’s episode , we talked about going the way of the non-pharma world. If we could just get the the medical world to take a look at it. We also talked about insurance coverage trends and how they’re not very favorable to chiropractors. As you probably already feel. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

On the personal end of things, we’re still interviewing nurse practitioners and still getting our ducks in a row. We have the attorney that is setting up the medical entity meeting with our CPAs out in St. Louis to make sure it is set up in the most tax-advantageous as well as the most ideal legal way.  Any time you have your CPA and your attorney working together, you’re probably in a good place me thinks. I have a meeting with the medical director this week to go over what services he’s going to be OK with us offering. When appropriate, we’ll be looking at things like intra-joint injections, trigger point injections, low-level scripts but no narcotics.  Basically, anything we offer here will be very low risk. Not only because it inherently lowers our risk to adverse events, which makes me sleep better every night, but it also helps to keep a happy medical director. If it all works right, this is almost mailbox money for the medical director while providing an awesome gig for a nurse practitioner that is at least halfway motivated to build their practice. 

Think about it, nurses and nurse pracs are used to 12-hour shifts. They’ve missed important holidays and important events in their personal life due to having to work. Here, there are no weekends, there are not holidays spent working, vacation time, it’s all good in the hood at my place. Plus, they get to learn as much about orthopedics as they want to learn and a whole bunch they maybe don’t want to learn but is required to learn in order to work here.  That’s the deal though right?

Gotta pick the right NP because it all hinges on that one decision. Pick the wrong one and you’re out of business until you can get another hired. Doesn’t sound like a big deal until you factor in the 3 months it takes to get a new one credentialed. Speaking of, I have to get re-credentialed under the new medical entity. That’s because of Stark and anti-kickback laws.  This isn’t something to go into lightly. It’s like I said last week or two weeks ago here on the podcast, the wheels on this thing turn slowly and I’m OK with that. That way I don’t get out over my skis and lose control.  So, that’s where we’re at on that. 

Currently, I’m taking the opportunity to type this out on a Sunday afternoon. We are up at the office throwing a staff member her baby shower. No, I’m not a baby shower kind of dude as you may have guessed. I’m a Bud Light and guitars kind of guy. But, my wife decided we’re throwing our staff member a baby shower so here I am at the office recording this while the chicks and the hens are out there clucking and cackling. And I don’t mean that in a misogynist way. I mean it in a funny, playful kind of way so take it that way. 

It brought up a thought; do you treat your staff members like workers? Or do you treat them more like family? Right or wrong, as a result of my nature and my heart, we treat ours like family when appropriate. I’ve had staff ask me advice on deep dark stuff they were struggling with. I’ve had staff whose family was going to prison, the whole town knew, they were ashamed, and they just need some love, a little extra consideration, and a few big hugs. That one still gets me a little emotional when I think about it.  I’m going to give you a few more examples here but before I do, I don’t want you to misunderstand anything here. I’ve learned over the years that you cannot buy loyalty from your staff. They’re either with you every step of the way, or they are not. And that’s OK. Everyone is coming from different places, experiences, and motivations. Not a thing wrong with that.  But don’t do things for the wrong reasons. Don’t think you’re going to do a bunch of things for staff thinking it’ll ensure they stay with you forever. That’s just not reality and it’s a good way to allow yourself to get hurt on some level.  If you’re going to treat staff like family, you do it for all of the right reasons. Love, appreciation for them and their character, admiration for a job well done, team building, and things like that.  Getting back to it, I’ve sold a car to a staffer that was coming out of a bad relationship and had no transportation. I sold it to them for about $4,000 less than I could have gotten for it and let them pay it out $50 a paycheck and zero interest.  I’ve created a new, extra job for a staffer that was about to lose their house. It cost me an extra $1500/month for the following 2-3 years but that’s the way I am. 

I’ve sponsored kids sports for staffers more times than I can even start to recall.  In the end, money will come and go. It can be lost and it can be made. But it’s the relationships that stay with us.

Were we put on the planet just to make money and take care of our families? 

Or were we put on this planet to make ALL of our immediate relationships prosper and make the world, or at least our part of it, a better place?  You probably know where I come down on all that. It may sound a little hippy-dippy there, which I’m not at all, but I do see it that way. Money is nice and I see it as a challenge. A challenge to make it and see how much I can make ethically and morally. It’s fun to make money! But money really isn’t my main motivation any more.

I’m a huge stats person and track stuff like crazy. I balance my own bank statement every month. But I don’t count pennies anymore. I just don’t. I’m more into people, smiles, and all the good feels. Making people’s lives better when possible.  Alright, enough mushy stuff. 

Item #1 This first one today is called “Temporal Associations Among Body Mass Index, Fasting Insulin, and Systemic Inflammation: A Systematic Review and Meta-analysis” by Wiebe et. al. [1] and was published in JAMA on March 12, 2021 and that so hot it’s got my glasses all steamy. I can’t see a thing. 

Why They Did It The authors wanted to answer the question of “What are the temporal associations among higher body mass index (BMI) and chronic inflammation and/or hyperinsulinemia?” They say that Obesity is associated with a number of noncommunicable chronic diseases and is supposedly a cause of premature death. They wanted to summarize evidence on the temporality of the association between higher body mass index (BMI) and chronic inflammation and hyperinsulinemia.

How They Did It

  • MEDLINE (1946 to August 20, 2019) and Embase (from 1974 to August 19, 2019) were searched
  • The data analysis was conducted between January 2020 and October 2020.
  • Longitudinal studies and randomized clinical trials that measured fasting insulin level and/or an inflammation marker and BMI with at least 3 commensurate time points were selected.
  • Of 1865 records, 60 eligible studies with 112 cohorts of 5603 participants were identified

Wrap It Up

The finding of temporal sequencing (in which changes in fasting insulin level precede changes in weight) is not consistent with the assertion that obesity causes non-communicable chronic diseases and premature death by increasing levels of fasting insulin. Meaning that that adverse consequences currently attributed to obesity could be attributed to hyperinsulinemia (or another proximate factor). Which is interesting in my book. I thought you all might like it. 

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Item #2 And our last item today is called “Effect of Osteopathic Manipulative Treatment vs Sham Treatment on Activity Limitations in Patients With Nonspecific Subacute and Chronic Low Back Pain: A Randomized Clinical Trial” by Nguyen et. al.  [2] and published in JAMA Internal Medicine on March 15, 2021 which is indeed too hot to manipulate by one’s hand. 

Why They Did It They say that Osteopathic manipulative treatment (OMT) is frequently offered to people with nonspecific low back pain (LBP) but never compared with sham OMT for reducing LBP-specific activity limitations. Knowing this, they wanted to compare the efficacy of standard OMT vs sham OMT for reducing LBP-specific activity limitations at 3 months in persons with nonspecific subacute or chronic LBP.

How They Did It

  • This prospective, parallel-group, single-blind, single-center, sham-controlled randomized clinical trial recruited participants with nonspecific subacute or chronic LBP in France starting February 17, 2014, with follow-up completed on October 23, 2017. 
  • Participants were randomly allocated to interventions
  • Six sessions (1 every 2 weeks) of standard OMT or sham OMT delivered by nonphysician, nonphysiotherapist osteopathic practitioners.
  • The primary end point was reduction in LBP-specific activity limitations at 3 months as measured by the self-administered Quebec Back Pain Disability Index. 
  • Secondary outcomes were mean reduction in LBP-specific activity limitations; mean changes in pain and health-related quality of life; number and duration of sick leaves, as well as number of LBP episodes at 12 months; 
  • and consumption of analgesics and nonsteroidal anti-inflammatory drugs at 3 and 12 months. 
  • Adverse events were self-reported at 3, 6, and 12 months.

What They Found

Overall, 200 participants were randomly allocated to standard OMT and 200 to sham OMT, with 197 analyzed in each group

Wrap It Up In this randomized clinical trial of patients with nonspecific subacute or chronic LBP, standard OMT had a small effect on LBP-specific activity limitations vs sham OMT. However, the clinical relevance of this effect is questionable. So, look…..this paper and these researches absolutely wasted time, effort, and money in an attempt to make spinal manipulative therapy look bad. Who in the h e double hockey sticks sees new patients once every 2 weeks for only 6 visits?? Especially in a chronic pain sufferer. Trash, garbage.

Or since it was in France…..garbage.  It’s dumb, useless, and meaningless and I’m almost offended that this is even a paper. I’m starting ANY brand new case with 3 per week for a week or two minimum. Minimum. Combined with other appropriate ancillaries including exercise, soft tissue stuff, maybe acupuncture, maybe laser, maybe a referral to cognitive-behavioral therapist, maybe biomechanics coaching, and on and on and on. 

Papers like this and authors like this should give it up and get out of the game if they’re not going to be able to throw something together that’s better than this heap of trash.  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 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.

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. Wiebe N, Y.F., Crumley ET, Bello A, Stenvinkel P, Tonelli M,, Temporal Associations Among Body Mass Index, Fasting Insulin, and Systemic Inflammation: A Systematic Review and Meta-analysis. JAMA Netw Open, 2021. 4.

2. Nguyen C, B.I., Zegarra-Parodi R,, Effect of Osteopathic Manipulative Treatment vs Sham Treatment on Activity Limitations in Patients With Nonspecific Subacute and Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Intern Med, 2021.

Breathing Through The Pain, Need For Rehab, & Forward Head Posture And Shoulder Pain

CF 164: Breathing Through The Pain, Need For Rehab, & Forward Head Posture And Shoulder Pain

Today we’re going to talk about the impact of chiropractic care on opioid use and then we’ll talk about garbage marketing in the chiropractic profession. I go off a bit. I can’t help it. They make me nuts. 

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.  If this episode has a different type of sound quality when compared to previous episodes, my main computer died. It choked a little and held it’s belly and rolled around in agony for about a month and then…..sadly, it straight up and died. 

So, I have another ordered and in the meantime, I’m figuring out how to do this through my MacBook Pro. Where there’s a will, there’s a way. We’ll make it happen.  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 #164 Now if you missed last week’s episode, we talked about opioids and spinal pain and then we talked about vitalists’ scripts. That was about the point that I lost my mind momentarily. Because they make me crazy and all.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Wow, what a week I had last week, y’all. And I’m not talking in a good way. Oh hell no. This was one of those kick you in the face and in the backside. And when you’re falling to the ground, putting a boot in your ribs for good measure.  One word, two syllables. Day-um.  For patients that I’m comfortable with, it’s common for them to ask me how my day’s going and my go-to answer is usually something similar to, “Ah you know….pissing excellence. As usual. It becomes a habit after a while.” Yeah, not last week. I wasn’t the windshield. I was the bug. 

First thing’s first, on last Tuesday, my longest tenured employee and office manager turned in her resignation. Over 11 years, down the drain. She’s not just a staff member. She’s become my little buddy. She’s hilarious. She was also our marketing girl. Definitely a boot to the face. Pow.  But there are a lot of positives there as well. Being my longest employed staffer, she was also my highest paid so we will save a good chunk of money. We just need to make some adjustments on the marketing and things of that nature.  Then, on Wednesday, as mentioned previously, we joined the Wealthability program and we had a meeting with our new accountants they matched us with. They’re out in St. Louis. Well, they found that our previous CPA was wrong and now we have to pay a gob in taxes we weren’t expecting to pay. We can spread it out over an amount of time and it’s fixable but day-um…..

Come on man.

When you hire professionals, you expect a professional job that will prevent you from getting into trouble. Don’t you? That was a kick to the nether regions. Smack.  Then, later that afternoon, my main computer that has my entire life on it straight up died. Luckily, it had slowed a bit and I called my computer guy to come in and back it up so it can be replicated on another computer. Still, that computer won’t be here for 2 damn weeks.  Kick to the shin. Thunk. 

Then, two of my girls got the second vaccine shot and both got sicker than dogs. One missed work on Wednesday. Not that big of a deal. Just kind of sucked.  Then I got a visit from a connection that works in my Dad’s nursing home. She came to my house on Thursday night after work to tell me my Dad is being mistreated and is withering away.  Stomp to the noggin while I’m down. Snap.  There were some other little things here and there but you get the picture. Rough week. But we’re on the mend.

We’re heading the right direction this week I think. We have some good ideas and I think we are going to make some changes.  So, as a learning lesson, bad things can be used for an impetus to change course and go in a positive direction. For example, I’ve begun going down the path of fully integrating. I’m saving enough money with the departure of my manager that I can use that money toward integrating and hiring a nurse practitioner. 

This would fit my long term plan of being able to remove myself from my day to day practice. It’s a piece of the puzzle. The final piece of the puzzle would be hiring an associate. At that point, I believe my time begins to get freed up a bit.  Hopefully in five years, I’m mentoring my colleagues and teaching them how to accomplish what I’ve accomplished. I’m sharing wisdom with hungry evidence-based chiros and spreading the good news about evidence-based, patient-centered chiropractic care.  We’re going to get there.  In other news, last week wasn’t a total loss. You may have seen where the Texas Chiropractors, after a ten-year battle, put the smackdown on the Texas Medical Association. People’s elbow, Kabam!!

The biggest bully of bullies got slapped the hell around by the Texas Chiropractic Association and the Texas Board of Chiropractic Examiners at the Texas Supreme Court level.  Just briefly, the TMA had sued the TCA and the TBCE approximately 10 years ago over our right to perform the VONT testing. Also known as vestibulo-ocular nystagmus test. Then that morphed into attacking our rights to diagnose and our rights to treat the Neuromusculoskeletal system rather than just the musculoskeletal system. Seemingly silly little things but, if they had won, technically, we couldn’t treat anything having to do with ‘nerve’ and we couldn’t have diagnosed our own patients so we’d depend on referrals from medical professionals……and how do you think that would have turned out in the long run?

Not good for an chiropractor on the planet because other medical associations would have precedence and would have repeated the process. Those of us in leadership positions for the TCA have been well-aware for the last decade that if we lost this case, we would be the first domino and it would effect every other chiropractor.  We lost, then we lost the appeal, then the Texas Supreme Court gave us the win. And the Texas Medical Association, the most predatory state medical association in the United States, has to cover the court costs. Oh, and on top of that, they can suck it.  We are going to have an entire episode where I’ll be joined by my fellow TCA members. Folks that have been the deepest in the trenches on this case and know every in and out of the entire process.  It’s going to be a good one so keep a lookout for that one.  Alright, let’s get to the good stuff shall we?

Item #1

This first one is called, “Can Slow Deep Breathing Reduce Pain? An Experimental Study Exploring Mechanisms” by Jafari, et. al. (1) and published in the Journal Of Pain in September/October of 2020. It’s not a lot hot but hot enough!

Why They Did It

This study sought to investigate effects of instructed breathing patterns on experimental heat pain and to explore possible mechanisms of action

How They Did It

  • In a within-subject experimental design, 48 healthy volunteers performed 4 breathing patterns: 
      1. Unpaced breathing, 
      2. Paced breathing (PB) at the participant’s spontaneous breathing frequency, 
      3. Slow deep breathing at 6 breaths per minute with a high inspiration/expiration ratio (SDB-H), and 
      4. Slow deep breathing at 6 breaths per minute with a low inspiration/expiration ratio (SDB-L)
  • During presentation of each breathing pattern, participants received painful heat stimuli of 3 different temperatures and rated each stimulus on pain intensity
  • Respiration, heart rate, and blood pressure were recorded.

What They Found

Compared to unpaced breathing, participants reported less intense pain during each of the 3 instructed breathing patterns.

Wrap It Up

Slow deep breathing is more efficacious to attenuate pain when breathing is paced at a slow rhythm with an expiration that is long relative to inspiration, but the underlying mechanisms remain to be elucidated. Oh…..elucidated. That’s a $5 word for the research crew there. Congrats on elucidated, folks. 

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Item #2

This one is called, “Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019” by Cieza, et. al.  (2) and published in The Lancet on December 19, 2020. Smokin’, sizzlin’, steamy pot of chili pie.  I have learned, by the way, that Frito Pies are not an American thing.  It’s just mostly a Texan thing. I have eaten Frito pies my whole damn life and didn’t figure this factoid out until just a few years ago. I play Call Of Duty here and there on xbox.

I know….I’m a nerd but I’m a killing’ nerd on occasion! I can kill real people in a fake way right there with the best of them when I want to. And I have my glasses on. And I haven’t had any more than a few beers. Lol.  Anyway, I play with a dude from Louisville, KY and he’d never heard of Frito pies. Holy cow people. There are some things you need to get tuned into if you’re not from Texas. They are as follows:

    • Frito Pie
    • Fried Okra
    • Fried squash. 

Yes, all are terrible for you so…..as a priest told me at the bar back when I went to college in Louisiana and was asking him how this whole ‘priest being in a bar’ worked out….he said, “Everything in moderation, Brother.” We should probably get back to the paper, Y’all. 

Why They Did It

Rehabilitation has often been seen as a disability-specific service needed by only few of the population. Despite its individual and societal benefits, rehabilitation has not been prioritized in countries and is under-resourced. We present global, regional, and country data for the number of people who would benefit from rehabilitation at least once during the course of their disabling illness or injury.

How They Did It

To estimate the need for rehabilitation, data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to calculate the prevalence and years of life lived with disability of 25 diseases, impairments, etc. 

What They Found

  • Globally, in 2019, 2.41 billion individuals had conditions that would benefit from rehabilitation, contributing to 310 million years of life lived with disability
  • This number had increased by 63% from 1990 to 2019
  • The disease area that contributed most to prevalence was musculoskeletal disorders with low back pain being the most prevalent condition in 134 of the 204 countries analyzed.

Wrap It Up

The authors wrap up their thoughts with this, “To our knowledge, this is the first study to produce a global estimate of the need for rehabilitation services and to show that at least one in every three people in the world needs rehabilitation at some point in the course of their illness or injury. This number counters the common view of rehabilitation as a service required by only few people. We argue that rehabilitation needs to be brought close to communities as an integral part of primary health care to reach more people in need.”

I will add that the vitalists that think they can only adjust their way out of every damn condition or complaint need to get in the back of the line and just keep quiet. If you are going to be current rather than look like a dumb dumb, then you need to understand that a good, learned chiropractor knows that we do not only mobilize with adjustments, stretching, and things of that nature. But we also much know when to stabilize through strengthening activities.  If you’re just hitting the high spots on all of your patients, you need to be better and raise you game. Mr. Vitalist…..I’m talking to you. 

Item #3

The last one today is called, “Does forward head posture change subacromial space in active or passive arm elevation?” By Dehqan, et. al. (3) and published in the Journal of Manual and Manipulative Therapy on November 30, of 2020 and that’s about the right amount of hot Why They Did It Forward head posture (FHP) is one of the most common musculoskeletal disorders that appears to affect the shoulder joint through the shared muscles between the head and neck area and the shoulder girdle. The present study compared the acromiohumeral distance between individuals with normal head and neck alignment and those with moderate and severe FHP in active and passive arm elevation.

How They Did It

  • Based on the craniovertebral angle, 60 volunteers were selected and equally distributed among three groups, including group one with normal head and neck alignment, group two with moderate FHP and group three with severe FHP
  • The space between the humeral head and the acromion was measured in 10°, 45° and 60° of active and passive arm elevation as the acromiohumeral distance.

What They Found

  • The acromiohumeral distance was only different between the three groups at 45° arm elevation angle, and this difference was significant between groups one and three
  • In active and passive arm elevation, increased arm elevation angle reduced the subacromial space significantly
  • Also, in each arm elevation angle, the subacromial space differed significantly between the active and passive arm elevations.

Wrap It Up

They concluded, “The acromiohumeral distance was significantly lower in the severe FHP group than the group with normal head and neck alignment in the 45° active arm elevation angle, which could be due to the changed tension in tissues between active and passive arm elevation and also the maximum muscle activity in the 45° active arm elevation angle.”

Shoulder impingement folks.

I didn’t know anything about it until I went through he DACO program. Which is now the Neuromusculoskeletal Diplomate. It’s a real estate issue and when you have an upper cross type setup, forward head posture, you decrease the real estate.  Increase the real estate, decrease the issue in this sort of a setup.  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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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 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.

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. Hassan Jafari, Ali Gholamrezaei, Mathijs Franssen, Lukas Van Oudenhove, Qasim Aziz, Omer Van den Bergh, Johan W.S. Vlaeyen, Ilse Van Diest, Can Slow Deep Breathing Reduce Pain? An Experimental Study Exploring Mechanisms, The Journal of Pain, Volume 21, Issues 9–10, 2020, 1018-1030
  2. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vox T, Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. 396 (10267), P2006-2017, December 19, 2020.
  3. Behdokht Dehqan, Cyrus Taghizadeh Delkhoush, Majid Mirmohammadkhani & Fatemeh Ehsani (2020) Does forward head posture change subacromial space in active or passive arm elevation?, Journal of Manual & Manipulative Therapy, DOI: 10.1080/10669817.2020.1854010

 

Three Year Anniversary Top Ten Countdown

CF 156: Three Year Anniversary Top Ten Countdown

It’s our THREE YEAR ANNIVERSARY episode!!! We’re going to cover our All-time Top Ten episodes spanning over our first three years on the air.  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. 

You have found yourself smack dab in the middle of Episode #156 Now if you missed last week’s episode, we talked about the crazy and very suspicious shake-up with the research committee earlier this year at the World Federation of Chiropractic. Make sure you don’t miss that info. I believe it is vital for you as an evidence-based, patient-centered practitioner. Listen to it anyway because it’s important to keep up with the class. 

On the personal end of things…..

Well, no hate mail from last week’s episode or from the week before that when we highlighted a vitalist bragging about seeing 99 patients and 9 new patients in the span of 3 hours. Dammit, my eyes just about rolled out of my head yet again. It’s like every time I say that I gotta keep an eye on my eyes so I can keep them in my noggin. And, I have to step back a bit to keep from throwing up.  Not getting hate mail is a good thing.

Of course, there’s the very solid chance I’m simply speaking to an echo chamber here, and honestly, that’s OK too. I’d much rather be able to build this among my brethren without being molested by the ones that don’t agree with me.  The more like-minded folks we have listening, the better. The best thing I can say is to tell someone about us. I’m serious. I appreciate every single listen. But if all you do is listen and consume a free product, that’s not helpful in growing it and putting back into the thing you find value in. 

So, please. Tell someone about this podcast and the messages we convey every single week. Let’s build this message. Like I said in last week’s episode, this profession is in a battle. Not just between vitalists and evidence-based chiropractors but in a battle for integration, progress, and overall respect.  A battle for professional standardization. a battle over our research community. As I said last week, the ICA won the battle with the WFC research committee. They know there’s a battle. Now it’s time for evidence-based chiropractors to realize that fact and proceed accordingly. Yes, go read your research papers but then go and defend the evidence-based, patient-centered practice. Advocate for it.  Outside of that mess, things have been slower at the office. With this second spike, we’ve taken a step back. And it’s making my butt pucker a bit. I hate taking steps back. I like only progress. Only movement forward.

I’m seeing the number that I saw 5 or 6 years ago or more. Probably more. We are paying the bills but we’re not profiting right now. We’re just surviving. It can’t be over soon enough.  So that I don’t sound too spoiled; I understand I have it better than a lot of folks. Bar owners, full-time musicians, bartenders, servers, restaurant owners. That’s just for starters. I don’t know how these people survive without forgiveness plans and things like that. It’s insane where we are but I’d rather be sitting here in December than back in March, April, or May.  That’s for damn sure. As of the typing of this episode, the first vaccines are projected to be taken by Americans in about 5 days. Bring it on!! Let’s start getting life back to normal and then sit back and watch the comeback!

Before we get to our Top Ten list and before we get to our sponsor spot, I have to tell you, I’m about to give you a code for discounts on ChiroUp. People sometimes think ChiroUp is one thing or another but in all honestly, it’s a little too much to describe in one spot. It does A LOT!! It helps you implement rehab confidently. It writes reports to those in the medical community. It teaches you what exam protocols are appropriate for regions of the body. It teaches you how you should treat certain diagnoses. It does your report of findings for you. It gets you Google reviews. It tracks your patients’ progress after 30 days so you know how good you’re doing with your patients. It sends emails to your new patients full of recommendations, patient education, and videos of the exercises you recommended for them. It gives you marketing plans for different aspects of healthcare. And it does a hell of a lot more than that.  I could go into every single one of these topics and speak on each of them for half an hour but you’ll just have to trust me here. It is worth so much more than what ChiroUp charges. So, here’s the spot, take my code, use it, and then get better and love your life. You can thank Ol’ Uncle Jeffro later. 

CHIROUP ADVERTISEMENT

Just do it, folks. It’s worth every penny and much much more. It’s literally changed my practice from top to bottom for the better. There’s not another product out there I can say that about. 

Now, let’s get to our all-time 3rd anniversary top ten most listened to episodes, shall we? If you go to the show notes at chiropracticforward.com, find this episode….#156….and you scroll down through the transcription of the episode, you will find the links to each of these episodes so you don’t have to scroll through and find them on your own.

Number Ten Coming in at Number 10: Our 10th most listened to episode was episode #137. We had a special guest for that episode. Dr. Aric Frisina-Deyo and we talked about chiropractors treating in an FQHC setting and we talked about setting the bar high. Higher than chiropractors typically set the bar for themselves or their profession. This guest….wow. Young, bright, driven, and very very impressive. There’s absolutely a good reason that one had so many listeners.  https://www.chiropracticforward.com/2761-2/

Number Nine It’s nice to see this one still in the Top Ten after so much time has gone by. It’s called What’s Good In A Chiropractor. It was way way back in Episode 101. Keep in mind here that we’re now on #156. This episode is more than a year old now so it’s good to see that the principles I covered in this episode are still resonating with our listeners. In this episode I discussed some key characteristics I feel make up a good chiropractor. We talked about things like honesty, being evidence-based, networking, listening, your office presentation, and things of that nature. It’s excellent to see this stuff staying relevant and meaningful.  https://www.chiropracticforward.com/what-makes-a-good-chiropractor-9-characteristics/

Number Eight Number eight is called Kids Still Hurt, Manipulation For Lumbar Radiculopathy, & Lack of Attention On The Boards for Biopsychosocial Matters. Our listeners gobbled this one up. I think because we need current thinking and information on things like adjusting in the region where we know there’s radiculopathy. We need to understand that just because a person is a kid doesn’t mean they don’t hurt. This episode covered that very well, in fact. And the biopsychosocial aspect of pain has been a big big topic over the last couple of years. I think people are struggling to learn more and more about it and how it can help their patients.  https://www.chiropracticforward.com/cf-145-kids-still-hurt-manipulation-for-lumbar-radiculopathy-lack-of-attention-on-the-boards-for-biopsychosocial-matters/

Number Seven Our 7th most listened to episode was a more recent one with one of my very favorites, Dr. Katie Pohlman who will be on again in the very near future. And will hopefully be on our podcast about a hundred times beyond that. Hell, maybe she’ll just be my co-host eventually. Lol. Anyway, this episode was number 147 and was called New Research, Upcoming Research, And the Need For It All. Dr. Pohlman is the head of research at Parker University and you’re starting to see her name anywhere and everywhere with regard to chiropractic research. She is a star and I’m happy that Parker has hitched their wagon to her shooting star. This episode was full of thoughts on chiropractic research, what she’s currently working on, and where it’s all going.  https://www.chiropracticforward.com/w-dr-katie-pohlman-new-research-upcoming-research-and-the-need-for-it-all/

Number Six Our sixth most listened to episode was episode number 113 with my friend, Dr. William Lawson. This one was called Brand New Guidelines On Neck Pain Treatment. Dr. Lawson had a hand in the new paper we discussed and it was basically an entire episode walking you through new guidelines on treating neck pain. It’s one of my favorite episodes because it laid out very clearly what we should be doing, what we should be thinking, and how we should be approaching case management for neck pain. Very informative and Dr. Lawson is always on the top of his game. https://www.chiropracticforward.com/w-dr-william-larson-brand-new-guidelines-on-neck-pain-treatment/

Number Five Our 5th most listened to episode of all time is number 140 with Dr. Chris Howson. It was called Chiropractors In Hospitals and Drop Release. Not only does Dr. Howson work in an outpatient hospital setting in North Dakota, but Dr. Howson is also the inventor of a newer chiropractic tool on the market called the Drop Release. Pretty cool stuff and Dr. Howson knows his stuff, folks. If you want to know how to integrate into a hospital setting and want to know what it’s like, this is the episode for you. Plus we talk a bit about the drop release, what it’s for, and all the goodies. Plus a discount code you can use if interested.  https://www.chiropracticforward.com/cf-140-w-dr-chris-howson-chiropractors-in-hospitals-drop-release/

Number Four Our 4th most listened to episode is number 144 and is called Common Surgeries Aren’t Well-Researched & Chiropractic Wins Again.  This one was a stroll through a current paper that really spotlighted the fact that the most common musculoskeletal surgeries that we see being performed today don’t have much research behind them. Especially research that tested having the surgery vs. not having it at all. You’d think that research would have been done but sadly it hasn’t in almost every case. In fact, they looked at 6,735 studies and only 64….less than 1% of them….only 64 compared a surgical intervention to not having surgery at all. And, get this, of that 64 that actually did compare the two, only 9 of them were actually favorable to having the surgery. Go to episode 144 for more on that. It’s astonishing to me.  https://www.chiropracticforward.com/common-surgeries-arent-well-researched-chiropractic-wins-again/

Number Three Alright, we’re in the top three now. Our 3rd most listened to episode of all time is number 143 and is called Spinal Manipulation Has No Effect On Chronic Pain – Our Experts’ Rebuttal. This one dealt with a paper that came out recently in JAMA and it was not favorable at all to chiropractors or spinal manipulative therapy. This episode went through our own experts thoughts on the paper and how you can rebut any mention you might get from this down the road as you navigate your relationships within the medical community. Very interesting and extremely useful episode right here. This one can actually help protect your bottom line in the right situation.  https://www.chiropracticforward.com/new-paper-spinal-manipulation-has-no-effect-on-chronic-pain-our-experts-rebuttal/

Number Two Number 2 on our top ten list is episode number 142 and is called Nonoperative Disc Treatment, D3 for Depression, and The Biopsychosocial Part Of Chronic Pain. This one really spoke to chiropractors because it was loaded with research. Of course, most of our episodes are loaded with research but this one had a paper about treating discs without operation. Well, who the heck doesn’t want to do that? It was very comprehensive and showed how 97% of 269,713 patients were treated without surgery. Good good stuff. Things look worse and worse for musculoskeletal surgery these days honestly. And, again, this paper covered the biopsychosocial aspect of pain and that’s a popular topic these days. Something for everyone in this episode! https://www.chiropracticforward.com/nonoperative-disc-treatment-d3-for-depression-the-biopsychosocial-part-of-chronic-pain/

Number One And our number one most listened to episode of all time for our 3rd Anniversary is one that actually surprised me. It’s episode number 141 and is called Lancet Low Back Update & Movement Disorders Mean Pain. Now why this one got all of the listens? I have no idea. The Lancet is well-respected and should absolutely be paid attention to. I’m glad it’s getting all of the listens, to be honest. It was basically an update on the original Lancet series on low back pain that we covered way back when. It’s top-level research having relevance to our chiropractic community and I’m glad to see so many of you appreciating it and paying close attention to it. It’s important. It’s not the sexiest topic we cover so that’s why I found it a bit surprising but it’s a great episode to catch the number one spot for sure. Very deserving.  https://www.chiropracticforward.com/lancet-low-back-update-movement-disorders-mean-pain/

An episode or series of episodes that fell off of the top ten list just this year is still important and one worth giving honorable mention to. Episodes 13, 14, and 15 are called Debunked, The Odd Myth That Chiropractors Cause Strokes.  If you don’t know the research on this topic, please, for the love of everything, go listen to those three episodes starting with 13. It’s knowledge fuel and it’ll give you more confidence if you happen to lack it.  https://www.chiropracticforward.com/debunked-the-odd-myth-that-chiropractors-cause-strokes/

Alright, that’s it. We made it through all ten of the most listened to episodes in the three-year history of The Chiropractic Forward podcast. I want to truly thank you all from the bottom of my heart for listening and being a part of this little part of the world. For being a part of this podcast. When I’m sitting down to type out an episode, you are who I have in mind. I try to identify things I’m interested in but I also try to identify tough conversations that are not being had that desperately need to be talked through. 

We aren’t as big and as widely listened to as I’d like to be but we are growing steadily. If I can get you all on my team and talking about it and sharing episodes with your buddies and interacting in the private group, this thing can begin turning into even more of what I envisioned when I first started it.  With your help, we can get the message out on evidence-based, patient-centered practice.  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 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 – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  

Chiropractic Helps VA Cut Opioids & Diagnosing Lumbar Stenosis

CF 146: Chiropractic Helps VA Cut Opioids & Diagnosing Lumbar Stenosis

Today we’re going to talk about the success of the VA in reducing prescription opioid use – psst, guess who has helped them do that? And we’ll talk about diagnosing and testing for stenosis.

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. No spam, just a reminder when the newest episodes go live. Nothing special so don’t worry about signing up. Just one a week friends. Check your JUNK folder!!

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #146

Now if you missed last week’s episode , we talked about how even kids can hurt. We talked about manipulation for lumbar radiculopathy. And we talked about the lack of attention found on the chiropractic boards for biopsychosocial issues. 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. 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. 

Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper. 

Kids Still Hurt, Manipulation For Lumbar Radiculopathy, & Lack Of Attention On The Boards For Biopsychosocial Matters

 

On the personal end of things…..

To kick off on a cool note you’ll all appreciate, I have a patient that is a med school student that has had amazing results for a pretty significant and lingering disc injury. Your truly opened his eyes to the power of what an evidence-based chiropractor is capable of and it’s paid off for him and, the more of the younger docs that experience something like he has with chiropractic, the more accepted the evidence-based faction of our profession becomes. And the more accepted, the more referrals we get. 

That’s not the good news I wanted to share though. The good news is that he said in one of his classes last week, when they were talking about back pain, manipulation was recommended. In med school. Did you freaking A hear that? Med school is now teaching medical doctors that spinal manipulation isn’t only accepted…..but it’s reco-freaking-mended. 

Bam, Kapow, Zap, Snap, Whack!!

Super hero noises for cool stuff. Hell yeah. 

Moving on, now that school is up and rocking and people are in their normal routines once again, the growth I was talking about a week or two ago is showing to be sustainable at this time. 17 new patients last week tells me we may be slowly getting back to where we were before the Rona. Climbing out of the hole slowly but surely. 

I know all states are different. Here in Texas, as many of you may suspect, is challenging. We probably have A LOT more anti-maskers than many states out there have. We’ve been at work, live…in person since May 1st. Some chiros never took the 2 weeks to step back and see what was up. They just kept motoring through. And….I have to say it looks like they were the smart ones from what I’ve seen. 

I lost out on 2 weeks of work by shutting down completely. Not only that, but from April 1st or so, we were open but emergency only. Honestly…..how many emergencies do we have? We have some but they’re not going sustain my practice. So….I lost two weeks but only doing the emergency thing made me lose a lot of business as well. 

Then, we’re open to everyone and anyone basically on May 1st. Cool, but it took a good while before people started coming in. They knew we closed for a bit and didn’t always know we were back open. Plus, a ton of them were just scared. Understandably. 

So, as with everyone else that follows science, rules, and recommendations, we lost out. For sure. Since I’ve been back at it….again….May 1st, it seems that maybe we could have been safely going the whole time. I could look back and be upset that I followed the rules and that I’m a boy scout like that. But, I’m not going to be. Because how quickly we may forget; it was spooky. Nobody knew the mortality rate. Nobody knew what percentage end up in the hospital or what percentage gets put on a ventilator and how those percentages change from age group to age group. 

We didn’t know anything about it. When you get reports that the death rate is as high as 5% and then a separate paper says it lives on plastic as much as 3 days…..well hell. Please excuse me a sec while my anxiety goes through the roof. I mean, I want to be polite and excuse myself but yeah, the anxiety was going through the roof for myself as well as for the majority of us out there. Not the subluxation slaying spine whisperers of course but for us sciencers….yeah….we were concerned. 

Now we know so much more. We know when everyone in the clinic is masked, we lower our chances of transmission. Life is continuing. Anxiety is still somewhat up there. But life’s continuing as it all seems to work itself out.  The college kid cases are going up all the time. As expected because they’re kids and they’re knuckleheads. As long as they don’t take it home to vulnerable folks, then I don’t see it as harmful. It’s only helpful. 

My daughter has been going to in-person on-campus junior high with over 1,000 fellow knuckleheads. In the first six weeks there have been 2-3 teachers come down with it and about 4 kids. While that may seem a lot to some of you, I see it as a win so far. All of those people in one building together for 6 weeks and that’s all the spread we have? And let’s be fair, I know one of the teachers for sure got it from her husband who brought it home from work. 

To me, it means so far, they are not giving it back and forth to each other at the schools as long as they’re being careful and masking. So far. I really thought they’d all be closed down and go back to strictly online learning by now. I’m still pleasantly wrong. I’ll take it. 

Alright folks Enough Rona rambling. I don’t start talking about it becuase I love the topic. I’ll admit that I do find it all fascinating though. I really do. I’m a bit nerdy about stuff like that. 

Anyway, I talk about it every week because….damnit….that’s what’s going on. It’s the way it is. It’s in my personal happenings as it is in yours as well. So, I might as well talk about it and share with you my experiences, what I’m seeing in my practice, and how I’m muddling through this mess. It’ll either let you know you’re not alone or it’ll show you what you don’t want to do. I’m good either way. As long as you get some use out of it!

Item #1

This one comes from the Office of Public and Intergovernmental Affairs(2020) and is called “VA reduces prescription opioid use by 64% during past eight years.” It was published online on July 30, 2020…..yep…..pretty damn hot. 

This was an article that was basically announcing that t he VA has successfully reduced prescription opioid use in patients within the VA system by 64%. They went from more than 679.000 veterans in 2012 to 247,000 in 2020. 

Lancet Low Back Update & Movement Disorders Mean Pain

 

They say they achieve this dramatic reduction by safer amd more responsible use of opioids but also by treating chronic pain using alternative therapies and treatments. Guess who’s a big part of that? Chiropractors. Yep that’s right. And to be fair…acupuncturists as well. We are getting referrals from the VA for both chiropractic and acupuncture. 

They say, the “VA takes an interdisciplinary approach to care focused on a Veteran’s Whole Health by using non-pharmacological, complementary pain management treatments, self-care, skill building, and support to transition from a biomedical to a biopsychosocial model of pain care. “

How many times have you heard me screaming about the biopsychosocial aspect of chronic pain? A LOT….a lot…

If you follow the link in the article to their list of complementary pain management treatments, chiropractic and acupuncture are the first two listed. Good stuff people. Good stuff. 

They’re just not there yet but wouldn’t have been nice if the title was something like, “The VA system reduces opioids 64% by be smarter and by using chiropractic and acupuncture.” I’m not holding my breath for that day but it really should read just like that. Baby steps I suppose. Itty bitty, teensy weensy baby steps it seems. 

Next paper covers diagnostic tests for stenosis but…

Before we get to the next paper, I want to tell you a little about this new tool on the market called Drop Release. I love new toys! If you’re into soft tissue work, then it’s your new best friend. Heck if you’re just into getting more range of motion in your patients, then it’s your new best friend.

Drop Release uses fast stretch to stimulate the Golgi Tendon Organ reflex.  Which causes instant and dramatic muscle relaxation and can restore full ROM to restricted joints like shoulders and hips in seconds.  

Picture a T bar with a built-in drop piece.  This greatly reduces time needed for soft tissue treatment, leaving more time for other treatments per visit, or more patients per day.  Drop Release is like nothing else out there, and you almost gotta see it to understand, so check out the videos on the website.

It’s inventor, Dr. Chris Howson, from the great state of North Dakota, is a listener and friend. He offered our listeners a great discount on his product. When you order, if you put in the code ‘HOTSTUFF’ all one word….as in hot stuff….coming up!! If you enter HOTSTUFF in the coupon code area, Dr. Howson will give you $50 off of your purchase.

Go check Drop Release at droprelease.com and tell Dr. Howson I sent you.

Item #2

This one is called “Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis: Consensus and Results of an International Delphi Study” authored by Tomkins-Lane et. al(Tomkins-Lane C 2020). and published in European Spine Journal in June of 2020. Damn hot enough!

Why They Did It

The authors wanted to reach a consensus on which diagnostic tests are most important in confirming the clinical diagnosis of lumbar spinal stenosis

How They Did It

  • Phase 1: 22 members of the International Taskforce on the Diagnosis and Management of LSS confirmed 35 diagnostic items
  • An on-line survey was developed that allows experts to express the logical order in which they consider the diagnostic tests, and the level of certainty ascertained from each test.
  • Phase 2, Round 1: Survey distributed to members of the International Society for the Study of the Lumbar Spine
  • Round 2: Meeting of 15 members of Taskforce defined final list of 10 items.
  • Round 3: Survey was distributed internationally, followed by Taskforce consensus.

What They Found

  • 432 clinicians from 28 different countries participated
  • Certainty of the diagnosis was 60% after selecting the first test and significant change in certainty ceasing after eight items at 90.8% certainty
  • The most frequently selected tests included MRI/CT scan, neurological examination and walking test with gait observation. 
  • The diagnostic test selected most frequently as the first test was neurological examination.

Wrap It Up

“This is the first study to reach an international consensus on which diagnostic tests should be used in the clinical diagnosis of LSS. The final recommendation includes three core diagnostic items: neurological examination, MRI/CT and walking test with gait observation. The Taskforce also recommends 3 ‘rule out’ tests: foot pulses/ABI, hip examination and test for cervical myelopathy.”

Related but on a separate note, the grocery cart sign hints you toward stenosis. If walking through a grocery store just kills the patient but they can lean over on the cart with their elbows and that alleviates the pain….or if sitting removes the complaint fairly quickly, you need to start sniffing up the stenosis tree. 

I am a big fan of Dr. Carmen Amendolia’s program which he was able to validate through research. It’s called the Boot Camp for Stenosis and it’s REALLY turned a very difficult condition to treat into a much more successful outcome for me personally. 

Basically, it’s just a lack of real estate in the canals and this program helps the patient understand the condition as well as self manage after a 2xweek for 6 week protocol. It’s well-thought out and very well done. And easy to do and understand. 

I highly recommend it. Your stenosis patients will thank you profusely.  

Alright, that’s it. Y’all be safe. Keep changing the world and our profession from your little corner of the world. Continue taking care of yourselves and taking care of your neighbors. 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. 

Key Takeaways

Store

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

Subscribe Button

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

  • (2020). “VA reduces prescription opioid use by 64% during past eight years.” VA US Dept Veterans Affairs.
  • Tomkins-Lane C, M. M., Wong A, (2020). “Diagnostic tests in the clinical diagnosis of lumbar spinal stenosis: Consensus and Results of an International Delphi Study.” European Spine Journal 29: 2188-2197.