sciatica

PT For Sciatica & Laser For Neck Pain

CF 320: PT For Sciatica & Laser For Neck Pain Today we’re going to talk about PT For Sciatica & Laser For Neck Pain 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 giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • 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 #320 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 8).  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. If you’ve been following along, you know I’m still digging my clinic out of the Winter doldrums but it’s coming along nicely. If you want to hear more about that and what we’ve been doing to change course and correct the path forward, listen to last week’s episode.  The plan laid down is starting to bring some fruit that I think we’ll be harvesting soon. I had 15 or 16 new patients last week. It’s not to the 20 or so I was used to before COVID but it’s better than the 9 or 10 I was seeing a month or so ago.  We’re back to doing the therapies on our patients that we should be legitimately doing. We’re not just failing to do them and watching that money simply walk out the door.  For example, we billed $106k in February as opposed to $82k in December. Quite a difference there. Now, that’s me and the nurse practitioner and while that may sound like a metric crap ton of money in a month, and it is for some, remember, my overhead monthly is approximately $65k or more. So, if you bill that much, guaranteed you’re not collecting that much. You might get $80 – $85 of that.  That leaves you with $15k….maybe $20k in profit for the month. So, it’s not where we want it but it’s moving in the right direction. We collected about $30k more in February than we did in each of the previous 3-4 months so collections is doing its deal and making me happy once again.  I’m such a fun guy when I’m making money instead of losing it!! Y’all!  This week is a short week for me. I’m flying out to Atlanta Thursday morning to the big VOAtlanta voice conference. Around 1,000 attendees. Last year, the dude that does all of the announcements for the TODAY show was sitting behind me. The guy that has voiced Goofy for the last 40 years was there. Nolan North who voiced the lead character in the video game Unchartered was there.  You just never know who’s going to be there but making the just right contact on these things could mean a lot financially. No doubt. So I go, I have some drinks at the bar, I attend classes and enjoy it and take it all in and just see what happens.   So that’s on tap this weekend and you know I’ll be talking about it on the podcast next week. But for now, let’s hop in on the research.  Item #1 The first one this week is called, “How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis” by Dove et. Al. and is published in European Spine Journal on December 29, 2022 and let’s do the hot thing just because! Remember, the citations can be found at chiropracticforward.com under this episode.  Dove, L., Jones, G., Kelsey, L. et al. How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. Eur Spine J 32, 517–533 (2023). https://doi.org/10.1007/s00586-022-07356-y Why They Did It Physiotherapy interventions are prescribed as first-line treatment for people with sciatica; however, their effectiveness remains controversial.  The purpose of this systematic review was to establish the short-, medium- and long-term effectiveness of physiotherapy interventions compared to control interventions for people with clinically diagnosed sciatica How They Did It This systematic review  Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Embase, PEDro, PubMed, Scopus and grey literature were searched from inception to January 2021 Inclusion criteria were randomised controlled trials evaluating PT interventions compared to a control intervention in people with clinical or imaging diagnosis of sciatica.  Primary outcome measures were pain and disability.  Study selection and data extraction were performed by two independent reviewers with consensus reached by discussion or third-party arbitration if required.  Risk of bias was assessed independently by two reviewers using the Cochrane Risk of Bias tool with third-party consensus if required.  Meta-analyses and sensitivity analyses were performed with random effects models  Subgroup analyses were undertaken to examine the effectiveness of physiotherapy interventions compared to minimal (e.g. advice only) or substantial control interventions (e.g. surgery). Three thousand nine hundred and fifty eight records were identified, of which 18 trials were included, with a total number of 2699 participants.  What They Found All trials had a high or unclear risk of bias. Meta-analysis of trials for the outcome of pain showed no difference in the short, medium or long term.  For disability there was no difference in the short, medium, or long term between physiotherapy and control interventions.  Subgroup analysis of studies comparing physiotherapy with minimal intervention favored physiotherapy for pain at the long-term time points.  Large confidence intervals and high heterogeneity indicate substantial uncertainty surrounding these estimates.  Many trials evaluating physiotherapy intervention compared to substantial intervention did not use contemporary physiotherapy interventions. Wrap It Up Based on currently available, mostly high risk of bias and highly heterogeneous data, there is inadequate evidence to make clinical recommendations on the effectiveness of physiotherapy interventions for people with clinically diagnosed sciatica. Item #2 The second one today is called “Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials” by Chow et. Cl and published in The Lancet on December 5, 2009.  Chow R, Johnson, M, ‘Efficiacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomized placebo or active-treatment controlled trials’, 374, 9705, P1897-1908, Dec. 5, 2009. DOI:https://doi.org/10.1016/S0140-6736(09)61522-1 Why They Did It Neck pain is a common and costly condition for which pharmacological management has limited evidence of efficacy and side-effects.  Low-level laser therapy (LLLT) is a relatively uncommon, non-invasive treatment for neck pain, in which non-thermal laser irradiation is applied to sites of pain.  They did a systematic review and meta-analysis of randomised controlled trials to assess the efficacy of LLLT in neck pain. How They Did It We searched computerised databases comparing efficacy of LLLT using any wavelength with placebo or with active control in acute or chronic neck pain.  Effect size for the primary outcome, pain intensity, was defined as a pooled estimate of mean difference in change in mm on 100 mm visual analogue scale. What They Found We identified 16 randomised controlled trials including a total of 820 patients.  Side-effects from LLLT were mild and not different from those of placebo. Wrap It Up We show that LLLT reduces pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. 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
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    

Sciatica & Mental Stimulation And Dementia

CF 307: Sciatica & Mental Stimulation And Dementia Today we’re going to talk about Sciatica & Mental Stimulation And Dementia But first, here’s that sweet sweet bumper music

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

Chiropractic evidence-based products

Integrating Chiropractors

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Then go Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on whatever platform you’re listening to 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
You have found yourself smack dab in the middle of Episode #307 Now if you missed last week’s episode , we talked about Pain Neuroscience Education & Cannabis And Bipolar Disorder. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I just got back from Colorado Springs yesterday. Many of you know that I do voice over projects in my spare time. Whatever that is. I don’t really have spare time these days. But, I flew from Amarillo, TX, to Las Vegas, then to Colorado Springs…..how dumb is that? I hae to do that same path on the way home too.  I was doing live announcing for a Redline Cheer and Dance competition. The season is here and I’ll be hopping all over to these competitions and meeting all kinds of new people. It’s always interesting and mostly fun. It can be a bit of a grind but it’s mostly fun. The traveling, hotels, and meals…..I always enjoy them. New experiences keep you jazzed. And you can’t hardly beat the view from anywhere in CS.  The week after Thanksgiving was slow. I just didn’t have a good week last week and that can get in your brain if you allow it to. I don’t like being slow and I don’t like what it does to morale. I like a good low grade excited buzz in the office. Not a subdued and draggy feeling. Which is what last week was.  Today is Monday and I have 45 on my schedule so that’s an improvement and I’ll take it. I’m a motivated dude. I need to move forward at all times. Any set back kind of pisses me off and gives me the grumps.  But, as a leader, you can be honest with your manager. But you have to put on the front for the rest of your staff. You can tell you manager, hey, I’m struggling with finances this week and this provider or that provider in the clinic isn’t quite covering their overhead. That gives me anxiety and we need to pay attention to that. Or whatever. Hey manager, I don’t have the extra funds to replace this equipment, let’s figure out a work around until we do. Something like that. You can have those conversations with your manager because that’s why they’re there. Or, it’s supposed to be why anyway.  But when it comes to the rest of the office, you need to have that front on that everything is great, we’re working through a couple of challenges but nothing you’ve never seen, and it’s time to rock n roll. Don’t let them see you sweat. It’s not good for them or for you.  Fake it till you make it. It’s never on autopilot folks. It’s always changing and you have to keep dodging punches and swinging every single day.  So, let’s get to it so I can go back to swinging some punches around here. Metaphorically, of course.  Item #1 Our first one today is called, “I Am Worried I Have Sciatica—What Do I Need to Know?” By Zhang et. Al. and published in JAMA Internal Medicine on November 12, 2023 and Aye crumb! Es muy caliente, mi amigos! Zhang GY, Incze MA. I Am Worried I Have Sciatica—What Do I Need to Know? JAMA Intern Med. Published online November 13, 2023. doi:10.1001/jamainternmed.2023.5990. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2811335 This is more of an article instead of a research project so let’s hit the highlights. 
  • They say, “Sciatica is a type of pain that is caused by irritation of the sciatic nerve. This nerve travels from the low back down the legs. Sciatica most commonly happens when a disk in your spine gets damaged or worn out and presses on the sciatic nerve.”
  • The pain can be sharp and aching. It is often accompanied by numbness, tingling, or shooting pain down the back of one leg. Rarely, sciatica can cause muscle weakness, like having difficulty lifting your foot.
  • A medical professional can usually diagnose sciatica by asking about your symptoms and doing a physical examination. For most people, blood tests and imaging such as x-ray or magnetic resonance imaging are not necessary. If you have had cancer, spine infections, or injection drug use; have a new fever; cannot feel your groin area; cannot control going to the bathroom; have trouble urinating; or your leg feels weak, you should see a medical professional right away.
  • Most people with sciatica fully recover without any treatment. About one-third of people with sciatica recover within 2 weeks, and three-fourths of people feel better within 3 months. It is hard to predict who will get better and who will still feel pain. Sciatica can come and go. If your sciatica lasts more than 12 weeks, it is a good idea to get reevaluated by a health care professional.
  • There are many ways to treat pain related to sciatica. Anti-inflammatory drugs like ibuprofen or naproxen may provide modest, short-term relief. Acetaminophen (Tylenol) can also be helpful for pain. Other prescribed medications such as muscle relaxers, steroids, opioids (eg, tramadol, oxycodone), and gabapentin are not proven to help, and some may have dangerous side effects. Talk with your doctor about what medications are best for you. Maintaining gentle physical activity (eg, walking, light housework) as tolerated is important for recovery. A physical therapist can help to coach you on specific exercises to speed up the recovery process. There is no strong evidence that treatments like back adjustments (eg, from chiropractors), gentle spine stretching (called lumbar traction), or acupuncture work. Doctors sometimes give injections of steroid or numbing medications near the spine to help with pain. These might help relieve pain for a short time, but they do not help to heal sciatica.
  • If treatments like physical therapy and pain medications do not help after 4 months, surgery may improve symptoms for some people. But there is a chance that the pain may return even after surgery. Most surgeries for sciatica use small cuts and special tools to remove the damaged part of the spinal disk. This can relieve pressure on the sciatic nerve. Recovery time from sciatica surgery varies among people but generally takes 6 to 12 weeks. While surgery can help, it has risks, including nerve damage and infection.
Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.  When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Last one today is called, “Lifestyle Enrichment in Later Life and Its Association With Dementia Risk” by Wu et al. and published in JAMA Network Open on July 14, 2023 and that’s a steamy stack something good! Wu Z, Pandigama DH, Wrigglesworth J, et al. Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. JAMA Netw Open. 2023;6(7):e2323690. doi:10.1001/jamanetworkopen.2023.23690 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807256?guestAccessKey=eaeccd11-7338-417d-a1b5-70481ff42466&utm_content=weekly_highlights&utm_term=072323&utm_source=silverchair&utm_campaign=jama_network&cmp=1&utm_medium=email Why They Did It Lifestyles enriched with socially and mentally stimulating activities in older age may help build cognitive reserve and reduce dementia risk. Objective  To investigate the association of leisure activities and social networks with dementia risk among older individuals. How They Did It
  • It was a longitudinal prospective cohort study 
  • Used population-based data from the ASPREE Longitudinal Study of Older Persons (ALSOP) for March 1, 2010, to November 30, 2020. 
  • Community-dwelling individuals in Australia aged 70 years or older who were generally healthy and without major cognitive impairment at enrollment were recruited study 
  • A total of 19 measures of leisure activities and social networks assessed at baseline were classified using exploratory factor analysis.
  • Dementia was adjudicated by an international expert panel according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. 
  • Cox proportional hazards regression examined dementia risk over 10 years, adjusting for education, socioeconomic status, and a range of health-related factors.
  • This study included 10,318 participants. Their median age was 73.8 years at baseline, more than half (52.6%) were women, and most self-identified as White
What They Found
  • In adjusted analyses, more frequent engagement in adult literacy activities (eg, writing letters or journaling, using a computer, and taking education classes) and in active mental activities (eg, playing games, cards, or chess and doing crosswords or puzzles) was associated with an 11.0% and a 9.0% lower risk of dementia, respectively. 
  • To a lesser extent, engagement in creative artistic activities (craftwork, woodwork, or metalwork and painting or drawing) and in passive mental activities (reading books, newspapers, or magazines; watching television; and listening to music or the radio) was also associated with reduced dementia risk. 
  • In contrast, interpersonal networks, social activities, and external outings were not associated with dementia risk in this sample.
Wrap It Up These results suggest that engagement in adult literacy, creative art, and active and passive mental activities may help reduce dementia risk in late life.  In addition, these findings may guide policies for geriatric care and interventions targeting dementia prevention for older adults. So, it appears that working the brain keeps the brain working. Basically.  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
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