CF 369: Cervicogenic Headache Treatment & Seeing A Chiropractor First Means Less Expense Overall Today we’re going to talk about Cervicogenic Headache Treatment & Seeing A Chiropractor First Means Less Expense Overall 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. 

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You have found yourself smack dab in the middle of Episode #369 Now if you missed last week’s episode, we talked about Spinal Manipulative Treatment And Biochemical Markers & SMT For Lumbar Disc Herniation.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Alright, we had July 4th Independence Day celebration last weekend so that was a nice little 3-day weekend, right? I’m sure we all made the best use of our holidays. Hopefully you all still have all of your fingers and toes.  I haven’t seen it from any chiropractic colleagues but this weekend has been a lesson in the incorrect way to use social media. I really don’t care what your political views are. I 100% don’t care. The Texas floods happened this weekend and I think the body count is up to 91 at the typing of this. Lots of kids in the Christian camp and all of that. Heart breaking. I can’t even allow myself to think about it because it’s just too much.  I’m a life long Texan and while I don’t live anywhere near the flooding, I know a ton of people in the area and they are kin in some way. We are related at Texans and it means more to me than maybe someone from Oregon or New York for example. I think that’s understandable. 

I saw where folks are posting for political points and it’s just gross. It’s a mental condition for some of these folks. DOGE made cuts to different parts of the government that included the National Weather Service so now natural disasters are, of course, because of Republicans. Now, when did cutting wasteful spending from the government become a bad thing?/ Honestly, that used to be a bipartisan, American idea.

But…..yeah, not so much these days. What if these ares of the govt. were overfunded and over staffed well-beyond what was needed? Does it make sense to cut staff to the regular, appropriate amount that services are not lost while waste is eliminated? Isn’t that possible too? Of course it is. But I’m getting off topic here.  I’m seeing this kind of post like Texas deserves everything they get, MAGA voted for it, now they can deal with it, and garbage like that.  If you wonder about me, I’ll be straight up with you and if you don’t like it, I could not care less. I’m fiscally conservative and socially I lean a little more Liberal. I find positives and negatives on both sides of the aisle and before I let memes or cable news get me fired up about something, I research it and form an educated opinion. 

If social media has taught me anything, it’s that a high percentage of my fellow humans do NOT do that. They just go spouting garbage, further dividing others, and keeping our world at a level of intensity that I’ve never seen before.  It’s awful when one side acts like the other side is literally, not figuratively, responsible for natural disasters and killing 91 people, including children. When all they had to do was research to find out that forecasting gave over 3 hours of advance notice of potential flooding and the totals were as accurate as they could have been for that kind of storm. NWS officials and meteorologists stated that the NWS offices were adequately staffed. The storm was beyond what models could predict with any precision, and while the warnings were released, local dissemination was slow.

But, it tracks because if you recall, Hurricane Katrina was Bush’s fault too. I remember well. 

So, with no education, we get social media posts like this from a Houston, TX pediatrician, “May all visitors, children, non-MAGA voters and pets be safe and dry. Kerr country MAGA voted to gut FEMA. They deny climate change. May they get what they voted for. Bless their hearts.” And Bless their hearts is rarely meant in a complementary way in the South, in case you were unaware.  Which led to this doctor being promptly and immediately fired. Her name is Dr. Christina Propst and she was with Blue Fish Pediatrics in Houston if you want to look into it yourself. 

The page at Blue Fish Pediatrics that used to have her bio now says, “This past weekend, we were made aware of a social media comment from one of our physicians. The individual is no longer employed by Blue Fish Pediatrics. As we previously mentioned in our original statement, we strongly condemn the comments that were made in that post. That post does not reflect the values, standards, or mission of Blue Fish Pediatrics. We do not support or condone any statement that politicizes tragedy, diminishes human dignity, or fails to clearly uphold compassion for every child and family, regardless of background or beliefs. We continue to extend our full support to the families and the surrounding communities who are grieving, recovering, and searching for hope. Sincerely, Blue Fish Pediatrics Leadership Team”

She gone!! And good for them. She’s 100% wrong and they are right. Unfortunately, she’s not even close to being the only one with that kind of mentality. She’s just the most famous one at the moment. And trust me, something like this is NOT why any of you want to be famous. One more tip from your Ol’ Uncle Jeffro, friends. 

Anyway, the point here is, yeah…I’m pretty spicy about how such a disaster has been politicized. It’s my state and I know people in the disaster. It’s more personal sure. I’m self aware on it. I also understand those that are concerned that DOGE cut too much and I understand those that hate Trump with every ounce of their being. I don’t personally like the guy myself so I get it. But there should be a self-governer within us that stops us from being a terrible person.  It goes both ways too. Let’s be fair. Thee Biden Administration was BLASTED just last year.However, the criticism you saw during the North Carolina flooding last year was not that Biden Administration caused the flood but that the response to take care of the people was a disaster in and of itself. I don’t recall anyone blaming the flooding on the administration itself though, or how NC voted, or any of that.

This Texas flood has been a whole different deal in my experience. 

One side is literally saying that the other side caused the death and destruction through cuts in various programs leading to a lack of proper warning leading to deaths, etc. Well, that’s just not the truth and it’s a little insane but the bigger point here is what is a good look on social media and what is not.  I mean, I get the school shootings. If that brings up the topic and a further discussion of stricter gun laws and things like that, I think that’s a legitimate discussion and a fair one to have. But a natural disaster?

Come on bruh……that’s embarrassing for you folks posting like that. 

If you are friends with me on social media, you may notice that I don’t engage in political discussions much and when I do, I am careful about it. I do not run one side down. I do not post about things when I’m pissed and I CERTAINLY don’t take a stance without educating myself thoroughly. 

The main reason is that as soon as you take any stance, you lose half of your audience immediately. HALF. That’s up to and including saying you’re proud to be an American this year. Which is almost just la la land stuff to me. WHY would you purposefully lose half of your patient base and/or get blasted on social media and made famous for the wrong reasons? When all you had to do was shut the hell up and just discuss it amongst your inner circle?  My spouting off here this week is not really taking one side over the other, though I think anyone posting to score political points on this deal is sick.  It’s more about it being in extremely poor taste and is just a bad look to run to the keyboard every time a disaster takes place so that you can ‘one up’ the other side and score some imaginary points.

Do you really think you’ll somehow change someone’s mind because of a stupid post on Facebook? I got some news for you friend…..you’re wasting your time, emotions, and energy because…..psssst…..nobody gives a damn. Not one single damn. We just aren’t that important. I’m sorry to break it to you.  And, again, I do not care what side you’re on. The kind of thinking that leads to this kind of posting is problematic and if that describes you, start figuring out what broke inside of you and what caused it so that you can fix it and ultimately….do better, be better, and raise kids that turn out better than you. 

If I’m describing you, fix it or stay off of social media. Your practice, your employees, and your patients will be appreciative of your efforts. I promise. Nobody and I mean NOBODY wants to have to work with THAT person day in and day out.  It truly is the very worst of us and, unfortunately, social media has allowed it to step into center stage. And it’s gross. 

Item #1

Our first one today is one I got from Dr. Mark King of Cincinnati and of Motion Palpation Institute fame. Mark is a good friend of mine and if he sends me something, better believe I’mma look at it.  It’s called, “Comparative safety and efficacy of manual therapy interventions for cervicogenic headache: a systematic review and network meta-analysis” by. Xu et al and published in Frontiers of Neurology on May 15, 2025 and it’s may caliente y en fuego! Remember, the citations can be found at chiropracticforward.com under this episode.  https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1566764/full https://doi.org/10.3389/fneur.2025.1566764

Why They Did It

To evaluate and compare the safety and efficacy of spinal manipulation, mobilization, and massage for the management of cervicogenic headache (CGH) using meta-analytic techniques.

How They Did It

Comprehensive searches were conducted in Cochrane, Embase, PubMed, and ClinicalTrials.gov to identify studies investigating the effects of manipulation, mobilization, and massage on pain, disability, and physical function in patients with CGH.  Key outcomes included pain severity (visual analog scale, VAS), Neck Disability Index (NDI), Flexion-Rotation Test (FRT), and Headache Disability Inventory (HDI) at various follow-up timepoints.

What They Found

Fourteen studies totaling 1,297 CGH patients were included.  Standard pairwise meta-analysis revealed that sustained natural apophyseal glides (SNAG) mobilization produced significantly greater improvements compared to non-sustained natural apophyseal glides interventions in VAS, Neck Disability Index, Flexion-Rotation Test, and Headache Disability Inventory, with benefits maintained over time.  Cervical Spinal Mobilization exhibited significantly greater VAS reductions compared to exercise, massage, and mobilization, while mobilization was superior to exercise and massage for VAS.  For Neck Disability Index, Cervical Spinal Mobilization was significantly better than exercise, but no other between-group differences were observed.

Wrap It Up

In patients with CGH, sustained natural apophyseal glides mobilization can significantly improve pain and function, with benefits maintained in the long-term.  Additionally, Cervical Spinal Mobilization may be the most effective short-term intervention for reducing pain and disability compared to mobilization, massage, and exercise, although clinician expertise appears to be an important factor.

Item #2

Our last one this week is called, “Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review” by Farabaugh et al and published in Chiropractic & Manual Therapies on March 6, 2024. It’s steamy….but not hot. 

Why They Did It

The cost of spine-related pain in the United States is estimated at $134.5 billion. Spinal pain patients have multiple options when choosing healthcare providers, resulting in variable costs. Escalation of costs occurs when downstream costs are added to episode costs of care. The purpose of this review was to compare costs of chiropractic and medical management of patients with spine-related pain.

How They Did It

A Medline search was conducted from inception through October 31, 2022, for cost data on U.S. adults treated for spine-related pain.  The search included economic studies, randomized controlled trials and observational studies.  All studies were independently evaluated for quality and risk of bias by 3 investigators and data extraction was performed by 3 investigators.

What They Found

The literature search found 2256 citations, of which 93 full-text articles were screened for eligibility.  Forty-four studies were included in the review, including 26 cohort studies, 17 cost studies and 1 randomized controlled trial.  All included studies were rated as high or acceptable quality.  Spinal pain patients who consulted chiropractors as first providers needed fewer opioid prescriptions, surgeries, hospitalizations, emergency department visits, specialist referrals and injection procedures.

Wrap It Up

Patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management.  The included studies were limited to mostly retrospective cohorts of large databases. Given the consistency of outcomes reported, further investigation with higher-level designs is warranted 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. 

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The Message

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

Key Point:

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

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

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

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

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