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The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy
By The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy
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FAQs about The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy:
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The podcast currently has 335 episodes available.
The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy episodes:
June 27, 2024Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter CF 336: Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter Today we’re going to talk about Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter 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!
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 [email protected] 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 #336 Now if you missed last week’s episode, we talked about Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things….. Trying to climb out of the valley again and it appears that we are. New patient number back on the rise and the days are filling up again. Today I have 57 patients. Which is honestly more than I want. I have a staff of 3 full timers in addition to a front desk person to help me do it but thats still just more than I want in one day. And only 19 tomorrow. Honestly…..couldn’t that have been spread out a little more efficiently? The answer is probably. But our front desk girl is an absolutey rock star and I’m not saying a word. She’s still a bit new and finding her way. Most of you know that scheduling is an art and when she sees we’re struggling to keep up with her schedule, she’ll adjust naturally. Is that the best way to take care of it?? No. I did send tell her at the start of the day that we are tapped out and cannot fit any more patients so she gets the message from the start. Then as far as the rest of it goes, she’ll find her way. I’d rather be scheduled heavy than light. But yeah, for an old 51 year old, 57 in one day is a little more than I can chew. I think it’s the increase in marketing and all of the changes I’ve been mentioning lately. We changed website companies, we increased our marketing and are just doing some things differently lately. And I think we are starting to see the fruits of our efforts. I’ll keep you updated on what’s up and what we’re doing. Stick around. It’s always interesting.
Item #1
Our first one today is called “Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty” by Fenton et al and published in Spine Journal in October 2023 and it’s just hot enough.
Remember, the citations can be found at chiropracticforward.com under this episode.
Fenton, Joshua J. MD, MPHa,b; Fang, Shao-You PhDb; Ray, Monika PhDb,c; Kennedy, John CCS, CDIPb; Padilla, Katrine MPPb; Amundson, Russell MDd; Elton, David DCd; Haldeman, Scott DC, MD, PhDe; Lisi, Anthony J. DCf; Sico, Jason MD, MHSf,g; Wayne, Peter M. PhDh; Romano, Patrick S. MD, MPHb,c. Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty. Spine 48(20):p 1409-1418, October 15, 2023. | DOI: 10.1097/BRS.0000000000004781
Why They Did It The objective was to compare utilization patterns for patients with new-onset neck pain by initial provider specialty.Initial provider specialty has been associated with distinct care patterns among patients with acute back pain; little is known about care patterns among patients with acute neck pain.
How They Did It Retrospective cohort study. Used Optum Labs Data Warehouse, which contains longitudinal health information on over 200M enrollees and patients representing a mixture of ages and geographical regions across the United States. Patients had outpatient visits for new-onset neck pain from October 1, 2016 to September 30, 2019, classified by initial provider specialty. Utilization was assessed during a 180-day follow-up period, including subsequent neck pain visits, diagnostic imaging, and therapeutic interventions.
What They Found
- The cohort included 770,326 patients with new-onset neck pain visits.
- The most common initial provider specialty was chiropractor (45.2%), followed by primary care (33.4%).
- Initial provider specialty was strongly associated with the receipt of subsequent neck pain visits with the same provider specialty.
- Rates and types of diagnostic imaging and therapeutic interventions during follow-up also varied widely by initial provider specialty.
- While uncommon after initial visits with chiropractors (≤2%), CT, or MRI scans occurred in over 30% of patients with initial visits with emergency physicians, orthopedists, or neurologists.
- Similarly, 6.8% and 3.4% of patients initially seen by orthopedists received therapeutic injections and major surgery, respectively, compared with 0.4% and 0.1% of patients initially seen by a chiropractor.
Wrap It Up Within a large national cohort, chiropractors were the initial provider for a plurality of patients with new-onset neck pain. Compared with patients initially seen by physician providers, patients treated initially by chiropractors or therapists received fewer and less costly imaging services and were less likely to receive invasive therapeutic interventions during follow-up.
Item #2 Our second and last one this week is called “Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study” by Trager et al and published in BMC Musculoskeletal Disorders on January 10, 2024. Kabam! That’s a hot one! Trager, R.J., Gliedt, J.A., Labak, C.M. et al. Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study. BMC Musculoskelet Disord 25, 46 (2024). https://doi.org/10.1186/s12891-024-07166-x
Why They Did It Patients who undergo lumbar discectomy may experience ongoing lumbosacral radiculopathy (LSR) and seek spinal manipulative therapy (SMT) to manage these symptoms. We hypothesized that adults receiving SMT for lumbosacral radiculopathy at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up.
How They Did It They searched TriNetX, Inc. for adults aged ≥ 18 years with lumbosacral radiculopathy and lumbar discectomy ≥ 1 year previous, without lumbar fusion or instrumentation, from 2003 to 2023. They divided patients into two cohorts: (1) chiropractic SMT, and (2) usual care without chiropractic SMT. They used propensity matching to adjust for confounding variables associated with lumbar spine reoperation (e.g., age, body mass index, nicotine dependence), calculated risk ratios (RR), with 95% confidence intervals (CIs), and explored cumulative incidence of reoperation and the number of SMT follow-up visits.
What They Found Following propensity matching there were 378 patients per cohort with a mean age of 61 years. Lumbar spine reoperation was less frequent in the SMT cohort compared to the usual care cohort, yielding an risk ratios of 0.55. In the SMT cohort, 72% of patients had ≥ 1 follow-up SMT visit.
Wrap It Up This study found that adults experiencing lumbosacral radiculopathy at least one year after lumbar discectomy who received spinal manipulative therapy were less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT. While these findings hold promise for clinical implications, they should be corroborated by a prospective study including measures of pain, disability, and safety to confirm their relevance. We cannot exclude the possibility that our results stem from a generalized effect of engaging with a non-surgical clinician, a factor that may extend to related contexts such as physical therapy or acupuncture.
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!
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 http://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
The post Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter appeared first on Chiropractic Forward.
...more June 20, 2024Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation CF 335: Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation Today we’re going to talk about Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation 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!
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 [email protected] 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 #334 Now if you missed last week’s episode, we talked about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things…..
Still slower this week. Making some tough decisions that maybe I’ll feel more comfortable getting into sometime in the future after it all shakes out. I’ve actually had a few things boiling under the surface that will all be shaking out in the next few months. One is a staffing issue that we may talk about down the road. But not at this time. One I mentioned last week. We are trying to move forward with an investment group out of Houston that has proposed purchasing 60% of my practice, taking over the billing, collections, and HR, helping at PT, helping at an associate, and helping us grow the clinic beyond what I’ve been able to grow it in its current state.
Helping me move more and more toward exiting day to day patient care and more into admin work while making more money overall. This cannot happen fast enough if they come with the right offer. Another is signing on with a legal group and putting my Forensics Diplomate to work finally. I was referrred to and engaged by a large legal group offering counter affidavits and medicolegal work.
Have the Forensics Diplomate and the Neuromusculoskeletal Medicine Diplomate, not to mention certfication in Biomechanics and Traumatology, puts me in a good position to be able to make good money outside of patient care. Which makes it easier to consider sellign 60% of what I’ve built over the years. If the investment group’s projections are fulfilled, I’ll make more money than I’ve ever made next year anyway. But, if not, I will still have the medicolegal work, the Airbnbs, and the Voiceover work.
I will always make money regardless. Even if everything with the clinic buyout and aftermath bluew and and it all went belly up – which will not happen- but assuming it could happen, I can move to Dallas and start over with little to zero issues.
I’ll always make money and be OK. That’s who I am. That’s who a whole bunch of the people that listen to my podcast are as well. So most of you know exactly where I’m coming from. Big moves are easier when you have that faith and that confidence in your ability to always provide. Another is being forced to file a grievance on a large law group here in Texas. I’ve been doing PI work since 2007 and have never had to do that before. I’ve thought about doing it several times as you can imagine. There are some amazing attorneys and, as most of you know, there are some miserable SOBs otu there that don’t deserve a law license.
This firm wormed their way into the state association and I tried to be a good association leader and use them as much as I could. Well, now they owe me $27k and have refused to pay after years of haggling with them. The patients got paid as far as I can tell. But nothing to us. They claim they sent us the checks and they were deposited. That’s not true. We balance out every check that comes in and somehow all 7 of these cases…..we somehow messed up. Nah, dawg…..nope.
Plus, we contacted out bank manager and they investigated and confirmed we never got any funds from them on the cases. So, I told them it was going to happen and I tried and tried to get them to settle but they refused. So I had to file a grievance with the state bar. We’ll see how that goes. Fun times right there but I’ve had it with sorry PI attorneys over the years and they’re not getting away with this one.
When I say not much is going on this week….sometimes that’s true. These larger things typically live in the background and they’re just constants to my life that I don’t necessarily have on my radar every day. Sometimes they’re much more in focus for me depending on where each of them lies in the process of resolution. The staffing one is front and center this week, we sent off P&Ls to the investment firm last week, I engaged with the legal group last week, and the Bar complaint had an extension filed out into July just last week so they’re all kind of front and center this week. There you have it. Welcome to my life. Time to treat some patients so let’s get to it
Item #1 The first one this week is called, “Flavored Vapes Might Expose Users to Hundreds of Dangerous Byproducts” by Emily Harris and published in JAMA Network on June 7, 2024, and OMG that is H-O-T! Remember, the citations can be found at chiropracticforward.com under this episode.
doi:10.1001/jama.2024.10326
https://jamanetwork.com/journals/jama/fullarticle/2819956?guestAccessKey=749c8b24-8407-42dc-8d29-754707b6f8ed&utm_source=silverchair&utm_medium=email&utm_campaign=jama_network&utm_content=network_highlights&utm_term=061624&adv=000003189471
This is an article that is in reference to a research paper that is linked at this point in the show notes if you want to go and see it. https://www.nature.com/articles/s41598-024-59619-x The reason I’m not just going through this paper and sticking to this JAMA summary is that….bruh…..it’s a workout for the brain. It’s a deep dive into pyrolysis, organic chemistry, and cold sweats and nightmares from my college days. Things I prefer to not re-live. God blessed us all with people that love that stuff, understand it, and can use it to benefit us.
But we don’t have to get in the weeds on it. We’ll just get straight to the info. “The liquid in flavored e-cigarettes likely produces an array of harmful chemicals when heated, as occurs during vaping, a recent study in Scientific Reports found. Again, that is linked above in the show notes. The researchers used artificial intelligence to predict what would happen when 180 substances known to be present in flavored e-cigarettes are exposed to high temperatures. According to their findings, the representative chemicals would transform into 127 acutely toxic products, 153 compounds that are health hazards, and 225 chemicals categorized as irritants based on the Globally Harmonized System classifications.
Long-term exposure to chemicals in e-cigarettes “makes it plausible that we are standing at the starting line of a new wave of chronic diseases that will only emerge in 15 to 20 years from now,” the researchers wrote, noting that the results suggest the number of compounds in e-liquids should be limited.” 127 acutely toxic product and 153 compounds that are health hazards. And I wonder how many of these people go out there and post about the harms of the covid vaccine and all of that stuff right before they hop into their car and vape some strawberry delight?
Item #2
The last one this week is called, “Adverse Events After Cervical Spinal Manipulation – A Systematic Review and Meta-Analysis of Randomized Clinical Trials” by Pankrath et al and published in Pain Physician Journal dated May/June 2024 and that’s some hot damn, smooth like candy.
https://www.painphysicianjournal.com/linkout?issn&vol=27&page=185&fbclid=IwZXh0bgNhZW0CMTEAAR3cd0i48Y25pF-5JQbXRtMIkg98so7Bg0BIBSKhR8zAVkTGMwNV0vBYQeI_aem_AU0JsgqrIkg6RHuBfM6nq6WJzrB96CUoo-DwiTYJC8n74dbmOyFNL3SUczMkQAEygR_XJRezjaPITCBKeYB8p2zP
Why They Did It
Cervical manipulations are widely used by physiotherapists, chiropractors, osteopaths, and medical doctors for musculoskeletal dysfunctions like neck pain and cervicogenic headache. First of all…..show me these MDs that are using SMT, please? The use of cervical manipulation remains controversial since it is often considered to pose a risk for not only benign adverse events (AEs), such as aggravation of pain or muscle soreness, but also severe AEs such as strokes in the vertebrobasilar or carotid artery following dissections.
Studies finding an association between cervical manipulation and serious AEs such as artery dissections are mainly case-control studies or case reports. These study designs are not appropriate for investigating incidences and therefore do not imply causal relationships. Randomized controlled trials (RCTs) are considered the gold standard study designs for assessing the unconfounded effects of benefits and harms, such as AEs, associated with therapies. Due to the unclear risk level of AEs associated with high-velocity, low-amplitude (HVLA) cervical manipulation, the aim of this study was to extract available information from RCTs and thereby synthesize the comparative risk of AEs following cervical manipulation to that of various control interventions.
How They Did It The project was a systematic review and meta-analysis. A systematic literature search was conducted in the PubMed and Cochrane databases. This search included RCTs in which cervical HVLA manipulations were applied and adverse events were reported. Two independent reviewers performed the study selection, the methodological quality assessment, and the GRADE approach. Incidence rate ratios (IRR) were calculated. The study quality was assessed by using the risk of bias 2 tool, and the certainty of evidence was determined by using the GRADE approach.
What They Found Fourteen articles were included in the systematic review and meta-analysis. The pooled Incidence rate ratios indicates no statistically significant differences between the manipulation and control groups. All the reported adverse events were classified as mild, and none of the events reported were serious or moderate.
Wrap It Up In summary, HVLA manipulation does not impose an increased risk of mild or moderate AEs compared to various control interventions. However, these results must be interpreted with caution, since RCTs are not appropriate for detecting the rare serious AEs. In addition, future RCTs should follow a standardized protocol for reporting AEs in clinical trials. 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!
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 http://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
The post Flavored Vape Issues & Adverse Events From Cervical Spinal Manipulation appeared first on Chiropractic Forward.
...more June 13, 2024The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15) CF 334: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15)…..it’s the final part of the series. 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!
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 [email protected] 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 #334 Now if you missed last week’s episode, we talked about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things…..
Up and down, peaks and valleys, getting hit and landing blows, riding the waves or gasping for air, whack-a-freaking-mole. Slow week this week and last. Two weeks ago and May overall, we killed it. Absolutely killed it. Now, I’m wondering if we should just close the doors and call it a good career. We tried. Lol.
Yes, that’s super dramatic.
No, we’re not closing up shop. Lol. But that’s how you get sometimes right? Damnit can’t it just be a set it and forget it thing? Well the answer is no. It cannot and will not. The competition is too great to rest solely on your reputation in the community. Yes, it helps but it’s not enough to stay where you want to be. It’s just not. We all feel important I’m sure but here’s the brutal truth. People start to forget us the minute we go silent. You have to keep that pedal to the metal with the marketing, being involved in the community, constant weekly touches in the community, and telling your current active patients how much you appreciate referrals. They don’t always know, ya know?
So, market market market. In separate news, I am re-engaging with the group I’ve mentioned in the past about purchasing 60% of the clinic, bringing in an associate or two, and having more time for voice-over work, real estate work, and medicolegal work in the chiropractic realm.
If my plans are solid and actually happen…..and I have a track record of making things happen……in 2 years, I’ll have more and more time to dedicate to podcast hosting and painting and sculpting and all of the aspects of life outside of the clinic that truly feed my soul. We’re working on it and so far, it’s looking good. It just takes time and I’ll keep you all updated as we go along. It may be something you want to consider as I go through it and come out the other side.
Item #1
The last paper in our series is called, “The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial” by Zaworski et al and published in European Journal Of Physical Rehabilitative Medicine in April of 2021. Remember, the citations can be found at chiropracticforward.com under this episode.
Zaworski K, Latosiewicz R. The effectiveness of manual therapy and proprioceptive neuromuscular facilitation compared to kinesiotherapy: a four-arm randomized controlled trial. Eur J Phys Rehabil Med. 2021 Apr;57(2):280-287. doi: 10.23736/S1973-9087.21.06344-9. Epub 2021 Mar 2. PMID: 33650840.
Last reminder on this series. The WHO recommends spinal manipulative therapy at very low confidence. I’ve been doing this podcast every single week for over 7 years and the amount of research in favor of smt for everything but especially low back pain is honestly pretty staggering.
So, when I see the WHO recommend SMT, I’m like….well of course they do. And then I see ‘at very low confidence’ which is the same level they recommended ultrasound, well, then I got miffed. I got ‘pressed’ as the kids say these days. Hundo P. So I found all of the papers the WHO used to make the determination and we went through them one by one and this is the last one.
Why They Did It
The aim of the study was to determine whether the use of combined therapy consisting of manual therapy and proprioceptive neuromuscular facilitation (PNF) is more effective than the use of manual therapy techniques, proprioceptive neuromuscular facilitation or traditional kinesiotherapy as single methods in the treatment of low back pain.
How They Did It
The setting was a Rehabilitation Department of Hospital in Parczew (Poland). The study was designed as four-arm randomized comparative controlled RCT and conducted on a group of 200 patients aged 27-55y. The patients were randomly divided into four 50-person groups: 1) group A – manual therapy; 2) B – proprioceptive neuromuscular facilitation; 3) C – manual therapy and proprioceptive neuromuscular facilitation; and 4) group D – traditional kinesiotherapy and control group. Pain intensity was measured using VAS and Laitinen’s questionnaire. Functional disability was assessed using Oswestry Disability Index (ODI) and Back Pain Functional Scale (BPFS).
What They Found
There was a statistically significant difference in pain reduction (VAS Scale) between Group C (4.8 points) and Group D (3.9 points). In all the groups there was a statistically significant reduction in a degree of disability as measured by the ODI. A level of functional capabilities increased significantly only in Group C (8.8 points) as compared to Group D (5.7 points).
Wrap It Up
All the evaluated methods caused pain reduction which lasted for at least 2 weeks after the end of treatment. The degree of disability as measured by ODI lowered evenly in all groups. Patients’ functional ability improved significantly in the group treated with combined manual therapy and proprioceptive neuromuscular facilitation as compared to the group of traditional kinesiotherapy.
OK, so there’s yet another paper the WHO used that’s in favor of SMT. I’m going to try to do a very fast summary of what we’ve learned here, folks.
For the record, I started this series on December 14, 2023 and today is June 10, 2024.
Yes, we’ve been at it for a while now. So, what DID we learn now that we’re at the end of our efforts? For starters, they cherry picked some pretty crappy papers. One was a pilot study. Why would you place the recommendation of a modality in part on a pilot study? Not sure about that. Many of them were very small sample sizes.
More strikingly though were the ages of these papers? Again, we cover new and fresh papers all of the time and low back pain specifically has been covered and covered and covered again in the last 5 – 10 years and almost all papers have been in favor of SMT. So why on Earth is the WHO sourcing and using old papers with mostly small sample sizes? I’m talking about papers from 1978, 1985, 1986, 1992, 2003, 2004, 2007, 2011, 2012, 2012 (pilot study), 2013, 2013.
Yes there are some papers they used that were from 2020, 2019, 2017 or so. But I’d venture a guess that well over 60% of the papers they used were over 10-12 years old and some were as old as 35 years, 38 years, and up to 46 years old. What the holy hell? For real. Wrap your damn heads around that hot garbage. Please tell me there’s an agenda to keep chiropractors in their place without telling me there’s and agenda to keep chiropractors in their place. It’s ponderous.
The final score is:
- In favor of SMT: 19
- Undetermined: 5
- Against: 4
So, you folks do what you will with the information. I don’t know that there’s anything that can be done. It’s the WHO out there doing WHO stuff but I’m telling your right now, them rating SMT at ‘very low confidence’ is incorrect in my opinion and I feel that our little experiment proves it beyond simply ‘my opinion’.
Keep fighting my friends. Lots of work left to do!
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!
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 http://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
The post The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 15) appeared first on Chiropractic Forward.
...more June 06, 2024Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic CF 333: Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic Today we’re going to talk about Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic 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!
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 [email protected] 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 #333 Now if you missed last week’s episode, we talked about Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things….. Nothiing too special is going on with the clinic this week. We’re just doing our deal. Seeing patients. No big events last week and nothing too huge on the horizon other than the big Texas Chiropractic Association convention called ChiroTexpo goign on in Frisco, TX which is basically Dallas. That will be June 28-30 I believe and if you’re in TX or wish you were, come on and join us. We’ve always got a great crown and would love to have you down there. Seminars are a great way to get that continuing education but an even better way to network and develop a little bit of influence. Why not? We sit around and we bitch about the state of our profession.
But are we doing anything at all to influence it? Are you a member of the ACA or your state association? If there are a bunch of subbies running your state association, instead of that being a turn-off, shouldn’t that be an amazing opportunity for you and some of your evidence-based friends to get involved and get yourselves in the seats of influence and control so that you can gently start to turn that air craft carrier the right direction? Instead of seeing the obstacle, see the opportunity. Ryan Holliday wrote a book called The Obstacle Is The Way. I highly recommend it.
I promise, when you walk into a board meeting and you realize that only 15-20 people in your entire state run the association, determine the speakers at your events, fight your fights and battles, etc….then you realize what kind of difference you can make. And I mean rather quickly if there’s a handful of you. So, get it together, get involved, and make this profession respected the way the 2024 brand of chiropractic should be respected. Stop letting the loud-mouthed and angry subbies run the show. It’s your turn now.
Item #1
The first one this week is called “Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer A Systematic Review and Meta-Analysis” by Demb et al and published in JAMA Network Open on May 24, 2024. Aye, Chihuaua!! Es muy caliente! Remember, the citations can be found at chiropracticforward.com under this episode.
Demb J, Kolb JM, Dounel J, et al. Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2024;7(5):e2413157. doi:10.1001/jamanetworkopen.2024.13157
Why They Did It To report the frequency of presenting red flag signs and symptoms among individuals with early-onset colorectal cancer, to examine their association with early-onset colorectal cancer risk, and to measure variation in time to diagnosis from sign or symptom presentation.
How They Did It
- PubMed/MEDLINE, Embase, CINAHL, and Web of Science were searched from database inception through May 2023.
- Studies that reported on sign and symptom presentation or time from sign and symptom presentation to diagnosis for patients younger than age 50 years diagnosed with nonhereditary colorectal cancer were included.
- Data extraction and quality assessment were performed independently in duplicate for all included studies using Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines.
- Joanna Briggs Institute Critical Appraisal tools were used to measure risk of bias. Data on frequency of signs and symptoms were pooled using a random-effects model.
- Outcomes of interest were pooled proportions of signs and symptoms in patients with early-onset colorectal cancer, estimates for association of signs and symptoms with early-onset colorectal cancer risk, and time from sign or symptom presentation to early-onset colorectal cancer diagnosis.
What They Found
- Of the 12,859 unique articles initially retrieved, 81 studies with 24,908 126 patients younger than 50 years were included.
- The most common presenting signs and symptoms, reported by 78 included studies, were hematochezia, abdominal pain, and altered bowel habits.
- Hematochezia (is the passage of fresh blood through the anus, usually in or with stools), abdominal pain, and anemia were associated with higher early-onset colorectal cancer likelihood.
- Time from signs and symptoms presentation to early-onset colorectal cancer diagnosis was a mean of 6.4 months and a median of 4 months.
Wrap It Up
- In this systematic review and meta-analysis of patients with early-onset colorectal cancer, nearly half of individuals presented with hematochezia and abdominal pain and one-quarter with altered bowel habits.
- Hematochezia was associated with at least 5-fold increased early-onset colorectal cancer risk.
- Delays in diagnosis of 4 to 6 months were common.
- These findings highlight the need to identify concerning early-onset colorectal cancer signs and symptoms and complete timely diagnostic workup, particularly for individuals without an alternative diagnosis or sign or symptom resolution.
Item #2
The second one is called, “Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data” by Trager et al and published in BMJ open in
Trager RJ, Cupler ZA, Srinivasan R, et al Association between chiropractic spinal manipulation and gabapentin prescription in adults with radicular low back pain: retrospective cohort study using US data BMJ Open 2023;13:e073258. doi: 10.1136/bmjopen-2023-073258
Why They Did It
Radicular low back pain (rLBP) is often treated off-label with gabapentin or by chiropractors using chiropractic spinal manipulative therapy (CSMT). To date, no studies have examined the association between these interventions. We hypothesised that adults under 50 years of age receiving CSMT for newly diagnosed rLBP would have reduced odds of receiving a gabapentin prescription over 1 year-follow-up.
How They Did It
Retrospective cohort study. Setting US network including linked medical records, medical claims and pharmacy claims of >122 million patients attending large healthcare organisations (TriNetX), queried 15 June 2023, yielding data from 2017 to 2023.
Participants Adults aged 18–49 were included at their first occurrence of rLBP diagnosis. Exclusions were severe pathology, other spinal conditions, on-label gabapentin indications and gabapentin contraindications. Propensity score matching controlled for variables associated with gabapentin use and receipt of prescription medication over the preceding year. Interventions Patients were divided into CSMT or usual medical care cohorts based on the care received on the index date of rLBP diagnosis. Primary and secondary outcome measures OR for gabapentin prescription.
What They Found
- After propensity matching, there were 1635 patients per cohort.
- Gabapentin prescription over 1-year follow-up was significantly lower in the CSMT cohort compared with the usual medical care cohort, with an OR of 0.53.
- Sensitivity analyses revealed early divergence in cumulative incidence of prescription; and no significant between-cohort difference in a negative control outcome (gastrointestinal medication) suggesting adequate control for pharmacological care preference.
Wrap It Up
- Our findings suggest that US adults receiving CSMT for newly diagnosed rLBP have significantly reduced odds of receiving a gabapentin prescription over 1-year follow-up compared with those receiving usual medical care.
- Results may not be generalisable and should be replicated in other healthcare settings and corroborated by a prospective study to reduce confounding.
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!
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 http://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
The post Colo-Rectal Cancer Recognition & Less Gabapentin With Chiropractic appeared first on Chiropractic Forward.
...more May 30, 2024Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion CF 332: Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion Today we’re going to talk about Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion 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!
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 [email protected] 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 #332 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14). We’re coming to the end of the series and will be wrapping it up soon. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things….. I’m typing this out after the Memorial Day weekend here in 2024. They just ran the 150th Kentucky Derby this month and guess what?? I just got back from a trip to Louisville KY for a high school graduation and you better believe your sweet behind that we took that opportunity to go to Churchill Downs and bet on some horses! We won about $5 overall so I’ll take it. We’re not big on gambling so it’s not about the money. It was about the experience and it was quite the experience. What a place. Pretty historic and pretty special. If you’re friends with me on Facebook, go check out the pics and videos.
My 16 year old daughter had never been to the horse races before and she had big ol’ wide eyes. She thought it was pretty darn cool! When you go to Louisville, AKA Bourbon Town, you have to bourbon a little so I had some smoked old fashions out there. One had bacon in it. I wasn’t too excited when they brought it to the table but it was yummo, folks.
Who knew?
Since we had Monday off, we have a short week which means I need to get on with this podcast and get back to work ASAP, mi amigo so let’s get right to it.
Item #1
Our first one this week is called, “Lower individual alpha frequency in individuals with chronic low back pain and fear of movement” by Ho et al and published in Pain Journal in May 2024 and it’s so incredibly en fuego! Remember, the citations can be found at chiropracticforward.com under this episode.
Ho, Rachel L.M.a; Park, Jinhana; Wang, Wei-ena; Thomas, James S.b; Cruz-Almeida, Yeniselc; Coombes, Stephen A.a,*. Lower individual alpha frequency in individuals with chronic low back pain and fear of movement. PAIN 165(5):p 1033-1043, May 2024. | DOI: 10.1097/j.pain.0000000000003098
Why They Did It
- Significant progress has been made in linking measures of individual alpha frequency (IAF) and pain.
- A lower individual alpha frequency has been associated with chronic neuropathic pain and with an increased sensitivity to pain in healthy young adults.
- However, the translation of these findings to chronic low back pain (cLBP) are sparse and inconsistent.
How They Did It
- They assessed individual alpha frequencys in a cohort of 70 individuals with cLBP,
- implemented 3 different individual alpha frequency calculations,
- and separated cLBP subjects based on psychological variables.
- They hypothesized that a higher fear movement in cLBP is associated with a lower individual alpha frequency at rest.
- A total of 10 minutes of resting data were collected from 128 electroencephalography channels.
What They Found
- Our results offer 3 novel contributions to the literature. First, the high fear group had a significantly lower peak alpha frequency.
- The high fear group also reported higher pain and higher disability.
- Second, we calculated individual alpha frequency using 3 different but established methods; the effect of fear on individual alpha frequency was robust across all methods.
- Third, fear of movement, pain intensity, and disability highly correlated with each other and together significantly predicted individual alpha frequency.
Wrap It Up They say, “‘Our findings are the first to show that individuals with cLBP and high fear have a lower peak alpha frequency.”
Item #2
Our last one this week is called, “McKenzie neck exercise versus cranio-cervical flexion exercise on strength and endurance of deep neck flexor muscles, pain, disability, and craniovertebral angle in individuals with chronic neck pain: a randomized clinical trial” by Chaiyawijit et al and published in Journal of Manual and Manipulative Therapy in October of 2023 and that’s some smoky sausage. Jalapeno flavored. Chaiyawijit, S., & Kanlayanaphotporn, R. (2024). McKenzie neck exercise versus cranio-cervical flexion exercise on strength and endurance of deep neck flexor muscles, pain, disability, and craniovertebral angle in individuals with chronic neck pain: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 1–11. https://doi.org/10.1080/10669817.2024.2337979
Why They Did It To compare the effectiveness of McKenzie neck exercise and cranio-cervical flexion (CCF) exercise on strength and endurance of deep neck flexor (DNF) muscles, pain, disability, and craniovertebral angle (CVA) in individuals with chronic neck pain.
How They Did It
- Forty individuals with chronic neck pain were randomly allocated to the McKenzie neck or cranio-cervical flexion exercise group.
- Each group performed exercises at home daily.
- The strength and endurance of deep neck flexor muscles were measured at baseline, immediately after the first exercise session, and each week follow-up for six weeks.
- Average pain over the past week was measured at baseline and each week follow-up for six weeks.
- Disability and craniovertebral angle were measured at baseline and the end of six weeks.
What They Found
- At six weeks, both groups exhibited significant improvements across all outcome variables but there were no differences between groups.
- The significant difference from baseline in the strength of deep neck flexor muscles was observed as early as the second week of each intervention.
- The significant difference from baseline in the endurance of deep neck flexor muscles was observed as early as the first week in the cranio-cervical flexion exercise group and the second week in the McKenzie neck exercise group.
- A significant decrease in pain intensity from baseline was observed after the first week in the McKenzie neck exercise group while it was after the second week in the cranio-cervical flexion exercise group
Wrap It Up
Both the McKenzie neck exercise and cranio-cervical flexion exercise produced similar effects in enhancing the strength and endurance of the deep neck flexor muscles, decreasing pain, alleviating neck disability, and improving the craniovertebral angle. And now you know stuff you didn’t already know.
You’re welcome!
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!
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 http://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
The post Individual Alpha Frequency & McKenzie vs. Cranio-Cervical Flexion appeared first on Chiropractic Forward.
...more May 23, 2024The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14) CF 331: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14) 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!
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 [email protected] 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 #331 Now if you missed last week’s episode, we talked about Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things…..
It’s a week of still growing. I think. We are currently in the best month we’ve been in since maybe COVID times. It’s been encouraging. I think there are a few things at work and I’m not sure I’m right about any of it. If you remember more recently, I’ve mentioned that we were in a business valley and that we were using that time to gear up with marketing and trying to make things happen that we haven’t had to make happen in a few years.
Well, Here’s what I think
We started a Cross-promotions campaign partnering with other local companies. We promote their business for one month while they promote our business for one month.
We changed website companies 6 months ago and have moved from the mid-20s up to about position #7 now so our Google SEO is finally getting back on track and should continue to improve.
External marketing: now that we aren’t constantly battling with staff turnover every single month, we have some stability and have been more able to go around in our community marketing our clinic and taking goodies to people that we know can and will refer to us. Strengthening relationships and making people happy.
The VA used to send us 5-6 new veterans just about every week. Then they hired their own DC out there at the hospital and the referrals went down to about 2 a month. That was a big hit but I felt that would be short-lived. There are simply too many veterans in the program for one chiro to adequately sustain the treatment on them.
Plus, a new vet referral yesterday notified me that the DC has already put in his notice and is leaving. I’m not sure if that’s a fact or not but the point is; the VA business seems to be coming back. If they’re booked out more than 28 days, the vets get to pick where they want to go.
Well….they’re booked out so hopefully we’re starting to see the vets come back here where we can see them more regularly and take better care of them. So those are some of the things that I think have gone right for us in the last 6 months or so. Which we desperately needed.
Honestly, in December….it was pretty bad. Reminds me of that Merle Haggard song..’If We Make It Through December’. It was slim Pickens around here in December. Which led to A LOT of brainstorming and action on my part.
Which brings up another thing – being alone. Being the owner and chiro at your clinic can get lonely. You feel that it’s all up to you and guess what….it is. But if that bothered you, you wouldn’t have opened up in the first place now, would you?
But it can get lonely. You just learn to count on yourself. When the chips are down, you look at your history, what’s worked in the past? You look at marketing, picking yourself up, maybe innovating, maybe some team meetings, maybe a new attitude. I was ready to retire and check out this time last year. This time this year….today….I’m in the fight and am fully engaged. And it shows in my stats and numbers.
Let’s get to it
We are coming to an end to the WHO series and I know my friend Dr. Steve Brown will be glad to hear it. Lol. The WHO says smt is recommended but only with very low confidence and I think that’s bunk so we’ve spent some time every other week diving into every paper they used to make that determination. After the two we have today, we’ll have one left and then summarize it a bit. That’ll be in two weeks so look for it
Item #1
The first one today is called, “Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation” by Xia et al and published in Spine Journal in June of 2016. Remember, the citations can be found at chiropracticforward.com under this episode.
Xia T, Long CR, Gudavalli MR, Wilder DG, Vining RD, Rowell RM, Reed WR, DeVocht JW, Goertz CM, Owens EF Jr, Meeker WC. Similar Effects of Thrust and Nonthrust Spinal Manipulation Found in Adults With Subacute and Chronic Low Back Pain: A Controlled Trial With Adaptive Allocation. Spine (Phila Pa 1976). 2016 Jun;41(12):E702-E709. doi: 10.1097/BRS.0000000000001373. PMID: 26656041; PMCID: PMC4902754.
Why They Did It
The aim of this study was to compare the short-term effects of a side-lying, thrust spinal manipulation (SM) procedure and a nonthrust, flexion-distraction SM procedure in adults with subacute or chronic low back pain (LBP) over 2 weeks.
How They Did It
- Participants were eligible if they were 21 to 54 years old, had LBP for at least 4 weeks, scored 6 or above on the Roland-Morris disability questionnaire, and met the diagnostic classification of 1, 2, or 3 according to the Quebec Task Force Classification for Spinal Disorders.
- Participants were allocated in a 3:3:2 ratio to four sessions of thrust or nonthrust SM procedures directed at the lower lumbar and pelvic regions, or to a 2-week waitlist control.
- The primary outcome was LBP-related disability using the Roland-Morris Disability Questionnaire and the secondary outcomes were LBP intensity using the visual analog scale, the Fear-Avoidance Beliefs Questionnaire, and the 36-Item Short Form Health Survey.
- The study was conducted at the Palmer Center for Chiropractic Research with care provided by experienced doctors of chiropractic.
- Clinicians and patients were not blinded to the treatment group.
What They Found
- Of 192 participants enrolled, the mean age was 40 years and 54% were male.
- Improvement in disability, LBP intensity, Fear-Avoidance Beliefs Questionnaire-work subscale, and 36-Item Short Form Health Survey-physical health summary measure for the two SM groups were significantly greater than the control group.
- No difference in any outcomes was observed between the two SM groups.
Wrap It Up
Thrust and nonthrust SM procedures with distinctly different joint loading characteristics demonstrated similar effects in short-term LBP improvement and both were superior to a waitlist control. How do the chiros that only think thrust, cavitations, and aggressive treatment reconcile that exactly?
I guess it’s not about the noise and more about movement then, right? That’s what I thought.
Item #2 “Clinical research on lumbar oblique-pulling manipulation in combination with sling exercise therapy for patients with chronic nonspecific low back pain” by Wang et al and published in July 2019 in Revista da Associacao Medica Brasileira.
Wang SQ, Chen M, Wei X, Gao XX, Zhao GD. Clinical research on lumbar oblique-pulling manipulation in combination with sling exercise therapy for patients with chronic nonspecific low back pain. Rev Assoc Med Bras (1992). 2019 Jul 22;65(6):886-892. doi: 10.1590/1806-9282.65.6.886. PMID: 31340321.
Why They Did It To investigate clinical curative effects of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training on chronic nonspecific lower back pain.
How They Did It
- A total of 60 patients with chronic nonspecific lower back pain in the Outpatient Department were included in this study.
- These patients were randomly divided into two groups: the observation group and the control group.
- The control group adopted a single sling-exercise-therapy training three times a week, while the observation group adopted lumbar oblique-pulling manipulation in combination with manipulation treatment once a week. The course of treatment lasted for four weeks.
What They Found
- Before and after treatment, the ODI score was compared within the group. A remarkable statistical significance was observed from the third day. At the third month of follow-up, the difference in ODI scores between these two groups was statistically significant.
- Before and after treatment, it was observed that differences in VAS scores from the third day were statistically significant.
- The difference in muscle strength between these two groups had remarkable statistical significance in the third month of follow-up
Wrap It Up
The effective rehabilitation function of lumbar oblique-pulling manipulation in combination with sling-exercise-therapy training in patients with chronic non-specific low back pain is superior to that of sling-exercise-therapy training alone. Still trying to figure out why they put us at very low confidence. I wonder what the hell got 80% or more and wound up with all of the confidence, quite honestly. Someone needs to track it down and let us all know. 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!
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 http://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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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
The post The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 14) appeared first on Chiropractic Forward.
...more May 16, 2024Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel CF 330: Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel Today we’re going to talk about Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel 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!
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 [email protected] If you haven’t yet I have a few things you should do.
- Go to Amazon and check out my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an 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 #330 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13). Make sure you don’t miss that info. Keep up with the class.
On the personal end of things….. What a week so far…..it’s always something isn’t it? While we are still working on the staffer in a bad relationship that I discussed last week, we had what we call a turdfloater here in the Texas panhandle. That rain and hail storm caused an already problematic roof to become even more problematic. Now we have three massage/acupuncture rooms that have wet carpets and smell moldy. This smell has permeated and percolated throughout the entire office now. Also, SONOS decided to do another update and now my music won’t play through the office. The IT guy is working on it. So, if you’ve heard me say that owning a clinic is like a big game of whack-a-mole…..it is. Something new daily. If not daily, definitely weekly.
But, all in all, I have to say, this has been one of the best months business-wise that I’ve had since before COVID. It’s a Tuesday and I have 153 lined up for the week. We know that will increase because Wednesday appointments will reschedule for Friday so it’s looking like a solid week.
Our acupuncturist has 31 on the schedule this week and our nurse practitioner has only 26 which is down from last week but, again, I’m typing this out on a Tuesday.
We use BlueIQ and we are FAR ahead of expectations for the month of May at the moment and it’s showing no signs of lightening up. I’m back to using my 7 account system and putting money away…..I have some staffing issues but overall, things are looking pretty positive. You get to hear me gripe when the tide is against me. You might as well hear me be positive when I’m going with the tide.
Item #1 The first one today is called “Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA” by Trager et. Al. and published in BMJ Open in June of 2022 Remember, the citations can be found at chiropracticforward.com under this episode. Trager RJ, Cupler ZA, DeLano KJ, Perez JA, Dusek JA. Association between chiropractic spinal manipulative therapy and benzodiazepine prescription in patients with radicular low back pain: a retrospective cohort study using real-world data from the USA. BMJ Open. 2022 Jun 13;12(6):e058769. doi: 10.1136/bmjopen-2021-058769. PMID: 35697464; PMCID: PMC9196200.
Why They Did It Although chiropractic spinal manipulative therapy (CSMT) and prescription benzodiazepines are common treatments for radicular low back pain (rLBP), no research has examined the relationship between these interventions. We hypothesize that utilization of SMT for newly diagnosed rLBP is associated with reduced odds of benzodiazepine prescription through 12 months follow-up.
How They Did It Retrospective cohort study. Setting: National, multicentre 73-million-patient electronic health records-based network (TriNetX) in the USA, queried on 30 July 2021, yielding data from 2003 to the date of query.
Participants: Adults aged 18-49 with an index diagnosis of rLBP were included. Serious etiologies of low back pain, structural deformities, alternative neurological lesions and absolute benzodiazepine
Outcome measures: The number, percentage and OR of patients receiving a benzodiazepine prescription over 3, 6 and 12 months’ follow-up prematching and postmatching.
What They Found 9206 patients per cohort. Odds of receiving a benzodiazepine prescription were significantly lower in the CSMT cohort over all follow-up windows prematching and postmatching Sensitivity analysis suggested a patient preference to avoid prescription medications did not explain the study findings.
Wrap It Up These findings suggest that receiving CSMT for newly diagnosed rLBP is associated with reduced odds of receiving a benzodiazepine prescription during follow-up. These results provide real-world evidence of practice guideline-concordance among patients entering this care pathway.
Item #2 Our second paper today is called, “Efficacy of topical curcumin on mild to moderate carpal tunnel syndrome: a randomized double-blind, placebo-controlled clinical trial” by Razavi et al and published in Pain Medicine in May of 2024 and it’s a hot one, folks!! Athena Sharifi Razavi, Fatemeh Mohajerani, Fatemeh Niksolat, Narges Karimi, Efficacy of topical curcumin on mild to moderate carpal tunnel syndrome: a randomized double-blind, placebo-controlled clinical trial, Pain Medicine, Volume 25, Issue 5, May 2024, Pages 327–333, https://doi.org/10.1093/pm/pnae001
Why They Did It Recently, there has been a renewed interest in traditional medicine for carpal tunnel syndrome (CTS). Curcumin has been reported as an agent with antioxidant, anti-inflammatory, analgesic, and neuroprotective attributes. This study is one of the first investigations to assess the effect of curcumin gel on CTS.
How They Did It
- This study is a prospective, 8-week, randomized, placebo-controlled, parallel-group clinical trial.
- A total of 70 patients with CTS were analyzed.
- The intervention group (n = 35) received a topical curcumin gel and a night wrist splint and the control group (n = 35) received a placebo gel and a night wrist splint for 8 weeks.
- The primary outcome was the assessment of the symptom severity scale (SSS) and functional status scale (FSS) of the participants using the Boston Carpal Tunnel Questionnaire (BCTQ) after 8 weeks. In addition, all participants were evaluated by electrodiagnostic (EDX) test at baseline and after 8 weeks.
What They Found
- The mean scores of SSS demonstrated a significant decrease in the curcumin group compared to the placebo group; P-value= 0.021.
- The mean change score of SSS after the intervention was 12.45 ± 8.18 in curcumin and 3.28 ± 7.06 in the placebo group; P-value = 0.0001 and the mean change score of FSS were 6.24 ± 4.91 and 2.31 ± 4.95 in curcumin and placebo groups, respectively; P-value = 0.002.
- However, the EDX study showed no significant changes in both groups.
Wrap It Up
It seems that curcumin gel could be effective in the improvement of the symptom severity and daily activity of patients with CTS. 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!
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 http://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
The post Chiropractic And Benzodiazepine & Curcumin And Carpal Tunnel appeared first on Chiropractic Forward.
...more May 09, 2024The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) CF 329: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) 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!
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 [email protected] 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 #329 Now if you missed last week’s episode, we talked about current tendinopathy thoughts and chiropractic vs. medical costs. Make sure you don’t miss that info. Keep up with the class.
On the personal end of things…..
Well the week is already starting off with a bang and not in a great way either. First thing this morning, I found out one of my employee’s was abused by her ex over the weekend. Broke into her house, prevented her from leaving, and beat her while the 4-year-old was in the house. For a whole weekend. You should see the girl’s leg. It’s insane.
So, as an employer, what do you do? Believe it or not, this isn’t the first time we’ve had our go around with crap heads like this. I don’t understand some boys. I say boys because they’re not men. Men respect, support, and boost up women. They don’t do what this guy has been doing. I can tell you what we do. We are pulling out all the stops to get this girl all of the help our area non-profits have to offer. We’re getting her a protective order.
We’re getting her housing. We’re getting her as far from danger as we can as quickly as we can. I’ve put my staff on notice about this guy. He’s already called the office today, by the way. They all know his name and what he looks like and my cop friend says call 911 if he shows his face. I have protection here should it come to that but it won’t.
This guy just likes to beat up and try to control and intimidate women that lack the confidence and support to do something about it.
Well, she’s got that now and I think he’s going to have a hard time ever doing something like this again. I tell you this because most of you listening are probably clinic owners yourself. In 26 years in practice, something similar with regards to being hyper aware of an individual that could come to the clinic, has happened maybe 3-5 times or so.
Once or twice it was a unstable patients. The other times, it’s been spouses, all male, all in need of hard-learned lessons.
It’s stressful. It makes everyone in the office anxious. Being a business owner is hard and some things like this we just cannot control. But we can be aware and we can be vigilant. We can help our team mate make the best decisions and we can do our part to try to make sure she’s protected to the very best of our ability. Like I said, my entire staff knows the plan, knows what he drives, knows his name, and knows exactly what he looks like.
It’s a journey and this week is just a little different from our regular journey. But, we’re making it happen, getting patients better while our team helps walk her through this.
Alright, on with the research. We are continuing our series we are doing every other week where we are trying to figure out what brand of crack the WHO was smoking when they chose and used citations to deem spinal manipulative therapy as being effective at ‘very low confidence’ recently. Two of those papers are covered in this episode.
Item #1
Our first one today is called, “Short term trial of chiropractic adjustments for the relief of chronic low back pain“ by Waagen et al and published in Manual Medicine in 1986. This one is so old that it can hardly be found.
Literally, I had search and search Remember, the citations can be found at chiropracticforward.com under this episode.
Waagen GN et al. Short term trial of chiropractic adjustments for the relief of chronic low back pain. Manual Med. 1986;2:63-67.
A double-blind study of the efficacy of spinal adjustive therapy delivered by chiropractors was designed and implemented at the clinic of a chiropractic college. Nineteen patients with low back pain completed a nominal two-week period of treatment. Nine patients in the experimental group received a series of chiropractic ‘adjustments’, while ten control patients received a comparable series of manual interventions. Experimental patients had significantly more relief from pain than control patients immediately after being treated as measured on a 10 cm visual analogue scale. After two weeks of treatments the experimental patients as a group exhibited significant overall pain relief, whereas improvement of patients in the control group was not significant. Using a global index for the objective measurements of change in spinal mobility it was also concluded that experimental patients improved significantly compared to control patients Because of the small sample size the results reported must be considered preliminary. Modification in the research design from other trials studying manipulative therapy included the use of chiropractic adjustments as the form of manipulation, use of a realistic manual control treatment and use of a global index as an outcome measure. So yes….it’s in our favor but….it’s a tiny sample size and it’s 38 years old. So why is the WHO using it?
Item #2
Your second one this week is called, “Short-term usual chiropractic care for spinal pain: a randomized controlled trial” by Walker et al and published in Spine Journal 11 years ago back in 2013.
Walker B.F et al. Short-term usual chiropractic care for spinal pain: a randomized controlled trial. Spine (Phila Pa). 2013;38(24):2071-2078. doi: 10.1097/01.brs.0000435032.73187.c7.
Why They Did It
The authors wanted to establish the short-term effectiveness of chiropractic therapy for spinal pain compared with a sham intervention and explore the predictors of chiropractic treatment satisfaction. Chiropractic treatment is widely used for spinal pain. However, a lack of sound evidence precludes conclusions about the effectiveness of chiropractic for spinal pain.
How They Did It
- Participants were adults experiencing spinal pain, randomized to receive 2 treatments of chiropractic or sham therapy.
- Participants and outcome assessors were blinded to group allocation.
- Primary outcomes at 2 weeks were NRS and Functional Rating Index).
- Secondary outcomes were global change, minimum acceptable outcome, and treatment satisfaction.
- Treatment effects were estimated with linear mixed models for the primary outcomes.
- And they used logistic regression to identify differences in the secondary outcomes and explore for predictors of treatment satisfaction.
What They Found
- One hundred eighty three participants were recruited and included in the analyses.
- Participants receiving chiropractic therapy reported greater improvements in pain, physical function, and were more likely to experience global improvement and treatment satisfaction.
- There was no between-group difference in achieving a minimally acceptable outcome.
- Awareness of treatment assignment and achieving minimally important improvement in pain intensity were associated with chiropractic treatment satisfaction.
Wrap It Up
Short-term chiropractic treatment was superior to sham; however, treatment effects were not clinically important. Awareness of treatment assignment and clinically important reductions in pain were associated with chiropractic treatment satisfaction
Alright, another puzzling episode of why does the WHO include garbage crap papers to decide if spinal manipulation is effective? I maintain that there is an agenda of some sorts that is bias against chiropractic.
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!
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 http://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
The post The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) appeared first on Chiropractic Forward.
...more May 02, 2024Current Tendinopathy Thoughts & Chiropractic Vs. Medical Costs CF 328: Current Tendinopathy Thoughts & Chiropractic Vs. Medical Costs Today we’re going to talk about Current Tendinopathy Thoughts & Chiropractic Vs. Medical Costs 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!
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 [email protected] 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 #328 Now if you missed last week’s episode, we talked about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 12). Make sure you don’t miss that info. Keep up with the class.
On the personal end of things…..
I have a good friend that just recently went through a health scare. As he told me, this is how it went; he was on his back porch or patio down on the Texas gulf when he woke up in the ER. Yeah, it was about that simple. Just tooling around doing his stuff and the next thing you know, waking up in the hospital not knowing what the hell, where, why or come here from sic ‘em.
He said, “Ultrasound was negative bilaterally for lower extremity DVT’s. Echocardiogram was negative for heart damage of clots. Labs negative for stroke or heart attack. Head and neck CT clear. All they found was chest CTA of pulmonary emboli. And I don’t know where they are in the lungs or if there’s 2 or 50. I have no idea why or when I fell on my back porch. I could’ve been out 30 seconds or 6.5 hrs. There’s a lot I don’t know. It bothers the hell outta me. It was dumb luck or divine intervention I made it back inside to my phone to call 911. I remember about 90 seconds total of EMT’s.” Now, why am I telling you about my friend’s little journey, here?? Because it’s crazy and I’m glad he is still around to tell the tale. I told him that the only thing mildly comforting about it all is that when it’s our time to go, there is a good chance we won’t know it or feel it.
That’s my positive take away.
And…..It’s a reminder to make our days count and tell our people how much we love them And…..it’s a helluva a reminder to work your butt off. That’s what we do when we’re trying to build a business, changer generational wealth for our family, and leave a legacy or sorts. BUT…..and it’s a big but that I’m so very guilty of to this very day…….make time for the work life balance and hugging your people.
It’s a reminder for us to try our best to have goals and a dream but to be absolutely grateful and satisfied with the here and now as well. Today is the gift. We’re not guaranteed tomorrow. It’s hard to focus on that when you’re buried in the mud and muck but I want to strive to do better than I have been doing, being more positive, being more patient, being more understanding, but still just as driven and goal-oriented as I’ve always been. We’re going to get tired no matter how much we make ourselves grin. But if we can keep an eye on our blessings and the good things and our friends and our family and our amazing patients, then I don’t know about you, but I bet my days will for sure be better overall. I’m tired today. I’m poopered you might say.
My business has been slower due to a thing or two that are simply out of my hands. But, I’m grateful. I have health, I have my friends, family, and still have a pretty dang solid business and education. We gonna be fine. See? I already feel better and thanks to my buddy who gave me his blessing to share the story with you. He also asked me to share a blurb from James 4:14 that says, “Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes.”
Alright, lets get on with the research shall we? We got some good ones this week!
Item #1
The first one today is called, “Current understanding of the diagnosis and management of the tendinopathy: An update from the lab to the clinical practice” by Canosa-Carro et al published in Disease-a-Month in October of 2022. Remember, the citations can be found at chiropracticforward.com under this episode.
Lorena Canosa-Carro, María Bravo-Aguilar, Vanesa Abuín-Porras, Jaime Almazán-Polo, Guillermo García-Pérez-de-Sevilla, Isabel Rodríguez-Costa, Daniel López-López, Emmanuel Navarro-Flores, Carlos Romero-Morales, Current understanding of the diagnosis and management of the tendinopathy: An update from the lab to the clinical practice, Disease-a-Month, Volume 68, Issue 10, 2022, 101314, ISSN 0011-5029, https://doi.org/10.1016/j.disamonth.2021.101314. (https://www.sciencedirect.com/science/article/pii/S0011502921001905)
Why They Did It
Tendinopathy is currently diagnosed as a clinical hypothesis based on the patient symptoms and physical context. One of the main goals of current clinical management is to personalize treatment approaches to adapt them to the many different needs of the population. Even when the pathoetiology of tendinopathy is unclear, there is a wide array of treatments available to treat and manage tendinopathy. Although tendinitis usually debuts with an inflammatory response, the majority of chronic tendinopathies do not present inflammation and so the choosing of treatment should vary depending on severity, compliance, pain and duration of symptoms.
This research paper examines tendinopathy, a common overuse injury. While the exact cause is unclear, repetitive stress likely plays a role. Common treatments focus on managing symptoms and preventing future issues. Exercise, especially eccentric exercises, is the gold standard for treatment. However, other exercises like isometric training may also be helpful. Importantly, increasing exercise load gradually (10% rule) is crucial to avoid further injury.
Wrap It Up Current advances and research in tendinopathy shows that even though there is still a lot we do not know, conservative treatment through exercise and load management should be the first source of treatment, aided by other conservative treatments like ShockWave. Surgical approach should only be used as a last resource once the conservative options have failed after six to twelve months of treatment. Future research lines are necessary in order to achieve a consensus of exercises dosage, intensity and type.
Item #2
Our last one today is called “Cost of chiropractic versus medical management f adults with spine-related musculoskeletal pain: a systematic review” by Farabaugh et al and published in Chiropractic & manual Therapies in 2024 and it’s gettin hot in here!
Farabaugh, R., Hawk, C., Taylor, D. et al. Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review. Chiropr Man Therap 32, 8 (2024). https://doi.org/10.1186/s12998-024-00533-4
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.
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!
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 http://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 – Diplomated of the International Academy of Neuromusculoskeletal Medicine (DIANM) 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
The post Current Tendinopathy Thoughts & Chiropractic Vs. Medical Costs appeared first on Chiropractic Forward.
...more April 25, 2024The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 12) CF 327: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 12)
Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 12) 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!
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. 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 #327 Now if you missed last week’s episode, we talked about SMT and Cauda Equine and SMT and Discectomy. Make sure you don’t miss that info. Keep up with the class. On the personal end of things…..
I recently returned from my Mastermind trip out to Nashville and we had a big time. We had a company called Vision Spark come to speak with us about hiring staff the proper way and it was enlightening. I think the whole group got lots of great ideas out of it.
Mastermind leader, Kevin Christie, shared some techniques and software he’s been using to create training modules and manuals for his office staff onboarding when necessary. Really cool stuff. Mastermind members Emma Minx and Jonathan Saigh from Wisconsin shared a new place to find qualified hires instead of Indeed. Which is outstanding because, honestly, Indeed has trashed the hiring process. In lots of ways but since Indeed came about, we have had them not show up for interviews around 50% of the time, we have hired candidates no less than 4 times where they accepted our job, gave their 2-weeks notice at their other job and after waiting out that 2 weeks….they never showed up at our job so we had to start over…. Indeed is garbage so that’s nice to have another technique or pond to fish in.
I got to hang out with Mike Massey for a while, which is always a pleasure. We talked about practice, bee keeping, music, and all of the worldly problems that we felt we could solve in one night.
Mastermind Dr. Anthony Houssain out in Huntsville Alabama shared that he’s saved over $1000 a month by changing to his current credit card processor. So that will be nice to get going I got our new billing and collections company from members Gerry Mitchell and Curt Kippenberger.
We all went out and acted like teenagers on Broadway in Nashville for a few nights. I watched Lindsey Mumma dance and sing to Shoop by Salt n Pepa and talked to Tiffany and Tyler Armstrong about decompression.
We’re looking forward to visiting Doug Krebs’s practice when we go out to Chicago for the next mastermind meeting.
My point being; get you a mastermind. If you don’t know where to find one, Dr. Christie still has some room in his Western Mastermind. Mine is the Eastern Mastermind and my group is full but still room in the Western group. If you’re interested, email Dr. Christie at [email protected] and start the conversation.
Item #1 We are continuing our series on why the hell the WHO has recommended spinal manipulative therapy at only very low confidence. I’m calling BS so I went and found all of the research they cited for this hullabaloo and going through it one at a time with you all here on the podcast.
The first one is called, “Osteopathic manipulative treatment in obese patients with chronic low back pain: a pilot study” by Vismara et. Al. and published in Manual Therapy in 2012. And why the hell are they basing their opinion and recommendation of SMT on a pilot study? This is the whole point of it. For better or worse, don’t we have better research available to base the whole profession on?
The answer is yes….yes we do.
Remember, the citations can be found at chiropracticforward.com under this episode.
Luca Vismara, Veronica Cimolin, Francesco Menegoni, Fabio Zaina, Manuela Galli, Stefano Negrini, Valentina Villa, Paolo Capodaglio, Osteopathic manipulative treatment in obese patients with chronic low back pain: A pilot study, Manual Therapy, Volume 17, Issue 5, 2012, Pages 451-455, ISSN 1356-689X, https://doi.org/10.1016/j.math.2012.05.002.
(https://www.sciencedirect.com/science/article/pii/S1356689X12000987)
Why They Did It Obesity is frequently associated with various musculoskeletal disorders including chronic low back pain (cLBP). Osteopathy is a discipline emphasizing the conservative treatment of the disease in an holistic vision. We designed a randomized controlled study to investigate whether Osteopathic Manipulative Treatment (OMT) combined with specific exercises (SE) is more effective than specific exercises alone in obese patients with cLBP.
How They Did It Nineteen obese females with cLBP, randomized into 2 groups: 1. specific exercises + Osteopathic Manipulative Treatment and 2. specific exercises alone were studied during the forward flexion of the spine using an optoelectronic system. A biomechanical model was developed in order to analyse kinematics and define angles of clinical interest.
What They Found Significant effects on kinematics were reported only for Osteopathic Manipulative Treatment + specific exercises with an improvement in thoracic range of motion of nearly 20%. All scores of the clinical scales used improved significantly. The greatest improvements occurred in the Osteopathic Manipulative Treatment + specific exercises group.
Wrap It Up Combined rehabilitation treatment including Osteopathic Manipulative Treatment (Osteopathic Manipulative Treatment + specific exercises) showed to be effective in improving biomechanical parameters of the thoracic spine in obese patients with cLBP. Such results are to be attributed to Osteopathic Manipulative Treatment, since they were not evident in the specific exercises group. We also observed a reduction of disability and pain. The clinical results should be considered preliminary due to the small sample size.
Item #2 The last one this week is called, “Pain, Range Of Motion And Back Strength In Chronic Mechanical Low Back Pain Before and After Lumbar Mobilixation”” by Verma et al published in International Journal Of Physiotherapy and Research in 2013.
Verma, Y., & Goyal, M. (2013). PAIN, RANGE OF MOTION AND BACK STRENGTH IN CHRONIC MECHANICAL LOW BACK PAIN BEFORE & AFTER LUMBAR MOBILISATION.
Both papers we are covering are from 2012 and 2013 so 11 and 12 years old and one of them is a pilot study. Just seeing if you all are keeping score here.
Why They Did It Joint mobilisations in the spine are used as an integral part of the treatment and rehabilitation to alleviate pain and reduce stiffness. Mobilisation has also been used to improve muscle strength as described in the literature. However, there is dearth of data exploring the effect of mobilisation on muscle strength in CLBP. Purpose:To investigate the effects of lumbar mobilisation on pain, range of motion and back strength chronic mechanical low back pain patients.
How They Did It Thirty subjects with chronic back pain participated in the randomized clinical trial. The effects of lumbar mobilisation & exercises were compared with the exercises alone. Pain levels were measured using visual analog scale, lumbar extension range of motion using modified Schobers test and strength by back-leg-chest dynamometer. Measurements were done before & after 2 and 4 weeks respectively.
What They Found A significantly greater improvement in pain, ROM, and strength after 4 weeks in experimental group than the control group.
Wrap It Up This study therefore provides experimental evidence to support the use of lumbar mobilization along with the exercises for the management of patients with chronic mechanical low back pain, who responded favorably to the intervention.
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!
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 http://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
The post The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 12) appeared first on Chiropractic Forward.
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