The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 353: Head And Neck Cancer & Degenerative Cervical Myelopathy Today we’re going to talk about Head And Neck Cancer & Degenerative Cervical Myelopathy 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. 

You have found yourself smack dab in the middle of Episode #353

Now if you missed last week’s episode, we talked about PT In The ER & Back Pain And Mortality. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Well, let’s see, what’s up this week? I think we’re picking up a little. We had 155 chiro visits last week and being a Monday when I’m sitting down and thinking about all this, we have 47 today which includes 3 new patients and 4 re-exams so we’re looking pretty good.  At the moment Monday morning, we have 134 set up for the whole week. Some will fall off and some will hop onto the schedule.

That’s just the deal but Wednesday folks will re-book on Friday and Tuesday folks will re-book on Thursday or Friday so I’m betting we wind up back around the 150-155 mark if not more.  We shall see. The story is that I’m still not where I was prior to COVID which is super frustrating. Back then I was around 180-200 per week. Which if I’m being honest, is too much for me. I’m too old for that. I’m actually pretty happy with 155-165.  But, have you considered your future? I know two folks with two different stories I’ll share. 

One worked his whole life until he was diagnosed with cancer when he was in his 60s. He didn’t have an exit plan. He ended up passing away and his practice at that point was worthless and there was nothing to sell. Nothing. I don’t want that for you.  The other died in his office working at about 75 or 80 years old. Now, this guy, I don’t believe in bad shape financially. I think he loved his job. But I also don’t want you forced into working into your 70s or 80s because you have failed to plan and you don’t have an exit plan. 

So, start at the end and work backward. What do you want your retirement to look like? What age would you like to retire? I’d recommend getting a wealth planner to help you plan it out, set goals, and keep you on track to reaching those goals.  How much do you have to make and how much do you need to be investing monthly? What other talents and skills do you have that can hurry up your plans? I promise you have knowledge that nobody else has. Write books, become a speaker, release online courses, podcasts, etc. Become the expert and monetize it. Real estate is a good investment. Lots of things that can be done that give you better returns than just doing the stock market alone. 

These things can get you there quicker.  One thing I’ll share is to make sure your clinic is sellable when you’re ready to sell one day. If you name the clinic ‘My Last Name Chiropractic’…..trust me if your last name is Williams, someone named Pavlochek doesn’t love the name ‘Williams Chiropractic’.  If you’ve made the whole thing about you (and sometimes it’s really hard to not be about you), then when someone else comes in, trust fades.  A lot of what we do in my clinic is ME centered but I advertise and promote our medical team a lot, acupuncture, massage, exercise/rehab and all that because I can’t have it being all about me.  And when we find an associate that wants to make Amarillo and my clinic their home, you better believe we’re promoting the crap out of that associate. Before they even start. You won’t see my face on much if anything. 

These are things that make your clinic more sellable. That’s why mine is called Creek Stone Integrated Medical….because I don’t want to be the focus. As a result, we are in talks with a private equity investment group to sell 60% of our clinic which will pay me a salary plus my commission plus the buyout.  Then, I can get an associate, and then once they’re busy and profitable, get another associate.

That system sets up redundancy. If one leaves, the remaining associate can step up and train the next that we hire without me needing to be in the mix.  Plus, we’ll be adding a PT soon so, with a nurse prac, a PT, an acupuncturist, 2 massage therapists, and 2 associate DCs….that is a system that begins to remove me from full time, hands-on treatment which frees me up to be more creative with marketing and community touches. 

Then I also have Airbnbs and voice-over to fill in any gaps that might pop up. I also do fine art that you can check out at riverhorseart.com but I don’t see that ever paying all my bills. Though I wish it would. That’s what I truly love. And I play gigs singing and playing and writing songs but again, that’s not paying any big bills. That’s more stuff that feeds my soul. Not my family So, you see…..I’ve been laying the groundwork to be able to, hopefully by the age of 55, to step away nice and slowly and responsibly while maintaining my lifestyle and maybe starting to even enjoy life a little more.  So, that’s my exit plan. What’s your exit plan? I’d love to hear all about it.

Shoot me an email. You may have some tips I can share with our listeners. 

Item #1

Our first one this week is called, “The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review” by Jiang et al and published in Global Spine Journal in May of 2024 and it’s hot enough to bring the smoke! Remember, the citations can be found at chiropracticforward.com under this episode. 

Jiang Z, Davies B, Zipser C, Margetis K, Martin A, Matsoukas S, Zipser-Mohammadzada F, Kheram N, Boraschi A, Zakin E, Obadaseraye OR, Fehlings MG, Wilson J, Yurac R, Cook CE, Milligan J, Tabrah J, Widdop S, Wood L, Roberts EA, Rujeedawa T, Tetreault L; AO Spine RECODE-DCM Diagnostic Criteria Incubator. The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review. Global Spine J. 2024 May;14(4):1395-1421. doi: 10.1177/21925682231210468. Epub 2023 Nov 2. PMID: 37917661; PMCID: PMC11289544.

Why They Did It

Delayed diagnosis of degenerative cervical myelopathy (DCM) is associated with reduced quality of life and greater disability. Developing diagnostic criteria for degenerative cervical myelopathy has been identified as a top research priority. They aimed to address the following questions: What is the diagnostic accuracy and frequency of clinical symptoms in patients with degenerative cervical myelopathy?

How They Did It

A scoping review was conducted using a database of all primary degenerative cervical myelopathy studies published between 2005 and 2020.  Studies were included if they 

What They Found

This review identified three studies that discussed the diagnostic accuracy of various symptoms and included a control group.  An additional 58 reported on the frequency of symptoms in a cohort of patients with degenerative cervical myelopathy.  The most frequent and sensitive symptoms in degenerative cervical myelopathy include unspecified paresthesias (86%), hand numbness (82%) and hand paresthesias (79%).  Neck and/or shoulder pain was present in 51% of patients with degenerative cervical myelopathy, whereas a minority had back (19%) or lower extremity pain (10%).  Bladder dysfunction was uncommon (38%) although more frequent than bowel (23%) and sexual impairment (4%).  Gait impairment is also commonly seen in patients with degenerative cervical myelopathy (72%).

Wrap It Up

Patients with degenerative cervical myelopathy present with many different symptoms, most commonly sensorimotor impairment of the upper extremities, pain, bladder dysfunction and gait disturbance.  If patients present with a combination of these symptoms, further neuroimaging is indicated to confirm the diagnosis of degenerative cervical myelopathy.

Item #2 And the last one which continues my full assault on legalizing cannabis for recreational use, we have this one called, “Cannabis Use and Head and Neck Cancer” by Gallagher et al and published in JAMA Otolaryngol Head Neck Surgery on August 8, 2024 psssstttt…..it’s smokin’! Gallagher TJ, Chung RS, Lin ME, Kim I, Kokot NC. Cannabis Use and Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. Published online August 08, 2024. doi:10.1001/jamaoto.2024.2419

Why They Did It

Cannabis is the most commonly used illicit substance worldwide. Whether cannabis use is associated with head and neck cancer (HNC) is unclear. Objective  To assess the clinical association between cannabis use and head and neck cancer

How They Did It

This large multicenter cohort study used clinical records from a database that included 20 years of data (through April 2024) from 64 health care organizations.  A database was searched for medical records for US adults with and without cannabis-related disorder who had recorded outpatient hospital clinic visits and no prior history of head and neck cancer.  Propensity score matching was performed for demographic characteristics, alcohol-related disorders, and tobacco use.  Subsequently, relative risks (RRs) were calculated to explore risk of head and neck cancer, including head and neck cancer subsites.  This analysis was repeated among those younger than 60 years and 60 years or older. Cannabis-related disorder Main Outcomes and Measures:  Diagnosis of head and neck cancer and any head and neck cancer subsite

What They Found

Wrap It Up

This cohort study highlights an association between cannabis-related disorder and the development of head and neck cancer in adult patients.  Given the limitations of the database, future research should examine the mechanism of this association and analyze dose response with strong controls to further support evidence of cannabis use as a risk factor for head and neck cancers.

So….for actual legitimate medical use only? Absolutely. For recreational use? Absolutely not. Yes, it’s probably less harmful than alcohol and maybe the same or less harmful than ciggies. But we tried to outlaw alcohol and it didn’t work very well. There are a lot of groups RIGHT NOW trying to get rid of ciggies. Right now. 

WHY ADD MORE BAD CRAP WHEN WE TRY TO GET RID OF THE BAD CRAP WE ALREADY HAVE? Hey, I see you’re drowning, here’s a 50 lbs weight just because you like weights and weights make you feel really good. Maybe it’ll help you get out of the water OK.  Probably not. 2 wrongs don’t make a right. So stop it damnit. 

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 Head And Neck Cancer & Degenerative Cervical Myelopathy appeared first on Chiropractic Forward.

CF 352: PT In The ER & Back Pain And Mortality Today we’re going to talk about PT In The ER & Back Pain And Mortality 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. 

You have found yourself smack dab in the middle of Episode #352 Now if you missed last week’s episode, we talked about Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Welp, October is wrapped up and here we are in November already. Time change and everything. Except for our brethren in Arizona who are basically geniuses for not going along with the rest of the idiots that are still changing time twice per year.  Why is that still a thing? This time change is fine because we gain an hour of sleep but it’s dark when we get out of work for 4 months. And that makes for a bitchy, Jeff. I’m just saying.  In the Spring, when it changes back to a sane time, how about we just leave it for once? Maybe that’s just too much to ask.  Business, we did great in October. Except for collections. Remember, clinic ownership is a game of whack-a-mole.

Over and over.

As soon as you get problems fixed, something else will pop its head up. Last month, it was collections. The month before, back in September, we collected about a third more than our overhead. Maybe even more than that. In October, we knocked it out of the park on our stats. Patient visits, new patients, billing, the whole thing. Except for collections which might have covered our overhead. Maybe.  It’s so damn frustrating. This is yet another reason that you have to leave some gas in your tank. You cannot control collections.

Especially if they’re off-site, which ours is off-site. One of our billing clearing houses had some sort of computer glitch two weeks ago and is still clearing it up. Well, we don’t have a bit of control over that. Unless we chose to go cash. Which I’m scared to death of because I’m a terrible salesperson. I didn’t get into this to sell. I got into it to heal.  Anyway, if I didn’t leave gas in the tank and have reserves, and this glitch continues, we’d really start to worry about payroll this Friday, right? But, the work was done, it’s out there.

We just gotta get it. And in the meantime, we have reserves to cover us until we can get it.  Other than that, the new medical team is up and running and really settling in here at the clinic and getting comfortable. It’s always difficult to get new providers started and up and running but we’re on it.  Whack-a-freaking-mole. Embrace it and lean into it because that’s the way of life for a clinic owner. If you’re an employee and you don’t own it, you’re good. Enjoy your life.  If you’re the owner, lean into it and give whack-a-mole an inappropriately long hug because you better get comfortable and get to know each other very well. 

Item #1 Our first one this week is called, “Advanced Musculoskeletal Physiotherapists Are Effective and Safe in Managing Patients with Acute Low Back Pain Presenting to Emergency Departments” by Sayer et al and published in the Australian Health Review in June of 2018.  Remember, the citations can be found at chiropracticforward.com under this episode. 

Sayer JM, Kinsella RM, Cary BA, Burge AT, Kimmel LA, Harding P. Advanced musculoskeletal physiotherapists are effective and safe in managing patients with acute low back pain presenting to emergency departments. Aust Health Rev. 2018 Jun;42(3):321-326. doi: 10.1071/AH16211. PMID: 28538139.

Why They Did It

The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-advanced PT clinicians (ED doctors and nurse practitioners).

How They Did It

A retrospective audit was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by advanced PT and non-advanced PT clinicians.  Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED. 

What They Found

One thousand and eighty-nine patients with low back pain were seen during advanced PT service hours (360 in the advanced PT group, 729 in the non-advanced PT group).  Patients seen by the advanced PT had a significantly shorter ED wait time and ED length of stay.  Significantly fewer patients seen by the advanced PT were admitted, and this difference remained after accounting for the difference in triage code between the groups.

Wrap It Up

Improved ED metrics were demonstrated in patients with low back pain when managed by an advanced PT compared with patients seen by doctors and nurse practitioners.  There is a growing body of literature regarding the role of advanced PTs in the Australian healthcare system in providing clinical services for patients with musculoskeletal conditions, including settings such as the ED.  advanced PTs have proven to be safe and cost-effective, achieving high patient satisfaction and improved patient outcomes. 

Item #2

Our last one this week is called, “Association of back pain with all-cause and cause-specific mortality among older men: a cohort study” by Roseen et al and published in Pain Medicine in August of 2024 and schiza it’s hot to the touch!

Eric J Roseen, David T McNaughton, Stephanie Harrison, Aron S Downie, Cecilie K Øverås, Casper G Nim, Hazel J Jenkins, James J Young, Jan Hartvigsen, Katie L Stone, Kristine E Ensrud, Soomi Lee, Peggy M Cawthon, Howard A Fink, for the Osteoporotic Fractures in Men (MrOS) Research Group, Association of back pain with all-cause and cause-specific mortality among older men: a cohort study, Pain Medicine, Volume 25, Issue 8, August 2024, Pages 505–513, https://doi.org/10.1093/pm/pnae040

Why They Did It

They wanted to evaluate whether more severe back pain phenotypes—persistent, frequent, or disabling back pain—are associated with a higher mortality rate among older men.

How They Did It

In this secondary analysis of a prospective cohort, the Osteoporotic Fractures in Men (MrOS) study, they evaluated mortality rates by back pain phenotype among 5,215 older men from 6 sites in the United States.  The primary back pain measure used baseline and Year 5 back pain questionnaire data to characterize participants as having no back pain, nonpersistent back pain, infrequent persistent back pain, or frequent persistent back pain.  Secondary measures of back pain from the Year 5 questionnaire included disabling back pain phenotypes. The main outcomes measured were all-cause and cause-specific death.

What They Found

After the Year 5 exam, during up to 18  years of follow-up (mean follow-up = 10.3 years), there were 3,513 deaths (1218 cardiovascular, 764 cancer, 1531 other).  A higher proportion of men with frequent persistent back pain versus no back pain died.  No association was evident after further adjustment for health-related factors, such as self-reported general health and comorbid chronic health conditions.  Results were similar for cardiovascular deaths and other deaths, but we observed no association of back pain with cancer deaths.  Secondary back pain measures, including back-related disability, were associated with increased mortality risk that remained statistically significant in fully adjusted models.

Wrap It Up

Although frequent persistent back pain was not independently associated with risk of death in older men, additional secondary disabling back pain phenotypes were independently associated with increased mortality rate.  And there you have it. It makes sense that if back pain has you disabled, then lack of movement, activity, and function would lead to increased mortality, no?  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 PT In The ER & Back Pain And Mortality appeared first on Chiropractic Forward.

CF 351: Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain Today we’re going to talk about Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain 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. 

You have found yourself smack dab in the middle of Episode #351 Now if you missed last week’s episode, we talked about Acupuncture For Sciatica & Adolescent Cannabis Usse And Academic Achievement.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Being a part of Parker College’s CBI or internship program…..folks…..it Ain’t easy. But, going to school there, I can share with you that it’s never been easy with Parker. Lol.  Example, I signed up with the preceptor program with Logan out in St. Louis. I sent in my sample notes, and was accepted and that was it. I don’t hear from them except once a year to make sure I’d like to remain in their program and the answer is always a pleasant yes.  Not with my alma mater. Nope, they need the updated license, the updated building liability policy, the updated malpracticee dec page, the updated CPR cert every two years, they need you to watch videos each year, they send emails fairly consitently, and it’s just a whole lot. Honestly. A LOT.  I told you that to tell you this; the entire team here at my clinic went to get our CPR certs re-newed last week. I had to stay late to pay for everyone.

My team left and I was talking with the CPR dude and he asked me if my whole team was different from when we came and did the training 2 years ago. I said, yes, completely different.  He shared with me that he has seen that with every organization and clinic in town that has come through. I told him that it’s so frustrating to me because I’ve never raised my voice to a team member. Ever. I get frustrated like everyone else. I’m not perfect but yelling isn’t my vibe. I can be calm and direct and they understand, hey, Boss is fussy about this…..let’s get that tightened up. Whatever it is.  So, I treat them with respect. Then another big one is money, right?

The least I pay any of them is $18/hr. I don’t cheap out on paying them. They need off to go to a doctor or pick up their kid from school?/

Okay, hurry and we’ll see you asap. 

I can’t tell you how many people we’ve gone through in the last 2-3 years but off the top of my head I can think of about 10 and I only have 4 full timers not counting myself. I’m pretty sure it’s more than 10 but we’ll go with it for the sake of the conversation.  I used to hold onto staff members for 3 or more years in general. That might demonstrate why 10 in 1-2 years has been such a challenge and so disappointing. It really has been a struggle.

And after so many of them, you start to wonder, “Was it me? Was there something I did or something I could have done better?” Many times, you can answer that question yourself. For example, I had one that went bad on me. At first I didn’t know but then it became overt and obnoxious. I love people and I believe in them and hung on too long. I should have cut that person loose much much faster.  This person made life difficult on everyone else after some time and the tension was just thick and palpable toward the end. 

I think this person was partly to blame for so much turnover as well. But, who knows? Sometimes, you can’t find something you could have done better. It just is what it is. But, what was somewhat comforting to hear is that it is not only me. It’s everyone. Eveyrone is having the turnover problem. Gen X peoplee like me look at it as a generational issue or a post-COVID issue.  I don’t know the issue. I just know that it is indeed a very real issue. However, my current team, I feel really really good about. I have the best front desk member that I’ve ever had in 27 years of practice. My 3 in the back office are all friends and work hard.

We enjoy being at work with each other now and look foward to seeing each other. My new medical team is excited to be here treating our patients and our team loves them.  So, as of right now, we are in the best, most positive, most optimistic spot we’ve been in business-wise in at least 2-3 years.  This was not a gripe session. This was more of a relaying of a conversation I had but to also say, we’ve gone through this, and may go through it again in the future. However, there is hope if you’re experiencing the turnover problem and just do your best until your reach some level of homeostasis like we finally have reached here in the clinic.  It’s still possible in 2024.  Alright, onto the research. 

Item #1

Our first onee today is called, “A Systematic Review of Clinical Practice Guidelines for Persons With Non-specific Low Back Pain With and Without Radiculopathy: Identification of Best Evidence for Rehabilitation to Develop the WHO’s Package of Interventions for Rehabilitation” by Zaina et al and published in Archives of Physical Medicine and Rehabilitation in November of 2023 and it’s not a year old so that makes it hot, hot, hot! Remember, the citations can be found at chiropracticforward.com under this episode. 

Fabio Zaina, Pierre Côté, Carolina Cancelliere, Francesca Di Felice, Sabrina Donzelli, Alexandra Rauch, Leslie Verville, Stefano Negrini, Margareta Nordin, A Systematic Review of Clinical Practice Guidelines for Persons With Non-specific Low Back Pain With and Without Radiculopathy: Identification of Best Evidence for Rehabilitation to Develop the WHO’s Package of Interventions for Rehabilitation, Archives of Physical Medicine and Rehabilitation, Volume 104, Issue 11, 2023, Pages 1913-1927,

This systematic review synthesized recommendations from high-quality clinical practice guidelines (CPGs) on the rehabilitation management of low back pain (LBP) with or without radiculopathy in adult populations. The researchers conducted a comprehensive search to identify relevant clinical practice guidelines, and then used the AGREE II tool to critically appraise the methodological quality of the included guidelines. They selected the 4 highest quality clinical practice guidelines for their final analysis. The key findings were:

This seems a bit more weighted toward exercise than anyhting else but for massage specifically, one guideline recommended considering manual therapy techniques like massage as part of a treatment package including exercise, with or without psychological therapy. For acupuncture specifically, one guideline recommended acupuncture for subacute low back pain, but another guideline did not recommend acupuncture for managing low back pain with or without sciatica. But, if you have listened in the last week or so, we covered a paper that addressed acupuncture and low back pain with sciatica that showed it to actually be an effective way to treat it.  And for spinal manipulative therapy specifically, for patients with chronic (>3 months) low back pain, the guidelines suggested or recommended SMT to decrease pain and disability, either alone or as part of a multimodal approach.

One guideline recommended considering SMT as part of early intervention for acute and subacute low back pain. The researchers noted that many guideline recommendations were based on lower quality evidence or expert opinion, highlighting the need for higher quality rehabilitation research.  Overall, this review provides a synthesis of the current best practice recommendations for the rehabilitation of adults with low back pain, emphasizing a biopsychosocial, multimodal approach centered on empowering patients through education and active treatment.

Item #2

OK, our second one today is called, “The relationship between emotion regulation and pain catastrophizing in patients with chronic pain” by Yuan et al and published in Pain Medicine in July of 2024 and get me an oven mitt… it’s too hot to freakin’ handle.  Yan Yuan, Kristin Schreiber, K Mikayla Flowers, Robert Edwards, Desiree Azizoddin, LauraEllen Ashcraft, Christina E Newhill, Valerie Hruschak, The relationship between emotion regulation and pain catastrophizing in patients with chronic pain, Pain Medicine, Volume 25, Issue 7, July 2024, Pages 468–477, https://doi.org/10.1093/pm/pnae009

Why They Did It

Pain catastrophizing (PC) is a cognitive/emotional response to and in anticipation of pain that can be maladaptive, further exacerbating pain and difficulty in emotion regulation (ER). There is a lack of research on the interplay between pain catastrophizing and emotion regulation and its impact on pain. Our aim was to investigate whether emotion regulation exacerbated the pain experience through pain catastrophizing.

How They Did It

What They Found

Wrap It Up

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 Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain appeared first on Chiropractic Forward.

CF 350: Acupuncture For Sciatica & Adolescent Cannabis Use And Academic Achievement Today we’re going to talk about Acupuncture For Sciatica & Adolescent Cannabis Use And Academic Achievement 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. 

You have found yourself smack dab in the middle of Episode #350 Now if you missed last week’s episode, we talked about Proprioceptive Neuromuscular Facilitation & SMT Adverse Events. Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. I missed last week annd I’m sorry about that. I was heading down to San Antonio for the MCM Mastermind weekend. As a result of taking two days off last week, everyone was jammed into just a few days and there just wasn’t enough time to get last week’s episode handled. So, my apologies.  The weekend was great with my Mastermind family. It was the last one of the year. It was the last one of the year which means we have a few leaving and we have a few coming in to take their place.  Which is exciting. For example, we have a large integrated clinic owner that is transitioning out of the group this year but have another bigger integrated clinic coming into the group. We have a great sports chiro going out but we have the team chiro for Clemson coming in.  So we’re excited. And the ones leaving, we’re still besties. We’re not magically losing each others’ phone numbers just because they’re leaving the group. These are connections that will last a lifetime. Inside or outside of the group.  I know the East Mastermind is full but the West Mastermind is not full and has plenty of available spots. If you’re interested, email Dr. Kevin Christie at [email protected] and he’ll get you all the info set.  I’m still playing catchup from being gone last week so I’m going to keep it short this week and go ahead and hop into the episode. 

Item #1 Our first one this week is called, “Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk A Randomized Clinical Trial” by Jian Feng Tu, et al and published in JAMA Internal Medicine on October 14, 2024.  And holy face of the sun, it’s a hot one today! Remember, the citations can be found at chiropracticforward.com under this episode. 

Tu J, Shi G, Yan S, et al. Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial. JAMA Intern Med. Published online October 14, 2024. doi:10.1001/jamainternmed.2024.5463

Why They Did It Sciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce. The wanted to investigate the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk.

How They Did It This was a multicenter 2-arm randomized clinical trial conducted in 6 tertiary-level hospitals in China of patients with chronic sciatica from herniated disk. 

Interventions  Participants were randomly assigned to receive 10 sessions of acupuncture (n = 110) or sham acupuncture (n = 110) over 4 weeks. Participants, outcome assessors, and statisticians were blinded.

Main Outcomes and Measures  The 2 coprimary outcomes were changes in visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) from baseline to week 4.  Secondary outcomes were adverse events.

What They Found A total of 216 patients were included in the analyses.  The VAS for leg pain decreased 30.8 mm in the acupuncture group and 14.9 mm in the sham acupuncture group at week 4  The ODI decreased 13.0 points in the acupuncture group and 4.9 points in the sham acupuncture group at week 4  For both VAS and ODI, the between-group difference became apparent starting in week 2 and persisted through week 52  No serious adverse events occurred.

Wrap It Up This randomized clinical trial found that in patients with chronic sciatica from herniated disk, acupuncture resulted in less pain and better function compared with sham acupuncture at week 4, and these benefits persisted through week 52.  Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk. Item #2 Our last one this week is called, “Cannabis Use During Adolescence and Young Adulthood and Academic Achievement A Systematic Review and Meta-Analysis” by Chan et al and published in JAMA Pediatrics on October 7, 2024.  Es muy en fuego, mi amigos!

Chan O, Daudi A, Ji D, et al. Cannabis Use During Adolescence and Young Adulthood and Academic Achievement: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online October 07, 2024. doi:10.1001/jamapediatrics.2024.3674

Before we hop in here, you see me talk about cannabis research when it pops up. Why would I do that? Well, I have lots of kids and parents come in my office every month smelling like the devil’s lettuce. I see more and more politicians acting like legalization for recreation is the way to go and I don’t agree. And research is clear as to why none of us as healthcare providers should agree. 

The common smoker’s retort is that it’s better than alcohol and less dangerous. On most accounts, you’re not wrong. But, we tried to outlaw Alcohol back in the early 1900’s and guess what? It didn’t work out so well. It was called Prohibition. Crack open that history book and take a stroll or watch some documentaries.  So, if we already have that harmful product legally in circulation, why in the HELL would we ever voluntarily legalize another harmful substance? Because some like living in an altered state at all hours of the day?

Might as well make it normalized. Because we want yet another way to make our populations tired and unmotivated? Yay!!! Sign the bill! I realize this makes me uncool in 2024 but I’m not on the recreational legalization train and never will be. I think it’s one of the dumbest things these 3 or so generations have every come up with.  Now, medicinal, properly prescribed use? All day every day, folks. We use morphine medically when appropriate. Why wouldn’t we use cannabis in the same way? But recreational….what are you smoking?

Why They Did It Cannabis use during adolescence and young adulthood may affect academic achievement; however, the magnitude of association remains unclear. Objective  To conduct a systematic review evaluating the association between cannabis use and academic performance.

How They Did It Data Sources  CINAHL, EMBASE, MEDLINE, PsycInfo, PubMed, Scopus, and Web of Science from inception to November 10, 2023. Study Selection  Observational studies examining the association of cannabis use with academic outcomes were selected. The literature search identified 17 622 unique citations. Main Outcomes and Measures  School grades, school dropout, school absenteeism, grade retention, high school completion, university enrollment, postsecondary degree attainment, and unemployment.

What They Found Sixty-three studies including 438,329 individuals proved eligible for analysis.  Moderate-certainty evidence showed cannabis use during adolescence and young adulthood was probably associated with lower school grades; less likelihood of high school completion, university enrollment, and postsecondary degree attainment; and increased school dropout rate and school absenteeism.  Absolute risk effects ranged from 7% to 14%.  Low-certainty evidence suggested that cannabis use may be associated with increased unemployment, with an absolute risk increase of 9%.  Subgroup analyses with moderate credibility showed worse academic outcomes for frequent cannabis users and for students who began cannabis use earlier.

Wrap It Up Cannabis use during adolescence and young adulthood was probably associated with increases in school absenteeism and dropout; reduced likelihood of obtaining high academic grades, graduating high school, enrolling in university, and postsecondary degree attainment; and perhaps increased unemployment.  Just a tip from your completely uncool Uncle Jeffro 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 Acupuncture For Sciatica & Adolescent Cannabis Use And Academic Achievement appeared first on Chiropractic Forward.

CF 349: Proprioceptive Neuromuscular Facilitation & SMT Adverse Events Today we’re going to talk about Proprioceptive Neuromuscular Facilitation & SMT Adverse Events 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. 

You have found yourself smack dab in the middle of Episode #349 Now if you missed last week’s episode, we talked about SMT Research Review & Mobile Phones And Cancer Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Welp, what can I say, some days you’re the nail and some days you’re the hammer. Today, my friends, I’m the hammer. What the hell does that mean you might ask.  Well, this is a slight departure from chiropractic clinic talk for a brief minute but I got some ‘splainin’ to do. In the VoiceOver realm, there are about 5 big national agencies that rep the big talents. The ones you mostly hear on the TVs and elsewhere. 

One of those agencies is called DPN out in Los Angeles. I have been talking with DPN for a bit and trying my best to make things happen. Well, it all came together today and I was signed by DPN.  Now here’s why that’s so cool. The Big 5 agencies have access to the biggest voice gigs in the country. I already have about 9 regional agents buut they don’t get the big boy gigs like the nationals get.

For example, DPN reps the national voice for Ford trucks and that dude makes north of $1 million per year.  THAT’s what I’m talking about, friends. Now that doesn’t mean I’m about to be a multi-millionaire and all that good stuff. It just means I now have access to those gigs and a real opportunity to land them.  So it’s all pretty exciting around the Williams Estate today. It’s electric you might say.  In the clinic, our old nurse prac is out and our new medical team is in. We are up and running and killing it already and super excited about it.

We went from full time salary position to hourly without health benefits for this first year.

Which means we save thousands and are super excited to be profitable on the medical side and staying that way despite the transition.  Change is stressful but this is a good change and will be huge in the long-term. The team we have coming in is outstanding and growth minded.  We are going to have some bumps along the way but sometimes, you just gotta jump in and get going. Which is waht we’re doing today. Seems like for the first time in about a year or two, we have all similar personalities, all goign in the right direction, all getting along and enjoying each others’ company. And that’s gold. It’s the sweet spot. 

Something I’ve been doing lately that will offer up some opportunities in the future: at the suggestion of one of our MCM Mastermind members, Vanessa, my wife and I started playing the points and miles game. With spends as high as we see in our offices, points and miles can add up very quickly.  I travel a lot for business and we have an overhead of about $60,000-$65,000 per month here at the clinic. So, you can see how we might stack up the point fast and score some free airline tickets and hotel packages.  If you’re interested in a free course to learn all about how to do it, go to https://10xtravel.com and click on Start With Our Free Course at the top of the page. I don’t get a thing out of it. No affiliate link or anything like that. But, if you decide to get a card, holler at me and I’ll send you a referral link so I can get some points out of that. Deal? Alright, let’s jump into the research this week shall we?

Item #1

This first one comes to us from our Parker intern. Mr. Austin Moya went and found this after I did a resisted ROM move on a patient that had a locked facet and SMT was just not going to happen.  So, thank you to Austin for making us all just a little bit smarter.  It was done by Kinet et al in 2012 and published in Journal of Human Kinetics.  Remember, the citations can be found at chiropracticforward.com under this episode. 

Hindle KB, Whitcomb TJ, Briggs WO, Hong J. Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function. J Hum Kinet. 2012 Mar;31:105-13. doi: 10.2478/v10078-012-0011-y. Epub 2012 Apr 3. PMID: 23487249; PMCID: PMC3588663.

Why They Did It

Proprioceptive neuromuscular facilitation (PNF) is common practice for increasing range of motion, though little research has been done to evaluate theories behind it. The purpose of this study was to review possible mechanisms, proposed theories, and physiological changes that occur due to proprioceptive neuromuscular facilitation techniques

How They Did It

Four theoretical mechanisms were identified: autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory. 

What They Found

The studies suggest that a combination of these four mechanisms enhances range of motion. When completed prior to exercise, proprioceptive neuromuscular facilitation decreases performance in maximal effort exercises.  When this stretching technique is performed consistently and post-exercise, it increases athletic performance, along with range of motion.  Little investigation has been done regarding the theoretical mechanisms of proprioceptive neuromuscular facilitation, though four mechanisms were identified from the literature.  As stated, the main goal of proprioceptive neuromuscular facilitation is to increase range of motion and performance. Studies found both of these to be true when completed under the correct conditions.

Wrap It Up These mechanisms were found to be plausible; however, further investigation needs to be conducted. All four mechanisms behind the stretching technique explain the reasoning behind the increase in range of motion, as well as in strength and athletic performance. Proprioceptive neuromuscular facilitation shows potential benefits if performed correctly and consistently. So, if someone has a locked up facet, do you just hammer through that neck regardless of the pain the patient is in?  If you’ve got extrapment of synovial folds, which can happen from sustained awkward sleeping positions, does it make sense to hammer through it on the first visit? Or do a little resisted ROM and stretching? I vote resisted ROM and stretching. The patients do well with it, they see immediate ROM improvement, and you didn’t give them an experience they had to figure out how to survive.  Then you got them in the office the next day and they were probably much easier to hands on adjust by that point. If I’m guessing. 

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 in May of 2024 and that’s the hot one, people!

Pankrath N, Nilsson S, Ballenberger N. Adverse Events After Cervical Spinal Manipulation – A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Pain Physician. 2024 May;27(4):185-201. PMID: 38805524.

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.  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

Systematic review and meta-analysis.

Methods: A systematic literature search was conducted in the PubMed and Cochrane databases.  This search included RCTs in which cervical HVLA manipulations were applied and AEs 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 (RoB-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 AEs were classified as mild, and none of the AEs 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 Proprioceptive Neuromuscular Facilitation & SMT Adverse Events appeared first on Chiropractic Forward.

CF 348:  SMT Research Review & Mobile Phones And Cancer Today we’re going to talk about SMT Research Review & Mobile Phones And Cancer 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. 

You have found yourself smack dab in the middle of Episode #348 Now if you missed last week’s episode, we talked about Plant vs. Animal Fat & Screen Time At Bedtime Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. It’s a Monday and, of course, we had a staffer call in sick again. It’s always Mondays it seems ya know? What the heck? But she’s one of my most dependable, most awesome-est people so I wont’ harrass her too much.  It’s a little slow today for us.

We’re used to being in the 40’s for a Monday and we had 33 today so I don’t know what’s up with that but we have a goo damount tomorrow and Wednesday so, maybe it was just one of those days. And, I got A LOT done so we’re all good in the hood. 

Let’s see, what’s up?

I have a presentation coming up for the FTCA. For those of you not in the know, that’s the Forward Thinking Chiropractic Alliance and they’re having the October 2024 FTCA Virtual Business Summit which will be held Friday October 11-Saturday October 12. For more info, just go to www.forwardthinkingchiro.com and give it a looksee.  My presentation will center on new ways of looking at and treating chronic pain via the biopsychosocial construct. Sounds boring as hell but it’s not and we treat a lot of pain, folks so I hope you’ll join us. Hell, you might learn something.  If you’re a long time listener, you’re probably tired of hearing it.

But I’m never tired of talking about it people!! I saw lots of my MCM Mastermind friends taking pictures together at the MPI Adjustathon. I didn’t even know that was a thing until I met this crazy group but I’m probably just going to have to go next year and just make it happen. My people were out there and they all had big smiles so I feel like I’m probably missing something and I hate FOMO.  I don’t have a ton to share at the moment except being an integrated clinic can be a challenge. We are replacing the Nurse Practitioner with two people.

We are hirng an RN that starts next week and then another Nurse Pracititoner that will just do the hormone replacement pellets. Both are hourly staffers so that will help. Thee full time salary position was a challenge for sure when we were just building up something brand new and getting it off the groud.  We know how to do it now and should be off and running with the new crew soon. And it’s going to be great. Everyone in the office is jazzed and there’s just an electric feeling in the office and when your crew is jazzed, good thing happen. 

Upward and onward Alright let’s get to the research shall we?

Item #1

Our first one thiis week was posted on Facebook by Dr. David Graber I believe. It’s called, “Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations” by Trager et al and published in Journal of Clinical Medicine on August 28, 2024 so it’s smokin all over the place.  Remember, the citations can be found at chiropracticforward.com under this episode. 

Trager, R.J.; Bejarano, G.; Perfecto, R.-P.T.; Blackwood, E.R.; Goertz, C.M. Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J. Clin. Med. 2024, 13, 5668. https://doi.org/10.3390/jcm13195668

Why They Did It

Chiropractors diagnose and manage musculoskeletal disorders, commonly using spinal manipulative therapy (SMT). Over the past half-century, the chiropractic profession has seen increased utilization in the United States following Medicare authorization for payment of chiropractic SMT in 1972. 

How They Did It

We reviewed chiropractic research trends since that year and recent clinical practice guideline (CPG) recommendations regarding SMT.  We searched Scopus for articles associated with chiropractic (spanning 1972–2024), analyzing publication trends and keywords, and searched PubMed, Scopus, and Web of Science for clinical practice guidelines addressing SMT use (spanning 2013–2024).  We identified 6286 articles on chiropractic.  The rate of publication trended upward.  Keywords initially related to historical evolution, scope of practice, medicolegal, and regulatory aspects evolved to include randomized controlled trials and systematic reviews. 

What They Found

The recommendations primarily targeted low back pain and neck pain; of these, 90% favored SMT for low back pain while 100% favored SMT for neck pain.  Recent clinical practice guideline recommendations favored SMT for tension-type and cervicogenic headaches.  There has been substantial growth in the number and quality of chiropractic research articles over the past 50 years, resulting in multiple clinical practice guideline recommendations favoring SMT.  These findings reinforce the utility of SMT for spine-related disorders.

Wrap It Up

Most chiropractic research articles and clinical practice guidelines regarding SMT have focused on spinal pain in adults.  From 1972 to 2024, research has transitioned from legal topics and case reports to randomized trials, observational studies, and evidence synthesis. 

We also found that there has been substantial growth in the number and rigor of standard scientific methods of chiropractic research articles over the past 50 years, resulting in multiple clinical practice guideline recommendations favoring SMT.  These findings reinforce the clinical utility of SMT for spine-related disorders.

Item #2

Our last one this week is called, “The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A systematic review of human observational studies – Part I: Most researched outcomes” by Karipidis et. Al and published by Environmental International in September of 2024 and it’s gettin’ hot up in here up in here. 

Ken Karipidis, Dan Baaken, Tom Loney, Maria Blettner, Chris Brzozek, Mark Elwood, Clement Narh, Nicola Orsini, Martin Röösli, Marilia Silva Paulo, Susanna Lagorio, The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A systematic review of human observational studies – Part I: Most researched outcomes, Environment International, Volume 191, 2024, 108983, ISSN 0160-4120, https://doi.org/10.1016/j.envint.2024.108983.

Why They Did It

The objective of this review was to assess the quality and strength of the evidence provided by human observational studies for a causal association between exposure to radiofrequency electromagnetic fields (RF-EMF) and risk of the most investigated neoplastic diseases.

What They Found

We included 63 aetiological articles, published between 1994 and 2022, with participants from 22 countries RF-EMF exposure from mobile phones (ever or regular use vs no or non-regular use) was not associated with an increased risk of glioma, meningioma, acoustic neuroma, pituitary tumours, salivary gland tumours, or pediatric brain tumours, with variable degree of across-study heterogeneity.  Exposure from broadcasting antennas or base stations was not associated with childhood leukaemia or pediatric brain tumor risks, independently of the level of the modelled RF exposure.  Glioma risk was not significantly increased following occupational RF exposure, and no differences were detected between increasing categories of modelled cumulative exposure levels.

Wrap It Up

For the analysis, commissioned by the World Health Organization, researchers reviewed 63 studies. They didn’t find any evidence that increased exposure to the type of radiation emitted from cell phones and other wireless electronics—non-ionizing radiation—causes brain cancer, even among people who spend many hours each day on their phones.

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 SMT Research Review & Mobile Phones And Cancer appeared first on Chiropractic Forward.

CF 347: Plant vs. Animal Fat & Screen Time At Bedtime Today we’re going to talk about Plant vs. Animal Fat & Screen Time At Bedtime 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. 

You have found yourself smack dab in the middle of Episode #347 Now if you missed last week’s episode, we talked about REM And TMD & Psychological Factors In Knee Osteoarthritis Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Another Monday, another staffing issue but this one is OK too. I told one of my girls today that if someone didn’t know us and all they knew was our staff changes over the last 2 years, they’d think we’re crazy people and hard to work for.  The truth is, when you have 12 or 13 employees, you just have people in different aspects of their lives going and coming and doing life like the rest of us. It is what it is. The one who turned in a resignation today is a massage therapist who’s been with us for 9+ years. No animosity. No problems.

She just wants to try things on her own where she rents a booth at a spa and does it on her own. We didn’t do anything wrong. Just a change in stages of her life and that’s OK. Not everyone’s dreams and goals are my dreams and goals. 

That’s the new pile of BS I stepped into this week. Last week was a whole different thing that I’m not getting into on the podcast but things have been challenging. But, on the encouraging side, you’ve heard me saying that business has been picking up again. And that has been maintained.  But, what it does is to serve as an impetus to make sure you’re giving and pouring into the ones on your team that are all in and doing what they can do to grow the clinic and take the best care of your patients.  If they’re performing and dependable, pay them. Keep them on board. Employees like career trajectory. But we don’t have a huge ceiling and not a lot of titles an employee can have in our clinics, do we?  So how do you pour into your staff? Some of the big drivers of employee satisfaction are:

Other things that matter are

There are several more but here’s the thing, you gotta do you and run your clinic how you best see fit but these things need to be in your mind as well because when you have happy employees, you have higher retention, increased productivity, and better customer/patient service. Every time. 

Just a tip from your Ol’ Uncle Jeffro

Item #

Our first one this week is called, “Plant and Animal Fat Intake and Overall and Cardiovascular Disease Mortality” by Zhao et al and published in JAMA Internal Medicine on August 12, 2024 aye chihuahua!

Zhao B, Gan L, Graubard BI, et al. Plant and Animal Fat Intake and Overall and Cardiovascular Disease Mortality. JAMA Intern Med. Published online August 12, 2024. doi:10.1001/jamainternmed.2024.3799 Remember, the citations can be found at chiropracticforward.com under this episode. 

Why They Did It Importance  The impact of dietary fat intake on long-term human health has attracted substantial research interest, and the health effects of diverse dietary fats depend on available food sources. Yet there is a paucity of data elucidating the links between dietary fats from specific food sources and health. They wanted to study the associations of dietary plant and animal fat intake with overall mortality and cardiovascular disease (CVD) mortality.

How They Did It This large prospective cohort study took place in the US from 1995 to 2019. The analysis of men and women was conducted in the National Institutes of Health–AARP Diet and Health Study. Data were analyzed from February 2021 to May 2024. Specific food sources of dietary fats and other dietary information were collected at baseline, using a validated food frequency questionnaire.

What They Found The analysis included 407,531 men and women  the mean age of the cohort was 61.2 During 8,107,711 person-years of follow-up, 185,111 deaths were noted, including 58 526 cardiovascular disease mortality deaths.  Now, I could dive into the weeds here for you but I’ll lose you like a sock in the laundry and we don’t want that so we’ll go to the wrap-up. We don’t want to get glassy-eyed and mushy-brained. 

Wrap It Up The findings from this prospective cohort study demonstrated consistent but small inverse associations between a higher intake of plant fat, particularly fat from grains and vegetable oils, and a lower risk for both overall and cardiovascular disease mortality.  A diet with a high intake of animal-based fat, including fat from dairy foods and eggs, was also shown to be associated with an elevated risk for both overall and cardiovascular disease mortality.

Basically, these findings provide detailed information about how increased intake of dietary fat from plant sources may help improve human health and related mortality outcomes. Particularly fat from grains and vegetable oils. In contrast, fats from animal fat, dairy products, and egg fats were associated with an increased risk for mortality for overall and CVD mortality.  And now that question no longer lingers within your brain chambers. 

Item #2

Our last one this week is called, “Brosnan B, Haszard JJ, Meredith-Jones KA, Wickham S, Galland BC, Taylor RW. Screen Use at Bedtime and Sleep Duration and Quality Among Youths. JAMA Pediatr. Published online September 03, 2024. doi:10.1001/jamapediatrics.2024.2914” by Brosnan et al and published in JAMA Pediatrics on September 3, 2024 and one word, two syllables…..Day-um….that’s hot, people. 

Brosnan B, Haszard JJ, Meredith-Jones KA, Wickham S, Galland BC, Taylor RW. Screen Use at Bedtime and Sleep Duration and Quality Among Youths. JAMA Pediatr. Published online September 03, 2024. doi:10.1001/jamapediatrics.2024.2914

Why They Did It To examine whether evening screen time is associated with sleep duration and quality that night in youths.

How They Did It This repeated-measures cohort study was performed in participant homes in Dunedin, New Zealand.  Participants included healthy kiddos aged 11 to 14.9 years.  Data analyzed from October to November 2023. Objectively measured screen time, captured using wearable or stationary video cameras from 2 hours before bedtime until the first time the youth attempted sleep (shut-eye time) over 4 nonconsecutive nights.  Video info was coded using a reliable protocol to quantify device and activity type. Sleep duration and quality were measured objectively via wrist-worn accelerometers.  The association of screen use with sleep measures was analyzed on a night-by-night basis using mixed-effects regression models including participant as a random effect and adjusted for weekends.

What They Found Of the 79 participants, all but 1 had screen time before bed.  Screen use in the 2 hours before bed had no association with most measures of sleep health that night  All types of screen time were associated with delayed sleep onset but particularly interactive screen use.  Every 10 minutes of additional screen time in bed was associated with shorter total sleep time  The mean difference in total sleep time was −9 minutes for passive screen use.  In particular, gaming and multitasking were associated with less total sleep time.

Wrap It Up In this repeated-measures cohort study, use of an objective method showed that screen time once in bed was associated with impairment of sleep, especially when screen time was interactive or involved multitasking.  These findings suggest that current sleep hygiene recommendations to restrict all screen time before bed seem neither achievable nor appropriate.

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 Plant vs. Animal Fat & Screen Time At Bedtime appeared first on Chiropractic Forward.

CF 346: REM And TMD & Psychological Factors In Knee Osteoarthritis Today we’re going to talk about REM And TMD & Psychological Factors In Knee Osteoarthritis 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. 

You have found yourself smack dab in the middle of Episode #346 Now if you missed last week’s episode, we talked about SMT Comparison Of Short-Term Effects & GLP-1 And Obesity-Associated Cancers Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Alright let’s talk about business. What are you all seeing? I spent a lot of time over the last several months wondering if I made someone mad, pissed on the mayor’s dog, or something like that.  Now, business seems to be picking back up a smidge. Before I went to NYC I had almsot 200 in one week by myself. I don’t have an associate so that was a challenge. Now this week, and we’re early in the week, I have 165 lined up. I think NYC knocked me back down but that’s OK. 200 in a week is honestly more than I want. I think about 180 is probably my sweet spot and I’m only 15 off of that so far this week.  Anyway, I’m seeing a return of business and new patients.

Being evidence-based, we depend on a consistent flow of new patients. So that’s what we got going here. A few things have played a part. We really buckled down and spent the money on website SEO. We started getting out and about in the community more. Shaking babies and kissing hands. And we made some key changes in our personnel. Once we were out with the bad seed, it just seemed like a cloud lifted. We have one more dark cloud on their way out in a couple of weeks and have a ray of sunshine replacing it and we can’t wait. 

It’s all good in the hood so we’re on the right path. Business is good. 

Another thing, yes the economy matters to our businesses and how much tax we pay each year but, don’t get tied up in politics if you can keep from it. They don’t care as much about you as they say they do. And for the love of all that’s holy, keep it off of Facebook and social media.

If you’re posting political crap on your socials every day all day, you limit your patient base to half of your community because a republican will never treat with a mouthy democrat provider and a democrat will never treat with a mouthy republican provider. That’s a freaking guarantee. Both sides of the aisle need care and you can’t do that if you’re mouthy. Be smart, wise, trustworthy, and have good character. Treat people right and carry yourself correctly and the money will take care of itself. 

Just a tip from your Ol Uncle Jeffro. 

Item #1 Our first one this week is called, “Elevated pain sensitivity is associated with reduced rapid eye movement (REM) sleep in females with comorbid temporomandibular disorder and insomnia” by Reid, et al and published in Pain Medicine on March 28 2024 and it’s hotter than cat piss. 

Remember, the citations can be found at chiropracticforward.com under this episode. 

Matthew J Reid, Katrina R Hamilton, Sophie J Nilsson, Michael Alec Owens, Jane L Phillips, Patrick H Finan, Claudia M Campbell, Alexandros Giagtzis, Dave Abhishek, Jennifer A Haythornthwaite, Michael T Smith, Elevated pain sensitivity is associated with reduced rapid eye movement (REM) sleep in females with comorbid temporomandibular disorder and insomnia, Pain Medicine, Volume 25, Issue 7, July 2024, Pages 434–443, https://doi.org/10.1093/pm/pnae022

Why They Did It Patients with chronic pain disorders, including Temporomandibular Disorders (TMDs) endorse high levels of sleep disturbances, frequently reporting reduced sleep quality.  Despite this, little is known about the effect that daytime pain has on the microstructure and macro-architecture of sleep. Therefore, we aimed to examine the extent to which daytime pain sensitivity, measured using quantitative sensory testing (QST), is associated with objective sleep parameters the following night, including sleep architecture and power spectral density, in women with TMD.

How They Did It 144 females with myalgia and arthralgia by examination using the Diagnostic criteria for TMD completed a comprehensive quantitative sensory testing battery consisting of General Pain Sensitivity, Central Sensitization Index, and Masseter Pressure Pain Threshold assessments.  Polysomnography was collected the same night to measure sleep architecture and calculate relative power in delta, theta, alpha, sigma, and beta power bands.

What They Found Central Sensitization, General Pain Sensitivity Indices, and Masseter Pain Pressure Threshold were significantly associated with lower REM% both before and after controlling for covariates.  Pain sensitivity measures were not significantly associated with relative power in any of the spectral bands nor with any other sleep architectural stages.

Wrap It Up Our findings demonstrate that higher generalized pain sensitivity, masseter pain pressure threshold, as well as central sensitization were associated with a lower percentage of REM in participants with myofascial pain and arthralgia of the masticatory system.  These findings provide an important step toward understanding the mechanistic underpinnings of how chronic pain interacts with sleep physiology.

Item #2 Our last one this week is called, “Quantitative sensory testing, psychological factors, and quality of life as predictors of current and future pain in patients with knee osteoarthritis” by Hertel et al and published in PAIN in August of 2024 and it’s a steamy pile of saucy spice.  Hertel, Emmaa; Arendt-Nielsen, Larsa,b,c,d; Olesen, Anne Estrupe,f; Andersen, Michael Skippera; Petersen, Kristian Kjær-Staala,b,*. Quantitative sensory testing, psychological factors, and quality of life as predictors of current and future pain in patients with knee osteoarthritis. PAIN 165(8):p 1719-1726, August 2024. | DOI: 10.1097/j.pain.0000000000003194

Why They Did It This exploratory study aimed to explain baseline OA pain intensity and predict OA pain after administration of a nonsteroidal anti-inflammatory drug in combination with paracetamol for 3 weeks. 

How They Did It The Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score was used to estimate OA pain presentation. One hundred one patients were assessed at baseline and follow-up using QST (pressure pain thresholds and temporal summation of pain [TSP]), symptoms of depression and anxiety, pain catastrophizing scales (PCSs), and health-related quality of life.  Linear regression with backward selection identified that PCS significantly explained 34.2% of the variability in baseline KOOS pain, with nonsignificant contributions from TSP.  Pain catastrophizing score and TSP predicted 29.3% of follow-up KOOS pain, with nonsignificant contributions from symptoms of anxiety. 

What They Found When assessed separately, PCS was the strongest predictor (32.2% of baseline and 24.1% of follow-up pain), but QST, symptoms of anxiety and depression, PCS, and quality of life also explained some variability in baseline and follow-up knee OA pain. Further analyses revealed that only TSP and PCS were not mediated by any other included variables, highlighting their role as unique contributors to OA pain presentation. 

Wrap It Up This study emphasizes the importance of embracing a multimodal approach to OA pain and highlights PCS and TSP as major contributors to the baseline OA pain experience and the OA pain experience after OA treatment. 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 REM And TMD & Psychological Factors In Knee Osteoarthritis appeared first on Chiropractic Forward.

CF 345: SMT Comparison Of Short-Term Effects & GLP-1 And Obesity-Associated Cancers Today we’re going to talk about SMT Comparison Of Short Term Effects & GLP-1 And Obesity-Associated Cancers 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. 

You have found yourself smack dab in the middle of Episode #345 Now if you missed last week’s episode, we talked about Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. Let’s talk about a two-week break shall we? Yes, I took two weeks off from the podcast becasue I basically had to. My wife and daughter and I went to NYC. We left on a Thursday and returned on a Tuesday. My business has kind of exploded lately and there simply was not enough time in either of those two weeks to get the podcast recorded. One day I had 60. Just me as a solo doc. That’s tough. No time for talkie talkie.  Now that I’m recovering and we’re sort of back to a normal week, I’m back at it.

First thing’s first, NYC was amazing. I went fully expecting to hate everything about it and I have to say….it was just sort of awesome. I didn’t hate it at all. The people were great for the most part.  There are some odd folks in NYC but not as many as those of us outside the city would think. I relate to WAY more than I ever expected. They’re just hard working, get it done folks like we are in Texas. Just different accents. 

I found New Yorkers friendlier than I expected. Except for a handful of them The NBC tour was a highlight as well as the mafia tour.  I’m not Italian but I loved Little Italy. We actually spent quite a bit of time there.  I’m going to make some of you disappointed here but we never used the subway. Not once. We used Lyft everywhere. First of all, I got 10x points on Lyft with my Chase Sapphire Reserve card so…..there’s that. Also, while you might say I missed out on an ‘experience’, from what I heard, it’s not all that great of one. Lol. On the other hand, I’d argue that we got to see a TON of the city by driving through it rather than riding under it. And I love the metro in DC so I’ve done the subway thing lots of times before. Just not in NYC.  The high line was cool. 

DUMBO wasn’t all that cool.  I loved Central Park.  The Met was by far the best museum out there. The Museum of Natural History was just blah. The Smithsonian in DC was much better. But the Met….that was awesome All the food….so good. The only way the New Yorkers are skinny is from all that walking. There’s not other excuse. The food is ridiculous.  We saw Moulin Rouge on Broadway….very cool.  Top of the Rock was great. I love Art Deco and Rockefeller Plaza is the epitome of Art Deco, man. It was gorgeous. 

All in all it was great. I didn’t care much about it all but went with an open mind and absolutely loved the weekend. There’s something about it. It’s ‘electric’ somehow.  I wouldn’t want to live in it all day every day but we loved the visit and we will most definitely be back sooner rather than later. Now that you have my impressions of NYC, as if you cared….losing that business while I was gone….ugh. We were just hitting our stride. But that’s OK, we have to have a life. We have to live and work can’t be all we do or we’ll go crazy.

Especially in our 50’s after almsot 27 years in the game. We have to have breaks and new experiences. Regardless of the hit to business.  Now I’m not advocating going on a trip for a month or even 2 weeks. But 5-6-7 day visits somewhere…..yep….that’s OK and you should do it no less than once per quarter. 

Just a tip from your ol uncle Jeffro….

Item #1 Our first one is called, “Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes” by Wang et al and published in JAMA Network Open on July 5, 2024 and that’s another hot tamale, hot tamale.  Remember, the citations can be found at chiropracticforward.com under this episode.  Wang L, Xu R, Kaelber DC, Berger NA. Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes. JAMA Netw Open. 2024;7(7):e2421305. doi:10.1001/jamanetworkopen.2024.21305

Why They Did It Is there clinical evidence supporting the potential benefits of glucagon-like peptide receptor agonists (GLP-1RAs) for the prevention of 13 obesity-associated cancers

How They Did It This retrospective cohort study was based on a nationwide multicenter database of electronic health records (EHRs) of 113 million US patients.  The study population included 1 651 452 patients with T2D who had no prior diagnosis of obesity-associated cancers and were prescribed GLP-1RAs, insulins, or metformin during March 2005 to November 2018.  Data analysis was conducted on April 26, 2024. Prescription of GLP-1RAs, insulins, or metformin.

Main Outcomes and Measures  Incident (first-time) diagnosis of each of the 13 obesity-associated cancers occurring during a 15-year follow-up after the exposure was examined

What They Found

Wrap It Up In this study, GLP-1RAs were associated with lower risks of specific types of obesity-associated cancers compared with insulins or metformin in patients with T2D. These findings provide preliminary evidence of the potential benefit of GLP-1RAs for cancer prevention in high-risk populations and support further preclinical and clinical studies for the prevention of certain obesity-associated cancers.

Item #2 The last one this week is called, “Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial” by Garcia-Gonzalez et al and published in Healthcare in June of 2024, OMG it’s HOT people! García-González, J.; Romero-del Rey, R.; Martínez-Martín, V.; Requena-Mullor, M.; Alarcón-Rodríguez, R. Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial. Healthcare 2024, 12, 1348. https://doi.org/10.3390/healthcare12131348

Why They Did It Spinal manipulations for chronic non-specific neck pain (CNNP) include cervical, cervicothoracic junction, and thoracic spine (CCT) manipulations as well as upper cervical spine (UCS) manipulations. This study aimed to compare the short-term effects of upper cervical spine manipulation versus a combination of cervicothoracic junction, and thoracic spine spine manipulations on pain intensity, disability, and cervical range of motion (CROM) in chronic non-specific neck pain patients.

How They Did It In a private physiotherapy clinic, 186 participants with chronic non-specific neck pain were randomly assigned to either the upper cervical spine or cervicothoracic junction, and thoracic spine manipulation groups. Neck pain, disability, and cervical range of motion were measured before and one week after the intervention. 

What They Found No significant differences were found between the groups regarding pain intensity and cervical range of motion.  However, there was a statistically significant difference in neck disability, with the cervicothoracic junction, and thoracic spine group showing a slightly greater decrease 

Wrap It Up The findings suggest that a combination of manipulations in the cervicothoracic junction, and thoracic spine spine results in a slightly more pronounced decrease in self-perceived disability compared to upper cervical spine manipulation in patients with chronic non-specific neck pain after one week. However, no statistically significant differences were observed between the groups in terms of pain intensity or cervical range of motion.

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 SMT Comparison Of Short-Term Effects & GLP-1 And Obesity-Associated Cancers appeared first on Chiropractic Forward.

CF 344: Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy Today we’re going to talk about Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy 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. 

You have found yourself smack dab in the middle of Episode #344 Now if you missed last week’s episode, we talked about Knee Osteoarthritis Recommendations & Ruptured Breast Implants Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things….. Still mumbling bumbling tumbling through the process of changing our medical provider. And it is a process. We’re working on a new contract and all that fun crap.  This is a post I made recently on my personal Facebook page – I just had a buddy remind me of this contraption that’s floating around and being shared.  The link to this contraption on Facebook can be found at this point in the show notes for this episode. 

https://heliomd.com/products/heliomd-cervical-traction-device

A brief description for those of you that aren’t going to go check it out but are curious.

It’s distributed by HelioMD and it’s called a manual pump neck brace. It rests on your shoulders and has a carriage under your chin and occiput.

I guess that’s the best way to describe it. It’s also called NeckRevive Neck stretcher.  It says it naturally relieves chronic neck pain in minutes, restore healthy neck posture and avoids further injuries. OK, where do you see the immediate problems? Chronic pain pathways are permanent and you’ll never correct chronic pain in minutes. Even with surgery typically. How can you ever avoid further injuries? That’s just silly right? It goes on to say that it eliminates neck humps. Through traction. Riiiigghhhhttt. As Dr. Evil would say. 

They’re asking $139.00 for this thing. Wow.  So I posted on my Facebook the following because it’s our duty to call out BS when we perceive BS is afoot. 

My plea to my friends is this: PLEASE understand something when you see claims like these. Every patient is different, everyone heals differently, everyone has different levels of fitness or degeneration and daily activity, and there is no ONE SINGLE DEVICE that’s going to solve all of your problems. 

Typically, when a ‘hump’ or other boney deformity develops over time, it is the body’s response to altered posture, altered activity, or altered body dynamics and stressors, etc.  Once those things appear, usually the body has remodeled itself and there is no reversing the issue. The best you can do at that point is simply try to alleviate pain that may result from it.  With that being said, I cannot personally see how this device can do what they claim, which is reversing a ‘hump’ in just two weeks.

My opinion is that something of that nature would be magical and I don’t see how it would be possible on any planet in our known universe. 

Also, posture isn’t as important as we’ve been led to believe all these years. As long as you’re changing positions regularly, sit however you like. You’ll suffer no consequences.  It’s the people who have SUSTAINED poor postures that have a hard time. Those people like professional drivers, dental workers, desk workers, teens on their phones all the time, and those that play video games for hours on end each day. Those people, if not changing positions regularly, will suffer consequences eventually. 

Back to this device…….however, if someone got some relief from pain through the traction this device might perform, well that might be something to talk about and for some, even useful.  But not some sort of ‘correction’. I would add that if traction is what is helpful, they sell $25 over-the-door traction mechanisms on Amazon. I think that would be the more reasonable route financially.  IF that traction didn’t do the job, we can do decompression here at the office that helps LOTS of folks with ongoing neck and back pain all of the time. Especially for those with disc injuries, stenosis, facet arthropathy, etc.  So, now my friends and family will hopefully be more aware, they see me as knowledgeable on the topic, and they’re more aware of their options up to and including coming to see me if they happen to be serious enough.  Is that effective social media marketing? I’m not sure.

The first thing is I don’t want to open myself to some sort of legal complaint so I’m careful to make sure they know that it’s my opinion based my experience and knowledge. Secondly, I’m mostly giving free information and advice without expecting anything in return. I’m offering a free service to my community and if they happen to like what they see and it turns their attention to me in a positive way, then it’s a win/win. Also, I’m not trying to be obnoxious about my disdain for the marketing practices.

I’m not using terms like ‘stupid company’, ‘asnine idiots’, or something like that. I think that looks bad on me and accomplishes the opposite of what I want. 

Anyway, just a tip from your Ol’ Uncle Jeffro. Don’t say I never gave you anything. 

Item #1 The first one today is called, “Obesity in Adolescents A Review” by Kelly et al and published in JAMA Network on August 5, 2024 schiza! Es muy caliente, mi ami! Yes, that was German, Spanish, and French in one exclamation! You are so very welcome.  

Remember, the citations can be found at chiropracticforward.com under this episode. 

Kelly AS, Armstrong SC, Michalsky MP, Fox CK. Obesity in Adolescents: A Review. JAMA. Published online August 05, 2024. doi:10.1001/jama.2024.11809

https://jamanetwork.com/journals/jama/fullarticle/2821829?guestAccessKey=f8345ddd-071d-47c4-b2c9-9cc8eafde342&utm_source=silverchair&utm_medium=email&utm_campaign=jama_network&utm_content=network_highlights&utm_term=081824&adv=000003189471

Why They Did It

Obesity affects approximately 21% of US adolescents and is associated with insulin resistance, hypertension, dyslipidemia, sleep disorders, depression, and musculoskeletal problems.  Obesity during adolescence has also been associated with an increased risk of mortality from cardiovascular disease and type 2 diabetes in adulthood.

What They Found

Obesity in adolescents aged 12 to younger than 18 years is commonly defined as a body mass index (BMI) at the 95th or greater age- and sex-adjusted percentile.  Comprehensive treatment in adolescents includes lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery.  Lifestyle modification therapy, which includes dietary, physical activity, and behavioral counseling, is first-line treatment; as monotherapy, lifestyle modification requires more than 26 contact hours over 1 year to elicit approximately 3% mean BMI reduction.  Newer antiobesity medications, such as liraglutide, semaglutide, and phentermine/topiramate, in combination with lifestyle modification therapy, can reduce mean BMI by approximately 5% to 17% at 1 year of treatment.  Adverse effects vary, but severe adverse events from these newer antiobesity medications are rare.  Surgery like gastric bypass and vertical sleeve gastrectomy for severe adolescent obesity (BMI ≥120% of the 95th percentile) reduces mean BMI by approximately 30% at 1 year.  Minor and major perioperative complications, such as reoperation and hospital readmission for dehydration, are experienced by approximately 15% and 8% of patients, respectively. Determining the long-term durability of all obesity treatments warrants future research.

Wrap It Up

The prevalence of adolescent obesity is approximately 21% in the US. Treatment options for adolescents with obesity include lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery.  Intensive lifestyle modification therapy reduces BMI by approximately 3% while pharmacotherapy added to lifestyle modification therapy can attain BMI reductions ranging from 5% to 17%. 

Surgery is the most effective intervention for adolescents with severe obesity and has been shown to achieve BMI reduction of approximately 30%. Item #2 Our second one today is called, “Combined Physiotherapy and Cognitive Behavioral Therapy for Functional Movement Disorders A Randomized Clinical Trial” by Macias-Garcia et al and published in JAMA Neurology on August 5, 2024 and that’s two hot one’s for the price of one, amigo. 

Macías-García D, Méndez-Del Barrio M, Canal-Rivero M, et al. Combined Physiotherapy and Cognitive Behavioral Therapy for Functional Movement Disorders: A Randomized Clinical Trial. JAMA Neurol. Published online August 05, 2024. doi:10.1001/jamaneurol.2024.2393

https://jamanetwork.com/journals/jamaneurology/fullarticle/2822067?guestAccessKey=2f88c764-a3c5-4f46-b321-8c21459326d6&utm_source=silverchair&utm_medium=email&utm_campaign=jama_network&utm_content=network_highlights&utm_term=081824&adv=000003189471

Why They Did It Question 

What is the efficacy of a multidisciplinary treatment (combining specialized physiotherapy and cognitive behavioral therapy) for individuals with functional movement disorders, comparing its effect on patient-reported quality of life with that of a control intervention (psychological support intervention)?

Findings  In this parallel randomized clinical trial that included 40 adults with functional movement disorders, multidisciplinary treatment significantly improved physical aspects of quality of life. There was no significant difference between interventions on mental health–related quality of life, but there was a nonsignificant improvement in general health self-perception; at months 3 and 5 after intervention, 42% and 47% of patients in the multidisciplinary-treatment group reported improved health compared with 26% and 16% in the control group, respectively.

Meaning  Results show that multidisciplinary treatment (physiotherapy plus cognitive behavioral therapy) effectively improves symptoms and physical aspects of the quality of life of patients with functional movement disorders against nondirected psychological support and education; this improvement seems to be driven by changes in mobility and pain domains.   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 Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy appeared first on Chiropractic Forward.