CF 133: Getting Patients Returning, Shoulder Impingement, Cervical Manipulation, & X-rays and Neurodegenerative Disease Today we’re going to talk about getting your patients back in your office, we’ll talk about shoulder impingement, cervical manipulation research, and we’ll talk about low dose x-rays being the cause of neurodegenerative disease.  But first, here’s that sweet sweet bumper music  

  OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

Do it do it do it.  You have found yourself smack dab in the middle of Episode #133 Now if you missed last week’s episode, we talked about giving, we talked about maintenance care, dry needling, and we also talked about vitalism.

Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

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

On the personal end of things….. The last two episodes have had a talk about vitalism and all of that. I got red in the face and gripey and some would even say…..disagreeable.  None of that this week. Fun and positivity. I made the mistake of going back to recording the personal part of the podcast….this part of the podcast….two weeks in advance. Well, it bit me in the butt an episode or two back. I should know by now that that damn COVID’s going to change the program. Lol. I said it was looking good and numbers were great and by the time we get to air time, 2 weeks down the road, the roadmap was different and crap was firing up everywhere again.

It sounded silly for it to be firing up everywhere and there I am on a fresh episode talking about how good it’s looking. Lol. So…..I’m not going to mention anything like that again.  Besides, you guys are probably not in the mood to hear more about it anyway. Instead, I’ll tell you that I’m at about 81% of where I want to be. The least I want to see per week is about 180 appointments. Each week. 13 – 15 new patients per week. That’s the LEAST I want to see.  As of this recording, last week I saw 146 and 15 patients.

So, I’m not at 180 yet but I’m more comfortable with my new patient count. Let’s keep that rocking and the other numbers should take care of itself sooner than later. It’s a Monday afternoon and I have 120 on the books. That’s before Wednesday gets booked up, Thursday, and Friday. So, starting a Monday with 120 already booked for the week, that tells me we have a good chance at a continued recovery.  What are your numbers looking like? Is your practice starting to get back to normal and stabilize?

What are you doing to make sure your business survives this mess? I want to hear about it so I can share it with our audience. If you’ll share with us on the Facebook page, in the Facebook group, or by sending me an email at [email protected]…..I’ll make sure and share with the rest of our listeners. This can be an excellent way to help others that are struggling right now.  Last week I talked about giving. Well, this is a great way to give back to your profession and colleagues that may not be doing as well as we are.  I’ll start.  I doubled down on Social Media Instead of one post a day, we went to 3 per day and 4 per day on the weekends.  We went from just talking about chiropractic to fun posts with a little bit of chiropractic here and there.

About every 4th or 5th post.

We want to entertain. I don’t know that anyone wants to be sold anything right now but, I don’t personally mind commercials or being interrupted if I’m simultaneously being entertained. So that’s what we did. We started entertaining our crowd We asked for people to help us by inviting their friends to our page. And they did! We hit numbers that would have taken us 3 years to build. We hit them in only about 4 days. I was amazed. Just because we asked and, it seems that at this time, more people are willing to help others.  Of course, that’s if they’re not bitching at each other about masks.  I got back to my weekly emails to my patients.

I had fallen off to emailing only once every 3-4 weeks. Now I’m back on a weekly schedule.  I revamped my To-Do list to include everything thing that I need to accomplish every day so I don’t forget or let things lapse. I want to stay on point with getting our message out every day, every week, every month.  I decided to try a professional company for Facebook ads. We still have a lot of really mixed results on that sucker right now so I haven’t talked much about it but I’ll let you know how we do down the road. 

In the meantime, as if I needed something else to occupy my time, I started a voice-over career on the side. Lol. To go along with my sculpting, drawing, and art career. To go along with my furniture building career. Which will go along nicely with my singer/songwriter/guitar-playing career?  Geez….is that the very definition of A.D.D. or what? But yeah, if you need any commercials voiced for you, holler at me. I’m happy to help. 

Back to the office, I got back to doing weekly YouTube videos. Every week like clockwork. That made me get back to writing my own weekly blog. That’s work I used to hire out to a guy in South Africa but I took it back over for a bit and it’s been fun actually.  So, as you can see, I’ve made A LOT of changes to get back on track and get this sucker not just where it was this time last year, but 10% or bigger. Why the hell not? Overall, I have made it a point to highlight what we are doing to help keep them as safe as we can. If COVID is the barrier, then we need to do everything we can to remove that barrier. 

Alright, as I said, you guys and gals send me your suggestions of things you are doing to get your patients back in your clinic. 

Item #1 This first one this week is called ‘Relationship between shoulder impingement syndrome and thoracic posture’ by Hunter et. al.(Hunter D 2020) and published in Physical Therapy journal in April of 2020 and that means that that is one hot son of a mother!!

Why They Did It They say that shoulder impingement is the most common form of shoulder pain and a persistent musculoskeletal problem and that we have had limited success in treating it. They wanted to test whether or not thoracic posture has anything to do with it. 

How They Did It

What They Found

Wrap It Up “Individuals with shoulder impingement had a greater thoracic kyphosis and less extension ROM than age- and gender-matched healthy controls. These results suggest that clinicians could consider addressing the thoracic spine in patients with shoulder impingement.”

Item #2 Item #2 this week is called “The Effect of High Velocity Low Amplitude Cervical Manipulations on the Musculoskeletal System: Literature Review” by Giacalone et. al.(Giacalone 2020) published in Cureus in April of 2020 which makes it too hot to handle for me!

Why They Did It They say that cervical manipulative techniques are mostly used for the treatment of biomechanical joint dysfunction, but little is known about possibly using them in order to achieve better performance on a healthy subject

How They Did It

What They Found

Item #3 Our last one is called ‘Low-dose x-ray imaging may increase the risk of neurodegenerative diseases’ by Caroline Rodgers(Rodgers C 2020) and published in Medical Hypotheses in April of 2020…..look at April…..not just bringing us COVID…but also bringing us a bunch of plates of steamy hot stuff. 

As the journal says, this is a hypothesis. The hypothesis presented in this paper explores the possibility that X-ray imaging commonly used in dental practices may be a shared risk factor for sporadic dementias and motor-neuron diseases. As the evidence will suggest, the brain is ill-equipped to manage the intrusion of low-dose ionizing radiation (IR) beyond that which is naturally occurring.

When the brain’s antioxidant defenses are overwhelmed by IR, it produces an abundance of reactive oxygen species (ROS) that can lead to oxidative stress, mitochondrial dysfunction, loss of synaptic plasticity, altered neuronal structure and microvascular impairment that have been identified as early signs of neurodegeneration in Alzheimer’s disease, Parkinson’s, amyotrophic lateral sclerosis, vascular dementia and other diseases that progressively damage the brain and central nervous system.

Common assumptions regarding the risks of low-dose IR will be addressed, such as 1) comparing rapid, repeated bursts of man-made IR sent exclusively into the head to equivalent amounts of head-to-toe background IR over longer periods of time; 2) whether epidemiological studies that dismiss concerns regarding low-dose IR due to lack of evidence it causes cancer, heritable mutations or shortened life spans also apply to neurodegeneration; and 3) why even radiation-resistant neurons can be severely impacted by IR exposure, due to IR-induced injury to the processes they need to function. 

If X-ray imaging is found to be associated with neurodegeneration, the risk-versus-benefit must be reevaluated, every means of reducing exposure implemented and imaging protocols revised. So…..we here at Chiropractic Forward will be following along here. Because if this turns out to confirm that radiation causes neurodegenerative disease, you know what that means for the chiropractors shooting x-rays on each and every patient and then doing several follow up x-rays on them?  They won’t be happy campers. But, maybe they’ll start following more guidelines that say no x-rays outside of red flags. I’ve said several times that I’m not against chiropractors that shoot initial x-rays. I’m really not.

Some are just more comfortable working on people when they’ve seen what they can see.  My issue is using the initial x-rays as a scare tactic and communicating in a catastrophic way to achieve a long treatment schedule out the patient. One they likely don’t need at all.  My other issue would be repeating x-rays several times through treatment.

That’s not evidence-based and the patient doesn’t need them. 

Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. 

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

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

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

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

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

Website https://www.chiropracticforward.com

Social Media Links https://www.facebook.com/chiropracticforward/

Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/

Twitter https://twitter.com/Chiro_Forward

YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q

iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2

Player FM Link https://player.fm/series/2291021

Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through

TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/

About the Author & Host Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography Giacalone A, F. M., Magnifica F, Ruberti E, (2020). “The Effect of High Velocity Low Amplitude Cervical Manipulations on the Musculoskeletal System: Literature Review.” Cureus 12(4): e7682. Hunter D, R. D., McKeirnan S, (2020). “Relationship Between Shoulder Impingement Syndrome and Thoracic Posture.” Phys Ther 100(4): 677-686. Rodgers C (2020). “Low-dose X-ray Imaging May Increase the Risk of Neurodegenerative Diseases.” Med Hypotheses 142(109726).

The post Getting Patients Returning, Shoulder Impingement, Cervical Manipulation, & X-rays and Neurodegenerative Disease appeared first on Chiropractic Forward.

CF 132: Giving, Maintenance Care, Dry Needling, and Vitalism Today we’re going to talk about Giving, Maintenance Care, Dry Needling, and Vitalism

But first, here’s that sweet sweet bumper music  

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. 

We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers.

I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  

If you haven’t yet I have a few things you should do. 

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #132

Now if you missed last week’s episode , we talked about 5 principles to change clinical practice. There was some great information in that one all based on a recent paper that came out. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points. 

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

On the personal end of things…..

One foot in front of the other. I’ve been thinking a lot lately. I know this concept but I don’t do it intentionally. Still….I definitely do it. I give away stuff and help others when I like them, their product, or service. I promote them without expecting anything in return. Because I don’t expect anything in return. I do it because of the reasons stated. 

Then, what happens is that through giving to others, things come back around and are given to you. That’s the way it works. Again, I don’t give to get something back.  To me, that’s just not how it works. You have to give because you have a giving heart. Not a greedy heart just giving to get. 

I talk about people that I believe in and things that I use because I like them and I think they’d be useful to you. I talk about other people’s stuff more than I talk about my own stuff. I have some awesome evidence based patient education brochures and posters on our website but I talk more about Forward Thinking Chiropractic Alliance than you hear me talk about my stuff. 

If you’re evidence-based, I firmly believe you need to be a part of the FTCA. It’s that simple. We had Kevin Christie with Modern Chiropractic Marketing Podcast on a couple weeks ago. He does it right. That’s why he was on. I believe in Dr. Christie, I like Dr. Christie, and I support him. 

ChiroUp, not only do I really like the co-owners personally, but I don’t know what I ever did without the product. Honestly, I have no idea. I was less than before I had ChiroUp in my office. 

It’s why you always hear me speak about the diplomate/fellowship through the international academy of neuromusculoskeletal medicine. I’m not sure I’ve ever professionally believed in anything more than the education you get through them. 

It’s why I talk often about involvement with the Texas Chiropractic Association. It’s because I hope you’ll see the value in being active and involved in your own associations. Doing so was one of the key gamechangers in my professional life. You can count on that. 

Same goes for philanthropy. If you’re not giving back to your local non-profits monthly, you really should consider doing so. It’s easy and it’s fun. We’ve made it a cornerstone of my personal business. 

This isn’t a ‘oh look at me and how awesome I am’ thing here. It’s just an honest conversation about something I was thinking the other day. Does any of this come back to benefit me financially? I don’t know. I really don’t have a clue. And honestly, I don’t care. Once again, that’s not why we give. We give because we have a giver’s heart. Not only do I like and believe in the people and the products or the causes, but I also think that our listeners will find value in it. If I’m providing you value, then you know you’ll get the best, most valuable information through this podcast. 

So, maybe, even if others aren’t necessarily talking us up or pumping our tires, it still comes back, huh? Either way, there’s nothing better than giving. At least for me. I came across a quote that made some sense recently. Pablo Picasso said that the meaning of life is to find your gift. The purpose of life is to give it away.” That’s a giver’s heart. Exactly what I’m talking about. Seems like it worked out for Pablo. 

I think about give vs. take and I think of people that are takers. Taking money from patients when they don’t need the treatment. But a doctor scared them into a ton of extra visits because it’s good for stats and the bottom line. That’s a taker. 

Being in a position to help but deciding to never do anything to help anyone unless it benefits them personally or financially. That’s a taker. 

Just being in the world to see what you can get out of it instead of what you can contribute. That’s a taker. What can you do to make your space better? How can you spread a little love and kindness? 

Just some random thoughts today. Hope it meant something to you. 

Item #1

Let’s get started with this one called “The Nordic maintenance care program: maintenance care reduces the number of days with pain in acute episodes and increases the length of pain free periods for dysfunctional patients with recurrent and persistent low back pain – a secondary analysis of a pragmatic randomized controlled trial” by andreas Eklund et al(Eklund A 2020) and published in Chirorpactic and Manual Therapies in April 2020. Hot cakes coming up, hot cakes people. 

Why They Did It

Eklund has shown in two previous papers the benefit of treating preventatively but thae benefit varied across psychological subgroups. 

The aims of this study were to investigate 

How They Did It

A secondary analysis of data from a randomized controlled trial of patients seeking chiropractic care for recurrent or persistent LBP used 52 weekly estimates of days with low back pain that limited activity. 

What They Found

Wrap It Up

Data support the use of MC in a stratified care model targeting dysfunctional patients for MC. For a carefully selected group of patients with recurrent and persistent LBP the clinical course becomes more stable and the number of pain-free weeks between episodes increases when receiving MC.

Item #2

Item 2 is called ‘Dry needling for spine related disorders: a scoping review’ by Funk et. al(Funk MF 2020). published in Chiropractic and Manual Therapies  in May of 2020…..bringin’ the heat people! Bringing the heat!

Why They Did It

The depth and breadth of research on dry needling (DN) has not been evaluated specifically for symptomatic spine related disorders (SRD) from myofascial trigger points (TrP), disc, nerve and articular structures not due to serious pathologies. Current literature appears to support dry needling for treatment of trigger points. Goals of this review include identifying research published on dry needling treatment for spine related disorders, sites of treatment and outcomes studied.

How They Did It

A scoping review was conducted following Levac et al.’s five part methodological framework to determine the current state of the literature regarding dry needling for patients with spine related disorders.

That sound fine and freaking dandy but what the hell is a scoping review vs. a systematic review? Well, I did the work for you and here’s what we have. Within the framework of research methods, a well- done scoping review is considered at a higher level than a straightforward review of literature or an integrative review, but not as in depth as a Cochrane or Johanna Briggs model systematic review

Researchers may conduct scoping reviews instead of systematic reviews where the purpose of the review is to identify knowledge gaps, scope a body of literature, clarify concepts or to investigate research conduct. While useful in their own right, scoping reviews may also be helpful precursors to systematic reviews and can be used to confirm the relevance of inclusion criteria and potential questions.

Although conducted for different purposes compared to systematic reviews, scoping reviews still require rigorous and transparent methods in their conduct to ensure that the results are trustworthy. 

And now we’ve both learned something so that’s awesome. 

Wrap It Up

Back to the paper here; I’m not even going to get into the meat and taters here on this paper because you’ll zone off and might even tune out. I have it cited in the show notes if you really want to find it and dive in. Getting straight to the conclusion, the authors say, “For spine related disorders, dry needling was primarily applied to myofascial structures for pain or TrP diagnoses. Many outcomes were improved regardless of diagnosis or treatment parameters. Most studies applied just one treatment which may not reflect common clinical practice. Further research is warranted to determine optimal treatment duration and frequency. Most studies looked at dry needling as the sole intervention. It is unclear whether dry needling alone or in addition to other treatment procedures would provide superior outcomes.”

We covered a paper on dry needling last year that suggested it had little use. It appears it does indeed have some use. They just don’t know how to best use it yet. If that makes sense.

Item #3

Our last one today is called ‘Vitalism in contemporary chiropractic:a help or a hinderance?” by J. Keith Simpson and Kenneth J. Young(Simpson J 2020) and published in Chiropractic and Manual Therapies June 11, 2020. See the sizzle on that stacks of steaming sizzlers.  

Why They Did It

Chiropractic emerged in 1895 and was promoted as a viable health care substitute in direct competition with the medical profession. This was an era when there was a belief that one cause and one cure for all disease would be discovered. The chiropractic version was a theory that most diseases were caused by subluxated (slightly displaced) vertebrae interfering with “nerve vibrations” (a supernatural, vital force) and could be cured by adjusting (repositioning) vertebrae, thereby removing the interference with the body’s inherent capacity to heal. DD Palmer, the originator of chiropractic, established chiropractic based on vitalistic principles. Anecdotally, the authors have observed that many chiropractors who overtly claim to be “vitalists” cannot define the term. Therefore, we sought the origins of vitalism and to examine its effects on chiropractic today.

Discussion

Vitalism arose out of human curiosity around the biggest questions: Where do we come from? What is life? For some, life was derived from an unknown and unknowable vital force. For others, a vital force was a placeholder, a piece of knowledge not yet grasped but attainable. Developments in science have demonstrated there is no longer a need to invoke vitalistic entities as either explanations or hypotheses for biological phenomena. Nevertheless, vitalism remains within chiropractic. In this examination of vitalism within chiropractic we explore the history of vitalism, vitalism within chiropractic and whether a vitalistic ideology is compatible with the legal and ethical requirements for registered health care professionals such as chiropractors.

They say that despite the obstacle of vitalism, chiropractic has made extraordinary inroads into the health care system worldwide. Having emerged from the pre-scientific health care era in the United States of America (USA) in the early twentieth century it now has a global footprint with representation in approximately 100 countries. It is the third largest regulated primary contact health care profession in the western world

Conclusion

Vitalism has had many meanings throughout the centuries of recorded history. Though only vaguely defined by chiropractors, vitalism, as a representation of supernatural force and therefore an untestable hypothesis, sits at the heart of the divisions within chiropractic and acts as an impediment to chiropractic legitimacy, cultural authority and integration into mainstream health care.

Y’all know by now how I feel about it. When you have someone following current research, updating their procedures and thought process as the knowledge base expands, and taking care of their patients and running their businesses in an ethical way with the highest of morals and love, then you’re my kind of person. I respect you and I’m proud of you. Most of our listeners are that kind of practitioner. 

If you’re scaring people into a bunch of visits based on stuff research says is no big deal, if you’re convincing people they depend on seeing you consistently, if you’re engaging in vaccine discussions when you’ve read a book or two but never been proper educated to do so, when you’re stats and your profits come before the true needs of the patient, then I don’t respect you and I wonder how you sleep at night with the knowledge of how you are screwing and stealing from patients coming to you for your help weighing heavily on your conscience. They come to you for your help. Not to buy you a big house. Not to be lied to. Not to have false, fake, or outdated ideas shoved up their poop shoot and to be taken advantage of. 

Stop it dammit. It’s gross and you give everyone that truly works their asses off a bad name. You’re the reason someone that gets a diplomate or some other significant continueing education ro certification…..you’re the reason they still get laughed at behind their backs. You should be ashamed of what you do to yourselves, your colleagues, and your profession. 

I’m really not a bitchy guy. I’m a fun-loving ‘let’s have a beer’ kind of guy. But very few things grind my geears worse than this stuff. Honestly. It’s the wrench in my gears, the salt in my wound if you will. I think about it and I start breaking out in hives and get all rashy. My eyes about roll out of my damn head onto the floor. 

I’ll be in a better mood next week. I hope. 

Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it.

Let’s get to the message. Same as it is every week. 

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. 

And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

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

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

Website

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https://www.facebook.com/chiropracticforward/

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TuneIn

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Eklund A, H. J., Jensen I, Leboeuf-Yde C, (2020). “The Nordic maintenance care program: maintenance care reduces the number of days with pain in acute episodes and increases the length of pain free periods for dysfunctional patients with recurrent and persistent low back pain – a secondary analysis of a pragmatic randomized controlled trial.” Chiropr Man Therap 28(19).

Funk MF, F.-D. A. (2020). “Dry needling for spine related disorders: a scoping review.” Chiropr Man Therap 28(23).

Simpson J, Y. K. (2020). “Vitalism in contemporary chiropractic: a help or a hinderance?” Chiropr Man Therap 28(35).

The post Giving, Maintenance Care, Dry Needling, and Vitalism appeared first on Chiropractic Forward.

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The post w/ Dr. Kevin Christie: Doing It Right, Marketing Chiropractic, & Book Release appeared first on Chiropractic Forward.

The post Updated Thinking On Chronic Pain and Exercise appeared first on Chiropractic Forward.

CF 128: Tylenol Fails For Back Pain, Cervical Disc Research, & CAM For Headache/Migraine Today we’re going to talk about Tylenol Fails For Back Pain, Cervical Disc Research, & complementary and alternative medicine For Headache/Migraine But first, here’s that sweet sweet bumper music  

  OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

Do it do it do it. 

You have found yourself smack dab in the middle of Episode #128 Now if you missed last week’s episode, we were joined on the show by Dr. William Morgan. You wanna hear a truly impressive individual speak and share, this is one of those episodes, my friends. I wouldn’t steer you the wrong way. Go to last week’s episode and give it a listen. We talked about all kinds of good stuff, we talked about excellence, we talked about Parker, we talked about chiropractic in general and Dr. Morgan shared some experiences with us about treating the President of the United States of America. Wow. Make sure you don’t miss that info. Keep up with the class. 

While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.  Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper. 

On the personal end of things….. I don’t know how long I’ve been back full force now but it’s been some time. As with anything, you start to adopt new procedures and then those new things become a habit and hardly even noticeable anymore.  I see chiros asking what others are wearing. Some don’t take COVID seriously so they don’t wear anything, to be honest. They just wash hands as if washing your hands takes it out of the air or prevents the coughing from putting it out there for you to breathe.  I wear a mask. I wear glasses so I just wear them for any eye cover. Who knows if that even matters? It probably doesn’t.  I wear gloves. Not because I’m afraid to touch anyone. I started out without gloves but the sanitizer and soap washing all of the time ate my hands up. Bad. So, gloves have solved that problem for me.

Maybe I just need some new soap and I can go back to no gloves.  Now after some unfortunate interactions on Facebook I’m stepping up onto my soapbox for a good old fashioned rant and, when I’m done, I hope we can still be friends.    The more interactions with people I have, even a select few supposedly educated chiropractors, the more I’m aware of how uneducated people can truly be. 

How can you confuse the mask issue? Yes, in the beginning, they said masks weren’t useful. Back when they were trying to prevent a run on N95 masks so the hospitals could have them available.  But for months now, they have recommended them for everyone when social distancing cannot be avoided. AKA; a chiropractor’s office.  Their latest update reiterates it. The best guess estimates are that 40% of COVID cases were due to a ‘healthy’ asymptomatic spreading it.  They also just said last week that up to 35% of positives were in completely asymptomatic cases. That’s excellent news!! That means that a little over 1/3 of people that get it do extremely well and never even know they have it. That’s amazing.  The problem is that that 1/3 is responsible for 40% of the cases because they don’t know they have it and are spreading it. 

How can we be so sure that masks are effective? There are three papers that were done. One in a bus, one in South Korea, and one in Washington State that suggest masks are EXTREMELY effective in stopping COVID in its tracks.  Let’s start with the choir practice(Hammer L 2020)  (https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm?fbclid=IwAR2iRGtCRNMPhYoxCtQnP1jGYobAhunSqWMH4DSpuga5oKaOHa4VbAH7pNc) 

Following a 2.5 hour choir practice attended by 61 persons, including a symptomatic, 32 confirmed and 20 probably secondary COVID cases occurred. If you’re counting, that’s 52 of the 61 members of the choir.  3 patients were hospitalized and 2 died. The transmission was likely facilitated by close proximity during practice and augmented by the act of singing.  Alright, now, let’s talk about the bus.  In short, scientists in China studied a guy in China who passed it on to 13 others.

On the bus, his germs jumped as far as 4.5 meters to other travelers and it lingered in the air for up to 30 minutes after the guy got off of the bus. 4.5 meters for us Americanos is almost 15 feet.  Now, let’s talk about a new paper that came out on May 13 so it’s recent news.

This paper was in the journal called Respiratory Medicine by Gao, et. al.(Gao M 2020) called ‘A study on infectivity of asymptomatic SARS-CoV-2 carriers’.  This paper follows a case of an asymptomatic spreader and 455 contact encounters to try to assess the infectivity of asymptomatic carriers.  The 455 contacts wore masks, the test subject wore masks. and nobody got sick. They didn’t give COVID to any of the 455. And all wore masks. This included family members.  Medical Express posted an article on May 17th about some research out of Hong Kong where they tested a masking mechanism with hamsters. https://medicalxpress.com/news/2020-05-hamster-masks-coronavirus-scientists.html

The research by the University of Hong Kong is some of the first to specifically investigate whether masks can stop symptomatic and asymptomatic COVID-19 carriers from infecting others. They placed hamsters that were artificially infected with the disease next to healthy animals. Surgical masks were placed between the two cages with airflow traveling from the infected animals to the healthy ones. The researchers found non-contact transmission of the virus could be reduced by more than 75 percent when the masks were used. Two-thirds of the healthy hamsters were infected within a week if no masks were applied. Not only that but, those that did become infected were also found to have less of the virus within their bodies than those infected without a mask. The most effective use of the masks was when the person wearing the mask was the infected one.  

The problem with that is that nobody knows who is infected because up to 35% of people infected don’t have any symptoms or feel sick.  So, you can pass it up to 15 feet away, you can be in close proximity to 61 others and give it to 52 of them, or we can all wear masks and mostly avoid giving it to anybody. Hmmm. Let me do the math, carry the three….and….yep, I’ll wear masks for a little while.

A mask is a small ask, people. That’s the new slogan. Just give me credit. That’s all I ask.  If you don’t require masks in your office as the CDC recommends right now, you’re putting yourself, your staff, and your immunocompromised patients at risk.  You can wash your hands until the skin falls off and think you’re protecting everyone and doing a good job but you’re not taking it out of the air.

The Czechoslovakian government got it right in their slogan, “My mask protects you and yours protects me.”

No, it’s not the damn flu. While the CDC’s latest updates have a lot of good news in it, it’s still clear it’s not the damn flu. If you claim it is, you are simply not very educated on it and you’re probably doing your patients a disservice by saying that it is.  COVID is estimated to have a .4 mortality rate. Flu is estimated at .1 so COVID is FOUR TIMES as deadly. We see that day to day because, in a BAD flu year, between 60k to 80k people die of it. IN A YEAR. 

COVID has killed over 100,000 Americans in just about 3 months or so. It’s not the same as the damn flu.  But, 0.4% is waaaayyy better than it was initially thought. Some other current news from Reuters out of Italy is that it is losing its potency. Meaning, it may have mutated to a less deadly version. That’s awesome news. 

In the beginning, I was worried and stressed and anxious. We all were. It was brand new and nobody knew anything about it. Not even the experts. Hell, when AIDS was brand new, the fear was that mosquitos could infect you. Then we learned more and then we were safer.  As more and more is known about this virus, I’m no longer as worried for myself or my family or even most of my patients. The newest CDC guesstimates show that 96.6% of COVID patients never even have to go to the hospital. That’s a pretty great stat right there. 

However, I AM afraid for my mother. I AM afraid for my Dad who is in a nursing home. I AM afraid for my other family member who is immunocompromised. I AM afraid for my patients that are immunocompromised. I AM going to continue to be safe and be smart for those people. Not out of fear but out of an abundance of education and because it’s not the flu. I hope you’re doing the same. 

While there’s a 96.6% chance none of us ever have to go to the hospital because of it, there’s a 100% chance I’d have to close my office for a bit. I don’t know about you but I can’t afford that. This podcasting gig doesn’t pay anything so I guess I need to mind my p’s and q’s and be smart about my day to day bidniz. 

I know several that say but, but, but….what about….but. All that crap is noise. Uneducated, noise tinged with a healthy dose of arrogance. It really is OK to follow science and evidence. We’ve been preaching it for 3 years now. Why would COVID change that?

Let science guide you. Not Bill Gates, Trump, or Pelosi. What does the science say? Stop listening to Fox and CNN. What does the science say? Stop listening to conservative or Liberal talk show hosts. What does the science say? Stop listening to Uncle Roy, the ranch manager or the warehouse worker. What does the science say? As far as that goes, stop listening to the physician on the hospital steps spouting politically biased crap and tying it into a COVID talk. Who the hell cares? What does the damn science say?

Keep it simple. Don’t let things confuse the topic. How severe, how easily spread, how can you avoid spreading or catching? Simple crap here.

The rest of those people are uneducated and arrogant noise. Noise I tuned out over a month ago. 

Alright, rant over. 

Item #1 Our first Item this week is called “Efficacy and safety of Paracetamol for Spinal Pain and Osteoarthritis: Systematic Review and Meta-Analysis of Randomized Placebo Controlled Trials” by Machado, et. al(Machado G 2015). and published in British Medical Journal in March of 2015. 

Why They Did It They wanted to investigate the efficacy and safety of paracetamol (acetaminophen) aka Tylenol… in the management of spinal pain and osteoarthritis of the hip or knee.

How They Did It

What They Found

Wrap It Up “Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines.”

Item #2 This one is called “Relationship of Modic Changes, Disk Herniation Morphology, and Axial Location to Outcomes in Symptomatic Cervical Disk Herniation Patients Treated With High-Velocity, Low-Amplitude Spinal Manipulation: A Prospective Study” by Kressig et. al(Kressig M 2016). and published in Journal of Manipulative Physiology and Therapeutics in October 2016. 

Why They Did It The authors here wanted to evaluate whether cervical disc herniation (CDH) location, morphology, or Modic changes (MCs) are related to treatment outcomes.

How They Did It

Wrap It Up Although patients who were Modic positive had higher baseline NDI scores, the proportion of these patients improved was higher for all time points up to 6 months. Patients with Modic I changes did worse than patients with Modic II changes at only 2 weeks.

Item #3 Our last one is called, “Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results From the 2012 National Health Interview Survey” by Zhang et. al(Zhang Y 2017). and was published in Headache journal in September of 2017. 

Why They Did It They did this to answer the following questions: (1) Which complementary and alternative (CAM) modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers?

What They Found

The most frequently used CAM modality for headache/migraine was manipulative therapy at only 22%. Herbal supplementation was at 21.7% usage, and mind-body therapy was at 17.9%. The top 3 reasons given for using CAM for headaches were for general wellness, at about 28.7%, improving overall health at about 26.8%, and for reducing stress at about 16.7%. Although CAM is used by many sufferers of headaches and migraines, its use specifically for the headache or migraine is low in the US. 

Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. 

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

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.

And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

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

That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 

Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 

We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 

Connect

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

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About the Author & Host

Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerBibliography

The post Tylenol Fails For Back Pain, Cervical Disc Research, & CAM For Headache/Migraine appeared first on Chiropractic Forward.

CF 127 w/ Dr. William Morgan: A Conversation About Excellence, Research, Parker University, and Chiropractic

Today we’re going to be joined by Dr. William Morgan, President of Parker University and over-all impressive human being.  But first, here’s that sweet sweet bumper music  

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.  We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.   If you haven’t yet I have a few things you should do. 

Do it do it do it.  You have found yourself smack dab in the middle of Episode #127 Now if you missed last week’s episode, we talked about immunity-boosting, coconut oil failures, and screen time and its apparent association with autism. Make sure you don’t miss that info. Keep up with the class.  While we’re on the topic of being smart, did you know that you can use our website as a resource? Quick and easy, you can go to chiropracticforward.com, click on Episodes, and use the search function to find whatever you want quickly and easily. With over 100 episodes in the tank and an average of 2-3 papers covered per episode, we have somewhere between 250 and 300 papers that can be quickly referenced along with their talking points.  Just so you know, all of the research we talk about in each episode is cited in the show notes for each episode if you’re looking to dive in a little deeper.  When we have a guest, we typically dispense with my personal thoughts and practice experiences over the course of the week. We will do that same this week outside of this; I was with many of you. I closed the shop for 2 weeks. Solid. Closed. Then, I gradually started back with urgent/emergent care just like our governing board in Texas recommended.  At this point, I’m in my 3rd week of being completely re-opened. Even to wellness and maintenance care. While I’m used to 180-220 patient visits per week, I’m now experiencing about 110-120. We’re low. Obviously. But, it’s growing every week. People are beginning to tire of the restrictions on their activities and, I’d assume to some extent, are becoming somewhat numb or less concerned…..or more comfortable I guess with the risk aspect of it all.  Regardless, they’re starting to return. I’m pretty sure those of you that closed and did a gradual re-opening like me are experiencing much the same. Now if we can get the massage therapists back to work safely. We’re still waiting to see what happens on that end of it.  OK, let’s get to our guest today. I tell you sincerely, we are hitting the high spots on this show. WI’m just sitting here thinking about all of the amazing guests we’ve had over the last three years and just in the last few months we’ve had Dr. Stu McGill, Dr. Mike Massey, and now Dr. Williams Morgan. It’s been fun to watch this thing of ours grow and continue to grow. You, the listener, is the main reason for that growth and I just want to continue to thank you and tell you how important you are to me and how much I appreciate you.  Usually, bios and intros can be a bit mundane. Not today, my friends.  When your guest has been the chiropractor to the US Congress, the US Supreme Court, and to the White Hosue, well, you know it’s going to be a good one don’t you? Not only that but Dr. William Morgan, as mentioned, is the President of Parker University, and an active member of the Texas Chiropractic Association and has been testifying on chiropractic issues in the last two Texas Legislative Sessions and is happy and proud to be a Texan. That’s my kind of guy right there!! Our Texan pride is indeed legendary and probably annoying to anyone outside of the state.  At age 17, he joined the Navy and served with an elite Marine Recon company as a hospital corpsman. During that time, he qualified in parachuting, military diving, submarine insertion, jungle warfare, combat swimming, explosives, mountaineering, winter warfare, and Arctic survival. Additionally, he attended anti-terrorist training at the FBI Academy. After leaving active military service and transferring to the Navy Reserves, Dr. Morgan began his educational journey to become a doctor of chiropractic. While at Palmer College of Chiropractic-West, he transferred to a Naval Special Warfare platoon as the unit’s primary hospital corpsman. He was sent to Special Operations Technician training to learn the principles of dive medicine. For the next eight years, he served as a dive medicine corpsman/combat swimmer for a platoon of Navy frogmen in Naval Special Warfare Unit One.   In 1985, Dr. Morgan received his Doctorate of Chiropractic from Palmer College of Chiropractic–West and soon after, married fellow Palmer graduate, Clare Pelkey. They practiced for thirteen years in California. In 1998, Dr. Morgan was chosen to establish the first chiropractic clinic at the National Naval Medical Center in Bethesda, Maryland, which later became Walter Reed National Military Medical Center. In 2015, Walter Reed recognized Dr. Morgan with its highest honor for clinical excellence, the Master Clinician’s Award. During the last 18 years at the military’s most prestigious medical centers, he practiced in an integrative setting, providing chiropractic care to the injured troops returning from the wars in Iraq and Afghanistan.  In the year 2000, Dr. Morgan was appointed as the Chiropractor to Congress at the U.S. Capitol. At the Office of the Attending Physician to Congress, doctors of many specialties care for members of Congress and the Supreme Court. In 2007, Dr. Morgan began serving as the White House Chiropractor. He was appointed chiropractor for the United States Naval Academy football team in 2009 (which never lost to Army while under his care).  In 2011, Dr. Morgan was appointed to the United States Navy Musculoskeletal Continuum of Care Advisory Board, an entity created to address the prevalent injuries sustained by U.S. Armed Forces Personnel during active-duty operations. Dr. Morgan also served on the Spine Subcommittee, which helps develop care algorithms for treating spinal conditions and determining the future of musculoskeletal management in the U.S. Armed Forces.  Dr. Morgan has completed a 2,000-hour residency in Integrated Medicine. He served on the Board of Trustees for Palmer College of Chiropractic for ten years. He is a Diplomate of the American Academy of Pain Management and has held adjunct faculty positions at F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, and New York Chiropractic College. Additionally, Dr. Morgan served as a consultant for the U.S. Department of Veterans Affairs (VA), helping to implement the VA’s chiropractic benefit and advocate for chiropractic research  Parker University inaugurated William E. Morgan as their seventh President in 2016. Upon arriving in Texas, he became an active member and supporter of the Texas Chiropractic Association (TCA). Almost immediately, he organized a leadership summit to establish a legislative agenda strategy for chiropractors in Texas. Texas Chiropractors had not won a significant legislative victory in two decades, but in 2017 four bills advantageous to the chiropractic profession passed. Additionally, Morgan has assisted in fundraising, membership recruitment, and awareness for the TCA. As a lifetime member of the American Chiropractic Association (ACA), he has also held several leadership positions in the organization.  Just last year, I was at the TCA President’s Gala when Dr. Morgan was awarded the Keeler Plaque which is awarded to the chiropractor of the year but is also a life time service award of sorts. It’s the most prestigious award the TCA gives so it’s quite an honor. And here in Texas, we are quite honored to have Dr. Morgan on our team. As a side note, I’m honored to know Dr. Morgan personally and really appreciate him agreeing to come on this podcast so let’s hop into it.  Welcome to the show Dr. Morgan, thank you so much for caving to my pestering and agreeing to shut me up by finally coming on the show.  Having the background you have, you’ve spent serious time on both coasts of our great nation. Now you find yourself dead center, right in the middle of the country. What was the allure of Texas for you, how has Texas treated you, and what has been your favorite thing about living here in Texas? Did you have any early perceptions of Texas or Texans when you moved here that proved to be false and did you have any that proved to be absolutely true? Everyone has a chiropractic story, what led you to want to be a chiropractor? Can you share a little about how you got to the point of climbing the ranks and becoming the chiropractor to Congress, the Supreme Court, and the White House? How did it all come about? Can you share some of the legally shareable and more unique stories or experiences of treating those types of patients? You moved to Dallas, TX to take the helm of Parker University as their 7th President. Just a little background on me personally, I was there when Jim Parker was still around. I was there when he passed away and his son Karl took over and I believe Fab Mancini was coming on board about the time I graduated. I’m well acquainted with Parker of yesteryear. When you got to Parker, what was one of the first things you wanted to change? What would you say has/have been the changes you’ve made since arriving that you are the proudest of? When I was in school there, exercise/rehab honestly was not a big aspect of the curricula. I know a bit about you and Parker Fit. Have exercises and rehabilitation taken on a larger role since 1998? Some areas of the country never experience something you all, unfortunately, went through last year. Tell us a bit about the tornado, the aftermath, and going forward from it.  Now, from one awful event to another. Our current global pandemic. How is Parker University handling this event? What can students expect going forward? During this crazy time, there have been a lot of divisions in the country from opening vs. closing to ‘I refuse to wear a mask’ vs. ‘can you please wear a mask’? Our profession, unfortunately, is no different. It’s been divided along clear lines for decades and this pandemic has brought some of the divisions into the spotlight. One of them is between those that promote spinal manipulative therapy as a way to boost immunity and those that do not support that. When this was really first unfolding and our Texas Board of Chiropractic Examiners, the WHO, the WFC, and the ACA were all telling chiropractors the support for immunity boosting is not present in the research literature, you and Dr. Katie Pohlman (I love Katie and need her on the show BTW)…you and Dr. Pohlman recorded a very smart and well-stated video saying that indeed, the research literature cannot support immunity-boosting at this time. Obviously, I was and am 100% on board with it and I said all of that to ask you this, was there any fallout to that? How did you handle it? And what went into the decision to record it in the first place.  Let’s move to legislative issues. What have you felt is our biggest issues in Texas and on the national level when it comes to chiropractic?  I have said repeatedly on this show that due to the opioid crisis and due to the emerging research over the last 5-10 years, I truly feel there’s not been a better time to be a chiropractor since the 1980s. As the President of a chiropractic college, what is the status of our profession right now? Not just in terms of the pandemic but over the course of the last year. Over the course of the next 5 years. Am I right about it being a great time? Am I wrong? Or a little bit of both? Thank you for joining us today! Alright, that’s it. Y’all be safe. Continue taking care of yourselves and taking care of your neighbors. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week.  Remember the evidence-informed brochures and posters at chiropracticforward.com.   

The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventativly after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website https://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      

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