Adjustments For Scoliosis & Importance Of Pain Perceptions

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 231: Adjustments For Scoliosis & Importance Of Pain Perceptions Today we’re going to talk about Adjustments For Scoliosis & Importance Of Pain Perceptions But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are 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.

• Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s a great resource for patient education and for YOU. It saves you time in putting talks together or just staying current on research. It’s categorized into sections and written in a way that is easy to understand for you and patients. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
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You have found yourself smack dab in the middle of Episode #231 Now if you missed last week’s episode , we talked about lumbar stenosis. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Weelllll, what a weekend I just wrapped up. You never know when life is going to throw darts with your nose as the bullseye but my pickup truck died a couple of weeks ago. Died died. I had to replace the entire engine. What a sheer joy. I guess COVID has made engines hard to find as well. So, over $3,000 to do that. Now, while it’s in the shop getting a new engine, I bought a 2021 Chevy Silverado down in the Houston, TX area.

I worked from 8-12 last Friday then hopped on an airplane for a 2-hour ride down to Houston, then an Uber from the airport to the dealership in Tomball, TX. About a 45-minute Uber. Then to the dealership, sign some papers, hop in this beautiful black beast of a truck, and headed back on the 10-hour drive to Amarillo, TX. Texas is a big place folk. It just is.

I made it all of the ways to Wichita Falls at about 11:00 that night, slept in a hotel, got up at 7:00 am, and made it the rest of the way. I was back in Amarillo by noon on Saturday. With a new vehicle that I’m in love with. I think side gigs are vital. We can kill it in our personal practices.

But, due to insurance reimbursements or the challenges of a cash practice, or whatever the reasons may be, it always seems the margins are a bit thin. When you have a catastrophe like a vehicle dying and you have to hop out and get a newer vehicle, especially one that runs North of $50 or $55k, it’s nice to have that extra side income. My side gigs are voice-over…..holy cow voice-over. It’s changed my life. For real.

The term ‘game-changer’ is so overused, but voice-over has been a literal game-changer. Real Estate – I’ve been doing some real estate work lately. We bought a short-term rental in Lubbock, TX, the home of Texas Tech. They are a D1 school and have all of the events that come with a D1 school. Without getting too deeply into numbers, my total overhead per month on the house is $1100.

Just last weekend it was graduation weekend. Just last weekend on a 3-night stay we made $1600. So you can see where you can go with short-term rentals. There is a method will encounter if you listen to the Bigger Pockets podcast and that method is called the BRRRR method. It stands for Buy – Renovate – Rent – Refinance – and Repeat.

So you buy it below value and you renovate it and raise the value. Then you rent it to start making some money. After a seasoning period of 4-6 months, you refinance the property and get your down payment mostly back out of the property. Then you put that money down on another fixer-upper and repeat the process. So, we refinanced our long-term rental home here locally and got a good chunk out of it. Now, with that chunk, we are buying another hosue in Lubbock for our kids to live in while they go through college saving us thousands and thousands over the years they’re down there. Then we’ll either convert it to a short-term rental or we’ll sell it all together and put the money on a beach house in Florida. We also are looking at the Texas A&M market for a short-term rental.

Who knows? But for the rest of this year, I think we settle down and watch what the market does. It’s due for a slow down. Just want to see where and how before getting in too deep. So, these two side gigs have been mostly non-time consuming and mostly hands-off. It only takes about 15 minutes per week to self-manage a short-term rental. And…..this truck payment isn’t going to put me in the poor house as it may have in the past.

So, what side gigs are you working on? What’s been successful for you? I’d love to hear about it and maybe share it with the rest of the think tank here at Chiropractic Forward. Shoot me an email at [e-mail] Right before we get to it today…… are you tired of getting paid peanuts for your good work? Insurance pays maybe half. Medicare and Medicaid even less. So how about full payment? This comes with PI cases. How do you get these cases you ask? Learn the system.

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Item #1

The first one here is called, “Clinical observation of chiropractic manipulation in the treatment of degenerative scoliosis” by Lu-Guang et. al. (Li LG 2022) and published in Zhongguao Gu Shang in May of 2022 smooookin’! I want to thank my New Jersey friend, Dr. David Graber, for posting this on on Facebook.

Why They Did It

To observe clinical efficacy of chiropractic manipulation in the treatment of degenerative scoliosis

How They Did It

• 120 patients with degenerative scoliosis were randomly divided into treatment group and control group
• From 2017 to 2019
• The patients in the treatment group were treated with chiropractic manipulation once every other day for 4 weeks.
• The patients in control group were treated with eperisone hydrochloride tablets combined with a thoracolumbar orthopedic (TSLO) brace, oral eperisone hydrochloride tablets 50 mg three times a day, wearing TSLO brace for not less than 8 hours a day.
• The course of treatment was 4 weeks.
• After the patients were selected into the group, visual analogue scale (VAS) and Oswestry Disability Index (ODI) were recorded before treatment, 1, 2, 3, 4 weeks after treatment and 1 month after treatment.
• The full length X-ray of the spine was taken before and 4 weeks after treatment, and the scoliosis Cobb angle, sagittal vertical axis (SVA) and lumbar lordosis (LL) were measured and compared.

What They Found

• There were significant differences in VAS and Oswestry Disability Index between the two groups at each time point after treatment There was significant difference in Cobb angle between treatment group and control group after treatment, but there was no significant difference in lumbar lordosis and sagittal vertical axis between treatment group and control group.
• There was no significant difference in Cobb angle, lumbar lordosis and sagittal vertical axis between two groups before and after treatment.
• During the treatment, there were 4 mild adverse reactions in the control group and no adverse reactions in the treatment group.

Wrap It Up

Chiropractic manipulation can effectively relieve pain and improve lumbar function in patients with degenerative scoliosis. The onset of action is faster than that oral eperisone hydrochloride tablets combined with TSLO brace, and it has better safety and can improve Cobb angle of patients with degenerative scoliosis.

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Item #2

This last one today is called, “Pain cognitions and impact of low back pain after participation in a self-management program: a qualitative study”” by Joem et. al. (Joern 2022) and published in Chiropractic and Manual Therapies on the 21st of February 2022. Schizahhhh….that one’s bringing the heat!

Why They Did It

Benefits from low back pain (LBP) treatments seem to be related to patients changing their pain cognitions and developing an increased sense of control. Still, little is known about how these changes occur. The objective of this study was to gain insights into possible shifts in the understanding of LBP and the sense of being able to manage pain among patients participating in a LBP self-management intervention.

What They Found

• Four main themes, corresponding to the characterization of four patient groups, were identified:
  • ‘Feeling miscast,
  • ‘Maintaining reservations’,
  • ‘Struggling with habits’ and
  • ‘Handling it’.
• The participants within each group differed in how they understood, managed, and communicated about their LBP.
• Some retained the perception of LBP as a threatening disease, some expressed a changed understanding that did not translate into new behaviors, while others had changed their understanding of pain and their reaction to pain.

Wrap It Up

The same intervention was experienced very differently by different people depending on how messages and communication resonated with the individual patient’s experiences and prior understanding of LBP. Awareness of the ways that individuals’ understanding of LBP interacts with behavior and physical activities appears central to providing adaptive professional support and meeting the needs of individual patients. I have repeated this time and time again on this podcast and to my patients. How people think about their pain goes a long way in determining how they will do in the long run.

Communicate through the optimistic and hopeful filter. Make sure you’re pulling your patients back from the cliff with your words instead of pushing them into the chronic pain pit. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

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The Message

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

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

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

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

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

Bibliography

Joern, L., Kongsted, A., Thomassen, L, (2022). “Pain cognitions and impact of low back pain after participation in a self-management program: a qualitative study.” Chiropr Man Therap 30(8).

Li LG, G. J., Gao CY, Sun W, Luo J, Yang KX, Yu J, Li JG, Wang BJ, Yang W, Zhuang MH (2022). “Clinical observation of chiropractic manipulation in the treatment of degenerative scoliosis.” Zhongguo Gu Shang 35(5): 442-447.

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