Communicating Imaging Findings & Acupuncture For Acute Pain

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 251: Communicating Imaging Findings & Acupuncture For Acute Pain Today we’re going to talk about Communicating Imaging Findings & Acupuncture For Acute 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 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, look down your nose at people 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. 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, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [e-mail] If you haven’t yet I have a few things you should do.

• Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
• Then go Like our Chiropractic Forward Facebook page,
• Join our private Chiropractic Forward Facebook group, and then
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• Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com

You have found yourself smack dab in the middle of Episode #251 Now if you missed last week’s episode , we talked about Night Owls Diabetes And Heart Disease & Medical Marijuana And Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

It’s been a tough one. My mother in law passed away last week. My wife’s parents live about an hour and 45 minutes to the North of Amarillo in our hometown of Perryton, TX. So, we’ve been back and forth and back and forth so many times I lost track. And there will be lots more back and forths to settle the estate and get Meg’s dad situated in a new town down around Longview TX. Lots of distractions coming up but I’ll do my best to keep this podcast on point, educational, and interesting. It’s like I’m trying to teach my kids right now. My daughter did not want to go to school today, which is a Monday. Her grandmother passed away Wednesday evening. She missed school Thursday and Friday. The memorial will be this Friday so she’ll miss another Thursday – fortunately, they’re out of school Friday. The day of the memorial. My point to her was this; life deals us blows.

We have loss and setbacks that get us down, make us sad, and give us the blues. But we have to do what we can to shoulder obligations, most of the time, give us an opportunity to move forward and take our minds off of our problems. Work can keep us from our lives in a good way as well as in a bad way. Sometimes, work keeps us from being able to enjoy our lives and engage in some of the things we are wanting to do more of. Me, I’m not able to spend time writing songs, playing music, sculpting, or painting and things like that. That’s work getting in the way in a bad way. But, then there’s the work that keeps our minds busy and occupied so that we’re not buried and consumed by worry and fret and the big bad blues life sometimes casts us into. So, for this week and the next, we go to school, we go to work, we occupy our minds, and let time take care of the rest. That may be a Gen X way of going about it but I’m Gen X and that’s what we do. Keep the nose down, work, and life will sort it out. Be upset, mourn, and take care of business, one foot in front of the other. Sorry to be so gloomy on the personal side of it all this week but, I’m always honest with you all and that’s what’s happening on the personal side. I’m certain next week’s episode will be a bit on the brighter side! Now, onto the research!

Item #1 Our first one today is called “Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update” by Nielsen et. al. (Arya Nielsen 2022) and published in Pain Medicine on June 17, 2020 and we got as hot one, people! These researchers by the way, are Phds and MDs. I think that’s notable.

Why They Did It A crisis in pain management persists, as does the epidemic of opioid overdose deaths, addiction, and diversion. Pain medicine is meeting these challenges by returning to its origins: the Bonica model of multidisciplinary pain care. The 2018 Academic Consortium White Paper detailed the historical context and magnitude of the pain crisis and the evidence base for nonpharmacologic strategies. More than 50% of chronic opioid use begins in the acute pain care setting. Acupuncture may be able to reduce this risk. This article updates the evidence base for acupuncture therapy for acute pain with a review of systematic reviews and meta-analyses on postsurgical/perioperative pain with opioid sparing and acute nonsurgical/trauma pain, including acute pain in the emergency department.

How They Did It

• To update reviews cited in the 2018 White Paper, electronic searches were conducted in PubMed, MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials with additional manual review of titles, links, and reference lists.
• There are 22 systematic reviews, 17 with meta-analyses of acupuncture in acute pain settings, and a review for acute pain in the intensive care unit. There are additional studies of acupuncture in acute pain settings.

Wrap It Up

• The majority of reviews found acupuncture therapy to be an efficacious strategy for acute pain, with potential to avoid or reduce opioid reliance.
• With an extremely low risk profile, acupuncture therapy is an important strategy in comprehensive acute pain care.

We see it every week in my clinic. The VA send over their vets regularly and our acupuncturist is like a golden laced angel to these veterans. It’s been impressive. Before getting to the next one, Go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody.

They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors.

Item #2

Our last one today is called “Integrating Epidemiological Information into MRI Reports Reduces Ensuing Radiologic Testing Costs Among Patients with Low Back Pain: A Controlled Study” by The Joint Commission Journal on Quality and Patient Safety 2020 by Weeks et. al. This was brought to me by Spine Care Partners who released a wonderful graphic that I got from Parker President, Dr. William Morgan, and shared in our Chiropractic Forward Facebook private group. The graphic showed what percentages in each age group that you can find ASYMPTOMATIC changes like degenerated discs, facets, bulges, herniations, etc. It was excellent. If you’re not in our private group on Facebook, go do that about right now.

This is more of a review so, let’s review about it shall we? They say, “Research has demonstrated that including epidemiological data along with the standard MRI results report has resulted in reduced opioid prescribing by the provider who ordered the study, as well as reduced referral to spine specialists. This new study includes an assessment of costs when frequency of common findings are included with the standard MRI results report.

The information included data on the prevalence of certain conditions over each decade of life in asymptomatic individuals. For example, degenerative disc disease findings in asymptomatic patients are seen in 68% in those 40-50 years of age, 80% in those 50-60, 88% if 60-70 years old, and 93% of 70-80 year olds. Totally asymptomatic! Which is amazing news for patients. Not great news for predatory providers that use rad findings to scare this holy living schnikees out of their patients so they’ll be forced to come see them a million times. Bad news for those asshats.

Great news for patients though. They say that their study showed that MRI reports with the addition of the prevalence of common findings triggered a downstream costs savings averaging $330 per report when compared to the standard MRI results report of the control group which meant there was no epidemiological charge included with the report. Best of all, repeat MRI use, spinal injection, opioid use, and surgery all decreased in the study group compared to the control group, while muscle relaxers and chiropractic utilization had a slight increase. They point out that one explanation for these findings is that the common language used in spine imaging reports, without statistical reference, is both fear invoking and inappropriately supportive of pathoanatomical understanding of back pain, as compared to the more clinically sound biophyschosocial model.

To put that in you and me speak, chiropractors are still relying heavily on the pathoanatomical model. Here’s the lesion, I’ll pop it, patient fixed. Cancer? Pop it. Bad hearing?? Pop it. Stomach ache? Pop it. COVID? Pop it. That’s so far from factual and being based in the evidence of literature that I cannot even begin to describe it.

They’re saying that chiropractors find stuff on the rad images and scare the crap out of their patients. Either because they’re not educated enough to know, or worst of all, because they’re predatory and miserable human beings that take advantage of their patients’ lack of education. All in order to get more visits and make that boat payment or that second house in the mountains or on the beach payment.

They’re also saying, start leaning into the BIOPSYCHOSOCIAL construct of pain, do right by your patients every day, and the money will just take care of itself. Treat others as you like to be treated. Kindergarten stuff. I don’t want myself or my family being taken advantage of so don’t do it to others. Get educated or get left behind.

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.

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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 Arya Nielsen, P., Jeffery A Dusek, PhD, Lisa Taylor-Swanson, PhD, Heather Tick, MD, (2022). “Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update.” Pain Med 23(9): 1582-1612.

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