Discs In Low Back Pain & Unnecessary Surgeries Via COVID

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 292: Discs In Low Back Pain & Unnecessary Surgeries Via COVID

Today we’re going to talk about Discs In Low Back Pain & Unnecessary Surgeries Via COVID

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
• Review our podcast on whatever platform you’re listening to
• Last thing real quick, we also have an evidence-based brochure and poster store at com

You have found yourself smack dab in the middle of Episode #292

Now if you missed last week’s episode, we talked about Racial and Ethnic Disparities In Chronic Low Back Pain & Pregnancy And Cannabis Use . Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

Isn’t it funny how things work sometimes? I had something odd happened recently here in the clinic. We found out that our acupuncturist was moving to a different chiropractor’s office. She’s been with us for about eight years. What she’s credentialed through me to see veterans through our VA system.

So the VA randomly called us one day inquiring on her moving to another office and when that is happening, etc. Well, it was news to us. So we reached out to the acupuncturist and she admitted that she had plans to move but had not shared them with us yet. Although Amarillo Texas is about 225,000 people, there are only 3 acupuncturists in the entire area. It’s just not that popular here.

Although, it is definitely gaining in popularity. So the prospects of us being able to bring on another acupuncturist quickly are very slim. However, we went ahead and reached out to the one we really wanted to work with us. I have a good relationship with her, but things have just not worked out to where we could’ve actually worked together before. It turns out that she was tired of her current situation and was interested in making a move.

So she came in for an interview, we talked, and she was on board. We started the credentialing process with the VA that very day, so, while it takes 90 days to get credentialed, at this point, we are already almost a month into the process. That should significantly shorten the waiting period for our veterans to switch to a new acupuncturist and soften the landing.

Oh, in the meantime, if our previous acupuncturist, had any plans of stealing our patients, and taking them to a new place, that is going to be hard for her to accomplish. She hast to get completely re-credentialed, and I promise you were ahead of her on getting that done. In addition, the veterans have to get authorization to see her and she hast to get credentialed before they can even start the process of getting authorized through her. Whereas here in my clinic the machine is already built. The gears are already oiled and greased, and we are at fine-tune the machine. I think there’s no doubt we are going to come out ahead on this transition.

One thing we all know is that the one constant in life is that things are always changing.

Many of us are going through changes with staff. I have 3 CA’s and that third spot. It’s just a constant turnover. I have another one that will start in two weeks. The last one lasted for about two weeks. The one before her lasted about three months. It’s been miserable but when we find the right one I think it will have been worth it anyway, that’s what’s on my mind this morning. Getting acupuncture back up and running and marketed, and getting another new staff member up and going.

It’s a constant churn and, as they say in the military, just embrace the suck and keep trucking. It all pays for your life and for the life of your family members. Might as well enjoy all of it that you can and embrace the parts you feel suck your soul and keep that part in the proper context.

Item #1

The first on today is called “Intervertebral disc degeneration and how it leads to low back pain” by Ashish D Diwan, James Melrose and published in Pub Med on Nov14 2022. Dayum. That’s hot.

Why They Did It

• The purpose of this review was to evaluate data generated by animal models of intervertebral disc (IVD) degeneration published in the last decade.
• The review aimed to highlight the valuable contributions of these animal models in identifying molecular events associated with pain generation.
• IVD degeneration is a complex process contributing to spinal pain, and understanding the underlying mechanisms is crucial for developing effective therapeutic strategies to alleviate pain, promote disc repair and regeneration, and prevent associated neuropathic and nociceptive pain.

How They Did It

• The researchers conducted a review of existing studies that employed animal models of IVD degeneration.
• They likely searched relevant databases, academic journals, and publications from the past decade to gather a comprehensive dataset.

• The selected studies would have used various animal models and experimental methods to induce IVD degeneration.

• These animal models mimic certain aspects of human IVD degeneration, allowing researchers to study the molecular events and mechanisms involved in pain generation.

What They Found

• Through their review, the researchers observed that in degenerated IVDs, there is nerve ingrowth and an increased number of nociceptors (pain-sensing neurons) and mechanoreceptors (sensors of mechanical stimuli).
• The biomechanically incompetent and abnormally loaded degenerated IVDs experience increased mechanical stimulation, leading to heightened low back pain.
• This finding helps establish a link between IVD degeneration and pain generation, shedding light on the complexity of the process.

• The review also highlighted the potential of a specific factor called “growth and differentiation factor 6” in addressing IVD degeneration. Studies using this factor in IVD puncture and multi-level IVD degeneration models, along with a rat xenograft radiculopathy pain model, demonstrated its ability to prevent further deterioration in degenerate IVDs. The factor exhibited regenerative properties that promoted the recovery of normal IVD architectural functional organization and inhibited the generation of inflammatory mediators, which contribute to disc degeneration and low back pain.

Wrap It Up

• The review of animal models of IVD degeneration provided valuable insights into the molecular events underlying pain generation in degenerate IVDs. It emphasized the importance of understanding the complex multifactorial process of IVD degeneration to identify potential therapeutic targets for pain relief and disc repair.

• One promising candidate identified through the review was “growth and differentiation factor 6,” which showed considerable potential in preventing further deterioration of degenerate IVDs, promoting regeneration, and inhibiting the generation of inflammatory mediators.

• The findings from these animal models suggest the need for human clinical trials with this compound to assess its efficacy in treating IVD degeneration and preventing low back pain generation in humans. Overall, this review underscores the significance of animal models in advancing our understanding of IVD degeneration and pain mechanisms, ultimately leading to improved treatment strategies for patients suffering from low back pain.

Before getting to the next one,

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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.

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Item #2

Our last one this week is called, “100,000 older Americans got unnecessary surgeries during dangerous first year of COVID-19” by Aaron Toleos and published in Lown Institute on May 17, 2022. Hot potato!

Why They Did It

The Lown Institute conducted this analysis to shed light on the issue of overuse of medical procedures in American healthcare, particularly during the COVID-19 pandemic. The aim was to bring attention to the fact that even during a public health crisis, unnecessary procedures were still being performed on vulnerable patients, potentially exposing them to harm and wasting healthcare resources.

How They Did It

The analysis was based on Medicare claims data from January to December 2020. The Lown Institute used the 100% Medicare claims database to evaluate the volume of overuse for eight common low-value procedures. The specific procedures and criteria for overuse were determined based on the institute’s previously published research into the measurement of low-value care at hospitals.

What They Found

• The Lown Institute found that a total of 106,474 unnecessary procedures were identified during the analyzed period. The most overused procedure by volume was coronary stents, with 45,176 procedures performed. Other procedures with high rates of overuse included vertebroplasty for osteoporosis, hysterectomy for benign disease, and spinal fusion for back pain.

• The analysis also revealed that approximately one in five of these low-value procedures met the criteria for overuse across the country. Even some of the nation’s most well-regarded hospitals had rates of overuse above the national average. For example, all of the top 20 hospitals ranked by U.S. News had rates of coronary stent overuse above the national average, with four of them having rates at least double that.

Wrap It Up

The analysis conducted by the Lown Institute highlights the persistence of overuse of medical procedures in U.S. hospitals, even during a major public health crisis like the COVID-19 pandemic. Despite previous knowledge that certain procedures, such as coronary stents for stable coronary disease, are of limited clinical benefit, they continue to be performed at high rates. This raises concerns about patient safety, healthcare costs, and the need to address the issue of overuse in the American healthcare system. The findings call for greater attention to evidence-based practices and the promotion of appropriate and necessary medical interventions to ensure better patient outcomes and more efficient use of healthcare resources.

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

Store

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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

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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

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