Chiropractic Misinformation, Patients Need Movement & Love

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 157: Chiropractic Misinformation, Patients Need Movement & Love

Today we’re going to talk about misinformation on the part of chiropractors during the COVID pandemic, we’ll talk about three papers covering pain and how patients need a little love while they also need movement and physical activity.

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You have found yourself smack dab in the middle of Episode #157. The first episode to kick off our 4th year in the podcasting business. To be 100% honest, it doesn’t seem like I’ve been doing this for that long. It’s crazy to think about.

Now if you missed last week’s episode , we talked about our Top Ten episodes over the previous 3 years. It was our 3rd Year Anniversary episode. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

I had a pretty decent weekend. Still just staying in and being smart. We drove around and looked at lights with the kiddos. More just to get outta the damn house and do something different. The wifey, myself, and the two kiddos are about ready to give each other the People’s Elbow from time to time. People are all like….COVID is a time we get to slow down and reconnect with our families.

I’m all like, I’d like to connect with some of them. Physically. With my hands and tinged with some level of aggression. Lol. It’s hard as a parent to watch your kids waste away into boredom and just allow it to happen. I’m a big believer in doing things. Creating things. Being busy on some level. I believe an idle mind is a dangerous thing. So, I’m the parent telling them to get the hell up and make something of themselves. Maybe it’s me or maybe it’s my generation. Generation X is a generation of do-ers I believe.

Either way, they get tired of me urging them to do, to make, or just to freaking be. Be something! No, you can’t lie on your bed reading fictional books all day long. Maybe for an hour or so at night before bed instead of the xbox. That’s a good time to read don’t you think? Not for hours smack dab in the middle of the day.

I’m a big believer in art of all forms. So they get pushed to play the guitar, the piano, draw something, paint something. Write a story or a poem. Freaking create something. ANYTHING! Just don’t lay or sit around like a lump on a log all day. I won’t have it. I won’t create lazy bums to put out into the world. I just won’t. Yeah, it probably sucks to be my kid. I know. I admit it. My daughter is a 7th grader and I’ve already got her learning the discus. Pumping my own tires for a second here, I won state here in Texas in the discus and went to state in the shot put so I love re-visiting those days by coaching others. My son had no interest but Joss….she’s in and she’s doing great! My son, I’ve got him on the guitar and piano and he’s doing great too. All I ask for is activity and some progress. That’s all.

It actually snowed in Amarillo this weekend. Yes, we get snow somewhat regularly in my part of TX. We’re in the northern plains of Texas. We are flat and there are really no trees unless someone planted them. But we do have the nation’s second largest canyon called Palo Duro canyon and it’s awesome! If you’re ever close to Amarillo, you gotta check it out. Well worth it.

I’m typing this up on Monday morning 12/14. I saw on the news this morning that the first healthcare workers are getting the vaccine today. That’s pretty dang exciting. I already called my doctor buddies here in town and told them that when they feel it’s appropriate for us to have one, my wife and I would love to be on their list. I know a lot of folks are freaky about the vaccine and here’s my deal; by the time it’s my turn, any adverse events will already be well-known. They started in the UK las week. Adverse events are pretty much sorted out in about 8 weeks.

I’m tired of it. I’m over it. I’ve said it before here but, if I get the Rona, I have to shutter my clinic for 2-4 weeks. I can’t afford that. Well, technically, I can afford it but it would drain resources that don’t need to be drained if I just try to stay smart and healthy. So why wouldn’t I do everything I can? Besides that, I’m ready to get back to my life. Traveling, building things, and moving forward instead of this stagnate state we’ve all been in for 8 or more months. The vaccine is the first real step out of it.

I am so over other chiropractors out there. One of the vitalists I talked about and was ashamed of in Episode 153 called Some Chiropractors Could Be Better…..well that Flat-Earther has been on his Facebook railing against the vaccines and acting like he is an epidemiologist and trained in the safety and efficacy of vaccines.

He wasn’t. I went through chiropractic school. Other than chiro philosophy, no real education on vaccines was had and certainly not enough to pretend to be an authority on them. One way or another. For or against them. So why the hell are so many wading out into those waters? Just stay the hell out of the discussion. It’s so dumb. It really is.

Can you imagine telling a young mother their baby doesn’t need the measles vaccine because your magical powers of subluxation slaying will protect them by boosting their immune system? And then the baby actually gets measles?

Why in the hell would you want to put yourself or that mother and baby in that position. Just shut up. Back off. Stay in your lane, pal. You’re not that cool. Same goes for COVID. Do you really want to be in the position of telling your patient they really shouldn’t take that vaccine because you’re a spine whisperer and detecting subluxations protects from viruses if they’ll just come to see you every week for the rest of their lives? First you create dependency on YOU. That’s not right and it’s damn sure not evidence-based. Good for the ol’ wallet though isn’t it?

Second, you weren’t trained on it. So back off.

Third, can you imagine that patient getting it anyway and, God forbid, dying from it. What if that patient mentioned to their family members that they weren’t getting the vaccine because Dr. Jackhole told them they didn’t need it and shouldn’t take it. Would the family have a legal claim against you? My opinion is hell yes they do and you should be calling your malpractice carrier to see how to handle it.

The point being. Just remove all of that by keeping your mouth closed and staying out of vaccine discussions. It’s completely appropriate to say that getting it is an individual choice and they should talk to their doctor about the risks vs. the benefits and take it from there. Because that really is what they should be doing.

This vitalist and others like him are going to get more people killed because they love themselves on a level that leads them to believe they have all of the answers. They don’t. In fact, when they’re recording selfie videos of themselves walking around their offices or sitting and driving in their cars, they look insane. Crazy-eyed insane people.

Enough of that. I made my point. Some of you listen enough or we’re friends on Facebook so you know that I’m an artist of sorts. Guitar singer songwriter, charcoal drawing and portraits and sculpting. I’ve been sculpting a race horse lately and I did the bridle and saddle this weekend. Looking back on it, I may rather take a swift kick in the cajones then repeat that. Geez. Straps, buckles, loops, cuss words. But, it’s shining up finally. If you want to follow some of my artistic escapades on Facebook, go like and follow River Horse Art. It’s fun. If nothing else, I’m keeping life interesting at the very least.

Another thing totally unrelated to chiropractic is Hot chocolate bombs. Here’s a tip from your Ol’ Uncle Jeffro. Be damned careful what you put on FB during the holidays people. My wife Meg and daughter Bitsy… her real name is Joss….they were making these things and I shared it in FB just to brag on them a bit. They were just making them for family and friends and they are pretty cool.I’m on Weight Watchers…down 33 pounds now…and so I can’t indulge but I did share one with my wife and they are absolutely sinful, people. Holy cow. They’ll make your hair stand up.

Anyway, now it’s an overnight success business sort of thing. Geez. She has orders for about $300 worth of these things and a guy that may order around $1500 worth of them for his business connections and marketing purposes. What in the holy chocolate hell? So now I have a factory in my kitchen with two bumblebees buzzing all over it.

In business, you have probably heard me mention that we have been down since the second spike hit. Down quite a bit. I used to gripe that my new norm was 145 a week rather than my pre-COVID average of about 190 per week. Well, turns out it could get worse. We’ve been averaging about 125 a week since the second spike came on BUT…..but….this week is starting off right with 41 and four new patients today. Fingers crossed.

I told you we did a radio run and, believe it or not, people are starting to tell me they’ve been hearing our ads. Which is encouraging. It’s still too early for me to share what we’ve done and it that’s why this week is better. I’m not sure the powers at play just yet. I’m going to keep monitoring it and will let you know.

Enough, let’s get to the research, shall we?

Item #1

This first one is new and it goes with one of my talking points in the intro section. It’s called “Misinformation, chiropractic, and the COVID-19 pandemic” by Iben Axen, et. al. and published in Chiropractic & Manual Therapies in November of 2020. Hopping jalapeños that’s hot!

Why They Did It

Before we get to why they did it, I think we all know. Yes, we know. If fact, look, I knew people were crazy before COVID. There are just crazy people out there in the world. That’s a given. But I had no idea how many truly crazy and impressionable people there really are until this pandemic. Holy huge balls of insanity, people. I have seen the most disappointing stuff coming from people. Not just chiropractors but definitely some chiropractor as well. No doubt. They crazier than bed bugs. Crazier than a craphouse rat.

They begin by saying, “During this time of crisis, some chiropractors made claims on social media that chiropractic treatment can prevent or impact COVID-19. The rationale for these claims is that spinal manipulation can impact the nervous system and thus improve immunity. These beliefs often stem from nineteenth-century chiropractic concepts. We are aware of no clinically relevant scientific evidence to support such statements.

We explored the internet and social media to collect examples of misinformation from Europe, North America, Australia and New Zealand regarding the impact of chiropractic treatment on immune function. We discuss the potential harm resulting from these claims and explore the role of chiropractors, teaching institutions, accrediting agencies, and legislative bodies.”

Despite this grave situation, some chiropractors have advocated a misbelief that spinal manipulative therapy (SMT) or “adjustments” can boost immunity and thus should be offered as a preventive measure for viral infections. The World Federation of Chiropractic (WFC) noted this development on March 17th 2020 and refuted this in a public statement: “… .there is no credible scientific evidence to support this notion and to suggest otherwise is potentially dangerous to public health” . Nevertheless, some chiropractors continue promoting misinformation on social media putting the chiropractic profession at odds with scientific evidence.

The chiropractor (and I use that term loosely) I discussed is 100% one of these people. Geez, he’s embarrassing. But he takes videos of his huge pool and big backyard he got from seemingly bilking the holy crap out of impressionable patients and young dumb chiropractors but whatever.…

Anyway…they say that the estimate is that 20% of the chiropractic profession has the vitalist, faith-based, philosophy, I’m going to pop this and protect you from virus approach to taking advantage of patients. I mean….going about their business.

They say, “Misinformation about adjustments and immunity taints public understanding of viral prevention, undermines the coordinated efforts of health authorities, and has become a cause for concern among researchers and public health authorities”

Wrap It Up

Members of the chiropractic profession share a collective responsibility to act in the best interests of patients and public health. We hope that all chiropractic stakeholders will view the COVID-19 pandemic as a call to action to eliminate the unethical and potentially dangerous claims made by chiropractors who practise outside the boundaries of scientific evidence.

CHIROUP ADVERTISEMENT

Item #2

This one is called “Effect of Physical Exercise Programs on Myofascial Trigger Points–Related Dysfunctions: A Systematic Review and Meta-analysis” by Guzman-Pavon, et. al. (Guzman-Pavon MJ 2020) and published in Pain Medicine on October 4, of 2020. Sizzlin’ succotash! It’s hot!

Why They Did It

Remember, this is a systematic review and meta-analysis and those are at the top of the research pyramid. They’re mostly reliable.

They say, “Myofascial pain syndrome is one of the primary causes of health care visits. In recent years, physical exercise programs have been developed for the treatment of myofascial trigger points, but their effect on different outcomes has not been clarified. Thus, this study aimed to assess the effect of physical exercise programs on myofascial trigger points.”

How They Did It

• A systematic search was conducted in Pubmed, Web of Science, and Scopus.
• Articles analyzing the effect of physical exercise programs on pain intensity, pressure pain threshold, range of motion, and disability were included
• 24 randomized controlled trials were included

Wrap It Up

Physical exercise programs may be an effective approach in the treatment of pain intensity, pressure pain threshold, and range of motion among patients with myofascial trigger points.

Let me just tell you that physical exercise programs are absolutely effective. Not just in the physical sense but in the biopsychosocial aspect as well. When people are gradually moving more and gradually building their confidence in movement and their abilities, the brain, or the centralized part of the pain experience is affected in for the positive which brings the pain level down overall. It’s just fascinating but in short, moving means more than just physical activity when we’re talking about pain.

Item #3

Item #3 here is called “Excess Body Mass and Leisure Time Physical Activity in the Incidence and Persistence of Chronic Pain” by Shiri, et. al (Shiri R 2020) and published in Pain Medicine on November 11, 2020. Which makes hotter than a habanero. And that’s real hot.

Why They Did It

To estimate the effects of excess body mass and leisure time physical activity on the incidence and persistence of chronic pain.

How They Did It

A prospective cohort study.

three cohorts of employees of the City of Helsinki (18,562 observations) and defined incident chronic pain as having pain in any part of the body for more than three months at follow-up in participants without chronic pain at baseline. This was a great sample size.

Persistent chronic pain was defined as having pain for more than three months at both baseline and follow-up

Wrap It Up

As if we didn’t know this already, they say, “Obesity not only increases the risk of developing chronic pain, but also increases the risk of persistent pain, while leisure time physical activity reduces the risk of developing chronic pain.”

Now consider the obesity issue in America today.

Item #4

And finally, our last one is called “Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain” by Penn et. al. (Penn T 2020) and published in Pain Medicine on April 24, 2020 which is hot enough because it just came out in the November 2020 issue. It’s not steaming but it is indeed very hot.

Why They Did It

For most patients with chronic low back pain (cLBP), the cause is “nonspecific,” meaning there is no clear association between pain and identifiable pathology of the spine or associated tissues. Just for the record here, Dr. Stuart McGill and his mustache would call total BS on the idea that nonspecific back pain exists. He’s say you just aren’t looking hard enough.

Anyway, they go on to say, “Laypersons and providers alike are less inclined to help, feel less sympathy, dislike patients more, suspect deception, and attribute lower pain severity to patients whose pain does not have an objective basis in tissue pathology. Because of these stigmatizing responses from others, patients with cLBP may feel that their pain is particularly unjust and unfair. These pain-related injustice perceptions may subsequently contribute to greater cLBP severity. The purpose of this study was to examine whether perceived injustice helps explain the relationship between chronic pain stigma and movement-evoked pain severity among individuals with cLBP.”

And honestly, these are things I haven’t considered before and I think it’s interesting as hell.

How They Did It

Participants included 105 patients with cLBP who completed questionnaires assessing chronic pain stigma and pain-related injustice perception, as well as a short physical performance battery for the assessment of movement-evoked pain and physical function.

What They Found

• Findings revealed that perceived injustice significantly mediated the association between chronic pain stigma and cLBP severity and physical function.
• Greater chronic pain stigma was associated with greater perceived injustice, which in turn was associated with greater movement-evoked pain severity.

Wrap It Up

“These results suggest that perceived injustice may be a means through which chronic pain stigma impacts nonspecific cLBP severity and physical function.”

So, today’s take-aways…..

• Be a science driven healthcare leader and practitioner. Don’t be crazy because you look insane and you make everyone else in your profession appear to be insane as well. That’s just rude as hell. Especially when you’re proving Parento’s Law by just 20% of you making the rest of us look like crazy people. We don’t appreciate it. Stop it now, dammit.
• Love your patients and if you worry about the outcomes, you won’t have to worry about the income
• And get them moving.

Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. 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.

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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 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!

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

Bibliography

• Guzman-Pavon MJ, C.-R. I., Martinez-Vizcaino V, (2020). “Effect of Physical Exercise Programs on Myofascial Trigger Points–Related Dysfunctions: A Systematic Review and Meta-analysis.” Pain Med 21(11): 2986-2996.
• Penn T, O. D., Aroke E, (2020). “Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain.” Pain Med 21(11): 3161-3171.
• Shiri R, L. T., RAhkonen O, Leino-Arjas P, (2020). “Excess Body Mass and Leisure Time Physical Activity in the Incidence and Persistence of Chronic Pain.” Pan Med 21(11): 3092-3101.

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