066- Medscape's Crucial New Article on Chiropractic

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langma. This week we are going to dive into a fantastic article that came out February 15th on Medscape and it is titled Spinal Manipulation for Neck and Back Pain. Does it Work? Great question and one that we will get down to the bottom of at least as far as Medscape is concerned momentarily. So before we dive in, I'll say a few words as I do each and every week on our podcast About Rock Tape Rock Tape, makers of the world's best kinesiology tape are proud to introduce completely redesigned Rocksauce and Rocksauce Chill Powerful topical muscle and joint pain relief now available in 30 ounce roll ons and 32 ounce clinical pump tops. Give long lasting pain relief to your patients. Learn more@rocktape.com topicals Again, that's rocktape.com topicals but today we are diving into a Medscape article, Spinal Manipulation for Neck and Back Pain. Does it work? So this was recently released. It was just released 2.15.20. And if you don't think Medscape is powerful, your patients certainly do. Medscape is part of the WebMD family. WebMD family gets over 53 million website unique visitors per month. Let me repeat that. WebMD, which Medscape is a part of, yields over 50 million unique visitors per month. Medscape themselves are well over 50,000 unique visitors visitors per month. So if you're not checking out Medscape again, you can rest assured that your patients are. So they came out with an article and Medscape historically has not been particularly chiropractic friendly. I know there's some debate out there, but historically Medscape was founded in the 1990s, mid-90s, so they've been around quite a while at this point in time, over 20 years and they've built up a reputation as at times not being protected, particularly chiropractic heavy, let's say, or chiropractic friendly. But this article goes a long, long way to change that thought process. So again, spinal Manipulation for Neck and Back pain. Does it work? A Medscape article released February in 2017. So here's a quote right from the top of the article I think gets to the heart of the matter here in her office at McMaster University in Toronto, Anita Gross has logged paper after paper showing that spinal manipulation can help control neck pain. Quote, the evidence keeps growing and growing, she says. So that is a heck of a start to this article. And interestingly, this article also begins to dive into chiropractic versus osteopathic approaches to adjusting or spinal manipulation. And it dives even into the mechanism of action as well that we'll talk about shortly. So I'll repeat it one more time because I think it bears repeating. Medscape, this article, it's going to get tens of thousands of web hits because the WebMD family, which Medscape is a part of, gets over 50 million unique visitors per month. This is really, really heavy hitting piece of content and the citations on it are actually fantastic, fantastic as well. So really when they look at this in the article, they're looking at it from osteopathic vers, his chiropractic approach. So they set the stage from line number one that the evidence keeps growing and growing regarding the efficacy of spinal manipulation. Then they even go in this article, which I will also link in the show Notes and I'll link on Facebook live below this piece or below this post, they also talk about osteopathic versus chiropractic approaches and they talk a little bit about I'll read kind of a quote here. Quote Two prominent traditions in the United States arose In the late 19th century when Andrew Still, MD, a physician and surgeon, founded osteopathy and osteopathic medicine and Daniel David Palmer, a practitioner of magnetic healing, founded chiropractic. And from there this article starts to dive into the differences between still and Palmer. And ultimately, as we've learned it, I think many of the chiropractors listening, we've learned it that Palmer really was looking at it from a neurological perspective, let's say, whereas still was looking at it more from a blood borne perspective. And the other big difference between the two, at least on the surface, was that still was looking really at long axises. So they were, you know, this is really the start of where the definition or differences between manipulation and adjustment came to be because the manipulations were typically cited as osteopathic. They were long lever, meaning they were very broad motions as opposed to the specificity induced with a chiropractic adjustment and really with a chiropractic adjustment trying to get down to that segmental level to the best of anybody's physical ability instead of these long lever manipulations. So that was the start between the osteopathic approach and what became ultimately a chiropractic approach. The other thing that this article touches on regarding this, which I found particularly interesting, is they also touch upon the fact that while osteopathic physicians have generally become allopaths, they're intertwined with MDs at this point in time. This article also touches on still the uniqueness of the chiropractic profession and the art of chiropractic and ultimately how chiropractors in the United States can't prescribe drugs or perform surgery. But many of us still focus our practices, and rightfully so, on that art of manual therapy, on the art of, of the chiropractic adjustment. So as this article goes further and dives further into does spinal manipulation work, doesn't it work? They start to look towards the mechanism of action. So this is really where we at the evidence based chiropractor have put in a lot of effort over the past few years to look at, discuss and ultimately talk about the research related to mechanism of action. So I'll read another quote directly from the paper. However spinal manipulation works, it's at least better than nothing when it comes to chronic low back pain, says Dr. Chow. Our general finding was that manipulation appears more effective than any controlled treatments, he explains. So that's not a very rousing statement from Dr. Chow as far as this article is concerned. But I think as we dive further into the mechanism of action, as we've talked about at the evidence based chiropractor on the podcast, and certainly through our membership to our members, it's really about stimulation of the central nervous system. The chiropractic adjustment is something unlike anything else. Where it gaps the facet joints, it provides an intense stimulus to our central nervous system of that proprioceptive input. And certainly from there it affects ultimately, as we've talked about with the evidence based chiropractor membership, just last month we looked at how that affects the brain and how ultimately a chiropractic adjustment to the spine gaps the facet joints, provides certainly cortical drive increased strength ultimately and really resonates deeply ultimately up into our brain. That adjustment impacts the central nervous system. And there is absolutely no doubt about it, the research keeps coming and coming. Just as Anita Gross at the top of this article in the first sentence has stated, the evidence keeps growing and growing. So that says a lot about what is going on. The other thing that they look at regarding the chiropractic adjustment or spinal manipulation is the evidence for cervical manipulation. This is a hot button topic really with the public at times and really with medical doctors to a certain degree. While we know that the safety of a chiropractic adjustment is absolutely unparalleled. You know, 15,000 people dying of NSAIDs per year, 30,000 dying of opioid overdoses, and less than one tragic event potentially per year related to a spinal manipulation, at least one per million, if not more. The thought, I mean, it's just I see some love and some hearts coming across on the screen right now from some of the people watching on Facebook Live, but it's just the truth. I mean, ultimately, the chiropractic manipulation, a chiropractic adjustment, it's just one of the safest healthcare treatment options ever known to man. Consequently, it also happens to be one of the most effective, which is an unbelievable combination. But with a medical doctor, I think all of us have to remember that a medical doctor might see a patient in acute neck pain and they just can't imagine a stimulus, an adjustment, a high velocity adjustment not hurting that individual. And it's not because that they are aloof. It's not because they hate chiropractors. It's just that they don't know the art. We know the art, the science, and certainly some of the philosophy as far as why we are giving that chiropractic adjustment or manipulation. But the medical doctors are just coming at it from a different angle. So the great thing about the research is again, it's continued to showcase the safety of a chiropractic adjustment time and time again, unequivocally. I always talk about, in one of the chiropractic seminars that I teach, there was once a nine year study done on the safety of chiropractic adjustments. Over 50,000 people adjusted over the course of nine years and there were zero, let me repeat that, zero serious adverse events after 50,000 adjustments in nine years. And I believe that was also in Spine Journal. So this was a randomized control trial. It was top tier research. But ultimately, when we get back to the Medscape article, as we've touched on today, this Medscape article absolutely points the finger in the right direction regarding chiropractic care and spinal manipulation. It's not over the moon on it, but it is a huge step in the right direction. Just last week we talked about the American College of Physicians coming out and supporting chiropractic or spinal manipulation prior to the prescription of any medication for patients suffering from back pain. And I'll repeat that one more time as well. The American College of Physicians came out with their guidelines. They released about every 10 years or so. And they strongly encouraged the advent or the working of a chiropractic manipulation or chiropractic adjustment prior to the prescription of any even NSAIDs in a primary care physician's office, which is one of the things primary care physicians typically do for patients that come in suffering from back pain, neck pain or musculoskeletal complaints. Chiropractic care does a lot more than neck pain or back pain. It's about performance, it's about function. But also it is important that we get the foundations of our research in place and the foundations of what we do as chiropractors in place first. And that starts with the research. It starts with narrowing the focus. It doesn't mean we can't take care of people. But from a research perspective, it's important to be laser focused on the goals and accomplishments. And the tide is starting to turn. The acp, the American College of Physicians, Medscape, et cetera. Starting to include what chiropractic and spinal manipulation can do for patients and people is a huge, huge step in the right direction. I expect there to be much more steps in the right direction as we continue to move through time here. The research, the breadth and depth of chiropractic research has never been bigger, it has never been better. And you are doing yourself a disservice if you are not actively utilizing research to grow your practice. There is no better way to do it. It is simple, it is straightforward. But you need to have a plan. If you need help with that, visit us@the evidencebasedchiropractor.com I also encourage you. We have a ton of free tools you may not ready to become a member. I'd encourage you download our free tools, learn how you can find, implement and use research to better your practice, to expand your impact, to gain better clarity, and certainly to create a better day for your friends and family in town. So I hope you guys have a great week in practice. If you're on Facebook live, shoot me a comment, shoot me a like. I'll be happy to answer anything that you would like. And until next week docs, I will talk to you.

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