075- Adjustments and Cervical Disc Herniations

Welcome to the Evidence Based Chiropractor providing you with elegant and efficient research based content to help your practice prosper and succeed. Now get ready for a variety of dynamic communication tools designed for immediate growth courtesy of your host, Dr. Jeff Langmaid.

Hello and welcome to the Evidence Based Chiropractor. I am your host Dr. Jeff Langmaid. This week we are back with another piece of hard hitting research and we are going to talk about cervical disc herniations and the chiropractic adjustments effect upon them. But before we get started I will say a few words as I do each and every week about Rock Tape. Rock Tape, makers of the world's best kinesiology tape are proud to introduce completely redesigned Roxas and Rocksauce Chill powerful topical muscle muscle and joint pain relief now available in 3 ounce roll ons and 32 ounce clinical pump tops. Give long lasting pain relief to your patients. Learn more@rocktape.com topicals again that is rocktape.com topicals also, rock tape is having their Rock Stock later this year which is going to be a huge event out in beautiful Huntington Beach, California. Literally one of my favorite places on planet Earth. I will be out there. You are sure to hear more about it. But I am pumped. That is Rock Stock by Rock Tape later this year. Also, by the time you are listening to this, I'm recording this on Wednesday you will be listening to this potentially Monday morning it comes out at 6am Eastern Time. I will be on my way back from the Kairo Sushi event so I'm recording this a couple days early because tomorrow I am taking the long long plane ride from Tampa to Vegas. I will be out at Kairo Sushi. When you are listening to this you will probably already have seen a bunch of video and pictures but I am greatly greatly looking forward to Also one last bit of housekeeping. If you have not given the Evidence Based Chiropractor Podcast feedback ratings review on itunes. Don't hold out on me any longer. I'm waiting for it. So we have over 3,000 plus chiropractors listening to the Evidence Based Chiropractor podcast every single week. It is unbelievably humbling. I am honored that you take the time to listen and I will keep delivering the goods. I ask one simple thing of you. If you could leave me some rating or feedback, I would greatly greatly appreciate it. So without further ado we will dive into this week's research. The research paper titled Outcomes from MRI Confirmed Symptomatic Cervical Disc Herniation Patients treated with high velocity low amplitude spinal manipulative therapy. So this is almost like a take we've done. A previous paper we had done was regarding a lumbar disc herniation. This was with an MRI confirmed symptomatic cervical disc herniation. Herniation treated with high velocity low amplitude spinal manipulative therapy, AKA a chiropractic adjustment. This study was produced by jmpt in October 2013. So again, I'll read the title one more time and you can also find it in the show notes. Outcomes from MRI confirmed Symptomatic cervical disc herniation Patients treated with high velocity low amplitude spinal manipulative therapy. JMPT, October of 2013. So you know cervical disc herniations typically cause severe pain and disability. These are agonizing when we see patients that come in with active symptomatic MRI confirmed doesn't have to be confirmed by an MRI at that point. But symptomatic disc herniations are unbelievably challenging for the patients that we see. The key part here is many primary care physicians rely on medications as a first line treatment to relieve that inflammation and pain. But again, new research such as this study from jmpt, even though it's a couple years old, probably a lot of you out there are not familiar with this paper and as I say, I feel like I say this each and every day, but it's the truth. If you're not intimately familiar with this research, how do you ever expect a primary care doctor in your community to have heard about it? They're just not going to unless you tell them so. New research such as this indicates that chiropractic adjustments can have a significant benefit for patients suffering from cervical nerve root compression. Ultimately, it's the nerve root compression. Symptomatic disc herniation typically is compressive in nature. So it is the disc herniating getting into either the lateral recess or the foraminal canal, causing unilateral pain and radiculopathy. So this study was one of the first to look at MRI confirmed disc herniations and ultimately investigate the outcomes associated when a chiropractic adjustment is used as a primary treatment. They found at three months over 8, 85% of the acute patients and 76%, excuse me, of the subacute and chronic patients had statistically significant improvement in their pain and disability. Let me repeat that one more time. After three months of care, 85% of the patients that had acute pain and 76% of the subacute and chronic patients had statistically significant improvement in their pain and disability. Also, there were no patients in this study at all that had an adverse event or adverse outcome as a result of the care. That is what I'm talking about when we're talking about safety and efficacy. So let's talk about a few quotes that the researchers found. One quote that they put out in this study was, by two weeks after the first treatment, 55% of all patients reported that they were significantly improved and none reported being worse. You name me any medication on planet Earth or really any other treatment option on planet Earth that we've ever known that can rival that, and I would be interested to know I'm gonna repeat that one more time. By two weeks after the first treatment, 55% over half of all patients reported they were significantly approved and none reported being worse. Researchers also found at three months after the first treatment, 76 point of the subacute chronic patients reported clinically relevant improvement, with no patients reported that they were worse. Again, just as we touched on earlier, and here's where I really take this. You know, there are times when chiropractic is criticizing the research, saying, okay, you do well with acute pain, but that might have gotten better on its own anyway. That is totally false, but that's a criticism that I've heard from time to time. This paper is showcasing three months after the first treatment, 3, 4, 76% of the chronic or the subacute patients had clinically relevant improvement, with no patients reported they were worse. That is unbelievably powerful. Research has also found. Finally, patients with symptomatic MRI confirmed cervical disc herniations treated with SMT to the level of herniation reported high levels of clinically relevant improvement at two weeks, one month and three months after the first treatment. So the patients not only responded early, a vast majority of them responded early, but they kept that positive response not only at two weeks, but at one month and ultimately at three months. So just really, really, really powerful research. I'm gonna read one other quote from this study because I think it's that important. The researchers found, quote, the large reductions in NRS neck and arm pain scores, as well as the NDI scores of approximately between 66% and 75% far exceed the threshold of 30% to 35% pain reduction considered clinically relevant. So let's break that down for clinical relevancy. The researchers say, well, you know, 30 to 35% in pain reduction is what we deem clinically relevant. So you could have a surgery, you could have an Adjustment, you could have anything. You could hit 30 to 35%. They say, hey, that's clinically relevant. Pain reduction 30%, 35% improvement. The patients in this study that had a big disc, a big disc pressing on a nerve, a cervical disc herniation causing radiculopathy that were treated with chiropractic adjustments, 66 to 75% reduction in pain. So over, literally over double the amount of pain reduction necessary to qualify as clinically relevant. So this paper is justi mean this paper's just guns blazing. It's October 2013, it came out, it's about cervical spine. So there's a lot more lumbar research than cervical research is what I see by and large. So it's a great cervical paper and truth be told, I'll be very upfront. We released this just this past month, April 2017 for all members of the evanoid space chiropractor. So as you're probably listening to this, you're saying, wow, I wish my primary care doctor knew about that. It'd be very interesting if you, you name it internally. The internal medicine doctor in town knew about that. If the orthopedist in town knew about that, it's not going to do one paper that's going to turn them into a referral gold mine for you. It takes a system, it takes time, it takes a little bit of process. But imagine if they were exposed to this paper. Imagine if then they were getting those case notes as we've talked about kind of showcasing the social proof of people coming into your practice and getting well imagine when they meet you and then you're able to find out where you can value add to them, where you can find out what they're currently doing with their patients and how you can make things easier and better for them. And then you just drip the research like this, you just drip the research like this consistently to them. There is no doubt in my mind because I've seen it too many times, I've seen it hundreds of times that that is gonna position your practice as the local leader. You are gonna get those referrals. So you know, again, this was released in October 2013, we just released it this past April. For members of the evidence based chiropractor, I've already been getting feedback that docs in the evidence based chiropractor that got this, they love it. There's been great feedback from the PCPs that they've given it to because again this is real life. There are patients going into primary care doctor, they're getting NSAIDs. They get the MRI as soon as there is a MRI confirmed, disc herniation, the patient's getting sent for injections or surgery. It's just overkill. We see it too many times again, 25,000 ESIs given per day, 9 million per year, a vast majority of them off label. This is really research that is relevant, that is important, that is outcome based and no adverse events. It absolutely showcases the safety and the efficacy of what we do as chiropractors. So I kind of went off there. I got pumped. I love this stuff. I'm gonna be bringing it to you each and every week as I have for over the last year. Evidence Based Chiropractor weekly podcast Monday 6am Eastern time if you have not left me feedback, please do so. One other bit of housekeeping before we close. I am putting a lot of effort and time into making sure that I put out the best chiropractic videos I possibly can. If you could check me out YouTube.com the evidencebasedchiropractor I would love a subscribe, give me a like on a video comment, let me know, give me some feedback. I'd love to know what you think of the videos that we've been putting out because I've been trying to make them exciting and engaging and informative so stuff that you can use in practice every day. So I hope you have a fantastic week in practice and I will be back next week and I will talk to you soon.

We appreciate you joining us for this episode of the Evidence Based Chiropractor. Learn more tips for explosive practice development at the evidence basedchiropractor.com youm can also join the Premier MD monthly membership, enabling you to use what you just heard to maximize results in your office. We look forward to providing you with more dynamic communication tools for immediate growth right here on the Evidence Based Chiropractor.

Sam.