094- Herniations, Quality of Life, and Care Options

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 Langmead. This episode is coming to you live from Austin, Texas where I am in the middle of Sumo Con which is all about entrepreneurship. I'm having a great time down here in Texas. It's actually put on by Noah Kagan who is the 30th employee at Facebook and the fourth employee at Mint who I had on the podcast just a few weeks ago. This as a special guest so if you haven't checked out that episode, be sure to do so. I might have a recap on Sumocon next week, but I wanted to hit it hard with research this week. We're gonna talk a little bit about disc herniations and really the application of the research regarding chiropractic and disc herniations and why it matters to your patients. That is what we are gonna talk about today. So again, more real life context and content for what you are see day in practice. But before we get started, I will say a few words about Rock Tape. Rock tape is revolutionizing the soft tissue world again with the new Rock Blades Mohawk featuring three tools in one. It is a stainless steel tool. It has a hand polish aspect and two attachments, a silicon sleeve and an ABS comb. Mohawk unlocks never before seen treatment protocols to reduce pain, improve mobility and address issues like nerve glide and neuropathy. You can check that out right now for 175@rocktape.com Mohawk again rocktape.com Mohawk but for the research today, as I alluded to it is all about disc herniations. We know it's a normal part of the degenerative and aging process and maybe I'll start there if you don't know. There was a landmark study performed in the mid-90s with the New England Journal of Medicine. They took 100 people that worked at a hospital that had no back pain whatsoever. They felt great. They ran MRIs on these individuals and like 30 to 40% or more had disc pathology, annular tears, herniations, disc bulges, even though they felt great. So what that told people is number one, you don't need to operate every single time there is a disc bulge or disc herniation and that the films are only part of the equation with the patient case History, evaluation, function are even more important. But additionally, it showed that, hey, degenerative changes happen to the discs and disc bulges and herniations can happen over time. And you'd be surprised to know that there's a lot of patients that still don't know that. In other words, they might have a spine. Maybe this sounds familiar to you. Have you had a patient that's had a challenge with their spine? They go get an MRI prescribed by their primary care physician, they get the report back. And of course, the report lists everything that's not perfect. So it lists, like, disc bulges, degenerative changes at every single level. And they come into you and they're saying, oh, boy, I have something to tell you. I have degenerative disc disease at multiple levels. And you're like, yeah, no big deal. Of course you do. You're 75 years old. So does everybody else above 35 or 40. But to them not knowing the context, that's devastating. And really, that also not only talks about degenerative changes, but those degenerative changes can lead to disc bulges, disc fissures, annular tears, disc hermit herniations. And when we look at the research behind it, what we find is that chiropractic care is the number one place that these patients should be if they do happen to be suffering from challenges associated with a disc herniation. And when I say challenges, what I mean by that is challenge could be pain, it could be numbness, it could be tingling, it could be decrease in quality of life. And really, the inability to perform the things that they would like to perform. It's impacting their day to day. And what the research shows. I'm going to pull a few quotes out of a couple different papers. And one of the papers found over 90% of people with disc herniations were better or much better with chiropractic care. Let me Repeat that. Over 90% of individuals with MRI confirmed disc herniations who were having pain became, quote, better or much better. With chiropractic care. They that's crazy. That is great efficacy. Consequently, the researchers also found that within two weeks, over 55% of people had significant improvement. That's substantial. Now, I'm going to take it even one step further. They actually pitted. If you did not know this, there was a study that pitted manipulation or microdissectomy, a surgical solution for sciatica. And it was a prospective randomized clinical study, came out just a couple years ago in 2010. And they found 60% of people with sciatica improved with chiropractic care just as much as they would have improved with a surgical intervention. And that is very, very powerful when you think about the power, the complexity and ultimately the skill, technique, art and science that goes into a chiropractic adjustment. The fact that 60% of people with sciatica improved with chiropractic adjustments just as much as they would have improved with surgery is an absolutely startling fact that every single person that undergoes a surgical intervention doesn't seek chiropractic care first. So, you know, these are some startling, startling things. The other, or if we take it even one step back from that, we can talk a little bit about injections. There was consequently another study that was done just in 2013. Symptomatic MRI confirmed lumbar disc herniations. A comparative effectiveness prospective observational study of two age and sex match cohorts treated with either high velocity low amplitude spinal manipulation therapy or imaging guided lumbar nerve root injections. What the researchers found there was also startling. Chiropractic care provided more pain relief, up to 10% more relief than those nerve root lumbar images, guided injections. So again, we see time and time again that other healthcare providers or patients are being given injections. Perhaps they're entertaining the idea of surgery when quite often the research shows that these patients should definitively be exploring chiropractic care before undergoing any of those advanced interventions. So this is just more and more research that is coming out to support the usage of chiropractic care. And in regard to disc herniations, I like to touch on both aspects because I think it's important to know all three brackets that when a patient has a disc herniation, it's causing pain. When chiropractic's not put up against anything else, 90% of individuals are getting near complete relief after chiropractic care. That's fantastic. But then we take it one step further and we say, okay, in that second camp, people who are entertaining the idea of injections. When we look at that chiropractic care outperforms nerve root injections by 10%, that is startling and substantial. And then we go even one step further, all the way to a microdiscectomy and a surgery. And the research shows us that people are improving with chiropractic care to the same degree as if they had a surgical intervention. So I love really to talk touch on all three of these aspects because these are three definitive camps of people that we see each and every day in our practices. We see people who are just starting out who have never been exposed to really anything as far as conservative care or surgical care. And the research shows those people get very well with chiropractic. Secondarily, we see individuals who might be entertaining the idea of an injection. Maybe they've been recommended, they're a little scared, they want to visit a chiropractor for first. Well, you can tell them with confidence that they are in the right place to start. Because chiropractic, when matched head to head against nerve root injections, performs just as well, if not up to 10% better. And consequently we can also sometimes see patients that maybe have been recommended a surgical intervention but have not explored chiropractic care. And again, you can feel confident explaining to those patients that, hey, chiropractic care has been shown to have just as much success as that surgical intervention. So you are starting in the right place. And after that, then that gives you the ability to also modify, talk about active care and really help them get back to the quality of life that they deserve and desire and help reach their health goals and expectations. So these are papers that are exciting to me. I hope they are exciting to you. I will make sure that I link them in the show notes, so please check that out. Additionally, I will say these papers are what we are featuring in the upcoming month of the Smart Chiropractor. Smart Chiropractor is research and patient education combined in the 21st century. So we make social media graphics, we make weekly patient handouts, videos for your reception area and much, much more that is delivered to you each and every month and that is at the smartchiropractor. So I hope you have a fantastic week in practice 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@the evidencebasedchiropractor.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.

There.