102- Adjustments or Neural Mobilization for a Hot Lumbar Disc

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 and this week we are back with more research related to chiropractic care. But before we get started I wanted to let you know the Cyber Monday sale for the Evidence Based Chiropractor is still going on. It is 15% off everything in our shop that includes chiropractic shirts, chiropractic prints and posters, reactivation post cards as well as our membership. So if you have been on the fence, now is the time. 15% off all everything in our shop including memberships to build your referral base and to build relationships with other healthcare providers in your community. We've been doing it for years. It's generated thousands of chiropractic referrals and I think you should check it out the evidencebasedchiropractor.com shop and that expires at 11:15 tonight Monday so be sure to check it out. Additionally, I'll say a few words about Rock Tape Rock Tape is revolutionizing soft tissue world again with new rock blades. Mohawk Featuring three tools in one a surgical stainless steel hand polish tool and two attachments silicon sleeve and an ABS comb. Rockblades Mohawk unlocks never before seen treatment protocols to reduce pain, improve mobility and address issues like nerve glide and neuropathy. And at 175 you can work it into your budget. Learn more and explore educational courses featuring mohawk@rocktape.com mohawk and as I said at the top, it is all about the research and we have a great paper to talk about today. The paper is titled Effect of Neural Mobilization versus Spinal Manipulation in Patients with Radicular Chronic Low Back Pain. I'll repeat that one more time and you can also find a link to it in the show. Notes Effect of Neural Mobilization versus Spinal Manipulation in Patients with Radicular Chronic Low Back Pain this was released by the European Journal of scientific research in April 2015 and it is being featured this month November for all members of the Evidence Based Chiropractor. So neuromobilization techniques such as the straight leg raise or slump technique, we know them as orthopedic tests, right? That slr to determine or not whether there's a hot disc or radiculopathy or slump technique. Same thing. Obviously it increases the pressure and if there is neural compromise in the foraminal canal due to a disc, it's gonna light the person up. But in this case, they were utilizing those, the slr, the straight leg raise and the slump technique in kind of repetitive fashion as a neural mobilization. And it was done by therapists in this case. So they were going through the motions on some of those orthopedic tests in repetition to mobilize the nerve root, which makes sense. Hey, if that test on things and it can cause pain, well, you don't have to go all the way to the point of pain, but you can get some mobilization of that nerve root. So they did that as a treatment option in this case. In every patient in this study, regardless of where they were randomized, which group they were randomized to, every single patient had an MRI that showed there was a disc, a lumbar disc at L5S1 that was pressing on the nerve and causing sciatica. Again, true sciatica comes from, has to go past the ankle technically. And we look towards that L5S1 level. So this was really tight to the definition on that. And this randomized clinical trial examined those neuromobilization techniques and put them head to head against lumbar spinal manipulation. And I'll tell you, the results were staggering. And they were staggering in favor of the spinal manipulation or the adjustments. Patients who received the lumbar manipulation experienced a sharper decrease in pain, a more significant improvement in functional ability, and a reduction in the degree of nerve root compression. So every single aspect that was measured, pain, functional ability and nerve root compression, spinal manipulation, adjustments. One out. And they also, in this study, I got really excited in this study because they also referenced a previous study that showed patients with similar symptoms, people that had radiculopathy, disc pressing on a nerve. They referenced a previous study that showed spinal manipulation was equal in outcome to people who underwent surgical intervention one to two years out. Let me say that one more time. This study not only showed just what we talked about, it showed that there is far greater benefit in pain, there is greater functional ability, there was decreased compression on the nerve root for everybody that underwent spinal manipulation got adjustments. But what they also did is they referenced a previous study that showcased one to two years after symptomatology, patients that received chiropractic adjustments, spinal manipulation had the same amount of benefit and than another subgroup that underwent a surgical intervention. So it becomes exceptionally clear why adjustments are considered a top treatment choice for patients. And let's look at a few quotes also from this research paper that I think that you also will be excited about. And these are great talking points to utilize in your practice and also to utilize in your conversation with other healthcare providers. So the researchers found the lumbar manipulation was more effective than neuromobilization. This may be due to direct influence of lumbar manipulation techniques on reduction of nerve root compression, then neuromobilization. So basically what they're saying there is that with the manipulation, hey, there's a physical opening, a gapping of the facets, the IVF is going to open up and that's direct. And they're postulating that that might be one of the reasons why we manipulation or adjustment worked out better in this case. The researchers also found it is important, it is important to evaluate possible non surgical interventions for patients with chronic low back pain with sciatica using appropriate patient based outcome measures. I love this because not only are the researchers saying, and again, remember this is coming from the European Journal of Scientific Research, this is typically not associated as a quote unquote chiropractic journal. So. And they are emphasizing the point, hey, it is important to evaluate patients for non surgical intervention. So don't jump to that surgery now. When people have a hot disc. You've seen it every day. I've seen it plenty of times in practice. It can be grueling and agonizing for the patient in that acute inflammatory state. But it does not mean that they should jump into a surgical intervention. And additionally, these researchers are standing behind appropriate patient based outcome measures. That gets me really excited because when you look at patient based outcome measures, functional ability, perceived improvement, happiness with care, and that goes to all a bunch of other studies outside of this one. But chiropractic care adjustments are at the top of the heap on all of that. So when they start talking about, hey, look for non surgical interventions and really focus on patient based outcome measures, that is right in our wheelhouse and gets me really, really excited. And should you as well. The researchers also found there was more significant decrease of pain level, functional disabilities and degree of nerve root compression in the group treated by lumbar manipulation techniques than the group treated by neuromobilization techniques. So just re emphasizing what we had touched on earlier, that patients that underwent adjustments spinal manipulation that had a MRI confirmed hot disc at L5S1. And not only was it hot acute setting in terms of inflammatory, but there was actual compression. They measured the degree of nerve root compression in the canal and they found that patients that underwent adjustments spinal manipulation, in this case not only had a decrease in pain, not only had an increase in functional ability, but literally had a less degree of nerve root compression after treatment. So I love this article. I think it's a great one to talk about with your patients. I believe it also is a fantastic article to bring up in your conversations with other healthcare providers. And again, if you are looking to bridge that gap, if you are looking to increase your incoming MD referrals, now is the best time of the year to hop on with us at the Evidence Based Chiropractor. We hardly ever do any sales and for Cyber Monday it is 15% off. And I'll tell you also that actually comes out our yearly membership. You get a 20% cut on that by going yearly instead of monthly and it's an additional 15. So you get like a crazy deal. If you want to go yearly. If you're not sure you don't want any risk whatsoever, come on month to month, 15% off that monthly membership. Or if you just want to make your office look sweet or you want to look sweet yourself, then don't hesitate to pick up a poster or a shirt. That is all going going away tonight at midnight, so be sure to check it out. The evidencebasedchiropractor.com shop also, as the holidays draw near, I am actively accepting your recommendations for what you would love to hear about and or people you would love to hear from in 2018. I have an unbelievably stocked calendar. I am pumped at the content that we have coming up and I think it's going to add a ton of value in your practice day in and day out. We will continue to really hammer home the research and all of the exciting stuff coming out within Chiropractic. We'll also continue to do some fantastic interviews with some influencers and in my opinion docs. Just doing really cool stuff inside of Chiropractic. But if you have anything specifically that you would love for me to touch on, never hesitate to reach out. Jeff the evidencebasedchiropractor.com 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.