261- Predicting Future Back Pain After an MVA

Welcome to the Evidence Based Chiropractor where each week we deliver the latest chiropractic research and marketing strategies all in the time it takes to get to your office. Now here's your host, Dr. Jeff Langmaid.

Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode we are talking about motor vehicle collisions and the risk of future back pain. It's a brand new study and it is a systematic review and meta analysis that came out in the year 2020. We're going to break down the stats. Some of them are pretty shocking and talk about how you can use this to drive conversations in your community. That's what's going on on today's episode. After you finish up this episode, this is head over to Shield. You can go to super secretsales.com EBC Shield has an array of fantastic products. If you use tens units and sell tens units in your practice, if you use and sell any sort of braces in your practice, head over to Shield and check it out. I had Dr. Steven Brown, the founder on just a couple of weeks back, super secretsales.com EBC and he's offering for any new doctor ordering with them. They're going to provide a complimentary SHIELD TENS and E STIM unit and they're gonna cover the shipping on that first shipment as well. So be sure to head over supersecretsales.com ebc I'll also drop that link down below in the show notes. But on today's episode we are talking research. As I said at the top, this study came out in 2020 in accident analysis and Prevention Journal. Hadn't heard of that one before but it's out there and it is peer reviewed and the study was titled and Exposure to a Motor Vehicle Collision and the Risk of Future Back Pain. A Systematic Review and Meta analysis. So this analyzed the studies that have already been published and sort of created maybe not best practices, but it took a look at them and then drew conclusions based upon multiple studies. That's basically the definition of a systematic review. Auto accidents. Let's just start there. They are a big deal. We have a sort of internal joke that I always say when I ask a chiropractor, I'll meet a doc, I'll say, hey, what percentage of your practice is pee? And they'll say, ah, 10 to 15%. And I'll say so it's about 80% of your revenue. You know, PI is a big time revenue generator for a lot of practices out there. Even practices that do a low percentage of PI, maybe if they see 100 patient visits a week, maybe only 10 are PI related, but that 10 in the PI realm can make up an overwhelming amount of the revenue that's disproportionate to the volume. And when we look at the numbers and as we break these down on today's episode, I think you're really gonna see how important this is. And the reason it's important is because for many patients out there, for many attorneys out there, for many other physicians out there, they're just not keeping up with exactly this type of literature which is critically important for them to be aware of. As a doctor, we want to be objective, right? We do not want to be speculative or we don't wanna be subjective. We wanna be as objective as possible. Now part of being objective, not all of it, but part of being objective is staying abreast of the latest research. So you know, what are these foundational concepts that I need to know? What are the stats out there regarding these topics? Because now I can go in and if I'm ever deposed, if I ever have to go to trial, or if I'm just taking care of somebody, if I'm not even involved in really PI, but I have a patient that gets hurt in an accident which gonna look at the stats. And many people are that you can give them accurate information, you can guide and direct them in the best way possible, and that ultimately you can have the best patient centered care in your practice. And in order to do that, you need to be able to keep up on the literature whether you're a quote unquote PI practice or not. So let's start right there and let's talk about low back pain in adults. This study found that 40% of low back pain in adults is persistent and nearly 30% is a recurrent bout from something that happened less than six months ago. So if you have a low back pain today, about a 30% chance it's gonna recur in the next six months, pretty high to begin with, about a 40% chance that that low back pain is gonna become what would be deemed persistent over time. Now let's take that one step farther and talk about auto accidents. Low back sprain and strain is one of the most common injuries that occur after a motor vehic. And they looked at a nationwide study in the United states over a two week period. 21,000 injury claims filed over a two week period. Let me repeat that one more time. 21,000 injury claims in only the United States Alone over a two week period. So this is a ton of injury claims that happen each and every year. What they found is that there's a 58% rate of low back pain after a motor vehicle collision, and that there's a 66% risk or chance of having neck pain after a motor vehicle collision. So let's extrapolate some of these numbers. We have hundreds of thousands of people becoming injured in motor vehicle collisions and accidents each and every year. And over half of those people are gonna struggle with low back pain or neck pain. So this just comes down to being really big numbers that is going to impact you and your practice whether you want it to or not. The numbers are just too big. It's actually over a million injury claims per year. So 58% of that. You have over half a million individuals who are gonna have low back pain due to a motor vehicle accident every single year. Half million. Half million. Half million in neck pain. You're Gonna have over 650,000 people each and every year just in the United States alone. They're gonna have neck pain as a result of that type of auto accident. Now why is this? You know, it doesn't matter if you are what they refer to as the target vehicle or whether you are the bullet vehicle. Get into some of that regarding whiplash on other episodes. But cars are big and heavy and they move fast and we don't. So, you know, ultimately when you get into a car, a motor vehicle, it's moving 5, 10, 15, 40, 50 miles an hour, and there starts to become, you know, just physics. The vector forces of that are super, super great. Seat belts, the fantastic at saving lives, essential at saving lives, but they can contribute to a lot of injuries that occur. They'll save your life. It's kind of like the, you know, they say in football, the bend but don't break defense, right? Similar with seat belts in some capacities. You can suffer a lot of injuries, you know, as a result of wearing the seatbelt, but those injuries are far less than what would happen if you're not wearing it, because the seatbelt ultimately saved your life. So this study looked at evidence from three papers that suggest that exposure to an injury in a motor vehicle collision more than doubles your risk of developing future low back pain. If you get into a car accident today, it's twice as likely that you're gonna have future low back pain. Now that's pretty startling and stark, but let's take that one step farther. I wanna go one step deeper with it. These researchers found, quote, the Three critically appraised studies support the conclusion that there is an increased risk of future low back pain in individuals who have been exposed to a prior injury in a motor vehicle collision compared to individuals without a history of injury in a motor vehicle collision and that rate, that likelihood was over double. Furthermore, they found, quote, there was a consistent positive association in the critically reviewed literature that investigated the risk of future low back pain following an acute motor vehicle related injury. For the patient with chronic low back pain who is initially injured in a motor vehicle collision, more often than not, 63% of the time, the condition was caused by the motor vehicle collision. That is impactful 63% of the time. So if you see somebody with chronic low back pain and in your practice, 63% of those individuals can probably trace it back to an initial motor vehicle collision. Now, this is very, very impactful when you have attorneys going in and fighting for futures, as they'd say, when they're going in and duking it out in a deposition or in court with the insurance company regarding the injuries and they want adequate compensation for their client to get the care that they need later on. Studies like this are really, really interesting. You could argue that this study is very, very plaintiff friendly. And in that way it is because it's showcasing, man, there is, it's more likely than not 63% of the time you get injured, you're going to, if you have chronic low back pain, you're going to be able to trace it back to this. That's a really, really big deal. But there's nothing in this study that showcases this is really subjective. I think it's an objective look at the literature that's currently out there and it's just stating the facts as they are. And that's important to know. As a clinician, it's important to know for a few different reasons. One is the care that you're giving at that time. So we all know maybe this is just a United States thing. But I know if you practice in the United States, we've all heard of these PIP mills, personal injury protection money mills. Right? They're just out there, you know, getting patients in, getting patients out, providing really, really poor and inferior care, maybe not much care at all. And they're milking the insurance company for that guaranteed insurance money that happens in a PIP state, which there are 10 in the United States, MedPay in other states that is kind of guaranteed money if you get into an accident to be able to take care of your injuries. And there are some unscrupulous doctors and clinicians out there that run these sort of pip mills as we call them, that really take advantage of that system. But for all of us that are not in that boat, and if you're listening to this, I'm going to assume that you're probably not in that boat. It's important to be aware of the fact of the care that you give early on after an auto accident, whether or not you are an auto focused practice or not. Somebody's been involved in an auto accident case or an auto accident, the research shows here they're very, very likely to have episodes of low back pain in the future. So what does that mean from a clinical sense? To me that means expectation management. It doesn't mean telling the person that they can't get well, but it means encouraging the fact that they should be proactive with their health. Showcasing to them if they come back in, in the future or they have a recurrent bout of low back pain, it's not a failure and as a matter of fact it could be expected is important. The other aspect that I think is important is on the other side of that pip mill equation is to provide fantastic care. The care that you deliver at the time, clearly these injuries, when it's involved in an acute motor vehicle accident, clearly these injuries more often than not, as the researchers say, come back to haunt people later on in life. So the better job that you do, the more complete job that you do, providing that care at the time of injury, of course that's going to improve their likelihood and chances that they're not going to have challenges later on in life. So really focusing on the examination, really focusing on what tissues are injured, really focusing on providing that great rehab is so, so important. And I'm gonna say there's really an opportunity for you from a business sense, just great patient centric care. But I'm gonna also say there's an opportunity in your case, from a business sense, if you start providing really, really A plus care to auto accident injury patients in your community, you can make a name for yourself pretty quickly. Because there are so many people doing auto accident care that I don't, it's just they just don't do a good job or they're just doing these mill type things where there's no personalization, there's no move screens, there's no movement assessments. And hey, maybe some of that contributes to why recurrent low back pain happens so frequently after a motor vehicle accident. Maybe it's because many people aren't getting great care early on. But I can tell you for sure whether or not that's the case, I can tell you for sure, delivering better care today will result in better outcomes tomorrow. So if you can take every case that you have really seriously, and if somebody's been involved in an auto accident, sometimes I think even as a clinician we see enough of those over time. Not that we're rolling our eyes, but, oh, another case of a sprain strain, ah, whiplash injury, ah, this person, they should be able to bounce back quickly, taking it more seriously, really going through your process, really understanding what they're dealing with, setting expectations appropriately and really managing their case each and every step of the way, from the acute phase to as they're getting back to more active and passive care, as they're going in to more of the rehab and really the active care on their own behalf, that can pay really big dividends in terms of health and wellness for people down the road. And I think that's all why we do what we do each and every day is ultimately to help people. And when we look at studies and we see studies like this, a systematic review and a meta analysis, looking back and saying, man, if you have low back pain, chronic low back pain, there's a 63% chance that you could trace that back to a motor vehicle accident, it tells me that we should be doing as good of a job as humanly possible at the time of these motor vehicle collisions. To take care of the patients that we have tells me that we need to make sure that we are accurately demonstrating that in the conversations we have with their attorney, with any other healthcare providers. And it also tells me that we need to set expectations for the future so that the patient can really understand exactly how this process is going to lay out. Make sure that they stay positive, make sure that they understand that there could be some setbacks in the future, but that you are there to support them each and every step of the way. That's how I take this research and this literature. You can take it how you will. And if you have any questions on it, you can hit me up. Jeff, the evidencebasedchiropractor.com and if you haven't seen it come through your email, we are in an open enrollment period right now for the smart. So if you want to automate your social media, your email marketing and get video streaming and much, much more, head over to thesmartchiropractor.com right now. This is our last chance before the end of the year to get our lowest price, 30 day money back guarantee. There's it's month to month. There's absolutely no risk and no reason why you shouldn't head over to the smartchiropractor.com and check it out. If you have a Facebook ads company, we are not competitive to that. We are complimentary. If your website company is maybe posting a blog now and again or your website company is doing social media, I'm going to, I'm going to encourage you to take a look at what we do. Our focus is content marketing and I'm going to say we do it better than anybody else out there. So check out the smart chiropractor.com get in before our open enrollment closes. It gives you a 25% off each and every month. It gives you the opportunity to get set up for 2021 and it also gives you the opportunity to get our best pricing. So be sure to head over to check that out. Our stats are pretty wild and crazy. We currently are driving over 1500 new patients for our member docs each and every month. We send over about 400,000 emails. We're making over 600,000 impressions on Facebook. Those things are happening each and every month. So if you'd love to join the chiropractors who are making that kind of impact, head over to the Smart Chiropractor. If you have any questions, ask me at jeff the evidencebasedchiropractor.com and I hope you have a fantastic week in practice and I'll talk to you soon.

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