440- How Chiropractic and Integrative Modalities Improve Quality of Life

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 have more research. A brand new study that came out with lots of clinical implications and it is all around the immediate effects of integrative health and medicine modalities among outpatients with moderate to severe symptoms. So if you have seen people, or maybe you'd like to see people that are struggling, they have moderate to severe symptomatology, they they're looking for help. This study analyzes, looked at thousands of them and said how does integrating chiropractic care amongst other modalities assist with helping people regain their quality of life? Nothing more important than that. We'll dive into this study, highlight some of the key takeaways and more, all on today's episode. Before we get started with that, I wanna say a few words about the smart chiropractor. If you would like to have more patient reactivations, your EHR is filled with opportunities to fill your schedule. These are your inactive patients, people that know, like and trust you. If you're not consistently communicating weekly with these individuals and generating red hot patient recall lists for your team, not based upon just when the last time they came in and when you notice that you're a little light on your schedule, but a system based upon engagement. If you're interested in that, which if you're a practicing doc, I think you should be, head over to the smart chiropractor.com, schedule a demo with our team. We'll show you exactly how patient pilot loads up those lists, helps more people get back on your schedule and makes patient reactivations faster and easier than ever before. But as I said at the top on today's episode, we're talking all about research. I'll drop a link in the show notes down to this study and it was a good one. They define integrative health and medicine, IHM as they call it in this study as the coordinated combination of traditional medicine, physical rehab, surgery, medication and evidence based modalities such as acupuncture, massage, chiropractic to address the mind, body and spirit of the individual. So I'm going to take that as kind of a biopsychosocial model. The crazy part about this is when they lead it off, they're like it's conventional medicine and then evidence based modalities. And the evidence based modalities are the proven modalities in conventional medicine. I don't mean to rag on it, but there's a lot to be desired in terms of people with musculoskeletal issues taking medications, having elective surgeries. It just is poor choices most of the time that does not result in the desired outcome. We all know movement based care, time, focus, attention, daily habits are going to outperform medications and surgery 9.9 times out of 10 with the 0.1% being the red flags and being those anomalies. But for most people, most of the time, movement based care, and as they call them, evidence based modalities, acupuncture, massage, chiropractic is a really, really good way to go. Now in this study they were looking at it in terms of the coordinated combination. So we're gonna have to deal with being dragged down by some of those previously aforementioned conventional medicine techniques. But it's a good real world application because a lot of people are doing multiple things. And the reason why this is so important is because many people that are seeking integrative health and medicine, they have a lot of stuff going on. And I'm not telling you anything you don't know. If you think about the patients you've seen today, tomorrow, yesterday, you think about who you're gonna see tomorrow, who you saw yesterday, who you're going to see today, you realize there's a lot of people that come in with a combination of physical and psychological issues, especially with those individuals dealing with chronic pain. Because chronic pain and specifically spine related pain is some of the only, only pain that has a really big tie in with depression, with a decreased outlook on life and these sort of things that contribute to it being a chronic pain type issue. So in 2019 and 2020 there was a survey taken and about 21% of adults in the United States reported chronic pain as pain most days or every day during the previous three months. 20% of people having pain most days or every day, that is a big, big number. And in a cross sectional study, 33% of people had chronic pain, 10% had acute pain, 10% had stress, 7, 8% had anxiety. And these were among the top 10 most common medical conditions outlined in this, in the subsequent study there. So these are issues a lot of people are dealing with. It's a lot of what you see all day, every day. But it's important to not become numb to that, but to actually highlight it. So the most common reasons people do seek integrative health and medicine services include spine issues, 71% of people, extremity issues 9%, neurological issues, 7%, other pain 6% and generalized muscle pain, 4%. So spine is like at the top of that list. And here's the beautiful part, we are a key component of that as chiropractors and we are the individuals that can help guide them perhaps better than anybody else and really quite quarterback that case in a truly meaningful way that has a truly patient centric approach to it. So there's no question that pain related issues are some of the most prevalent by far among people that seek integrative health solutions. And there have been a variety of studies done previously regarding some of these individuals seeking integrative care. And why do they do it? Well, there's a couple of reasons and they're pretty good. One, a perception that integrative care is safe and effective at addressing their needs. That's actually really cool because we often hear the other side of the story, the skeptics. But the number one reason people do choose it is because they actually believe it's going to be a viable solution, which is good. Number two is they're doing it in response to dissatisfaction with the conventional medical providers. And again, this is what we probably see in practice all the time. People who have disappeared bend through the ringer misdiagnosis, wrong diagnosis, right diagnosis, wrong treatment, however you wanna slice it and dice it. And not everybody responds to what we do. Don't get me wrong, nobody's perfect, nothing's a panacea. However, the number two reason why people do choose integrative medicine is they just are tired of the conventional medical system. And number three, a desire to approach their care that emphasizes a therapeutic relationship and control over their health. And this is really important and it can't be overstated. There are individuals that are out there saying, just give me the pill. But that's not everybody. And quite frankly, that's not our ideal patients and clients, those individuals who want control over the health. It's the number three factor on why they choose. And the beautiful part is us as chiropractors typically do spend the time helping them understand what's going on, guiding the process of healing and helping them understand how to reduce the likelihood it comes back in the future. Not everybody's going to listen to, but it doesn't mean it's a story that shouldn't be told and focused on in our practices each and every day. And there have been a tremendous amount of studies over the years and systematic reviews supporting the effectiveness of integrative health for pain related challenges. So this study looked at individuals 18 years and older at one of four outpatient I H M clinics between January 2019 and July of 2020 20. And what they found was interesting. They found that a majority of the patients that had integrative care, the average age was about 49 years old, 76% were white, 15% were African American, non Hispanic, 87% and 81% were females. Really interesting. That's super high. More than half of the patients reported a chief complaint of pain at nearly 61% and specific pain complaints that, uh, the back was number one, 34%, neck at 26% and shoulder interestingly as number three at 26%. So interesting to think about those numbers. When you think about, I always think in terms of marketing. When you think about how are you showing up, how are you showing up online, what videos and information are you putting out on your website, at events, on your social channels, through your emails, communicating with your past patients, Little plug there for patient pilot by the smart chiropractor. Communicating how you can proact answering the questions people have about their health proactively. Great way to generate new and repeat business. Why? Because it's obvious. People then like you, they trust you and they're like, oh, this guy's got the answer, this gal's got the answer, of course I'm gonna go there. And that's the way the world works. So it's mostly breaking through obscurity by ensuring that you're putting out content consistently and following up with those who have already said yes, which is the biggest opportunity out there. So almost half of the sample in this study had from an integrative health perspective had massage, 46%. Acupuncture was number two with 34%. And 17% of the individuals had chiropractic care. So a minority, pretty low amount quite frankly, in my opinion, receiving chiropractic care over double the rate of acupuncture uptake, double the rate or more than that of massage. So chiropractic was not number one in terms of usage, but it was an important component to this and the purpose of this study. They had a couple different things they were looking at. One, they were trying to describe the pre encounter clusters of individuals. Two, they were examining the immediate clinical effects of these modalities on pain, stress and anxiety. So this was kind of an immediate study, not a super long term follow up in terms of that. And it was interesting because Most clinical encounters, over 74% within this study were among patients who reported moderate to severe pain. So over, they said over a four on the scale there. So interesting patients within the study also did report, here's the take home messages we're getting into clinically meaningful and that's an interesting one because it's not just subjective, but it actually meets a threshold of being clinically meaningful reductions in pain and clinical meaningful reductions in stress and clinically meaningful reductions in anxiety. So we really touched upon all three. So that was a huge win in this study to identify the fact that those individuals that are coming in and they're receiving integrative care are seeing clinically meaningful benefits in pretty much all of the criteria they're looking for. Decreases in pain, decreases in anxiety, decreases in stress. And that's a testament in my opinion, to the hands on component. And when we look at some of the commonalities between acupuncture, massage and chiropractic, there are overlap but distinct differences between the mechanisms of action with how these modalities influence the nervous system system, how they influence the neuromusculoskeletal system, I should say as a whole. But there are some commonalities and often that is time spent with the provider. It's more than 30 seconds. Typically it doesn't have to be 30 minutes, but it doesn't have to be 30 seconds. It also is meaningful conversation around the root cause of the issues. And typically it involves some amount of awareness of what to do afterward as opposed to here's the script, pick up the drug on your way home and good luck to you. Which is that's a dramatically different approach. So the conclusion in this study were patients presenting to an outpatient center with moderate to severe symptoms, most often presented with pain, stress and anxiety, followed by pain alone. And the results supported clinical, clinically meaningful impact that these modalities can have on moderate to severe symptoms. So good news is this is just one more feather in the cap saying when you are adding in integrative modalities into a care plan, people are going to get good result and probably going to get better result than if they didn't. And for those individuals that do make those choices, that's an important item. And for those that haven't yet again, I'll speak to it. This is the fact of understanding this should give you the clinical confidence and certainty to get out there and tell this story because there are a lot of people that are not choosing integrative care and they could, should and would be better off if they did. But typically there's a knowledge gap there. Your job is to approach that knowledge gap. Absolutely. Get it out of the way and help people towards making the right decisions for their health, whether it's in your office or out of your office. But most of the time, the beauty of our business is that it will be within our practices. So before we wrap up today, I want to say a few words about Neckcare necare.com if you are into assessments, if you're into movement assessments, and I know you are out there, you have to check out netcare.com they have the best technology on planet Earth, reliable and objective assessments and exercises for neuromusculoskeletal control, proprioception, range of motion, and sensory motor integration. I put up a ton of YouTube shorts and YouTube videos and they're getting thousands upon thousands of views. Many of them. Why? Because the technology is that cool. I wish I could say because I'm a great host, but it's because the technology is that cool. I'll drop a link down below neckcare.com see about getting it in your practice. And finally, if you're looking to bring Shockwave therapy into your practice, I recommend Stem Wave. Can't recommend it enough. Go to if you are thinking about it, have a conversation with Stemwave. Go stemwave.com the evidence based chiropractor yes, it's long but go there. I'll drop a link down below as well. In the show notes. They'll hook you up with their best deal by being a listener. They want to support people who support this podcast. I love that. So go stemwave.com the evidence basedchiropractor it's what we use in the practice that I own, so I stand behind it. If you have any questions, you can always hit me up. If you have not left a rating or review for this podcast, I would love it if you would take a moment and do so. It helps more and more people find out and listen. And thank you for being a chiropractor. Have a fantastic week in practice and I will talk to you soon.

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