507- Exploring New Research and Real-World Care for Lumbar Radiculopathy

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 back with more brand new research all around lumbar radiculopathy. Fantastic study, brand new big take home messages. We'll get into that and much more on today's episode. Before we get started, we have extended founder member pricing for Velo, our new AI call agent for a few days. Never miss a new patient call again. Velo is awesome. I've been using in my practice 24, 7, 365. But please use it at least off hours and on weekends. As I always say, ain't nobody leaving a voicemail. So if you are not having your phones answered overnights and on weekends, you are missing new patient opportunities literally every single week. We have a special of founder member pricing going on right now. We are about to wrap it up up. So head over to the evidencebasedchiropractor.com Velo V E L L O the evidencebasedchiropractor.Com Velo or I will drop a link down in the show notes. Hit me up with any questions as well. But as I said at the top on today's episode we are talking research, brand new study and it is titled treatment choices and Healthcare Services utilization amongst Lumbosacral Radiculopathy Patients Results from a randomized controlled trial. Again drop that link in the show notes. Now here is a quick stat right off the bat that might surprise you. 58% of patients with lumbar radiculopathy, basically sciatic pain radiating down leg, have already been to a chiropractor before they joined this clinical trial. And I'll go one step farther. More than half were using two or more integrative treatments at the same time. So this is a big deal. And this tells us what patients and highlights to us what patients are actually doing in the real world. Not for what the guidelines say, what the insurance companies say or anything else. It tells us they are searching for relief and many of these individuals are ending up in practices just like mine and just like yours. So we're gonna dive into the study, highlight the areas I think of opportunity that clearly still exist with people that are struggling with radiculopathy. We'll talk a little bit about how to position this with, with existing patients and also how to attract more new patients. By utilizing this information for the benefit of your patient number one, which the side effect of that is, your practice grows. So again, this is a randomized control trial looking at the treatment history of people with radiculopathy or sciatica. And here's kind of the setup. We know, you know, low back pain, it's the leading cause of disability worldwide, but when you add the radiculopathy onto it, pain shooting down the leg, numbness, tingling weakness, this becomes massively more disabling and complex. Now, this study was conducted at National University of Natural Medicine in Oregon, the Oregon Health and Science University. And it set out to look at what patients had already tried before they joined a trial for a mindfulness based intervention program. Now, why does that matter? This matters because treatment guidelines for sciatica are literally all over the place. Some recommend some form of medications, some injections, in some case, some physical therapy, some surgery. And this inconsistency can lead to mass confusion for providers or patients. Now, I'm not saying that the guidelines are incorrect or stepping on each other. What I'm saying is the segmentation of these patients also matter a lot. And if we're just calling it as it is, who's funding the research matters a lot. Research papers are put on the shelf, I'll say, every single day, because of the outcomes. Not every piece of research is released. And often who funds the research informs where the research is going. It's just the truth. So when you see guidelines that can be contradicting each other, there's really good reasons for that. There's deep institutional reasons for that. And sometimes it's just the way it is. And sometimes it's hard to come to a consensus because people are dynamic. And just because somebody has radiculopathy and they're within a 20 year age period of the other person in the study, that can mean two wildly different things. As you can imagine. You've seen probably people come into your practice that are 38 years old, in fantastic shape with acute radiculopathy, and people that are 48, 85 pounds overweight, with a whole host of other issues. So those individuals may respond differently and may in some cases some of the time respond better and worse to various options, right? So that's where there can be some, I would say, conflicting statements in the guidelines. So for many people, especially with chronic symptoms, taking matters into their own hands and seeking out complementary and integrative healthcare is kind of at the point where they're At. And again, this is no news to you. Many people come to your practice, probably tell you, I've been to two people, I've been to five doctors. Nobody can figure this out. I've been dealing with this for two years, 20 years, and that is really where you and I can step up and lean in. And if we take a look at some of the numbers, in this study, 73% of the individuals had tried physical therapy, 61% had used NSAIDs, 34% had undergone ESIs, epidural steroid injections, 17% had surgical intervention. And let's go one step farther, 58% had tried chiropractic care, 59% had tried acupuncture, 42% had tried supplements, and more than half were using two or more of these at the same time. So when we compare that to national data like the National Health Interview Survey, this group reported way higher utilization of chiropractic, acupuncture and natural products than the general population of pain patients. Now, remember, these individuals were going into a mindfulness program, and this was some of the data taken on intake. So you might be thinking, like, what's really going on here? Well, these patients had been living with radiculopathy for a super long period of time. The average was 13 years, more than a decade of persistent pain. And by the time they enrolled in this study, they'd really gone through the medical mill. Medication, therapy, injections. Almost 20% had had surgery. But despite that, a huge portion of these people were still looking at complementary approaches, because for many of them, the standard medical path was not enough. They were still struggling. And when you compare these results to some of the guideline reviews that are out there, you'll see a mismatch. Guidelines can often give mixed recommendations for things like acupuncture, chiropractic care, and supplements. Yet more than half of the people in the study reported using them. And the gap between those guidelines is and patient behavior is again, where you and I can stand up, lean in, and shine. So why does this matter? Patients with chronic pain are already primed for what you and I do. Many, Most have tried PT, they've taken NSAIDs, and many have done steroid injections. But six, you know, with six out of 10 had sought chiropractic care. And many continue to look for these multimodal therapies. So that's your sweet spot. You're not an alternative in this. You're actually the mainstream choice for people with radicular pain. And patients are open. Here's another thing, just because they saw one chiropractor. It sounds almost silly and contrite because I know we said this, we've talked about this before and you probably have talked about this with many of your colleagues in the past. It's like, man, somebody sees one chiropractor, it doesn't mean that they that chiropractic didn't work. Nobody sees a medical. It just doesn't make any sense when you bring it outside of chiropractic. Of course nobody sees a medical doctor is like, well, I took the NSAID that they recommended. It didn't work. So I'm not going back and seeing any medical doctors ever again. That's silly, right? It just doesn't make any sense. Yet there is a consensus mindset that that exists in chiropractic and I'm here to say it shouldn't. But the work's on us to break that and people are open to it. But we need to do a better job describing that. Chiropractic is more than just the adjustment. And I'm not taking anything away. I think the adjustment is the cornerstone and highlight of what we do. It is the most powerful modality probably out there for a far reaching number of things. But just because one chiropractor's adjustment didn't achieve the goal doesn't mean that going to a different chiropractor won't. And especially if you combine that with another modality. So this data reinforces that people are not satisfied. They are not satisfied with a medications only type approach. When patients walk into your office, you can be absolutely confident that you're not trying to quote, unquote, convince them of something foreign. You are meeting them with where they are at. And if we want to make this actionable and dive in, I think there's a few talking points that you can consider to think of whether it's in your office or on social media, I letting people know they're not alone. That most people with sciatica end up trying multiple options. And the great news is chiropractic care is most of the one of the most common and effective options people turn to. That right there is powerful. Most people don't know. Many people have no clue. As a matter of fact, many people believe if they have sciatica and a disc issue, it's a contraindication for going to see a chiropractor. That is the truth. So literally highlighting in plain English, you are not alone if you're struggling with sciatica. Many people try multiple things, man. Great. Now I Feel better about myself. I'm not alone. I've been dealing with this. I felt as though I'm the only person. And then again, transitioning. The good news, that what you do is one of the most common and effective options. Also letting people know that, hey, there's studies that show over half of people with chronic leg pain or radiculopathy from the spine choose chiropractic as part of their care plan, right alongside physical therapy, exercise and other strategies. And even if you've tried medications or injections, it doesn't mean you're out of options. Chiropractic remains a proven and trusted choice for people that are looking to overcome sciatica. You can be. It can be simple, you can be friendly, it can be reassuring. And all of that is backed by evidence. So making sure that the people in your community know about this, what does that mean? Well, it means in your report of findings, when a new patient comes in, let them know that this ain't your first rodeo, that you've seen this, and that other people are in the same boat. This helps normalize their choice and builds the confidence in making the right decision. Of course, in all of your marketing, creating content, whether it's email, Facebook posts, community talks, letting people know over half of people with sciatica choose chiropractic is massive social proof. Utilizing your reactivation campaigns, no brainer, individuals that came in for other conditions might literally have no idea you take care of sciatica. So highlighting that critically important and, and then collaboration, right when you're building relationships, hopefully if you're listening to this podcast, you're a member of MD Connection, we're gonna help you build relationships faster and better than you can do on your own. That's for sure. We've helped hundreds of docs do that, probably over a thousand at this point in time. So using this as you're getting out there and building referral relationships as a way to bridge the gap. So in this study, again, a majority of individuals in this study had tried physical therapy and medications. A third, a third had had injections, some had even had surgery, and many were using multiple integrative approaches. So this is validation that what you are doing is a trusted modality. It's a trusted option for people that are struggling with sciatica, even if they've had it for a number of years. And while you might be painfully aware of me saying that, I can guarantee you 90% plus, realistically, probably 99% of, of the human beings in your community have absolutely no idea, again, Many probably believe that what they have with radiculopathy and a disc issue is a contraindication for coming in. So helping them understand. Many people, most people with sciatica go in and see a chiropractor. We are some of the most safe and effective way to help you overcome that in putting it in simple language at multiple touch points. Again, when you heard me say this social posts upfront, perhaps on your website, reinforcing that in a report of findings, getting it into your reactivation emails, all of that gives you a 360 approach, a multi platform approach which is going to give you ultimately the best result. So I thought this study was fantastic. I'll drop a link down in the show notes. I know we've been talking lumbar spine, but let's talk cervical spine for a moment. 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So thank you so much for tuning in. Thank you for being a chiropractor. Thank you. Have a fantastic week in practice and I will talk to you soon.

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