Jeff LangmaidFounder, The Evidence Based Chiropractor

Chiro vs. MRIs & Misery! Exposing the "Pain Pipeline" (Docs, Save Your Patients!)

26 Jun 2024 · 1 min

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Jeff Langmaid (speaker/creator) criticizes the common clinical pathway for patients with radiculopathy: initial medication, referral for MRI, radiologic finding of foraminal compression, followed by epidural steroid injections and often surgical escalation. He calls this sequence the "pain pipeline" driven by professional indifference and argues clinicians (including chiropractors) can and should detect structural causes earlier through exam and communicate better to offer superior primary options for patients.

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I practiced in a few multidisciplinary groups throughout my career. And what I saw happen was this. This is the truth of what people are dealing with. Somebody has radiculopathy, well, they go in and they don't see you, they go somewhere else. They're typically going to be prescribed a medication. That medication doesn't work because they have a structural issue. So then the patient sent for an mri. Well, the MRI shows foraminal compression. We would have picked that up immediately on the exam, but now they are already down the pipeline or the journey of what I call professional indifference. And now it is time for shots. Epidural steroid injections, which are the fast track to surgical intervention. I believe this sucks. I believe we can and should do better. And I believe people deserve better than this as their primary option. That means we need to understand and communicate at a level that we never have before, because we know that's just scratching the surface. Think about how much more we can do beyond this. But, man, there are hundreds of millions of people struggling with this type of thing going on right now.