Helping Lumbar Disc Herniations with Chiropractic Adjustments | Podcast Ep. 91

Hello and welcome to the Evidence Based Chiropractor. I am your host, Dr. Jeff Langmaid. A lot of news to catch up on in the last few weeks. I flew out to California and had the great opportunity to speak at the California Sports Symposium. I went to the fca, the national event in in Orlando, Florida and I have been cruising all over the place. I did a television spot for ABC News just this morning so we can talk about that in a moment. But really today's podcast is going to be about a real world case. I'm excited about this piece of research in this piece of literature because I think it is exactly what many of us see day to day in practice. And it's an article from JMPT. It's it was in 2009 and the title of the article is A Non Surgical Approach to the Management of Patients with Lumbar Radiculopathy Secondary to Disc Herniation. A Prospective Observational Cohort Study with follow up. So basically this is people that are having sciatic like complaints, they have radicular complaints and they have a herniated disc that has been confirmed by an mri. This not only has during the treatment but it also has a follow up phase and the results and you are going to want to stick around to hear about for sure. So before we get started I will say a few words as I do each and every week about Rock tape. Rock stock 2017 is coming up next month. Huntington Beach September. I was with Dr. Steve, their medical director out in California. I met up with Stefano and Allison over in Orlando. So I've and MJ as well. I've been meeting up with the whole crew all over the place and I can tell you this, they are pumped. Maybe even more pumped than myself. You can check out and get tickets still it is going to sell out. So do not sleep on this. If you are into CrossFit, if you're into movement, if you're into soft tissue work and if you're into cool people hanging out and learning and having fun, then this is an event you don't Want to miss. Rocktape.com Rockstock Rocktape.com Rockstock make sure to check out that and I will be out there as well. Also huge shout out to Dr. Cliff and Greg Parks. They came up and said hello at the National Conference in Orlando and said they are avid listeners so I wanted to give them props and say thank you for listening. I have been traveling all over the place so keep your eyes peeled on Facebook, on YouTube and if you've been following the Instagram, you've been seeing it. There is a lot of travel coming up for me and I want to give as much behind the scenes access to that as possible. So I have been very fortunate. I'm very grateful for all of the opportunity that I have. But I will tell you it is an opportunity that all of us can take. So for those who are interested, I want to make sure that I am giving as much value and as much behind the scenes. So you can go do it for yourself for sure if it interests you. And if not, you can just check it out and shoot me a comment, shoot me a like and let me know what you think of all the endeavors. But without further ado, let's get to today's paper. Again, the title A Non Surgical Approach to the Management of Patients with Lumbar Radiculopathy Secondary to Disc Herniation. A Prospective Observational Cohort Study with follow up so the bottom line is we know lumbar radiculopathy is a common and debilitating problem for a ton of people. Only a very small percentage end up needing any sort of surgical intervention. But to date, conservative options have been kind of all over the place. Some of these people are getting injections, some of them are going to pt. It's really a mixed bag. So this research paper from JMP kind of shows a combination of spinal manipulation, joint mobilization, soft tissue techniques, active exercise and education. And basically they're using what's called a diagnosis based clinical decision. So when the patient comes in, the practitioner is using out of that tool set and that toolbox what they want to any combination of that to try to get the patient well. And what the research found is pretty staggering. And spinal manipulation, chiropractic adjustments were at the top of the list. So it was used in every one of the cases. So what the researchers found was nearly 90% of patients reported their outcome to be either excellent or good clinically. Excuse me. Meaningful improvement in disability was seen in more than 70% of patients and clinically meaningful improvement in pain intensity was seen in over 74% of patients. These improvements were maintained 14.5 months after cessation of treatment. So the long term follow up the treatment worked. And not only did it work then, but it also helped people out down the road. Researchers also found improvement was self described as good or excellent in 80% of patients. And finally, and this is kind of a different take on kind of a different subset of data, the researchers found clinical meaningful improvements in pain and disability were seen in 79 and 80, 73% of patients, respectively. So that's powerful. I mean, there's no question about that. These are patients with MRI confirmed disc herniations. They got the pain traveling down. They are in tough shape. Now, here's the interesting part about this and see if this makes sense to you. These are patients that we all see each and every day. But often what I have found is that if I haven't built that relationship with the primary care doctor, if, if an MRI is ordered and it comes back with a disc herniation and the patient's having radicular complaints, I can almost put my money on the fact that the primary care doctor is gonna say, why don't you go get an injection? And as we talked about just last week, for a lot of people out there, this isn't the correct way it should be. And it's actually contrary to what the research shows. But for a lot of people, they say, I'm gonna go get the injection. That means if they get the injection, that means I'm gonna stop chiropractic care. And that's crazy. We know that the injection performs when needed. It performs way better if an adjustment is given. I'll kind of leave that where that remains as far as what's really doing the work and the heavy lifting there. But as far as this paper is concerned, it's a really good point of communication with other referral partners in your community. So here's what I mean by that. Imagine if all the primary care doctors in your community knew that even in patients with MRI confirmed disc herniations and radiculopathy, that patients are getting excellent and good results with chiropractic care and it's lasting a long time. Not only is chiropractic safe, but it is unbelievably effective. What if every primary care doctor in your community knew about this research study? Think about that. I'd implore you to make that a reality. If you want to take this research, I'm going to have this linked in the show notes to PubMed. Take this research study and make a handout. Make a research brief. Bring this to the attention. If you didn't know, here, I'll put this into perspective. If you did not know about this study when I started talking about it at the top of the episode. How do you ever expect the primary care doctors, internal medicine doctors, sports medicine physicians, orthopedic guys, neurologists, midwife doula. I don't care what kind of healthcare provider they are. How would you expect them to know about it if you did not have intimate knowledge of the material. So I am going to link this study in the show notes directly to PubMed. You can then grab it and do your thing from there. Now the other thing I will say, I'd be remiss not to say it is that's exactly what we do for all the members of the evidence based chiropractor. So if you have not hopped on board yet, there are thousands of you listening and while we have a very strong membership, it is not 4000 docs plus that are listening to this podcast. So if you want us to do that work for you and give you the research, give you the video modules on how you can reach out the three pillars of referrals and basically set you up for success like nobody else in the business, then check us out@the evidencebasedchiropractor.com Again, I think the most important thing is that we are getting this research out to the other healthcare providers in our community. Now we also want to get it out to our patients. Don't get me wrong. And that's where we've talked about the smart chiropractor. If you need extra help with that. But for other healthcare providers, this study is just a natural fit to be able to have other healthcare providers understand the value of what we're doing. It doesn't happen with just one paper, it doesn't happen with one case note. But when you make it a habit, you can do it very, very inexpensively and get absolutely fantastic results and build long term referral relationships. I've seen it happen time and time again around the globe. So if you want a little extra help, check us out the evidencebasedchiropractor.com and if you have any comments, if you have any questions, if you're a little bit unsure of whether it's for you, shoot me an email. Jeff the evidencebasedchiropractor.com I'm happy to answer any questions and make sure it's a win win. It's month to month, there's no commitment and all of that fun stuff. I'll tell you what, I have docs out there that are getting 12, 24, 36, 48 additional referrals per year and it's adding a ton to their bottom line. So if you're interested in that, make sure you check it out. However, if you want to do some of that heavy lifting yourself, you don't mind the trial and error, you want to go through some of the pain involved in figuring it out I encourage you go for it because when you build those relationships they are some of the best items. Aside from a patient referral, a physician physician referral or a healthcare provider referral is one of the best you can get. Patients that are compliant, patients that are ready to go and patients that are really interested in what you do. And to me this research study is so real world. It's real life. It's what we see that it's a great opportunity to extend that hand to educate others in your community and to move forward from there. So I have a bunch of trial hopefully that was inspiring for you and I want everybody out there to feel comfortable, to feel confident with what they're doing in practice and to build their practice in multiple fashions. Still do your advertising direct to consumer but you have to be able to do that physician advertising. I say physician, I mean all healthcare providers. Midwife doula, MD do. I don't care who it is. I think that's exceptionally important because I've seen it time and time again. But I have a bunch of travel coming up as well. Check the calendar. I will be in Connecticut. I will be on Huntington Beach. I will be. Oh my gosh. I got a whole bunch of travel coming up. So if you are going to be in any of those areas. Wow, that was a mouthful. Then definitely hit me up. I would love to meet up and chat and say hello. Otherwise I will catch you on the flip side next Monday morning for another episode of the Evidence Based Chiropractor podcast. I have been your host, Dr. Jeff Langmaid. I hope you have a great week in practice Doc and I will talk to you soon.

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