Reducing Leg Pain with Chiropractic Adjustments and Exercise | Podcast Ep. 134

Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On the heels of this week's CNN Health article that said less than 23% of Americans get get the adequate amount of exercise each and every week, I wanted to take a look back at some of the research showcasing home exercise versus spinal manipulation for chronic back related leg pain, AKA radiculopathy and sciatica, and see what the research had to say. And that is what this week is all about. So as I said at the top, this week we are looking at a study from the Annals of Internal Medicine, Volume 161, Number 6. And the title of this study is Spinal Manipulation and Home Exercise with Advice for Subacute and Chronic Back Related Leg Pain. That was a little confusing to say, but anyhow, this is an important topic and it's one that's near and dear to the heart of everybody, I think who follows the evidence based chiropractor. Because subacute and chronic back related leg pain is super challenging to treat in a primary care setting. Their tools just are not good. Right? We look at medications, sometimes they're referring for injections, but really there's chiropractic and there's physical therapy which I'm gonna kinda lump in a little bit unfairly with home exercise. But ultimately we're looking at exercise versus spinal manipulation. And the challenge is that when acute pain becomes subacute or ultimately chronic, it can traditionally the patients that suffer from it develop significant disabilities. There's lower quality of life and there's diminishing ability to perform ADLs. So the symptoms progress if there's not adequate care or treatment and quite often it results in a poor quality of life, quite frankly. So recent research as we talk about each and every week has showcased how adjustments or spinal manipulation, which is a hallmark of chiropractic, can play an important role in the treatment of back related leg pain. Exercise or active care can certainly assist with the long term stability of the spine, but perhaps even prevent future symptomatic episodes. But this study kind of looked at one versus the other and see where the results landed. So here are a few key quotes from this study that I think are super important. The researchers found most patients with back related leg pain are treated with prescription medications and injections, although little to no evidence supports their use. Let's dive into that one a little bit. So they're saying most patients with back related leg pain, AKA radiculopathy in the lower extremity are treated with prescription Medications and injections, although little to no evidence supports their use. So, you know, time and time again, I think we as chiropractors hear, where's the evidence for an adjustment. I don't believe, you know, the heing and hawing about this. When internal medicine, you know, the annals of internal medicine are gonna sit here and talk about the fact that, hey, medications and injections, there's little to no evidence that support their use. And that is something, again, I think, you know, these bits in the research, these hidden, you know, gems, I say gems. Unfortunately, a lot of people are getting this sort of care and not getting the results. That's the bad part about it. But the nice part is research has continued to showcase what we do, the efficacy, the cost effectiveness, the safety. But we have to have the framework to be able to have those conversations. Another quote that the researchers had was, quote, at 12 weeks, 37% of patients receiving manipulation plus home exercise had at least 75% reduction in leg pain, compared with only 19% in the home exercise group. So nearly twice the amount of people that received chiropractic adjustments or spinal manipulation in addition to their home Exercise program had 75% reduction in leg pain. So almost twice the amount of people. Say it one more time. If you added chiropractic care, you're doing home exercise, but you added in chiropractic care, it was twice as likely that you would have a 75% or more reduction in the leg pain. Now think about that. That is substantial. That's taking somebody from a 10 out of 10 pain to a 2.5 out of 10. It's taking somebody from an 8 out of 10 to a 1 out of 10 pain. That is life changing. So do not underestimate the results of this study. Research has also found, quote, we saw consistent statistically significant and clinically important group differences for nearly all other outcomes in the short term and for some secondary outcomes in the long term in favor of spina manipulation plus home exercise, including global improvement and important and recommended patient centered outcome. So let's break that statement down a little bit as well. So again, we've talked about it a couple times. Statistically and clinically significant and important are hardcore research terms. They don't just hand those things out. So there's some thresholds needed to get there. And they are saying that, hey, when spinal manipulation was added to home exercise, nearly every short term outcome and many secondary long term outcomes found statistically and clinically significant differences when chiropractic care was added. So that's Absolutely fantastic. They also cite global improvement as one of those factors. And as they say, it's an important and recommended patient centered outcome. Global improvement, excuse me, is very important from a patient point of view. What's their global improvement? How has their quality of life overall changed or enhanced as time has gone on? And in this study it's unequivocal that they found when spinal manipulation or adjusting was added into the mix in addition to home exercise, that undoubtedly patients received better results to the tune of what was considered clinically and statistically significant. So this was a paper that we released for our members of the Emma's base chiropractor a little while back. I thought it was a nice one to touch on with that recent article from CNN which Showcased less than 23% of people out getting the adequate amount of weekly exercise. So home exercise and active care, in my opinion is an extremely important part of the healing process. When we can do that in our clinics and in our practices, I think that's fantastic because when it's supervised, you can really track the results a little bit better and make sure people are doing things in a safe and appropriate way and progressing the way you'd want. But certainly if they're able to do some at home as well, it's great to be able to do that between those visits. It makes me think back to Dr. Greg Lehman, who we had on earlier this year and he was kind of talking about that protect or expose. And quite often a systematic exposure to a painful stimulus helps the body heal and recover. Again, systematic, you want to be safe, you don't want to push people too hard. But ultimately, specifically with spine related complaints, exposure to painful stimulus seems to get great results. And that goes hand in hand in concert with exercise, right movement, exercise, biomechanics, how individuals are moving and any compensations that they're picking up along the way. So this research paper, again, to me it touches upon all of those factors. It emphasizes the fact that exercise and active care is an important part of the process. But when chiropractic adjustments are added into the mix, the results go absolutely through the roof. It's what we've seen time and time again with other papers as well as this one. And it's why this information needs to get out there into your community. It needs to get out to the people of your community, to the other healthcare providers in your community. And when the papers themselves are talking about how little evidence to no evidence there are from medications and injections, yet these things are being done to the tune of millions of times per year, hundreds of millions in terms of medications and into the millions, 9 million injections for spine related complaints per year. This is something that we need to really take the reins, get out there in our community, have these conversations and showcase our expertise as the leaders in spine related complaints, as the leaders in musculoskeletal care, and in my opinion, in the leaders in care beyond that as well. But until we're able to really take hold of spine, really take hold of musculoskeletal, I think that's where we need to start. 95% of people are going to experience some form of back pain in their life. When I look at the literature, when I look back, there's no question that a vast majority of those individuals should be utilizing chiropractic care along the way, and certainly when they're suffering from some challenges because the research supports again the safety, the efficacy and ultimately the cost effectiveness. Yet our utilization hovers around 15% or perhaps less. So getting out there B2C talking on Facebook, showcasing your practice, getting your message out there. Extremely important. If you're looking to do that with other healthcare providers and build referral relationships, you know that's what we do at the Evidence Based Chiropractor. You can check out our membership@the evidencebasedchiropractor.com where we white label research just like this and make sure we get it out to you so you can share great information in the proper context with other providers in your area and give you the whole process A through Z to do so. So I hope you have a great week in practice. If you have not had the chance to give this podcast a rating or review on itunes, I would greatly appreciate it. That helps us get exposure to more and more chiropractors and we are over 10,000 11,000 strong listeners each and every week. So thanks for tuning. I hope you have a great week in practice and I will talk to you soon.

We appreciate you joining us for this episode of the Evidence Based Chiropractor. Learn more tips for explosive practice development@the evidencebasedchiropractor.com youm can also join the Premier MD monthly membership, enabling you to use what you just heard to maximize results in your office.