Subacromial Dry Needling & Lumbar Discs With Stenosis Present

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 276: Subacromial Dry Needling & Lumbar Discs With Stenosis Present

Today we’re going to talk about Subacromial Dry Needling & Lumbar Discs With Stenosis Present

But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re spending your time with us learning together. Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [e-mail] If you haven’t yet I have a few things you should do.

• Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
• Then go Like our Chiropractic Forward Facebook page,
• Join our private Chiropractic Forward Facebook group, and then
• Review our podcast on whatever platform you’re listening to
• Last thing real quick, we also have an evidence-based brochure and poster store at com

You have found yourself smack dab in the middle of Episode #276 Now if you missed last week’s episode , we talked about Remote Myofascial Release & Manual Versus Instrumental Spinal Manipulation. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. As we speak, I’m getting ready to meet my friends from the MCM Florida Mastermind this coming weekend. Now, I’m a couple of weeks ahead on these podcast episodes for most of you so by the time you hear this one, it’ll have come and gone but that’s what’s happening right now. What the hell is the MCM Mastermind you might ask? Well, Dr. Kevin Christie of the Modern Chiropractic Marketing podcast put it all together a couple of years ago. It started out at about 15 of us from around the country and I think we’re up to about 24 right now. Pretty capped out I believe. Kevin doesn’t want it any bigger than that but listen up!! He has talked about starting a West Coast mastermind as well. A separate sister group. They won’t be the OGs like our Florida group or anything but just as important…..as far as they know. : ) Anyway, it’s a very unique and very professionally run and organized thing. Lots of masterminds are thrown together a little willy nilly but Kevin, through his work with Strategic Coach, has this down to a science. The education and the speakers are always top notch, the networking and bonding opportunities are ideal for the exchange of ideas and inspiration, and it’s a damn good reason to get out of your clinic and experience something besides those walls. Plus, Kevin has some pretty talented connections. Our members include Brett Winchester, Mark King of MPI, Jay Greenstein, Ben Fergus, and lots lots more. Also, you get perspectives from a range of areas of the country. For example, our members are from

• Texas
• Alabama
• Florida
• North Carolina
• Montana
• Ohio
• Connecticut
• Illinois
• Missouri
• New Jersey

And I probably missed a few states but you get the idea. It’s a pretty cool thing to be a part of and I value the incredible connections I’ve made over the last two years. Whether it’s one of Kevin Christie’s masterminds or it’s another you come across, I highly encourage you hop into one….or form your own. You’ll thank yourself. In addition, I’m lining up my stuff for the big 100 Men Who Give A Damn event tonight. I’ve talked about this on the podcast before but we have to be in the community. You must. You can’t do business sitting on your ass in the words of Dan Kennedy so get out and go and do. One of the easiest and best ways to do that is through setting up your own 100 Men Who Give A Damn. Although I’d just go ahead and drop the Men from it and say 100 Who Give A Damn because when the wives come, the men spend more so let’s get all inclusive and get everyone there. You don’t have to do much. I asked 3-4 folks to help me and I picked them from different areas of the community and different industries for a wider net. One being internet, website, etc. We got a site up and were off and running. You have one event per quarter. Most businesses are happy to donate their space for charitable events. No membership, no committees or regular meetings. Low maintenance way to have your very own philanthropic group. Check out our site at www.100menamarillo.com and ask me any questions at [e-mail] I’m happy to help you get up and running if interested. No paper work or anything. Just start. Item #1 The first on today is called, “Dry Needling for Subacromial Pain Syndrome: A Systematic Review with Meta-Analysis” by David Griswold and published in Pain Medicine on 26 August 2022. Dayum. That’s hot. Why They Did It The authors of this systematic review with meta-analysis evaluated the evidence for the effectiveness of various applications of dry needling (DN) combined with other conservative treatments for subacromial pain syndrome (SAPS). How They Did It

• Six databases (PubMED, CINAHL, Biosis, Web of Science, SPORTDiscus, and Cochrane Central Register of Controlled Trials) were searched after the study had been registered in PROSPERO.
• The authors included randomized clinical trials investigating the clinical effects of DN in combination with other conservative interventions for SAPS.
• Outcomes included pain and disability.

What They Found

• Eight studies were selected. All eight studies involving 10 comparisons were included in the analyses (N = 538). A random-effects model was used to analyze between-group effects.
• Dry needling performed in combination with other conservative interventions produced favorable outcomes at all time points for pain and disability.

Wrap It Up The meta-analysis suggests that various applications of DN performed with other conservative interventions are more effective than conservative treatment alone for reducing pain and disability in patients with SAPS. Direct-comparison studies are needed to determine whether one application of DN is superior to another. Before getting to the next one, Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office. When you decide you can’t live without those products, send me an email and I’ll give you the hookup. They will 100% differentiate your clinic from your competitors. I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it. Item #2 Our last one this week is called, “Conservative Treatments for Lumbar Disc Herniation at L3-4 or L4-5 Were More Likely to Fail When Ipsilateral Foraminal Stenosis Was Present at the Caudally Adjacent Segment” by Shuchen Ding and published in PubMed on 14 February 2023. Hot potato! Why They Did It To prove conservative treatments are important in lumbar disc herniation (LDH), but predictors for poor outcomes are unclear. How They Did It

• Consecutive patients with unilateral single-level LDH at L3-4 or L4-5 were enrolled. Baseline clinical data were collected, and lumbar spine magnetic resonance imaging was evaluated.
• Foraminal stenosis was evaluated using Lee’s approach and further categorized as absence (grade 0 and 1) or presence (grade 2 or 3).
• Each patient underwent conservative treatments (oral meloxicam and dexamethasone, corset, back extension exercise, physiotherapy, and manual therapy) for 6 weeks.
• Conservative treatments were defined as failed if a patient underwent surgery within 6 weeks or reported poor recovery at 6-week follow-up.
• Multivariate logistic regressions were used to examine the associations of failed conservative treatments with baseline characteristics and magnetic resonance imaging findings.

What They Found

• The study included 222 patients (mean age 45.5 ± 9.8 years). Of patients, 48 (21.6%) had concurrent ipsilateral foraminal stenosis at the caudal segment, and conservative treatments failed in 39 (17.6%).
• At baseline, patients with LDH and caudal foraminal stenosis were older (50.79 ± 6.14 years vs. 44.10 ± 10.13 years, P < 0.001), had greater leg pain (7.06 ± 1.17 vs. 6.39 ± 1.40, P = 0.003), and had a higher rate of positive straight leg raising test (54.2% vs. 33.3%, P = 0.008) than patients without caudal foraminal stenosis.
• In multivariate regression, failure of conservative treatments was associated with positive straight leg raising test (odds ratio 2.26, P = 0.046), and caudal foraminal stenosis (odds ratio 3.20, P = 0.007).

Wrap It Up In the presence of caudal foraminal stenosis and positive SLR test, conservative treatments were more likely to fail in patients with LDH. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.

When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.

It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.

And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….

That’s Chiropractic!

Contact

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Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

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