Adjustments As Immune Boosters & Pain – Mind or Matter?

The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF 182: Adjustments As Immune Boosters & Pain – Mind or Matter? Today we’re going to talk about adjustments being immune boosters and then we talk about osteoarthritis and if pain is mind or matter. But first, here’s that sweet sweet bumper music

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 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. If you haven’t yet I have a few things you should do.

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You have found yourself smack dab in the middle of Episode #182 Now if you missed last week’s episode , we talked about NSAIDS causing GI events and we talked about chronic pain and how it’s being handle within the VA system. Make sure you don’t miss that info. Keep up with the class. On the personal end of things….. As seems to be the common thread lately, time is short this week. I am preparing for the book launch tomorrow. Now I’m recording this on Monday, June 7. And the lunch is Tuesday, June 8 so when you get this when you hear this, it’s already up and live. I would love for you to go and purchase yourself a copy of my new book. It is called the remarkable truth about chiropractic: a unique journey into the research. It has been a long time coming and it is finally finished. For those of you that reached out enjoying the lunch team, thank you so much. I have some special people in my life and I am grateful for each of them. So, about the time I am recovering from the New Orleans trip, it’s time to take two days off this week to go to the state chiropractic convention which is called Cairo Texaco. Of course, we missed the chiropractic conference last year because nobody could be in the same room with each other for fear of dying a slow and painful death. But this year is different. We are looking forward to seeing each other again and shaking hands and hugs and conquering the chiropractic world yet again. Going to your state conference and being involved in your state association is one of the most important and impactful things you can do for yourself, your business, and your profession. If we are to ever get the message of evidence-based, patient-centered practice to be big business and the way things are done, it Hass to be done through leadership, activity, and guidance on our part. And that starts not only locally, but also on the state level. So I implore you to get active in your state association. Get to know the players. And once they get to know you and respect you, and you can start to steer the ship a bit. It takes all of us. Including vitalists by the way, because some evidence chiropractors have taken it so far that they don’t even use spinal manipulative therapy. Do you have to have a vitalist to offset that? But, the point is to get active and if you don’t recall part of the podcast from last week, I don’t wanna hear that crap about not having time. Nobody has time. But if not us, then who? Make it a priority and just get involved. Dive in. Raise your hand. Volunteer. It’s that simple Seriously, nobody has time. It’s like voting. If you don’t vote, don’t bitch. If you don’t get active in your state association and maybe eventually your national association, don’t bitch. Sit down and let the A Team handle it. Sorry for the harsh tone there but after being so active for so long and watching the benchwarmers gripe about everything all the time no matter what…..well…..I’m over it. Here we go. Item #1 Let’s step into it here, shall we. It’s called “The Potential Mechanisms of High-Velocity, Low-Amplitude, Controlled Vertebral Thrusts on Neuroimmune Function: A Narrative Review” by Heidi Haavik, [1] the vitalist’s brand new hero, and it was published in Medicina on May 25, of 2021. Servin’ it up fresh! Why They Did It Heidi says, “The current COVID-19 pandemic has necessitated the need to find healthcare solutions that boost or support immunity. There is some evidence that high-velocity, low-amplitude (HVLA) controlled vertebral thrusts have the potential to modulate immune mediators. However, the mechanisms of the link between HVLA controlled vertebral thrusts and neuroimmune function and the associated potential clinical implications are less clear. This review aims to elucidate the underlying mechanisms that can explain the HVLA controlled vertebral thrust–neuroimmune link and discuss what this link implies for clinical practice and future research needs.” How They Did It

• A search for relevant articles published up until April 2021 was undertaken.
• Twenty-three published papers were found that explored the impact of HVLA controlled vertebral thrusts on neuroimmune markers, of which eighteen found a significant effect.
• These basic science studies show that HVLA controlled vertebral thrust influence the levels of immune mediators in the body, including neuropeptides, inflammatory markers, and endocrine markers.
• This narrative review discusses the most likely mechanisms for how HVLA controlled vertebral thrusts could impact these immune markers.

What They Found

• The mechanisms are most likely due to the known changes in proprioceptive processing that occur within the central nervous system (CNS), in particular within the prefrontal cortex, following HVLA spinal thrusts.
• The prefrontal cortex is involved in the regulation of the autonomic nervous system, the hypothalamic–pituitary–adrenal axis and the immune system.
• Bi-directional neuro-immune interactions are affected by emotional or pain-related stress. Stress-induced sympathetic nervous system activity also alters vertebral motor control.

Wrap It Up She says, “There are biologically plausible direct and indirect mechanisms that link HVLA controlled vertebral thrusts to the immune system, suggesting HVLA controlled vertebral thrusts have the potential to modulate immune function. However, it is not yet known whether HVLA controlled vertebral thrusts have a clinically relevant impact on immunity. Further research is needed to explore the clinical impact of HVLA controlled vertebral thrusts on immune function” OK, Heidi is way more intelligent than I am so I’m not debating or arguing with her. I would just say that is getting hit in the butt with a board influential on the immune system as well? How about exercise? Having sex? What about getting slapped in the face? Then I would wonder how long-lasting any effect on the immune system is, is any effect a strong enough effect on the immune system to actually be able to fight of viruses, and…..if its that effect needed 3 x per week? Once per week? Would trying to maintain this immune boost lifetime lead to worse things like spinal instability? I have my doubts on this line of research but will definitely be watching. Wouldn’t it be great if she can prove it 100%? I doubt that’s going to happen so don’t hold your breath, please. CHIROUP ADVERTISEMENT Item #2 Our last one today is called “Factors associated with pain intensity and magnitude of limitations among people with hip and knee arthritis” by Kopp et. al. [2] and published in the Journal of Orthopaedics in the May-June 2021 issue and you can’t get any steamier than that my friends. Why They Did It The pain and limitations associated with osteoarthritis of the hip and knee have a notable variation that does not correspond directly with pathophysiology. The purpose of this study is to assess the influence of location of the arthritis on pain intensity and magnitude of limitations accounting for personal and psychological factors. How They Did It

• 154 patients with osteoarthritis of the hip or the knee were enrolled in this prospective cross-sectional cohort study.
• Patients answered questionnaires which included demographics, site of arthritis, laterality, pain intensity,(PROMIS PF CAT), and psychologic questionnaires

What They Found

• Magnitude of limitations was independently associated with years of education, work status, time spent exercising, catastrophic thinking (PCS-4), and symptoms of depression.
• They accounted for 50% of variability in physical function, with the major contributor being catastrophic thinking. The model for pain intensity included time spent exercising and fear of painful movement (TSK-4). Anatomic site and radiographic severity of arthritis were not associated with either physical function or pain in our patient sample.

Wrap It Up This study confirms that limitations and pain from osteoarthritis of the hip and knee are more closely related to personal and psychological factors, less effective cognitive coping strategies such as catastrophic thinking and kinesiophobia in particular, than to pathological and anatomical factors such as location and severity of arthritis. Care that incorporates incremental correction of common misconceptions that accompany the nociception from osteoarthritis have the potential to improve function and comfort in people with osteoarthritis. The power of the mind folks. Use it to your advantage. Remember, words matter. Be optimistic, relay confidence and be supportive. Never be pessimistic or communicate in a catastrophic way. Ever. See what happens. Alright, that’s it. Y’all be safe. Keep changing our profession from your little corner of the world. Keep taking care of yourselves and everyone around you. Tough times are upon us but, the sun will shine again. Trust it, believe it, count on it. Let’s get to the message. Same as it is every week. Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

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 Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 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. Website

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Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerBibliography 1. Haavik, H.N., I.K.; Kumari, N.; Amjad, I.; Duehr, J.; Holt, K, The Potential Mechanisms of High-Velocity, Low-Amplitude, Controlled Vertebral Thrusts on Neuroimmune Function: A Narrative Review. Medicina, 2021. 57(6): p. 536. 2. Kopp B, F.K., Goldberg T, Ring D, Koenig K,, Factors associated with pain intensity and magnitude of limitations among people with hip and knee arthritis. J Orthopaedics, 2021: p. 295-300.

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