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Hi, I’m Dr. Mark Studin, and I’d like to thank ChiroSecure for allowing me to share just so much great information with you. And today we’re going to talk about a chiropractic spinal adjustment, the chiropractic spinal adjustment versus a manipulation. Let’s go to the slides. So when we look at these two things, they’re interchangeable, especially with the ICD or actually CPT terminology of manipulation of the procedure.
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But really, they’re very different and outcomes are extremely different and language is critical. So we are chiropractors doing a chiropractic spinal adjustment. And when we look at that, we have to look at what outcomes and what a manipulation is versus an adjustment. So before we get cranking, I’d like to just throw some QR codes up.
If you’re interested in learning more about our consulting site, that’s the top Q. Just take a picture of this with your cell phone. Synverda is digitizing. EMR Cairo is by far the best chiropractic record system in the industry. helps you compete with corporate and do all those other wonderful things.
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And if you’re interested in any academics, the bottom QR code is our academics or you could give me a jingle. So just take a picture of this with your cell phone. But when we look at a chiropractic spinal adjustment, these are two facets. And when we look at the facets, We go in the joint. You’ve got two bones right here.
You see this little piece right here. This is called a menis. This menis, or a plica is a spacer. And when you have a microtrauma or a series of microtraumas. That spacer gets dislodged, and when that, and I can show you MRI images, but that’s not what today is for. We don’t have the time to do it, but when that spacer gets dislodged, the two facets approximate like symbols, and there are no susceptors on the end of those facets.
Folks, that’s your bone on nerve. Not at the root level. You cannot have bone on nerve at root level. Can’t exist. There’s osseous locking mechanisms that prevent that. But here’s your bone on nerve. But the other thing that occurs is you’ve got a joint capsule here. And with that joint capsule, it’s made of pacinian corpuscles, which are your crimp receptors, your raffinic corpuscles, which are your stretch receptors, Golgi tendon apparatus, which I don’t have on here which are at the end of the tendons.
And there’s also ones in the ligaments and more nociceptors in the area. It all feeds into the lateral horn. But it doesn’t go directly up the spinal thalamic tract. These are your mechanoreceptors. Mechanical, from the outside in. They then feed into your, whoop, wrong one. It then goes into, and I don’t, again, we don’t have time to explain all this.
This is explained in Primary Spine Care 15 and 16 on teachdoctors. com. But these nerves, these nerve impulses now feed into, through the piezo ion channels, The deep paraspinal muscles, which tells you where your body is in time and space. Then that feeds back into the lateral horn, goes up the spot, spinal thalamic tract through the peri euc gray area into the thalamus, which is a clearinghouse.
It then feeds into the insula, the anterior singular cortex, the prefrontal cor, the orbital cortex, the motor cortex, the sensory cortex, and a bunch of other areas. And then it goes back down into the thalamus, which is the clearinghouse, and then goes efer potentially into disparate areas. Because if this is off, you are off kilter, maybe a degree or two, and when you’re off kilter, a degree or two, the body wants to bring you plum.
So you might have a lesion in your lumbar spine, but it’s going to cause spasticity through ether and distribution from that motor cortex, which now tells the cervicals or thoracics to pull or tighten or spasm, usually on opposite sides, which is the beginning of that S curve. So you might have pain in your thoracic area.
which is your most pain or your patient’s most pain, but the primary lesion is in your lumbar spine, which is why you need a tool like Synverta that will help you diagnose where that primary lesion is. Now, what we do as chiropractors is we deliver a high velocity, low amplitude thrust. Which then helps it separates the joint and helps recede that meniscoid into place.
And when that occurs, it’s a spacer, it’s a washer. It stops that whole negative neurological cascade I just chatted about. But when you do a manipulation, you are moving this joint. Arthro Kinematically or Ortho Kinematically, it’s a movement of the joint through its normal excursion that does not reede, that menis.
It does, and by the way, it releases substance P and all that other stuff, which I don’t have time to get into. But what occurs is when you do that, because you’re just moving it through the joint and you don’t receive the menis. Guess what happens? First of all, as recently as now, and I only put a 22 19, a 2022 citation here.
But even if I pulled a 2025 citation, it says early physical therapy is the number one choice. Guess what? What do physical therapists do? Physical therapists do orthokinematic lights. Moving through the joint. 2012, the same thing. 1976, McKenzie method. Take your neck and push it forward. Get your spine in place.
You physically do it. Have the physical therapist do it. And when you do that’s moving through an orthokinematic maneuver. According to a study, Where you had four thousand eight hundred and twenty seven patients in 2023 and look at this all most doctors DPTs doctors of physical therapy with PhDs doctors of physical therapy doctors of physical therapy There is one chiropractor Michael Schneider’s a PhD also, but all the rest are PTs and doctors of PhD from the VA Defense Health Agency, Falls Church, Naval Medical Center, San Diego, Bethesda, Uniformed Health Sciences, Henry Jackson in Bethesda and on.
What did they find? What did they find? And this is your citation, 1993, from Physical Therapy. That in 89 percent of the patients, 89. 9, 90%, opioids increased by 80%. There’s no opioid reduction. if only physical therapy and no modalities, heat, stem exercise, but they all do all those things. But the answer is a spinal injections increased by 53 percent if they do an arthro kinematic maneuver or manipulation with exercise.
Okay, so you have injections go up empty specialty care, which is server surgery. All of these things go up, but here’s your marker. If just a manipulation is done with exercise, opioids increase by 80 percent and 90 percent of the patients. That’s unconscionable. That’s what physical therapy does. Now we have another study from a cohort.
Which one is this? Chiropractic? Now this is the likelihood of Tramadol, which is an opioid. with ridiculous back pain. This is in 2024. They studied 1171 patients. Cleveland Medical Center, Case Western, Duke, Butler, Virginia Health Care System, University of Pittsburgh. This is Duke again. Another one.
Cleveland Medical Center. You’re not talking you know, some obscure place in the middle of nowhere. What do they find chiropractic versus medical care for the same diagnosis reduces trauma doll, which is an opiate by 308 percent following the ridiculous event in a 2018 study, 6, 868 patients. What do they find chiropractic decreased opioids by 55 percent with older folks, 56 percent opioids prescriptions decreased.
By 54%, 365 days, and the costs by 74% went down. That’s 2018. There was a 313% decrease in secondary and 239% decrease in primary disability versus chiropractic care. That’s because folks, you are doing a chiropractic spinal adjustment. You are not doing a manipulation. The outcomes are huge. According to the data in 2020, they studied 8, 023, 162 patients over four years.
96 percent got better 96 percent out of 8 million because you’re doing a chiropractic spinal adjustment in my notes. When I put my manipulation code, I write in parentheses, chiropractic spinal adjustment. What you do matters. It makes a huge difference. 96 percent of patients are satisfied with chiropractic care.
These are the outcomes. This is it. But here’s the thing, and here’s the thing. You have to understand. You have to be able to find that primary lesion. Verta will help you do that, and it’ll make you understand it very easy. Go to verta.com, go listen and learn. Your documentation has to be easy and it has to work.
So you also must, and I really didn’t intend to put this slide up right now, but I’ll share with it. I’ll share this with you anyhow, if you wanna grow your practice. and have relationships with lawyers and MDs. You have to become a peer with similar training to a lot of the MDs. Oh, you’re only a chiropractor.
You’re not a medical doctor. You don’t go to medical school. So I’ve heard that for, I’m in the game 44 years now. So I’ve heard that a lot. So what we’ve done is it took me over a decade, but I created a relationship with the state university of New York at Buffalo. School of Medicine and Biomedical Sciences.
And we were able to negotiate with them and get courses that lead towards a fellowship in primary spine care. You get an FPSC after your DC. And you get all the courses credentialed through SUNY Buffalo Medical School. You can earn a mini fellowship in neuroradiology and MRI spine through the medical school and through Cleveland University College of Chiropractic.
I’ve worked with Dr. Cleveland for years and the courses are done in joint providership. with both entities. So you can earn a mini fellowship in MSK radiology, neuro radiology. There’s another one in advanced spine imaging all through SUNY Buffalo medical school. You can become trauma qualified through Cleveland university with all the courses accredited through SUNY Buffalo medical school, MRI spine qualified, primary spine care qualified.
There’s a dozen of them. You can now get a CAQ after your DC also, which is certificate and added qualification. Which all courses are recognized through SUNY Buffalo Medical School and Cleveland University Chiropractic and Health Sciences. So we’ve created a pathway now, and I’ve heard this so much Talking to a primary care medical doctor.
Oh, that sounds like chiro mumbo jumbo That’s exactly what the last primary care told me and said where did you learn all this chiro mumbo jumbo stuff? I said, through the State University of New York at Buffalo School of Medicine. He goes, really? I said, yeah. He goes, explain it again to me. I didn’t fully understand it.
What are you doing? I’m talking about spinal biomechanics. Where were you trained? They all want to know where you were trained. When you’re lecturing, or I’m sorry, when you’re testifying or dealing with attorneys, and whether you testify or not is not relevant, lawyers judge you by their endgame. Where were you trained?
And I’ve had almost every single judge who’s allowed a chiropractor in an expert hearing to testify, quote, State University of New York at Buffalo School of Medicine. Folks, it’s real. The credits are real, everything’s real, and it works. So listen, there’s so much more I want to share with you. But I do want to share with you that the most important thing is to talk about a chiropractic spinal adjustment.
It’s much different than a manipulation. Once you start talking about a manipulation, they’re gonna lump you in with physical therapists and osteopaths, which don’t even remotely do what we do. They don’t do what we do. You’ve got to be a chiropractor doing a chiropractic spinal adjustment. The outcomes dictate everything.
It’s all about outcomes, patients, referrals. That’s where you need to be. Folks, I’m Dr. Mark Studin and with ChiroSecure, I hope you’ve enjoyed this information and we look forward to seeing you next time.
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