This research review covers the topic of the "therapeutic alliance" and how person-centered care impacts outcomes in MSK care. Dr. John Stenberg defines the term "therapeutic alliance", details the three main components of the TA and how they relate to upper cervical care, and ends with 5 actionable steps to maximize outcomes and the therapeutic alliance in upper cervical practice.

Access the full text PDF for the research article reviewed in this episode here:

https://pubmed.ncbi.nlm.nih.gov/39151365/

Previous Episodes referenced:

Data Driven Chiropractic and the Anti-Fragile Approach with Dr. Jacob Coffman

Mastering the Message: The Neuroscience of Nocebos with Dr. Jonathan Chung

In this "upper cervical unplugged" style episode, Dr. Cameron Bearder and Dr. Chad Billiris recap their experience at the 2024 NORA Conference in Orlando Fl.

Takeaways

• The NORA conference was a multi-disciplinary event with diverse practitioners.

• Networking with other professionals is crucial for building relationships.

• Understanding legal considerations in practice is essential for practitioners.

• Billing and coding practices can significantly impact practice success.

• Nutrition plays a vital role in brain health and recovery.

• Optometry is increasingly recognized in concussion care.

• Visual snow syndrome is an important area for further exploration.

• Collaboration between chiropractors and optometrists can enhance patient care.

• Presentations at the conference provided valuable insights into various topics.

• Chiropractors should attend conferences outside their field to broaden their understanding.

Check out NORA online here to learn more about the organization and to find a NeuroOptometrist near your practice:

https://noravisionrehab.org/

Dr. John Stenberg and Dr. Cameron Bearder sit down to recap their experience at the ASAP Conference 2024. The hosts recap their experience at the ASAP conference, which focuses on Chiari malformations and related conditions.

They discuss the unique format of the conference, where patients can learn from top experts and ask questions. They emphasize the importance of understanding the different types of Chiari malformations and the need for clear communication when discussing these conditions.

They also highlight the need for a thorough diagnosis, as Chiari malformations are a radiographic diagnosis that must be correlated with signs and symptoms. The hosts discuss the complexity of these cases, including the potential involvement of connective tissue disorders, inflammatory conditions, and genetics. They stress the importance of being aware of the interconnections between these conditions and considering co-management with other healthcare professionals. They also mention the need for further research and learning in this area.

The conversation explores the philosophy of health from a functional perspective, emphasizing the importance of understanding why the body is not functioning properly. It delves into the chronic neuroinflammatory processes and how they remodel tissues, particularly in the cervical spine and lumbosacral spine. The discussion highlights the need for a methodical approach in treating patients with acquired hypermobility and managing their symptoms.

The conversation also emphasizes the importance of imaging, particularly CBCT and MRI, in identifying structural abnormalities and CSF flow issues. It concludes with a discussion on CSF leaks and the various factors that can contribute to them. In this final part of the conversation, the speakers discuss various topics related to cranio-cervical instability, Chiari malformation, and scoliosis.

They talk about the potential causes and symptoms of CSF leaks, the radiographic signs of CSF leaks on MRIs, and the importance of considering the entire spine and all the tissues when assessing CSF flow obstructions. They also touch on the challenges of conducting research in this field and the need for multidisciplinary approaches to patient care. The speakers emphasize the importance of being knowledgeable, humble, and collaborative in order to provide the best possible care for patients.

Resources from this episode:

ASAP YouTube Channel

Comprehensive Chiari Care with Haley Fitzgerald of Global Neurosciences Institute

What Happens When Two Upper Cervical Chiropractors Attend a Neurosurgery Conference