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

On this episode, Dr. Joey Miles shares his journey into chiropractic and upper cervical care, highlighting the importance of personal experiences and curiosity. He discusses the evolution of the upper cervical community and the collaborative nature of the field.

Dr. Miles emphasizes the significance of being outcome-driven and utilizing a comprehensive set of assessments to track patient progress. He also emphasizes the value of ongoing evaluation and the importance of incorporating multiple data points to provide a holistic approach to care.

In this conversation, Dr. John Stenberg and Dr. Joey Miles discuss the importance of developing proficiency in chiropractic techniques before adding new variables. They emphasize the need for ongoing learning and development, caution against complacency, and stress the value of reevaluations and exams.

They also discuss the importance of setting reasonable timelines for care plans and the role of patient compliance in achieving positive outcomes. They highlight the need for critical thinking and thoughtful contemplation in patient care and the importance of empowering patients to make informed decisions about their health.

Check out Healthy Living Spinal Care on their website here

Takeaways

• Personal experiences and curiosity play a significant role in the journey into chiropractic and upper cervical care.

• The upper cervical community has evolved over time, with a shift towards collaboration and a focus on progress and improvement.

• Being outcome-driven and utilizing a comprehensive set of assessments allows for a holistic approach to patient care.

• Ongoing evaluation and tracking of patient progress are essential for providing effective and individualized care. Develop proficiency in chiropractic techniques before adding new variables

• Continuously learn and ask questions to avoid complacency

• Regular reevaluations and exams are important for tracking progress

• Set reasonable timelines for care plans based on individual needs

• Patient compliance plays a crucial role in achieving positive outcomes

• Critical thinking and thoughtful contemplation are essential in patient care

• Empower patients to make informed decisions about their health

Thanks for tuning in!

On this episode, Dr. John Stenberg sits down with Dr. Randy Culig to discuss the difference between x-ray and CBCT in upper cervical practice.

Takeaways

• Understanding the biomechanics of the cervical spine is crucial in upper cervical care.

• Asymmetry is prevalent in the upper cervical spine and plays a significant role in misalignments.

• CBCT provides a clear view of the articulations and allows for a more comprehensive analysis.

• Early adoption of CBCT in Orthospinology requires manual measurement and analysis.

• Integrating different techniques and taking a patient-centric approach is essential in upper cervical care. CBCT imaging provides valuable information for upper cervical chiropractic care

• Understanding the unique anatomy and architecture of each patient is crucial

• Important findings such as elongated styloids and narrow canals can be identified with CBCT

• Precision in adjusting techniques based on these findings can lead to improved outcomes

• Collaboration with other healthcare professionals is beneficial for patients

Check out Dr. Culig's Website here:

https://www.pierceuc.com/

View the speaker line-up and register for the Orthospinology Symposium here:

https://www.orthospinology.org/

View the speaker line-up and register for the Blair Annual Conference here:

https://www.blairtechnique.com/2024blairconference/

Dr. John Stenberg and Dr. Jake Hollowell sit down to discuss news and updates from the Blair Technique including the upcoming conference and the release of the NEW Blair Technique manual.

Takeaways

• The Blair Society is a volunteer-run organization focused on serving the public and advancing the Blair technique.

• Certifications offered by the Blair Society include student certification, level one and level two certifications, instructor certification, and faculty instructor certification.

• The upcoming conference will feature diverse speakers discussing topics such as communication, marketing, brain changes, clinical impacts of lower cervical adjusting, CBCT analysis, and evidence-based approach to the 33 principles.

• There is a growing interest and enthusiasm for the Blair technique in South America, particularly in Brazil and Argentina. The Blair Technique has gained traction and momentum globally, with practitioners teaching and practicing it in different parts of the world.

• The release of the latest version of the Blair Technique Manual provides a valuable reference for practitioners, covering various aspects of the technique.

• The manual includes chapters on biomechanics, thermography, exam procedures, X-ray troubleshooting, CBCT analysis, and adjusting procedures.

• A special chapter on special populations written by Dr. Forrest is included in the manual.

• Being a "straight" chiropractor means focusing on the detection and correction of vertebral subluxation.

Click here to check out the speaker line up and register for the Blair Conference.

On this episode, Dr.s John Stenberg, Cameron Bearder, Al Cobb, Dustin Dingus, Brett Berner, Jeffrey Hannah debrief their experience at the first of two functional neurology courses for the Diplomate in Chiropractic Craniocervical Junction Procedures.

Key Takeaways

• Understanding neuroanatomy and physiology is crucial for providing specific and effective care in upper cervical chiropractic practice.

• Differential diagnosis is important in order to identify the underlying causes of patient symptoms and choose appropriate interventions.

• Implementing functional neurology concepts into daily practice can enhance patient outcomes and expand treatment options.

• Ongoing learning and adaptation are necessary to stay current with new techniques and advancements in the field. Differentiating between cervicogenic and peripheral dizziness requires comprehensive exams.

• Being open to change and new information is important in the field of upper cervical chiropractic.

• Ongoing learning and data analysis can improve the practice of upper cervical chiropractic.

• Understanding the underlying causes of conditions is crucial for effective treatment.

• A unified upper cervical diplomat exam could provide consistency in the field.

This is part of a monthly series giving you an inside scoop on the conversations and experiences that happen behind the scenes during the process of becoming and upper cervical diplomate. Just search the episode list for "Upper Cervical Unplugged" to find more episodes like this.

In this conversation, Dr. John Stenberg, Dr. Cameron Bearder and Dr. Rich Schoonmaker discuss the importance of critical thinking and evidence-based practice in chiropractic care. They highlight the need for chiropractors to be open to different perspectives and to constantly update their knowledge and skills. They also emphasize the value of patient-centered care and the importance of effective communication with patients.

The conversation touches on topics such as the role of neuroscience in chiropractic, the impact of social media on the profession's image, and the need for collaboration among healthcare professions. Dr. Schoonmaker shares his experience transitioning from chiropractic to osteopathic medicine and the opportunities it provides for a more comprehensive approach to patient care.

The conversation explores the need for chiropractic to integrate with other healthcare professions and move away from the identity issues that have held it back. The speakers discuss the importance of using updated science and research to understand the vertebral subluxation and its multiple components. They also touch on the need for chiropractors to have a clear and consistent message about what they can offer and to avoid making unsupported claims about treating medical conditions. The conversation emphasizes the importance of patient-centered care, continuous learning, and collaboration with other healthcare providers.

To follow along with Rich's medical school journey, follow @richs_medstudent on IG

Thanks for listening!