In episode 13 of season 1 of Inside the Science, we’re highlighting the study, Transforaminal Epidural Steroid Injections Followed by Mechanical Diagnosis and Therapy to Prevent Surgery for Lumbar Disc Herniation and discussing it with one of its authors Hans van Helvoirt. He shares a look at this popular paper analyzing the effects of epidural steroid injections on non-responders per MDT assessment. He explains what prompted this work, its clinical implications, how he uses it with patient education, the big takeaways, and recommended other work that would shed further light on this topic.
Season 1, Episode 12 with Nikolai Bogduk: Cervicogenic headache: an assessment of the evidence
In episode 12 of season 1 of Inside the Science we’re highlighting the study, Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment and discussing it with one of its authors Dr. Nikolai Bogduk. He shares a look at the paper analyzing whether the cervical spine structures are responsible for headache and if so, in what scenarios. He explains his analysis, how the determination was made, common treatments and their efficacy, and recommended other work which would shed further light on this topic.
Season 1, Episode 11 with Nikolai Bogduk: Cervical Discs as a Source of Neck Pain. An Analysis of the Evidence
In episode 11 of season 1 of Inside the Science we’re highlighting the study, Cervical Discs as a Source of Neck Pain. An Analysis of the Evidence and discussing it with one of its authors Dr. Nikolai Bogduk. He shares a look at the paper analyzing whether the cervical disc can be the source of neck pain and if so, in what scenarios. He explains his analysis, how the determination was made, the reason common treatments may weigh in on whether discs can cause pain, and recommended other work which would shed further light on this topic
Season 1, Episode 10 with Richard Rosedale: Extremity Pain of Spinal Source (EXPOSS)
In episode 10 of season 1 of Inside the Science, we’re summarizing the study, A study of exploring the prevalence of Extremity Pain of Spinal Source and discussing it with its primary author Mr. Richard Rosedale. He shares a look at what in clinical practice prompted him and his colleagues to conduct the study, some of the results which surprised him, how he uses this study to educate his patients and referral sources, and the big takeaways.
Season 1, Episode 9 with Richard Rosedale: Ortho Shoulder Special Tests and Effects of MDT
In episode 9 of season 1 of Inside the Science we’re highlighting the study, Consistency of commonly used orthopedic special tests of the shoulder when used with the McKenzie system of mechanical diagnosis and therapy and discussing it with one of its authors Mr. Richard Rosedale. He shares a look at the results of three orthopedic special tests of the shoulder with and without the classification per Mechanical Diagnosis and Therapy. He explains the study, how he uses this information in clinical practice and how this has impacted his use of special tests and his patient education in this patient population.
Season 1, Episode 8 with Byron Schneider: Pain and Functional Outcomes and Association for SI Joint Injection
In episode 8 of season 1 of Inside the Science we’re highlighting the study, Pain and Functional Outcomes After Sacroiliac Joint Injection with Anesthetic and Corticosteroid at Six Months, Stratified by Anesthetic Response and Physical Exam Maneuvers and discussing it with the primary author, Dr. Byron Schneider. He shares the the six month outcomes of SI joint injection and their relationship to injection response and physical maneuver findings. You’ll hear the summary of the paper, an initial explanation of what prompted this study. Premium version subscribers will hear the full explanation of how Dr. Schneider has changed his practice patterns and how the conservative care clinician should behave with this population of patients based on this evidence.
Season 1, Episode 7 with Byron Schneider: Validity of Physical Exam Maneuvers for SI Joint Pathology
In episode 7 of season 1 of Inside the Science we’re highlighting the study, Validity of Physical Exam Maneuvers in the Diagnosis of Sacroiliac Joint Pathology and discussing it with one of its authors Dr. Byron Schneider. He shares the physical examination maneuvers and their sensitivity, specificity and association with SI joint pathology
Season 1, Episode 6 with Audrey Long: A Case Series on Specific Directional Exercise on Low Back Pain
In Season 1 Episode 6 of Inside the Science I’m joined by Ms. Audrey Long, to discuss her paper Specific Directional exercise for Low Back Pain; A Case Series which was published in Physiotherapy Canada in 2008. Audrey gives the back story of this case series and how it was born out of the previous RCT “Does it Matter Which Exercise” from 2004. She explains what prompted her to conduct it, how it was originally intended to be performed, some limitations and criticisms, what the big takeaways are and how she uses this for patient and prospective patient education. This study gives important implications to those patients who’ve “tried therapy or exercise before” and haven’t found relief - another super-important study!
Season 1, Episode 5 with Audrey Long: An RCT of exercise for LBP
In Season 1 Episode 5 of Inside the Science I’m joined by Ms. Audrey Long, author of Does it matter which exercise? A randomized controlled trial of exercise for low back pain which was published in Spine in 2004. Although it’s over 15 years old it is a fundamental study for any clinician who evaluates and treats patients with low back pain. Being how common comparative effectiveness studies which show results where all the groups are improved but none more than the others, this study shows a different result. Comparing groups with a matched program to their directional preference, a non-matched program and a control group who received “evidence based” nondirectionally-specific exercises this trial revealed stark differences in patient responses. Hear Audrey acknowledge its limitations, how she uses this study with her patient education and how she’d encourage clinicians to be careful to not exaggerate its findings.
Season 1, Episode 4 with Ron Donelson: Predicting Annular Competence Based on Pain Response
In Season 1 Episode 4 of Inside the Science we summarize and discuss with the author, Dr. Ron Donelson, the study, A Prospective Study of Centralization of Lumbar and Referred Pain: A Predictor of Symptomatic Discs and Annular Competence. This paper hypothesized that the morphology and image findings of lumbar discs could be predicted by MDT therapists based on their symptom response. Dr. Donelson gives some background to the study, the limitations, big takeaways and an additional paper the avid clinician will want to read.
Season 1, Episode 3 with Cody Mansfield: Systematic review of the Sharp-Purser test
In S1E3 we summarize a systematic review of the Sharp-Purser test by Dr. Cody Mansfield. We share its four aims including to determine its diagnostic accuracy, its reliability, its safety and patterns of use. We share sensitivity, specificity, positive and negative likelihood ratios and we hear from Dr. Mansfield as to what prompted this work.
Season 1, Episode 2 with Cody Mansfield: A case report identifying the cause of a false positive Sharp–Purser test
In S1E2 we highlight a case report by Dr. Cody Mansfield entitled, Cervical myelopathy causing numbness and paresthesias in lower extremities: A case report identifying the cause of a false positive Sharp–Purser test. Differential diagnosis, the diagnostic accuracy and safety and appropriateness of utilizing the Sharp-Purser test are all major themes in this paper. Subscribers to the premium version will hear more details on this case, how this case prompted a systematic review of the Sharp-Purser test which we’ll highlight in S1E3, the big takeaways and additional studies which will further focus on screening for red flags, special test sensitivity, and other, related special tests.
Season 1, Episode 1 with Ron Donelson - The cost impact of mechanical assessment in primary care.
S1E1 includes a review of the JMMT 2019 study, The Cost Impact of Quality-Assured Mechanical Assessment in Primary Low Back Pain Care. Subscribers of Inside the Science premium will hear Dr. Donelson share the motivation behind conducting and publishing this study, limitations, the implications, additional studies and the big takeaways for those clinicians treating patients with low back pain. A high definition infographic of the study specifics and insights from the author (like the image below) is made available.
(A high definition version of the image below is available for all premium subscribers)
