Blog, Chirosecure Live Event December 4, 2023

Chiropractic Malpractice Insurance – Do Biomechanical Pathologies (Subluxations) Create Brain Dysfunction?

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  We suggest you watch the video while reading the transcript.

Hi, I am Dr. Mark Studin, and first, I’d like to thank ChiroSecure for giving me this unbelievable platform to share the most cutting edge information in our industry. And and they just do an incredible job. I’d really, again, to thank them so much. So let’s go to the slides and let’s talk about our topic for today.

Today we’re gonna talk about chiropractic. It’s real easy. We’re gonna talk about biomechanical pathology, which many of you call vertebral subluxation. And I’ve been writing on that lately, and I’m not gonna really get into it, but it’s a whole different. Topic, but how does biomechanical pathology work?

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How does the lesion work? How does the adjustment work? What are the mechanisms, and we’re really going to dig into that today. We really need to get into the how. How does it work? We all know we adjust the spine. Are we turning life on? Are we breaking up pain? Are we getting muscle spasms to relax? Are we doing anything neurologically?

Is there bone on nerve? All of these things have to be answered, and you need to know all of those things because of, a lot of it is factual. And by the way, everything I’m sharing with you is purely based upon the evidence and the literature I. I am not giving you anything. That’s my opinion today.

I am just the storyteller. And you need to fully understand what it is that you do because some of it’s incredible and some of it’s pure, unadulterated nonsense. So you’ve gotta understand those things. And when we look at how it works, the chiropractic adjustment works. It’s all about the Arin. Remember this?

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Aerin and Efer. Arin is up, efer is down. Excuse me, I got something stuck in my throat. Little sip tea is gone. So we’re gonna be talking a whole lot about afar and that’s critically important. And when we look at the pathway for pain generators, there are three primary areas of pain generators. And when you adjust, that needs to be eff, that needs to be effective.

Number one is the facet thesal joint. Number two is the joint . Capsule itself and number three of the muscle spindles. These are the three areas we need to focus on, but before we move forward there, we have to understand . Prop receptors and mechanoreceptors proprio receptors. It’s how your body senses where it is in time and space.

How do I know where I am? How does my brain know where I am? Okay, so there are sensory receptors located in subcutaneous tissue under the skin muscle tended there’s perus in the bone joints all over the place and position the body through stimulus produced within the body. Such as Golgi tendon organs, joint receptors, the vestibular system, skin, all of these are proprio receptors.

And then you have mechanoreceptors. Mechanoreceptors are your reini corpus, your pacinian corpus. Your pacinian are your crimp receptors, your reini or stretch receptors, the goi tendon organs, and free nerve endings. This is what determines what’s going outside of you. Is there a thermal stimuli Are your bending, twisting, deforming, et cetera?

You’ve got meers core puzzles, a whole bunch of things within the body. That tell you what’s going on from the outside in. So your mechanical receptors are on the outside, your proprio receptors interpret those and then tell the body what’s going on the inside. And that’s important to understand.

Then you have deep paraspinal muscles, which are actually prop receptors and mechanoreceptors. But in our conversation we’re gonna talk about them in terms of proprio receptors, and there’s something called the pizo two ion channels. So what effect, what happens is when the propriocept informa, sorry, when the ME receptor information goes into the dorsa root ganglia on the cord.

It shoots over to the muscle spindles and in there is golgi tendon organs, NP Azo, two ion channels, which feed back into the lateral hornet and up the spinal thalamic tract to the brain, pinging pongs around to different areas, and then efer to help your body create homeostasis and balance, and B count of the balance and biomechanical balancing.

So all of these things are really important to understand. So what we’re looking at right now, and we’re gonna start, we’re gonna start with facet joints, and this is an MRI in an axial or top-down view. You should be very familiar with this. If not, you go need to take some MRI courses, but this is your facet joint.

Look at the gapping here. I colorized it for you. The left is separated versus the right, which is not. So you’ve got a gap right here and you’ve got a problem. So what occurs is, and by the way, I am giving you in 30 minutes an overview, a snapshot of hours, weeks, months, and years worth of study. I’m going to give you a pathway to learn this better as we progress.

But you need to understand the overview. And if you look, there’s gonna be references on all of these different slides. So what happens is when the joint goes out of position. As I shared with you here, thick open, wide open, not gapping. So there is a menis or a disc that’s a spacer between the facets.

When you have, and here’s what it looks like under MRI, it’s right here. The stain, MRI, that’s the menis. It’s a spacer. So when that spacer goes out of position. And you can see here when the joint buckles, the repetitive microtraumas or a microtrauma, that Menis goes out of position. And when that menis goes out of position, here is your bone on nerve.

It’s not on the nerve root. Folks, that physiologically cannot happen. A bone does not sit on the nerve root. Non-negotiable, but right here is where the bone on nerve is and it’s affecting the nociceptors on the facet joint. But what’s happening is not only is it affecting the nociceptors when it does, it causes cytokines and chemokines to be released.

And it affects substance P, which is pain, inflammation immunity, a whole bunch of things. And it takes CGRP. Which is a pro-inflammatory mediator, and it upregulates substance p meaning it goes up it helps feed stuff into the brain and into the spinal cord. So all of that stuff occurs.

When it does, it goes, as I said a moment ago through the dorsal ganglion up to the brain. And how does it get there? It goes up to the spinal thalamic tract through the peri ducted gray area, hits the thalamus ping pongs around the insulate, the prefrontal cortex, the anterior cingular cortex, the motor cortex centric cortex, hypothalamus, et cetera, and then goes efer to create biomechanical homeostasis.

Amongst other things because you’re creating a lack of homeostasis and internal monitoring, which affects systemic issues as well, which is not the topic of today’s presentation. But we also know that when that menis goes outta place, you’re affecting the joint capsule. And when the joint capsule gets affected, you’ve got the pisidian corpus, which are your crimp receptors, your affinity corpus, which are stretch receptors.

You have Merkel discs and other things been free nerve endings, and all of those feed in afer into the dorsal rec ganglia into the spinal cord. But when that happens, it also spills and then goes to fire the deep paraspinal muscles. And in those deep paraspinal muscles, as I said a moment ago, and this is where a lot of the magic happens, as far as deregulating or regulating, because they feed back through the Golgi tendon apparatus and the pazo two ion channels, which feed back into the dorsal rec ganglia, and that whole cascade up to the brain and sends proprioception information to the brain.

Now the brain is expecting you to be in a certain time and place. The brain is expecting how you’re going to react to stimuli. The brain is expecting how you’re walking. People say their gait is off. Usually the propriocept is off when they say they try to talk and their speech is a second delayed, their proprioception is off.

A myriad of things happen and the appropriate reception off and the power to do things to put energy into muscle. There was a research article just recently done that showed that stroke victims have a 63.4% increase muscular strength with one adjustment. With one. Why? Inherently with stroke it’s even weaker to start with.

But it enables this whole schema of the internal external body along with the prop receptors, mechanoreceptors what the brain is expecting and it puts down, and for non-symptomatic patients, especially athletes, there’s a 16% increase. So in fact, there is a tremendous amount of evidence of showing how this works.

So what we’re doing is there is emerging evidence, and we’re looking at the deep paraspinal muscles. There is emerging evidence. Altered vertebral sensory input from mechanically or chemically sensitive neurons in the paraspinal tissue can modify central neural processing and integration of sensory motor multimodal.

No susceptive and automatic afar information Autonomic, I’m sorry, afar and information. These alterations can change sensory motor autonomic and visceral motor outputs likely by impacting the brain body schema. And that’s directly from Harv, by the way, in 2021, who pulled information from research he did in 2012 and 2013 in about five or six other places.

It is it’s just incredible of how the evidence in the literature. We’re still stuck on bone on nerve, folks. We’re still stuck. Oh, bone on a nerve root. That is nonsense. Now it’s interesting that I shared with a a neurosurgeon and I showed him a digitization of biomechanical failure, which showed that the ligaments and pathology failed, which it does at approximately 0.78 millimeters.

Of translation and the neurosurgeon said 95% of my spinal related, it’s actually 98% according to the evidence in the literature. 98% of my spinal pain patients are non-specific Back pain. We just send them to PT or give them some drugs ’cause we don’t know what to do with them. And he was being honest.

His medicine doesn’t know what to do. They operate on one to 2% of anatomical pain, which is fractured tumor and infection. So I showed him one simple graph. I. I said, listen, I have no skin in the game. I’m not looking for your referrals. Not at all. So I said, but here’s your non-specific pain. And we showed him what that looked like.

It was from a piece of technology called Verta, S-Y-M-V-E-R-T-A. He looked at the graph and he said, holy crap. Who do you have in my area? And he was in Louisiana. I referred him to that doctor. He now refers almost every one of his spine patients to this doctor. I’ve done the same thing in Atlanta. I’ve done the same thing in Denver.

I’ve done the same thing in New York. I’ve done the same thing in New Jersey. I. I’m Connecticut, I can go all around the country because we now have demonstrative evidence showing what I’m showing you at the macro level, not the micro level, but there are so many things that I’m gonna get to in just a few minutes, which validate

What I’m showing you is to be real and what you’re doing in your office. So how does the deep paraspinal muscles do that? Number one, it looks at the Golgi tendon apparatus, the Golgi tendon organs. We’re looking at those at the end of the muscles, which is feeding back into. Time and space. It’s selling as well.

This is wrong. It’s just wrong. Okay, now what we do is we go back into here, we get sensory information, and by the way, this is slide one of four in this series and you’re not gonna get a whole lot ’cause we don’t have, we don’t have the time to do that. But sensory information from deep paraspinal muscles around the central segmental motor control.

Central. This is central segmental Motor. Motor meaning goes central nervous system goes up to the brain. It’s thought to be the driving factor in the widespread maladaptive. Neuroplastic changes within the central nervous system. The central nervous system can’t adapt, it can’t accommodate, it just can’t happen.

And the literature is talking about systemic issues as well, not just motor, but systemic. With such clear evidence that maladaptive fun dysfunction of the deep paraspinal muscles can occur, it is likely to reduce the ability of the central nervous system to accurately perceive what’s going on at the level of vertebral column, which over time is reflected.

By the blurring of sensory motor cortical area and is likely to lead to poor vertebral motor control, maintaining a central segmental motor control problem. So what the evidence in the litre literature is saying, this leads to a huge amount of dysfunction within the brain. This is number two of four central segmental motor control problems change the century or afar and input.

Two, the central nervous system to the brain from small, deep paraspinal muscles. The vertebral column, this leads to altered sensory sensoral. Sensory motor’s a tough word and multimodal integration of the afar. Input and changes the accuracy of inner body and external world schemas. It doesn’t know where you are in time and space.

I see this with athletes all the time. Who fund even high school athletes? Who are your better athletes? Then I also see this in the poor athletes because they’re a mess. I see this in kids who have biomechanical pathology, what we call subluxation. It, it creates issues and they can’t function.

And over time these changes in awareness, essential nervous system is what occurs inside the body and the world around it are thought to lead to maladaptive changes in neural function as well as maladaptive changes in body structure and function. Worsening its ability to adapt and respond to internal and environmental cues, thus leading to development of less than ideal motor control, a variety of symptoms, diseases, and disorders.

Now we’re getting into neuromuscular diseases and disorders, and it even talks in terms of systemic and there is clear evidence um, of systemic disease from all of this. I Also have a direct . Line, by the way, from what we do in a chiropractic spinal adjustment, which I’m gonna be talking about next time, the critical importance of not talking about manipulation, and it’s not a physiological issue because just a spoiler alert, a chiropractic spinal adjustment creates central segmental motor control and a manipulation has no change on CNS, and we’ll talk about that next time.

But I’ve created a vehicle. To validate in the scientific arena where a chiropractic spinal adjustment changes systemic issues, and it’s just easy. But I’m still working to find the researchers to do that. And actually I need a statistician or a research department who wants to take this on. I see nothing more important than our in our industry than that, nothing.

So if anyone knows anyone, feel free to chat with me. So again, we talk about at the level of the deep paraspinal muscles. You have the golgi tendon organs and the pizo two ion channels. Where are they feeding? They’re feeding the brain. It goes up to brain mapping folks. The, this creates the brain, creates a map of surrounding localization.

The sound localization map is influenced for sound, for somatosensory, vestibular and visual auditory information, as well as proprioception and interceptive information from ether, copies from the brain itself, all of which could impact neuromuscular function, meaning that all of these things that you’ve got a hearing right over here, that’s your somatosensory, auditory right in here.

There is EENs from all around feeding into this. And then you have Aerin feeding up until all of these other areas, they all interconnect. So now the brain is anticipating certain signals and when it doesn’t come, there’s a disconnect in the person is confused. Several brain functions are involved in creating these maps, including brain stem, your motor stuff.

Insular Cortex, other interoceptive centers, primary and secondary sensory cortices for extra receptive inputs, frontal cortical areas, including the prefrontal cortex, as well as the cerebellum, vestibular cortex, autonomic ganglion, and many limbic areas together, everything. Is critical for coordination of everyday movement of all kinds, as well as a host of other functions such as homeostatic, regulation of the body, how you feel emotionally, how your body functions and feels, and they even influence your motivation and behavior.

When everything is out of sync, your body’s not functioning. In my formative years, patients would tell me, and I’m in the game. This is beginning my 43rd year in practice. I. Patients would come in and say, doc, I gotta adjust it. I could see clearer, I hear better. I’m happy, I feel good. Everything just is better.

And I said, wow, that’s outstanding. You know when we release energy from above down inside out, you know what? It’s all I had. But you know what the reality is when you create. Central SE segmental Marty control, and you get rid of those disconnects and what’s going on inside matches what’s going on in the outside.

You’re reducing stress, you’re helping homeostasis within the body. You feel better. You do. These are the reasons why. Hey, I wanna help people get rid of their back pain. But this really excites me because this answers so many questions for patients. I have personally cared for my entire career. I can’t begin to tell you.

And I would say, Mrs. Jones, the things seem brighter since you’re beginning adjusted. Doc, how did you know? Do things seem clearer? Can you hear better? Is there a pep in your step? How did you know? Because everyone before you told me, I just never knew why. Now I know why, and it’s, it, listen, it’s in the literature.

I, my, the question, my life has always been why? It’s in the literature. There’s no, there is bone on nerve. It’s not the nerve root. It’s not about the nerve root with pain in your arm or your legs or your chest or your back. It’s about the nerve on the bone, on the nociceptors, on the facet joints, which also affects the joint capsule, which affects the Ian Corpus or any corpus GoGy tendon apparatus, Merle disc, et cetera.

Feeding into the do to the do rec klia. Spilling over into the proprioceptors, into the deep paraspinal muscles going back through the gogi tendon organs and the deep paraspinal muscles and the PA two ion channels up the par spinal thalamic tract through the periaqueductal gray area, hitting the thalamus ping-ponging around from the anterior cingular cortex of prefrontal cortex, motor cortex sin singular cortex the limbic system, et cetera, pinging ponging and affecting every single part of the human brain.

Which then fer is going to change. The autonomics change, everything changes. That’s it, folks. That’s the whole ball of wax, and that’s not my opinion. I’m just the storyteller here. I’ve been waiting to tell this story the way I’m telling it right now. For 43 years. 43 years, I’ve been waiting to tell this story.

And I even have another tool that I’m waiting for the right researcher to come along to actually give tremendous evidence of showing how all of what I just said to you affects systemic change from a chiropractic spinal adjustment. Because I know it does. How do I know it does? Because I have thousands of patients of written testimonials from me, and I knew why, but now I have the evidence and I need to get into the literature.

I’m excited. Could you tell You’ve got ligament receptor compensation. So when you adjust the spine, the increased tone of contracting muscles, contracting opposing muscles, stiffens and stabilize the joint, protecting the articular surface. So what it occurs before the adjustment, when that information goes into those muscle spindles, into the deep paraspinal muscles, it pulls it over.

You create antalgia. You are protecting those facet surfaces. And then when you adjust it, it gets to go away. ’cause the brain does. That doesn’t happen at the segmental level. The brain creates that to happen. So when we look, oh, by the way here, this was slide one of four. There’s three more slides to go after this.

Just don’t have the time. So after we get into this is slide of one of 15, which I’m not gonna get into, and I’m gonna be talking about. At a very significant level, how to handle biomechanical homeostasis. I gotta go back to the beginning. When you adjust a patient, how does it happen? How does biomechanical homeostasis occur?

I need to show you all of those things. How does you get, how do you get plumb? What happens when it goes off? Why does it go sideways? What happens when a patient comes in intelligent? There’s ways to explain all those things, and beyond that, you need to learn how to code it. So we need to get into the coding of this.

I’m not Sam Collins who does this, and he’s incredible, but I’ll teach you how to code it now. That QR code up there if you want hours and hours of this, plus a whole lot more. We do primary spine care programs once to twice a year. We just did once, two weeks ago. We spend hours delving into the subject.

Take your phone out, look at the QR code and that’ll tell you how to get there. Or you can always reach me. So listen, folks, here’s the issue. The issue is that what we do is a whole lot more. Oh, we adjust the panel, go away. It’s more than that. Don’t minimize who and what you are. You’re a doctor of chiropractic, and by the way, don’t minimize the doctor part.

It’s equally as important to take height, weight, blood pressure, and pulse. It’s equally important to do a thorough neurological evaluation to ensure your patient’s not undergoing a current vascular incident. You need to work carefully with the medical community for the betterment of your patient, just like they need to work carefully with you for the betterment of the patient.

You don’t want ’em to take needless drugs and surgery, but you don’t want ’em to. You don’t want your patient to miss urgent scenarios and they die and you got no one left to adjust, but they get really sick and delay necessary care. We’re part of a community and a team. We are underutilized. We are grossly underutilized, but you know whose fault that is?

Yours and mine because we’re not out there educating. Our referral sources. Not one chiropractor in the nation should ever worry about a new case. I don’t care if it’s personal injury, pediatrics, sports or Mrs. Jones who’s 89 years old, bent over, we’re underutilized and that’s our fault for not having the credentials.

You need advanced credentials. You want to talk about this? Go get credentials in spinal biomechanical engineering. It’s recognized through Cleveland University, Kansas City College of Chiropractic. But that course is also recognized through the State University of New York and Buffalo Jacob School of Medicine and Biomedical Science’s Office of Continuing Medical Education.

You need to function in a world where medicine recognizes what we do and what we recognize what medicine does. Let’s put the slides back up for one second, please. So the other thing is if you need to chat with me. Here is my personal contact information. I’m more than happy to talk to you, communicate with you.

Here’s my email, my cell phone. Now you can get me off the slide. So now I’m happy to do any I’m happy to work with you and talk with you in any way. So there is a lot of stuff going on, a lot, and it’s my pleasure to work with you. So listen, I can’t believe I got this all within my allotted time. I want to thank you so much, and again, I want to thank ChiroSecure so much for giving me the opportunity to do this.

Thank you, and I look forward to chatting with you again.


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