Stenosis of the Spine: The 3 Most Common Types

Stenosis is a narrowing the nerve channels in and around your spine, which can result in pain, numbness, and fatigue. This condition affects millions of people per year and is the #1 cause of spine surgery for people over the age of 40.

For most people, the symptoms of stenosis usually start with a simple case of low back or neck pain. Over time, the pain may progress towards numbness and tingling that travels downs your arms or legs. In this article, I'll break down the three main types of stenosis. Once you can identify the type of stenosis you have, you'll be empowered to take the first steps towards finding lasting relief.

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The 3 Types of Spine Stenosis

Spinal Stenosis:

Spinal stenosis is pinching or compression on your spinal cord. Between the bones, or vertebrae, of your spine, are your spinal discs. The discs act as small spacers between the bones and allow your spine and body to move in a variety of directions.

Behind the disc is a large canal or hole in each bone. That hole is your spinal canal and is the channel that your spinal cord travels down. When a disc, bone, or ligament gets into the spinal canal, whether due to injury or age, it can cause compression on the spinal canal. This compression is called...spinal stenosis.

The hallmark of spinal stenosis is numbness and tingling into your legs and feet. Also, you may notice your endurance starts to decline. Where you used to be able to walk around the entire grocery store, now you may only make it up and down an aisle or two before you notice yourself leaning on the carriage to provide support and relief.

Many people suffering from spinal stenosis eventually feel like they are always "looking for the next chair." If that statement resonates with you, then you may have spinal stenosis.

Also, spinal stenosis tends to affect both legs evenly. If you have pain or numbness only down one leg that you may have foraminal stenosis, which we will dive into next.

Foraminal Stenosis:

The second most common type of stenosis is called foraminal stenosis. Foraminal stenosis is what many people know as a "pinched nerve."

While the spinal cord travels up and down the backside of your spine, your nerve roots exit out the left and right sides of the bones. These nerve channels are called the foraminal canals. If a disc bulge, bone spur, or ligament overgrowth encroaches into the canal, then it can cause compression that is called foraminal stenosis.

Foraminal stenosis typically results in extreme pain or numbness down one arm, or one leg is depending upon whether the pinch is occurring your neck or back.

A compression in your neck would cause arm pain/numbness, where a pinch or compression in your low back would cause symptoms into your legs.

It's also important to keep in mind just how small these nerve canals are. At about 10 mm in height and 8 mm in width, there isn't a lot of wiggle room. Even a disc bulge or herniation of 3 mm could decrease the size of the canal by nearly 30%!

Lateral Recess Stenosis:

Lateral recess stenosis is the third most common form of stenosis. This occurs when compression occurs at the junction point of the spinal cord and nerve root.

The spot where the nerve root branches off the spinal cord is referred to as the lateral recess.

In private practice, I would often see lateral stenosis accompany either spinal or foraminal stenosis. Since the nerve root is not protected by the outer laters of the spine at the lateral recess, it's "unprotected." The lack of protection by the spinal cord leaves the nerve root exposed, and compression at this spot (the lateral recess) tends to result in piercing, sharp pain down the arms or legs.

Like spinal stenosis and foraminal stenosis, lateral recess compression can occur due to disc, bone, or ligament encroachment.

Get a FREE Research Brief Showing the Results of Chiropractic with Stenosis

Next Steps:

Once you can identify the type of stenosis you're dealing with; now you have the opportunity to seek out the best treatment possible to find relief.

The good news is that regardless of which type of stenosis you are suffering with; conservative care such as chiropractic is still the best first option (in the absence of red flags).

Researchers have actually discovered that chiropractic care and adjustments can provide equal (and in some cases more) relief than injections, medications, and surgery.

“Improvement (with conservative care) was self-described as “good” or “excellent” in 80% of patients.” - JMPT, 2009

The Top Chiropractic Podcasts You Should Follow

Line these chiropractic podcasts up for your morning commute.

Which chiropractic podcasts are worth listening to? It's a great question, and we've made it easy for you by rounding up the five best chiropractic podcast for once and for all.

Whether you are an all action sports chiropractor, research-based pain relief specialist, or wellness advocate- there is a chiropractic podcast featuring information that will help you grow your practice.

Podcasts are exploding in popularity for a few reasons. First is the fact that you can listen anywhere- even while driving your car or working out. Usually, these aren't times where you want to be watching videos or reading articles! Also, most podcasts present their content in a way that is fun, exciting and leaves you wanting more.

The chiropractic podcasts featured below showcase an array of information- from in-depth interviews with industry heavy hitters, practical marketing advice from the trenches, to showcasing the research that matters- they provide a venerable masterclass in modern chiropractic practice. All of them featured a patient-centric approach that ties directly to modern chiropractic practice building.

If your goal is to stay up to date on research, hone your craft at marketing, and learn about industry news and happenings- podcasts are the ideal choice.

The Modern Chiropractic Marketing Show-

The Modern Chiropractic Marketing Show is a podcast which offers practical marketing tips, exciting interviews, and proven strategies for practicing docs. Hosted by Dr. Kevin Christie, a fantastic chiropractor practicing in South Florida, this podcast features a bunch of tactics and information that Kevin has personally used in his practice. For listeners interested in chiropractic marketing advice that has been battle-tested, The Modern Chiropractic Marketing Show is a must listen, someone who has scaled multiple practice locations has been involved with the NFL, and regularly attend entrepreneurial conferences, Kevin is a great mentor for many chiropractors in the trenches.

Chiropractic Science-

Chiropractic Science is a podcast focused on the research. If your an evidence-informed doc that geeks out on the latest research, a subscription to Chiropractic Science is in order. This podcast examines the most recent research and interviews many of the researchers, giving you a behind the scenes look at what it's like to produce modern chiropractic research. Not afraid to get into the details- Chiropractic Science is the PubMed of chiropractic podcasts.

The Evidence Based Chiropractor Podcast-

Offering chiropractic research and marketing each week in the time it takes to get to your office; The Evidence Based Chiropractor is the official podcast of this website. Approaching nearly 200 episodes, The EBC Podcast provides listeners with research updates and marketing strategies that can be immediately implemented in their practice. Research can be super, and marketing can be super complicated- The EBC Podcast does the hard work of sifting through the information, picking out the gold nuggets that can impact your practice, and delivering those nuggets on a silver platter every Monday morning.

Black Sheep DC Podcast-

Hosted by Jerry Kennedy, Black Sheep is a podcast that takes an unfiltered look at chiropractic practice. Whether it's evaluated hot button topics, showcasing high leverage marketing tips, or interviewing trendsetters, Jerry isn't afraid to dive deep. Relationship marketing is a hallmark or tenant of the podcast, and Jerry delivers incredibly valuable information for new, and seasoned docs, who are looking to grow in an ethical, patient-centric way.

Forward Thinking Chiropractic Alliance Podcast-

As the official podcast of The Forward Thinking Chiropractic Alliance you know host Dr. Bobby Maybee isn't afraid to tackle the tough issues affecting chiropractors around the world. Interviews with heavy hitters, previews of upcoming events, and tactical information for evidence-informed docs have all been featured on the Forward Podcast. Based on the guest list of interviews, it would be easy to shrink; but Bobby does a great job of stepping up, leaning in, and getting his guests to unpack their experience and knowledge base.

Clinic Gym Radio Podcast-

Do you like movement and health? Do you cringe at 3x wk forever treatment plans but secretly wish there was a better way towards financial freedom practicing in an ethical, patient-centric way? If so, you’ll love Josh Satterlee’s Clinic Gym Radio Podcast.

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The 3-Step Chiropractic Marketing Success Strategy

“I’d like to learn a confusing, expensive, and unproven system to market my practice.”- said no chiropractor ever

Have no fear! You’re about to discover a simple, 3 step marketing strategy that you can use to generate more new patients, drive more traffic to your website, and build your reputation in your community.

I’ve met a ton of docs who have built impressive followings on Instagram, Facebook, and YouTube. And I’ve met even more docs that want to build a big audience.

But don’t confuse vanity metrics (like follower count) with engagement, trust, and new patients.

It feels great to build a big following. Heck, content production and audience creation is step 1 of the process as you’ll see below. But second and third step is where all of the real opportunity sits.

By creating an easy to follow system and process- your practice will be able to produce a dependable and consistent new patient flow, decrease your overall marketing expenses, and grow at a faster rate.

How do I know?

I’ve seen it first hand.

The 3 Steps Chiropractic Marketing Strategy includes:

1. The Content Factory

2. Lead Magnet Attraction

3. Follow Up for Success

This marketing strategy is used by many of the most successful companies in the world- and it can work for you too.

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Having a proven chiropractic marketing strategy doesn't mean you need to use sleazy or cheesy sales tactics.

A great marketing strategy won't feel marketing it all. It's merely a way for you to provide value to the people in your community, in a patient-centric way, that will enable them to achieve better overall health and well-being.

If you’d rather watch than read; you can check out the video below!

1. The Content Factory

The heart of any solid chiropractic marketing strategy is content production. Putting out content online is how you can get people paying attention to you.

If someone doesn’t know you exist- they’ll never become a patient.

You may be wondering if there is an alternative to content production. The answer is yes. The alternative is to buy advertising. There is nothing inherently wrong with this approach; except that it can be expensive! Producing content is much cheaper than advertising when building a relationship based on trust, rapport, and expertise instead of discounted services.

Here are a few questions to ask yourself about content production:

• are you building your “know, trust, and like” factor each day online?

• do they know you, your staff, and your practice (even if they haven’t come in as a patient yet)?

• are you creating weekly video content that highlights the latest research that matters, why it matters to them, and the action steps they can take to benefit their life?

Your answer to all 3 of these questions should be a resounding “YES.” If not, then content production needs to be your #1 short-term goal.

Let’s breakdown the three primary avenues of content production.

VIDEO:

The best way to put out content is through video. Creating videos is, by far the most powerful way to connect with the people in your community. As a bonus, nearly every social platform (including Facebook) currently favors video and will help you reach more people than if you posted just an image or text.

Click Here to Get a FREE Video Script

For those of you who are looking to boost posts and put a little ad spend behind your videos on Facebook- you should be able to get down to less than $0.05/view. That means you should be able to get over 1,000 people in your community to see your video for under $50 bucks!

The keys to creating excellent video content are to be: engaging, educational, and entertaining. If you are new to video, then I recommend picking up my video script above.

PICTURES:

The second best way to put out content is with pictures. Facebook, Instagram, and many other social platforms are visual by nature.

Eye-catching images are a great way to get attention and start getting clicks and traffic back to your website. Best practice includes posting at least 3x wk to your primary social platforms like Facebook and Instagram.

Grab a free social media graphic pack below to get started.

GET A SET OF FREE SOCIAL MEDIA GRAPHICS!

TEXT/BLOGS:

Finally, you have the option to distribute content and information as text (or blog). Most written pieces or blogs will still have some image attached to them, but there are some exceptions where you may post just text without and pictures.

Also, don’t forget that written blogs can be used as patient education handouts in your practice!

Click for a FREE blog post

2) Your Call to Action and Lead Magnet Attraction

The goal of putting out this content is for the viewer to take an action step. In the marketing world, this is called a “call to action” or CTA. What do you want the person to do after watching your video, seeing your picture, or reading your blog?

Nearly every piece of content you put out should have a call to action.

One of the most potent CTA’s you can use for your practice includes getting someone to give you their email address in return for information. This information is usually in a PDF or video form and is commonly referred to as a Lead Magnet.

For example, if you create a short video highlighting an exercise that can help reduce back pain, you may want to have a CTA that asks your viewers to learn more by getting your 3 Steps to Reduce Low Back Pain guide (which is the lead magnet).

Your call to action should include the following elements:

1. clear and direct

2. short and easy to understand

An example of a Lead Magnet

A few examples to great CTA’s include:

- Get Daily Health Updates By Subscribing Here

- Struggling with (condition), Call Today

Remember- the goal of your call to action is simple- get the viewer to take action!

A good lead magnet is one of the best ways to build your email list, provide valuable health information to your community, and consistently generate more new patients who already know/trust/like you.

The key to a good lead magnet is that it should provide information directly in line with the original content. In other words, if you have a video about headaches and your lead magnet shouldn’t be related to how you can identify the healthiest ice cream! Ideally, you want your lead magnet to extend the conversation, or go more in-depth on the topic.

Also, don’t forget about convenience. Some of my best performing lead agents are just PDF’s of the blog (the content piece) itself. People are busy- so giving them the option to download the blog as a PDF so they can reference later is convenient, easy, and can lead to very high conversions.

But don’t stop at step two.

Delivering your lead magnet is the beginning of the exchange, not the end.

3) Follow Up for Success

And number three follow up with email.

Sending a consistent email over a long period (known as a long-term drip or nurture sequence) is a critical final step of the strategy.

By sending consistent (in most cases 1x week is enough) you can build a deeper relationship, stay top of mind, and continue to provide value. Who do you think will be the first person they reach out to (or recommend to others) for care? A long-term email drip sequence can ensure it’s you!

You don't need to be hitting people three times a day. Don't get crazy. But if they have opted-in for your lead magnet, they want to know more. That's the exchange.

Start by delivering your lead magnet and then follow up and expand into some other areas of interest as well.

Dripping content does not mean that you should overwhelm your audience with a tidal wave of junk. That’s called spam, and no one likes it.

Make sure that you're putting out excellent content. Make sure that you have a friendly, tight call to action and lead magnet right in line with it. Follow up with an email after that.

This is the engine that can drive results for your practice.

Comment down below. I'd love to know if this is valuable for you and the first action step you intend to take!

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I know a lot of docs that struggle with the time and expertise to market their practice effectively. So I have developed the key tools that can make this process super easy for you and your practice.

The Smart Chiropractor is a complete content production factory. We supply you with social media graphics, blogs posts, videos, video scripts, trainings, fully automated email follow up (ChiroEmails is built in!), and much much more.

Or, if you have your social channels rocking and are just looking for email automation- check out ChiroEmails which is our full service email automation platform for chiropractor. We give you all of the automations and content!

Chiropractic SEO | 3 Tips to Rank Higher on Google

Here are three simple and easy to implement tips to help your chiropractic practice rank higher on Google using SEO.

Marketing your chiropractic practice through search engine optimization, or SEO, is critical as patients search online for doctors before making an appointment.

SEO that is "working for you" can help you climb up those Google rankings, get more exposure for your practice,, and ultimately see more new patients walk through your front door .

The Top 3 Chiropractic SEO tips are

1. Compelling headlines- how to create clicks and drive traffic

2. Imaging sizing- keep your page speed lean and mean

3. Update your content- Google likes new stuff, don't let your website get digital cobwebs

Get Our Chiropractic SEO Guide Here!

1. Compelling Headlines

How to create clicks and drive crazy traffic

Your headlines, or subject line, is the "hook" of your article. Is it compelling enough to get people to click?

There is a fundamental framework that you can utilize to make sure that you have a compelling headline- ask a question, solve a problem, and include targeted or specific keywords.

Asking questions is pretty straightforward. "Have you been suffering from chronic headaches? Discover how the experts find relief" would be an example. If a person in your community was searching for information regarding chronic headaches- I can nearly guarantee they will click to discover your information based off of that headline.

The second headline tip involves problem-solving. Try creating a compelling headline focused on the benefit or solution you can provide to the most commonly asked questions in your community. For example, "3 Exercises to Eliminate Low Back Pain" is an excellent example of a headline that peaks interest, hints at solving a problem, and has the potential to stimulate a lot of clicks!

And as always keep your targeted keywords in mind. In the above examples, I included "chronic headaches" and "low back pain" in my headline to get extra Google juice by adding the keywords in the title!

This table will help you get started:

2. Image Sizing

Google loves a fast website (and pictures slow things down)

Today's modern websites are typically loaded with beautiful pictures. The catch is that every single one of those pictures takes up a lot of "space" on your web server. When someone heads over to your website, Google has to queue up the images so your visitor can see them.

If your photos are big (and you have a lot of them), this can end up costing you precious seconds of load time. And the slower your load time becomes, the more likely it is that you are going to be pushed down the Google rankings.

Slow load time is considered poor user experience, and Google will do anything possible to eliminate it. I recommend asking your website provider if all of your images have been squashed (literally)! Software tools like Squash allow you to trim your image sizes but up to 90%, while they stay looking sharp and crisp.

Even squashing just a few pictures can make a dramatic difference in your overall page speed.

So speed up your Web page. Better that user experience and help Google push you up by keeping your image size small.

3. Updating Your Content Consistently

No one likes digital cobwebs

Let me set the stage. You're excited to buy a new product after you hear all about it from your friends.

So you head online and click over to the website only to discover it hasn't been updated since 2014...

Hmmm...now you're wondering- will they ship the product if you order it? Have they changed business models? Is anyone home?

It doesn't inspire confidence!

The same applies to your website. People are skeptical of chiropractors, to begin with. If a prospective new patient heads over to your website and it looks like it was created back when "dial-up" was a thing- there is a high likelihood they will keep looking.

Also, by not updating your content- Google will start to push you down the rankings slowly. And your competitors, who are producing a bunch of updated content, will overtake your coveted positioning- taking your traffic and your patients with them.

Not sure if you can keep up with the content? Join us at The Smart Chiropractor, where we will give you everything you need to stay up to date (blog posts, social graphics, videos, videos scripts, patient handouts, and more.). Or look at your websites greatest hits. If you have some previous blogs that performed well and get a ton of traffic, update them every year or two!

Get a Pack of FREE Social Posts!

So in short, make your headlines compelling, keep your image sizes down and make sure that you are updating the content on your website. Those are three key aspects to help Google help you push you up those rankings get more people onto your Web site more traffic to your website and ultimately more people into your practice.

If you loved that information, be sure to subscribe to The Evidence Based Chiropractor YouTube Channel. Each week we put exclusive videos at the intersection of marketing and research, showing you how to grow your practice.

Get Our Chiropractic SEO Guide Here!

The Top 5 Researched Benefits of Chiropractic

New research has showcased an array of health benefits you can expect after receiving chiropractic adjustments.

Whether you are an elite athlete, weekend warrior, battling back from an injury, or just looking to live your best life- chiropractic has been shown to provide many benefits that can improve your quality of life.

Get the 5 Top Benefits as a Patient Friendly Handout!

1. Pain Reduction

The first benefit of chiropractic care may be the most impactful- reducing your pain. Before you are living your optimal life, you have to be free of pain.

Multiple research studies have shown that chiropractic is considered one of the most safe and effective treatments to reduce pain from your neck, low back, and more. Even if you are suffering from spinal stenosis, disc herniations, or foraminal encroachment- chiropractic may be able to help.

““Patients with symptomatic MRI-confirmed cervical disk herniations treated with SMT to the level of herniation reported high levels of clinically relevant improvement at 2 weeks, 1 month, and 3 months after the first treatment.””

— Outcomes from Magnetic Resonance Imaging-Confirmed Symptomatic Cervical Disk Herniation Patients Treated with High-Velocity, Low-Amplitude Spinal Manipulative Therapy. Journal of Manipulative and Physiological Therapeutics. October 2013

““Most of the patients who were considered surgical candidates for the treatment of radiculopathy from LDH improved with standardized spinal manipulative care to the same degree as those who had undergone surgery. Of those who failed spinal manipulation treatment, subsequent surgical intervention provided excellent outcome.””

— Manipulation or Microdiskectomy for Sciatica? A Prospective Randomized Clinical Study. Journal of Manipulative and Physiological Therapeutics. Volume 33, Number 8. October 2010

2. Reduce the Frequency, Severity, and Intensity of Headaches

The second health benefit of chiropractic care, especially important if you have struggled with chronic headaches. Researchers have discovered that chiropractic care can reduce the frequency and intensity of headaches.

With over 20 million people suffering from headaches every day, this is a massive development in healthcare! The most common type of headaches includes; tension headaches and migraines. Tension headaches often include neck pain, muscle pain, and facial pain. Migraines are usually throbbing, can cause nausea and light sensitivity, and some even include an aura.

““With regard to the weekly register on frequency and intensity of pain, these parameters showed significant improvement in the groups with manipulation and combined treatment...””

— Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Patients with Tension-Type Headache: A Randomized, Controlled Clinical Trial. Journal of Chiropractic Medicine. (2014) 13, 4-13

3. Improved Function and Quality of Life

Many people don't go to the doctor when they have pain. They go to the doctor when that pain interferes with their quality of life!

If you have a healthcare issue that is keeping you for enjoying your hobbies, hanging out with friends and family, and limit your ability to perform well at work- then you are likely going to start researching on Google and eventually call a doctor to get answers.

Fortunately, getting back to your active lifestyle, and improving your quality of life (or in science-speak, "functional ability") is one proven benefits of chiropractic care.

4. Reduced Medication Usage

Reducing medication use, and specifically opioids are one of the primary focuses of our healthcare world today.

Each day over 100 people die due to an opioid overdose. And it's not only affecting addicts and junkies. A majority of opioid deaths come from people who were taking medications prescribed by their doctor.

Not only are these medications addictive and deadly, but in many cases, they are ineffective at helping people recover from spine pain, which is why most people start taking them. This vicious cycle leads people to take MORE medication an attempt to find relief, which only increases the likelihood of an adverse event or addiction.

There is a better way. Researchers have discovered that people who receive chiropractic care are 49% less likely to fill an opioid prescription. And, in my opinion, if we were able to reduce opioid use by nearly 50% just be helping people get well with chiropractic care- this world would be a different place!

Even what many people consider to be "safe" medications like NSAID's contribute to over 100,000 hospitalizations, and over 3,000 deaths each year. Drugs should rarely be viewed as a first line treatment for spinal pain. Your body is designed to move and recover- so going to a doctor focused on movement and recovery seems like a good idea to not only reduce your medication use but to get the best results possible.

“patients who visited a chiropractor for a musculoskeletal pain condition were 49% less likely to receive an opioid prescription than their counterparts who went to other healthcare providers.”

— MedScape- Chiropractic Care Tied to Significant Reduction in Opioid Scripts

5. Sports Performance Improvements

Did you know that every major sports team has a chiropractor available to their athletes to help with injury prevention and sports performance?

That's right, teams in the NFL, MLB, NBA, and NHL all have chiropractors integrated into their healthcare team to keep their athletes performing at their top level all season long.

No one can perform their best when in pain, so chiropractors are used to keeping the athletes feeling good, but with a focus and eye towards sport-specific performance.

Working with the athletes on flexibility, biomechanics, and range of motion, and sport-focused training is critical to raising the bar of performance.

““The increased V-wave amplitudes observed in the current study possibly reflect an increased cortical drive in the cortico-spinal pathways and corresponding increased excitability of the motoneuron following spinal manipulation.””

— The effects of a single session of spinal manipulation on strength and cortical drive in athletes. European Journal of Applied Physiology. January 2018

Quite frankly, whether you are working at an office or whether you are on the professional sports field, a balance of strength and flexibility is one of the top keys to stay well long term.

So those are the five significant benefits of chiropractic care. If you've experienced any of those, please comment down below let us know, or if you have any questions, I'm happy to answer those as well.

Get the 5 Top Benefits as a Patient Friendly Handout!