Activate Your Practice Podcast
The Activate Your Practice Podcast is hosted by the Chairman & Founder of Activator Methods, Dr. Arlan Fuhr. This podcast will cover a variety of subjects. Dr. Fuhr will interview guests from different backgrounds and professions, as well as talk about his 50+ years in chiropractic care.
Activate Your Practice Podcast
How Activator And Biomarkers Are Shaping Chiropractic Care - Dr. Ricardo Fujikawa
What if pain relief could be tracked as clearly as a lab result? We sit down with Dr. Ricardo Fujikawa—a physician who became a chiropractor—to explore how precision tools, rigorous research, and biomarkers are reshaping conservative spine care. From Brazil to Madrid, he’s built programs, founded a research foundation, and pushed chiropractic into high-impact journals where the broader medical community pays attention.
WATCH THE FULL PODCAST AT: https://www.youtube.com/watch?v=eaWZCdk_NB4
We dig into mechanism research that moves beyond small, expensive clinical trials to answer how an adjustment creates change. In osteoporotic rat and osteoarthritic rabbit models, controlled force from an activator instrument produced measurable tissue effects, including changes tied to mechanogrowth factor and bone density. That same reproducibility has opened doors at major universities and fueled NIH-funded collaborations, proving that standardized inputs let researchers isolate variables and ask smarter questions about dose, timing, and outcomes.
The conversation shifts to objective measurement with TNF alpha and related inflammatory biomarkers. Patient-reported pain scales still matter, but they’re subjective; urine-based testing and algorithmic prediction promise a practical, noninvasive way to track real physiological improvement. Imagine a clinic where a quick strip test guides care plans, validates progress, and reduces reliance on drugs—while giving medical doctors, physical therapists, and chiropractors a shared language for results.
We also touch on the future of chiropractic technology, from instrumented assessments to precisely targeted adjustments, and the rise of global education standards that prepare the next generation to practice with data-driven confidence. With an international network of proficiency-rated practitioners, patients can expect consistent, high-quality care whether they’re in Phoenix or Madrid. If you care about evidence, safety, and real-world outcomes, this conversation lays out a compelling blueprint for where spine care is heading.
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SPONSORED BY Softec - Use promo code: ACTIVATE25 at https://www.softectables.com/ayp
Softtech manufactures specialized treatment tables designed to help chiropractors who utilize the activator method, maximize their time, and the success of their procedures. Upgrade to the only adjusting tables endorsed by Activator Methods at SoftechTables.com.
SPEAKER_01:Today's podcast is brought to you by SoftTech Chiropractic Tables. We finally found a table that is maintenance free, as maintenance free as you can get, and that will withstand the hard use of chiropractic gear. You can find more information on this table at softechtables.com. Okay, now let's get into the podcast. Hi, I'm Dr. Arlen Foor, the chairman and founder of Activator Methods International. And I'm welcome to the activate your practice podcast. Today I'm really honored to have the guest be here because he's from Madrid, Spain, Dr. Ricardo Fujukawa. And welcome, Dr. Ricardo. Thank you for having me here. Well, Dr. Ricardo has an interesting background. Tell us about your degrees.
SPEAKER_02:Well, I went through medical school. So I studied from 1988 until 1993. I graduated from medical school and then went through residency, medical residency in internal medicine and hematology and oncology.
SPEAKER_01:So then how did you get interested in chiropractic?
SPEAKER_02:Well, while I was doing um part of my residency at the University of Kentucky in the US, here in the US, uh, I got to know a chiropractor, and I was really impressed. I had never heard about chiropractic in my life. He took care of me, and then I got interested. So I returned to Brazil to check. And in a country of 200 million people, there were only 10 chiropractors in the whole country. So I decided that I would like to become one.
SPEAKER_01:And give me a little history. Your parents are Japanese, and uh how did they go to Brazil?
SPEAKER_02:Yeah, my family uh immigrated from Japan to Brazil at that time. They Japan they were looking for a new place to get started. So it was like discovering the West. So they they came, part of the family returned to Japan, but my grandfather decided to stay, and then like my family. Well, we we just like it was the nucleus that started my family there.
SPEAKER_01:Your dad, if I remember correctly, was a lawyer.
SPEAKER_02:Yes, he retired, he's retired now, but he's a lawyer, and my mother was a nurse.
SPEAKER_01:I knew that they were really professional people. You live in Madrid, Spain. I mean, you went from Brazil to Spain. Tell me a little bit about that journey.
SPEAKER_02:Yes, I was uh working in Brazil teaching at the chiropractic college and being the coordinator for the clinic train clinical training. Then I also had a private practice, and then I saw the opportunity to start the first chiropractic program in Spain. So I moved to Spain in 2007, and I stayed with that program until two years ago. And that was the college in Madrid, is that correct? Yeah, that was a school in Madrid. It's not working anymore. They they closed the program. And two years ago, when I left, before they closed the program, I opened a foundation.
SPEAKER_01:Now tell us a little bit about your research foundation. We know about it in Activator because the last three papers that you had published were published in Nature. And uh for those of you that don't know, uh in the world of chiropractic GMPT serves about 3% of the medical population. That's how many people look at JMPT. Well, Nature has scientific reports, that's the medical side, and they service 83% of the medical community. So if you get published in Nature, you're really published in a top-notch journal. Tell us a little bit about how you worked up to that level.
SPEAKER_02:Well, um in Spain, chiropractic is not regulated. So there's still we still need to build credibility. Um nobody knows exactly what the profession it's all about. They don't know that we study in the university level, so we can get a degree in chiropractic. So I think that uh at that time when I left the academia, together with my partner in business, Dr. Arancho Ortega, we decided that it was time for us to build up evidence and chiropractic research within Spain so the authorities would recognize the profession as a legitimate profession.
SPEAKER_01:Well, you know, um we got doing things with you when uh I had a I had a randomized control trial and it was about a hundred people, and they were people were complaining in the research world that didn't give it enough uh numbers to really validate it. And uh John Triano is a researcher in chiropractic, is a friend of mine for years, and his wife, uh Marianne McGregor, was a PhD in statistics, and she said to me when I was complaining about how much it costs to do a randomized control trial, she said, Why don't you research the mechanism? And I didn't know what she meant by the mechanism. She said, Well, I'm sure you have some things you'd like to know that can you use chiropractic on? And that's the mechanism. So research that. That's how we got together, and I think our first go at it was the osteoporosis of the hip. I wanted to find out is it safe to adjust a hip with an activator?
SPEAKER_02:Exactly. That was a study that we developed with rats, and uh we did that at the uh uh we call the research foundation. It's a hospital, it's called Jimenez Diaz uh hospital, and I remember that you also visited our lab there at that time. So we did research to understand the mechanism of how using the instrument we could recover the bone in osteoporotic animals. Of course, it's a preclinical kind of study, but that gave us some uh some ideas about the mechanism, like the MGF, the mechanogrowth factor, increasing bone density. And then we moved on to rabbits to study uh osteoarthritis, also in the same hospital. Um, and we were using the models that they used to test drugs and medications. And they said, Here are the rabbits, you can use chiropractic. And it was osteoarthritis, uh an osteoarthritic model, and we used chiropractic using the activator, and the results were outstanding.
SPEAKER_01:We're gonna stop the podcast briefly just to remind you that this podcast is brought to you by SoftTech, the table company in chiropractic that we use. You can find more information on this table at softtechtables.com. Well, that's the ones that got published in Nature, and that got a lot of traction. And I don't know if you knew this, but uh about six months ago I got a call from Ohio State University, and they call it the Ohio State University. She was very clear about that. And they said, We understand you're an expert in force. And I said, Well, I'm not, but I got biomechanical PhDs that are. Well, she said, we are going to do a rat study. And she said, Have you ever done a rat study? I said, Oh, yes, we've done a rat study because you guys did the rat study. And long story short, they said, Would you be willing to go on the study with us? We just got a$4 million grant from NIH, and we'd like to have you, you know, give us an activator to get started with it. And they have been very impressed because of the reproducibility. And uh, we made a tip for Fred Kerrick to do the animal adjusting, and so we uh modified that for them. And uh the tests just got done. They just finally completed the test. But what I'm saying is we wouldn't have had an opportunity to be in Ohio State had it not been for you and being published in Nature. Um why do you use Activator?
SPEAKER_02:Because, first of all, I like technology and I like precision. I think it has to do with my Japanese uh mindset that to have precision and to have a protocol and to use something that you can trust that every single time will produce the same results. So I think that what got my attention when I was a chiropractic student.
SPEAKER_01:Well, the other thing is I want to bring up a little bit because you uh and uh Rancha Ortega de Meuse, she by the way, she is a PhD in molecular biology and uh discovered a TNF alpha, is that right, a TNF uh molecule?
SPEAKER_02:Yes, we are working now with our research foundation in biomarkers because we want to see how how can we show that the patient is improving? How can we have like an objective measure? Because so far we have subjective measures, uh we have patient reported outcome measures. No, the patient will report on pain and other things. So we wanted to verify a biomarker that could tell us what's going on. So we are working with TNF alpha and showing that we can get inflammation down using we are using the activator, treating patients and seeing the pattern of the TNF alpha in those patients. And we correlate the pain, the decrease of low back pain, together with the decrease of levels of TNF alpha.
SPEAKER_01:Well, and the good thing it used to be called a visual analog scale or the ossewestri, and you ask the patient, where are you where's your pain level between one and ten? Everybody said ten. And it was a not it was just a subjective way of talking to a patient, didn't prove anything. And today now this is a uh the new way of doing it is a lab test, and uh it's a urine test, and there's a strip that goes in the urine. Is that correct?
SPEAKER_02:Yes, and that's what we were trying to do because you can measure that in the blood, but some of these biomarkers can be found in the urine. So that's non-invasive, that would be really practical if we could develop a kit doctors could use in their practice, you know, medical doctors, physical therapists, chiropractors, to measure that inflammation and to predict, because now we are working with algorithms that will tell you and predict the improvement of the patient.
SPEAKER_01:Now you're getting the into real diagnosis.
SPEAKER_02:Exactly, exactly. That that's the whole point of the usage of technology.
SPEAKER_01:Now, you know, medicine has advanced like crazy. Uh if you look at surgery today, they're using robotic surgery and the surgeon isn't even in the operating room. And uh what do you see in chiropractic as the future for research and for things that we need to do?
SPEAKER_02:I think that because medicine works a lot with um several procedures, pharmacology and other things, that it's important to develop that technology. And so far we have been using our hands and now we have instruments, even electronic instruments. And I think that the next step is to go deep into diagnosing and understanding better how we can find that dysfunction, the articular uh neurological dysfunction, and address that in a very precise way. I think that that's the next step for our technology.
SPEAKER_01:Well, how would you rate chiropractic in the educational world?
SPEAKER_02:I think we are doing a pretty good job. I mean, it has improved a lot from the days of small private colleges all the way to university integrated programs. I think that more and more the education is reaching uh higher standards. And we see now that pretty much um all continents, they have a CCE, a council on chiropractic education. Now Latin America is building their own to standardize the programs, to verify the levels. So I think we are doing a pretty good job around the world. It's like the next generation of doctors are going to have all this knowledge and education.
SPEAKER_01:Uh one thing I found interesting in casual conversation, you talked about getting patients from the activator website. Tell me a little bit about how that happened.
SPEAKER_02:Oh, yes, I'm uh probably the only two advanced proficiency doctors in in Spain. And uh once in a while I get patients that come through the website, especially I now I have a couple of missionaries from the U.S. working in Spain, and I also have flight attendants from American uh airlines that when they are in Madrid, they want to be seen by an activator doctor. So yeah, I get once in a while a few patients through the website.
SPEAKER_01:Well, last month we sent 17,000 new patients to our doctors of chiropractic. We got about 2,000 proficiency-rated doctors now. And so we're getting pretty good infiltration around the the well, the U.S. for sure, but then there you are sitting out in Madrid, Spain, and somebody can go to you and get the same adjustment as they do in Phoenix, Arizona. So uh I think our project is coming along. It only took 15 years to get there, but we're we're making progress. Well, I want to thank you for being on the podcast. You know, we've been friends for a long time, and uh we've been through many trials and tribulations, but I think we're starting to see, for example, the uh the urine test to find out if you're making progress in pain is a big deal because you know, with the drug problems today and the different uh oxycontins and so forth, I'm sure a medical doctor would like to have that test too.
SPEAKER_02:Exactly. I think that that's going to open the open the door for more collaboration and also better understanding of what we do.
SPEAKER_01:Aaron Ross Powell Well, thank you again, Dr. Ricardo Fujukawa from Madrid, Spain. Uh we're very happy to have you on the program, and uh we'll look forward to spending some time. Thank you. Thanks for listening to Activate Your Practice Podcast. Remember, this is brought to you by Softtech Table Company. You can find more information on this table at softtechtables.com.
SPEAKER_00:Softtech manufactures specialized treatment tables designed to help chiropractors who utilize the activator method, maximize their time, and the success of their procedures. Upgrade to the only adjusting tables endorsed by Activator Methods at SoftechTables.com.
