The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

CF Episode 389: PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research   Today we’re going to talk about PNF Stretching For Knee OA And A 50-Year Review Of Chiropractic Research. First here’s that sweet sweet bumper music.   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.   I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.   Things You Should Do Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast Check our website at chiropracticforward.com   Episode 389 You have found yourself smack dab in the middle of Episode #389.   Now if you missed our last episode, we talked about Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections. Make sure you don’t miss that info. Keep up with the class.   On the Personal End of Things… Sorry, it’s been a week or two since the last podcast episode. I have been traveling a little bit. I just got back from Tampa, Florida, and my mastermind meeting with Dr. Kevin Christie.   We had a great time out there. I just can’t explain to you how proud I am of that group that I’m a part of. It really does have some of the best minds and most talented individuals in the entire profession. I count myself as very fortunate for being asked to be a part of it.   One of my colleagues is Vanessa Wilczak from Jacksonville, Florida. She and I have really buried ourselves in AI, and we have made a pretty effective team with regard to coming up with some pretty cool stuff that AI can do to help us in business.   Vanessa recently took that a step further and has really created something very, very interesting. She figured out a way to make Claude work with a permanent storage or brain, if you will, so that when you are talking to Claude, it can reference and remember exactly what you’ve trained on it at all times.   So, if you consider that you can train it on all of your office stats, all of your provider contracts and pay scales. All your fee schedules. Every statter, every report that you can think of that you can run through your EHR. And everything else that you have on your computer that’s relevant, then you sort of have a chief operating officer or chief financial officer or a CEO or whatever you want to call it. that has all of the financials and all of the information it could ever possibly need to help you make decisions going forward.   That includes KPIs, or seeing gaps and opportunities that you wouldn’t normally see.   For example, I was able to have a conversation with our new provider today that included very precise facts and figures that I wouldn’t have had… access to… Just two days ago. I was also able to give her very realistic and conservative. Ideas about patient numbers and potential income in the next year, and in the next two years. Then I was able to have… an effective conversation with our front desk about… some of our stats and how we can easily improve them.   The potential is absolutely and 100% limitless when AI remembers what you have trained it on and can reference it at any point in any conversation you’re having. I’m training it on the medical side of things, too, for peptides, and IV therapy, and PRP on the research, and all of that good stuff.   So it’s basically going to be one big, huge brain. for my clinic. And I could not be more excited. Vanessa really knocked it out of the park on this. So that’s why I’ve been busy, but I felt like it had been long enough since I had put out an episode.    So we’re gonna throw this one together fairly quickly. I hope you don’t mind, but there’s a really great paper in this episode that you’ve just got to hear about. So don’t go anywhere.   Let’s hop into the research. Item #1   Alright, let’s jump into our first paper this week and it’s a good one for those of you treating knee pain — which I’m guessing is about 100% of you listening. This one is titled…   “Effect of Proprioceptive Neuromuscular Facilitation on Pain and Joint Mobility in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials”   Remember, the citations can be found at chiropracticforward.com under this episode.   Hu Z, Dong J, Zeng Y, He Z, Wang Q, Luo Q. Effect of proprioceptive neuromuscular facilitation on pain and joint mobility in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. PeerJ. 2026 Jan 16;20581. DOI: 10.7717/peerj.20581. PMID: 41561818.   Why They Did It Knee osteoarthritis is one of the most common and debilitating conditions we see — pain, stiffness, loss of mobility, and that slow grinding decline in quality of life. Standard medical management tends to lean on pain medications, cortisone injections, and eventually surgery. In this they explore some conservative means.   These researchers wanted to find out whether Proprioceptive Neuromuscular Facilitation — PNF — could make a meaningful difference in pain and knee range of motion for people with knee OA. Now if you’re not super familiar with PNF, it’s a rehabilitation technique that combines passive stretching with active muscle contractions to improve flexibility, strength, and motor control. How They Did It This was a systematic review and meta-analysis following PRISMA They cast a wide net, searching seven major databases for randomized controlled trials from database inception all the way through August 2025. They ended up with five studies — 201 total participants — comparing PNF to control interventions, and four studies — 202 participants — comparing PNF to other rehabilitation techniques like soft tissue mobilization, neuromuscular exercise, and stretching. Primary outcomes were change in pain intensity and change in active range of motion. What They Found Compared to control interventions, PNF showed significantly greater improvements in pain reduction. And it significantly improved knee active range of. Highly significant results on both fronts.   When they compared PNF qualitatively against other rehab techniques — soft tissue mobilization, neuromuscular exercise, and stretching — results were more mixed. Not clearly better across the board, but not worse either. The strongest, most consistent signal was PNF versus no real intervention, and there it was a clear win.   Wrap It Up PNF is a conservative technique producing significant reductions in pain and real improvements in joint mobility for knee osteoarthritis patients.   Move the patient. Restore function. Reduce pain without putting something into their body or cutting them open. Sounds good to me, what about you?/   Item #2   Alright, paper number two is one I have been waiting to talk about because it is a direct shot of espresso for your chiropractic soul. This one comes to us from a group out of Duke University School of Medicine — yeah, you heard that right — Duke — and it’s titled…   “Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations”   Remember, the citations can be found at chiropracticforward.com under this episode and yes, one of our previous guests on the podcast is the esteemed Dr. Christine Goertz who we simply adore.   Trager RJ, Bejarano G, Perfecto RP, Blackwood ER, Goertz CM. Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med. 2024 Sep 24;13(19):5668. DOI: 10.3390/jcm13195668. PMCID: PMC11476883.   Why They Did It The story of chiropractic research is a story of a profession that has been building its evidence base for over 50 years. Medicare authorized payment for chiropractic spinal manipulative therapy back in 1972 — and since then, utilization has grown, research has grown, and the profession has evolved. But how much has the research actually matured? And what do today’s clinical practice guidelines — the CPGs that medical organizations use to drive treatment decisions — actually say about spinal manipulation? That’s what this team set out to document.   How They Did It They searched Scopus for all chiropractic-related research published from 1972 through 2024 — over five decades of literature — and analyzed publication trends and keyword evolution to track how the research landscape has changed. Then separately, they searched PubMed, Scopus, and Web of Science for clinical practice guidelines published between 2013 and 2024 that addressed spinal manipulative therapy. They were looking at what the guidelines say, and what conditions they cover.   What They Found They identified 6,286 articles on chiropractic, and the publication rate trended upward across the entire period. The keyword analysis tells the story: early research focused on history, scope of practice, medicolegal issues, and regulatory concerns. Over time — as the profession gained footing and credibility — the keywords shifted to include randomized controlled trials and systematic reviews. That’s the arc of a profession doing the work. Here’s the number you want to remember: 90% of the guidelines favored spinal manipulation for low back pain. For neck pain? 100%. Every single one. And recent CPGs also supported SMT for tension-type headaches and cervicogenic headaches.     Wrap It Up Ninety percent for low back pain. One hundred percent for neck pain. I need you to sit with that for a second. Let that percolate, people. These are not numbers coming from a chiropractic trade publication. These are clinical practice guidelines — the formal, rigorous documents that major medical and healthcare organizations use to tell clinicians how to treat patients. And they are saying: use spinal manipulation.   This paper is a gift. Print it out. Laminate it. Put it in your waiting room. When someone asks you — a patient, a skeptical physician, an insurance reviewer — whether there’s evidence for what you do, you hand them this. Over 50 years of growing, maturing, increasingly rigorous research culminating in guideline after guideline saying that spinal manipulation works for the spine-related disorders that walk through our doors every single day.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.   Let’s get to the message. Same as it is every week.   Store Remember the evidence-informed brochures and posters at chiropracticforward.com.   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.   When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.   It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.   And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!   Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….   That’s Chiropractic!   Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.   We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.   Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.   Website & Social Media Links Home https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP: https://www.facebook.com/groups/1938461399501889/ Twitter: https://twitter.com/Chiro_Forward YouTube: https://www.youtube.com/channel/UCtcIrhlK19hWlhaOGld76Q iTunes: https://itunes.apple.com/us/podcast/chiropractic-forwardpodcast-chiropractors-practicing/id1331554445?mt=2 Player FM: https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forwardpodcast-chiropractors-practicing-through TuneIn: https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Prp1089415/   About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post PNF Stretching For Knee OA & A 50-Year Review Of Chiropractic Research appeared first on Chiropractic Forward.

CF Ep. 388 – Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections Today we’re going to talk about Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections. But first, here’s that sweet sweet bumper music!   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! Welcome Back OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Things You Should Do Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page. Join our private Chiropractic Forward Facebook group. Review our podcast on whatever platform you’re listening on — it really does make a big difference. And then check our website at chiropracticforward.com ──────────────────────────────────────────────────────────── Episode Number + Previous Episode Recap You have found yourself smack dab in the middle of Episode #388. Now if you missed our last episode, we talked about Water Instead of Diet Drinks & Neuromobilization In The Chronic Neck Make sure you don’t miss that info. Keep up with the class. ──────────────────────────────────────────────────────────── Personal Happenings I would have to say that 2026 is really shaping up for us. I know that I’m still not back to pre-Covid numbers. However, it’s pretty standard for me to see 145 to 165 each week now. If you’ve been a long time listener, then you may recall the days when I was seeing 180 and even sometimes 200 in a week. So we are far from those numbers currently. And I’m kind ok with that. I did not like being that rushed and that busy. It made my life fairly miserable to be honest. However, with our new chiropractor, Dr. Easter, on board I bet we’ll see those sorts of numbers combined soon. I am impressed every single day with her and have zero doubt that her schedule will be busting at the seams before you know it. A friend of mine is Dr. Mark King, president of motion palpation Institute, and he happens to be in my mastermind group you always hear me talk about. I believe he has somewhere between five and seven associates so I guess he’s got it figured out. But what he said at the last mastermind meeting was that you need to be trying to give your associate somewhere around 15 new patients a month that you would personally have taken. You have to feed them to get them where they are really kicking butt and taking names and putting some money in their pockets right along with bringing patients and revenue to the clinic as well. With credentialing and all the things involved in that, I’m not able to shift that many her way just yet. However, that is definitely the plan when we were able and strictly on sending her cash new patients and her being able to start to cultivate her own patience here and there, we already have her up to about 25 a week or so sometimes more sometimes less. When you consider, she’s only had her license for a little over a month maybe two months, I think we’re in a good spot. Outside of that I have been studying for the California QME exam coming up next week and hopefully we knock that sucker straight out of the park into the windshields of the cars parked in the parking lot. And we can get well on our way performing QME‘s and building that revenue stream. QME is my path out of day today hands-on patient treatment. I’ll be 54 in August and if I can get down to just a day or 2 x 56. I’m gonna be a happy dude. OK, that’s it. Let’s get on with the research.  Item #1 – Radial Shockwave Therapy + Rehab for Acute Hamstring Injuries Remember, the citations can be found at chiropracticforward.com under this episode. Citation: Crupnik J, Silveti S, Wajnstein N, Rolon A, Wuerfel T, Stiller P, Morral A, Furia JP, Maffulli N, Schmitz C. Radial ESWT combined with a specific rehabilitation program (rESWT+RP) is more effective than sham rESWT+RP for acute hamstring muscle complex injury type 3b: a randomized, controlled trial. British Medical Bulletin. 2025 Sep 2;155(1):ldaf009. DOI: 10.1093/bmb/ldaf009. Why They Did It Hamstring injuries are an absolute plague in sports. They’re one of the most common soft tissue injuries across virtually every athletic discipline — soccer, track and field, sprinting sports, you name it. The specific type we’re dealing with in this study is a type 3b injury, which is what the Munich Muscle Injury Classification calls a bundle or interfascicular tear — a structural, partial tear of the muscle, not just a minor strain. These are the ones that knock athletes out for weeks, and they carry a high re-injury rate. Conservative rehab is the standard treatment, but outcomes are often frustratingly slow, and there’s a real clinical need for adjunct therapies that can accelerate tissue recovery. Shock wave therapy has shown some promising signals in muscle healing, but at the time this trial was being designed, the evidence was thin. These researchers set out to test whether adding radial ESWT to a structured rehab program could meaningfully change the game for athletes recovering from these serious hamstring tears. How They Did It This was a prospective, randomized, double-blind, sham-controlled single-center trial conducted at the KinEf Sports Physiotherapy Center in Buenos Aires, Argentina. 40 semi-professional athletes with ultrasound-confirmed acute type 3b hamstring complex injuries who presented within 7 days of the injury. The athletes were randomized into two groups: the active treatment group received real radial ESWT combined with an 8-week structured rehabilitation program; the control group received sham rESWT Both patients and the assessors measuring outcomes were blinded to treatment assignment. The rESWT protocol consisted of nine sessions over three weeks — three sessions per week — with 2,500 radial shock waves per session at an energy density the patient could tolerate. The primary outcome was return-to-sport time. Secondary outcomes included post-treatment muscle strength, patient satisfaction, and re-injury rate. After the trial concluded, a small number of participants had their ultrasound images re-reviewed and 4 of the original 40 were re-classified as type 3a injuries and excluded — leaving a final analysis population of 36 athletes, 18 per group. What They Found The results clearly favored the group that received real rESWT. The athletes who received actual shock wave therapy combined with the rehabilitation program returned to sport significantly faster than those who received sham treatment plus the same rehab. Beyond faster return-to-sport, the rESWT group also showed superior post-treatment muscle strength and higher patient satisfaction scores. Re-injury rates were not significantly different between groups, though the sample size was modest. Wrap It Up Hamstring injuries are one of the most common and one of the most aggravating injuries that active patients and athletes deal with. Return to sport after a significant type 3b hamstring tear can take weeks, and the re-injury risk hangs over the athlete’s entire return. What this trial tells us is that we have a non-invasive, drug-free adjunct therapy — radial shock wave— that, when combined with a well-structured rehabilitation program, can meaningfully reduce recovery time and improve functional outcomes compared to rehab alone. This is important for those of us in the chiropractic and conservative care space. ESWT is a tool that fits squarely within evidence-based conservative management. No surgery. No injections. No drugs. Just targeted mechanical energy to the injured tissue to accelerate natural healing, combined with a progressive rehabilitation protocol. That is exactly the kind of multi-modal conservative approach that gets real results and that we should be able to offer our patients. Now, is this a massive trial? No — 36 athletes at a single center. But it’s randomized, it’s double-blind with a sham control, it’s published in the British Medical Bulletin — a well-respected peer-reviewed journal — and the findings are clinically meaningful. Add this to the growing body of evidence that says ESWT has legitimate utility in musculoskeletal care. If you’re working with athletes or active patients dealing with hamstring injuries, this is absolutely worth having in your clinical back pocket. ──────────────────────────────────────────────────────────── Item #2 – Severe Vitamin D Deficiency Linked to Higher Hospitalizations for Respiratory Tract Infections Remember, the citations can be found at chiropracticforward.com under this episode. Citation: Bournot AR, Hart KH, Johnsen S, Givens DI, Lovegrove JA, Ordóñez-Mena JM, de Lusignan S, Bartlett DB, Lanham-New SA, Darling AL. Association between serum 25-hydroxyvitamin D status and respiratory tract infections requiring hospital admission: unmatched case-control analysis of ethnic groups from the United Kingdom Biobank cohort. The American Journal of Clinical Nutrition. 2025. DOI: 10.1016/j.ajcnut.2025.101179. Why They Did It Respiratory tract infections — bronchitis, pneumonia, and their relatives — are a massive public health burden. Lower respiratory tract infections rank in the top 20 causes of death globally for people aged 50 to 74. For those 75 and older, they crack the top 10. We’ve known for a while that vitamin D has a role in immune function — it has documented antibacterial and antiviral properties. There’s been growing evidence that vitamin D deficiency may increase susceptibility to respiratory infections. But what was missing was hard, large-scale population data specifically tying vitamin D levels to actual HOSPITALIZATIONS for respiratory infections. This team out of the University of Surrey — working with colleagues from the University of Reading and Oxford — set out to fill that gap using one of the largest health databases in the world. How They Did It This was the largest study of its kind. The researchers analyzed NHS data from the UK Biobank — a massive cohort study with linked health records. They looked at 36,258 participants between the ages of 40 and 69. Vitamin D levels were measured via blood samples and cross-referenced against linked NHS hospital admission records for respiratory tract infections. Participants were categorized into vitamin D status tiers, with severe deficiency defined as below 15 nanomoles per liter, and sufficient levels defined as 75 nmol/L or above. They used survival analyses and binary logistic regression models to determine the relationship between vitamin D status and the rate of hospitalization. The analysis accounted for confounders including age, sex, BMI, lifestyle factors, socioeconomic status, and existing health conditions. What They Found Here’s the headline: people with severe vitamin D were 33 percent more likely to be hospitalized for a respiratory tract infection compared to those with sufficient levels. That’s a significant, clinically meaningful finding backed by a dataset of over 36,000 people. And the dose-response relationship is interesting. And basically the better your Vitamin D levels, the lower your risk of being hospitalized. The researchers also examined whether ethnicity modified this relationship, since vitamin D levels vary across ethnic groups — white participants had higher median levels, while Asian participants had lower. Despite those baseline differences, the association between deficiency and hospitalization risk was consistent across all ethnic groups. The risk of being severely deficient, however, falls disproportionately on ethnic minority communities, which is a public health equity issue worth flagging. Additional risk factors tied to higher hospitalization included obesity, male sex, being over 60, lower income, and statin use. Wrap It Up We know from the research that vitamin D deficiency is extremely common. Estimates suggest up to a billion people worldwide are deficient. A BILLION. And here we have one of the largest population studies ever conducted on this topic showing that severe deficiency is directly and significantly associated with a higher rate of landing in the hospital with a respiratory infection. This matters for us as practitioners in integrative, whole-person care. We are not just treating spines — we are caring for people. If your patients are walking around with severe vitamin D deficiency, you have an opportunity to identify that and address it. Especially your older patients, your patients with chronic conditions, those who work indoors The recommendation to supplement — particularly in winter months when sunlight exposure is limited — is well-supported and straightforward. It’s safe. It’s cheap. It’s widely available. And the data suggests it may be keeping your patients out of the hospital. That kind of simple, evidence-based preventive intervention is exactly the kind of whole-person care we should be championing. Test your patients’ vitamin D. Talk to them about supplementation. It matters. ──────────────────────────────────────────────────────────── Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week. ──────────────────────────────────────────────────────────── Store Remember the evidence-informed brochures and posters at chiropracticforward.com. Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! ──────────────────────────────────────────────────────────── Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. ──────────────────────────────────────────────────────────── Website & Social Media Links Home https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP: https://www.facebook.com/groups/1938461399501889/ Twitter: https://twitter.com/Chiro_Forward YouTube: https://www.youtube.com/channel/UCtcIrhlK19hWlhaOGld76Q iTunes: https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM: https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn: https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Prp1089415/ ──────────────────────────────────────────────────────────── About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Shockwave Therapy for Hamstring Injuries and Vitamin D for Respiratory Infections appeared first on Chiropractic Forward.

Water Instead of Diet Drinks & Neuromobilization In The Chronic Neck ──────────────────────────────────────────────────────────── INTRO Today we’re going to talk about Water Instead of Diet Drinks & Neuromobilization In The Chronic Neck But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   WELCOME BACK Hello, everybody. Welcome back to the Chiropractic Forward Podcast. I’m Dr. Jeff Williams, and I’m glad you’re spending a few minutes of your day with me. This is the podcast where we don’t just talk about chiropractic — we build the case for it, one piece of research at a time. Evidence-based, patient-centered, and unapologetically. ────────────────────────────────────────────────────────────. ──────────────────────────────────────────────────────────── THINGS TO DO Real quick — just a few things I’d love for you to do: Number one — if you haven’t already, grab a copy of my book on Amazon. It’s a great resource and it helps support the show. Number two — come join us on Facebook. Find our page and our group and be part of the conversation. Number three — and this one I’ll come back to in a minute — please take a moment to leave us a review on whatever podcast platform you’re using. It genuinely helps. And number four — visit chiropracticforward.com for more content, resources, and information about what we do. ────────────────────────────────────────────────────────────   EPISODE RECAP This is Episode #387. Last week, in Episode #386, we talked about Exercise & Nutrition In Low Back Pain & Migraine In Chiropractic Patients. If you haven’t had a chance to listen to that one yet, go back and check it out. Good stuff. You gotta keep up with the class! ──────────────────────────────────────────────────────────── PERSONAL HAPPENINGS Alright, let’s talk a little bit about life around here before we get into the research. I’ve been listening to a new podcast lately that I’m really enjoying — it’s called Dan Snow’s History Hit. Currently I’m working through episodes about military commanders, and they’ve been covering Erwin Rommel. And I have to tell you — I’ve been fascinated by Rommel since I was a kid. I remember watching some documentary when I was young, and they called him the Desert Fox — and I mean, come on. That’s an incredible nickname. Obviously, as a kid you don’t fully grasp the horrors of what the Nazis represented, but you figure that out pretty quickly as you get older. Even so, Rommel as a military figure has always been a genuinely interesting study to me. If you’re into military history at all, check out Dan Snow’s History Hit. Good podcast. Speaking of podcasts, I would really appreciate it if you would take a minute to review and share this podcast with colleagues you think would benefit from it. Look, I’ll be honest with you — we spent some time on cruise control, just recording episodes and letting them ride. And that’s fine, but I really want to see growth and real traction here. I want to get to the point where, when somebody asks for a chiropractic podcast recommendation, there are fifteen people immediately pointing to this one. I’m biased, obviously — but I genuinely believe that evidence-based, patient-centered information is the best thing we can do for our profession and for our communities. Anything that reduces the noise and elevates the people doing it right is good for everyone. So I’d appreciate your help spreading the word. In other news — I am deep in study mode right now. I’m preparing to take the Qualified Medical Evaluator examination out in California. That test is in April, and I hear they run about a fifty-fifty pass-fail ratio — which is honestly pretty humbling. I do not plan on being on the fail side of that equation, so I am busting my hump to make sure I’m well prepared. I’ll tell you though — when you’re 53 and you’ve got everything going on in your life that I have going on, sitting down to study isn’t always the easiest thing in the world. But the tools available now versus when I was in school are just incredible. One thing that’s really helping me is an app called Brainscape. Essentially it’s a flashcard system, but the smart part is that it has you rate how well you know each card — and the cards you don’t know very well keep coming back more frequently until you rate them higher. That’s a genuinely smart design. There’s also a website called Stuvia that has practice tests and learning materials that have been helpful. Add in a prep class on top of all of that, and I feel like I’m going in well-prepared. But as I always say — we shall see. And one more piece of good news from the clinic. Our acupuncturist’s husband got a job offer in Missouri, so she and her family will be relocating in May. That’s bittersweet — we love her — but here’s the stroke of luck: our brand new associate, fresh out of chiropractic school, was already interested in learning acupuncture. She’s going through the certification process right now and has her test in April. If all goes well, she’ll be ready to step right in line as soon as our current acupuncturist leaves. That means she’ll essentially be paying for herself almost immediately, once she takes over the VA acupuncture patients and our regular acupuncture caseload. I like to say even a broken clock is right twice a day — and sometimes God just smiles down on his people. This one felt a little like both. Alright. Let’s get into the research. ──────────────────────────────────────────────────────────── ITEM #1 The First one today is called, “Effects of Replacing Diet Beverages with Water on Sustained Weight Loss and Type 2 Diabetes Remission — An 18-Month Randomized Clinical Trial” by Farshci et al and was presented at the 85th Scientific Session of American Diabetes Associaiton in Chicago in 2025 and it’s a hot one, stand back   Remember the citations are in the show notes in this episode.   Citation Farshchi, M., Madjd, A., & Farshchi, H.R. (2025). Effects of Replacing Diet Beverages with Water on Sustained Weight Loss and Type 2 Diabetes Remission — An 18-Month Randomized Clinical Trial. Presented at the 85th Scientific Sessions of the American Diabetes Association, Chicago, IL. Abstract 586-P. Published in Diabetes, 74(Supplement 1).   Why They Did It About one in five Americans drinks a diet beverage every single day. And for a long time, the conventional wisdom was that diet sodas were a safe substitute for full-sugar drinks — especially for people trying to manage their weight or their blood sugar. After all, they’re calorie-free, right? Well, some emerging research started suggesting that diet beverages might be affecting the body differently than water, and that maybe the “free pass” thinking wasn’t as solid as we assumed. So these researchers set out to do something no one had done before in this specific population: a long-term, randomized clinical trial looking at what happens when women with type 2 diabetes actually replace their diet drinks with water — and track those results over 18 months. How They Did It They recruited 81 adult women with type 2 diabetes who also had either overweight or obesity — BMI between 27 and 35 — and who were all being managed with metformin. All of them regularly consumed diet beverages as part of their daily routine. The women were randomly split into two groups: one group was told to replace their diet drinks with water five times per week after lunch, and the other group simply continued drinking diet beverages as they normally would. The study included a 6-month active weight loss phase followed by a 12-month weight maintenance phase, for a total of 18 months of follow-up. Researchers tracked weight, BMI, fasting glucose, insulin, insulin resistance, postprandial glucose, and triglycerides. They used an intention-to-treat analysis, which means everyone who was randomized counted in the final results. What They Found The water group lost significantly more weight. At the end of 18 months, the water group had lost an average of 6.82 kilograms compared to 4.85 kilograms in the diet beverage group — a statistically significant difference. But the number that really jumps out? Diabetes remission. Ninety percent — 37 out of 41 women — in the water group achieved diabetes remission. In the diet beverage group, it was 45 percent — 18 out of 40. That is a massive, statistically significant difference. And it wasn’t just remission and weight. The water group also showed meaningful improvements in BMI, fasting plasma glucose, insulin levels, insulin resistance as measured by HOMA-IR, two-hour postprandial glucose, and serum triglycerides. Across the board, water won — and it wasn’t close. Wrap It Up The researchers concluded that sustained replacement of diet beverages with water after meals in women with type 2 diabetes may promote greater weight reduction and offer meaningful benefits in glycemic control and long-term diabetes remission. And look — this is important information for us as chiropractors and conservative care providers. We deal with patients every single day who are managing metabolic conditions, carrying extra weight, dealing with inflammation. Diet and lifestyle are always part of that conversation. And what this study is telling us is that the advice is almost embarrassingly simple: drink water. Not a diet soda. Not a zero-calorie something. Water. A small change with potentially enormous consequences for long-term health. That’s the kind of practical, evidence-based lifestyle counseling we can offer our patients every day without a prescription pad. ──────────────────────────────────────────────────────────── ITEM #2 The second one today is called ‘Routine Physical Therapy With and Without Neural Mobilization in Chronic Musculoskeletal Neck Disorder with Nerve-Related Symptoms: Systematic Review and Meta-Analysis’. And you know, if they’d have just tried a little harder, I feel they could have made that title just a scootch longer if we’re being honest. This one was doen by Lopez-Pardo et al in 2024. Citation López-Pardo, M.J., Calvache-Mateo, A., Martín-Núñez, J., Heredia-Ciuró, A., López-López, L., Valenza, M.C., & Cabrera-Martos, I. (2024). Routine Physical Therapy with and without Neural Mobilization in Chronic Musculoskeletal Neck Disorders with Nerve-Related Symptoms: Systematic Review and Meta-Analysis. Healthcare, 12(12), 1225. https://doi.org/10.3390/healthcare12121225 Why They Did It Chronic neck pain with nerve-related symptoms — think cervical radiculopathy, arm pain, tingling, numbness — is incredibly common and incredibly frustrating for both patients and providers. Routine physical therapy is widely used, but the question the researchers were asking is: does adding neural mobilization to that routine physical therapy make it more effective? And here’s the thing — nobody had systematically looked at that specific comparison before for this population. No previous study had specifically evaluated routine physical therapy with versus without neural mobilization in patients with chronic musculoskeletal neck disorders and cervical radiculopathy. So this team set out to fill that gap with a systematic review and meta-analysis of randomized clinical trials. How They Did It They conducted a thorough systematic review following PRISMA guidelines and registered their protocol with PROSPERO They searched four major databases: PubMed, Web of Science, Scopus, and Google Scholar. They were specifically looking for randomized controlled trials involving neural mobilization techniques for chronic musculoskeletal neck disorders and cervical radiculopathy. After their screening process, they identified and included 20 clinically controlled trials in the meta-analyses. Their primary outcomes were pain and neck mobility. What They Found Here’s where it gets interesting. When they compared adding neural mobilization to routine physical therapy against minimal intervention, physical therapy plus neural mobilization came out ahead — and it wasn’t just a scootch. The combination provided superior pain relief and significant reductions in disability. On the other hand, when they compared routine physical therapy plus neural mobilization against other active treatment approaches, the differences were not statistically significant. In other words: neural mobilization adds real value when you’re comparing against doing very little. But head-to-head against other established active therapies, it holds its own without clearly dominating. Wrap It Up So what do we take away from this? The authors concluded that adding neural mobilization to routine physical therapy is a clinically meaningful upgrade over minimal intervention for patients dealing with chronic neck conditions and nerve-related symptoms. The treatment approach is showing genuine benefit for pain relief and disability reduction. And for us in the chiropractic world, this is validating. Neural mobilization techniques — neurodynamic work — are conservative, manual-based interventions that fit squarely in what we do and I use it and recommend it daily in our clinic. Patients with chronic neck pain and radiculopathy-type symptoms are some of the most challenging cases in our offices, and here we have systematic review-level evidence saying that adding these techniques to a physical therapy routine makes a real difference. If you haven’t incorporated neural mobilization or neurodynamic testing and treatment into your practice toolkit, this is a good time to consider it. The evidence is building, and it points in the right direction. ──────────────────────────────────────────────────────────── Alright, that’s going to do it for Episode #387 of the Chiropractic Forward Podcast. Two great papers today — one reminding us that the simplest interventions can be the most powerful, and one confirming that what we do in the treatment room for chronic neck pain with nerve symptoms has solid evidence behind it. That’s the kind of research that makes me proud to be in this profession. As always, thank you for being here, thank you for caring about evidence and about doing right by your patients. That’s what this podcast is about and that’s what this profession deserves. ──────────────────────────────────────────────────────────── Don’t forget to check out our store at chiropracticforward.com. We’ve got resources and tools for chiropractors who want to stay sharp and keep building their practices on a solid foundation.   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.   Store Remember the evidence-informed brochures and posters at chiropracticforward.com.     Subscribe Button The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website Home Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Water Instead of Diet Drinks & Neuromobilization In The Chronic Neck appeared first on Chiropractic Forward.

CF Ep. 386: PRP For Knee OA & Diagnosing Cervical Arterial Dissection Today we’re going to talk about PRP For Knee OA & Diagnosing Cervical Arterial Dissection But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.   Hiring Plug Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected]   Things You Should Do Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast Check our website at chiropracticforward.com   You have found yourself smack dab in the middle of Episode #386 Now if you missed last week’s episode, we talked about Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally. Make sure you don’t miss that info. Keep up with the class.   On the Personal End of Things… Here we are, mid March in 2026. And what do I have going on? Well, a lot of the same as last week so let’s just hop into some advice based on what I’m currently focusing on in my life and career at 53 years old. The biggest advice to younger chiropractors is get a plan in advance. Don’t wait until you’re 48 to go, Hey, you know, at some point, I might want to retire. I had a buddy who was older than me that ended up getting cancer and passing away before he enacted any kind of retirement plan. His wife was left with a business that wasn’t worth anything with him gone, and all she could do was sell it for parts. I don’t know their finances at all. But if he hadn’t laid down some plans for her, that probably didn’t work out very good. Make plans early. I have another buddy… who ended up… having a heart attack and dying right there in his practice. He was in his 70s. Some people want to work that long, period. They love it that much. I love what I do for a living, but I don’t want to do it my whole life. I have another buddy who was in his 60s, and just a year or two ago, had a stroke, and can’t speak. So all of his patients had to go somewhere else, and he had to close down his shop and sell it off for parts. This all goes to say, for most of you, when you’re building your practice, build it to sell. Don’t name it after yourself. It’s hard to sell Williams Chiropractic to Joseph Salazar. Don’t make all of the marketing all about you. When it’s person-driven, your clinic is associated so strongly with YOU that it’s hard to remove yourself and turn it over to someone else. My practice is called Creek Stone Integrated Medical. It was Creek Stone Integrated Care before we added our medical branch. You can sell that to anybody. I think you get my point there. Build it to sell, plan early. Roth IRAs, compound interest. Maybe you get some inheritance along the way. And a side gig or two that you enjoy isn’t always the worst idea either. If you want to work your whole damn life, that’s OK. That’s just not what I want for my one and only trip on this rock. Alright, that’s it. I don’t have a lot more to share personally than that this week. I’m just getting ready for the QME test. Which will be in mid April. Once I hopefully pass that dude, one of my side gigs will be engaged, so cheers to that. Let’s get into the research.   Item #1 Our first one today is called, “Validation of a Diagnostic Support Tool for the Early Recognition of Cervical Arterial Dissection in Primary Care” by Thomas et al published in December 2024, and it’s a hot potato, Remember, the citations can be found at chiropracticforward.com under this episode. Citation: L. Thomas, M. Fowler, L. Marsh, K. Chu, Claire Muller, A. Wong, Validation of a diagnostic support tool for early recognition of cervical arterial dissection in primary care, Clinical Neurology and Neurosurgery, Volume 247, 2024, 108627, ISSN 0303-8467, https://doi.org/10.1016/j.clineuro.2024.108627. (https://www.sciencedirect.com/science/article/pii/S0303846724005146)   Why They Did It Cervical arterial dissection is one of the leading causes of stroke in young adults, and here’s the tricky part — it often shows up first looking just like everyday musculoskeletal pain. Neck pain, headache — things that walk through chiropractic and primary care doors every single day. The problem is, there are currently no validated tests to help clinicians identify it early. That means it can get missed, and a missed CeAD can mean a missed stroke. The goal of this research was to validate a diagnostic support tool that could help clinicians in primary care know when to refer urgently for imaging, when to monitor, and when it’s safe to proceed with treatment.   How They Did It This was a prospective observational study. They took adults over 18 years old presenting to a tertiary metropolitan hospital with an initial diagnosis of headache or neck pain — sound familiar? Participants were split into those with radiologically confirmed CeAD and controls without CeAD. They crunched the diagnostic values, looked at sensitivity and specificity, and then refined the tool based on what they found.   What They Found Thirty participants had confirmed CeAD and 261 were controls with non-CeAD causes of headache and neck pain. The original tool was an excellent predictor with an AUC of 0.83, but it had poor specificity — meaning too many false positives.  So they refined it. The updated tool uses four simpler, equally-weighted criteria: acute or sudden onset of pain, unusual or unfamiliar headache or neck pain, recent trauma or infection, and neurological features. Each criterion scores 1 point for a total of 4. At a cut-off of 3 out of 4, the refined tool hit 100% sensitivity and 74% specificity Wrap It Up This is pretty important for us! The refined tool shows solid clinical utility at a cut-off of 3 or higher, and the recommendation is clear: at that score, refer for vascular imaging. The authors acknowledge that further validation in emergency departments and primary care settings is still needed, but the foundation is strong. For chiropractors, this is a practical screening tool. Sudden, unusual neck pain or headache plus any neurological features in a patient under 55 should be raising flags. Know the signs, use a tool like this, and refer when the score demands it. Stroke prevention starts in our offices. You don’t wanna be a dummy and end up in court and your name run down in your town.   Item #2 The last one this week is called, “Efficacy and Safety of Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy for Knee Osteoarthritis: A Systematic Review and Meta-Analysis” by Gao, Ma, Tang, Zhang, and Zuo, published in the Archives of Orthopaedic and Trauma Surgery in September of 2024. New enough to smoke!! Remember, the citations can be found at chiropracticforward.com under this episode. Gao J, Ma Y, Tang J, Zhang J, Zuo J. Efficacy and safety of platelet-rich plasma and hyaluronic acid combination therapy for knee osteoarthritis: a systematic review and meta-analysis. Arch Orthop Trauma Surg. 2024 Sep;144(9):3947-3967. doi: 10.1007/s00402-024-05442-y. Epub 2024 Jul 7. PMID: 38972025 Why They Did It Knee osteoarthritis is one of the most common degenerative joint conditions out there, and it hammers quality of life. The traditional conservative options — corticosteroids, hyaluronic acid injections, NSAIDs — offer temporary relief at best and come with real side effects. Platelet-rich plasma, or PRP, has been generating a lot of buzz as a regenerative alternative. Hyaluronic acid has been a go-to injectable for years. But what happens when you combine them? That’s what this team wanted to know. Is PRP plus HA more effective and safer than either treatment alone? How They Did It This was a systematic review and meta-analysis, the gold standard of evidence-based research. They searched MEDLINE, the Cochrane Library, EMBASE, and Web of Science for articles published up through January 2024. They only included randomized controlled trials — the highest quality study design — that directly compared PRP plus HA combination therapy against PRP alone or HA alone. Primary outcomes were pain, functional outcomes, and adverse events. They followed PRISMA guidelines, used two independent researchers for data extraction, and applied fixed or random effects models based on heterogeneity. Ten RCTs involving 943 patients were included.   What They Found The combination of PRP and HA produced more significant pain reduction and functional improvement compared to HA treatment alone. And here’s a clinically important piece — the combination therapy also appeared to have a higher safety profile than either PRP or HA used as monotherapy. In other words, you get better results AND fewer adverse events when you combine them. That’s a pretty compelling argument for combination therapy in the right patient population.   Wrap It Up This meta-analysis adds meaningful evidence to the growing case for regenerative, non-surgical options for knee OA. PRP combined with hyaluronic acid outperformed HA alone on both pain and function, and the safety profile was favorable. For chiropractors and other conservative care providers, this is a reminder that our patients don’t have to choose between suffering and surgery. Orthobiologic options like PRP, especially in combination with HA, are showing real promise. This is the direction musculoskeletal medicine is heading — patient-centered, conservative, and regenerative. That’s our lane.   Closing Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.   Store Remember the evidence-informed brochures and posters at chiropracticforward.com.         Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective, can decrease surgeries & disability, and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!   Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.   Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.   Website & Social Media Links Website: http://www.chiropracticforward.com Facebook: https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP: https://www.facebook.com/groups/1938461399501889/ Twitter: https://twitter.com/Chiro_Forward YouTube: https://www.youtube.com/channel/UCtcIrhlK19hWlhaOGld76Q iTunes: https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM: https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn: https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Prp1089415/   About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger          The post PRP For Knee OA & Diagnosing Cervical Arterial Dissection appeared first on Chiropractic Forward.

CF 385: Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally Today we’re going to talk about Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #385 Now if you missed last week’s episode, we talked about Motor Weakness In Cervical Radiculopathy & Exercise And Dementia. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, as you might guess, things have been crazy. I recently returned from about 6 days out in Los Angeles where I was taking a prep class for the QME exam that’s coming up this Spring. What is a QME you might ask. Well let me clear that up for you, friend. It stands for Qualified Medical Evaluator and once I’m a QME, I’ll fly out to California every 4-5 weeks or so and spend a couple of days doing impairment ratings exams on injured workers. Then fly home and do all the reports.  For the QME exam, it’s about a 50/50 pass/fail rate on that deal and I plan on passing that dude the first time around. Ain’t nobody got time to do it again. Of course, I will if I need to but I don’t plan on it, man.  Outside of that, we’ve been getting this new associate up and running and y’all, she’s just a gem. Plain and simple. I’m really proud of her. She’s smart, she’s good with patients, she’s a good adjuster, and she just gets it. You show her once and she’s got it. Lots of times better than I got it! We are working hard on our PVA. I see patients around 8-9 times lifetime. And that’s with having VA and PI patients that are compelled to come in. That’s terrible and we are underserving by strictly looking at pain.  We are transitioning into pain relief followed by the functional movement screen, and then into maintenance. We believe this will better serve the patient but will also see our PVA go from around 8-9 up to about 15 or so. I can live with that. And our assoicate is all over it as well.  I’m the one that is FMS certified but made intense notes and through the help of AI, have created a way of training her up on FMS and now, she does it better than I ever did. Plus, she has the time to do it whereas, I just don’t.  So, we have all that. Through our new nurse prac, we are bringing in peptides and getting that all up and rolling so again…..lots and lots of action here with your ol uncle Jeffro. Trust that I’m not falling behind on the podcasts because I don’t care. I am just trying to balance this crazy life.  Becomeing a QME is no joke. It Ain’t easy my friends.  Wiith that, let’s jump in on that research.  Item #1 Our first one today is called, “Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging” by Ibounig et al and published in Jama Internal Medicine in February of 2026 and check out the shizzle on that shucker!! Remember, the citations can be found at chiropracticforward.com under this episode.  Ibounig T, Järvinen TLN, Raatikainen S, et al. Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging. JAMA Intern Med. Published online February 16, 2026. doi:10.1001/jamainternmed.2025.7903 Why They Did It Shoulder pain is a common musculoskeletal complaint often attributed to rotator cuff (RC) abnormalities. Diagnostic imaging is frequently used, but the association between RC abnormalities and shoulder symptoms remains uncertain. Objective  To determine the prevalence of RC abnormalities in a general population sample and their association with shoulder symptoms. How They Did It Population-based cross-sectional study in a nationally representative random sample of adults aged 41 to 76 years who underwent standardized clinical assessment and MRIs of the shoulders conducted from February 2023 to April 2024 in Finland.  Main Outcomes and Measures  RC tendon status was classified on MRI as normal, tendinopathic, partial-thickness tear (PTT), or full-thickness tear (FTT).  Shoulder symptoms were defined as pain or dysfunction in the preceding week.  The prevalence of RC abnormalities was compared across age groups and between symptomatic and asymptomatic shoulders, adjusting for demographic factors, concurrent MRI findings, and clinical examination. What They Found Among 602 participants, RC abnormalities on MRI were found in 595: 25% tendinopathy, 62% partial thickness tears, and 11% full thickness tears.  The prevalence and severity of abnormalities increased with age but did not differ between sexes.  RC abnormalities were present in 96% of asymptomatic shoulders (1039 of 1076) and 98% of symptomatic shoulders (126 of 128).  Only full thickness tears were more prevalent in symptomatic shoulders (14.6%) than in asymptomatic shoulders (6.5%), but this difference diminished after adjustment  Wrap It Up In this population-based study, rotator cuff abnormalities were nearly universal after age 40 years and showed poor concordance with shoulder symptoms.  These findings suggest that rotator cuff abnormalities often represent normal age-related changes rather than disease and call into question the clinical value of routine imaging for atraumatic shoulder pain. Item #2 The last one this week is one of those that continues to make me uncool amidst the rising popularity and money that has gone into its acceptance and legalizations.  It’s called, “Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders” by Young-Wolff et all and published in JAMA Health Forum in February of 2026 and it’s smokin up the place.  Young-Wolff KC, Cortez CA, Alexeeff SE, et al. Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders. JAMA Health Forum. 2026;7(2):e256839. doi:10.1001/jamahealthforum.2025.6839 Why They Did It As cannabis becomes more accessible and socially accepted, concerns have grown about its potential implications for adolescent mental health. While prior research has linked adolescent cannabis use to psychiatric symptoms, few large, population-based, longitudinal studies have examined associations with clinically diagnosed psychiatric disorders. Objective  To evaluate whether adolescent cannabis use is associated with an increased risk of incident psychotic, bipolar, depressive, and anxiety disorders during adolescence and young adulthood. How They Did It This cohort study included adolescents aged 13 to 17  Adolescents were followed up through age 25 years or until December 31, 2023.  Main Outcomes and Measures  Incident clinician-diagnosed psychotic, bipolar, depressive, and anxiety disorders, which were identified through electronic health records using International Classification of Disease codes.  Cox proportional hazards regression models were used to measure the strength of associations between adolescent cannabis use and incident psychiatric diagnoses, with adjustments for sex, race and ethnicity, neighborhood deprivation index, insurance type, and time-varying alcohol and other substance use. What They Found Of 463,396 adolescents included in the sample At baseline, 26,345 adolescents (5.7%) self-reported past-year cannabis use.  Past-year cannabis use was associated with an increased risk of incident psychotic, bipolar, depressive, and anxiety disorders.  The strength of the associations between cannabis use and incident depressive and anxiety disorders decreased as adolescents aged This pattern was similar but slightly attenuated after additional adjustment for past psychiatric conditions Wrap It Up This cohort study found that adolescent cannabis use was associated with increased risk of incident psychiatric disorders, particularly psychotic and bipolar disorders.  These results could inform the development of clinical and educational interventions for parents, adolescents, and clinicians, as well as protective policies to prevent or delay adolescent cannabis use in the context of expanding cannabis legalization. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!   Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally appeared first on Chiropractic Forward.

CF 384: Motor Weakness In Cervical Radiculopathy & Exercise And Dementia Today we’re going to talk about Motor Weakness In Cervical Radiculopathy & Exercise And Dementia But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little person ality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #384 Now if you missed last week’s episode, we talked about Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well February is off to a big start. I think I personally saw 175 last week which is leaps and bounds beyond what I normally see each week. Especially since COVID came around and crashed the practice. Since 2020, my average week is anywhere from 135 or so, up to about 160 on a good week. So to run 175 last week, that’s a big deal for me and a very very welcome change.  Now, if I can just get them to spread evenly in the mornings and afternoons instead of the vast majority of them only wanting to come in in the afternoons. We sit around a little in the mornings and lose our minds in the afternoons trying to keep up with everyone. It’s a problem to be honest. A good problem, of course. But a problem all the same.  Also in today’s news, after a very welcome sabbatical from traveling since my New Orleans trip last October, the travel season is kicking back in and there will be non-stop coming and going from now until probably next November. That’s my life.  In late January, I headed to Park City, Utah with my Mastermind group. I’ve only ever been to Utah when I had a layover in Salt Lake City but I’ve never seen any of the state so that was nice and I always love seeing my Mastermind family.  If you’re not in one, I encourage you to get in one. My MCM East group is sold out. But the MCM West group has openings. If you’re interested, contact Dr. Kevin Christie at modernchiropracticmarketing.com/contact Go do it! But If you do, you better tell Kevin you’re there because of me, pal! In other news, I finally got my California chiropractic license. I had to fly to Dallas to take the jurisprudence/legal test….it’s actually called the CCLE exam. That was the last step I needed out of the way to get the CA license.  I’ve also been studying up for the QME exam that will be in April. They have about a 50% pass/fail rate but the folks who attend the class I’m taking live out in Marina del Rey have more of a 80% pass/fail rate so I’m doing it. I’m ready to get this Qualified Medical Examiner licensing out of the way so I can start building that arm of my retirement income.  So, if you’re keeping track, the arms of retirement for me now include: Whatever is made from the exit of practice (percentage, buyout, etc) Airbnbs Voice over work QME work in CA Art income Music if needed Stocks, IRA’s, inheritance, and investments I didn’t start this stuff until I was almost 50 folks. Please, start considering your exit when you’re younger. There is a building phase when you cannot invest in other arms. But when you build that practice, it’s time to start keeping an eye on your exit. The sooner you start, the sooner you can act when burnout hits and trust me, burnout WILL hit.  Especially if you’re good, smart, and ambitious. Count on it.  Alright, into the research people! Item #1 Our first one today is called, “Is motor weakness in cervical radiculopathy an indication for surgery? Analysis of risk factors for poor recovery” by Kwon et al and published in European Spine in December 2025.  Remember, the citations can be found at chiropracticforward.com under this episode.  Kwon K, Park S, Song MG, Park WS, Hwang CJ, Cho JH, Lee DH. Is motor weakness in cervical radiculopathy an indication for surgery? Analysis of risk factors for poor recovery. Eur Spine J. 2025 Dec 26. doi: 10.1007/s00586-025-09677-0. Epub ahead of print. PMID: 41452372. Why They Did It To investigate the natural course of motor weakness in cervical radiculopathy and analyze risk factors associated with poor recovery. How They Did It A cohort of prospectively enrolled patients presenting with motor weakness due to cervical radiculopathy between March 2024 and March 2025 was retrospectively analyzed.  All patients were initially managed conservatively, with surgery reserved for persistent weaknesses or intolerable symptoms.  Demographic, clinical, and imaging data were reviewed.  Motor strength was assessed using the modified Medical Research Council (mMRC) scale.  Patients achieving a motor grade 4 or higher were classified as the recovery group; those who did not were assigned to the non-recovery group.  We compared both groups and evaluated possible risk factors for non-recovery. Wrap It Up Most patients with motor weakness due to cervical radiculopathy recovered functional strength within 2-3 months of conservative treatment.  However, older age, severe initial motor deficits, and persistent pain were associated with a higher risk of incomplete recovery. Item #2 Our second one today is called, “Physical Activity Over the Adult Life Course and Risk of Dementia in the Framingham Heart Study” by Marino et al and published in JAMA network Open in November of 2025 and that’s a muy en fuego. Mucho caliente.  Marino FR, Lyu C, Li Y, Liu T, Au R, Hwang PH. Physical Activity Over the Adult Life Course and Risk of Dementia in the Framingham Heart Study. JAMA Netw Open. 2025;8(11):e2544439. doi:10.1001/jamanetworkopen.2025.44439 Why They Did It The authors say that being physically active is protective against dementia. Yet, it is unknown when during the adult life course physical activity is most associated with dementia risk. Objective  To determine whether higher physical activity levels in early adult life, midlife, or late life are associated with lower risk of all-cause or Alzheimer disease (AD) dementia. How They Did It This prospective cohort study used data from the Framingham Heart Study Offspring cohort.  The offspring of participants in the original Framingham Heart Study cohort who were dementia free and had physical activity measured at baseline (early adult life, midlife, or late life) were followed up for a mean of 37.2, 25.9, or 14.5 years for the development of incident all-cause or AD dementia until December 31, 2023. Physical activity was self-reported using the physical activity index, a composite score weighted by hours spent sleeping and in sedentary, slight, moderate, or heavy activities.  Physical activity was divided into quintiles (Q). As far as outcomes, All-cause and AD dementia were classified by expert consensus based on established diagnostic criteria. What They Found This study included 1526 early adult–life, 1943 midlife, and 885 late-life participants.  There were 567 cases of incident all-cause dementia during follow-up.  Higher levels of midlife and late-life physical activity were associated with lower risk of all-cause dementia.  There were no associations between early adult–life physical activity and dementia risk.  Wrap It Up In this cohort study of adults in the Framingham Heart Study Offspring cohort, higher levels of midlife and late-life physical activity were associated with similar reductions in risk of all-cause and AD dementia.  These findings may inform future efforts to delay or prevent dementia through timing interventions during the most relevant stages of the adult life course. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger          The post Motor Weakness In Cervical Radiculopathy & Exercise And Dementia appeared first on Chiropractic Forward.

  CF 383: Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions Today we’re going to talk about Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #383 Now if you missed last week’s episode, we talked about SMT and disc regression and biopsychosocial factors for hip osteoarthritis.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. We have our new associate chiropractor up and running. Now the job is….how do we get her busy busy the quickest way possible? It’s a race to profitability, right?  Here are some of our ideas. We’d love to hear your suggestions as well if you have lots of experience in building an associate’s schedule.  First, we’re going to leverage the fact that she’s from Amarillo so she’s the local hero returning to town. We’ll do that with social media and her high school alumni network.  We’ll have her partner with local fitness studios when possible. She’s fit and she’s into fitness so that’s a perfect fit.  We’ll also see if she’s into working with youth sports programs.  We’ll do the ‘New Doc In Town’ thing. We’re going to be giving her some of my new patients when appropriate and possible. I say appropriate because a lot of big guys come to me and not too many will be pleased if I stick them with a smaller female. So they’ll have to be a good fit to pass on to her.  Visits to PT offices. The problem there is that I’m noticing PTs are offering many of the same services we offer now so they may look at her as competition now rather than a partner.  Lots of rehab and treatment videos. Videos with Q&A with our associate.  Lots of ideas but again, if you have a great strategy, I’d love to hear from you at [email protected] Send them my way! Item #1 The first one this week is called, “Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials” by Ceding et al and published in the American Journal of Sorts Medicine in October of 2024.  Remember, the citations can be found at chiropracticforward.com under this episode.  Oeding JF, Varady NH, Fearington FW, Pareek A, Strickland SM, Nwachukwu BU, Camp CL, Krych AJ. Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2024 Oct;52(12):3147-3160. doi: 10.1177/03635465231224463. Epub 2024 Feb 29. PMID: 38420745. Why They Did It Based in part on the results of randomized controlled trials (RCTs) that suggest a beneficial effect over alternative treatment options, the use of platelet-rich plasma (PRP) for the management of knee osteoarthritis (OA) is widespread and increasing.  However, the extent to which these studies are vulnerable to slight variations in the outcomes of patients remains unknown. Purpose: To evaluate the statistical fragility of conclusions from RCTs that reported outcomes of patients with knee OA who were treated with PRP versus alternative nonoperative management strategies. How They Did It Systematic review and meta-analysis All RCTs comparing PRP with alternative nonoperative treatment options for knee OA were identified.  The fragility index (FI) and reverse FI were applied to assess the robustness of conclusions regarding the efficacy of PRP for knee OA.  Meta-analyses were performed to determine the minimum number of patients from ≥1 trials included in the meta-analysis for which a modification on the event status would change the statistical significance of the pooled treatment effect. What They Found In total, this analysis included outcomes from 1993 patients with Based on random-effects meta-analyses, PRP demonstrated a significantly higher rate of successful outcomes when compared with hyaluronic acid, as well as higher rates of patient-reported symptom relief, not requiring a reintervention after the initial injection treatment, and achieving the minimal clinically important difference (MCID) for pain improvement when compared with all alternative nonoperative treatments.  Wrap It Up Conclusions drawn from individual RCTs evaluating PRP for knee OA demonstrated slight robustness.  On meta-analysis, PRP demonstrated a significant advantage over hyaluronic acid as well as improved symptom relief, lower rates of reintervention, and more frequent achievement of the minimal clinically important difference for pain improvement when compared with alternative nonoperative treatment options.  Statistically significant pooled treatment effects evaluating PRP for knee OA are more robust than approximately half of all comparable meta-analyses in medicine and health care.  Future RCTs and meta-analyses should consider reporting fragility indexes and fragility quotients to facilitate interpretation of results in their proper context.   Item #2 Our last one today is called “Telehealth Mindfulness-Based Interventions for Chronic Pain The LAMP Randomized Clinical Trial” by Burgess et al and published in JAMA Internal Medicine on August 19, 2004.  Burgess DJ, Calvert C, Hagel Campbell EM, et al. Telehealth Mindfulness-Based Interventions for Chronic Pain: The LAMP Randomized Clinical Trial. JAMA Intern Med. 2024;184(10):1163–1173. doi:10.1001/jamainternmed.2024.3940 Why They Did It Importance  Although mindfulness-based interventions (MBIs) are evidence-based treatments for chronic pain and comorbid conditions, implementing them at scale poses many challenges, such as the need for dedicated space and trained instructors. Objective  To examine group and self-paced, scalable, telehealth mindfulness-based interventions, for veterans with chronic pain, compared to usual care. How They Did It This was a randomized clinical trial of veterans with moderate to severe chronic pain, recruited from 3 Veterans Affairs facilities from November 2020 to May 2022. Follow-up was completed in August 2023. Interventions  Two 8-week telehealth mindfulness-based interventions (group and self-paced) were compared to usual care (control).  The group mindfulness-based interventions was done via videoconference with prerecorded mindfulness education and skill training videos by an experienced instructor, accompanied by facilitated discussions.  The self-paced mindfulness-based interventions was similar but completed asynchronously and supplemented by 3 individual facilitator calls. The primary outcome was pain-related function using the Brief Pain Inventory interference scale at 3 time points: 10 weeks, 6 months, and 1 year. Secondary outcomes included biopsychosocial outcomes: pain intensity, physical function, anxiety, fatigue, sleep disturbance, participation in social roles and activities, depression, patient ratings of improvement of pain, and posttraumatic stress disorder. What They Found Among 811 veterans randomized, 694 participants (85.6%) completed the trial.  Averaged across all 3 time points, pain interference scores were significantly lower for both mindfulness-based interventions compared to usual care  Additionally, both mindfulness-based intervention arms had significantly better scores on the following secondary outcomes: pain intensity, patient global impression of change, physical function, fatigue, sleep disturbance, social roles and activities, depression, and posttraumatic stress disorder.  Both group and self-paced mindfulness-based interventions did not significantly differ from one another.  The probability of 30% improvement from baseline compared to control was greater for group mindfulness-based interventions at 10 weeks and 6 months, and for self-paced MBI, at all 3 time points. Wrap It Up In this randomized clinical trial, scalable telehealth mindfulness-based interventions improved pain-related function and biopsychosocial outcomes compared to usual care among veterans with chronic pain.  Relatively low-resource telehealth-based mindfulness-based interventions could help accelerate and improve the implementation of nonpharmacological pain treatment in health care systems. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Platelet-Rich Plasma In Knee Osteoarthritis & Telehealth Mindfulness-Based Interventions appeared first on Chiropractic Forward.

CF 382: SMT And Disc Regression & Biopsychosocial Factors For Hip Osteoarthritis Today we’re going to talk about SMT And Disc Regression & Biopsychosocial Factors For Hip Osteoarthritis But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!     OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #382 Now if you missed last week’s episode, we talked about SMT And Re-operation Rates & The Most Expensive Condition.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, if you’re a dedicated listener, then you know the last podcast episode was roughly three weeks ago. That’s a little crazy.  But there are a couple of factors at play on that.  It’s hard to keep pouring energy and time into something that doesn’t seem to grow. I mean, I’ve been doing this podcast every single week until recently. That’s 381 episodes, every single week, for almost 8 years. And our listenership is still just about the same it’s ever been. There is little to zero engagement in the Facebook private group and, after a while, the piss and vinegar starts to empty out. It really would help if those of you that know and love Chiropractic Forward posted about it now and then and shared relevant episodes with your groups and network. Whether that’s on Facebook or just a text with the link. It’s all helpful and growing the listenership really would make the effort mean more and more for me personally. Now, understand, I feel a commitment to those of you that are true blue fans and we’re going to still keep pumping the episodes out as I’m able. It just can’t be my priority right now. Here’s why: I am entering into the serious back half of my chiropractic career and am making plans ahead of time. That includes me going through my CA licensure and entering into some designated doctor work out on the West Coast.  In addition to that new venture, I have made two significant and huge hires. I finally found an associate chiropractor to come in and help blow the lid off of this practice. I also just hired a nurse practitioner with a decade of experience under her belt and a belly full of excitement. These folks are going to demand a good portion of my time and attention and trust me, the ROI on them will be much more significant than the ROI on this podcast. Lol.  So, as you can see, lots of moving parts here, the sale of the clinic is off for now due to the passing of the owner of the purchasing group, and it’s time to buckle up, hunker down, and make things happen.  That’s where it’s at. Let’s hop into the research.  Item #1 Our first one today is called, “Is regression in lumbar disk herniation possible by spinal mobilization? A single-blind randomized controlled clinical study” by Taskaya et al and published in International Journal of Osteopathic Medicine in June 2025 and that’s hotter than a chili pepper.  Remember, the citations can be found at chiropracticforward.com under this episode.  Is regression in lumbar disk herniation possible by spinal mobilization? A single-blind randomized controlled clinical study Taşkaya, Burhan et al. International Journal of Osteopathic Medicine, Volume 56, 1007 I want to thank Dr. Mark King, President of Motion Palpation Institute for sending this one to me. Mark is an incredible person and such a valuable friend and colleague. He is one who makes you proud to be a chiropractor.  Why They Did It This study aimed to examine the impacts of spinal mobilization practices on herniation distance, disc height, and facet joint distance, as well as functional status, pain, range of motion (ROM), and flexibility in lumbar disc herniation (LDH) patients. How They Did It Thirty-two participants participated in the study, divided into an Intervention and Control Group.  Radiological findings were evaluated by MRI before and after the study.  The Back Performance Scale, Visual Analogue Scale, The S, and The Sit and Reach Test were assessed before, after, and at three months.  The control group received ten sessions of stabilization exercises for five weeks, two sessions per week.  In the intervention group, spinal mobilization applications were applied in addition to stabilization exercises What They Found Intra-group analysis revealed significant reductions in herniation distance, increases in facet joint distance, pain alleviation, functional improvement, enhanced flexibility, and extended ROM in both groups  Notably, a significant increase in disc height was observed exclusively in the Intervention Group.  Inter-group analysis revealed no significant differences between the groups post-intervention Wrap It Up Mobilization applications applied in LDH patients may have a positive effect on radiological findings, functional status, pain, ROM, and flexibility. May…..MAY, they say…….lol. OK Boomers…..ugh. I can’t wait until they are finally forced to recognize the effectiveness and cost saving of our industry for non-complicated musculoskeletal conditions.  Item #2 The second one this week is called, “Psychosocial factors are associated with altered pain processing in individuals with hip osteoarthritis: a cross-sectional study” by Sergooris et al and published in Pain Medicine March 24th, 2025 and it’s still a steaming supper special! Abner Sergooris, Jonas Verbrugghe, Bruno Bonnechère, Timo Meus, Maaike Van Den Houte, Kristoff Corten, Katleen Bogaerts, Annick Timmermans, Psychosocial factors are associated with altered pain processing in individuals with hip osteoarthritis: a cross-sectional study, Pain Medicine, Volume 26, Issue 8, August 2025, Pages 468–476, https://doi.org/10.1093/pm/pnaf030 Why They Did It Alterations in central pain processing are hypothesized to underlie the discordance between pain and radiographic osteoarthritis severity, as well as the association between psychological trauma and pain sensitivity. This cross-sectional study explored whether psychosocial factors and traumatic experiences are associated with central pain processing in individuals with hip osteoarthritis. How They Did It Independent variables included sociodemographic information, traumatic experiences, psychiatric disorders, symptoms of anxiety and depression, fear-avoidance, perceived injustice, general self-efficacy, perceived stress, social support, and pain-related variables.  Thermal quantitative sensory testing was used to assess central pain processing through heat pain thresholds, temporal adaptation and summation, and conditioned pain modulation.  Least absolute shrinkage and selection operator (LASSO) regression analyses were performed. What They Found One hundred thirty-three individuals with hip osteoarthritis were included.  Sex differences were identified in measures of central pain processing.  In combination with biological and pain-related factors, psychosocial factors explained between 11% and 21% of the variance in central pain processing.  The selection of biopsychosocial variables and the direction of their effect differed between male and female participants.  Inconsistent results were found with regard to the association between traumatic experiences and central pain processing. Wrap It Up Psychosocial factors contributed to the variance in quantitative sensory testing outcomes beyond the influence of biomedical variables.  Different associations were found in male and female participants between psychosocial factors and central pain processing.  Inconsistent results were found with regard to the association between traumatic experiences and altered central pain processing. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.          Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website Home Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter Tweets by Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger            The post SMT And Disc Regression & Biopsychosocial Factors For Hip Osteoarthritis appeared first on Chiropractic Forward.

CF 381: SMT And Reoperation Rates & The Most Expensive Condition Today we’re going to talk about SMT And Reoperation Rates & The Most Expensive Condition But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #381 Now if you missed last week’s episode, we talked about Low Back Chronic Pain & Osteoporosis Medications and the Decrease in Societal Fracture Risk Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Nothing too crazy. Still enjoying the Fall bounce where business acts like it should act and I’m better behaved with regard to traveling all over the world. It’s weird; when you stay put, business just does better.  You remember I mentioned that I am on the medical side carousel? We have a NP interview this afternoon so we’ll see how that goes.  I went to teh cardiologist the other day. I’m 53 and never been so I thought, maybe I’m missing out on all of the fun so let’s see what it’s all about. Well, it Ain’t all it’s cracked up to be. The first visit was fine. The dude saiid I don’t see anything particularly concerning here but let’s do an echocardiogram and just dive in and see what’s there.  So I got that done and what do you know? I got a call from his NP saying that overall I look good BUT….the bottom of my heart contracts too much and doesn’t relax like it should. What the hell does that mean anyway?? So she recommends putting me on the lowest dose diruetics to keep the upper portion of the heart from eventually enlarging.  Well, I’m in no mood to go on life long meds but diving into these meds, they’re pretty much like taking an antiacid every day so, maybe not so bad. I’m still checking it out but will probably take them. At least until I can finally get some damn weight off. 6’4” and 275 lbs is big and I’d much rather be around 230-240 lbs. Or less. But my body doesn’t want to be that. No matter what I do or try. It’s crazy.  The weight loss meds that work so well for everyone….yeah, I’m a non-responder. Because that’s my life. I look like I eat like a horse but I don’t. I eat fairly lightly overall day to day. It’s like my body has set it’s weight point at 275-280 and it doesn’t matter what the hell I do. It doesn’t want to budge from that spot.  So, it’s a constant battle. One that I know I’m not alone in. Many of us struggle with it. Just trying to figure it out.  Butt the good news is, the cardio suggested I reduce stress and try to relax more. Which means I’m getting a massage this afternoon. Yay! Which also means I gotta get going on this episode so let’s hop into the research.  Item #1 The first one is an article from Forbes called, “The Most Expensive Medical Condition Is Not What You Think” by Peter Ubel, a physician and behavioral scientist at Duke University. It was updated in July of 2025 so it’s sizzlin like a stack of fajitas! Remember, the citations can be found at chiropracticforward.com under this episode.  The article from Forbes reveals that the most expensive medical condition in the United States is not heart disease or diabetes, as commonly assumed, but rather low back and neck pain.  While heart disease and diabetes are both serious and costly—ranked fourth and third respectively, with expenditures of $90 billion and $111 billion annually—back and neck pain surpasses them with costs exceeding $130 billion each year. This substantial burden is linked to the sheer number of people affected and the chronic nature of these conditions.  The article highlights that individuals suffering from low back and neck pain commonly undergo expensive diagnostic procedures like X-rays and MRIs (often unnecessarily), use pain medications, participate in physical therapy, seek chiropractic care, and may ultimately face surgery—with almost half of these operations deemed unnecessary.  The impact extends beyond the healthcare system, affecting productivity due to missed work and causing considerable suffering among adults during their most productive years. Additionally, the piece points out a major discrepancy in government research investment: In 2021, the National Cancer Institute received over $7 billion, while the National Institute for Arthritis and Musculoskeletal and Skin Diseases (which includes spinal research) received just $685 million—barely a tenth by comparison.  The article concludes with a call to prioritize research and funding for back and neck pain to match its immense medical and financial toll on American society. You guys know this stuff. It’s preaching to the choir but it’s also updating the knowledge base and putting numbers to it too.  So there ya go.  Item #2 And #2 this week is called, “Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study” by Trager et al and published in BMC Musculoskeletal Disorders in January of 2024.  Trager, R.J., Gliedt, J.A., Labak, C.M. et al. Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study. BMC Musculoskelet Disord 25, 46 (2024). https://doi.org/10.1186/s12891-024-07166-x Why They Did It Patients who undergo lumbar discectomy may experience ongoing lumbosacral radiculopathy (LSR) and seek spinal manipulative therapy (SMT) to manage these symptoms.  We hypothesized that adults receiving SMT for LSR at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up. How They Did It We searched a United States network of health records (TriNetX, Inc.) for adults aged ≥ 18 years with LSR and lumbar discectomy ≥ 1 year previous, without lumbar fusion or instrumentation, from 2003 to 2023.  We divided patients into two cohorts: (1) chiropractic SMT, and (2) usual care without chiropractic SMT.  What They Found Following propensity matching there were 378 patients per cohort (mean age 61 years).  Lumbar spine reoperation was less frequent in the SMT cohort compared to the usual care cohort, yielding an RR of 0.55.  In the SMT cohort, 72% of patients had ≥ 1 follow-up SMT visit. Wrap It Up This study found that adults experiencing LSR at least one year after lumbar discectomy who received SMT were less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT.  While these findings hold promise for clinical implications, they should be corroborated by a prospective study including measures of pain, disability, and safety to confirm their relevance.  We cannot exclude the possibility that our results stem from a generalized effect of engaging with a non-surgical clinician, a factor that may extend to related contexts such as physical therapy or acupuncture. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Diplomate of the International Academy of Neuromusculoskeletal Medicine (DIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post SMT And Reoperation Rates & The Most Expensive Condition appeared first on Chiropractic Forward.

CF 380: Low Back Chronic Pain & Osteoporosis Medications and the Decrease in Societal Fracture Risk Today we’re going to talk about Low Back Chronic Pain & Osteoporosis Medications and the Decrease in Societal Fracture Risk But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #380 Now if you missed last week’s episode, we talked about Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. It’s been a bit cray cray around here. We’re on the hamster wheel again with regards to the nurse practitioner. Our nurse that’s been in NP school and we’ve been waiting to graduate got an offer for full time from the clinic she’s been doing her clinicals with and, just from a pure financial standpoint, she had to take it. I can only offer part time until the schedule fills up.  So….down the road we go. Looking for a new staff member to help us grow the clinic medically and service-wise. She/He is out there. We just gotta find ‘em.  Next, you’ve heard me speak about selling part of the clinic several times over the last several years. We were going to have a final discussion after going back and forth on the contract. What changes could they live with and what could we live with in a final contract. That sort of thing.  Well, unfortunately and tragically, the CEO of the company was heading to one of their clinics in a small airplane that unbelievably crashed with no survivors. Absolutey unbelievable. His name was Dr. Justin Ramsey and he was a great guy. Not only was a lot of this a business thing but, I got to know Justin fairly well and we were friends.  It’s been very hard to process on lots of different levels. Losing a friend and who knows where that puts us with selling a portion of the clinic? We don’t know. But I do know this; I’m getting up every morning and going to work and making patients feel better.  It will all fall into place as soon as it is supposed to fall into place. That’s enough, let’s hop in.    Item #1 The first one is called, “Reduction of Chronic Primary Low Back Pain by Spinal Manipulative Therapy is Accompanied by Decreases in Segmental Mechanical Hyperalgesia and Pain Catastrophizing: A Randomized Placebo-controlled Dual-blind Mixed Experimental Trial” by Gevers-Montaro et al and published in the Journal Of Pain in August 2024.  Remember, the citations can be found at chiropracticforward.com under this episode.  Reduction of Chronic Primary Low Back Pain by Spinal Manipulative Therapy is Accompanied by Decreases in Segmental Mechanical Hyperalgesia and Pain Catastrophizing: A Randomized Placebo-controlled Dual-blind Mixed Experimental Trial Gevers-Montoro, Carlos et al. The Journal of Pain, Volume 25, Issue 8, 104500 Why They Did It Chronic primary low back pain (CPLBP) refers to low back pain that persists over 3 months, that cannot be explained by another chronic condition, and that is associated with emotional distress and disability.  Previous studies have shown that spinal manipulative therapy (SMT) is effective in relieving CPLBP, but the underlying mechanisms remain elusive. How They Did It This randomized placebo-controlled dual-blind mixed experimental trial aimed to investigate the efficacy of SMT to improve CPLBP and its underlying mechanisms.  Ninety-eight individuals with CPLBP and 49 controls were recruited.  Individuals with CPLBP received SMT or a control intervention, 12 times over 4 weeks.  The primary outcomes were CPLBP intensity and disability (Oswestry Disability Index).  Secondary outcomes included pressure pain thresholds in 4 body regions, pain catastrophizing, Central Sensitization Inventory, depressive symptoms, and anxiety scores. What They Found Individuals with CPLBP showed widespread mechanical hyperalgesia and higher scores for all questionnaires.  SMT reduced pain intensity compared with the control intervention, but not disability.  Similar mild to moderate adverse events were reported in both groups.  Mechanical hyperalgesia at the manipulated segment was reduced after SMT compared with the control intervention.  Pain catastrophizing was reduced after SMT compared with the control intervention, but this effect was not significant after accounting for changes in clinical pain Wrap It Up Although the reduction of segmental mechanical hyperalgesia likely contributes to the clinical benefits of SMT, the role of pain catastrophizing remains to be clarified. Previous studies on the efficacy of SMT have suggested that its clinical benefits may rely on nonspecific effects.22,28,84 In contrast, a clinical trial designed to examine and control for nonspecific effects showed specific pain reduction by SMT.85  Accordingly, the present study shows that SMT produces greater pain relief compared with a control intervention that was undistinguishable from SMT.  This medium effect (η2p = .07) persisted up to 12 weeks after SMT, suggesting that SMT produces long-lasting pain relief, possibly through specific mechanisms. Item #2 Our second one today is called, Long Dosing Intervals of Parenteral Antiosteoporosis Medications and the Decrease in Societal Fracture Risk by Fu et al published in Mayo Clinic Proceedings in January 2025 and it’s a hot one today! Long Dosing Intervals of Parenteral Antiosteoporosis Medications and the Decrease in Societal Fracture Risk Fu, Shau-Huai et al. Mayo Clinic Proceedings, Volume 100, Issue 1, 68 – 79 Why They Did It To evaluate the relationship between different dosing intervals of antiosteoporosis medications (AOMs) and the subsequent fracture risk among patients with newly initiated AOM therapies. How They Did It In a nationwide population-based cohort study based on Taiwan’s National Health Insurance Research Database, osteoporosis patients with 50 years of age or older who newly initiated AOM from January 1, 2008, to December 31, 2018 were included.  We categorized AOMs into short dosing intervals or long dosing intervals.  The adherence of treatment by medication possession ratio and subsequent fracture after treatment for 3 years were measured. What They Found Among patients who initiated parenteral AOMs, the percentage of patients with high adherence increased from 33% in 2008 to 69% in 2018.  However, among patients who initiated oral AOMs, the percentage of high adherence remained stable (30%) between 2008 and 2018.  The use of parenteral AOMs increased from 1% in 2008 to 62% in 2018.  At the same time, the percentage of high adherence of those initiated AOMs significantly increased from 34% in 2008 to 61% in 2018.  The risk of subsequent fracture decreased significantly between 2008 and 2018 after controlling for all potential confounders Wrap It Up AOMs with long dosing intervals not only increased adherence but also associated with the decrease in subsequent fracture risk at a nationwide scale. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger          The post Low Back Chronic Pain & Osteoporosis Medications and the Decrease in Societal Fracture Risk appeared first on Chiropractic Forward.

CF 379: Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection Today we’re going to talk about Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #379 Now if you missed last week’s episode, we talked about Differences In Whiplash And Normal Neck Pain & Spinal Manipulative Therapy And Scoliosis.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Now that the Fall is upon us, things are leveling out and getting mroe and more stable around here. Which means less travel and more living in my house like a regular normal person. Except, we stayed in my hometown last weekend for my 35th high school reunion. Which is weird as hell to say. But it is what it is. I have the gray hair to prove it.  Got to see a lot of folks I haven’t seen in a while and that’s always good. Some never go back. They didn’t have a good experience in high school so they care nothing about it. I get that. That wasn’t me though. I had an incredible experience. I won state in the discus and was a two-way starter and football captain, honor grad, and had a great circle of friends that I absolutely still stay in touch with and still enjoy texting and seeing every now and then.  High school was somethign else for me and I wouldn’t trade it for anything. So we go back when it’s time.  Something I’ve been working on lately; through Facebook, a colleague reached out to me and said that with my ortho diplomate cert and my Forensics diplomate cert, that I should consider doing designated doctor work or medicolegal work out of state. She said she travels out of state once every 6-8 weeks and makes a gob of money doing so every year.  Well hell, you don’t have to tell me twice. There absolutely SHOULD be more benfits to having Diplomates so, if I got ‘em, miight as well use them. So, I started down the path of getting licensed elsewhere and holy guacamole what a sincere time suck pain in the ass. Wow. Absolutely stupid the hoops you gotta jump through. I’ve been licensed in TX since 1998 but I have to do mental gymnastics to add a license somewhere else?? Insantiy.  But, I’m getting there. Then, once licensed, I have to take a course that will prepare me for the Qualified Medical Examiner exam. Then I take that QME and pass it and Kablamo! I’m off to the races and adding an extra revenue source that can be maintained once I retire from actively treating patients every day.  Which, psssst…..between me and you….if you don’t want to die in yoru practice or sell it someday desperately for pennies on teh dollar, is exactly what we should all be doing. We should be acting as if there is an end game. Because there is and none of us are getting out alive.  Why do you think I have the VoiceOver thing going? The Airbnbs thing? You think I post my paintings and my sculptures on social media so often so that I can brag? Hell no. I want a portfolio and people to know, like, and eventually buy my art. If myy paintints annd sculptures are news to you, go to www.riverhorseart.com and check it out.  The point is; I’m trying to plan for the end game. I’m trying to do what I can to maximize my end game. You should be too.  Item #1 Our first one this week is called Association of Opioid use Disorder Diagnosis with Management of Acute Low Back Pain: A Medicare Retrspective Cohort Analysis by Moyo et al and published in Journal of General Internal Medicine in 2024.  Remember, the citations can be found at chiropracticforward.com under this episode.  Moyo, P., Merlin, J.S., Gairola, R. et al. Association of Opioid Use Disorder Diagnosis with Management of Acute Low Back Pain: A Medicare Retrospective Cohort Analysis. J GEN INTERN MED 39, 2097–2105 (2024). https://doi.org/10.1007/s11606-024-08799-3 Why They Did It They wanted to see if people with this opioid problem were treated differently for sudden back pain. How They Did It The main independent variable was OUD diagnosis measured prior to the first LBP claim (i.e., index date).  Using multivariable logistic regressions, they assessed the following outcomes measured within 30 days of the index date:  nonpharmacologic therapies (physical therapy and/or chiropractic care), and  prescription opioids.  Among opioid recipients, we further assessed opioid dose and co-prescription of gabapentin.  Analyses were conducted overall and stratified by receipt of physical therapy, chiropractic care, opioid fills, or gabapentin fills during the 6 months before the index date. What They Found Most people got less help like physical therapy or chiropractic care if they had opioid use disorder. Instead, these people were more likely to get strong medicines (opioids), sometimes in higher amounts, and were also given another medicine called gabapentin. Wrap It Up Doctors recommend starting with safer ways to treat pain (like exercises and Chiropractic therapy) instead of medicine—especially for people who’ve had problems with opioids before.  But this study found that doctors often use medicines anyway, and not enough non-medicine treatments. Specifically, the authors said this, “Medicare beneficiaries with aLBP and OUD underutilized nonpharmacologic pain therapies and commonly received opioids at high doses and with gabapentin. Complementing the promulgation of practice guidelines with implementation science could improve the uptake of evidence-based nonpharmacologic therapies for aLBP.” Which means people with back pain aren’t going to a chiro or PT nearly often enough and to compound the matter, people in the medical castles are STILL prescribing too many opioids and gabapentin whihc means they’re acting in a non-evidence-based way.    Item #2 Our last one this week is called, “Impact of transforaminal epidural steroid injection on pain and disability outcomes by lumbar intervertebral disc herniation class: a prospective study” by Saracoglu et al and published in Pain Medicine in August of 2025 and is muy cliente me amigos.  Tuba Tanyel Saraçoğlu, Burak Erken, Impact of transforaminal epidural steroid injection on pain and disability outcomes by lumbar intervertebral disc herniation class: a prospective study, Pain Medicine, Volume 26, Issue 8, August 2025, Pages 440–450, https://doi.org/10.1093/pm/pnaf040 Why They Did It To evaluate the effects of transforaminal epidural steroid injection on pain and disability across different lumbar disc morphologies using the Michigan State University (MSU) classification system. How They Did It Prospective cohort study. A single center pain management clinic. A total of 168 patients with single-level lumbar disc herniation at L4-L5 or L5-S1 treated with transforaminal epidural steroid injection.  Patients were divided into 7 subgroups according to the Michigan State University classification based on MRI findings. The numerical rating scale (NRS) for pain and Oswestry Disability Index (ODI) for assessing disability were measured at baseline, 1-month and 3-months post-procedure. What They Found Transforaminal epidural steroid injection significantly reduced NRS and ODI scores in all groups.  At 1-month follow-up, NRS scores of group 1B were significantly lower than those of groups 2A and 2A; at the 3-month follow-up, no differences were observed between the groups.  Although ODI scores improved over time, they did not exhibit significant differences among the subgroups throughout the study period. Wrap It Up   Transforaminal epidural steroid injection effectively reduces pain and disability across varying disc morphologies.  At the 1-month mark, pain relief was more pronounced in group 1B compared to 2A and 2AB groups, whereas at the 3-month mark, the results were similar between subgroups.  So, these groups know that these injections are short-term relief only but they’re recommending larger studies with longer follo-up to improve patient selection and optimze the tx strategies.  Instead of looking at the American College of Physician’s recommended hierarchy of treatment. While I was messing with Perplexity AI, the best research-leaning AI that I’m aware of, I asked Perplexity the following: “Qaseem et al published in the Annals of Internal Medicine by the American College of Physicians suggests a hierarchy of treatment with things like spinal manipulative therapy, exercise, massage, acupuncture, low-level laser, yoga, tai chi, mindfulness, cognitive behavioral therapy, and heat being first-line recommended therapies. These recommendations come from the largest medical group in the world. Why are these not more widely recommended by AI and by primary care providers as well as surgeons?” Perplexity returned with this response which, I thought, was fairly accurate minus the part where many chiropractors are causing the issue as well.  The AI engine responded with,  “Reasons First-Line Therapies Are Underused Medical Training and Habit: Many doctors are trained in settings where medications, injections, or surgery are considered more definitive solutions.  Healthcare System Incentives: The system often rewards faster, procedure-based approaches instead of time-intensive therapies like exercise or counseling.  Patient Expectations: Patients sometimes believe injections or surgery are ‘stronger’ or more effective, even when research shows non-drug therapies often work as well or better with fewer risks.  Insurance and Coverage: Not all non-drug treatments are covered by insurance, making them harder for patients to access.  Why Noninvasive Therapies Should Come First Noninvasive therapies have fewer side effects and lower risks compared to drugs or surgery.  Most people with back pain get better over time without surgery or injections. Guidelines support these therapies because strong evidence shows they help with pain and function and keep people active without causing harm.  In summary, while the largest medical group in the world encourage starting with non-drug therapies, they’re not always widely recommended because of habits, system pressures, patient expectations, and insurance rules—even though science backs their effectiveness and safety as first-line care.” Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Opioids And Low Back Pain & Transforaminal Epidural Steroid Injection appeared first on Chiropractic Forward.

CF 378: Differences In Whiplash And Normal Neck Pain & Spinal Manipulative Therapy And Scoliosis Today we’re going to talk about Differences In Whiplash And Normal Neck Pain & SMT And Scoliosis But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #378 Now if you missed last week’s episode, we talked about Neuroplastic Responses to Chiropractic Care & Screen Time and Depression. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well what’s new this week? Still going through the sale process with the investment group you’ve heard me talk about in some of the past episodes. It’s a lot, ya know? Selling a percentage of your lifelong blood sweat and tears and your pride and joy isn’t something you go into lightly. But I think we’re closer than we’ve ever been.  They sent us a contract, our attorney pointed out his concerns, we sent those back to them, it took about 4 months but we got the contract back and are going through it to see what we can meet in the middle on. Once we firm that up, we should be good to go with the closing.  So that’s been going in the background for a long time. Like for a few years at one level or another but more seriously here in just the last year. Hopefully, that chapter is about closed so we can start looking at the next chapter.  Our Parker intern is doing great. She’s smart and very capable. All new DCs need as much adjusting time as they can get. I always think the Motion Palpation Institute is the best start anyone can get. Those folks are top tier. I’m personal friends with Dr. Mark King the President of MPI and with Dr. Lindsay Mumma, who is one of their instructors. I know the level of Doctors they have leading that and really respect them all and their organization.  I know them through our Mastermind and speaking of Mastermind, we’ll all be in New Orleans on October 22nd through that weekend. Really looking forward to being with my people and for the first time ever, we will have Dr. Kevin Christie’s East Group and West Group combined meeting.  My group is the East group and we’ve never met the folks from the West group so it’ll be a good time to build and expand the network. Good stuff and really looking forward to it.  Dr. Jay Greenstein will be there as well and it’s always a good time with Jay. He’s got the vibe down. Also, Dr. Tim Bertlesman of ChiroUp will be there as well. Put those guys on top of Kevin, Mark King, Lindsay Mumma, Ben Fergus, David Rudnick, Vanessa Wilczak, Curt Kippenburger, Anthony Houssain, Tiffany and Tyler Armstrong, and all of my other great friends…..well….it’s going to be solid. As you can imagine.  Lastly, as you know we purchased the Kinas Miracle Wave Radial Shockwave unit last month, attended the shockwave masterclass a week and a half ago out in Atlanta, and are off to the races.    Admittedly, we are behind some of our competitiors but I think with the knowledge base we get to draw from and the masterclass under our belt, we are well-positioned to catch up, differeniate from our competitors, and build this thing! If you need the Kinas hook-up, shoot me and email at [email protected] and I’ll get you in touch with the folks that can help you get started.  Item #1 The first one today is called, “Effects of High-Velocity Spinal Manipulation on Quality of Life, Pain and Spinal Curvature in Children with Idiopathic Scoliosis: A Systematic Review” by Piqueras-Toharias et al and published in children in 2024.  Remember, the citations can be found at chiropracticforward.com under this episode.  Piqueras-Toharias, M.; Ibáñez-Vera, A.J.; Peinado-Rubia, A.B.; Rodríguez-Almagro, D.; Lomas-Vega, R.; Sedeño-Vidal, A. Effects of High-Velocity Spinal Manipulation on Quality of Life, Pain and Spinal Curvature in Children with Idiopathic Scoliosis: A Systematic Review. Children 2024, 11, 1167. https://doi.org/10.3390/children11101167 Why They Did It Scoliosis is a condition that involves deformation of the spine in the coronal plane and commonly appears in childhood or adolescence, significantly limiting a person’s life.  The cause is multifactorial, and treatment aims to improve the spinal curvature, prevent major pathologies, and enhance aesthetics.  The objective of this review was to determine whether high-velocity low-amplitude (HVLA) spinal manipulation is more effective than other treatments for children with idiopathic scoliosis (IS). How They Did It The PubMed, Web of Science, Scopus and PEDro databases were searched for both clinical trials and cohort studies.  Methodological quality was assessed via the PEDro scale (for clinical trials) and the Newcastle–Ottawa scale (for observational studies).  The protocol of this systematic review was registered in PROSPERO (CRD42024532442). What They Found Five studies were selected for review. The results indicated moderate improvements in pain and the Cobb angle and limited improvements in quality of life Wrap It Up HVLA spinal manipulation does not seem to have significant effects on reducing spinal deformity in IS patients, nor does it significantly impact quality of life.  However, this therapy may have significant effects on reducing pain in these patients. Item #2 The last one this week is called, “Differences in the clinical presentation of chronic whiplash-associated disorders and nontraumatic neck pain: a systematic review and meta-analysis” by Junze et al and published in Pain in August 2025 and it’s a hot tamale hot tamale! Chen, Junzea; Farrell, Scott F.a; Huang, Wanyun Irenea; Cagnie, Barbarab; Murillo, Carlosb; Sterling, Michelea,*. Differences in the clinical presentation of chronic whiplash-associated disorders and nontraumatic neck pain: a systematic review and meta-analysis. PAIN 166(8):p 1738-1756, August 2025. | DOI: 10.1097/j.pain.0000000000003554 Why They Did It Health outcomes may be worse for individuals with whiplash-associated disorders (WAD) compared to nontraumatic neck pain (NTNP), and clinical characteristics may differ.  This systematic review examined evidence comparing WAD and NTNP in terms of pain, disability, psychological status, quality of life, measures of nociceptive processing, movement, sensorimotor, and muscle function. How They Did It Studies were identified through electronic database searches and included after screening against predefined eligibility criteria. Standardized mean differences (SMD) or mean differences (MD) and 95% confidence intervals (CI) were calculated. Associations between MDs with demographics and study characteristics were explored using meta-regression. Certainty of evidence was assessed using Grades of Recommendation, Assessment, Development, and Evaluation. Sixty-one studies were eligible with 45 included in meta-analysis. What They Found Individuals with WAD reported  clinically relevant higher disability,  greater remote cold sensitivity,  lower quality of life,  greater depression,  greater local and  remote pressure sensitivity,  less cervical flexion and extension,  higher pain intensity, and  greater kinesiophobia.  No between-group differences were found for dizziness symptoms, stress, anxiety, balance, and local cold sensitivity.  Wrap It Up Certainty of evidence was mostly moderate.  Individuals with chronic WAD have a worse clinical presentation compared to those with chronic non-traumatic neck pain, which has implications for patient assessment and management. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.    Store Remember the evidence-informed brochures and posters at chiropracticforward.com.            Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Differences In Whiplash And Normal Neck Pain & Spinal Manipulative Therapy And Scoliosis appeared first on Chiropractic Forward.

CF 377: Neuroplastic Responses to Chiropractic Care & Screen Time And Depression Today we’re going to talk about Neuroplastic Responses to Chiropractic Care & Screen Time And Depression But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 12-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with me and we’re learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] Things you should do.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #377 Now if you missed last week’s episode, we talked about Acupuncture For Chronic Low Bac k And Spinal Manipulative Therapy for Acute Neck Pain Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I just recently returned from the Academy Of Shockwave Excellence Masterclass out in Atlanta, GA and now, I’m a master in Shockwave.  In case you are wondering, I started on this path and journey because of my Mastermind group that you always hear me talking about. Two of our members are instructors and masters in Shockwave. Dr. Ben Fergus in Evanston, IL and Dr. David Rudnick from Boynton Beach, FL.  These two guys are freaks on the. Shockwave and they BOTH use Kinas radial and focused shockwave units. So, I ordered Kinas, then attended the Masterclass, and now, I’m up and running and pissing some excellence.  If you are entertaining the thought of getting shockwave, I want you to send me an email at [email protected] and let’s talk about it. It is my understanding that this is the only group that has a materclass academy that really gets you and your staff trained. If you just get a manual from the manufacturer and don’t really get traning, then this is your group. I encourage you to get going on it. Send me an email and I’ll point you the right direction. [email protected] Item #1 Our first one is called “Role of Sleep and White Matter in the Link Between Screen Time and Depression in Childhood and Early Adolescence” by Santos et al published in JAMA Pediatrics on September 1, 2025 and it’s hotter than Angelina.  Remember, the citations can be found at chiropracticforward.com under this episode.  Lima Santos JP, Soehner AM, Biernesser CL, Ladouceur CD, Versace A. Role of Sleep and White Matter in the Link Between Screen Time and Depression in Childhood and Early Adolescence. JAMA Pediatr. 2025 Sep 1;179(9):1000-1008. doi: 10.1001/jamapediatrics.2025.1718. PMID: 40549406; PMCID: PMC12186512. Why They Did It To identify the association between screen time during late childhood and depressive symptoms in early adolescence, and to investigate whether these associations are mediated by sleep duration and white matter organization. How They Did It Prospective study was conducted from January 2024 to June 2024.  Data from the Adolescent Behavior Cognitive Development (ABCD) Study were used  Children and their parent/caregiver were recruited across 21 US cities.  Participants with no past/current psychiatric disorders were selected for analyses.  Outcomes included screen time assessed using a self-report questionnaire, sleep duration assessed using the Munich Chronotype Questionnaire, and depressive symptoms characterized using the Child Behavior Checklist.  Neurite orientation dispersion and density imaging and a tract profile approach were used to characterize the orientation dispersion index of 3 white matter tracts that are known to be implicated with depression: cingulum bundle, forceps minor, and uncinate fasciculus. Analyses included 976 participants What They Found Each additional hour of daily screen time at T1 (defined as aged 9-10 years old) was associated with a 0.12-point increase in Child Behavior Checklist depressive score at T2 (defined as aged 11-13 years old).  Shorter sleep duration and worse cingulum bundle organization at T2 mediated 36.4% of the association between more screen time and more depressive symptoms. Wrap It Up Results of this study show that more screen time in late childhood was associated with more depressive symptoms, potentially due to shorter sleep and worse white matter organization during early adolescence.  These findings emphasize the importance of promoting healthy habits and balancing screen time with adequate sleep. Item #2 Our last one today is called, “Neuroplastic Responses to Chiropractic Care: Broad Impacts on Pain, Mood, Sleep, and Quality of Life” by Haavik et al and published in Brain Science in 2024.  Haavik, H.; Niazi, I.K.; Amjad, I.; Kumari, N.; Ghani, U.; Ashfaque, M.; Rashid, U.; Navid, M.S.; Kamavuako, E.N.; Pujari, A.N.; et al. Neuroplastic Responses to Chiropractic Care: Broad Impacts on Pain, Mood, Sleep, and Quality of Life. Brain Sci. 2024, 14, 1124. https://doi.org/10.3390/brainsci14111124 What This Study Found: Chiropractic Care and Brain Changes This 2025 research paper looked at how chiropractic care (spinal adjustments) affects the brain, particularly focusing on people with chronic lower back pain. Here’s what they discovered, explained simply: The Main Question: The researchers wanted to understand how chiropractic care works in the brain. They knew it helped people feel better, but they wanted to see what was actually changing in the brain itself. What They Did: The study recruited 122 participants with chronic low back pain and gave them chiropractic care approximately three times per week for four week.s They used brain scans (EEG), measured nerve responses, tracked sleep with Fitbit devices, and asked people about their quality of life. The Big Discovery: The researchers found that chiropractic care changed how a specific brain network called the “Default Mode Network” (DMN) functions. Think of the DMN as the part of your brain that’s active when you’re daydreaming, thinking about yourself, or reflecting on your life. Chronic problems, such as chronic musculoskeletal pain, as well as common chronic disorders such as anxiety and depression have been found to have clear deficits in access, engagement and disengagement of the DMN Why This Matters: It is thought that when suffering is ongoing long-term the feelings of pain may become part of one’s internal self-story, and, similarly, ongoing worry can develop into anxiety and ongoing sadness can become depression. In other words, chronic pain can literally become part of your identity. What Improved: After four weeks of chiropractic care, participants showed: Significantly improved overall quality of life with significant improvements in the domains of anxiety, depression, fatigue, pain intensity and pain interference  Better sleep quality (more light sleep) Changes in brain activity suggesting better pain processing Improved connections between different brain regions The Bottom Line: The current findings provide compelling evidence for why chiropractic care, that includes the HVLA adjustments directed towards subluxated segments, can impact not only chronic pain symptoms, but also influence anxiety and depression symptoms.  The study suggests that chiropractic adjustments don’t just help with pain directly—they actually change how your brain processes sensory information and how you think about yourself and your pain, which can break the cycle of chronic pain becoming part of your identity. This research helps explain why some people with chronic pain find relief through chiropractic care and why that relief extends beyond just physical symptoms to include mental health improvements.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.          Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger        The post Neuroplastic Responses to Chiropractic Care & Screen Time And Depression appeared first on Chiropractic Forward.

CF 376: Acupuncture For Chronic Low Back & Spinal Manipulative Therapy For Acute Neck Pain Today we’re going to talk about Acupuncture For Chronic Low Back & Spinal Manipulative Therapy For Acute Neck Pain But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, judgemental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 12-er.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with me and we’re learning together.  Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast  Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #376. Can you believe I’ve done 376 episodes of this podcast?/ That’s weird to think. Doing 376 reps of anything is a lot. Much less something like this. I’m in the 8th year of doing this. Weird.  Now if you missed last week’s episode, we talked about Neural Mobilization & Cannabis And Heart Attacks And Strokes.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. As part of the Kinas Shockwave purchase, a staff member and I are headed to Atlanta this weekend for the shockwave masterclass where we will learn master level shockwave. Or at least that is what the name implies! Which is awesome because I get to learn from one of my fellow Mastermind members and friends, Dr. David Rudnick out of Boynton Beach, FL which is basically Boca Raton. David is the man and I’m looking forward to learning from him. He and Dr. Ben Fergus from Evanston, Illinois (Chicago) are the Shockwave masters and both are in my Mastermind. Which is incredibly handy.  I’ve said it before but it stands repeating that any time you can get into a room where you are not the smartest or most capable, that is a room you desperately want to be in. That is definitely the case with my Mastermind group.  Now, let’s talk about business. It’s coming back and coming back strong. We just had to get out of Summer and the travel season that comes with the Summer. Getting everyone back on a schedule has made all the difference in the world.  Another thing is that we recently had a local chiro suffer a stroke. From what I hear, he is able and capable, but unable to speak or communicate efficiently or effectively. So at 72, he’s had to call it quits and retire.  While unfortunate and terrible, it means that many of his patients have somehow found their way here to our clinic. So we had a big number of new patients last week and continuing into this week and most of them are from that clinic.  So, it’s been a plus for our clinic for sure but nothing to celebrate. This chiro was an excellent person and, from all indicators, a great chiro whose patients really loved.  Now the challenge here is that we need to figure out how to blend with these new ones. Imagine going to a brand new chiro when you’ve been going to the same one for years and years. That’s a difficult thing.  So, it’s clear I’m different so I have to make sure I explain at length why they might hear something different from me vs. their old chiro without bashing their old chiro. It’s OK to say something like, “‘While I agree with Dr. So and so on this, I can tell you that just in the last few years, research has started suggesting this on this issue over here.” Or something similar. So they know you’re on top of your crapola but you’re not trashing the other or throwing them under the bus.  That’s important. They need to know you’re sensitive to them having to come see you and they need to know that you really appreciate them being here and you’d like for them to become a part of your practice.  I also tell them what Clinical Compass tells us on their treatment schedule but, remember, they’ve been going to the chiro a long time. They have their schedule and their routine. So you can commonly hear me say, “Clinical Compass suggests starting at twice per week for a month but you’ve been going for a while and you know what works for you so use me how you would like and I’ll see you on your next visit.” Pretty simple but delicate too  That’s the dance we’ve been doing lately. OK, here is this week’s research.  Item #1 Our first one this week is called, “Acupuncture for Chronic Low Back Pain in Older Adults: A Randomized Clinical Trial” by DeBar et al and published in JAMA Open on September 12, 2025. Hell yeah it’s hot! Remember, the citations can be found at chiropracticforward.com under this episode.  DeBar LL, Wellman RD, Justice M, et al. Acupuncture for Chronic Low Back Pain in Older Adults: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(9):e2531348. doi:10.1001/jamanetworkopen.2025.31348 Why They Did It To determine the effectiveness of standard acupuncture (SA) or standard acupuncture plus maintenance (enhanced acupuncture [EA]) to improve CLBP-related disability relative to usual medical care (UMC) at 3, 6, and 12 months after randomization. How They Did It This multisite, 3-arm, parallel-group randomized clinical trial of older adults with CLBP collected data from 4 US health care systems in 3 geographic areas and compared SA and enhanced acupuncture treatment with UMC only.  Both standard acupuncture, which was 8-15 treatment sessions over 12 weeks plus UMC,  and enhanced acupuncture, whiich was standard acupuncture plus 4-6 maintenance sessions during the next 12 weeks, were provided  Participants were randomized to the 3 groups. The primary outcome was CLBP-related disability measured by a baseline-to-6-month change in the Roland-Morris Disability Questionnaire (RMDQ) score.  What They Found The trial identified 800 individuals who were randomized to 3 groups  At 6 months, RMDQ change scores were significantly better in both the SA and EA groups compared with the UMC only group  SA and EA change scores did not differ significantly from one another.  Benefits were still present at 12 months.  Pain intensity exhibited a relative benefit of EA over SA at 6 months, and both acupuncture groups had significant improvement over UMC.  Wrap It Up The findings of this randomized clinical trial of older adults with CLBP suggest that acupuncture needling provided greater improvements in back pain–related disability at 6 months and at 12 months compared with UMC alone.  Item #2 Our second one today is called, “Efficacy and safety of spinal manipulative therapy in the management of acute neck pain: a systematic review and meta‐analysis” by Diao et al and published in BMC on May 1, 2025 and that’s a steamy plate of goodness.  Diao Y, Liu Y, Pan J, Chen J, Pan J, Liao M, Liu H, Liao L. Efficacy and safety of spinal manipulative therapy in the management of acute neck pain: a systematic review and meta-analysis. Syst Rev. 2025 May 1;14(1):97. doi: 10.1186/s13643-025-02855-7. PMID: 40312450; PMCID: PMC12044948. Why They Did It This study aims to comprehensively evaluate the efficacy and safety of SMT in the treatment of acute neck pain. How They Did It A thorough search was conducted in PubMed, Embase, Web of Science, PEDro, and Cochrane Library databases, covering all studies from inception to March 20, 2023.  Mean differences (MD) with 95% confidence intervals (CIs) were calculated to assess outcomes such as pain intensity, cervical range of motion, and disability.  The PEDro Scale and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were utilized to evaluate the methodological quality and strength of evidence. What They Found Eight randomized controlled trials (RCTs) with 965 patients were included.  Their PEDro scores ranged from 4-9.  Forest plot analysis showed SMT was better than the control in reducing pain and improving cervical range of motion in all measured aspects.  It also significantly reduced disability scores.  No serious adverse events were reported. Wrap It Up The evidence supports the use of SMT as an effective and safe intervention for reducing pain, improving cervical range of motion, and decreasing disability in patients with acute neck pain.  These findings provide valuable insights for clinical practitioners and highlight the potential of SMT as a viable therapeutic option in managing acute neck pain.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.  Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerThe post Acupuncture For Chronic Low Back & Spinal Manipulative Therapy For Acute Neck Pain appeared first on Chiropractic Forward.

CF 375: Neural Mobilization & Cannabis And Heart Attacks And Strokes Today we’re going to talk about Neural Mobilization & Cannabis And Heart Attacks And Strokes But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #375 Now if you missed last week’s episode, we talked about Non-surgical Disc Treatment & Cognitive Functional Therapy.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, now that school’s back in and people are getting back on a schedule, I am starting to see patients returning. Which is quite a relief. I was starting to wonder if I pissed on the mayor’s dog or something and made the whole town mad at me. It’s been slow all summer long and that’s no fun.  While this week is still slower than I like to see, the new patients are well on the rise. I think I have 18 new patients this week and that’s A-OK with me.  Especially when you factor in that we have what is called the Tri-State Fair going on here. It’s a week long thing and people will literally take out small loans to take their family to this thing. Which is something we don’t really understand but, yeah, it’s a real thing.  The fair typically slows us down but this year, we’re on the rise while the fair is happening and that’s even better news.  Our intern from Parker is doign great. She’s really smart, very professional, and seems to be learning a ton. She asks great questions and seems pretty happy with her experience. Which is great. We don’t get a ton of interns here in Amarillo so it’s nice to have an extra set of hands around the clinic. Especially and extra set of hands that we enjoy having around. She’s been great.  Still getting goign with the launch of Shockwave here in the clinic. Still introducing it to our patients and so far, they love it. As an old college football player myself, I’m using it as well. Both shoulders and low back to start with. Once I get them in shape, we’ll move to the knees and a hammy. Hey if you pay for something, you might as well be engaging in some healthcare too. That’s just another tip from your Ol’ Uncle Jeffro.  Before we get to the research I’ll leave you with this. Go Cowboys! Item #1 The first on etoday is called, “Neural mobilisation effects in nerve function and nerve structure of patients with peripheral neuropathic pain: A systematic review with meta-analysis”’ by Bittencourt et al and published in PLOS One on November 8, 2024 and it’s a lil bit smoky.  Remember, the citations can be found at chiropracticforward.com under this episode.  Neural mobilisation effects in nerve function and nerve structure of patients with peripheral neuropathic pain: A systematic review with meta-analysis Juliana Valentim Bittencourt , Leticia Amaral Corrêa, Maria Alice Mainenti Pagnez, Jéssica Pinto Martins do Rio, Gustavo Felicio Telles, Stephanie Mathieson, Leandro Alberto Calazans Nogueira Published: November 8, 2024 https://doi.org/10.1371/journal.pone.0313025   Why They Did It To assess the effects of neural mobilisation on nerve function and nerve structure of patients with peripheral neuropathic pain. How They Did It A systematic review with meta-analysis was conducted.  Eligibility criteria included controlled trials or quasi-experimental studies comparing neural mobilisation versus sham, active or inactive control in adults with peripheral neuropathic pain.  Primary outcomes were the change in peripheral nerve cross-sectional area.  Secondary outcomes included nerve echogenicity, nerve excursion and nerve conduction.  What They Found Eleven randomised controlled trials and four quasi-experimental studies (total sample = 722 participants) were included.  Thirteen studies included participants with carpal tunnel syndrome.  Two studies examined the cross-sectional area, revealing improvements (i.e., a reduction) in the cross-sectional area after the neural mobilisation.  Neural mobilisation improved motor and sensory conduction velocity in short-term, compared to control.  Neural mobilisation did not alter distal motor or sensory latency. Wrap It Up Neural mobilisation seems to improve the cross-sectional area and sensory conduction velocity.  Neural mobilisation was superior to control in improving motor conduction velocity in patients with peripheral neuropathic pain with moderate quality evidence.  Distal motor or sensory latency presented similar results compared to other interventions.  Our findings should be interpreted cautiously since most studies included patients with carpal tunnel syndrome.   Item #2 Here we go….Ol Uncle Jeffo is being uncool again and trying to tell people what to do with their recreational drug habits. I’m not trying to tell you what to do. I’m not your real mom.  But if you’re going to do it, at least know the real risks and not what your bud dealer Ernie told you about the safety.  Yes, I know alcohol is worse and all the other pro-weed arguments. I get it. We actually tried outlawing alcohol in the 30’s because it’s so bad. I get it. But just because alcohol is legal does not mean weed is good, safe, and smart for legalization. Why make two things legal when you don’t have to? Keep it for medical use without abusing the term and disrespecting those that actually need it for medical use. Hell yeah, Francis. But don’t legalize it. It’s ridiculous.  With my total uncoolness now being on full display, the last one today is an online article called, “Cannabis use raises risk of heart attack and stroke more than cocaine, other drugs, major review suggests Marijuana users may face twice the risk of cardiovascular death, research finds” by Angelica Stabile with Fox News and posted June 19, 2025 and aye carumba!!! Es muy caliente!! https://www.foxnews.com/health/cannabis-use-raises-risk-heart-attack-stroke-more-than-cocaine-other-drugs-major-review-suggests Here it is summarized in a nutshell: A major new study has found some concerning links between marijuana (cannabis) use and heart problems. Here’s what the research shows in simple terms: The Big Study: French researchers looked data from over 400 million patients across 24 different studies to see how cannabis affects heart health. It was a “meta-analysis,” so it’s no small thing. The Scary Numbers: The study found cannabis users had a 29% higher chance of heart attacks, 20% higher risk of strokes, and twice the risk of dying from heart problems The risks were especially high for people who used cannabis at least once a week. More Dangerous Than Expected:  Surprisingly, one study found cannabis was a bigger predictor of heart attacks than other illegal drugs like cocaine and opioids This challenges what many people assume about cannabis being “safer.” Young People at Risk:  The dangers weren’t just for older adults either. Several studies found higher risks for younger people, including those aged 15-22 and 18-36 Women appeared to face higher risks than men. Why This Matters:  As more states legalize marijuana and more people (including seniors) use it, doctors are seeing more emergency room visits related to cannabis.  A medical expert compared marijuana’s effects on the heart and lungs to cigarette smoking. The Bottom Line:  While medical marijuana can help some patients with serious conditions, this research suggests regular cannabis use carries real heart risks that many people don’t realize.  The researchers say doctors should ask all heart patients about cannabis use, just like they ask about smoking or drinking. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Neural Mobilization & Cannabis And Heart Attacks And Strokes appeared first on Chiropractic Forward.

CF 374: Non-surgical Disc Treatment & Cognitive Functional Therapy Today we’re going to talk about Non-surgical Disc Treatment & Cognitive Functional Therapy But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #374 Now if you missed last week’s episode, we talked about Vertebral Artery Dissection Recognized and Referred By Chiropractor. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I got back from Florida Keys annd am doing everything I can do to catch up. I’m nowhere near being caught up so I hope you’ll understand that I’m keeping it short this week.  Our new intern is on board and getting settled in and says she’s learning fast so that’s good. We’ll have her doing the exams by next week I believe. If you have a great intern training program, send it my way at [email protected]. I’d love to see it. I have one. But I’m open to all suggestions.  We are up and running with the new shockwave machine. While it’s going well early on, we have an obstacle we didn’t expect. The entire Eastern half of the country can get shockwave covered through the VA system.  I assumed the West part of the US was the same but it is not. Much to my chagrin. The East is served by Optum Server. The West is served by Tri-West. You’d think it’d all be Federal and uniform. Yeah, no. It’s not.  So, we put on our big boy pants and knock it out the hard way. Cash pay patients. But it’s going OK.  That’s all I have today. Between the Ukranian refugee girl being stabbed and murdered on the train in Charlotte and Charlie Kirk being shot and killed today…….I’m just not feeling it. I’m sure I’m not the only one.  2025 has been a tough one. For me nand for lots and lots of my friends. Just crazy.  I’ll be back next week with more time and more ability to form a great thought process for you. Or, at least, a normal for your Ol’ Uncle Jeff anyway.  Item #1 Our first one today is called, “Non-Surgical Approaches to the Management of Lumbar Disc Herniation Associated with Radiculopathy: A Narrative Review” by Melhat et al published in Jorunal of Clinical Medicine in February 2024. Sizzlin’ hot! Remember, the citations can be found at chiropracticforward.com under this episode.  El Melhat, A.M.; Youssef, A.S.A.; Zebdawi, M.R.; Hafez, M.A.; Khalil, L.H.; Harrison, D.E. Non-Surgical Approaches to the Management of Lumbar Disc Herniation Associated with Radiculopathy: A Narrative Review. J. Clin. Med. 2024, 13, 974. https://doi.org/10.3390/jcm13040974 Why They Did It Lumbar disc herniation associated with radiculopathy (LDHR) is among the most frequent causes of spine-related disorders.  This condition is triggered by irritation of the nerve root caused by a herniated disc.  Many non-surgical and surgical approaches are available for managing this prevalent disorder.  Non-surgical treatment approaches are considered the preferred initial management methods as they are proven to be efficient in reducing both pain and disability in the absence of any red flags.  The objective of this article is to introduce advanced and new treatment techniques, supplementing existing knowledge on various conservative treatments. It provides a comprehensive overview of the current therapeutic landscape, thereby suggesting pathways for future research to fill the gaps in knowledge.  How They Did It Extensive exploration of recent clinical research, focusing on various non-surgical approaches for LDHR.  By exploring the effectiveness and patient-related outcomes of various conservative approaches, including physical therapy modalities and alternative therapies, therapists gain valuable insights that can inform clinical decision-making, ultimately contributing to enhanced patient care and improved outcomes in the treatment of LDHR. What They Found Specific to our detailed review, we identified the following interventions to yield moderate evidence (Level B) of effectiveness for the conservative treatment of LDHR: patient education and self-management, McKenzie method, mobilization and manipulation, exercise therapy, traction (short-term outcomes), neural mobilization, and epidural injections.  Two interventions were identified to have weak evidence of effectiveness (Level C): traction for long-term outcomes and dry needling.  Three interventions were identified to have conflicting or no evidence (Level D) of effectiveness: electro-diagnostic-based management, laser and ultrasound, and electrotherapy. Item #2 The last one this week is called, “Effectiveness of cognitive functional therapy for chronic spinal pain: a systematic review with meta-analysis” by Marelli et al and published in Pain Medicine in May of 2025 and it’s a hottie too! Michele Marelli, Matteo Cioeta, Leonardo Pellicciari, Fabio Rossi, Stefania Guida, Silvia Bargeri, Effectiveness of cognitive functional therapy for chronic spinal pain: a systematic review with meta-analysis, Pain Medicine, Volume 26, Issue 5, May 2025, Pages 248–260, https://doi.org/10.1093/pm/pnaf002 Why They Did It To assess the effectiveness of cognitive functional therapy (CFT) in reducing disability and pain compared to other interventions in chronic spinal pain patients. How They Did It Five databases were queried to October 2023 for retrieving randomized controlled trials (RCTs), including patients with chronic spinal pain and administering cognitive functional therapy.  Primary outcomes were disability and pain. Secondary outcomes included psychological factors, quality of life, patient satisfaction, and adverse events.  Two independent reviewers performed study selection, data extraction, risk of bias assessment  What They Found Compared to other conservative interventions, cognitive functional therapy may reduce disability and pain at short-term follow-up with probable to possible clinical relevance in CLBP and with low and very low evidence certainty, respectively.  Similar results, with larger effect sizes, were observed for cognitive functional therapy compared to any unstructured or unsupervised minimal care treatments.  Efficacy persisted in longer-term follow-ups, except for comparison with other conservative interventions. The study showed positive results for cognitive functional therapy. Evidence certainty was low to very low. Wrap It Up Cognitive functional therapy may offer clinically relevant benefits for CLBP, although the evidence remains mainly of low to very low certainty.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Non-surgical Disc Treatment & Cognitive Functional Therapy appeared first on Chiropractic Forward.

CF 373: Vertebral Artery Dissection Recognized And Referred By Chiropractor Today, we’re going to talk about Vertebral Artery Dissection Recognized And Referred By Chiropractor But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #373 Now if you missed last week’s episode, we talked about Spinal Manipulative Therapy and Lumbar Re-operation & SMT And Fall Risk Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. First things first here; we’re gonna be short of episodes for a couple of weeks. I’m heading out early next week for a family end-of-summer trip to the Florida Keys. Key Largo, to be more specific. You guys can have Key West and all of its crazy college kid craziness. I prefer the slower, more laid-back and mature pace of Key Largo.  We go to a resort there called Playa Largo. It’s a Marriott property, and it’s just a wonderful place. Look it up. Just a tip from your ol’ Uncle Jeffro. It’s a resort with restaurants and a spa and such. Your Ol’ Uncle Jeffro has a lil birthday massage scheduled while he’s down there too.  So, we got that going on, and I’m not going to have the opportunity to get the podcast put together next week. We don’t get back that next week from Florida until Wednesday, so, yeah, I won’t have time that following week either. So, this is it for a couple of weeks.  The new thing for me in my office is the purchase of a radial shockwave unit. We are getting up and running and figuring it out. We did a session, or a sesh as the kids call it, this morning on a vet that has had 3 surgeries on his ankle and until today, hasn’t felt anything in his leg or ankle in over a year.  He walked out today, almost in tears, because it made that much of a difference in one sesh. That’s a pretty great start to our Shockwave journey. I’m pretty excited to see how it goes.  From our Mastermind group, we have around 25 in the group, and I think I was one of the last to get the shockwave. I think there are still 3-4 of us that have yet to get one. We have two masters of the shockwave in the group. Ben Fergus from Evanston/Chicago area actually teaches the course in the videos from the company, and David Rudnick is one of the Shockwave instructors for the masterclass that we’ll be going out to Atlanta to take in September.  So yeah, we got the smart folks in our Mastermind. Be jealous.  That’s the big news for this week. I’m cutting it short so I can get the research put together.  Here we go.  Item #1 Our only one this week is called “Recognition of Vertebral Artery Dissection In a High-Risk Postpartum Patient by a Chiropractic Physician” by Demetrious et al. Et al also includes some of our industry’s heavy hitters like Robert Trager, Stephen Veigh, Peter Tuchin, and my friend Ol’ Uncle David Graber.  I don’t really call him Ol’ Uncle Dave but I may now. Time will tell. This was published in Cureus on August 18, of 2025 and is sizzlin’ like steak.  Remember, the citations can be found at chiropracticforward.com under this episode.  Demetrious J, Trager R J, Veigh S, et al. (August 18, 2025) Recognition of Vertebral Artery Dissection in a High-Risk Postpartum Patient by a Chiropractic Physician. Cureus 17(8): e90389. doi:10.7759/cureus.90389   Why They Did It They say, “We report a case of vertebral artery dissection (VAD) in a patient with postpartum preeclampsia and underscore the contribution of chiropractic assessment in recognizing vascular pathology, facilitating neurovascular imaging, and expediting emergency intervention.” What The Hell Had Happened? A 36-year-old woman with a history of mixed connective tissue disease presented to the emergency department five days postpartum with facial and peripheral edema, recent onset of hypertension, acute severe neck pain, headache, lightheadedness, confusion, and gait instability.  Magnetic resonance angiography (MRA) and magnetic resonance venography of the head were performed. Small, unruptured bilateral internal carotid artery aneurysms were visualized. The patient was admitted and treated for postpartum preeclampsia.  Upon discharge, she followed up with a neuroendovascular specialist.  Although the patient improved with preeclampsia management, concerning neurologic symptoms persisted. The patient later consulted a chiropractor, who suspected VAD.  On the day she sought ED care, her clinical condition rapidly deteriorated. She developed a severe occipital headache and new, excruciating, left-sided posterior neck pain with radiation into the left shoulder.  The pain significantly restricted active cervical rotation bilaterally. Visual disturbances progressed to include diplopia and intermittent scotomata described as “seeing spots,” along with worsening photophobia.  Additionally, the patient experienced dyspnea, lightheadedness, and progressive bilateral lower extremity edema that impaired ambulation. So…..looky here folks, I’ve been preaching this stuff on the podcast for years now, and if you, as a doctor, do not know that this patient needs to be punted like a football in the Super Bowl of life, then you need to know it. This is life and death for the patient, and it’s survival or bankruptcy for you as far as your business.  You aren’t going to ‘pop it out’. Working on this patient will not work out for you. Please pay attention to these warning signs. Pay attention to what we’re talking about here. It’s really really important.  Emergent neck MRA was recommended and performed, confirming VAD 12 days after the initial emergency department visit.  The patient was initiated on antithrombotic therapy, with subsequent resolution of symptoms and no evidence of ischemic stroke.  This case underscores the importance of maintaining a high index of suspicion for VAD in postpartum patients presenting with new-onset neurological symptoms, particularly in the context of hypertensive disorders of pregnancy and underlying connective tissue disease.  It further illustrates the potential role of chiropractic evaluation in the early clinical recognition of vascular pathology, which may facilitate timely diagnosis and intervention and reduce the risk of stroke. So that’s the story, but I also want to highlight some things that were stated in the paper, in addition to the abstract.  It may cause ischemic stroke, particularly in young adults, and has an incidence rate of approximately two per 100,000 person-years Notice it’s in YOUNG adults. These stroke cases you see in the news are usually young folks. Not older  Because I don’t think it can be repeated enough times, they say, “The clinical presentation of VAD may include occipital headache, neck pain, and other potential features such as visual disturbances, dizziness, and gait abnormalities that can be indicative of brain ischemia.  Risk factors for VAD are increasingly understood, such as hypertension, migraine, and connective tissue disorders.  A tip from your Ol’ Uncle Jeffro – Test with the Beighton Scale and do it often if you see someone that’s looking bendy. If you do an SLR on someone and their knee basically goes backward, do the Beighton. When doing ROM, if they bend right over and put their hands flat on the floor, do the Beighton. You get the idea.  They say, “Pregnancy is an increasingly recognized risk factor for CeAD and VAD. One study reported that pregnant women had approximately two times the risk of VAD compared to non-pregnant controls, with an elevated incidence of VAD during a one-year window including pregnancy and postpartum” The chiropractor is the one that recognized it, the chiropractor is the one that recommended the emergency MR-A, and this chiropractor is A-OK with me.  I’m sure the ER probably still asked her if she’d been adjusted by a chiropractor but, you know….that’s comes with the territory, doesn’t it? Another important consideration is that should an adjustment be deemed to CAUSE the stroke, symptoms are going to appear almost immediately.  With regards to that, they say, “The earlier chiropractic neck manipulation warrants careful contextual analysis. A history of connective tissue disorder, pregnancy, and recent childbirth warrants consideration, as these factors may represent relative risk factors for spinal manipulative therapy.(SMT). Although some literature suggests an association between cervical manipulation and VAD, high-quality evidence does not support a causal relationship. Importantly, this patient did not experience acute headache, dizziness, or neurological symptoms that may or may not be present in this cohort immediately following the manipulation. These symptoms emerged only postpartum, coinciding with the onset of preeclampsia. I liked this paper enough that it’s the only one I’m doing this week. It’s important and full of information that demands our focus. So that’s what we’re doing; we’re focusing on this one and only paper this week and I want to thank the crew that put it together. You’re doing God’s work in our profession.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.            Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Diplomate of the International Academy of Neuromusculoskeletal Medicine (DIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Vertebral Artery Dissection Recognized And Referred By Chiropractor appeared first on Chiropractic Forward.

CF 372: Spinal Manipulative Therapy and Lumbar Re-operation & SMT And Fall Risk Today we’re going to talk about Spinal Manipulativer Therapy and Lumbar Re-operation & SMT And Fall Risk But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #372 Now if you missed last week’s episode, we talked about Pain Reprocessing Therapy & Chiropractic And Tramadol.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I’m gearing up for a few things around here. The first is that I’ve got three main pushes for the immediate, right now, as we speak. We did this in the Mastermind group you always hear me talk about. Each of us decided what our main push is. But, since I have so many things and moving parts going around here at all times, I actually have three main focuses.  They are: Get my numbers back to Pre-COVID numbers Launch Shockwave treatments Get my medical providers back to the level of treatment we were seeing prior to our providers changing So, what are my plans for each? Well, that’s what I’m figuring out while we have a little back-to-school slowdown.  To boost numbers, it makes sense to boost marketing. That could be more boosted posts on social media, targeted ad campaigns, more effective content creation, Google Ads, sales funnels, internal marketing, referral marketing, and on and on and on.  We have a company that is helping us with Google Ads and content creation so we’re already acting there. We have a great website company so we are SEO optimized and going the right direction there.  We could run a re-activation campaign internally. I’m not sure what that looks like off the top of my head but we can figure it out. Lots of ideas to help boost numbers.  It’s been weird since COVID, honestly. As soon as business starts building and we’re getting our numbers back, something always seems to happen. A long term attorney relationship changes hands and the new attorneys aren’t as dependable. Or the VA hires their own chiropractor, and on and on.  It just seems like the Universe is holding us back for some reason so we’re just trying to bend the universes will back in our favor. We can do it. I’ve been doing it for years.  On the second one, the Mastermind will be a huge help to us in getting Shockwave all launched and successful. Those folks have been all over Shockwave for the last year.  I’m not worried about #2 and shockwave at all.  Number three is a little more difficult. Some of the medical services we have are fairly saturated. Joint regeneration like biologics and PRP…..well a lot of orthos are already doing them and who goes to this outlier over here vs. going to an ortho for that? Of course, on the other hand, a lot of orthos are quick to surgery so you have a bunch of them running patients off too.  Bio-Identical hormone pellets, lots of folks are doing Bio-T. Trigger point injections, IV Therapy, Semaglutide…..yep, it’s all pretty saturated so breaking through the noise is tough.  It’s all marketing. How do you break through the noise? They call it the USP or unique selling proposition. Which means, what makes you different? I think what makes us different is that with the services we offer, we can treat the body in a whole body context. Medical, alternative care, exercise….everything. That part is still unique.  Short of surgery, everything under one roof. That’s our USP and we’re going to hammer the hell out of it.  Item #1 Our first one today is called, “Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study” by Trager et al and published in BMC Musculoskeletal Disorders in January of 2024 and es steamy, hot to the touch.  Remember, the citations can be found at chiropracticforward.com under this episode.  Trager, R.J., Gliedt, J.A., Labak, C.M. et al. Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study. BMC Musculoskelet Disord 25, 46 (2024). https://doi.org/10.1186/s12891-024-07166-x Why They Did It Patients who undergo lumbar discectomy may experience ongoing lumbosacral radiculopathy (LSR) and seek spinal manipulative therapy (SMT) to manage these symptoms.  We hypothesized that adults receiving SMT for lumbosacral radiculopathy at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up. How They Did It We searched a United States network of health records (TriNetX, Inc.) for adults aged ≥ 18 years with lumbosacral radiculopathy and lumbar discectomy ≥ 1 year previous, without lumbar fusion or instrumentation, from 2003 to 2023.  We divided patients into two cohorts: (1) chiropractic SMT, and (2) usual care without chiropractic SMT.  What They Found Following propensity matching there were 378 patients per cohort (mean age 61 years).  Lumbar spine reoperation was less frequent in the SMT cohort compared to the usual care cohort.  Wrap It Up This study found that adults experiencing lumbosacral radiculopathy at least one year after lumbar discectomy who received SMT were less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT.  While these findings hold promise for clinical implications, they should be corroborated by a prospective study including measures of pain, disability, and safety to confirm their relevance.  We cannot exclude the possibility that our results stem from a generalized effect of engaging with a non-surgical clinician, a factor that may extend to related contexts such as physical therapy or acupuncture. Item #2 Our second one today is called, “Chiropractic Spinal Manipulation and Fall Risk in Older Adults With Spinal Pain: Observational Findings From a Matched Retrospective Cohort Study” by Trager et al and yes, the man is a rock star….obviously. It was published in Cureus in October of 2024 and that’s hot as hell as well.  Trager RJ, Burton WM, Loewenthal JV, Perez JA, Lisi AJ, Kowalski MH, Wayne PM. Chiropractic Spinal Manipulation and Fall Risk in Older Adults With Spinal Pain: Observational Findings From a Matched Retrospective Cohort Study. Cureus. 2024 Oct 24;16(10):e72330. doi: 10.7759/cureus.72330. PMID: 39583476; PMCID: PMC11585376. Why They Did It Limited research suggests that spinal manipulative therapy (SMT) might positively influence balance, yet its association with falls remains underexplored.  We hypothesized that older adults receiving chiropractic SMT for spinal pain would have a reduced fall risk during 13 months of follow-up compared to matched controls. How They Did It We searched >116 million patient records from TriNetX to identify adults aged ≥65 years with spinal pain.  After excluding those with major fall risk factors, we formed SMT and non-SMT cohorts, using propensity score matching  We explored the cumulative incidence of falls and fractures and negative control outcomes What They Found After matching, each cohort had 1,666 patients (mean age 72 years).  The SMT cohort had a lower fall rate than the non-SMT cohort, yielding an risk ratio of 0.71.  Cumulative incidences revealed a brief lag in SMT cohort fall incidence.  There was no meaningful difference in limb fractures.  Negative control outcomes were similar between cohorts. Wrap It Up This study suggests that older adults receiving SMT for spinal pain may have a reduced risk of falls.  However, given the observational nature of the study and the lack of significant differences in limb fracture incidence, the clinical significance of these findings remains uncertain.  Further research, including randomized controlled trials, is needed to explore injurious falls, care utilization, pain, and costs. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger        The post Spinal Manipulative Therapy and Lumbar Re-operation & SMT And Fall Risk appeared first on Chiropractic Forward.

CF 371: Pain Reprocessing Therapy & Chiropractic And Tramadol Today we’re going to talk about Pain Reprocessing Therapy & Chiropractic And Tramadol But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #371 Now if you missed last week’s episode, we talked about Unnecessary Surgery & Gabapentin Linked To Dementia.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. It’s back to school time which, as I mentioned last week, is traditionally our slower time of the year. What does slow time mean? It means sit around and tremble in fear that patients will never grace your door step again. It means You’re DONE in this town! Just kidding of course. What it means is you have time to clean off that pile of papers on the corner of your desk, get into that ‘Learning File’ on your computer. Take those courses you’ve been meaning to take. Get some marketing going for your practice. You know…..do the stuff you never have the time to do.  That’s what I’m doing anyway and it’s definitely what your Ol’ Uncle Jeffro suggests you get moving on too. Some of you are going to kick on the computer games. I see you!!! Don’t do it.  Invest your time. Or waste your time. It’s totally up to you. But I suggest you invest it. You’re the hammer or your the nail, the bug or you’re the windshield. You either make things happen, watch things happen, or wonder what in the hell just happened.  You can probably guess which one I am in each scenario. Very few minutes go by in my day that are not invested in one way or another. I’m almost 53 and I don’t have as much time to jack around as I used to have. I mean that figuratively as well as literally.  Speaking of being in a bit of a rush, I am this week so what do you say we cut the chit chat a-hole (that’s an old Nicolas Cage from The Rock reference there) and let’s get to the research.  Item #1 The first one today is called, “Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain 5-Year Follow-Up of a Randomized Clinical Trial” by Ashar et al and published in JAMA Psychiatry on July 30, 2025 and aye carumba, es en fuego! Remember, the citations can be found at chiropracticforward.com under this episode.  Ashar YK, Low EL, Knight K, et al. Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: 5-Year Follow-Up of a Randomized Clinical Trial. JAMA Psychiatry. Published online July 30, 2025. doi:10.1001/jamapsychiatry.2025.1844 Why They Did It Effective treatments for chronic back pain (CBP) are lacking.1 We previously reported that a novel psychological treatment, pain reprocessing therapy (PRT), led to large reductions in CBP severity, with benefits generally maintained through 1-year follow-up.2 Here, we report clinical outcomes at the 5-year follow-up, testing the long-term durability of gains. How They Did It This secondary analysis of a randomized clinical trial received institutional review board approval to invite participants to complete patient-reported outcome measures in 2023, 5 years after randomization.  The trial protocol has been published previously.2 We followed the Consolidated Standards of Reporting Trials (CONSORT) reporting guideline. In 2017 to 2018, 151 adults with CBP recruited from community settings in the Boulder-Denver metropolitan area of Colorado reporting at least 4 of 10 pain intensity were randomized to 1 of 3 conditions: PRT, placebo, or usual care (UC) PRT participants attended 1 telehealth physician session and 8 face-to-face therapist sessions aiming to help participants reframe their CBP as due to nociplastic processes,3 reduce fear and avoidance of pain, and regulate nonpain threats (eg, anxiety, difficult emotions).4  Placebo participants received 1 open-label placebo injection subcutaneously into the back, accompanied by patient education about the power of placebo.5   All participants, including UC participants, were asked to continue any ongoing CBP care. What They Found Of 151 participants, 113  or 75% provided 5-year follow-up data, with similar follow-up rates by randomization group.  PRT participants reported significantly lower pain intensity at 5 years than placebo and UC participants.  In the PRT group, 21 participants (55%) were nearly or completely pain free at 5 years, compared with 10 placebo participants (26%) and 13 UC participants (36%)  The largest effects were found in harm beliefs (TSK-11) and in pain attributions to mind-brain processes Wrap It Up This 5-year follow-up of a randomized clinical trial found that PRT provided long-term pain reduction in CBP.  Whereas improved coping with chronic pain is the goal of some psychological treatments, our findings indicate that PRT can provide durable recovery from CBP for some patients.  A main limitation is that the original trial sample had low to moderate severity of CBP2; studies testing PRT in higher-severity samples are needed.   Item #2 The second one today is called, “Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back pain: a retrospective cohort study using US data” by Trager et al and published in British Medical Journal Open in 2024 and it’s at least still smoldering.  Trager RJ, Cupler ZA, Srinivasan R, et al Chiropractic spinal manipulation and likelihood of tramadol prescription in adults with radicular low back pain: a retrospective cohort study using US data BMJ Open 2024;14:e078105. doi: 10.1136/bmjopen-2023-078105 Why They Did It Patients receiving chiropractic spinal manipulation (CSM) for low back pain (LBP) are less likely to receive any opioid prescription for subsequent pain management.  However, the likelihood of specifically being prescribed tramadol, a less potent opioid, has not been explored.  We hypothesised that adults receiving CSM for newly diagnosed radicular LBP would be less likely to receive a tramadol prescription over 1-year follow-up, compared with those receiving usual medical care. How They Did It Retrospective cohort study. Setting was a US medical records-based dataset including over 115 million patients attending academic health centers, queried 9 November 2023. Participants were Opioid-naive adults aged 18–50 with a new diagnosis of radicular LBP.  What They Found After propensity matching, there were 1,171 patients per cohort (mean age 35 years).  Tramadol prescription was significantly lower in the Chiropractic cohort compared with the usual medical care cohort A cumulative incidence graph demonstrated that the reduced incidence of tramadol prescription in the CSM cohort relative to the usual medical care cohort was maintained throughout 1-year follow-up.  Utilization of NSAIDs, physical therapy evaluation, and lumbar imaging was similar between cohorts. Wrap It Up This study found that US adults initially receiving chiropractic spinal manipulation for radicular LBP had a reduced likelihood of receiving a tramadol prescription over 1-year follow-up.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Pain Reprocessing Therapy & Chiropractic And Tramadol appeared first on Chiropractic Forward.

CF 370: Unnecessary Surgery & Gabapentin Linked To Dementia Today we’re going to talk about Unnecessary Surgery & Gabapentin Linked To Dementia But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #370 Now if you missed last week’s episode, we talked about Cervicogenic Headache Treatment & Seeing A Chiropractor First Means Less Expense Overall.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. What a crazy as hell Summer, folks. Europe, two trips to Dallas, and one to Boston the weekend before last…..then Dallas at the end of August and then Key largo at the very tail end of August.  I love travel. Please don’t get me wrong. But it plays hell on your clinic when you’re the only chiro in it. Most of you know exactly what I’m saying. So, I’m looking forward to the kids getting back to school and everyone getting back on a schedule. The kids can’t be traveling which means my travel is dramatically reduced. Which means my patient numbers go back up! Traditionally, our slow times of the year are back to school and dead in the middle of the holidays. So, that used to start first week in August and now the kids are goign to school starting August 13th believe it or not. So now the slow down starts at the end of July. Like right now.  We’re not going to fuss though. My travel schedule has brought on some of it so don’t sit around and piss and moan about things you brought on yourself.  Looking forward, we have a Parker intern coming in to work with us very soon and we’re always looking forward to that. She’ll be in at the end of the month or the very beginning of September. I’m not exactly sure just yet. Up here in Amarillo, about 5.5 hours NW of Dallas, we only see interns about once per year. Sometimes less. We always enjoy it though and we’re looking forward to this one too. She seems to be a go getter and it’s always fun to watch a go getter grow.  Who knows….maybe she’ll wanna stick around with us after she graduates. Then I can quit telling all of you how we need an associate!!. I cna’t believe y’all haven’t taken me up on that yet. We have a staff change comign up in the clinic and this girl means a lot to me. I hate to see her go but with every departure comes an opportunity to have a new special person come on board and bring them in to the family and get ‘em up and running.  In the last month or so, I made one of our rock stars the manager and she is a rock start folks. This girl runs the front desk and just never seems to drop the ball about anyhting. I’ve had 20 or so front desk staff over the years. Give or take. And this girl is heads and tails above them all. Kudos to my wife for hiring such a stud.  So I made her the manager and this is her first hire. We shall see how good she is at hiring. If she’s as good at hiring as she is at everything else, then she’ll have knocked it out of the park and settled in on the perfect staffer. I’m looking forward to it and…..I didn’t have to do all of the hiring so that’s a big plus! Item #1 Our first one today is an oldie but a goodie. It’s called, ““Unnecessary” spinal surgery: A prospective 1-year study of one surgeon’s experience” by Epstein et al and no, it’s not THAT Epstein. It’s Nancy Epstein and it was published in Surgical Neurology in 2011.  Remember, the citations can be found at chiropracticforward.com under this episode.  Epstein NE, Hood DC. “Unnecessary” spinal surgery: A prospective 1-year study of one surgeon’s experience. Surg Neurol Int. 2011;2:83. doi: 10.4103/2152-7806.82249. Epub 2011 Jun 21. PMID: 21776403; PMCID: PMC3130462. Why They Did It There are marked disparities in the frequency of spinal surgery performed within the United States over time, as well as across different geographic areas. One possible source of these disparities is the criteria for surgery. How They Did It During a one-year period, the senior author, who is a neurosurgeon, saw 274 patients for cervical and lumbar spinal, office consultations.  A patient was assigned to the “unnecessary surgery” group if they were told they needed spinal surgery by another surgeon, but exhibited pain alone without neurological deficits and without significant abnormal radiographic findings [dynamic X-rays, MR scans, and/or CT scans]. Here’s a tip from your Ol’ Uncle Jeffro that’s in line with this, pain is not a reason to have surgery. Now I feel pretty good today so that’s easy for me to say, right? But in general, pain is not a reason for surgery. The reason for surgery should be progressive neurological deficits. Cauda equina, DTRs, motor strength, dermatomes and sensory….you get the point.  OK, let’s proceed… What They Found Of the 274 consults, 45 patients were told they needed surgery by outside surgeons, although their neurological and radiographic findings were not abnormal.  An additional 2 patients were told they needed lumbar operations, when in fact the findings indicated a cervical operation was necessary.  In 29 patients there were one or more overlapping comorbidities. Wrap It Up During a one-year period, 47 [17.2%] of 274 spinal consultations seen by a single neurosurgeon were scheduled for “unnecessary surgery”. The author went on to offer this in the summary of the body of the paper, “This is an underestimate of the percentage of unnecessary surgeries as the 274 patients include those coming for first opinions. If we only considered the patients coming for second opinions, then the percentage of unnecessary operations would have been considerably larger.” I have seen estimates suggesting that only 5% of spinal surgeries actually taking place day-to-day are actually necessary. I will try to track down the source for the stat and share in a future episode for you.  To be fully honest, this is one of the things that keeps me up at night. All of the people getting unnecessary spinal surgeries because a surgeon is just way behind on their research, too arrogant to think they could be wrong, or worst….doing surgeries based purely on financial gain.    Item #2 Our second one today is called “Risk of dementia following gabapentin prescription in chronic low back pain patients” by Eghrari et al and publisehd in Regional Anesthesia & Ain Medicine in July 2025 and that’s hotter than a Texas tin roof in August. If you know, you know…that’s pretty hot.  Eghrari NB, Yazji IH, Yavari B, Van Acker GM, Kim CH. Risk of dementia following gabapentin prescription in chronic low back pain patients. Reg Anesth Pain Med. 2025 Jul 10:rapm-2025-106577. doi: 10.1136/rapm-2025-106577. Epub ahead of print. PMID: 40639955. Why They Did It Gabapentin is widely used to treat chronic pain, but its association with cognitive decline and dementia remains unclear. This study examined whether gabapentin prescription is associated with dementia in adults with chronic low back pain. How They Did It We conducted a retrospective cohort study using the TriNetX national database of de-identified patient records from 2004 to 2024.  Adults diagnosed with chronic low back pain were included; those with prior gabapentin use, dementia, epilepsy, stroke, or cancer were excluded.  Propensity score matching controlled for demographics, comorbidities, and pain medications.  Patients were stratified by age and gabapentin prescription frequency.  Primary outcomes were dementia and mild cognitive impairment. What They Found 26,416 adults we analyzed following propensity-score matching.  Patients with six or more gabapentin prescriptions had an increased incidence of dementia and mild cognitive impairment   When stratified by age, non-elderly adults prescribed gabapentin had over twice the risk of dementia and mild cognitive impairment compared to those not prescribed gabapentin.  Risk increased further with prescription frequency: patients with 12 or more prescriptions had a higher incidence of dementia and mild cognitive impairment than those prescribed gabapentin 3-11 times. Wrap It Up Gabapentin prescription in adults with chronic low back pain is associated with increased risk of dementia and cognitive impairment, particularly in non-elderly adults.  Physicians should monitor cognitive outcomes in patients prescribed gabapentin. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Diplomate of the International Academy of Neuromusculoskeletal Medicine (DIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerThe post Unnecessary Surgery & Gabapentin Linked To Dementia appeared first on Chiropractic Forward.

CF 369: Cervicogenic Headache Treatment & Seeing A Chiropractor First Means Less Expense Overall Today we’re going to talk about Cervicogenic Headache Treatment & Seeing A Chiropractor First Means Less Expense Overall But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #369 Now if you missed last week’s episode, we talked about Spinal Manipulative Treatment And Biochemical Markers & SMT For Lumbar Disc Herniation.  Make sure you don’t miss that info. Keep up with the class.    On the personal end of things….. Alright, we had July 4th Independence Day celebration last weekend so that was a nice little 3-day weekend, right? I’m sure we all made the best use of our holidays. Hopefully you all still have all of your fingers and toes.  I haven’t seen it from any chiropractic colleagues but this weekend has been a lesson in the incorrect way to use social media. I really don’t care what your political views are. I 100% don’t care. The Texas floods happened this weekend and I think the body count is up to 91 at the typing of this. Lots of kids in the Christian camp and all of that. Heart breaking. I can’t even allow myself to think about it because it’s just too much.  I’m a life long Texan and while I don’t live anywhere near the flooding, I know a ton of people in the area and they are kin in some way. We are related at Texans and it means more to me than maybe someone from Oregon or New York for example. I think that’s understandable.  I saw where folks are posting for political points and it’s just gross. It’s a mental condition for some of these folks. DOGE made cuts to different parts of the government that included the National Weather Service so now natural disasters are, of course, because of Republicans. Now, when did cutting wasteful spending from the government become a bad thing?/ Honestly, that used to be a bipartisan, American idea. But…..yeah, not so much these days. What if these ares of the govt. were overfunded and over staffed well-beyond what was needed? Does it make sense to cut staff to the regular, appropriate amount that services are not lost while waste is eliminated? Isn’t that possible too? Of course it is. But I’m getting off topic here.  I’m seeing this kind of post like Texas deserves everything they get, MAGA voted for it, now they can deal with it, and garbage like that.  If you wonder about me, I’ll be straight up with you and if you don’t like it, I could not care less. I’m fiscally conservative and socially I lean a little more Liberal. I find positives and negatives on both sides of the aisle and before I let memes or cable news get me fired up about something, I research it and form an educated opinion.  If social media has taught me anything, it’s that a high percentage of my fellow humans do NOT do that. They just go spouting garbage, further dividing others, and keeping our world at a level of intensity that I’ve never seen before.  It’s awful when one side acts like the other side is literally, not figuratively, responsible for natural disasters and killing 91 people, including children. When all they had to do was research to find out that forecasting gave over 3 hours of advance notice of potential flooding and the totals were as accurate as they could have been for that kind of storm. NWS officials and meteorologists stated that the NWS offices were adequately staffed. The storm was beyond what models could predict with any precision, and while the warnings were released, local dissemination was slow. But, it tracks because if you recall, Hurricane Katrina was Bush’s fault too. I remember well.  So, with no education, we get social media posts like this from a Houston, TX pediatrician, “May all visitors, children, non-MAGA voters and pets be safe and dry. Kerr country MAGA voted to gut FEMA. They deny climate change. May they get what they voted for. Bless their hearts.” And Bless their hearts is rarely meant in a complementary way in the South, in case you were unaware.  Which led to this doctor being promptly and immediately fired. Her name is Dr. Christina Propst and she was with Blue Fish Pediatrics in Houston if you want to look into it yourself.  The page at Blue Fish Pediatrics that used to have her bio now says, “This past weekend, we were made aware of a social media comment from one of our physicians. The individual is no longer employed by Blue Fish Pediatrics. As we previously mentioned in our original statement, we strongly condemn the comments that were made in that post. That post does not reflect the values, standards, or mission of Blue Fish Pediatrics. We do not support or condone any statement that politicizes tragedy, diminishes human dignity, or fails to clearly uphold compassion for every child and family, regardless of background or beliefs. We continue to extend our full support to the families and the surrounding communities who are grieving, recovering, and searching for hope. Sincerely, Blue Fish Pediatrics Leadership Team” She gone!! And good for them. She’s 100% wrong and they are right. Unfortunately, she’s not even close to being the only one with that kind of mentality. She’s just the most famous one at the moment. And trust me, something like this is NOT why any of you want to be famous. One more tip from your Ol’ Uncle Jeffro, friends.  Anyway, the point here is, yeah…I’m pretty spicy about how such a disaster has been politicized. It’s my state and I know people in the disaster. It’s more personal sure. I’m self aware on it. I also understand those that are concerned that DOGE cut too much and I understand those that hate Trump with every ounce of their being. I don’t personally like the guy myself so I get it. But there should be a self-governer within us that stops us from being a terrible person.  It goes both ways too. Let’s be fair. Thee Biden Administration was BLASTED just last year.However, the criticism you saw during the North Carolina flooding last year was not that Biden Administration caused the flood but that the response to take care of the people was a disaster in and of itself. I don’t recall anyone blaming the flooding on the administration itself though, or how NC voted, or any of that. This Texas flood has been a whole different deal in my experience.  One side is literally saying that the other side caused the death and destruction through cuts in various programs leading to a lack of proper warning leading to deaths, etc. Well, that’s just not the truth and it’s a little insane but the bigger point here is what is a good look on social media and what is not.  I mean, I get the school shootings. If that brings up the topic and a further discussion of stricter gun laws and things like that, I think that’s a legitimate discussion and a fair one to have. But a natural disaster? Come on bruh……that’s embarrassing for you folks posting like that.  If you are friends with me on social media, you may notice that I don’t engage in political discussions much and when I do, I am careful about it. I do not run one side down. I do not post about things when I’m pissed and I CERTAINLY don’t take a stance without educating myself thoroughly.  The main reason is that as soon as you take any stance, you lose half of your audience immediately. HALF. That’s up to and including saying you’re proud to be an American this year. Which is almost just la la land stuff to me. WHY would you purposefully lose half of your patient base and/or get blasted on social media and made famous for the wrong reasons? When all you had to do was shut the hell up and just discuss it amongst your inner circle?  My spouting off here this week is not really taking one side over the other, though I think anyone posting to score political points on this deal is sick.  It’s more about it being in extremely poor taste and is just a bad look to run to the keyboard every time a disaster takes place so that you can ‘one up’ the other side and score some imaginary points. Do you really think you’ll somehow change someone’s mind because of a stupid post on Facebook? I got some news for you friend…..you’re wasting your time, emotions, and energy because…..psssst…..nobody gives a damn. Not one single damn. We just aren’t that important. I’m sorry to break it to you.  And, again, I do not care what side you’re on. The kind of thinking that leads to this kind of posting is problematic and if that describes you, start figuring out what broke inside of you and what caused it so that you can fix it and ultimately….do better, be better, and raise kids that turn out better than you.  If I’m describing you, fix it or stay off of social media. Your practice, your employees, and your patients will be appreciative of your efforts. I promise. Nobody and I mean NOBODY wants to have to work with THAT person day in and day out.  It truly is the very worst of us and, unfortunately, social media has allowed it to step into center stage. And it’s gross.  Item #1 Our first one today is one I got from Dr. Mark King of Cincinnati and of Motion Palpation Institute fame. Mark is a good friend of mine and if he sends me something, better believe I’mma look at it.  It’s called, “Comparative safety and efficacy of manual therapy interventions for cervicogenic headache: a systematic review and network meta-analysis” by. Xu et al and published in Frontiers of Neurology on May 15, 2025 and it’s may caliente y en fuego! Remember, the citations can be found at chiropracticforward.com under this episode.  https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1566764/full https://doi.org/10.3389/fneur.2025.1566764 Why They Did It To evaluate and compare the safety and efficacy of spinal manipulation, mobilization, and massage for the management of cervicogenic headache (CGH) using meta-analytic techniques. How They Did It Comprehensive searches were conducted in Cochrane, Embase, PubMed, and ClinicalTrials.gov to identify studies investigating the effects of manipulation, mobilization, and massage on pain, disability, and physical function in patients with CGH.  Key outcomes included pain severity (visual analog scale, VAS), Neck Disability Index (NDI), Flexion-Rotation Test (FRT), and Headache Disability Inventory (HDI) at various follow-up timepoints. What They Found Fourteen studies totaling 1,297 CGH patients were included.  Standard pairwise meta-analysis revealed that sustained natural apophyseal glides (SNAG) mobilization produced significantly greater improvements compared to non-sustained natural apophyseal glides interventions in VAS, Neck Disability Index, Flexion-Rotation Test, and Headache Disability Inventory, with benefits maintained over time.  Cervical Spinal Mobilization exhibited significantly greater VAS reductions compared to exercise, massage, and mobilization, while mobilization was superior to exercise and massage for VAS.  For Neck Disability Index, Cervical Spinal Mobilization was significantly better than exercise, but no other between-group differences were observed. Wrap It Up In patients with CGH, sustained natural apophyseal glides mobilization can significantly improve pain and function, with benefits maintained in the long-term.  Additionally, Cervical Spinal Mobilization may be the most effective short-term intervention for reducing pain and disability compared to mobilization, massage, and exercise, although clinician expertise appears to be an important factor.   Item #2 Our last one this week is called, “Cost of chiropractic versus medical management of adults with spine-related musculoskeletal pain: a systematic review” by Farabaugh et al and published in Chiropractic & Manual Therapies on March 6, 2024. It’s steamy….but not hot.  Why They Did It The cost of spine-related pain in the United States is estimated at $134.5 billion. Spinal pain patients have multiple options when choosing healthcare providers, resulting in variable costs. Escalation of costs occurs when downstream costs are added to episode costs of care. The purpose of this review was to compare costs of chiropractic and medical management of patients with spine-related pain. How They Did It A Medline search was conducted from inception through October 31, 2022, for cost data on U.S. adults treated for spine-related pain.  The search included economic studies, randomized controlled trials and observational studies.  All studies were independently evaluated for quality and risk of bias by 3 investigators and data extraction was performed by 3 investigators. What They Found The literature search found 2256 citations, of which 93 full-text articles were screened for eligibility.  Forty-four studies were included in the review, including 26 cohort studies, 17 cost studies and 1 randomized controlled trial.  All included studies were rated as high or acceptable quality.  Spinal pain patients who consulted chiropractors as first providers needed fewer opioid prescriptions, surgeries, hospitalizations, emergency department visits, specialist referrals and injection procedures. Wrap It Up Patients with spine-related musculoskeletal pain who consulted a chiropractor as their initial provider incurred substantially decreased downstream healthcare services and associated costs, resulting in lower overall healthcare costs compared with medical management.  The included studies were limited to mostly retrospective cohorts of large databases. Given the consistency of outcomes reported, further investigation with higher-level designs is warranted Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.    Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & VloggerThe post Cervicogenic Headache Treatment & Seeing A Chiropractor First Means Less Expense Overall appeared first on Chiropractic Forward.

CF 368: Spinal Manipulative Treatment And Biochemical Markers & SMT For Lumbar Disc Herniation Today we’re going to talk about Spinal Manipulative Treatment And Biochemical Markers & SMT For Lumbar Disc Herniation.  But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #368 Now if you missed last week’s episode, we talked about Transcranial Direct Current for Fibromyalgia & Methotrexate For Knee Osteoarthritis. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Things are clicking along this Summer. Still getting back up to steam. We have the big Texas Chiropractic Association ChiroTexpo coming up this weekend in Frisco, TX which is basically Dallas.  This is our state convention. We usually have around 400 or so attendees. Good stuff. It’s a great time to reconnect to old TCA buddies and to connect with the newer, younger group coming up in the Association and some of the newer folks are just brilliant. It’s a joy to see.  I’m still involved. I’ve been involved for a long time now on the state level. I’ve been in the seat when we were fighting the Texas Medical Association for our right to diagnose or for our right to keep acupuncture or for our right to keep the Neuro aspect of neuromusculoskeletal…..I’ve been there. And I can tell you that you tend to form a bond with those that are in the seats next to you and across from you when you’re in the middle of these battles.  If you are not involved in your state association or the ACA, I cannot encourage you quite enough to raise your hand and jump in. There are only 25% of chiropractors in the state of Texas that are members of our association. But I promise, 100% of them want their rights to practice protected.  That’s a damn promise. Take that to the bank folks.  Well, that’s taking instead of giving, isn’t it? That’s actually the definition of it and, honestly, the apathy in our industry is straight up appalling. Most just don’t know what’s going on in their own profession on a state or a national level.  I can give you time after time when I was able to call my fellow TCA connections and friends and bounce something off of them. Whether it was an idea or a problem. They’ve come through for me a million times.  I had an evidence-based chiro tell me they don’t get involved because they’re state association is all vitalists. Wouldn’t you think that THAT WOULD BE THE PERFECT REASON TO GET INVOLVED? Well, is the perfect reason but it was being used as an excuse to continue being a lazy taker rather than a giver.  I get to influence who speaks at our events. Don’t you think that’s important? If you have a ton of vitalists influencing your membership, that’s no bueno mi amigo. But if you have top-notch genius evidence-based chiros speaking, well, I can only imagine that it would make an incredible impact. And it does.  I had a buddy, Dr. Ben Fergus, say something that I thought was just wonderful. He said, “The body responds to force and repetition.” I use that with my patients all day every day now. Because it’s true. I’d say the same goes for changing your profession. Your profession responds to positive forces used repetitively. Over time, vitalists will dwindle. They’ll always be amongst us. I’m not a fool. But they will eventually be out of the drivers’ seats and more toward the back of the short bus.  But ONLY if our evidence-based, high-performing doctors get off their asses, get involved, and make it happen. Otherwise, we keep sitting back watching it happen and bitching to each other about it non-stop.  So….this is your call. Google your state association, get the name and contact info for your states executive director and/or executive committee members, then email them and tell them you’d like to get more involved. Raise your hand. They’re desperate for active members. Alright, go google it up and send that email right now, then come back and let’s cover some research! Item #1 The first one this week is called ,”Changes in biochemical markers following a spinal manipulation – a systematic review update” by Sampath et al and published in Journal of Manual & Manipulative Therapy in August of 2023.  Remember, the citations can be found at chiropracticforward.com under this episode.  Kovanur Sampath, K., Treffel, L., P.Thomson, O., Rodi, J. D., Fleischmann, M., & Tumilty, S. (2023). Changes in biochemical markers following a spinal manipulation – a systematic review update. Journal of Manual & Manipulative Therapy, 32(1), 28–50. https://doi.org/10.1080/10669817.2023.225218 Why They Did It The aim of this systematic review was to update the current level of evidence for spinal manipulation in influencing various biochemical markers in healthy and/or symptomatic population. How They Did It This is a systematic review update.  Various databases were searched from May 2023 and fifteen trials with 737 participants that met the inclusion criteria were included in the review.  Two authors independently screened, extracted and assessed the risk of bias in included studies.  Outcome measure data were synthesized using standard mean differences and meta-analysis for the primary outcome which were biochemical markers.  The GRADE criteria was used for assessing the quality of the body of evidence for each outcome of interest. What They Found There was low-quality evidence that spinal manipulation influenced various biochemical markers (not pooled).  There was low-quality evidence of significant difference that spinal manipulation is better than control in eliciting changes in cortisol levels immediately after intervention.  Low-quality evidence further indicated (not pooled) that spinal manipulation can influence inflammatory markers such as interleukins levels post-intervention. There was also very low-quality evidence that spinal manipulation does not influence substance-P, neurotensin, oxytocin, orexin-A, testosterone and epinephrine/nor-epinephrine. Wrap It Up Spinal manipulation may influence inflammatory and cortisol post-intervention. However, the wider prediction intervals in most outcome measures point to the need for future research to clarify and establish the clinical relevance of these changes. Item #2 Our last one this week is called, “Brain plasticity following lumbar disc herniation treatment with spinal manipulation therapy based on resting-state functional magnetic resonance imaging” by Du et al and published in Heliyon in September of 2024 and that’s just hot enough! https://www.cell.com/heliyon/fulltext/S2405-8440(24)13734-6 Why They Did It As a prevalent spine disorder, Lumbar disc herniation (LDH) has been affecting more than 2 % of the worldwide population and is characterized by uncertain causes and recurring episodes.  Studying the brain activity of patients could potentially provide insights into its pathogenesis and significantly enhance therapy.  Therefore, we here examined brain function in patients under Spinal Manipulative Therapy (SMT).  By analyzing regional homogeneity (ReHo) at different frequency bands, we identified the discrepancies in brain activity between LDH patients and healthy people, highlighting the frequency dependence of spontaneous low-frequency oscillations among patients with LDH. How They Did It The test subjects underwent a single fMRI scan upon enrollment.  Patients with LDH underwent their initial functional MRI scan after completing the VAS and C-SFODI scales.  They then completed a second assessment of the VAS and C-SFODI scales, along with another fMRI scan, after receiving six adjustments. The clinical evaluation indicators were as follows:  The VAS was used to assess the patient’s pain level; The Chinese Short Form Oswestry Disability Index Questionnaire (C-SFODI) was used to evaluate the patient’s functional limitations.  Wrap It Up Overall, this study showed that SMT significantly reduced pain, improved dysfunction, and partially rectified aberrant local consistency and functional connection in patients with LDH, not only offering insights into the pathophysiology of LDH from a neurological standpoint, but also providing inspiration for the development of new therapies based on neurobiology. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger            The post Spinal Manipulative Treatment And Biochemical Markers & SMT For Lumbar Disc Herniation appeared first on Chiropractic Forward.

CF 367: Transcranial Direct Current for Fibromyalgia & Methotrexate For Knee Osteoarthritis Today we’re going to talk about Transcranial Direct Current for Fibromyalgia & Methotrexate For Knee Osteoarthritis But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #367 Now if you missed last week’s episode, we talked about Europe, SMT Review, & Informed Consent.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. OK, on to week two of my post-Europe, post-14-day vacation. The first 2-week vacation I’ve taken in almost 30 years. The vacay I was anxious about and borderline freaking about because I thought my practice would be a ghost town when I got back.  In last week’s episode, I gave you a precise guideline of how I was able to avoid the ghost town scenario so I won’t re-hash it. Go listen to episode #366 if interested in my exact timeline and strategy.  Remember, I want to see around 165 for so per week but have been a little slow this year for many reasons. One would be me losing both my Mom and my Dad within 2 months of each other and my truck dying and having to be replaced within that time frame at the same time. There’s no way that doesn’t affect your work life in some way.  So, although I want to see 165+, this year I’ve been seeing closer to 140 or so per week. Not something I’ve been happy about either. Several factors play in on that. One being that the VA hired a chiropractor and all of the veterans went away. That was a big hit. But that chiro went back to Pennsylvania and now the veterans are returning. Thank the good Lord.  All of that to tell you this: I’m looking at 151 on the schedule at the moment and that’s on a Tuesday so we’ll end up with more as we have new ones pop on and some re-schedule. Maybe we’ll wind up around 160+ and that’s in June, which is not typically our busiest time of the year.  Once again, take that vacation!! One more tip from your Ol’ Uncle Jeffro.  Item #1 Our first one today is called, “Home-Based Transcranial Direct Current Stimulation vs Placebo for Fibromyalgia A Randomized Clinical Trial” by Caumo et al and published in JAMA Network Open on June 6, 2025 and that’s D-Day hot damnit!! Remember, the citations can be found at chiropracticforward.com under this episode.    Caumo W, Franca BR, Orzechowski R, et al. Home-Based Transcranial Direct Current Stimulation vs Placebo for Fibromyalgia: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(6):e2514262. doi:10.1001/jamanetworkopen.2025.14262   Why They Did It Previous trials with smaller samples and shorter follow-up periods showed that multiple-session home-based anodal transcranial direct current stimulation (A-tDCS) on the left dorsolateral prefrontal cortex (DLPFC) improved fibromyalgia symptoms. However, the duration of the effect, the influence of exercise and pain neuroscience education (PNE), and the role of placebo remain unclear. Objective  To evaluate whether A-tDCS targeting the left DLPFC, combined with exercise and PNE, is more effective than sham tDCS in reducing pain and disability, based on placebo-test responses (responders vs nonresponders). How They Did It This double-blind, sham-controlled randomized clinical trial enrolled women aged 18 to 65 years with fibromyalgia.  Participants were randomized to receive the real deal or the sham treatment between April 2022 and April 2024.  They were treated at home and at the outpatient Clinical Research Center What They Found I’m not going to tell you. Because I want you to enjoy this podcast and not question your life choices by listening to it so instead of diving head first into weeds most of us do not frequent, we’ll just go to the Wrap Up  Wrap It Up This trial found that anodal transcranial direct current stimulation along with exercise and pain neuroscience education improved disability due to pain, especially in placebo test responders. The findings support fibromyalgia management and enhance understanding of dorsolateral prefrontal cortex-related placebo effects. Just another feather in your cap if you have Fibro patients that are at the end of their ropes and you can send them somewhere or tell them about some new research you just became aware of that could potentially help.  Just a random tip from your Ol’ Uncle Jeffro.  Item #2 Our last one this week is called, “Low-Dose Methotrexate for the Treatment of Inflammatory Knee Osteoarthritis A Randomized Clinical Trial” by Zhu et al published in JAMA Intern Med on June 2, 2025……the roof is on fire! Zhu Z, Yu Q, Leng X, et al. Low-Dose Methotrexate for the Treatment of Inflammatory Knee Osteoarthritis: A Randomized Clinical Trial. JAMA Intern Med. Published online June 02, 2025. doi:10.1001/jamainternmed.2025.1359   Why They Did It A recent study reported that methotrexate may reduce joint pain in patients with inflammatory hand osteoarthritis (OA). However, it remains unknown whether methotrexate has similar effects on inflammatory knee OA. Objective  To examine whether methotrexate has symptom-relieving and disease-modifying effects for participants with knee OA and effusion-synovitis. How They Did It This multicenter, placebo-controlled randomized clinical trial was conducted at 11 sites in China between July 18, 2019, and January 15, 2023.  Community-dwelling patients with inflammatory knee OA with effusion-synovitis on magnetic resonance imaging were included. Participants were randomly assigned (1:1) to receive methotrexate, up to 15 mg weekly, or placebo using block randomization, stratified by study site. The primary outcomes were knee visual analog scale (VAS) pain change and effusion-synovitis maximal area change, over 52 weeks in the intention-to-treat population. What They Found Of 278 participants screened, 215 participants, and 175 (81%) completed the trial.  Changes in VAS pain and effusion-synovitis maximal area were not significantly different between the methotrexate and placebo group over 52 weeks.  No significant between-group differences were found for any of the pre-specified secondary outcomes.  At least 1 adverse event occurred in approximately 32 participants (29.6%) in the methotrexate group and 26 participants (24.3%) in the placebo group. Wrap It Up The results of this randomized clinical trial show that, compared to placebo, low-dose methotrexate did not reduce pain or effusion-synovitis over 52 weeks in patients with knee OA and effusion-synovitis. So, remember, in most places, it is beyond our scope to put people on or try to take them off of meds. However, if you get a knee OA patient that’s taking methotrexate, you can absolutely share this info with them and suggest they share it with the one that prescribed it and have a discussion. That’s appropriate in my opinion.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Transcranial Direct Current for Fibromyalgia & Methotrexate For Knee Osteoarthritis appeared first on Chiropractic Forward.

CF 366: Europe, SMT Review, & Informed Consent Today we’re going to talk about Europe, SMT Review, & Informed Consent But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #366 Now if you missed last week’s episode, we talked about  Dosing Lumbar SMT & Short Term Effects of Different Forms of SMT Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, as mentioned when we last left off, I was headed to Europe for a VoiceOver retreat and VoiceOver retreat I did. Went, saw, and conquered.  One thing that struck me as interesting and something that maybe some of you can relate to is that I have some form of anxiety. Most of it is absolutely useless. I have it in all aspects of my life and it drives me crazy.  For example, this trip to Europe, I’ve never been across the pond before so I was losing sleep about the trip. What if a plane is late and causes us to miss our connection? What if we can’t figure out the train system? What if I have a hard time with all of the bags getting on and off the trains? What if they lose a bag on one of our flights? What if we have a hard time getting where we need to be? What if I can’t communicate with the people I need help from? Yeah……all of that stuff.  Welcome to my brain. That’s my life on the reg, as the kids say.  I do it with the clinic too. What if it stays slow? What if I can’t get our collectors to get it going this month? What if’s out the damn wazoo.  Now, to some extent, that’s helpful, right? Keeps you on your toes and doing what we’re supposed to be doing. On the other side of that though, it can be detrimental. It can make you miserable, stressed, and not so healthy.  Here’s the thing my mom used to tell me, “”99% of the things we worry about never ever happen.”” And she was right.  We had smooth travels in Europe. They lost our bag on a direct flight from Edinburgh Scotland to Amsterdam but after about an hour, they found it. Other than that, everything was smooth sailing, everyone spoke English, and we did everything we wanted with no issues.  Well, except for in Paris when their soccer team won their first-ever championship and the town had riots two nights in a row but, even that stupidity was able to be navigated through.  Edinburgh was magical, Amsterdam was fun, Valkenburg was relaxing, and Paris was beautiful. The French folks were super nice. Don’t buy into the haters. It was great.  Now that we’ve been once, we can’t wait to return. What will our next adventure be? Time will tell.  Now tying that back into clinic life, that’s the first time in 28 years that I’ve been out of the clinic for 2 weeks straight. That’s stressful, right? It’s not the cost of a trip that keeps me from going. It’s the cost of being gone out of the clinic that keeps me from going.  Let’s say a trip will cost $20k overall. OK, that stings a little but we can figure that out. BUT …..for round numbers and easy math….let’s say I bill out $100k per month and I’m gone for 2 weeks, that’s a loss of $50k. So that makes it a $70k trip, folks. And that freaking hurts.  Most of my career has been spent taking little 4-5 day trips leaving on a Thursday and coming back on a Monday or something like that. I’m sure you can relate.  On this one, I worked Wednesday morning from 8-10:30 am on Wednesday and saw only about 14 patients. For the three days of that week, we saw about 100. I’m typically seeing around 150+ per week for context.  We had a coverage doc come in for three days that week I was gone all week. So they saw 86 in those 3 days.  Then, on the week I got back, I missed Monday and Tuesday. We flew in Wednesday morning from Europe and I was back at work Wednesday afternoon. Yes…..I was tired. BUT, for that week I saw 110.  So, you can see that yes…we missed out on some patients. No doubt. But we were able to minimize the damage.  Now the job I have is rebuilding the numbers. Here it is my first Monday back from vacay and we are set with 105 for the week. No, that’s not where I want to be but y’all know how that works. Our Monday patients will reschedule Wednesday and Friday and I suspect we’ll end up somewhere around 135 or 140 this week.  That’s not too much of a drop-off. So I think my strategy may have worked. One of my mastermind colleagues shared with me that he went to Europe for two weeks and it took him a month to rebuild his clinic when he got back. And that’s with an associate. I don’t have an associate. He freaked me the hell out.  I think that we have managed to minimize the hit to our numbers and will hopefully be back to full steam by the end of the week and starting of next week.  Anyway, kind of in the weeds a bit there but I wanted to share with you all how I think we were able to leave for two weeks with minimal damage to our bottom line. Maybe it’ll come in useful for you too. Work a little on Wednesday in the morning, fly out in the afternoon, hire coverage three days the full week you’re gone, and fly in Tuesday or Wednesday morning and get back at it Wednesday afternoon. Great formula I think.  Just a tip from your ol Uncle Jeffro.  Alright that’s it, let’s hop in.    Item #1 Our first one this week is called “Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations” by Trager et al and published in the Journal of Clinical Medicine in August of 2024 and it’s hot enough for some hot talk! Remember, the citations can be found at chiropracticforward.com under this episode.  Trager RJ, Bejarano G, Perfecto R-PT, Blackwood ER, Goertz CM. Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. Journal of Clinical Medicine. 2024; 13(19):5668. https://doi.org/10.3390/jcm13195668 This one is a little more than just a short thing we can breeze through so I did a little Grok AI summary and he’s what we got.  It provides a comprehensive review of chiropractic care, focusing on spinal manipulative therapy (SMT) from 1972 to 2024. Key Points: Historical Context and Growth: Chiropractic care, particularly SMT, has seen increased utilization in the U.S. since Medicare authorized payment for chiropractic SMT in 1972. The study analyzed 6,286 articles from Scopus (1972–2024), noting an upward trend in publication rates. Early research focused on the profession’s history, scope, and regulatory aspects, while recent studies emphasize randomized controlled trials and systematic reviews. Research Trends: Keywords in chiropractic literature have evolved from historical and medicolegal topics to evidence-based research, reflecting a shift toward scientific validation. Common conditions treated include low back pain, neck pain, and other musculoskeletal disorders, with growing interest in SMT’s mechanisms and efficacy. Clinical Practice Guidelines (CPGs): The review analyzed CPGs from 2013 to 2024 (sourced from PubMed, Scopus, and Web of Science), finding consistent recommendations for SMT in managing low back pain and neck pain. Guidelines often support SMT for acute and chronic musculoskeletal conditions but highlight the need for further research on long-term outcomes and specific patient populations. Evidence Gaps: Despite progress, gaps remain in understanding SMT’s mechanisms, optimal treatment protocols, and effectiveness for non-musculoskeletal conditions. Limited high-quality evidence exists for certain applications, and there is a need for standardized outcome measures and larger, well-designed trials. Implications: The authors emphasize the importance of addressing evidence gaps to strengthen the scientific foundation of chiropractic care. They advocate for integrating CPG recommendations into practice to enhance patient outcomes and inform policy decisions. Conclusion: The paper underscores the growing acceptance of chiropractic SMT, supported by increasing research and guideline endorsements, particularly for musculoskeletal disorders. However, it calls for further studies to address evidence gaps and optimize clinical applications.   Item #2 Our second one this week was sent to me by my buddy, Dr. Steve Brown hailing from Gilbert, AZ. Gilbert, gateway to Tucson.  It is titled, “THE CONNECTICUT LAW ON CHIROPRACTIC INFORMED CONSENT TO CERVICAL ARTERY DISSECTION AND STROKE: A NARRATIVE REVIEW” Dr. Brown wrote this article with Dr. Robert Cooperstein and it was published in Journal of Contemporary Chiropractic on June 2, 2025 and it’s hot hot hot, en fuego!   Brown S, Cooperstein R. THE CONNECTICUT LAW ON CHIROPRACTIC INFORMED CONSENT TO CERVICAL ARTERY DISSECTION AND STROKE: A NARRATIVE REVIEW. JCC. 2025;8(1):162-169. https://journal.parker.edu/article/139042-the-connecticut-law-on-chiropractic-informed-consent-to-cervical-artery-dissection-and-stroke-a-narrative-review   Why They Did It This paper reviews the evidence considered by the Connecticut Board of Chiropractic Examiners in their 2010 memorandum concluding  stroke or cervical artery dissection (CAD) is a not likely to be a risk or side effect of joint mobilization, manipulation, or adjustment of the cervical spine; and  chiropractors are not required to address stroke or CAD as a part of securing informed consent by patients for such treatment.  The 2010 memorandum contains 5 Findings of Fact. An additional objective of this narrative review was to determine if there is sufficient evidence to support the Board’s third and fourth Findings of Fact. How They Did It We analyzed the 2010 memorandum to determine what evidence was considered by the Connecticut Board in arriving at their third and fourth Findings of Fact. Analysis revealed that the Connecticut Board reviewed 3 studies. All 3 studies were acquired and reviewed. What They Found Analysis of the Connecticut Board’s 2010 memorandum shows that they relied solely on the first conclusion of the 2008 Cassidy et al. study, Risk of Vertebrobasilar Stroke and Chiropractic Care: Results of a Population-based Case-Control and Case-Crossover Study. Wrap It Up We conclude that the third and fourth Findings of Fact in the 2010 memorandum of the Connecticut Board of Chiropractic Examiners are not supported by the evidence.  Patients have the right to consider whether the clinical benefits they seek are worth the inherent risks.  The present authors therefore recommend that chiropractors include the risk of stroke and/or CAD in securing informed consent by patients to manipulation of the cervical spine.  This practice would be both evidence-based and patient-centered, and constitute an important element of the chiropractic standard of care. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in the leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Europe, SMT Review, & Informed Consent appeared first on Chiropractic Forward.

CF 365: Dosing Lumbar SMT & Short Term Effects of Different Forms of SMT Today we’re going to talk about Dosing Lumbar SMT & Short Term Effects of Different Forms of SMT But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #365 Now if you missed last week’s episode, we talked about SMT And Stroke & Metformin For Knee Osteoarthritis Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. It’s a bit of a rush this week. I can’t even tell you why. It just is. Anxiety is at a high point with this trip next week to Europe. There won’t be a new episode for 2-3 weeks because of the trip plus I’ll be playing catch up when I get back so let’s let the dust settle and then I’ll get back on it and kick out new episodes.  Iin case you don’t know what I’m talking about, I’m headed to Europe for a voice over retreat. Voice acting has become quite the side gig. In fact it’s not a side gig. I basically have two full time gigs. Chiropractic and voice over.  This retreat will serve several purposes but basically, it’s a networking thing, I’ll learn some, make lots of connections, and have a tax deductibe reason to go to Europe. So we’re doing it and I’m excited about it.  Scotland, Amsterdam, Valkenburg, and Paris….look out because ol’ Uncle Jeffro is coming your way. So, I’mma keep it short in the personal happenings. We’re tryinng to close on the sale of 60% of the practice this week. More to come on that.  For now, let’s see what research we can get hold of here.  Item #1 Our first one this week is called, “Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial” by Garcia-Gonzalez et al and published in Heathcare on June 2024 and it’s still pretty hot! Remember, the citations can be found at chiropracticforward.com under this episode.  García-González J, Romero-del Rey R, Martínez-Martín V, Requena-Mullor M, Alarcón-Rodríguez R. Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial. Healthcare. 2024; 12(13):1348. https://doi.org/10.3390/healthcare12131348 Why They Did It Spinal manipulations for chronic non-specific neck pain (CNNP) include cervical, cervicothoracic junction, and thoracic spine (CCT) manipulations as well as upper cervical spine (UCS) manipulations.  This study aimed to compare the short-term effects of upper cervical spine manipulation versus a combination of cervical, cervicothoracic junction, and thoracic spine spine manipulations on pain intensity, disability, and cervical range of motion (CROM) in chronic non-specific neck pain patients How They Did It In a private physiotherapy clinic, 186 participants with chronic non-specific neck pain were randomly assigned to either the upper cervical spine (n = 93) or cervical, cervicothoracic junction, and thoracic spine (n = 93) manipulation groups.  Neck pain, disability, and cervical range of motion were measured before and one week after the intervention. What They Found No significant differences were found between the groups regarding pain intensity and cervical range of motion.  However, there was a statistically significant difference in neck disability, with the cervical, cervicothoracic junction, and thoracic spine group showing a slightly greater decrease Wrap It Up The findings suggest that a combination of manipulations in the cervical, cervicothoracic junction, and thoracic spine spine results in a slightly more pronounced decrease in self-perceived disability compared to upper cervical spine manipulation in patients with chronic non-specific neck pain after one week.  However, no statistically significant differences were observed between the groups in terms of pain intensity or cervical range of motion. Item #2 Our second one is called, “Dosing of lumbar spinal manipulative therapy and its association with escalated spine care: A cohort study of insurance claims” by Anderson et al and published in Plos One on January 5 of 2024 and it’s just a little steamy https://doi.org/10.1371/journal.pone.0283252 Why They Did It The objective of this study was to evaluate the relationship between three distinct spinal manipulative therapy dose groups and escalated spine care by analyzing insurance claims from a cohort of patients with low back pain. How They Did It We compared three distinct spinal manipulative therapy dose groups  low = 1 SMT visits,  moderate = 2–12 SMT visits,  high = 13+ SMT visits to a control group (no spinal manipulative therapy) regarding the outcome of escalated spine care.  Escalated spine care procedures include imaging studies, injection procedures, emergency department visits, surgery, and opioid medication use.  Propensity score matching was performed to address treatment selection bias.  Modified Poisson regression modeling was used to estimate the relative risk of spine care escalation among three spinal manipulative therapy doses, adjusting for age, sex, retrospective risk score and claim count. What They Found There were lots of findings and dizzying numbers that would make you go cross eyed and your ears smoke like a Choo Choo train. So we’re skipping to the conclusion here.  Wrap It Up For claims associated with initial episodes of low back pain, low and moderate dose spinal manipulative therapy groups were associated with a 55% and 42% reduction, respectively, in the relative risk of any escalated spine care. Alright, that’s it. See ya in a few weeks friends! Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Dosing Lumbar SMT & Short Term Effects of Different Forms of SMT appeared first on Chiropractic Forward.

CF 364: Spinal Manipulative therapy And Stroke & Metformin For Knee Osteoarthritis Today we’re going to talk about SMT And Stroke & Metformin For Knee Osteoarthritis But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #364 Now if you missed last week’s episode, we talked about Lateral Lumbar Stenosis & Manual Therapy Combined With PT Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Man, what have I been up to? Let’s see, I went to Charleston weekend before last, we had the big MCM Mastermind quarterly meeting with Dr. Kevin Christie and other incredibly smart, high level docs.  I get plenty fromt he speakers but the majority of what you get is with the side, private discussions with fellow group members and the friendships and the network that builds out from there.  I came back from this one with a solid direction to add $50k-$100k per year to the practice. I’d say that’s worth the the yearly membership and travel finances. Very much worth it.  Outside of that, I’ve been doing a pretty deep dive on AI lately and how it can add to my life and help with the clinic. It’s just stunning if I’m being honest. It surprises me every single day, basically.  I’ve been testing them all but have really settled in on ChatGPT, for now at least. It seems to have the edge for me. It named itself Chippy. I helped it but yeah….Chippy is coming in pretty damned handy these days.  Here are some of what Chippy has been up to: It helped me organize my thoughts on my dad’s obituary and really helped me smooth it out It’s helped a ton on VoiceOver with helping me expand that. Marketing ideas, lead generation, things like that Helped me with some anxiety I have around my first big European trip in about 15 days. It answered questions about Heathrow airport, the baggage situation, etc. Even found the embassy numbers for me! I’ve been kicking around the idea of a new YouTube channel using AI and it helped me formulate that idea It gave me a daily schedule reverse-engineered from what I want my final result to be. Broke it down into 15-30 increments to help me build daily and weekly habits to get me where I need to be.  Chippy helps me with brainstorming ideas all of the time.  Of course it’s helped with social media postings and marketing campaigns.  My wife runs her family’s oil trust and they have interest in around 180+ oil wells. She’s never had to keep track of all that stuff so Chippy broke down everyhtiing she needs to be doing, how to do it, and then how to train a virtual assistant to do it every month.  And a million other things…. AI is amazing. Chippy is astounding. Yeah, AI worries me. I have concerns about whether the VoiceOver business will even be a business in 5 years. I have concerns about the bots taking over the world some day. I have all of those worries. But if we don’t use it, we fall behind. If we don’t use it, we get beat by those that embraced it. I truly believe that.  I’m using it. I’m just saying thank you and please so that if they do take us over, I’ll be one of the last to go. : ) Outside of that, I’m still walking through the steps toward closing on the sale of 60% of the practice. We’re bringing in a partner and I can’t wait. They’ll do HR, billing, collecting, and all of the soul-sucking part of it.  I’ll get a percentage of my collections off of my services. I’ll get 40% of the profits of the clinic, and I’ll get the loan payment from the sale every month until the balance is paid off.  I have their guarantee that issue #1 is to get an associate chiropractor in here to take some heat off of myself. Here’s my deal and listen up close, mi amigos.  I have a friend that got cancer in his late 60s. He died last year. Nobody would buy his clinic so, at the end of the day, his wife sold off the equipment and that was it.  I’ve had COVID 5-6 times now and I’ve only missed one day of work. That’s not fair to me, my family, my patients, or my staff when the entire operation depends so much on me being in the office working on patients personally.  I think I’m irresponsible if I don’t do my part to make it more stable and more sustainable when I am not present. When I’m not in the clinic personally. So that’s a big part of what I’m trying to accomplish here.  I have two TCA colleagues that have done this with this company already and they both said they work less and make more. I went to the owner’s retreat in February and met their other 11 owners. They all said they’d do it again and wish they’d have done it sooner.  So, I’m doing it for my future, for stability, for longevity, for my sanity, and for a higher quality of life. My life at this point is a good life. But it’s not the life I would imagine or desire for myself. Not yet anyway. Once I get some support, life improves.  If you want more info to see if that’s something you’d like to explore, give me a shout at [email protected].  Item #1 Our first one today is by my good friend Dr. Steve Brown out in Gilbert, AZ. Dr. Brown has been an expert witness in several court cases involving DCs and strokes. I met Dr. Brown in Chicago a year and half or so at my Forensics Diplomate conference. He was attending and speaking at the event.  In fact, I was on the elevator talking to someone and a voice from the back of the elevator said, “Hey, aren’t you the guy with the podcast?” Or something like that. Lol.  That started a friendship and Dr. Brown is not just a buddy now but a go-to source for everything SMT or stroke related. He gets beat up by some other DCs that don’t like what he has to say but at the end of the day, he’s a proponent of educating and of DCs being educated thoroughly so that you can avoid the hot seat. So, ignore him at your peril.  Dr. Brown has 10 peer reviewed studies under his belt now so the dude knows his stuff. When I get my life together and have an opportunity to start having guests on the podcast again, he’ll be the first one.  With that said, let’s dive into his latest called, “Stroke vs. toxin release after chiropractic spinal manipulation: A plausible hypothesis” by Dr. Steven Brown and published in Medical Hypostheses in May of 2025 and Shitake Mushrooms….that’s hot. Remember, the citations can be found at chiropracticforward.com under this episode.  Stroke vs. toxin release after chiropractic spinal manipulation: A plausible hypothesis, Medical Hypotheses, Volume 198, May of 2025, 111629, ISSN 0306-9877, https://doi.org/10.1016/j.mehy.2025.111629. (https://www.sciencedirect.com/science/article/pii/S0306987725000684) Why They Did It Multiple chiropractors report that some patients experience symptoms of dizziness/vertigo, nausea/vomiting, neck pain, headaches, sweating, fatigue, diarrhea, and fever after spinal manipulation. These chiropractors attribute these symptoms to toxic release caused by spinal manipulation. The objective of this study was twofold. First, to evaluate the research supporting the claim that these symptoms after spinal manipulation are the result of toxin release. Second, to propose a plausible alternative hypothesis for these symptoms of alleged toxin release. How They Did It PubMed, Index to Chiropractic Literature, and Google Scholar were searched from inception to November 2024.  What They Found This is a novel hypothesis. No peer reviewed studies were found supporting or refuting the proposition that alleged toxin release following neck manipulation is instead a minor ischemic stroke. However, the proposition that cervical spine manipulation can cause a thromboembolic stroke when performed in the presence of an existing undiagnosed cervical artery dissection is not novel.  This mechanism of causation has been supported in 15 peer reviewed studies by researchers from neurology, Courses reviewing the body of research on the potential causal relationship between cervical spine manipulation and stroke should be mandatory for chiropractic students.  Mandatory annual continuing education courses on the adverse effects of spinal manipulation, including stroke, are indicated for chiropractors. Wrap It Up These symptoms of alleged toxin release after cervical spine manipulation may instead be an adverse event, a minor thromboembolic ischemic stroke caused by performing neck manipulation in the presence of an undiagnosed cervical artery dissection.  More education and clinical training in arterial dissection and stroke are recommended for chiropractors. Look, it’s complicated and I know Dr. Brown would agree with that statement. There are no simple and easy answers. We are all at risk of having patients that are dangerous to adjust their cervical area with HVLA.  We know that Chaibi 2017 tells us that the main symptoms of danger are neck pain, headache, nausea, dizziness. Well hell. How many patients do we have that fit the neck pain and headache category? All day every day.  I’ll put the research link at this point in the notes: https://www.tandfonline.com/doi/full/10.1080/07853890.2019.1590627?fbclid=IwAR3IYn5P5ppJsYymEpHEQe8AmOhNzH8xOfPJaswqNx3EQND-KiCxaXIK7LQ   But in Chaibi they say these are the key symptoms: New, sudden-onset neck pain or headache (especially if different in character than previous headaches) Pain localized behind the eye or in the upper neck Neurological symptoms, such as: Dizziness or vertigo Diplopia (double vision) Dysarthria (difficulty speaking) Dysphagia (difficulty swallowing) Drop attacks or sudden weakness Ataxia or imbalance Numbness or tingling Signs of Horner’s syndrome (ptosis, miosis, anhidrosis on one side of the face) Well that’s a little more than a simple headache or neck pain, right? So that’s a little more clarity.  Jsut be educated. It’s not typically the older folks you’d think it is. It’s the young female that is usually vascularly compromised from hypermobility, EDS, connective tissue disorders.  Just a tip from your Ol’ Uncle Jeffro   Item #2 Our last one is called, “Metformin for Knee Osteoarthritis in Patients With Overweight or Obesity A Randomized Clinical Trial” by Pan et al and published in JAMA Network on April 24, 2025 and it’s all hotter a tin roof in Texas.  Pan F, Wang Y, Lim YZ, et al. Metformin for Knee Osteoarthritis in Patients With Overweight or Obesity: A Randomized Clinical Trial. JAMA. Published online April 24, 2025. doi:10.1001/jama.2025.3471 https://jamanetwork.com/journals/jama/fullarticle/2833338?guestAccessKey=d11068e6-4d4d-48d2-ae41-e4c6dc1e0c2c&utm_source=silverchair&utm_medium=email&utm_campaign=jama_network&utm_content=network_highlights&utm_term=050425&adv=000003189471   So let’s start here: Traditionally, Metformin is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. So….it surprised me when I saw a paper having to do with metformin possibly being used in knee osteoarthritis. The math wasn’t mathing for me so it caught my eye and surprised me. So here we go.  Why They Did It To evaluate the effects of metformin on knee pain at 6 months in participants with symptomatic knee osteoarthritis and overweight or obesity. How They Did It Community-based randomized, parallel-group, double-blind, placebo-controlled clinical trial Individuals with knee pain for 6 months or longer, a pain score greater than 40 out of 100 on the visual analog scale (VAS), and body mass index of 25 or higher were recruited from the community through local and social media advertisements in Victoria, Australia, between June 16, 2021, and August 1, 2023.  Interventions  Participants were randomly assigned to receive either oral metformin, 2000 mg/d (n = 54), or identical placebo (n = 53) for 6 months. Main Outcomes and Measures  The primary outcome was change in knee pain, measured using a 100-mm VAS (score range, 0-100; 100 = worst; minimum clinically important difference = 15) at 6 months. What They Found Of 225 participants assessed for eligibility, 107 (48%) were randomized and assigned to receive metformin or placebo.  Eighty-eight participants (82%) completed the trial.  At 6 months, the mean change in VAS pain was −31.3 in the metformin group and −18.9 mm in the placebo group, corresponding to an effect size (standardized mean difference) of 0.43.  The most common adverse events were diarrhea and abdominal discomfort. Wrap It Up These results support use of metformin for treatment of symptomatic knee osteoarthritis in people with overweight or obesity. Because of the modest sample size, confirmation in a larger clinical trial is warranted. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Spinal Manipulative Therapy And Stroke & Metformin For Knee Osteoarthritis appeared first on Chiropractic Forward.

  CF 363: Lateral Lumbar Stenosis & Manual Therapy Combines With PT Today we’re going to talk about Lateral Lumbar Stenosis & Manual Therapy Combines With PT But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #363 Now if you missed last week’s episode, we talked about Coffee In The Morning & PRP Beats Cortisone In Meta-Analysis. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Still progressing on the sale of 60% of the clinic. That’s an ongoing process, of course. It’s hard to turn over almost 30 years of blood, sweat, and tears but I’m also tired of blood, sweat, and tears, if you know what I mean. Lol.  We are in the part of it all now where we’ve been sent a contract and have hired a contract attorney down in Dallas to review it and make sure we’re not doing anything entirely stupid. I trust this company and really like the folks running it. Quite a bit as a matter of fact.  But, let’s face it; it’s a business and when the contract is generated by them, it probably favors them. Of course. It’s important to spend the money and hire your own advocate just to make sure. Regardless of your feelings of the folks running it. At the end of the day, it’s your baby and it’s your future so you gotta have an advocate so you know what you’re getting into.  That’s where we are with that. Just waiting on that process to play out. And I’ll keep you updated as always.  What else? I have my MCM Mastermind meeting in Charleston next weekend so don’t be surprised if I don’t have the chance to get an episode out next week. Daddy’s gotta work and all.  Then we’re planning the European extravaganza starting May 21st. Never been to Europe so I don’t have a clue what to expect but we’ll dummy through it all and get it figured out.  I’m starting to see some patients come back now. Now that the Winter is lifting, people have recovered from the holidays, and deductibles are getting met….they’re starting to return slowly but surely. Also, the VA hired their own chiro a year ago or so and we saw our veterans having to go to the VA for treatment.  We lost a ton of business with that little move but, great news! Their chiropractor quit so we’re seeing the vets returning again too! Lots of familiar faces finally coming back to see us.  I’m not in the 180 appointments per week range that I really like but we’re climbing. We’re probably around 145-155 or so this week. Not too far off.  Alright, no reason for idle chat, let’s just hop in.  Item #1 First one this week is called, “Lateral Lumbar Spinal Stenosis: Associations With the Oswestry Disability Index, Visual Analogue Scale, and Magnetic Resonance Imaging” by Norisyam et al and published in Cureus 12/13/23 Remember, the citations can be found at chiropracticforward.com under this episode.  DOI: 10.7759/cureus.50475 Review began 12/04/2023 Review ended 12/07/2023 Published 12/13/2023 © Copyright 2023 Norisyam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC- BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Why They Did It Degenerative lumbar spinal stenosis is a communal problem in the sixth decade of life involving L4/L5 and L5/S1 levels. Lateral spinal stenosis is often underestimated because of no established relationship between the clinical symptoms and MRI findings.  We conducted a study to establish an association between the degree of anatomical lateral stenosis, posterior disc height, and disc degeneration from MRI with the daily disability and pain severity for lateral lumbar spinal stenosis How They Did It This was a cross-sectional study involving 121 patients with distinct clinical symptoms of lateral lumbar spinal stenosis evaluated from February 2018 to December 2019.  The clinical data were evaluated using the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS), while MRI was assessed qualitatively for the anatomical gradation of lateral spinal stenosis, the magnitude of posterior disc height, and the extent of disc degeneration.  What They Found The analysis of 121 patients showed the mean age of the patients was 58.7 ± 7.1 years old.  The number of female patients was higher compared to male patients, 52.9% and 47.1%, respectively.  97.5% of the patients were married or cohabiting, and 76.0% had an abnormal body mass index.  49.6% of the patient presented with a crippling disability with ODI assessment, while 59.5% presented with high pain intensity with VAS assessment.  MRI assessment of anatomical grading lateral stenosis of L4/L5 level revealed that 45.5% of the patients had grade 2 lateral recess stenosis, 63.6% had grade 2 foraminal stenosis, and 44.6% had extraforaminal stenosis.  L5/S1 level analysis showed that 43.0% had grade 2 lateral recess stenosis, 62.0% had grade 2 foraminal stenosis, and 29.8% had extraforaminal stenosis. Wrap It Up There was no significant association between the clinical symptoms of pain and disability and the MRI findings for the anatomical gradation of lateral spinal stenosis, the magnitude of posterior disc height, and the extent of disc degeneration.  A comprehensive clinical evaluation remains essential for an accurate diagnosis, emphasizing the necessity of appropriately correlating MRI findings with their clinical significance. I would add that in the Ortho Diplomate, it was made clear that it is not the grade of stenosis or the size of the holes that matters. What matters is what’s happening to the stuff going through the holes. For lack of a better term.  If the stuff in the holes is inflamed, stenosis would be more pronounced, basically.  Here in my clinic, a good combination for stenosis has been an anti-inflammatory diet, low level laser, and the Dr. Carmen Amendolia protocol. It’s been impressive. Just a lil tip from your ol Uncle Jeffro.    Item #2 Our second one today is called “The Influence of Active, Passive, and Manual Therapy Interventions on Escalation of Health Care Events After Physical Therapist Care in Veterans With Low Back Pain” by Mayer et al and published in Physical Therapy and Rehabilitation Journal in July of 2024 and it’s hotter n a pancake off the griddle.  John M Mayer, Michael Jason Highsmith, Jason Maikos, Charity G Patterson, Joseph Kakyomya, Bridget Smith, Nigel Shenoy, Christopher L Dearth, Shawn Farrokhi, The Influence of Active, Passive, and Manual Therapy Interventions on Escalation of Health Care Events After Physical Therapist Care in Veterans With Low Back Pain, Physical Therapy, Volume 104, Issue 10, October 2024, pzae101, https://doi.org/10.1093/ptj/pzae101 Why They Did It The objective of this study was to examine the associations between active, passive, and manual therapy interventions with the escalation-of-care events following physical therapist care for veterans with low back pain (LBP). How They Did It A retrospective cohort study was conducted in 3,618 veterans who received physical therapist care for LBP between January 1, 2015 and January 1, 2018.  The Department of Veterans Affairs (VA) Corporate Data Warehouse was utilized to identify LBP-related physical therapist visits and procedures, as well as opioid prescription and non–physical therapy clinic encounters.  The association between physical therapist interventions with 1-year escalation-of-care events were assessed using adjusted odds ratios from logistic regression. What They Found Nearly all veterans (98%) received active interventions, but only a minority (31%) received manual therapy.  In the 1-year follow-up period, the odds of receiving an opioid prescription were 30% lower for those who received manual therapy in addition to active interventions, as compared with patients who received only active interventions.  Moreover, the odds of receiving primary care, specialty care, and diagnostic testing were 30% to 130% higher for patients who received electrical stimulation or more than 1 passive intervention in addition to active treatments, as compared with patients who received only active interventions. Wrap It Up The use of manual therapy along with active interventions was associated with reduced prescription of opioids, while utilization of specific passive interventions such as electrical stimulation or multiple modalities in conjunction with active interventions resulted in increased escalation-of-care events. The use of active interventions, which is supported by most clinical practice guidelines, was the cornerstone of physical therapist care for veterans with LBP.  However, the use of clinical practice guideline–recommended manual therapy interventions was low but associated with reduced opioid prescriptions. I would extend that to include spinal manipulative therapy, just continues to pile up. And up and up and up. Sooner or later, the healthcare industrial complex (whatever that might be) HAS to pay attention and at some point, it will start to be outside of the standard of care when medical providers ignore it.    Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger          The post Lateral Lumbar Stenosis & Manual Therapy Combined With PT appeared first on Chiropractic Forward.

CF 362: Coffee In The Morning & PRP Beats Cortisone In Meta-Analysis Today we’re going to talk about Coffee In The Morning & PRP Beats Cortisone In Meta-Analysis But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #362 Now if you missed last week’s episode, we talked about Healthcare Expenditures & Sleep And Pain Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Hey hey, here’s another for you this week. I used to be so solid with this podcast. Every single week without fail. Just banging ‘em out.  Here’s what I noticed. It doesn’t make any difference. Consistency didn’t seem to matter when it came to listenership. We just reached a peak number and it just stays there. No matter what I do. I don’t have the opportunity to plan and do interviews these days. I’d love to. I just don’t have the time and lots of weeks, I just don’t have the energy to be honest.  Life has been hitting pretty heavy in the last 3-4 months so my consistency has been a bit off. I am trying to get better.  Another issue is that, as I’ve discussed several times here on the podcast, I am bringing in a partner organization. Bringing them into our practice to help me grow more and depend less on my sole efforts to accomplish that goal. With that though comes some time-consuming activities. Like a call with the transition team every Tuesday afternoon. Which used to be when I would get the podcast all wrapped up and recorded. So that’s been a challenge.  Plus I decided to hire a personal trainer twice a week to get this 52 year old body of mine back into some sort of healthy shape. I’m not getting any younger and if I keep waiting until I have more time to make it a priority, well, sooner or later, I’m just going to run out of time all together.  I tell my patients that the best way to create a new habit is to have buy in and accountability so hiring a personal trainer makes a lot of sense. I decided to take my own advice. Leg day was a few days ago and I’m still walking around my office like I have a stick stuck up my butt. I’m so sore, y’all. It’s real.  All of that to say that I am trying to get back to being consistent with the episodes. I would ask that you try to help me as well. Help me to get this podcast out to others. Recommend us, review the podcast wherever you do your listening. Advocate for us. We are trying to change the profession by bringing it closer to the center of the healthcare industry instead of some outlying satellite floating by itself in outer space.  Sharing is easy, I ask you to help me and, by proxy, help the profession.  Item #1 The first one today is called, “Drinking coffee only in the morning lowers risk of death from any cause” by the StudyFinds Staff and research by Dr. Lu Qi at Tulane University. It was released on January 8, 2025 and that’s a hot one.  Remember, the citations can be found at chiropracticforward.com under this episode.  https://academic.oup.com/eurheartj/article/46/8/749/7928425?login=false Xuan Wang, Hao Ma, Qi Sun, Jun Li, Yoriko Heianza, Rob M Van Dam, Frank B Hu, Eric Rimm, JoAnn E Manson, Lu Qi, Coffee drinking timing and mortality in US adults, European Heart Journal, Volume 46, Issue 8, 21 February 2025, Pages 749–759, https://doi.org/10.1093/eurheartj/ehae871 Why They Did It A recent study led by Dr. Lu Qi at Tulane University, published in the European Heart Journal, examined the impact of coffee consumption timing on mortality risks.  Analyzing data from over 40,000 American adults, researchers identified two primary groups: “morning-type” coffee drinkers, who consumed coffee between 4 a.m. and noon, and “all-day-type” drinkers, who spread their intake throughout the day.  The study found that morning coffee drinkers had a 16% lower risk of death from all causes and a 31% lower risk of death from heart disease compared to non-coffee drinkers.  Notably, those who consumed two to three cups in the morning experienced a 29% reduction in all-cause mortality risk. In contrast, individuals who drank coffee throughout the day did not exhibit significant mortality benefits.  The researchers suggest that consuming coffee later in the day may disrupt circadian rhythms and melatonin production, potentially diminishing coffee’s health benefits. Additionally, coffee’s anti-inflammatory properties may be more effective when aligned with the body’s natural inflammatory cycles, which are higher in the morning. These findings indicate that not only the quantity but also the timing of coffee consumption plays a crucial role in its health effects.  While the study highlights an association between morning coffee consumption and reduced mortality risk, it does not establish causation.  Further research is needed to understand the underlying mechanisms and to determine if adjusting coffee consumption timing can directly influence health outcomes.  Nonetheless, these insights may inform future dietary guidelines, emphasizing the importance of considering not just what we consume, but also when we consume it. Item #2 The second one today is. “PLATELET-RICH PLASMA VERSUS CORTICOSTEROID IN THE TREATMENT OF KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS” by Wang et al and published in Georgian Medical News in April of 2024 and that’s hot enough for some hot talk.  Wang R, Xie Y, Xie L, Liu J, Jia J, Chen X, Wu Q. PLATELET-RICH PLASMA VERSUS CORTICOSTEROID IN THE TREATMENT OF KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. Georgian Med News. 2024 Apr;(349):169-182. PMID: 38963222. Why They Did It The aim of this meta-analysis is to evaluate the clinical effectiveness of intra-articular injections of platelet-rich plasma (PRP) versus corticosteroid (CS) in treating knee osteoarthritis (KOA).  How They Did It A comprehensive search of the PubMed, Embase, and Web of Science databases was conducted for literature on intra-articular PRP and CS injections for the treatment of knee osteoarthritis, with the search period extending to December 2023.  The risk of bias was assessed using the Cochrane Risk of Bias tool, and statistical analysis was subsequently carried out using Review Manager 5.4.1 software.  The efficacy of PRP versus CS injections across various studies was compared based on the weighted mean difference and 95% confidence interval for scores from the Visual Analogue Scale (VAS), Knee Osteoarthritis Outcome Score (KOOS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).  In our analysis, we incorporated twelve studies encompassing a total of 801 joints, of which 404 were in the PRP group and 397 in the CS group.  What They Found The PRP group was significantly reduced the VAS score than CS group in 3-month, 6-month and 9-month; PRP group was significantly reduced the WOMAC total score compared to CS group in 1-month, 6-month, 9-month and 12-month; In 3-month and 6-month, PRP group were significantly increased the KOOS pain relief score, the KOOS activities of daily living scores and the KOOS quality of life score compared to CS group; PRP group also were significantly increased the KOOS sports score in 3-month compared to CS group.  The leukocyte-poor PRP (LP-PRP) group had significantly reduced VAS scores compared to CS group.  Wrap It Up Recent findings indicate that intra-articular injections of PRP yield superior results in alleviating pain and enhancing functionality in individuals with knee osteoarthritis, as opposed to CS injections.  During short-term follow-up, no significant difference was observed between knee injections of PRP and CS.  However, the benefits of PRP injections primarily become apparent in the medium to long-term management of clinical symptoms, including pain relief, enhancing patients’ quality of life, increasing activities of daily living, and improving sports capabilities.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post Coffee In The Morning & PRP Beats Cortisone In Meta-Analysis appeared first on Chiropractic Forward.

CF 361: Healthcare Expenditures & Sleep And Pain Today we’re going to talk about Healthcare Expenditures & Sleep And Pain But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #361 Now if you missed last week’s episode, we talked about Selling Part Of The Clinic, Females Controlling High Blood Pressure, & Muscle Strength and Cardiorespiratory Fitness Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Sorry I missed last week’s episode. I have a trip to Atlanta for the big VOAtlanta voice over conference. If you’ve listened for some time, then you know that I moonlight as a voice actor. It started during covid and basically turned into a full time job on top of my full time job. It’s something that can be done in a robe in my basement. No overhead. No employees. Just a microphone, agents, managers, and clients if you can get ‘em! So, considering the money that can be made in VoiceOver, it’s worth chasing and exploring. I’d be a fool not to. I’m not in my 5th year of vo and have reached the level that a lot voice actors strive for. I have a national agent out of Beverly Hills and I have a management company out of New York City. Both are achievements that any vo is hungry for so I am super grateful and have been blessed beyond description.  In addition to these, I have accumulated around 10 regional agencies as well. On top of that, I’m on several rosters for producers and marketing agencies across the country.  You can probably feel that this isn’t really a hobby. It’s a thing and it’s a thing that keeps growing so it’s pretty exciting. To the point that I have auditions coming in as I type this right now!  VOAtlanta is the country’s largest gathering each year of voice talent from across the world. Not just the USA. There were folks from Ireland, England, New Zealand, Venezuela and more. All over. There are typically around 1,000 or more vo folks at the Atlanta show.  As you might imagine, there are a lot of regular ol’ folks like me there but there are also what you would picture Los Angeles, Hollywood, eccentric creatives to be. It’s a mish mash of folks from all walks and you what? It’s pretty cool. Of course I hang out with folks more like me the most but I’ve made friends from all walks of the world and it’s a pretty cool thing overall.  So yeah, that was last week and this week is a chiro conference in Lubbock, TX. In the words of Ferris Bueller, life moves pretty fast my friends, if you don’t stop and look around, you might miss it.  I’ve been very active in the Texas Chiropractic Association for years and years now. Probably since about 2008. So, about 16 years now. I’ve served on the Board, as the PI chair, as the chair for fundraising, and as the Director of Dept of Scientific Affairs. Which is all cool and all very useful but what I got out of it and still get out of it, is far beyond anything put into it.  I have friends that I call family from all over the State of Texas. Some are in pretty influential positions in our industry. Any time I have an issue, I have a network of plugged-in friends that can help guide me and advise me and you can’t beat that with a big ol’ stick, my friends. That means something.  Also, I misspoke last episode when I mentioned bringing in a private equity partner. They technically are NOT a private equity partner. They are a true partner that invests in the clinic and helps you grow it in size, capability, and finances.  We have been doing weekly 1 hour transition calls to get ready for the sale and all that goes with it. We are excited. It’s going to be work but, once the work is put in for the first few months, then we should be hitting the cruise control and watching things grow as some of the responsibility is gradually taken off of my shoulders.  Maybe I’ll start to breathe and sleep better. Won’t that be nice?? I’ll keep you updated as we go through the process.  Item #1 Our first one this week is called, “Fatigue, sleep disturbance, and pain interference in children and adolescents with chronic pain: a longitudinal study” by Roman-Juan et al and published in Pain in April 2025…..hell that so en fuego, it hasn’t even happed yet!! Remember, the citations can be found at chiropracticforward.com under this episode.  Roman-Juan, Josepa,b; Ceniza-Bordallo, Guillermoc; Sánchez-Rodríguez, Elisabeta,b; Jensen, Mark P.d; Miró, Jordia,b,*. Fatigue, sleep disturbance, and pain interference in children and adolescents with chronic pain: a longitudinal study. PAIN 166(4):p 927-935, April 2025. | DOI: 10.1097/j.pain.0000000000003432 Why They Did It Research has shown that pain and sleep disturbance often co-occur and influence each other over time in children and adolescents with chronic pain.  Longitudinal studies examining the underlying mechanisms of this association are scarce and have focused primarily on the role of internalizing mental health symptoms and mood.  This longitudinal study aimed to determine whether fatigue underlies the co-occurrence and mutual maintenance of sleep disturbance and pain over time in children and adolescents with chronic pain.  How They Did It Participants were 355 school-aged children and adolescents with chronic pain.  The participants provided sociodemographic information and responded a survey that included measures of pain (duration, intensity, interference), sleep disturbance, and fatigue at first assessment and 12 months later.  What They Found Findings revealed that sleep disturbance, pain intensity, and pain interference co-occurred at both time points.  Higher levels of sleep disturbance, pain intensity, and pain interference at first assessment predicted higher levels of sleep disturbance, pain intensity, and pain interference at follow-up, respectively.  Higher levels of pain interference at first assessment predicted higher levels of sleep disturbance at follow-up while controlling for initial levels of sleep disturbance.  Furthermore, fatigue was found to mediate the association between first assessment and follow-up sleep disturbance, the association between first assessment and follow-up pain interference, and the association between first assessment pain interference and follow-up sleep disturbance. Wrap It Up Basically, this study used a fancy math model to look at how sleep problems, pain levels, and the way pain affects daily life are connected over time.  They checked these things at two different points and found that if you had more sleep issues, stronger pain, or bigger problems because of pain at the first check, you’d likely have more of those same issues later on.  Also, if pain was messing up your life a lot at first, it could make your sleep worse later, even if you account for how bad your sleep was to begin with.  On top of that, feeling tired seemed to play a role in linking these problems together—so it helped explain why early sleep or pain issues led to worse sleep or pain problems later. In the ortho diplomate I went through, it was very clear in the curricula and in the research that a big component of pain, regardless of age, is a lack of sleep and if one were to engage in more sleep, they tend to suffer less pain. Ideal sleep was somewhere around 7-8 hours for adults. More around 9+ hours for kiddos if I recall correctly.  So, turn the phone and the TV off and get some damn sleep people!  Item #2 Our second and last one this week is called, “Comparative Analysis of Individuals With and Without Chiropractic Coverage Patient Characteristics, Utilization, and Costs” by Legorreta et al and published in JAMA Internal Medicine in October of 2004. Not hot but definitely worth covering.  Legorreta AP, Metz MD, Nelson CF, Ray S, Chernicoff HO, DiNubile NA. Comparative Analysis of Individuals With and Without Chiropractic Coverage: Patient Characteristics, Utilization, and Costs. Arch Intern Med. 2004;164(18):1985–1992. doi:10.1001/archinte.164.18.1985 Why They Did It Back pain accounts for more than $100 billion in annual US health care costs and is the second leading cause of physician visits and hospitalizations.  This study explores the effect of systematic access to chiropractic care on the overall and neuromusculoskeletal-specific consumption of health care resources within a large managed-care system. How They Did It A 4-year retrospective claims data analysis comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit. What They Found Members with chiropractic insurance coverage, compared with those without coverage, had lower annual total health care expenditures ($1463 vs $1671 per member per year).  Having chiropractic coverage was associated with a 1.6% decrease in total annual health care costs at the health plan level. Back pain patients with chiropractic coverage, compared with those without coverage, had lower utilization (per 1000 episodes) of plain radiographs, low back surgery, hospitalizations, and MRIs.  Patients with chiropractic coverage, compared with those without coverage, also had lower average back pain episode–related costs ($289 vs $399). Wrap It Up Access to managed chiropractic care may reduce overall health care expenditures through several effects, including  positive risk selection;  substitution of chiropractic for traditional medical care, particularly for spine conditions;  more conservative, less invasive treatment profiles; and  lower health service costs associated with managed chiropractic care.  Systematic access to managed chiropractic care not only may prove to be clinically beneficial but also may reduce overall health care costs. Tis study was led by an MD and this study was published in 2004. Later, in about 2016/17, in Qaseem et al, the American College of Physicians published their recommendations for first line therapies for back pain, both acute and chronic. They included SMT, exercise, massage, acupuncture, and low level laser. All things that are encompassed by chiropractic care.  Why is the wheel turning so damn slowly? They say it takes 15 years for research to come out and for it to trickle down to the PCPs and it to become regularly and widely implemented. Well, that was 20 years ago. And here we are. Still struggling like that squirrel trying to get a nut. It’s exhausting isn’t it? Still, it’s better in 2024 than it was in 2004. No doubt. Progress moves slowly. Especially when you have a loud, obnoxious factions of your profession trying desperately to hold you back in 1897.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Healthcare Expenditures & Sleep And Pain appeared first on Chiropractic Forward.

CF 360: Selling Part Of The Clinic, Females Controlling High Blood Pressure, & Muscle Strength and Cardiorespiratory Fitness Today we’re going to talk about Selling Part Of The Clinic, Females Controlling High Blood Pressure, & Muscle Strength and Cardiorespiratory Fitness But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #360 Now if you missed last week’s episode, we talked about ‘Do physicians follow guidelines and updated chiropractic trends’. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I just returned from a trip to Ft. Worth for a business thing. I mentioned last episode that I am potentially selling 60% interest in the clinic here to a private equity group out of Houston.  You know, selling 60% of your blood sweat and tears over the course of 25 years or so….that’s a hard thing to come to terms with. But, when you consider some factors, it starts to shine up like a bright shiny penny.  For example, I live in Amarillo, TX. While I love my city, there aren’t a ton of chiros busting down the gates to be established here. If I wanted to sell my practice on the market by myself, I’d be hard pressed to find a buyer. If I DID actually find a buyer, I don’t think I could get what I’d want for it at all.  How many stories do I need to hear about chiros that are ready to retire not being able to sell their practices so they’re basically just SOL and have to shut the doors and get nothing for their years of work? How many of those do I have hear before I actually take them to heart and believe them? This group is offering more for 60% than I believe I could get for 100% on my own. Basically.  Another thing is that I’m 52 and while I am young for retirement when we consider other professions, I am getting to an age that a full day take more of a toll on my body and my energy than I’d like to admit. When I see 45 patients in one day at 52 vs when I was 42….there’s just a damn difference.  Here’s the most important factor; I’ve had COVID 5-6 times now and I’ve only missed 1 day of work. I know some of you are clutching pearls right now but I didn’t always know at that exact time that I actually had COVID and just to safe, I always wore a mask and was OCD about keeping my hands clean.  The point is; that’s not fair to me, it’s not fair to my patients, it’s not fair to my family, and it’s not fair to my employees that LITERALLY EVERYTHING depends on my presence in the clinic. IF I’m out, everything suffers. I’m a fool and I’m irresponsible if I don’t do everything I can to make this clinic and the lives of my people more stable.  If I get sick sick, if I need a surgery, if I break a bone…..everybody is wondering if they need to find a new job. We can’t have that and bringing in a partner is how we’re going to be bigger, stronger, and more stable.  They’re going to help me bring in an associate, when the finances make sense, they’re going to help bring in a PT, and they’re going to help bring in pain management services.  When you combine these with the fact that we already have a young and slowly building medical brand, acupuncture, massage, etc….these things should all contribute to a very well-rounded, comprehensive clinic that can run should I happen to be absent.  And lastly, I want to travel while my hips and knees allow me to travel. I want to paint and sculpt and make music and do my voiceover and do more of the things that feed my soul. Instead of ONLY the things that feed my family. I need more of a mix. The longer I live, the less time I have to live.  So it’s time to make a move and make it count.  See? When you really start to break it down and put it into context, selling 60% doesn’t seem quite so awful now does it??  Plus, the clinic doesn’t change. We’re already successful. They don’t want to change what make my clinic what it is. They just want to add to it and optimize what we’re already doing so well.  Yes please. And pay me while we’re at it and allow me to get off of the damn hamster wheel I’ve been on for 27 years.  So….that’s what’s up with me. Ft. Worth was an owner’s meeting for this group and I met with and made friends with chiros and PTs and MDs from around the state of Texas.  All of them except for one, when I asked them if they were happy and would they sell part of their clinics again…..all but one said absolutely and if I’d have known about them sooner, I’d have done it sooner. And I have two good TCA buddies that have been with this group for over 3-4 years or so and they say they’re working less and making more money and would absolutely do it again.  There you have it. I’ll talk more about this as I go through the selling process but now you know my thinking on it and why, for me, the price is right and why we’re doing it.  More to come. Here’s this week’s research. Item #1 Our first on today is called, “Hypertension Management in Women With a Multidisciplinary Approach” by Nobakht et al and published in the Mayo Clinic Proceedings in March 2025 and that’s This Month kind of HOT!! Remember, the citations can be found at chiropracticforward.com under this episode.  Hypertension Management in Women With a Multidisciplinary Approach Nobakht, Niloofar et al. Mayo Clinic Proceedings, Volume 100, Issue 3, 514 – 533 Why They Did It Current clinical practice guidelines were established by several organizations to guide the diagnosis and treatment of hypertension in men and women in a similar manner despite data demonstrating differences in underlying mechanisms. Few publications have provided a contemporary and comprehensive review focused on characteristics of hypertension that are unique to women across their life spectrum.  How They Did It We performed a computerized search using PubMed, OVID, EMBASE, and Cochrane library databases between 1995 and 2023 that highlighted relevant clinical studies, challenges to the management of hypertension in women, and multidisciplinary approaches to hypertension control in women, including issues unique to racial and ethnic minority groups Basically they found the following: They say 626 million women are living with hypertension and in the US, nearly 1 in 2 adults has it.  Hypertension is more prevalent with black women at 45.3% followed by white, hispanic, and asian all very close to each other in the 31% range.  Some risk factors are oral contraceptives, salt sensitivity, and endocrine conditions. Pregnancy, of course. Menopause as well.  Some of the multidisciplinary recommendations are as follows: DASH diet Weight loss Physical activity Stress management Adequate sleep Limiting alcohol consumption Smoking cessation   Recommendations of the review are: Multidisciplinary approach to hypertension management Personalized strategies considering lifecycle, race, and individual factors Increased awareness and culturally sensitive screening Long-term cardiovascular risk monitoring   Item #2 The second one this week is called, “Comparison of Muscle Strength and Cardiorespiratory Fitness in Relation to Cardiovascular and All-Cause Mortality: The Copenhagen City Heart Study” by Schnohr et al and published in Mayo Clinic Proceedings in March 2025 and it’s all so damn hot.  Comparison of Muscle Strength and Cardiorespiratory Fitness in Relation to Cardiovascular and All-Cause Mortality: The Copenhagen City Heart Study Schnohr, Peter et al. Mayo Clinic Proceedings, Volume 100, Issue 3, 488 – 498 Why They Did It To compare the association between muscle strength (MS), cardiorespiratory fitness (CRF), and all-cause and cardiovascular disease (CVD) mortality. How They Did It The Copenhagen City Heart Study is a prospective longitudinal study comprising a random sample of adults; they excluded participants with a history of coronary heart disease or cancer, leaving 9,896 men and women for analyses.  A self-administered questionnaire at baseline documented self-rated muscle strength and cardiorespiratory fitness, categorized as low, moderate, or high.  Muscle strength was measured in 3,299 participants by a hand grip strength of the dominant hand with isometric dynamometry.  Multivariable adjusted analyses were performed adjusting for potential confounders. What They Found During follow-up of 27 years, 4,971 all-cause deaths and 2,128 cardiovascular disease deaths occurred.  Compared with moderate cardiorespiratory fitness, high cardiorespiratory fitness was associated with lower all-cause mortality and lower cardiovascular disease mortality.  There were approximately 10% higher risk reductions for cardiorespiratory fitness than for muscle strength in comparing high with moderate levels for both all-cause and cardiovascular disease mortality; comparing moderate with low levels, cardiorespiratory fitness was 19% better than muscle strength for decreasing risk of all-cause mortality and 33% better for reducing cardiovascular disease mortality.  The self-rated muscle strength reports corresponded well with the hand grip results. Wrap It Up Both cardiorespiratory fitness and muscle strength are inversely associated with cardiovascular disease mortality and all-cause mortality, but of the 2, cardiorespiratory fitness confers stronger protection. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Selling Part Of The Clinic, Females Controlling High Blood Pressure, & Muscle Strength and Cardiorespiratory Fitness appeared first on Chiropractic Forward.

CF 359:  Do Physicians Follow Guidelines & Updated Chiropractic Trends Today we’re going to talk about Do Physicians Follow Guidelines & Updated Chiropractic Trends But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.    Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #359 Now if you missed last week’s episode, we talked about how the first provider chosen matters and then we talked about neural mobilization.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. We are in the quadremic around the Texas Panhandle and, from what I hear, around the USA.  What’s the quadremic, you might ask. Well, it’s RSV, the Flu, COVID, and the regular norovirus. Evidently it’s hitting from all directions this month.  I’ve had COVID. Just two weeks ago. But now it’s like I have something else on top of that. My head is all stopped up, trouble catching my breath, and just sort of messy all over.  But I’m here, damnit! I’m Gen X-ing it, pushing through, and making things happen regardless.  If you’re a regular around here, then you know last week I spoke about all of the random ays I’ve had off in the last month or so and how, for a practice that doesn’t scare people into a million visits, days off can be pretty detrimental. A true schedule killer.  So, we’re not letting this little lingering illness keep me down and at the house.  I mentioned some time back that I am entertaining the idea of selling 60% of the clinic to a private equity group out of Houston, TX. As I go through the process, I’ll share more and more about what’s going on, why it makes sense, and if you want to have a valuation done on your own clinic, you can just get hold of me and I’ll get you with the right people.  But, I will walk you through it and talk about it as I go. We have a transition team Zoom call this afternoon so will know a bit more for next week’s podcast.  But for now, let’s hop into the research.  Item #1 Our first one this week is called, “Diagnostics and treatment of acute non-specific low back pain: do physicians follow the guidelines?” By Trachsel et al and published in Swiss Medical Weekly on January 24, 2025. Holy smokes it’s a hot one!! Remember, the citations can be found at chiropracticforward.com under this episode.  Trachsel M, Trippolini MA, Jermini-Gianinazzi I, Tochtermann N, Rimensberger C, Hubacher VN, Blum MR, Wertli MM. Diagnostics and treatment of acute non-specific low back pain: do physicians follow the guidelines?. Swiss Med Wkly [Internet]. 2025 Jan. 24 [cited 2025 Feb. 17];155(1):3697. Available from: https://smw.ch/index.php/smw/article/view/3697 Why They Did It Clinical guidelines for acute non-specific low back pain recommend avoiding imaging studies, refraining from strong opioids and invasive treatments, and providing information to patients to stay active.  Despite these recommendations, many patients undergo diagnostic and therapeutic assessments that are not in line with the current evidence. AIM: To assess the management of acute non-specific low back pain by Swiss general practitioners (GPs) and their adherence to guideline recommendations. How They Did It We performed a survey using two clinical case vignettes of patients with acute non-specific low back pain without red flags or neurological deficits.  The main differences between the vignettes were sex, age, profession, pain duration and medical history. GPs were asked about their management of those patients.   What They Found Of 1,253 GPs, 61% reported knowing current clinical guidelines and 76% being aware of “Choosing Wisely” recommendations.  Diagnostic evaluations included X-ray and magnetic resonance imaging (MRI).  For pain management, GPs recommended mostly non-steroidal anti-inflammatory drugs, paracetamol and metamizole.  Treatments with potential harm included muscle relaxants (78% and 77%), oral steroids (26% and 33%), long-acting opioids (8% and 11%) and spinal injections (28% and 42%).  A very high proportion recommended activity restrictions (82% and 71%) and some recommended bed rest (3% and 2%). Wrap It Up Although GPs reported being aware of current guideline recommendations, management of acute non-specific low back pain was not in line with these recommendations.  A substantial proportion of GPs considered imaging, treatments (e.g. muscle relaxants, long-acting strong opioids), and activity and work restrictions with potentially harmful consequences. How surprising is that? Not very is you ask me. I hear it every day just about. Bed rest for a bad back but they’ll have post-surgical patients walking around the hospital with their IV poles in hand.  Item #2 Our second one today is called “National Trends in the Utilization and Expenditure of Chiropractic Care in U.S. Adults: Analysis of the 2007-2016 Medical Expenditure Panel Survey” by Chen et al and published in the Journal Of Manipulative and Physiological Therapeutics on September 27th, 2024 and es muy caliente mi amigo! Muy!   Baojiang Chen, Henry S. Brown, David Douphrate, Jud Janak, Kelley Pettee Gabriel, Trent Peng, National Trends in the Utilization and Expenditure of Chiropractic Care in U.S. Adults: Analysis of the 2007-2016 Medical Expenditure Panel Survey, Journal of Manipulative and Physiological Therapeutics, 2024, ISSN 0161-4754, https://doi.org/10.1016/j.jmpt.2024.08.005. (https://www.sciencedirect.com/science/article/pii/S0161475424000447) Why They Did It This study aimed to examine the trends in the utilization and expenditure of chiropractic care in a representative sample of US adults, aged ≥18 years. How They Did It Serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey (MEPS) were examined.  Weighted descriptive statistics were analyzed to obtain national estimates of chiropractic utilization and expenditure, and time-series linear regression was used to assess trends over time.  Socio-demographic characteristics and musculoskeletal diagnoses associated with chiropractic use were also reported. What They Found A statistically significantly increasing trend was observed for the number of adults receiving chiropractic care, number of visits and utilization rate from 2007 to 2016.  A similar trend was not found for chiropractic expenditure during this period.  The mean number of visits was 8.3 visits per year, with a mean expenditure of $86.94 USD per visit and $721.43 USD per person per year.  Mean age of adult chiropractic users each year ranged between 48.6 and 51.2 years old, and users were primarily female (56.3%-60.4%),  White persons (90.1%-93.5%), and privately insured (77.3%-82.8%).  The most prevalent musculoskeletal diagnoses associated with chiropractic use were low back conditions (45.4%-58.1%), inflammatory/degenerative disc or joint conditions (21.2%-26.8%) and head and neck complaints (9.8%-13.7%). Wrap It Up The findings showed statistically significant increasing trends for the number of adult chiropractic users, the number of visits, and percent utilization of chiropractic care from 2007 to 2016.  Conversely, we found a statistically null trend for the total annual expenditure on chiropractic care during the same time period.  Findings from this analysis imply that, while chiropractic care appears to be growing, it may still be under-utilized, and more efforts should be devoted to ensuring sustained growth and a larger role in the management of musculoskeletal health.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Do Physicians Follow Guidelines & Updated Chiropractic Trends appeared first on Chiropractic Forward.

CF 358: First Provider Matters & Neural Mobilization Today we’re going to talk about First Provider Matters & Neural Mobilization But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #358 Now if you missed last week’s episode, we talked about Utilization and Expenditure of Chiropractic and we talked about Hormone Therapy in Females.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, if you’re a regular listener, then you know we have gone a couple of weeks without a podcast.  Unfortunately, my mother went through a battle with her health and ultimately lost that battler on January 24, 2025. She had been in the hospital for several weeks prior and every minute before work, at lunch, and after work was spent at the hospital.  Not writing podcasts, as I’m sure you all understand.  Then, we’ve kind of been in recovery mode. Trying to get my thoughts together and honestly…..just taking a little time to breathe.  So, here we are this week. Can I tell you what some time off will do to an evidence-based practice. Day-um…. One word….two syllables….Day-um.  Christmas was on a Wednesday which is a week wrecker. Then NYE was on a Wednesday, yes…a week wrecker. Then we had the snow storms and over 11 inches of snow so a couple of days off there. Then my mom’s passing then my mom’s funeral so a couple more days off there. Next thing you know a good Monday for me was 45 patients and I was looking at 28 or so. Not a good thing so fortunately, I’m getting the train back on the track now with 38 this Monday and Wednesday is looking solid as well as Thursday and Friday so I think the ball is back in play.  Which takes some stress off. Oh, and while my mom is in the hospital and we don’t know if she’s going to make it, I had to take a quick trip to support my daughter’s cheer team down in Fort Worth, TX. My damn sexy pick up truck died on the way home and has been in a mechanic shop 250 miles away for the last 3-4 weeks.  Then, after the funeral, my wife and I got COVID.  2025 is hating on my but we’re winners around here and, like I said, I think we’re already back on track.  If you’re a praying person, I’d ask you to include us today. Include us for mom, our clinic’s health, and for a better, stronger 2025. That would be amazing of you.  Now, enough woe is me, let’s get to the research.  Item #1 Our first one this week is called, “First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization” by Bise et al and published in Physical Therapy and Rehabilitation Journal in September 2023.  Remember, the citations can be found at chiropracticforward.com under this episode.  Christopher G Bise, Michael Schneider, Janet Freburger, G Kelley Fitzgerald, Galen Switzer, Garry Smyda, Pamela Peele, Anthony Delitto, First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization, Physical Therapy, Volume 103, Issue 9, September 2023, pzad067, https://doi.org/10.1093/ptj/pzad067 Why They Did It Costs associated with low back pain (LBP) continue to rise. Despite numerous clinical practice guidelines, the evaluation and treatments for LBP are variable and largely depend on the individual provider. As yet, little attention has been given to the first choice of provider.  Early research indicates that the choice of first provider and the timing of interventions for LBP appear to influence utilization. We sought to examine the association between the first provider seen and health care utilization. How They Did It Using 2015–2018 data from a large insurer, this retrospective analysis focused on 29,806 patients seeking care for a new episode of LBP.  The study identified the first provider chosen and examined the following year of medical utilization.  Cox proportional hazards models were calculated using inverse probability weighting on propensity scores to evaluate the time to event and the relationship to the first choice of provider.   What They Found The primary outcome was the timing and use of health care resources.  Total health care use was lowest in those who first sought care with chiropractic care or physical therapy.  Highest health care use was seen in those patients who chose the emergency department.   Wrap It Up Overall, there appears to be an association between the first choice of provider and future health care use.  Chiropractic care and physical therapy provide nonpharmacologic and nonsurgical, guideline-based interventions.  The use of physical therapists and chiropractors as entry points into the health system appears related to a decrease in immediate and long-term use of health resources.      Item #2 Our second one this week is called, “Efficacy of neural mobilization and Maitland accessory mobilization in patients with tennis elbow- randomized controlled trial” by Jain et al and published in Journal Of Bodywork and Movement Therapies in April of 2024 and……why not??? Because it’s Hot! Chanchal Jain, Manu Goyal, Saumya Kothiyal, Efficacy of neural mobilization and Maitland accessory mobilization in patients with tennis elbow- randomized controlled trial, Journal of Bodywork and Movement Therapies, Volume 38, 2024, Pages 525-533, ISSN 1360-8592, https://doi.org/10.1016/j.jbmt.2024.01.013. (https://www.sciencedirect.com/science/article/pii/S1360859224000287)   Why They Did It The objective of the study was to evaluate the efficacy of Maitland accessory mobilization and neural mobilization in patients with tennis elbow.   How They Did It Twenty-five patients meeting the selection criteria were randomly assigned to three experimental groups:  Group C (conventional treatment),  Group B (neural mobilization), and  Group A (Maitland mobilization).  Quality of life was assessed using the Patient Rated Tennis Elbow Evaluation (PRTEE), while pain, range of motion, and grip strength were evaluated using the Visual Analog Scale (VAS), a universal goniometer, and a handheld dynamometer.  The interventions were administered three times per week for four weeks to the respective groups.   What They Found The results of the between-group analysis demonstrated significant differences in pain (p = 0.018) and quality of life (p = 0.045) among the three groups.   Wrap It Up After a 4-week intervention, all three groups exhibited notable improvements in discomfort levels, grip strength, and quality of life.  Notably, Group B (neural mobilization) demonstrated the most substantial increase in range of motion (ROM) compared to Groups A and C.  Consequently, incorporating neural mobilization into the treatment plan is recommended for patients experiencing Tennis Elbow. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post First Provider Matters & Neural Mobilization appeared first on Chiropractic Forward.

CF 357: Utilization and Expenditure of Chiropractic & Hormone Therapy In Females Today we’re going to talk about Utilization and Expenditure of Chiropractic & Hormone Therapy In Females But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #357 Now if you missed last week’s episode, we talked about Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Alright, the first week of getting back to a normal schedule. As I mentioned, I don’t love January as a healthcare provider. Especially one that accepts insurance. Insurance re-sets for most in January and people are broke from Christmas in January.  We start getting a little more back to normal in late February to mid March. So…we’re starting with 42 on the Monday I’m typing here. That’s not a terrible start and I’ll tell you why. I came up with the perfect schedule. Here’s how that would look if I could have the ideal set up.  Monday  – 43 patients (6 new patients, 3 morning and 3 in the afternoon) Tuesday – 28 patients (2-3 new patients) Wednesday – 43 Patients (6 new patients, 3 morning and 3 in the afternoon) Thursday – 43 patients (6 new patients, 3 morning and 3 in the afternoon) Friday – 28 patients (2-3 new patients) 185 Patients Per Week 22-24 New Patients Per Week These are just general ideas. Do not undershoot them trying to stay below them!!! Now that’s not ideal for the provider that thinks they have to be hands on with every single patient from start to finish and spend an hour with each of them. It would actually be impossible.  But, for me, I do all exams and re-exams and I do all adjustments. I do this with an assistant standing in the doorway doing the chart notes as they’re happening. Then the patients are handed to the CA and, when appropriate, taken for therapy and rehab exercises. It’s not a cookie cutter thing and not all patients have the same things goign on.  Some get just rehab, some get just therapy, some come in for decompression and/or laser alone without being adjusted. We have massage patients I’ve never met in my life. Same with acupunture and the medical end of the business.  That is the whole point with mutilple directions and streams. Some patients utilize it all. Some utilize only what they are really interested in. We always have the opportunity to cross market internally with our existing and past patients to help float the whole boat rather than just one service.  Hell yes that’s challenging to promote so many diifferent revenue streams. I knew your question before you even verbalized it. That’s why you use AI to come up with a monthly marketing plan to evenly support and promote all streams of business throughout the year.  This month, for example, is January so AI say’s let’s do a “New Year, New You” campaign and concentrate on Weight loss meds, hormone pellets and balanceing, IV therapy, and chiropractic to start 2025 with more function, feeling better, and looking better.  Not a bad idea. We’ll promote PRP and other services through February and on and on.  Anyway, a little peek into the inner workings here at Ol Uncle Jeffro command and control. Take what you like, leave what you hate.  Onto the research! Item #1 Our first one this week is called, “Hormone Therapy and Biological Aging in Postmenopausal Women” by Liu et al and published in JAMA Netowrk Open in August of 2024, hot potato, look out! Remember, the citations can be found at chiropracticforward.com under this episode.  Liu Y, Li C. Hormone Therapy and Biological Aging in Postmenopausal Women. JAMA Netw Open. 2024;7(8):e2430839. doi:10.1001/jamanetworkopen.2024.30839 Why They Did It Menopause is associated with biological aging, and hormone therapy is associated with health outcomes in postmenopausal women. Objective  To evaluate the association between hormone therapy use and discrepancies between chronological and biological age in postmenopausal women as well as the potential modifying role of socioeconomic status. How They Did It This population-based, retrospective cohort study included postmenopausal women registered in the UK Biobank.  A baseline survey on hormone therapy use and biological aging biomarkers was conducted from March 2006 to October 2010.  Information regarding hormone therapy use, the age at starting hormone therapy, and hormone therapy duration was collected via a touchscreen questionnaire.  Socioeconomic status was evaluated by education, family income, occupation, and the Townsend Deprivation Index. What They Found Biological aging discrepancy was evaluated using validated phenotypic age, which was calculated using chronological age and 9 biomarkers measured at baseline.  All-cause and cause-specific mortality were also assessed. Among the 117,763 postmenopausal women, 47,461 ever used hormone therapy.  The mean phenotypic age was 52.1 years.  Ever use of hormone therapy was associated with a smaller biological aging discrepancy than never use of hormone therapy.  This smaller aging discrepancy was more evident in those who started hormone therapy at age 55 years or older and in those who used hormone therapy for 4 to 8 years.  The association between hormone therapy and a smaller aging discrepancy was more evident in women with low socioeconomic status, with a significant interaction observed for education  Phenotypic aging discrepancy mediated 12.7% of the association between hormone therapy and all-cause mortality and cause-specific mortality. Wrap It Up In this study, postmenopausal women with historical hormone therapy use were biologically younger than those not receiving hormone therapy, with a more evident association observed in those with low socioeconomic status.  The biological aging discrepancy mediated the association between hormone therapy and decreased mortality. Promoting hormone therapy in postmenopausal women could be important for healthy aging.   Item #2 The last one this week we got from the ChiroUp yearly roundup and it’s called, “National Trends in the Utilization and Expenditure of Chiropractic Care in U.S. Adults: Analysis of the 2007-2016 Medical Expenditure Panel Survey” by Chen et al and published in Journal of Manipulative and Physiological therapeutics in September of 2024 and it’s equally hotter ’n hell! Why They Did It This study aimed to examine the trends in the utilization and expenditure of chiropractic care in a representative sample of US adults, aged ≥18 years. How They Did It Serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey (MEPS) were examined.  Weighted descriptive statistics were analyzed to obtain national estimates of chiropractic utilization and expenditure, and time-series linear regression was used to assess trends over time.  Socio-demographic characteristics and musculoskeletal diagnoses associated with chiropractic use were also reported. What They Found A statistically significantly increasing trend was observed for the number of adults receiving chiropractic care, number of visits and utilization rate from 2007 to 2016.  A similar trend was not found for chiropractic expenditure during this period.  The mean number of visits was 8.3 visits per year, with a mean expenditure of $86.94 USD per visit and $721.43 USD per person per year.  Mean age of adult chiropractic users each year ranged between 48.6 and 51.2 years old, and users were primarily female, White persons, and privately insured.  The most prevalent musculoskeletal diagnoses associated with chiropractic use were low back conditions, inflammatory/degenerative disc or joint conditions and head and neck complaints. Wrap It Up The findings showed statistically significant increasing trends for the number of adult chiropractic users, the number of visits, and percent utilization of chiropractic care from 2007 to 2016.  Conversely, we found a statistically null trend for the total annual expenditure on chiropractic care during the same time period.  Findings from this analysis imply that, while chiropractic care appears to be growing, it may still be under-utilized, and more efforts should be devoted to ensuring sustained growth and a larger role in the management of musculoskeletal health. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Utilization and Expenditure of Chiropractic & Hormone Therapy In Females appeared first on Chiropractic Forward.

CF 356: Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain Today we’re going to talk about Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #356 Now if you missed last week’s episode, we talked about Daily Water Intake & Curcumin Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Christmas is over now and this week we contend with New Year’s Day. What a pain in the butt, right? I enjoy a day off here and there just like anyone else but right in the middle of the week two weeks in a row starts to mess with business.  So, last week I worked Monday, 1/2 of Tuesday, and 1/2 of Friday so basically two full days if you combine it all. We ended up with about 75 chiro patients for the Christmas week. That’s not great buut it’s better than nothing. Especially when you total the profit on 75 patients vs the total profit on zero patients had I chosen to take the full week off.  Then, this week, we have New Years Day off and we’re slow becauuse it’s the damn holidays and, of course, insurance people renew on January 1st, so it’s looking bleak this week, folks. Typing out on a Monday, I have 78 or so for the whole damn week. Of course that will grow because Monday will re-book and then re-book again on Friday but that’s still bleak.  What I’ve discovered over my career that you may or may not agree with is that the last 2 weeks in December and December as a whole really…it starts to slow up. People are getting ready for Christmas, xmas parties, buying gifts, and things like that.  Then the insurance plans re-set in January and it just takes some time to re-engage in healthcare for these folks. So we start to see February as a growth month and start to hit our full stride again in March. That’s my experience anyway.  I have 2 Airbnbs and I can attest that I’ve been booked at almost 100% capacity for months now but January and on are almost empty at the moment.  It’s just that time of the year so, if you’ve slowed up like I have, you didn’t do anything wrong. It is what it is. Take this break to plan for 2025. Don’t have a plan? Get one. Use AI to give you ideas for growing your practice in 2025. At this point, its almost a crime to not be taking advantage of AI for purposes like these.  OK, on to the research… Item #1 Our first one this week is called, “Association of Opioid Use Disorder Diagnosis With Use of Physical Therapy and Chiropractic Care Among Chronic Low Back Pain Patients: A Group-Based Trajectory Analysis” by Moyo et al and published in The Journal of Pain in 2024….and it’s muy en Fuego! Remember, the citations can be found at chiropracticforward.com under this episode.    Patience Moyo, Jessica S. Merlin, Miriam George, Theresa I. Shireman, Brandon D.L. Marshall, Association of Opioid Use Disorder Diagnosis With Use of Physical Therapy and Chiropractic Care Among Chronic Low Back Pain Patients: A Group-Based Trajectory Analysis, The Journal of Pain, Volume 25, Issue 3, 2024, Pages 742-754, ISSN 1526-5900, https://doi.org/10.1016/j.jpain.2023.10.003.   Why They Did It Nonpharmacologic approaches are recommended as first-line treatment for chronic pain, and their importance is heightened among individuals with co-occurring opioid use disorder (OUD), in whom opioid therapies may be particularly detrimental.  Our objectives were to assess the receipt and trajectories of nonpharmacologic pain treatment and determine the association of opioid use disorder diagnosis with these trajectories. How They Did It This retrospective cohort study used Medicare claims data from 2016 to 2018 and applied group-based trajectory models to identify distinct patterns of physical therapy (PT) or chiropractic care treatment over the 12 months following a new episode of chronic low back pain.  We used logistic regression models to estimate the association of co-occurring opioid use disorder with group membership in PT and chiropractic trajectories.  Our sample comprised 607,729 beneficiaries at least 18 years of age, of whom 11.4% had a diagnosis of opioid use disorder.  The 12-month prevalence of PT and chiropractic treatment receipt was 24.7% and 27.1%, respectively, and lower among Medicare beneficiaries with co-occurring opioid use disorder (PT: 14.6%; chiropractic: 6.8%). What They Found The final models identified 3 distinct trajectories each for PT, delayed and increasing use, and early and declining use; and chiropractic, early and declining use, and early and sustained use. Wrap It Up People with opioid use disorder were more likely to belong in trajectories with little/no PT or chiropractic care as compared to other trajectories.  The findings indicate that people with co-occurring chronic pain and opioid use disorder often do not receive early or any nonpharmacologic pain therapies as recommended by practice guidelines. Item #2 The last one this week is called, “Effectiveness of Neural Mobilisation on Pain Intensity, Functional Status, and Physical Performance in Adults with Musculoskeletal Pain – A Systematic Review with Meta-Analysis” by Baptista et al and published in Clinical Rehabilitation in November of 2023.    Baptista FM, Nery E, Cruz EB, Afreixo V, Silva AG. Effectiveness of Neural Mobilisation on Pain Intensity, Functional Status, and Physical Performance in Adults with Musculoskeletal Pain – A Systematic Review with Meta-Analysis. Clinical Rehabilitation. 2024;38(2):145-183. doi:10.1177/02692155231215216   Why They Did It To investigate up-to-date evidence of the effectiveness of neural mobilisation techniques compared with any type of comparator in improving pain, function, and physical performance in people with musculoskeletal pain. How They Did It The following sources were consulted: PubMed, Web of Science, CENTRAL, CINAHL, Scopus, and PEDro databases; scientific repositories; and clinical trial registers. The last search was performed on 01/06/2023. Two reviewers independently assessed the studies for inclusion.  We included randomised, quasi-randomised, and crossover trials on musculoskeletal pain in which at least one group received neural mobilisation (alone or as part of multimodal interventions).  Meta-analyses were performed where possible.  The RoB 2 and the Grading of Recommendations Assessment, Development and Evaluation tools were used to assess risk of bias and to rate the certainty of evidence, respectively. What They Found Thirty-nine trials were identified.  There was a significant effect favouring neural mobilisation for pain and function in people with low back pain, but not for flexibility.  For neck pain, there was a significant effect favouring neural mobilisation as part of multimodal interventions for pain, but not for function and range of motion.  Regarding other musculoskeletal conditions, it was not possible to conclude whether neural mobilisation is effective in improving pain and function.  There was very low confidence for all effect estimates. Wrap It Up Neural mobilisation as part of multimodal interventions appears to have a positive effect on pain for patients with low back pain and neck pain and on function in people with low back pain. For the other musculoskeletal conditions, results are inconclusive. As I once heard Dr. Brandon Steele say at a conference, if you have a patient suffering from radiculopathy and you can only give them one thing or do one thing for them, it’s nerve flossing. I’ve seen it work wonders.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Opioid Use Disorder, Physical Therapy, and Chiropractic & Neural Mobilization And Pain appeared first on Chiropractic Forward.

CF 355: Daily Water Intake & Curcumin Today we’re going to talk about Daily Water Intake & Curcumin But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #355 Now if you missed last episode, we talked about Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach Make sure you don’t miss that info. Keep up with the class.    On the personal end of things….. Hello, and it’s nice to be back in the saddle here at Uncle Jeffro studios. I don’t know if you’ve noticed or not but it’s a been a few weeks and I haven’t had a break from the podcast since I started it over 7 years ago.  So, what’s that all about you might ask? Well, lemme tell you. As mentioned in more recent episodes, I’ve made some significant moves and important signings in the VoiceOver industry in the last month or two and I had to start acting like I’m important.  Some projects come in with a Rushed audition request. Well, if I’m at the clinic all day every day, how the hell am I supposed to do that? I can’t just run home between patients, knock out an important audition, then run back to the office for patients.  That’s a good way to lose voice over jobs and lose patients so, in an effort to find a way to balance it all a bit and make it all work together, I’ve spent the time and money to make my personal office space more hospitable to being able to perform auditions at the clinic when absolutely necessary.  I actually just knocked one out today and I just got everything working last night. Good timing! Anyway, I had to hang sound absorption panels on the walls, sound absorbing curtains on the windows, get an audio interface up and running with all the right software and audio plug-ins, a new microphone, and on and on.   People think you can just buy a mic, plug it in, and start making money. Of course, it’s more difficult than that and drowning out the sound of a bustling and busy clinic is a challenge. So that’s what’s been up. I don’t have it all dialed in perfectly yet but it will be and I’ll hopefully sound like gem when it’s all set up and tuned in! On other fronts, it’s about Christmas and it lands on a Wednesday this year. Which as a business person, sucks a lot. Now some of you I know just take the whole damn week off. Because y’all either make more money they you deserve or because you’re just young and you think you should have the whole week off no matter how much you lose for that week.  I know…..they wouldn’t be comign in anyway. That’s a lie. They absolutely still come to the chiropractor the week of Christmas.  What we’ll be doing this year is working all of Monday, half of Tuesday, off Wednesday and off Thursday and then working half of Friday. It’s a compromise. In an half day, we can fit in about 30-40 if we have to. I don’t llke to bust my hump that hard but I will if needed and I like having more than enough in the bank when it comes time for pay day. So that’s waht we’re doing.  New Years is the same but it’s not as big of a deal as Christmas so we’re just taking off New Years day and that’s it. And then Yay!!! Life gets back to normal again. That’ll be refreshing.  OK, enough personal stuff, let’s hop into the research Item #1 Our first one this week is called, “”Outcomes in Randomized Clinical Trials Testing Changes in Daily Water Intake A Systematic Review” by Hakam et al and published in JAMA Network Open on November 25, 2024 and thassa hot un’ honey!! Remember, the citations can be found at chiropracticforward.com under this episode.    Hakam N, Guzman Fuentes JL, Nabavizadeh B, et al. Outcomes in Randomized Clinical Trials Testing Changes in Daily Water Intake: A Systematic Review. JAMA Netw Open. 2024;7(11):e2447621. doi:10.1001/jamanetworkopen.2024.47621   Why They Did It Several public recommendations exist regarding the amount of daily water intake, yet the supporting evidence is not clear, and benefits of increasing water consumption are not well-established. Objective  To summarize evidence from randomized clinical trials (RCTs) pertaining to the health-related outcomes associated with increased or decreased daily water consumption. How They Did It A systematic search of PubMed, Web of Science, and Embase was performed up to April 6, 2023. Studies were included if they aimed to assess the impact of daily water consumption by any defined amount on any health-related outcome. What They Found Of 1464 records screened, 18 (1%) eligible studies were included in the review.  Interventions in these studies consisted of a recommendation to alter the daily amount of water intake by a specific amount for a predefined period ranging between 4 days and 5 years, while the control groups were mostly asked to maintain their usual intake habits.  Recurring primary end points included weight loss, fasting blood glucose level, headache, urinary tract infection, and nephrolithiasis. As a refresher, nephrolithiasis is a condition where solid masses of minerals and salts form in the urinary tract. Ouch. Consuming additional water was associated with greater weight loss (range, 44%-100% more than control conditions) and fewer nephrolithiasis events (15 fewer events per 100 participants over 5 years).  Single studies suggested benefits related to migraine prevention, urinary tract infection, diabetes control, and hypotension.  Ten studies (55%) reported at least 1 positive result, and 8 studies (44%) reported negative results. Wrap It Up This systematic review found that there is a limited number of clinical trials in the literature assessing the benefits of increasing water intake related to a large variety of health outcomes.  While the quality and quantity of evidence is limited, a small number of studies suggested benefits of water intake on weight loss and nephrolithiasis, while single studies raised the possibility of benefits for patients with migraine, urinary tract infection, diabetes, and hypotension.    Item #2 The last one is called, “A Comprehensive Review on the Benefits and Problems of Curcumin with Respect to Human Health” by Liu et al published in Molecules in July of 2022. Liu S, Liu J, He L, Liu L, Cheng B, Zhou F, Cao D, He Y. A Comprehensive Review on the Benefits and Problems of Curcumin with Respect to Human Health. Molecules. 2022 Jul 8;27(14):4400. doi: 10.3390/molecules27144400. PMID: 35889273; PMCID: PMC9319031. Curcumin, a natural substance found in turmeric, has been the subject of much research in recent years due to its potential health benefits. This review article summarizes the current state of knowledge on curcumin, focusing on its potential benefits, safety, and efficacy. The review begins by discussing the potential health benefits of curcumin. Studies have shown that curcumin has anti-inflammatory, antioxidant, and anti-tumor properties. It may also help with mental health, heart disease, and stroke. However, curcumin is poorly absorbed by the body and its purity can vary. There is also a lack of high-quality studies on curcumin in humans, so we don’t know all of its side effects. The review then discusses the potential safety concerns of curcumin. High doses of curcumin may harm the kidneys, heart, liver, blood, and immune system. More research is needed to determine how safe and effective curcumin is for people. Overall, the review concludes that curcumin is a promising natural substance with potential health benefits. However, more research is needed to determine its safety and efficacy. It is important to talk to your doctor before taking curcumin, especially if you are taking any other medications. In addition to the information provided in the review, here are some additional points to consider: Curcumin is a complex molecule with many different potential health effects. More research is needed to understand how curcumin works in the body. Curcumin is often taken in combination with other substances, such as piperine, which may help to increase its absorption. The quality of curcumin supplements can vary. It is important to choose a high-quality supplement from a reputable manufacturer. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post Daily Water Intake & Curcumin appeared first on Chiropractic Forward.

CF 354: Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach Today we’re going to talk about Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #354 Now if you missed last week’s episode, we talked about Head And Neck Cancer & Degenerative Cervical Myelopathy Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Nothing crazy this week. Just in the grind. I think we’re looking at a great week numbers-wise. We’re looking at about 165 or so this week. Maybe more. Hopefully more.  Still doing the whack-a-mole thing with our billing and collections company. I don’t know exactly what’s going on with them but we just aren’t collecting much in the last month or so.  It’s stressing me. After some time in business, you’ll start to feel a bit like a hamster on a wheel that never ever ends and it’s frustrating and stressful and somewhat maddening. If you describe yourself as a weak-minded person, start working for someone else. Just listen to your ol Uncle Jeffro on this folks. It ain’t for the faint of heart sometimes.  It’s whack-a-mole but with potentially serious implications. Maybe I need to learn some meditation or something like that. Because you know what I’ve found? At the end of the day, it’s all going to be fine. It all works out.  Hell, I lost $750k over a three year period because I had a girl who wasn’t doing her job but was convincing when asked if she was doing her job. Sometimes stats don’t tell the whole story when you’re doing PI work and reducing balances and all that.  Anyway, if I can get over a loss like that, you can get over most things in life wouldn’t you agree?  Remember, keep smacking each and every mole as they pop up, take a long weekend trip somewhere at least once per quarter, smile even when you’re sick, tired, don’t feel good, or are just in a bad mood, treat your staff and your family right, give you patients the best evidence-based, patient-centered care, make sure you are always marketing and keeping your eyes out for new treatment techniques and modalities and you should be good to go.  Some big news on the VoiceOver side of my life. I recently made two really big moves.  I signed with DPN Talent which is a group out of Beverly Hills and is one of the big five national talent agencies in the US. It’s the major leagues and it’s huge.  This week, I signed with ACM which is a big national management group. So we have agents and management. DPN agent, ACM is management.  When you hear someone’s voice on a Super Bowl commercial or some big campaign or movie trailer or something of that size and stature, you’re probably hearing someone that is with a large national agent or with a large management group like these two I’ve signed with.  The point is: things just got really real on the VoiceOver front and Ol Jeffro needs to figure out how to be more available from day to day if needed.  Which bring up one more thing I’ve was talking with our intern, Austin, about recently. Don’t wait until you’re my age to start considering an associate. I could have hired one years ago but my wife was resistant and, honestly……it’s kind of scary. We looked at what it would cost us instead of what it would give us.  Having the right associate would give us security should something happen to me and it would give us clinical growth.  I’ve said it before but, for better or worse, I have a big machine that I’ve built with about 11 or 12 employees currently. That’s a lot of mouths to feed every day. I’ve had COVID four and maybe five times and I only missed one day of work. Yes, blast me for going to work sick if you like. I wore my mask and kept my hands washed and all that good stuff but yeah……I know.  Anyway, the point is that that is not fair to me, it’s not fair to patients, it’s not fair to my family, and it’s not fair to my staff for me to not have better systems in place for a machine this size.  The entire thing still depends on my presence and suffers a great deal should I have to be gone traveling, sick, or injured. That’s not good planning on my part and it’s not fair. Not to mention that 155-175 patients every week is exacting a toll on my 52-year-old, former college football-playing body.  So, for that reason, I’ve been looking for a good associate that wants to be great. My problem is that nobody wants to move to Amarillo. Which I get but I don’t get. It’s dry. No humidity. Yes it can get hot. It can get up to 105 or so on some days in the Summer but no humidity is real. It makes a difference. Then it can get cold as hell. The average Winter temp is probably 35-45 degrees. Some warmer some colder. Yes we get 2-3 snows per year. Some major, some not.  No there are not a ton of trees and lakes in Amarillo but, we are only 3.5 hours from the ski resorts in New Mexico and only about 5 hours from Colorado Springs, 4 hours to Albuquerque 4 hours to OKC, 5.5 hours to Dallas.  And we have a nice little airport to get us where we’re going and there’s about 270k people or more in our immediate region.  So, if you want to give Amarillo some consideration, I hope you will. Email me at [email protected] and let’s get to know each other. The long-term plan is to hire an associate and get them profitable asap. Then hire another associate and repeat. Once that is in place, you’ll both see less and less of me day to day. Voiceover work is calling and I can’t do it at the level it will require if I’m busy doing the hands-on work of patient treatment all day every day. It’s impossible.  So come on y’all. Help a brother out here! Just an offer from your ol Uncle Jeffro.    Item #1 Our first one today is called, “Study raises hopes of treating aggressive cancers by zapping roque DNA” by The Guardian statt and published in November 2024 cheese and rice that’s hot!  Remember, the citations can be found at chiropracticforward.com under this episode. https://www.theguardian.com/society/2024/nov/06/zapping-rogue-dna-key-treating-aggressive-cancers-study Bailey, C., Pich, O., Thol, K. et al. Origins and impact of extrachromosomal DNA. Nature 635, 193–200 (2024). https://doi.org/10.1038/s41586-024-08107-3 Tang, J., Weiser, N.E., Wang, G. et al. Enhancing transcription–replication conflict targets ecDNA-positive cancers. Nature 635, 210–218 (2024). https://doi.org/10.1038/s41586-024-07802-5 Hung, K.L., Jones, M.G., Wong, I.TL. et al. Coordinated inheritance of extrachromosomal DNAs in cancer cells. Nature 635, 201–209 (2024). https://doi.org/10.1038/s41586-024-07861-8   This is an article so we’re just hitting the highlights.  Scientists have made a promising discovery about treating aggressive cancers by focusing on a unique type of DNA called extrachromosomal DNA (ecDNA). Here are the key points: 1. What is ecDNA? Small, circular DNA fragments that break off from chromosomes Previously thought to be rare and unimportant in cancer development Now recognized as a critical factor in tumor growth and treatment resistance 2. Research Findings: Study analyzed nearly 15,000 UK patients across 39 tumor types 17.1% of tumors contained ecDNA More common in breast, brain, and lung cancers 3. Why ecDNA is Problematic: Carries cancer-driving genes Helps tumors suppress the immune system Allows tumors to replicate rapidly and unevenly, increasing genetic diversity Makes cancers more resistant to traditional treatments 4. Potential Treatment breakthrough: Researchers identified CHK1 inhibitors as a potential targeted treatment Initial mouse experiments showed promise in reducing tumors and preventing drug resistance The researchers are hopeful this discovery could transform cancer treatment, potentially turning “terrible prognosis into a treatable one” by targeting these unique DNA fragments. The article references three research papers published in Nature, but does not provide the specific citation details. Based on the text, the research was: A collaborative US-UK study Funded by Cancer Grand Challenges (an initiative co-founded by Cancer Research UK and the US National Cancer Institute) Analyzed tumors from nearly 15,000 UK patients Involved researchers including: Paul Mischel (Stanford University) Charles Swanton (Francis Crick Institute) I’ve seen other cancer papers coming out more recently that really give me a lot of hope that maybe, just maybe with all of the new technology we have access to now, that cancer is about to go the way of polio. We can only hope.    Item #2 The second one is called, “Effect of Chiropractic Intervention on Oculomotor and Attentional Visual Outcomes in Young Adults With Long-Term Mild Traumatic Brain Injury: A Randomized Controlled Trial” by Cade et al and published in the Journal of Manipulative and Physiological Therapeutics on November 4, 2024, and good gravy almighty it’s a hot one, comin’ through.  Effect of Chiropractic Intervention on Oculomotor and Attentional Visual Outcomes in Young Adults With Long-Term Mild Traumatic Brain Injury: A Randomized Controlled Trial Cade, Alice E. et al. Journal of Manipulative & Physiological Therapeutics, Volume 0, Issue 0 Why They Did It This study aimed to establish if chiropractic care can improve oculomotor and cognitive symptoms in individuals with persistent postconcussion syndrome (PPCS). Wait a minute, hold the damn phone, what exactly is PPCS? Well, lemme tell ya: a condition that occurs when symptoms of a concussion continue past the normal recovery period and last for more than three months.  Symptoms can include: Physical symptoms, such as headaches, dizziness, nausea, and sensitivity to light and sound Cognitive symptoms, such as difficulty concentrating and memory problems Psychological symptoms, such as depression, anxiety, and irritability Sleep issues, such as insomnia or hypersomnia Sensory symptoms, which can affect vision, hearing, smell, taste, touch, and balance OK, now that we’re all up to speed….. How They Did It A single-blind, randomized controlled intervention study recorded baseline computerized eye-tracker assessment (CEA) outcomes in 40 young adults with PPCS following mild traumatic brain injury.  Participants were randomly allocated to either a chiropractic or age-matched active control intervention, and the change in CEA outcomes following intervention was compared between the chiropractic and control groups.  A battery of CEAs including egocentric localization, fixation stability, pursuit, saccades, Stroop, and the vestibulo-ocular reflex, were used to assess oculomotor function, visual attention/processing, and selective attention. What They Found Relative to the control group, participants receiving the chiropractic intervention scored better in the Stroop test, had improved gaze stability during both vestibulo-ocular reflex and fixation stability, and a lower vertical error in egocentric localization.  However, performance was poorer in pursuits, where they had an increased tracking error Wrap It Up Chiropractic care in participants with PPCS significantly improved static and dynamic gaze stability, and performance in the Stroop test, compared with a control intervention.  These results suggest that chiropractic care can offer a novel avenue for alleviating certain visual and cognitive symptoms in patients with PPCS.  It also adds to the growing evidence that suggests that some longstanding PPCS visual symptoms may have a spinal or proprioceptive basis. And there you have it, smarter now than before. Y’all have a great week and we’ll see you right here again next week.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.    Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger          The post Chiropractic Treatment Of Mild Traumatic Brain Injury & New Cancer Treatment Approach appeared first on Chiropractic Forward.

CF 353: Head And Neck Cancer & Degenerative Cervical Myelopathy Today we’re going to talk about Head And Neck Cancer & Degenerative Cervical Myelopathy But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #353 Now if you missed last week’s episode, we talked about PT In The ER & Back Pain And Mortality. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Well, let’s see, what’s up this week? I think we’re picking up a little. We had 155 chiro visits last week and being a Monday when I’m sitting down and thinking about all this, we have 47 today which includes 3 new patients and 4 re-exams so we’re looking pretty good.  At the moment Monday morning, we have 134 set up for the whole week. Some will fall off and some will hop onto the schedule. That’s just the deal but Wednesday folks will re-book on Friday and Tuesday folks will re-book on Thursday or Friday so I’m betting we wind up back around the 150-155 mark if not more.  We shall see. The story is that I’m still not where I was prior to COVID which is super frustrating. Back then I was around 180-200 per week. Which if I’m being honest, is too much for me. I’m too old for that. I’m actually pretty happy with 155-165.  But, have you considered your future? I know two folks with two different stories I’ll share.  One worked his whole life until he was diagnosed with cancer when he was in his 60s. He didn’t have an exit plan. He ended up passing away and his practice at that point was worthless and there was nothing to sell. Nothing. I don’t want that for you.  The other died in his office working at about 75 or 80 years old. Now, this guy, I don’t believe in bad shape financially. I think he loved his job. But I also don’t want you forced into working into your 70s or 80s because you have failed to plan and you don’t have an exit plan.  So, start at the end and work backward. What do you want your retirement to look like? What age would you like to retire? I’d recommend getting a wealth planner to help you plan it out, set goals, and keep you on track to reaching those goals.  How much do you have to make and how much do you need to be investing monthly? What other talents and skills do you have that can hurry up your plans? I promise you have knowledge that nobody else has. Write books, become a speaker, release online courses, podcasts, etc. Become the expert and monetize it. Real estate is a good investment. Lots of things that can be done that give you better returns than just doing the stock market alone.  These things can get you there quicker.  One thing I’ll share is to make sure your clinic is sellable when you’re ready to sell one day. If you name the clinic ‘My Last Name Chiropractic’…..trust me if your last name is Williams, someone named Pavlochek doesn’t love the name ‘Williams Chiropractic’.  If you’ve made the whole thing about you (and sometimes it’s really hard to not be about you), then when someone else comes in, trust fades.  A lot of what we do in my clinic is ME centered but I advertise and promote our medical team a lot, acupuncture, massage, exercise/rehab and all that because I can’t have it being all about me.  And when we find an associate that wants to make Amarillo and my clinic their home, you better believe we’re promoting the crap out of that associate. Before they even start. You won’t see my face on much if anything.  These are things that make your clinic more sellable. That’s why mine is called Creek Stone Integrated Medical….because I don’t want to be the focus. As a result, we are in talks with a private equity investment group to sell 60% of our clinic which will pay me a salary plus my commission plus the buyout.  Then, I can get an associate, and then once they’re busy and profitable, get another associate. That system sets up redundancy. If one leaves, the remaining associate can step up and train the next that we hire without me needing to be in the mix.  Plus, we’ll be adding a PT soon so, with a nurse prac, a PT, an acupuncturist, 2 massage therapists, and 2 associate DCs….that is a system that begins to remove me from full time, hands-on treatment which frees me up to be more creative with marketing and community touches.  Then I also have Airbnbs and voice-over to fill in any gaps that might pop up. I also do fine art that you can check out at riverhorseart.com but I don’t see that ever paying all my bills. Though I wish it would. That’s what I truly love. And I play gigs singing and playing and writing songs but again, that’s not paying any big bills. That’s more stuff that feeds my soul. Not my family So, you see…..I’ve been laying the groundwork to be able to, hopefully by the age of 55, to step away nice and slowly and responsibly while maintaining my lifestyle and maybe starting to even enjoy life a little more.  So, that’s my exit plan. What’s your exit plan? I’d love to hear all about it. Shoot me an email. You may have some tips I can share with our listeners.  Item #1 Our first one this week is called, “The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review” by Jiang et al and published in Global Spine Journal in May of 2024 and it’s hot enough to bring the smoke! Remember, the citations can be found at chiropracticforward.com under this episode.    Jiang Z, Davies B, Zipser C, Margetis K, Martin A, Matsoukas S, Zipser-Mohammadzada F, Kheram N, Boraschi A, Zakin E, Obadaseraye OR, Fehlings MG, Wilson J, Yurac R, Cook CE, Milligan J, Tabrah J, Widdop S, Wood L, Roberts EA, Rujeedawa T, Tetreault L; AO Spine RECODE-DCM Diagnostic Criteria Incubator. The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review. Global Spine J. 2024 May;14(4):1395-1421. doi: 10.1177/21925682231210468. Epub 2023 Nov 2. PMID: 37917661; PMCID: PMC11289544.   Why They Did It Delayed diagnosis of degenerative cervical myelopathy (DCM) is associated with reduced quality of life and greater disability. Developing diagnostic criteria for degenerative cervical myelopathy has been identified as a top research priority. They aimed to address the following questions: What is the diagnostic accuracy and frequency of clinical symptoms in patients with degenerative cervical myelopathy? How They Did It A scoping review was conducted using a database of all primary degenerative cervical myelopathy studies published between 2005 and 2020.  Studies were included if they  assessed the diagnostic accuracy of a symptom using an appropriate control group or  reported the frequency of a symptom in a cohort of degenerative cervical myelopathy patients. What They Found This review identified three studies that discussed the diagnostic accuracy of various symptoms and included a control group.  An additional 58 reported on the frequency of symptoms in a cohort of patients with degenerative cervical myelopathy.  The most frequent and sensitive symptoms in degenerative cervical myelopathy include unspecified paresthesias (86%), hand numbness (82%) and hand paresthesias (79%).  Neck and/or shoulder pain was present in 51% of patients with degenerative cervical myelopathy, whereas a minority had back (19%) or lower extremity pain (10%).  Bladder dysfunction was uncommon (38%) although more frequent than bowel (23%) and sexual impairment (4%).  Gait impairment is also commonly seen in patients with degenerative cervical myelopathy (72%). Wrap It Up Patients with degenerative cervical myelopathy present with many different symptoms, most commonly sensorimotor impairment of the upper extremities, pain, bladder dysfunction and gait disturbance.  If patients present with a combination of these symptoms, further neuroimaging is indicated to confirm the diagnosis of degenerative cervical myelopathy.   Item #2 And the last one which continues my full assault on legalizing cannabis for recreational use, we have this one called, “Cannabis Use and Head and Neck Cancer” by Gallagher et al and published in JAMA Otolaryngol Head Neck Surgery on August 8, 2024 psssstttt…..it’s smokin’! Gallagher TJ, Chung RS, Lin ME, Kim I, Kokot NC. Cannabis Use and Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. Published online August 08, 2024. doi:10.1001/jamaoto.2024.2419 Why They Did It Cannabis is the most commonly used illicit substance worldwide. Whether cannabis use is associated with head and neck cancer (HNC) is unclear. Objective  To assess the clinical association between cannabis use and head and neck cancer How They Did It This large multicenter cohort study used clinical records from a database that included 20 years of data (through April 2024) from 64 health care organizations.  A database was searched for medical records for US adults with and without cannabis-related disorder who had recorded outpatient hospital clinic visits and no prior history of head and neck cancer.  Propensity score matching was performed for demographic characteristics, alcohol-related disorders, and tobacco use.  Subsequently, relative risks (RRs) were calculated to explore risk of head and neck cancer, including head and neck cancer subsites.  This analysis was repeated among those younger than 60 years and 60 years or older. Cannabis-related disorder Main Outcomes and Measures:  Diagnosis of head and neck cancer and any head and neck cancer subsite What They Found The cannabis-related disorder cohort included 116,076 individuals  The non–cannabis-related disorder cohort included 3,985,286 individuals The rate of new head and neck cancer diagnosis in all sites was higher in the cannabis-related disorder cohort.  After matching, patients with cannabis-related disorder had a higher risk of any head and neck cancer than those without head and neck cancer.  A site-specific analysis yielded that those with cannabis-related disorder had a higher risk of oral, oropharyngeal, and laryngeal cancer.  Results were consistent when stratifying by older and younger age group. Wrap It Up This cohort study highlights an association between cannabis-related disorder and the development of head and neck cancer in adult patients.  Given the limitations of the database, future research should examine the mechanism of this association and analyze dose response with strong controls to further support evidence of cannabis use as a risk factor for head and neck cancers. So….for actual legitimate medical use only? Absolutely. For recreational use? Absolutely not. Yes, it’s probably less harmful than alcohol and maybe the same or less harmful than ciggies. But we tried to outlaw alcohol and it didn’t work very well. There are a lot of groups RIGHT NOW trying to get rid of ciggies. Right now.  WHY ADD MORE BAD CRAP WHEN WE TRY TO GET RID OF THE BAD CRAP WE ALREADY HAVE? Hey, I see you’re drowning, here’s a 50 lbs weight just because you like weights and weights make you feel really good. Maybe it’ll help you get out of the water OK.  Probably not. 2 wrongs don’t make a right. So stop it damnit.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger        The post Head And Neck Cancer & Degenerative Cervical Myelopathy appeared first on Chiropractic Forward.

CF 352: PT In The ER & Back Pain And Mortality Today we’re going to talk about PT In The ER & Back Pain And Mortality But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we  are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #352 Now if you missed last week’s episode, we talked about Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Welp, October is wrapped up and here we are in November already. Time change and everything. Except for our brethren in Arizona who are basically geniuses for not going along with the rest of the idiots that are still changing time twice per year.  Why is that still a thing? This time change is fine because we gain an hour of sleep but it’s dark when we get out of work for 4 months. And that makes for a bitchy, Jeff. I’m just saying.  In the Spring, when it changes back to a sane time, how about we just leave it for once? Maybe that’s just too much to ask.  Business, we did great in October. Except for collections. Remember, clinic ownership is a game of whack-a-mole. Over and over. As soon as you get problems fixed, something else will pop its head up. Last month, it was collections. The month before, back in September, we collected about a third more than our overhead. Maybe even more than that. In October, we knocked it out of the park on our stats. Patient visits, new patients, billing, the whole thing. Except for collections which might have covered our overhead. Maybe.  It’s so damn frustrating. This is yet another reason that you have to leave some gas in your tank. You cannot control collections. Especially if they’re off-site, which ours is off-site. One of our billing clearing houses had some sort of computer glitch two weeks ago and is still clearing it up. Well, we don’t have a bit of control over that. Unless we chose to go cash. Which I’m scared to death of because I’m a terrible salesperson. I didn’t get into this to sell. I got into it to heal.  Anyway, if I didn’t leave gas in the tank and have reserves, and this glitch continues, we’d really start to worry about payroll this Friday, right? But, the work was done, it’s out there. We just gotta get it. And in the meantime, we have reserves to cover us until we can get it.  Other than that, the new medical team is up and running and really settling in here at the clinic and getting comfortable. It’s always difficult to get new providers started and up and running but we’re on it.  Whack-a-freaking-mole. Embrace it and lean into it because that’s the way of life for a clinic owner. If you’re an employee and you don’t own it, you’re good. Enjoy your life.  If you’re the owner, lean into it and give whack-a-mole an inappropriately long hug because you better get comfortable and get to know each other very well.  Item #1 Our first one this week is called, “Advanced Musculoskeletal Physiotherapists Are Effective and Safe in Managing Patients with Acute Low Back Pain Presenting to Emergency Departments” by Sayer et al and published in the Australian Health Review in June of 2018.  Remember, the citations can be found at chiropracticforward.com under this episode.  Sayer JM, Kinsella RM, Cary BA, Burge AT, Kimmel LA, Harding P. Advanced musculoskeletal physiotherapists are effective and safe in managing patients with acute low back pain presenting to emergency departments. Aust Health Rev. 2018 Jun;42(3):321-326. doi: 10.1071/AH16211. PMID: 28538139.   Why They Did It The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-advanced PT clinicians (ED doctors and nurse practitioners). How They Did It A retrospective audit was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by advanced PT and non-advanced PT clinicians.  Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED.  What They Found One thousand and eighty-nine patients with low back pain were seen during advanced PT service hours (360 in the advanced PT group, 729 in the non-advanced PT group).  Patients seen by the advanced PT had a significantly shorter ED wait time and ED length of stay.  Significantly fewer patients seen by the advanced PT were admitted, and this difference remained after accounting for the difference in triage code between the groups. Wrap It Up Improved ED metrics were demonstrated in patients with low back pain when managed by an advanced PT compared with patients seen by doctors and nurse practitioners.  There is a growing body of literature regarding the role of advanced PTs in the Australian healthcare system in providing clinical services for patients with musculoskeletal conditions, including settings such as the ED.  advanced PTs have proven to be safe and cost-effective, achieving high patient satisfaction and improved patient outcomes.  Item #2 Our last one this week is called, “Association of back pain with all-cause and cause-specific mortality among older men: a cohort study” by Roseen et al and published in Pain Medicine in August of 2024 and schiza it’s hot to the touch! Eric J Roseen, David T McNaughton, Stephanie Harrison, Aron S Downie, Cecilie K Øverås, Casper G Nim, Hazel J Jenkins, James J Young, Jan Hartvigsen, Katie L Stone, Kristine E Ensrud, Soomi Lee, Peggy M Cawthon, Howard A Fink, for the Osteoporotic Fractures in Men (MrOS) Research Group, Association of back pain with all-cause and cause-specific mortality among older men: a cohort study, Pain Medicine, Volume 25, Issue 8, August 2024, Pages 505–513, https://doi.org/10.1093/pm/pnae040   Why They Did It They wanted to evaluate whether more severe back pain phenotypes—persistent, frequent, or disabling back pain—are associated with a higher mortality rate among older men. How They Did It In this secondary analysis of a prospective cohort, the Osteoporotic Fractures in Men (MrOS) study, they evaluated mortality rates by back pain phenotype among 5,215 older men from 6 sites in the United States.  The primary back pain measure used baseline and Year 5 back pain questionnaire data to characterize participants as having no back pain, nonpersistent back pain, infrequent persistent back pain, or frequent persistent back pain.  Secondary measures of back pain from the Year 5 questionnaire included disabling back pain phenotypes. The main outcomes measured were all-cause and cause-specific death. What They Found After the Year 5 exam, during up to 18  years of follow-up (mean follow-up = 10.3 years), there were 3,513 deaths (1218 cardiovascular, 764 cancer, 1531 other).  A higher proportion of men with frequent persistent back pain versus no back pain died.  No association was evident after further adjustment for health-related factors, such as self-reported general health and comorbid chronic health conditions.  Results were similar for cardiovascular deaths and other deaths, but we observed no association of back pain with cancer deaths.  Secondary back pain measures, including back-related disability, were associated with increased mortality risk that remained statistically significant in fully adjusted models. Wrap It Up Although frequent persistent back pain was not independently associated with risk of death in older men, additional secondary disabling back pain phenotypes were independently associated with increased mortality rate.  And there you have it. It makes sense that if back pain has you disabled, then lack of movement, activity, and function would lead to increased mortality, no?  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.    Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger        The post PT In The ER & Back Pain And Mortality appeared first on Chiropractic Forward.

CF 351: Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain Today we’re going to talk about Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #351 Now if you missed last week’s episode, we talked about Acupuncture For Sciatica & Adolescent Cannabis Usse And Academic Achievement.  Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Being a part of Parker College’s CBI or internship program…..folks…..it Ain’t easy. But, going to school there, I can share with you that it’s never been easy with Parker. Lol.  Example, I signed up with the preceptor program with Logan out in St. Louis. I sent in my sample notes, and was accepted and that was it. I don’t hear from them except once a year to make sure I’d like to remain in their program and the answer is always a pleasant yes.  Not with my alma mater. Nope, they need the updated license, the updated building liability policy, the updated malpracticee dec page, the updated CPR cert every two years, they need you to watch videos each year, they send emails fairly consitently, and it’s just a whole lot. Honestly. A LOT.  I told you that to tell you this; the entire team here at my clinic went to get our CPR certs re-newed last week. I had to stay late to pay for everyone. My team left and I was talking with the CPR dude and he asked me if my whole team was different from when we came and did the training 2 years ago. I said, yes, completely different.  He shared with me that he has seen that with every organization and clinic in town that has come through. I told him that it’s so frustrating to me because I’ve never raised my voice to a team member. Ever. I get frustrated like everyone else. I’m not perfect but yelling isn’t my vibe. I can be calm and direct and they understand, hey, Boss is fussy about this…..let’s get that tightened up. Whatever it is.  So, I treat them with respect. Then another big one is money, right? The least I pay any of them is $18/hr. I don’t cheap out on paying them. They need off to go to a doctor or pick up their kid from school?/ Okay, hurry and we’ll see you asap.  I can’t tell you how many people we’ve gone through in the last 2-3 years but off the top of my head I can think of about 10 and I only have 4 full timers not counting myself. I’m pretty sure it’s more than 10 but we’ll go with it for the sake of the conversation.  I used to hold onto staff members for 3 or more years in general. That might demonstrate why 10 in 1-2 years has been such a challenge and so disappointing. It really has been a struggle. And after so many of them, you start to wonder, “Was it me? Was there something I did or something I could have done better?” Many times, you can answer that question yourself. For example, I had one that went bad on me. At first I didn’t know but then it became overt and obnoxious. I love people and I believe in them and hung on too long. I should have cut that person loose much much faster.  This person made life difficult on everyone else after some time and the tension was just thick and palpable toward the end.  I think this person was partly to blame for so much turnover as well. But, who knows? Sometimes, you can’t find something you could have done better. It just is what it is. But, what was somewhat comforting to hear is that it is not only me. It’s everyone. Eveyrone is having the turnover problem. Gen X peoplee like me look at it as a generational issue or a post-COVID issue.  I don’t know the issue. I just know that it is indeed a very real issue. However, my current team, I feel really really good about. I have the best front desk member that I’ve ever had in 27 years of practice. My 3 in the back office are all friends and work hard. We enjoy being at work with each other now and look foward to seeing each other. My new medical team is excited to be here treating our patients and our team loves them.  So, as of right now, we are in the best, most positive, most optimistic spot we’ve been in business-wise in at least 2-3 years.  This was not a gripe session. This was more of a relaying of a conversation I had but to also say, we’ve gone through this, and may go through it again in the future. However, there is hope if you’re experiencing the turnover problem and just do your best until your reach some level of homeostasis like we finally have reached here in the clinic.  It’s still possible in 2024.  Alright, onto the research.  Item #1 Our first onee today is called, “A Systematic Review of Clinical Practice Guidelines for Persons With Non-specific Low Back Pain With and Without Radiculopathy: Identification of Best Evidence for Rehabilitation to Develop the WHO’s Package of Interventions for Rehabilitation” by Zaina et al and published in Archives of Physical Medicine and Rehabilitation in November of 2023 and it’s not a year old so that makes it hot, hot, hot! Remember, the citations can be found at chiropracticforward.com under this episode.  Fabio Zaina, Pierre Côté, Carolina Cancelliere, Francesca Di Felice, Sabrina Donzelli, Alexandra Rauch, Leslie Verville, Stefano Negrini, Margareta Nordin, A Systematic Review of Clinical Practice Guidelines for Persons With Non-specific Low Back Pain With and Without Radiculopathy: Identification of Best Evidence for Rehabilitation to Develop the WHO’s Package of Interventions for Rehabilitation, Archives of Physical Medicine and Rehabilitation, Volume 104, Issue 11, 2023, Pages 1913-1927, This systematic review synthesized recommendations from high-quality clinical practice guidelines (CPGs) on the rehabilitation management of low back pain (LBP) with or without radiculopathy in adult populations. The researchers conducted a comprehensive search to identify relevant clinical practice guidelines, and then used the AGREE II tool to critically appraise the methodological quality of the included guidelines. They selected the 4 highest quality clinical practice guidelines for their final analysis. The key findings were: Education: guidelines emphasized the importance of providing patients with tailored education and advice to promote self-management and encourage continued activity. Exercise: Recommendations focused on exercise-based approaches, often in combination with other interventions like manual therapy and cognitive-behavioral strategies. Multimodal rehabilitation: For chronic, complex cases, the guidelines recommended intensive interdisciplinary rehabilitation programs with a cognitive-behavioral emphasis. Limited role of passive modalities: guidelines generally did not support the use of passive physical agents like ultrasound, TENS, and interferential therapy. Cautious use of pharmacotherapy: The guidelines recommended judicious, short-term use of medications like NSAIDs and limited the role of opioids and antidepressants. This seems a bit more weighted toward exercise than anyhting else but for massage specifically, one guideline recommended considering manual therapy techniques like massage as part of a treatment package including exercise, with or without psychological therapy. For acupuncture specifically, one guideline recommended acupuncture for subacute low back pain, but another guideline did not recommend acupuncture for managing low back pain with or without sciatica. But, if you have listened in the last week or so, we covered a paper that addressed acupuncture and low back pain with sciatica that showed it to actually be an effective way to treat it.  And for spinal manipulative therapy specifically, for patients with chronic (>3 months) low back pain, the guidelines suggested or recommended SMT to decrease pain and disability, either alone or as part of a multimodal approach. One guideline recommended considering SMT as part of early intervention for acute and subacute low back pain. The researchers noted that many guideline recommendations were based on lower quality evidence or expert opinion, highlighting the need for higher quality rehabilitation research.  Overall, this review provides a synthesis of the current best practice recommendations for the rehabilitation of adults with low back pain, emphasizing a biopsychosocial, multimodal approach centered on empowering patients through education and active treatment. Item #2 OK, our second one today is called, “The relationship between emotion regulation and pain catastrophizing in patients with chronic pain” by Yuan et al and published in Pain Medicine in July of 2024 and get me an oven mitt… it’s too hot to freakin’ handle.  Yan Yuan, Kristin Schreiber, K Mikayla Flowers, Robert Edwards, Desiree Azizoddin, LauraEllen Ashcraft, Christina E Newhill, Valerie Hruschak, The relationship between emotion regulation and pain catastrophizing in patients with chronic pain, Pain Medicine, Volume 25, Issue 7, July 2024, Pages 468–477, https://doi.org/10.1093/pm/pnae009 Why They Did It Pain catastrophizing (PC) is a cognitive/emotional response to and in anticipation of pain that can be maladaptive, further exacerbating pain and difficulty in emotion regulation (ER). There is a lack of research on the interplay between pain catastrophizing and emotion regulation and its impact on pain. Our aim was to investigate whether emotion regulation exacerbated the pain experience through pain catastrophizing. How They Did It Adults with chronic non-cancer pain of >3 months’ duration (n = 150) who were taking opioid medication were recruited from a large medical center in Pennsylvania.  A battery of questionnaires was conducted to gather data on demographics, substance use, mental health histories, and health and pain outcomes.  Measures used included the 18-Item Difficulties in Emotion Regulation Scale, the Pain Catastrophizing Scale, the Brief Pain Inventory–Short Form, and the Hospital Anxiety and Depression Scale.  A structural equation model with latent variables was conducted to examine our aim. What They Found Both pain interference and severity were significantly positively associated with several psychosocial variables, such as anxiety, depression, emotion regulation constructs, pain catastrophizing, and distress intolerance.  The associations between subscales and pain interference were larger than the associations between subscales and pain severity. pain catastrophizing fully mediated the paths from emotion regulation to pain experiences. Wrap It Up Our results highlight the importance of several cognitive and emotional constructs: nonacceptance of negative emotions, lack of emotional awareness, magnification of the pain experience, and a sense of helplessness.  Furthermore, by showing the indirect effects of pain catastrophizing in affecting emotion regulation and pain, we posit that emotion regulation, mediated by pain catastrophizing, might serve a critical role in influencing the pain experience in patients with chronic pain. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Guides Treating Non-specific Low Back Pain & Pain-Catastrophizing With Chronic Pain appeared first on Chiropractic Forward.

CF 350: Acupuncture For Sciatica & Adolescent Cannabis Use And Academic Achievement Today we’re going to talk about Acupuncture For Sciatica & Adolescent Cannabis Use And Academic Achievement But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #350 Now if you missed last week’s episode, we talked about Proprioceptive Neuromuscular Facilitation & SMT Adverse Events. Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. I missed last week annd I’m sorry about that. I was heading down to San Antonio for the MCM Mastermind weekend. As a result of taking two days off last week, everyone was jammed into just a few days and there just wasn’t enough time to get last week’s episode handled. So, my apologies.  The weekend was great with my Mastermind family. It was the last one of the year. It was the last one of the year which means we have a few leaving and we have a few coming in to take their place.  Which is exciting. For example, we have a large integrated clinic owner that is transitioning out of the group this year but have another bigger integrated clinic coming into the group. We have a great sports chiro going out but we have the team chiro for Clemson coming in.  So we’re excited. And the ones leaving, we’re still besties. We’re not magically losing each others’ phone numbers just because they’re leaving the group. These are connections that will last a lifetime. Inside or outside of the group.  I know the East Mastermind is full but the West Mastermind is not full and has plenty of available spots. If you’re interested, email Dr. Kevin Christie at [email protected] and he’ll get you all the info set.  I’m still playing catchup from being gone last week so I’m going to keep it short this week and go ahead and hop into the episode.  Item #1 Our first one this week is called, “Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk A Randomized Clinical Trial” by Jian Feng Tu, et al and published in JAMA Internal Medicine on October 14, 2024.  And holy face of the sun, it’s a hot one today! Remember, the citations can be found at chiropracticforward.com under this episode.  Tu J, Shi G, Yan S, et al. Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial. JAMA Intern Med. Published online October 14, 2024. doi:10.1001/jamainternmed.2024.5463 Why They Did It Sciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce. The wanted to investigate the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk. How They Did It This was a multicenter 2-arm randomized clinical trial conducted in 6 tertiary-level hospitals in China of patients with chronic sciatica from herniated disk.  Interventions  Participants were randomly assigned to receive 10 sessions of acupuncture (n = 110) or sham acupuncture (n = 110) over 4 weeks. Participants, outcome assessors, and statisticians were blinded. Main Outcomes and Measures  The 2 coprimary outcomes were changes in visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) from baseline to week 4.  Secondary outcomes were adverse events. What They Found A total of 216 patients were included in the analyses.  The VAS for leg pain decreased 30.8 mm in the acupuncture group and 14.9 mm in the sham acupuncture group at week 4  The ODI decreased 13.0 points in the acupuncture group and 4.9 points in the sham acupuncture group at week 4  For both VAS and ODI, the between-group difference became apparent starting in week 2 and persisted through week 52  No serious adverse events occurred. Wrap It Up This randomized clinical trial found that in patients with chronic sciatica from herniated disk, acupuncture resulted in less pain and better function compared with sham acupuncture at week 4, and these benefits persisted through week 52.  Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk. Item #2 Our last one this week is called, “Cannabis Use During Adolescence and Young Adulthood and Academic Achievement A Systematic Review and Meta-Analysis” by Chan et al and published in JAMA Pediatrics on October 7, 2024.  Es muy en fuego, mi amigos! Chan O, Daudi A, Ji D, et al. Cannabis Use During Adolescence and Young Adulthood and Academic Achievement: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online October 07, 2024. doi:10.1001/jamapediatrics.2024.3674 Before we hop in here, you see me talk about cannabis research when it pops up. Why would I do that? Well, I have lots of kids and parents come in my office every month smelling like the devil’s lettuce. I see more and more politicians acting like legalization for recreation is the way to go and I don’t agree. And research is clear as to why none of us as healthcare providers should agree.  The common smoker’s retort is that it’s better than alcohol and less dangerous. On most accounts, you’re not wrong. But, we tried to outlaw Alcohol back in the early 1900’s and guess what? It didn’t work out so well. It was called Prohibition. Crack open that history book and take a stroll or watch some documentaries.  So, if we already have that harmful product legally in circulation, why in the HELL would we ever voluntarily legalize another harmful substance? Because some like living in an altered state at all hours of the day? Might as well make it normalized. Because we want yet another way to make our populations tired and unmotivated? Yay!!! Sign the bill! I realize this makes me uncool in 2024 but I’m not on the recreational legalization train and never will be. I think it’s one of the dumbest things these 3 or so generations have every come up with.  Now, medicinal, properly prescribed use? All day every day, folks. We use morphine medically when appropriate. Why wouldn’t we use cannabis in the same way? But recreational….what are you smoking? Why They Did It Cannabis use during adolescence and young adulthood may affect academic achievement; however, the magnitude of association remains unclear. Objective  To conduct a systematic review evaluating the association between cannabis use and academic performance. How They Did It Data Sources  CINAHL, EMBASE, MEDLINE, PsycInfo, PubMed, Scopus, and Web of Science from inception to November 10, 2023. Study Selection  Observational studies examining the association of cannabis use with academic outcomes were selected. The literature search identified 17 622 unique citations. Main Outcomes and Measures  School grades, school dropout, school absenteeism, grade retention, high school completion, university enrollment, postsecondary degree attainment, and unemployment. What They Found Sixty-three studies including 438,329 individuals proved eligible for analysis.  Moderate-certainty evidence showed cannabis use during adolescence and young adulthood was probably associated with lower school grades; less likelihood of high school completion, university enrollment, and postsecondary degree attainment; and increased school dropout rate and school absenteeism.  Absolute risk effects ranged from 7% to 14%.  Low-certainty evidence suggested that cannabis use may be associated with increased unemployment, with an absolute risk increase of 9%.  Subgroup analyses with moderate credibility showed worse academic outcomes for frequent cannabis users and for students who began cannabis use earlier.   Wrap It Up Cannabis use during adolescence and young adulthood was probably associated with increases in school absenteeism and dropout; reduced likelihood of obtaining high academic grades, graduating high school, enrolling in university, and postsecondary degree attainment; and perhaps increased unemployment.  Just a tip from your completely uncool Uncle Jeffro Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.          Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Acupuncture For Sciatica & Adolescent Cannabis Use And Academic Achievement appeared first on Chiropractic Forward.

CF 349: Proprioceptive Neuromuscular Facilitation & SMT Adverse Events Today we’re going to talk about Proprioceptive Neuromuscular Facilitation & SMT Adverse Events But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #349 Now if you missed last week’s episode, we talked about SMT Research Review & Mobile Phones And Cancer Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Welp, what can I say, some days you’re the nail and some days you’re the hammer. Today, my friends, I’m the hammer. What the hell does that mean you might ask.  Well, this is a slight departure from chiropractic clinic talk for a brief minute but I got some ‘splainin’ to do. In the VoiceOver realm, there are about 5 big national agencies that rep the big talents. The ones you mostly hear on the TVs and elsewhere.  One of those agencies is called DPN out in Los Angeles. I have been talking with DPN for a bit and trying my best to make things happen. Well, it all came together today and I was signed by DPN.  Now here’s why that’s so cool. The Big 5 agencies have access to the biggest voice gigs in the country. I already have about 9 regional agents buut they don’t get the big boy gigs like the nationals get. For example, DPN reps the national voice for Ford trucks and that dude makes north of $1 million per year.  THAT’s what I’m talking about, friends. Now that doesn’t mean I’m about to be a multi-millionaire and all that good stuff. It just means I now have access to those gigs and a real opportunity to land them.  So it’s all pretty exciting around the Williams Estate today. It’s electric you might say.  In the clinic, our old nurse prac is out and our new medical team is in. We are up and running and killing it already and super excited about it. We went from full time salary position to hourly without health benefits for this first year. Which means we save thousands and are super excited to be profitable on the medical side and staying that way despite the transition.  Change is stressful but this is a good change and will be huge in the long-term. The team we have coming in is outstanding and growth minded.  We are going to have some bumps along the way but sometimes, you just gotta jump in and get going. Which is waht we’re doing today. Seems like for the first time in about a year or two, we have all similar personalities, all goign in the right direction, all getting along and enjoying each others’ company. And that’s gold. It’s the sweet spot.  Something I’ve been doing lately that will offer up some opportunities in the future: at the suggestion of one of our MCM Mastermind members, Vanessa, my wife and I started playing the points and miles game. With spends as high as we see in our offices, points and miles can add up very quickly.  I travel a lot for business and we have an overhead of about $60,000-$65,000 per month here at the clinic. So, you can see how we might stack up the point fast and score some free airline tickets and hotel packages.  If you’re interested in a free course to learn all about how to do it, go to https://10xtravel.com and click on Start With Our Free Course at the top of the page. I don’t get a thing out of it. No affiliate link or anything like that. But, if you decide to get a card, holler at me and I’ll send you a referral link so I can get some points out of that. Deal? Alright, let’s jump into the research this week shall we? Item #1 This first one comes to us from our Parker intern. Mr. Austin Moya went and found this after I did a resisted ROM move on a patient that had a locked facet and SMT was just not going to happen.  So, thank you to Austin for making us all just a little bit smarter.  It was done by Kinet et al in 2012 and published in Journal of Human Kinetics.  Remember, the citations can be found at chiropracticforward.com under this episode.  Hindle KB, Whitcomb TJ, Briggs WO, Hong J. Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function. J Hum Kinet. 2012 Mar;31:105-13. doi: 10.2478/v10078-012-0011-y. Epub 2012 Apr 3. PMID: 23487249; PMCID: PMC3588663.   Why They Did It Proprioceptive neuromuscular facilitation (PNF) is common practice for increasing range of motion, though little research has been done to evaluate theories behind it. The purpose of this study was to review possible mechanisms, proposed theories, and physiological changes that occur due to proprioceptive neuromuscular facilitation techniques How They Did It Four theoretical mechanisms were identified: autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory.  What They Found The studies suggest that a combination of these four mechanisms enhances range of motion. When completed prior to exercise, proprioceptive neuromuscular facilitation decreases performance in maximal effort exercises.  When this stretching technique is performed consistently and post-exercise, it increases athletic performance, along with range of motion.  Little investigation has been done regarding the theoretical mechanisms of proprioceptive neuromuscular facilitation, though four mechanisms were identified from the literature.  As stated, the main goal of proprioceptive neuromuscular facilitation is to increase range of motion and performance. Studies found both of these to be true when completed under the correct conditions. Wrap It Up These mechanisms were found to be plausible; however, further investigation needs to be conducted. All four mechanisms behind the stretching technique explain the reasoning behind the increase in range of motion, as well as in strength and athletic performance. Proprioceptive neuromuscular facilitation shows potential benefits if performed correctly and consistently. So, if someone has a locked up facet, do you just hammer through that neck regardless of the pain the patient is in?  If you’ve got extrapment of synovial folds, which can happen from sustained awkward sleeping positions, does it make sense to hammer through it on the first visit? Or do a little resisted ROM and stretching? I vote resisted ROM and stretching. The patients do well with it, they see immediate ROM improvement, and you didn’t give them an experience they had to figure out how to survive.  Then you got them in the office the next day and they were probably much easier to hands on adjust by that point. If I’m guessing.    Item #2 The last one this week is called, “Adverse Events After Cervical Spinal Manipulation – A Systematic Review and Meta-Analysis of Randomized Clinical Trials” by Pankrath et al and published in Pain Physician in May of 2024 and that’s the hot one, people! Pankrath N, Nilsson S, Ballenberger N. Adverse Events After Cervical Spinal Manipulation – A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Pain Physician. 2024 May;27(4):185-201. PMID: 38805524. Why They Did It Cervical manipulations are widely used by physiotherapists, chiropractors, osteopaths, and medical doctors for musculoskeletal dysfunctions like neck pain and cervicogenic headache.  The use of cervical manipulation remains controversial, since it is often considered to pose a risk for not only benign adverse events (AEs), such as aggravation of pain or muscle soreness, but also severe AEs such as strokes in the vertebrobasilar or carotid artery following dissections.  Studies finding an association between cervical manipulation and serious AEs such as artery dissections are mainly case control studies or case reports.  These study designs are not appropriate for investigating incidences and therefore do not imply causal relationships. Randomized controlled trials (RCTs) are considered the gold standard study designs for assessing the unconfounded effects of benefits and harms, such as AEs, associated with therapies. Due to the unclear risk level of AEs associated with high-velocity, low-amplitude (HVLA) cervical manipulation, the aim of this study was to extract available information from RCTs and thereby synthesize the comparative risk of AEs following cervical manipulation to that of various control interventions. How They Did It Systematic review and meta-analysis. Methods: A systematic literature search was conducted in the PubMed and Cochrane databases.  This search included RCTs in which cervical HVLA manipulations were applied and AEs were reported.  Two independent reviewers performed the study selection, the methodological quality assessment, and the GRADE approach.  Incidence rate ratios (IRR) were calculated. The study quality was assessed by using the risk of bias 2 (RoB-2) tool, and the certainty of evidence was determined by using the GRADE approach. What They Found Fourteen articles were included in the systematic review and meta-analysis.  The pooled Incidence rate ratios indicates no statistically significant differences between the manipulation and control groups.  All the reported AEs were classified as mild, and none of the AEs reported were serious or moderate. Wrap It Up In summary, HVLA manipulation does not impose an increased risk of mild or moderate AEs compared to various control interventions.  However, these results must be interpreted with caution, since RCTs are not appropriate for detecting the rare serious AEs. In addition, future RCTs should follow a standardized protocol for reporting AEs in clinical trials.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.        Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post Proprioceptive Neuromuscular Facilitation & SMT Adverse Events appeared first on Chiropractic Forward.

CF 348:  SMT Research Review & Mobile Phones And Cancer Today we’re going to talk about SMT Research Review & Mobile Phones And Cancer But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #348 Now if you missed last week’s episode, we talked about Plant vs. Animal Fat & Screen Time At Bedtime Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. It’s a Monday and, of course, we had a staffer call in sick again. It’s always Mondays it seems ya know? What the heck? But she’s one of my most dependable, most awesome-est people so I wont’ harrass her too much.  It’s a little slow today for us. We’re used to being in the 40’s for a Monday and we had 33 today so I don’t know what’s up with that but we have a goo damount tomorrow and Wednesday so, maybe it was just one of those days. And, I got A LOT done so we’re all good in the hood.  Let’s see, what’s up? I have a presentation coming up for the FTCA. For those of you not in the know, that’s the Forward Thinking Chiropractic Alliance and they’re having the October 2024 FTCA Virtual Business Summit which will be held Friday October 11-Saturday October 12. For more info, just go to www.forwardthinkingchiro.com and give it a looksee.  My presentation will center on new ways of looking at and treating chronic pain via the biopsychosocial construct. Sounds boring as hell but it’s not and we treat a lot of pain, folks so I hope you’ll join us. Hell, you might learn something.  If you’re a long time listener, you’re probably tired of hearing it. But I’m never tired of talking about it people!! I saw lots of my MCM Mastermind friends taking pictures together at the MPI Adjustathon. I didn’t even know that was a thing until I met this crazy group but I’m probably just going to have to go next year and just make it happen. My people were out there and they all had big smiles so I feel like I’m probably missing something and I hate FOMO.  I don’t have a ton to share at the moment except being an integrated clinic can be a challenge. We are replacing the Nurse Practitioner with two people. We are hirng an RN that starts next week and then another Nurse Pracititoner that will just do the hormone replacement pellets. Both are hourly staffers so that will help. Thee full time salary position was a challenge for sure when we were just building up something brand new and getting it off the groud.  We know how to do it now and should be off and running with the new crew soon. And it’s going to be great. Everyone in the office is jazzed and there’s just an electric feeling in the office and when your crew is jazzed, good thing happen.  Upward and onward Alright let’s get to the research shall we? Item #1 Our first one thiis week was posted on Facebook by Dr. David Graber I believe. It’s called, “Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations” by Trager et al and published in Journal of Clinical Medicine on August 28, 2024 so it’s smokin all over the place.  Remember, the citations can be found at chiropracticforward.com under this episode.  Trager, R.J.; Bejarano, G.; Perfecto, R.-P.T.; Blackwood, E.R.; Goertz, C.M. Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J. Clin. Med. 2024, 13, 5668. https://doi.org/10.3390/jcm13195668 Why They Did It Chiropractors diagnose and manage musculoskeletal disorders, commonly using spinal manipulative therapy (SMT). Over the past half-century, the chiropractic profession has seen increased utilization in the United States following Medicare authorization for payment of chiropractic SMT in 1972.  How They Did It We reviewed chiropractic research trends since that year and recent clinical practice guideline (CPG) recommendations regarding SMT.  We searched Scopus for articles associated with chiropractic (spanning 1972–2024), analyzing publication trends and keywords, and searched PubMed, Scopus, and Web of Science for clinical practice guidelines addressing SMT use (spanning 2013–2024).  We identified 6286 articles on chiropractic.  The rate of publication trended upward.  Keywords initially related to historical evolution, scope of practice, medicolegal, and regulatory aspects evolved to include randomized controlled trials and systematic reviews.  What They Found The recommendations primarily targeted low back pain and neck pain; of these, 90% favored SMT for low back pain while 100% favored SMT for neck pain.  Recent clinical practice guideline recommendations favored SMT for tension-type and cervicogenic headaches.  There has been substantial growth in the number and quality of chiropractic research articles over the past 50 years, resulting in multiple clinical practice guideline recommendations favoring SMT.  These findings reinforce the utility of SMT for spine-related disorders. Wrap It Up Most chiropractic research articles and clinical practice guidelines regarding SMT have focused on spinal pain in adults.  From 1972 to 2024, research has transitioned from legal topics and case reports to randomized trials, observational studies, and evidence synthesis.  We also found that there has been substantial growth in the number and rigor of standard scientific methods of chiropractic research articles over the past 50 years, resulting in multiple clinical practice guideline recommendations favoring SMT.  These findings reinforce the clinical utility of SMT for spine-related disorders.   Item #2 Our last one this week is called, “The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A systematic review of human observational studies – Part I: Most researched outcomes” by Karipidis et. Al and published by Environmental International in September of 2024 and it’s gettin’ hot up in here up in here.  Ken Karipidis, Dan Baaken, Tom Loney, Maria Blettner, Chris Brzozek, Mark Elwood, Clement Narh, Nicola Orsini, Martin Röösli, Marilia Silva Paulo, Susanna Lagorio, The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A systematic review of human observational studies – Part I: Most researched outcomes, Environment International, Volume 191, 2024, 108983, ISSN 0160-4120, https://doi.org/10.1016/j.envint.2024.108983. Why They Did It The objective of this review was to assess the quality and strength of the evidence provided by human observational studies for a causal association between exposure to radiofrequency electromagnetic fields (RF-EMF) and risk of the most investigated neoplastic diseases. What They Found We included 63 aetiological articles, published between 1994 and 2022, with participants from 22 countries RF-EMF exposure from mobile phones (ever or regular use vs no or non-regular use) was not associated with an increased risk of glioma, meningioma, acoustic neuroma, pituitary tumours, salivary gland tumours, or pediatric brain tumours, with variable degree of across-study heterogeneity.  Exposure from broadcasting antennas or base stations was not associated with childhood leukaemia or pediatric brain tumor risks, independently of the level of the modelled RF exposure.  Glioma risk was not significantly increased following occupational RF exposure, and no differences were detected between increasing categories of modelled cumulative exposure levels. Wrap It Up For the analysis, commissioned by the World Health Organization, researchers reviewed 63 studies. They didn’t find any evidence that increased exposure to the type of radiation emitted from cell phones and other wireless electronics—non-ionizing radiation—causes brain cancer, even among people who spend many hours each day on their phones. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post SMT Research Review & Mobile Phones And Cancer appeared first on Chiropractic Forward.

CF 347: Plant vs. Animal Fat & Screen Time At Bedtime Today we’re going to talk about Plant vs. Animal Fat & Screen Time At Bedtime But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #347 Now if you missed last week’s episode, we talked about REM And TMD & Psychological Factors In Knee Osteoarthritis Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Another Monday, another staffing issue but this one is OK too. I told one of my girls today that if someone didn’t know us and all they knew was our staff changes over the last 2 years, they’d think we’re crazy people and hard to work for.  The truth is, when you have 12 or 13 employees, you just have people in different aspects of their lives going and coming and doing life like the rest of us. It is what it is. The one who turned in a resignation today is a massage therapist who’s been with us for 9+ years. No animosity. No problems. She just wants to try things on her own where she rents a booth at a spa and does it on her own. We didn’t do anything wrong. Just a change in stages of her life and that’s OK. Not everyone’s dreams and goals are my dreams and goals.  That’s the new pile of BS I stepped into this week. Last week was a whole different thing that I’m not getting into on the podcast but things have been challenging. But, on the encouraging side, you’ve heard me saying that business has been picking up again. And that has been maintained.  But, what it does is to serve as an impetus to make sure you’re giving and pouring into the ones on your team that are all in and doing what they can do to grow the clinic and take the best care of your patients.  If they’re performing and dependable, pay them. Keep them on board. Employees like career trajectory. But we don’t have a huge ceiling and not a lot of titles an employee can have in our clinics, do we?  So how do you pour into your staff? Some of the big drivers of employee satisfaction are: Recognition and appreciation Opportunities for growth and development Work-life balance Positive work environment Autonomy and decision-making authority Other things that matter are Reputation – are they proud to tell people where they work? Senior management – what confidence do they have in you as the captain of the ship? Immediate manager – if you are the owner but have a manager running the staff, what is their confidence and relationship with that leader and what kind of leader are they? There are several more but here’s the thing, you gotta do you and run your clinic how you best see fit but these things need to be in your mind as well because when you have happy employees, you have higher retention, increased productivity, and better customer/patient service. Every time.  Just a tip from your Ol’ Uncle Jeffro Item # Our first one this week is called, “Plant and Animal Fat Intake and Overall and Cardiovascular Disease Mortality” by Zhao et al and published in JAMA Internal Medicine on August 12, 2024 aye chihuahua! Zhao B, Gan L, Graubard BI, et al. Plant and Animal Fat Intake and Overall and Cardiovascular Disease Mortality. JAMA Intern Med. Published online August 12, 2024. doi:10.1001/jamainternmed.2024.3799 Remember, the citations can be found at chiropracticforward.com under this episode.    Why They Did It Importance  The impact of dietary fat intake on long-term human health has attracted substantial research interest, and the health effects of diverse dietary fats depend on available food sources. Yet there is a paucity of data elucidating the links between dietary fats from specific food sources and health. They wanted to study the associations of dietary plant and animal fat intake with overall mortality and cardiovascular disease (CVD) mortality. How They Did It This large prospective cohort study took place in the US from 1995 to 2019. The analysis of men and women was conducted in the National Institutes of Health–AARP Diet and Health Study. Data were analyzed from February 2021 to May 2024. Specific food sources of dietary fats and other dietary information were collected at baseline, using a validated food frequency questionnaire. What They Found The analysis included 407,531 men and women  the mean age of the cohort was 61.2 During 8,107,711 person-years of follow-up, 185,111 deaths were noted, including 58 526 cardiovascular disease mortality deaths.  Now, I could dive into the weeds here for you but I’ll lose you like a sock in the laundry and we don’t want that so we’ll go to the wrap-up. We don’t want to get glassy-eyed and mushy-brained.  Wrap It Up The findings from this prospective cohort study demonstrated consistent but small inverse associations between a higher intake of plant fat, particularly fat from grains and vegetable oils, and a lower risk for both overall and cardiovascular disease mortality.  A diet with a high intake of animal-based fat, including fat from dairy foods and eggs, was also shown to be associated with an elevated risk for both overall and cardiovascular disease mortality. Basically, these findings provide detailed information about how increased intake of dietary fat from plant sources may help improve human health and related mortality outcomes. Particularly fat from grains and vegetable oils. In contrast, fats from animal fat, dairy products, and egg fats were associated with an increased risk for mortality for overall and CVD mortality.  And now that question no longer lingers within your brain chambers.    Item #2 Our last one this week is called, “Brosnan B, Haszard JJ, Meredith-Jones KA, Wickham S, Galland BC, Taylor RW. Screen Use at Bedtime and Sleep Duration and Quality Among Youths. JAMA Pediatr. Published online September 03, 2024. doi:10.1001/jamapediatrics.2024.2914” by Brosnan et al and published in JAMA Pediatrics on September 3, 2024 and one word, two syllables…..Day-um….that’s hot, people.  Brosnan B, Haszard JJ, Meredith-Jones KA, Wickham S, Galland BC, Taylor RW. Screen Use at Bedtime and Sleep Duration and Quality Among Youths. JAMA Pediatr. Published online September 03, 2024. doi:10.1001/jamapediatrics.2024.2914   Why They Did It To examine whether evening screen time is associated with sleep duration and quality that night in youths. How They Did It This repeated-measures cohort study was performed in participant homes in Dunedin, New Zealand.  Participants included healthy kiddos aged 11 to 14.9 years.  Data analyzed from October to November 2023. Objectively measured screen time, captured using wearable or stationary video cameras from 2 hours before bedtime until the first time the youth attempted sleep (shut-eye time) over 4 nonconsecutive nights.  Video info was coded using a reliable protocol to quantify device and activity type. Sleep duration and quality were measured objectively via wrist-worn accelerometers.  The association of screen use with sleep measures was analyzed on a night-by-night basis using mixed-effects regression models including participant as a random effect and adjusted for weekends. What They Found Of the 79 participants, all but 1 had screen time before bed.  Screen use in the 2 hours before bed had no association with most measures of sleep health that night  All types of screen time were associated with delayed sleep onset but particularly interactive screen use.  Every 10 minutes of additional screen time in bed was associated with shorter total sleep time  The mean difference in total sleep time was −9 minutes for passive screen use.  In particular, gaming and multitasking were associated with less total sleep time. Wrap It Up In this repeated-measures cohort study, use of an objective method showed that screen time once in bed was associated with impairment of sleep, especially when screen time was interactive or involved multitasking.  These findings suggest that current sleep hygiene recommendations to restrict all screen time before bed seem neither achievable nor appropriate.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post Plant vs. Animal Fat & Screen Time At Bedtime appeared first on Chiropractic Forward.

CF 346: REM And TMD & Psychological Factors In Knee Osteoarthritis Today we’re going to talk about REM And TMD & Psychological Factors In Knee Osteoarthritis But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #346 Now if you missed last week’s episode, we talked about SMT Comparison Of Short-Term Effects & GLP-1 And Obesity-Associated Cancers Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Alright let’s talk about business. What are you all seeing? I spent a lot of time over the last several months wondering if I made someone mad, pissed on the mayor’s dog, or something like that.  Now, business seems to be picking back up a smidge. Before I went to NYC I had almsot 200 in one week by myself. I don’t have an associate so that was a challenge. Now this week, and we’re early in the week, I have 165 lined up. I think NYC knocked me back down but that’s OK. 200 in a week is honestly more than I want. I think about 180 is probably my sweet spot and I’m only 15 off of that so far this week.  Anyway, I’m seeing a return of business and new patients. Being evidence-based, we depend on a consistent flow of new patients. So that’s what we got going here. A few things have played a part. We really buckled down and spent the money on website SEO. We started getting out and about in the community more. Shaking babies and kissing hands. And we made some key changes in our personnel. Once we were out with the bad seed, it just seemed like a cloud lifted. We have one more dark cloud on their way out in a couple of weeks and have a ray of sunshine replacing it and we can’t wait.  It’s all good in the hood so we’re on the right path. Business is good.  Another thing, yes the economy matters to our businesses and how much tax we pay each year but, don’t get tied up in politics if you can keep from it. They don’t care as much about you as they say they do. And for the love of all that’s holy, keep it off of Facebook and social media. If you’re posting political crap on your socials every day all day, you limit your patient base to half of your community because a republican will never treat with a mouthy democrat provider and a democrat will never treat with a mouthy republican provider. That’s a freaking guarantee. Both sides of the aisle need care and you can’t do that if you’re mouthy. Be smart, wise, trustworthy, and have good character. Treat people right and carry yourself correctly and the money will take care of itself.  Just a tip from your Ol Uncle Jeffro.  Item #1 Our first one this week is called, “Elevated pain sensitivity is associated with reduced rapid eye movement (REM) sleep in females with comorbid temporomandibular disorder and insomnia” by Reid, et al and published in Pain Medicine on March 28 2024 and it’s hotter than cat piss.  Remember, the citations can be found at chiropracticforward.com under this episode.  Matthew J Reid, Katrina R Hamilton, Sophie J Nilsson, Michael Alec Owens, Jane L Phillips, Patrick H Finan, Claudia M Campbell, Alexandros Giagtzis, Dave Abhishek, Jennifer A Haythornthwaite, Michael T Smith, Elevated pain sensitivity is associated with reduced rapid eye movement (REM) sleep in females with comorbid temporomandibular disorder and insomnia, Pain Medicine, Volume 25, Issue 7, July 2024, Pages 434–443, https://doi.org/10.1093/pm/pnae022 Why They Did It Patients with chronic pain disorders, including Temporomandibular Disorders (TMDs) endorse high levels of sleep disturbances, frequently reporting reduced sleep quality.  Despite this, little is known about the effect that daytime pain has on the microstructure and macro-architecture of sleep. Therefore, we aimed to examine the extent to which daytime pain sensitivity, measured using quantitative sensory testing (QST), is associated with objective sleep parameters the following night, including sleep architecture and power spectral density, in women with TMD. How They Did It 144 females with myalgia and arthralgia by examination using the Diagnostic criteria for TMD completed a comprehensive quantitative sensory testing battery consisting of General Pain Sensitivity, Central Sensitization Index, and Masseter Pressure Pain Threshold assessments.  Polysomnography was collected the same night to measure sleep architecture and calculate relative power in delta, theta, alpha, sigma, and beta power bands. What They Found Central Sensitization, General Pain Sensitivity Indices, and Masseter Pain Pressure Threshold were significantly associated with lower REM% both before and after controlling for covariates.  Pain sensitivity measures were not significantly associated with relative power in any of the spectral bands nor with any other sleep architectural stages. Wrap It Up Our findings demonstrate that higher generalized pain sensitivity, masseter pain pressure threshold, as well as central sensitization were associated with a lower percentage of REM in participants with myofascial pain and arthralgia of the masticatory system.  These findings provide an important step toward understanding the mechanistic underpinnings of how chronic pain interacts with sleep physiology. Item #2 Our last one this week is called, “Quantitative sensory testing, psychological factors, and quality of life as predictors of current and future pain in patients with knee osteoarthritis” by Hertel et al and published in PAIN in August of 2024 and it’s a steamy pile of saucy spice.  Hertel, Emmaa; Arendt-Nielsen, Larsa,b,c,d; Olesen, Anne Estrupe,f; Andersen, Michael Skippera; Petersen, Kristian Kjær-Staala,b,*. Quantitative sensory testing, psychological factors, and quality of life as predictors of current and future pain in patients with knee osteoarthritis. PAIN 165(8):p 1719-1726, August 2024. | DOI: 10.1097/j.pain.0000000000003194 Why They Did It This exploratory study aimed to explain baseline OA pain intensity and predict OA pain after administration of a nonsteroidal anti-inflammatory drug in combination with paracetamol for 3 weeks.  How They Did It The Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score was used to estimate OA pain presentation. One hundred one patients were assessed at baseline and follow-up using QST (pressure pain thresholds and temporal summation of pain [TSP]), symptoms of depression and anxiety, pain catastrophizing scales (PCSs), and health-related quality of life.  Linear regression with backward selection identified that PCS significantly explained 34.2% of the variability in baseline KOOS pain, with nonsignificant contributions from TSP.  Pain catastrophizing score and TSP predicted 29.3% of follow-up KOOS pain, with nonsignificant contributions from symptoms of anxiety.  What They Found When assessed separately, PCS was the strongest predictor (32.2% of baseline and 24.1% of follow-up pain), but QST, symptoms of anxiety and depression, PCS, and quality of life also explained some variability in baseline and follow-up knee OA pain. Further analyses revealed that only TSP and PCS were not mediated by any other included variables, highlighting their role as unique contributors to OA pain presentation.  Wrap It Up This study emphasizes the importance of embracing a multimodal approach to OA pain and highlights PCS and TSP as major contributors to the baseline OA pain experience and the OA pain experience after OA treatment. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post REM And TMD & Psychological Factors In Knee Osteoarthritis appeared first on Chiropractic Forward.

CF 345: SMT Comparison Of Short-Term Effects & GLP-1 And Obesity-Associated Cancers Today we’re going to talk about SMT Comparison Of Short Term Effects & GLP-1 And Obesity-Associated Cancers But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #345 Now if you missed last week’s episode, we talked about Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Let’s talk about a two-week break shall we? Yes, I took two weeks off from the podcast becasue I basically had to. My wife and daughter and I went to NYC. We left on a Thursday and returned on a Tuesday. My business has kind of exploded lately and there simply was not enough time in either of those two weeks to get the podcast recorded. One day I had 60. Just me as a solo doc. That’s tough. No time for talkie talkie.  Now that I’m recovering and we’re sort of back to a normal week, I’m back at it. First thing’s first, NYC was amazing. I went fully expecting to hate everything about it and I have to say….it was just sort of awesome. I didn’t hate it at all. The people were great for the most part.  There are some odd folks in NYC but not as many as those of us outside the city would think. I relate to WAY more than I ever expected. They’re just hard working, get it done folks like we are in Texas. Just different accents.  I found New Yorkers friendlier than I expected. Except for a handful of them The NBC tour was a highlight as well as the mafia tour.  I’m not Italian but I loved Little Italy. We actually spent quite a bit of time there.  I’m going to make some of you disappointed here but we never used the subway. Not once. We used Lyft everywhere. First of all, I got 10x points on Lyft with my Chase Sapphire Reserve card so…..there’s that. Also, while you might say I missed out on an ‘experience’, from what I heard, it’s not all that great of one. Lol. On the other hand, I’d argue that we got to see a TON of the city by driving through it rather than riding under it. And I love the metro in DC so I’ve done the subway thing lots of times before. Just not in NYC.  The high line was cool.  DUMBO wasn’t all that cool.  I loved Central Park.  The Met was by far the best museum out there. The Museum of Natural History was just blah. The Smithsonian in DC was much better. But the Met….that was awesome All the food….so good. The only way the New Yorkers are skinny is from all that walking. There’s not other excuse. The food is ridiculous.  We saw Moulin Rouge on Broadway….very cool.  Top of the Rock was great. I love Art Deco and Rockefeller Plaza is the epitome of Art Deco, man. It was gorgeous.  All in all it was great. I didn’t care much about it all but went with an open mind and absolutely loved the weekend. There’s something about it. It’s ‘electric’ somehow.  I wouldn’t want to live in it all day every day but we loved the visit and we will most definitely be back sooner rather than later. Now that you have my impressions of NYC, as if you cared….losing that business while I was gone….ugh. We were just hitting our stride. But that’s OK, we have to have a life. We have to live and work can’t be all we do or we’ll go crazy. Especially in our 50’s after almsot 27 years in the game. We have to have breaks and new experiences. Regardless of the hit to business.  Now I’m not advocating going on a trip for a month or even 2 weeks. But 5-6-7 day visits somewhere…..yep….that’s OK and you should do it no less than once per quarter.  Just a tip from your ol uncle Jeffro…. Item #1 Our first one is called, “Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes” by Wang et al and published in JAMA Network Open on July 5, 2024 and that’s another hot tamale, hot tamale.  Remember, the citations can be found at chiropracticforward.com under this episode.  Wang L, Xu R, Kaelber DC, Berger NA. Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes. JAMA Netw Open. 2024;7(7):e2421305. doi:10.1001/jamanetworkopen.2024.21305 Why They Did It Is there clinical evidence supporting the potential benefits of glucagon-like peptide receptor agonists (GLP-1RAs) for the prevention of 13 obesity-associated cancers How They Did It This retrospective cohort study was based on a nationwide multicenter database of electronic health records (EHRs) of 113 million US patients.  The study population included 1 651 452 patients with T2D who had no prior diagnosis of obesity-associated cancers and were prescribed GLP-1RAs, insulins, or metformin during March 2005 to November 2018.  Data analysis was conducted on April 26, 2024. Prescription of GLP-1RAs, insulins, or metformin. Main Outcomes and Measures  Incident (first-time) diagnosis of each of the 13 obesity-associated cancers occurring during a 15-year follow-up after the exposure was examined What They Found GLP-1RAs compared with insulin were associated with a significant risk reduction in 10 of 13 obesity-associated cancers, including in gallbladder cancer, meningioma, pancreatic cancer, hepatocellular carcinoma, ovarian cancer, colorectal cancer, multiple myeloma, esophageal cancer, endometrial cancer, and kidney cancer.  Although not statistically significant, the HR for stomach cancer was less than 1 among patients who took GLP-1RAs compared with those who took insulin.  GLP-1RAs were not associated with a reduced risk of postmenopausal breast cancer or thyroid cancer.  Of those cancers that showed a decreased risk among patients taking GLP-1RAs compared with those taking insulin, HRs for patients taking GLP-1RAs vs those taking metformin for colorectal and gallbladder cancer were less than 1, but the risk reduction was not statistically significant.  Compared with metformin, GLP-1RAs were not associated with a decreased risk of any cancers, but were associated with an increased risk of kidney cancer  Wrap It Up In this study, GLP-1RAs were associated with lower risks of specific types of obesity-associated cancers compared with insulins or metformin in patients with T2D. These findings provide preliminary evidence of the potential benefit of GLP-1RAs for cancer prevention in high-risk populations and support further preclinical and clinical studies for the prevention of certain obesity-associated cancers.   Item #2 The last one this week is called, “Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial” by Garcia-Gonzalez et al and published in Healthcare in June of 2024, OMG it’s HOT people! García-González, J.; Romero-del Rey, R.; Martínez-Martín, V.; Requena-Mullor, M.; Alarcón-Rodríguez, R. Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial. Healthcare 2024, 12, 1348. https://doi.org/10.3390/healthcare12131348 Why They Did It Spinal manipulations for chronic non-specific neck pain (CNNP) include cervical, cervicothoracic junction, and thoracic spine (CCT) manipulations as well as upper cervical spine (UCS) manipulations. This study aimed to compare the short-term effects of upper cervical spine manipulation versus a combination of cervicothoracic junction, and thoracic spine spine manipulations on pain intensity, disability, and cervical range of motion (CROM) in chronic non-specific neck pain patients. How They Did It In a private physiotherapy clinic, 186 participants with chronic non-specific neck pain were randomly assigned to either the upper cervical spine or cervicothoracic junction, and thoracic spine manipulation groups. Neck pain, disability, and cervical range of motion were measured before and one week after the intervention.  What They Found No significant differences were found between the groups regarding pain intensity and cervical range of motion.  However, there was a statistically significant difference in neck disability, with the cervicothoracic junction, and thoracic spine group showing a slightly greater decrease  Wrap It Up The findings suggest that a combination of manipulations in the cervicothoracic junction, and thoracic spine spine results in a slightly more pronounced decrease in self-perceived disability compared to upper cervical spine manipulation in patients with chronic non-specific neck pain after one week. However, no statistically significant differences were observed between the groups in terms of pain intensity or cervical range of motion. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger  The post SMT Comparison Of Short-Term Effects & GLP-1 And Obesity-Associated Cancers appeared first on Chiropractic Forward.

CF 344: Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy Today we’re going to talk about Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #344 Now if you missed last week’s episode, we talked about Knee Osteoarthritis Recommendations & Ruptured Breast Implants Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Still mumbling bumbling tumbling through the process of changing our medical provider. And it is a process. We’re working on a new contract and all that fun crap.  This is a post I made recently on my personal Facebook page – I just had a buddy remind me of this contraption that’s floating around and being shared.  The link to this contraption on Facebook can be found at this point in the show notes for this episode.  https://heliomd.com/products/heliomd-cervical-traction-device A brief description for those of you that aren’t going to go check it out but are curious. It’s distributed by HelioMD and it’s called a manual pump neck brace. It rests on your shoulders and has a carriage under your chin and occiput. I guess that’s the best way to describe it. It’s also called NeckRevive Neck stretcher.  It says it naturally relieves chronic neck pain in minutes, restore healthy neck posture and avoids further injuries. OK, where do you see the immediate problems? Chronic pain pathways are permanent and you’ll never correct chronic pain in minutes. Even with surgery typically. How can you ever avoid further injuries? That’s just silly right? It goes on to say that it eliminates neck humps. Through traction. Riiiigghhhhttt. As Dr. Evil would say.  They’re asking $139.00 for this thing. Wow.  So I posted on my Facebook the following because it’s our duty to call out BS when we perceive BS is afoot.  My plea to my friends is this: PLEASE understand something when you see claims like these. Every patient is different, everyone heals differently, everyone has different levels of fitness or degeneration and daily activity, and there is no ONE SINGLE DEVICE that’s going to solve all of your problems.  Typically, when a ‘hump’ or other boney deformity develops over time, it is the body’s response to altered posture, altered activity, or altered body dynamics and stressors, etc.  Once those things appear, usually the body has remodeled itself and there is no reversing the issue. The best you can do at that point is simply try to alleviate pain that may result from it.  With that being said, I cannot personally see how this device can do what they claim, which is reversing a ‘hump’ in just two weeks. My opinion is that something of that nature would be magical and I don’t see how it would be possible on any planet in our known universe.  Also, posture isn’t as important as we’ve been led to believe all these years. As long as you’re changing positions regularly, sit however you like. You’ll suffer no consequences.  It’s the people who have SUSTAINED poor postures that have a hard time. Those people like professional drivers, dental workers, desk workers, teens on their phones all the time, and those that play video games for hours on end each day. Those people, if not changing positions regularly, will suffer consequences eventually.  Back to this device…….however, if someone got some relief from pain through the traction this device might perform, well that might be something to talk about and for some, even useful.  But not some sort of ‘correction’. I would add that if traction is what is helpful, they sell $25 over-the-door traction mechanisms on Amazon. I think that would be the more reasonable route financially.  IF that traction didn’t do the job, we can do decompression here at the office that helps LOTS of folks with ongoing neck and back pain all of the time. Especially for those with disc injuries, stenosis, facet arthropathy, etc.  So, now my friends and family will hopefully be more aware, they see me as knowledgeable on the topic, and they’re more aware of their options up to and including coming to see me if they happen to be serious enough.  Is that effective social media marketing? I’m not sure. The first thing is I don’t want to open myself to some sort of legal complaint so I’m careful to make sure they know that it’s my opinion based my experience and knowledge. Secondly, I’m mostly giving free information and advice without expecting anything in return. I’m offering a free service to my community and if they happen to like what they see and it turns their attention to me in a positive way, then it’s a win/win. Also, I’m not trying to be obnoxious about my disdain for the marketing practices. I’m not using terms like ‘stupid company’, ‘asnine idiots’, or something like that. I think that looks bad on me and accomplishes the opposite of what I want.  Anyway, just a tip from your Ol’ Uncle Jeffro. Don’t say I never gave you anything.  Item #1 The first one today is called, “Obesity in Adolescents A Review” by Kelly et al and published in JAMA Network on August 5, 2024 schiza! Es muy caliente, mi ami! Yes, that was German, Spanish, and French in one exclamation! You are so very welcome.   Remember, the citations can be found at chiropracticforward.com under this episode.  Kelly AS, Armstrong SC, Michalsky MP, Fox CK. Obesity in Adolescents: A Review. JAMA. Published online August 05, 2024. doi:10.1001/jama.2024.11809 https://jamanetwork.com/journals/jama/fullarticle/2821829?guestAccessKey=f8345ddd-071d-47c4-b2c9-9cc8eafde342&utm_source=silverchair&utm_medium=email&utm_campaign=jama_network&utm_content=network_highlights&utm_term=081824&adv=000003189471   Why They Did It Obesity affects approximately 21% of US adolescents and is associated with insulin resistance, hypertension, dyslipidemia, sleep disorders, depression, and musculoskeletal problems.  Obesity during adolescence has also been associated with an increased risk of mortality from cardiovascular disease and type 2 diabetes in adulthood. What They Found Obesity in adolescents aged 12 to younger than 18 years is commonly defined as a body mass index (BMI) at the 95th or greater age- and sex-adjusted percentile.  Comprehensive treatment in adolescents includes lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery.  Lifestyle modification therapy, which includes dietary, physical activity, and behavioral counseling, is first-line treatment; as monotherapy, lifestyle modification requires more than 26 contact hours over 1 year to elicit approximately 3% mean BMI reduction.  Newer antiobesity medications, such as liraglutide, semaglutide, and phentermine/topiramate, in combination with lifestyle modification therapy, can reduce mean BMI by approximately 5% to 17% at 1 year of treatment.  Adverse effects vary, but severe adverse events from these newer antiobesity medications are rare.  Surgery like gastric bypass and vertical sleeve gastrectomy for severe adolescent obesity (BMI ≥120% of the 95th percentile) reduces mean BMI by approximately 30% at 1 year.  Minor and major perioperative complications, such as reoperation and hospital readmission for dehydration, are experienced by approximately 15% and 8% of patients, respectively. Determining the long-term durability of all obesity treatments warrants future research. Wrap It Up The prevalence of adolescent obesity is approximately 21% in the US. Treatment options for adolescents with obesity include lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery.  Intensive lifestyle modification therapy reduces BMI by approximately 3% while pharmacotherapy added to lifestyle modification therapy can attain BMI reductions ranging from 5% to 17%.  Surgery is the most effective intervention for adolescents with severe obesity and has been shown to achieve BMI reduction of approximately 30%. Item #2 Our second one today is called, “Combined Physiotherapy and Cognitive Behavioral Therapy for Functional Movement Disorders A Randomized Clinical Trial” by Macias-Garcia et al and published in JAMA Neurology on August 5, 2024 and that’s two hot one’s for the price of one, amigo.  Macías-García D, Méndez-Del Barrio M, Canal-Rivero M, et al. Combined Physiotherapy and Cognitive Behavioral Therapy for Functional Movement Disorders: A Randomized Clinical Trial. JAMA Neurol. Published online August 05, 2024. doi:10.1001/jamaneurol.2024.2393 https://jamanetwork.com/journals/jamaneurology/fullarticle/2822067?guestAccessKey=2f88c764-a3c5-4f46-b321-8c21459326d6&utm_source=silverchair&utm_medium=email&utm_campaign=jama_network&utm_content=network_highlights&utm_term=081824&adv=000003189471 Why They Did It Question  What is the efficacy of a multidisciplinary treatment (combining specialized physiotherapy and cognitive behavioral therapy) for individuals with functional movement disorders, comparing its effect on patient-reported quality of life with that of a control intervention (psychological support intervention)? Findings  In this parallel randomized clinical trial that included 40 adults with functional movement disorders, multidisciplinary treatment significantly improved physical aspects of quality of life. There was no significant difference between interventions on mental health–related quality of life, but there was a nonsignificant improvement in general health self-perception; at months 3 and 5 after intervention, 42% and 47% of patients in the multidisciplinary-treatment group reported improved health compared with 26% and 16% in the control group, respectively. Meaning  Results show that multidisciplinary treatment (physiotherapy plus cognitive behavioral therapy) effectively improves symptoms and physical aspects of the quality of life of patients with functional movement disorders against nondirected psychological support and education; this improvement seems to be driven by changes in mobility and pain domains.   Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Obesity In Adolescents & Combined Cognitive Behavioral Therapy and Physical Therapy appeared first on Chiropractic Forward.

CF 343: Knee Osteoarthritis Recommendations & Ruptured Breast Implants Today we’re going to talk about Knee Osteoarthritis Recommendations & Ruptured Breast Implants But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #343 Now if you missed last week’s episode, we talked about Cancer Vaccines & Cognitive Behavioral Therapy Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. It’s a Monday as I sit and put my thoughts together. Just got back from the big One Voice Conference in Dallas. I took my son, Jake, who is 22. He had a big time and I think Voice over is his new love but we shall see.  Getting back to work today and getting back in the swing of things now so let’s look at what’s on my plate this week. I had 50 on my personal chiro schedule today. That made for quite a Monday.  On top of that, we are still going through the process of changing out our medical provider and that’s been a chore for sure but of course, it would be. There is a reason the average run-of-the-mill chiro doesn’t do the integrated setup. It’s because it ain’t easy, folks.  It’s just not. But, all of the heavy lifting is out of the way for us. We did all that 3 years ago. Now we just have to replace and hopefully maintain as much of the medical business as we possibly can. And the girl we have coming in is outstanding.  If you listen a week or so ago, I said that I no longer fear change now that I’m 26 years into this deal. What kills me is uncertainty. I can’t have it. So it’s not the change that gets me. It’s the middle ground. It’s the not knowing what the new normal is going to look like. It’s that middle gray area that works over my anxiety levels and my sleep schedule.  So the faster I can get confident in what the change is and how it looks, the faster I can get back to fun boss.  So that’s the main thing happening at my place lately. Just that big change and navigating the waters of it. And I think it’s looking really really good so far.  I’m not going to waste time here. I don’t have a lot left to say. Let’s just jump in, shall we?   Item #1 Our first one this week is called, “Case Study: Ruptured Breast Implant Claim is a Bust” by NCMIC and published on their site base on a paper in Case Studies that was published on Wednesday, July 17, 2024 and you know we got a spicy saucy one today! Remember, the citations can be found at chiropracticforward.com under this episode.   https://www.ncmic.com/resources/case-studies/case-study-ruptured-implant-claim-is-a-bust/?utm_source=ActiveCampaign&utm_medium=email&utm_content=Case+Study:+Breast+Implant+Claim+is+a+Bust&utm_campaign=July+Examiner&fbclid=IwY2xjawEXhUxleHRuA2FlbQIxMQABHWC76Qb-7vghWR58UcwLL9xhtVCxnmdsbmr6dNSZY0cUS5TT8MEnTiv9iA_aem_9kTK0RZdji9iQdqHkcLe7A A 42-year-old CrossFit competitor named Mary Chase sought chiropractic treatment from Dr. Richardson for pain following a car accident. Chase had breast implants from a 2013 surgery. During a thoracic manipulation, Chase heard a “pop” and felt pain in her right breast. Dr. Richardson noted a possible ruptured implant. Chase later saw a plastic surgeon who confirmed a ruptured implant. She filed a malpractice lawsuit against Dr. Richardson, claiming he used excessive force and performed contraindicated therapy, resulting in a ruptured implant, need for surgery, and lost wages from inability to compete. Dr. Richardson’s defense team hired chiropractic and plastic surgery experts. The chiropractic expert found no deviation from standard care, stating that treating patients with implants is routine and not contraindicated. The plastic surgery expert deemed it unlikely that chiropractic manipulation caused the rupture, suggesting it was more likely due to normal wear, the car accident, and Chase’s intense fitness routine. Chase’s experts argued that the adjustment violated the standard of care due to her implant history, and that the rupture was clearly caused by the chiropractic manipulation based on the timing of pain and the “pop” sound. Despite an initial $75,000 settlement demand, the case proceeded to trial due to minimal alleged damages and favorable expert reviews. Chase ultimately dropped the lawsuit. Key lessons from this case include: Timing of injury doesn’t automatically indicate negligence. Taking a complete patient history is crucial. Informed consent is essential, especially for patients with previous surgeries or health concerns. Standing firm on treatment decisions can be beneficial, as not all lawsuits end in settlements or payouts.   Item #2 Our second one today is called, “Recommendations for the management of hip and knee osteoarthritis: A systematic review of clinical practice guidelines” by Gibbs et. Al. and published in Osteoarthritis and Cartilage in October of 2023.  Alison J. Gibbs, Bimbi Gray, Jason A. Wallis, Nicholas F. Taylor, Joanne L. Kemp, David J. Hunter, Christian J. Barton, Recommendations for the management of hip and knee osteoarthritis: A systematic review of clinical practice guidelines, Osteoarthritis and Cartilage, Volume 31, Issue 10, 2023, Pages 1280-1292, ISSN 1063-4584, https://doi.org/10.1016/j.joca.2023.05.015. (https://www.sciencedirect.com/science/article/pii/S1063458423008324) Why They Did It Guideline adherence for hip and knee osteoarthritis management is often poor, possibly related to the quality and/or inconsistent recommendations.  This systematic review of hip and knee osteoarthritis guidelines aimed to appraise the quality and consistency in recommendations across higher-quality guidelines. How They Did It Guideline quality was appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II tool) (six domains). What They Found Seven higher-quality and 18 lesser-quality guidelines were included.  Higher-quality guidelines consistently recommended in favor of education, exercise, and weight management and non-steroidal anti-inflammatory drugs (hip and knee), and intra-articular corticosteroid injections (knee).  Higher quality guidelines consistently recommended against hyaluronic acid (hip) and stem cell (hip and knee) injections.  Other pharmacological recommendations in higher-quality guidelines (e.g., paracetamol, intra-articular corticosteroid (hip), hyaluronic acid (knee)) and adjunctive treatments (e.g., acupuncture) were less consistent.  Arthroscopy was consistently recommended against in higher-quality guidelines.  No higher-quality guidelines considered arthroplasty. Wrap It Up Higher-quality guidelines for hip and knee osteoarthritis consistently recommend clinicians implement exercise, education, and weight management, alongside consideration of Non-Steroidal Anti-Inflammatory Drugs and intra-articular corticosteroid injections (knee).  Lack of consensus on some pharmacological options and adjunctive treatments creates challenges for guideline adherence. Future guidelines must prioritize providing implementation guidance, considering consistently low applicability scores. Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.      Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Knee Osteoarthritis Recommendations & Ruptured Breast Implants appeared first on Chiropractic Forward.

CF 342: Cancer Vaccines & Cognitive Behavioral Therapy Today we’re going to talk about Cancer Vaccines & Cognitive Behavioral Therapy But first, here’s that sweet sweet bumper music Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #342 Now if you missed last week’s episode, we talked about Lumbar Disc Regression and Music’s Effect On Dementia Make sure you don’t miss that info. Keep up with the class.    On the personal end of things….. It’s a short week for me, many of you know that my full time side gig is as a voice actor and they’re having the big One Voice conference in Dallas this weekend so off we go. I’m taking my kid to this one. He’s 22 and thinks he wants to try his hand at voice acting so we’re going to get his feet wet and see what he thinks.  Kids can me iffy. It could go either way. It’ll spark something in him or he’ll hate it. We’ll see.  Chiropractically, I am about to dive head first into a shockwave machine. I bought a course through Physio-tutors that I’m making my way through first. Once I’ve finished the course and am feeling solid on it, I’ll jump off into a shockwave machine. The way my office operates, I can’t bring something new in that will take up more of my time. I don’t have the time to give.  So, as long as I can learn everything about it and then teach and delegate, then we have something. If at the end of the day it’s too hard to generate protocols and delegate, I won’t get it. I just don’t have the time to do things myself. It’s not possible.  And let that be a lesson to you. It’s the newest latest greatest gadget, right? Everyone’s getting one, right? So that means you should get one too right? Wrong! It’s not always what you say yes to. It’s also about what you say no to.  You have to protect your time. Trust me. This is coming from a guy that has busted his hump for 26 years now and failed to protect my time and my availability. So, now, I’m the dude on the hamster wheel with no path to getting off of it. Actually, I do have a path. It just hasn’t played out yet. I have a few roadblocks I’m dealing with and changing medical providers here in the clinic hasn’t been helpful. But I think it will be soon.  So, back to the point; don’t turn away patients but protect your time. You control the schedule. Don’t allow the patients to control it. Be convenient and offer a flexible schedule but sometimes, it’s better for your productivity if a patient comes in at 3:00 instead of 3:45 so give them the 3:00 choice and make sure they know that’s when they can be seen the fastest. Just don’t tell them you’ll be available at 3:45 but that time is already earmarked for marketing or for a team meeting or for brainstorming and goal setting, or whatever.  Just protect your time to the best of your ability without losing or turning away business.  That’s all. Just a tip from your Ol’ Uncle Jeffro there.  Item #1 The first one this week is called “The promise of vaccines to treat cancer” by NBC News that just came out last week so it’s hotter than a $2 pink pistol! Remember, the citations or links can be found at chiropracticforward.com under this episode.  https://www.nbcnews.com/paid-content/paid-content/promise-vaccines-treat-cancer-n1310224?utm_source=Facebook&utm_campaign=FBPaidPost1&fbclid=IwZXh0bgNhZW0BMAABHVQwHCVFVrXEB1rPJVpNVuAMNFpjyIBovF7ITxGJu23eH5pku89wzEb9qA_aem_E68bKa9WJjTAFv35r75-_A&utm_medium=paid&utm_id=120210984734920033&utm_content=120210984900240033&utm_term=120210984858110033 Cancer is a common disease in the U.S., with about 40% of people developing it in their lifetime. Scientists are working on cancer vaccines to both treat and prevent cancer. These vaccines work in three main ways: Treatment: Fighting existing cancer Preventing recurrence: Stopping cancer from coming back in patients who’ve had it Prevention: Stopping cancer before it starts, like other vaccines Researchers at Mayo Clinic are developing personalized cancer vaccines. These teach the body to recognize and attack specific proteins on cancer cells. This targeted approach could be better than chemotherapy, which often harms healthy cells too. “We know that human cancers are widely different,” says Keith L. Knutson, Ph.D., co-leader of the David F. and Margaret T. Grohne Cancer Immunology and Immunotherapy Program at Mayo Clinic Comprehensive Cancer Center in Florida and a professor in the Mayo Clinic College of Medicine and Science. “We can target multiple antigens, and some of those do overlap. Our challenge is in developing vaccines across the notable differences among varying cancer types.” There are ongoing trials for breast cancer vaccines, including for aggressive types like triple-negative and HER2-positive breast cancers. They’re also working on a vaccine to prevent breast cancer in people who’ve never had it. Another exciting development is a vaccine for ovarian cancer, which is often deadly. In a small study, 40% of patients who received this vaccine have been cancer-free for almost 10 years, much better than the usual 10% survival rate. This ovarian cancer vaccine uses special immune cells called dendritic cells to boost the body’s immune response. It’s personalized for each patient using their own white blood cells. While most cancer vaccines are still being tested, researchers are making progress. The goal is to create effective, personalized treatments that help the body fight cancer with fewer side effects than current therapies. Item #2 The last one this week is called, “The effectiveness of cognitive behavioural therapy in chronic neck pain: A systematic review with meta-analysis” by Korakakis et al and published in Cognitive Behavior Therapy in May of 2022 and online in July of 2023 so it’s fairly recent.  Ploutarchou, G., Savva, C., Karagiannis, C., Pavlou, K., O’Sullivan, K., & Korakakis, V. (2023). The effectiveness of cognitive behavioural therapy in chronic neck pain: A systematic review with meta-analysis. Cognitive Behaviour Therapy, 52(5), 523–563. https://doi.org/10.1080/16506073.2023.2236296 Why They Did It We evaluated the effects of Cognitive Behavioural Therapy (CBT) alone or with additional interventions on pain, disability, kinesiophobia, anxiety, stress, depression, quality of life, and catastrophizing of patients with chronic neck pain (CNP)   How They Did It Nineteen studies met the inclusion criteria, and fourteen studies were quantitatively analyzed.  Risk of bias was assessed using the PEDro scale and the certainty of evidence using the GRADE approach.  Studies were pooled (where applicable) and subgroup analyses were performed for CNP, or whiplash-associated disorders.  Studies compared—directly or indirectly—CBT interventions to no treatment, conservative interventions such as exercise and/or physiotherapy, or multimodal interventions. We present effect estimates at 8-week, 12-week, 6-month, and 1-year follow-up.   What They Found Low certainty evidence suggests a clinically significant pain reduction (short-term) favoring CBT with or without additional intervention compared to no intervention  Very low and low certainty evidence suggest clinically significant improvements in kinesiophobia (very short-term, depression, and anxiety favoring a multimodal intervention with CBT (short-term) compared to other conservative interventions.  If you’re not taking advantage of the newer thinking around centralized or upregulated sensitization and chronic pain, you’re missing a big piece of the pain puzzle, folks.  Reach out to me at [email protected] if you want an article that I wrote to hand out to all of my chronic pain patients. I think you’ll like it.  Also, I teach a 1-2 hour course to other chiropractors called Chronic Pain and the Upregulated CNS. Be sure to book me for one of your state’s or organization’s conferences.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger      The post Cancer Vaccines & Cognitive Behavioral Therapy appeared first on Chiropractic Forward.

CF 341: Lumbar Disc Regression & Music’s Effect On Dementia Today we’re going to talk about Lumbar Disc Regression & Music’s Effect On Dementia But first, here’s that sweet sweet bumper music   Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #341 Now if you missed last week’s episode, we talked about Semaglutide And Kidneys & Trying To Target Just One Vertebra Make sure you don’t miss that info. Keep up with the class.  On the personal end of things….. Another day, another dollar my friends. I hope you’re all doing well.  Let’s talk about back-to-school, shall we? I don’t know about you, but for me, historically, we experience a sincere slow down during back-to-school. I can’t explain it. I mean, school supplies and new clothes will set you back for sure but, for the most part, our patient population isn’t affected too much by that financially. At least that’s what I’d think.  But, nevertheless, it slows up and I’ve been gone a ton this summer so it seems already to be a little slow for us so…..yeah, we’ll keep an eye on that. Remember, I say it over and over, when you have your traditional slow times, just recall that you didn’t make everyone mad. It’s not your fault, it’ll come back when the dust settles.  Just take that time to take a course, meet with your staff more, do the things you never have time to do and make sure you’re marketing is on point. Use the time.  Time is one of those things; you either invest in your time or you waste your time. Don’t waste it.  Also, I had an amazing patient. One of those that you’d love for your clinic to be filled with all day every day. She’d sing our praises online. She’d be excited to be here all of the time every time. Just a ray of sunshine. Then, she just quit coming to see us. At all. It’s been about a year now and since I’m an over thinker about literally everything, it’s weighed on me and worried me.  Are we doing something wrong? Did we make her mad and didn’t realize it? How were we able to actually run off one of our very closest and favorite patients? What could have possibly gone wrong? I don’t want to contact her because that would be an intrusion, blah, blah blah.  Well, I said hell with it today. Just this morning I decided that I’d send her a message. After all, we’re friends! I basically apologized for intruding but that I wanted to reach out because she’s been heavy on my mind. I explained that she used to come see us all the time and now we don’t see her at all. I wanted to know if I did something I was unaware of and if I somehow upset her, I want to apologize, explain, or make it right.  Basically, she said, “Hey sunshine!” Which was a good start I thought. Then she told me that she found herself in a divorce and depressed and even considered suicide. She said she’s in a much better place now and wanted to get back out and start going places again but didn’t want to have to explain to everyone about where she’s been. Which is exactly what I asked, by the way.  But she was amazing, it wasn’t me or my staff that ran her off, and she’s making an appointment to get her butt back in here. I told her that we’d be happy to see her and that we could hug it out when she gets here. Which is OK. Some patients are closer to us than others and I can totally hug this one.  So, don’t overthink it and, if your relationship is at a point you feel comfortable and you think someone needs to be checked on, reach out. I be they’d appreciate it.  Alright, let’s get to the research.  Item #1 The first one today is called, “Systematic review and meta-analysis of predictive factors for spontaneous regression in lumbar disc herniation” by Rashed et al and published in Journal of Neurosurgery in July of 2023 Remember, the citations can be found at chiropracticforward.com under this episode.  Volume 39: Issue 4 (Oct 2023) in Journal of Neurosurgery: Spine Figure from Zancolli et al. (pp 593–599). Left panel: © Anne Pecsek, published with permission. https://thejns.org/spine/view/journals/j-neurosurg-spine/39/4/article-p471.xml Why They Did It Relatively little evidence exists on predictive factors for the spontaneous regression of lumbar disc herniation (LDH), although it is a well-documented phenomenon.  Therefore, current care is not optimized to identify those who would benefit from early surgery versus those who could avoid surgical risks and pursue nonsurgical therapy.  In this study, the authors aimed to analyze and summarize all literature to date on predictive factors for spontaneous disc regression as well as suggest future research strategies to aid in the decision-making for this cohort. How They Did It A literature search was conducted of the Cochrane, Embase, and MEDLINE databases for articles that described LDH in terms of the North American Spine Society task force definitions: bulging, protruded, extruded, and sequestered disc morphologies.   All articles described a nonsurgical primary symptomatic LDH cohort with at least two MR images to assess regression.  The primary outcome was to assess the probability of disc regression for each disc morphology, with a secondary analysis for any other predictive factors identified. The authors synthesized their results with the only previous review (examining articles published before March 2014) to comprehensively describe the literature. A qualitative analysis of the wider literature was also performed for those studies with differing definitions of LDH but meeting all remaining inclusion criteria. What They Found Sixteen articles describing 360 cases of LDH were identified.  Participants tended to be younger and male and presented with radiculopathy and L4–5 or L5–S1 LDH.  The mean time to follow-up imaging was 11.5 months.  The probabilities of spontaneous regression with bulging, protruded, extruded, and sequestered discs were 13.3%, 52.5%, 70.4%, and 93.0%, respectively.  Extruded and sequestered discs were also significantly more likely to completely regress than smaller morphologies.  Other predictors of regression were larger baseline herniation volume, transligamentous herniation, and higher Komori types.  The authors also found similar trends in qualitative data as well as confirmed that symptom improvement was associated with disc regression. Wrap It Up This study shows further evidence of the influence of disc morphology on predicting disc regression as well as provides the first meta-analysis of data indicating additional predictive factors.  Item #2 The last one this week is called, “Age and familiarity effects on musical memory” by Suave et al and published July 24, 2024, and holy schnikeys! That’s some seriously hot stuff! https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0305969 https://doi.org/10.1371/journal.pone.0305969 Why They Did It A common complaint in older adults is trouble with their memory, especially for new information. Current knowledge about normal aging and changes in memory identify a divide between memory tasks that are unaffected by aging and those that are.  Among the unaffected are recognition tasks. These memory tasks rely on accessing well-known information, often include environmental support, and tend to be automatic.  Negative age effects on memory are often observed at both encoding and during recall.  Older adults often have difficulty with recall tasks, particularly those that require effortful self-initiated processing, episodic memory, and retention of information about contextual cues.  Research in memory for music in healthy aging suggests a skill-invariance hypothesis: that age effects dominate when general-purpose cognitive mechanisms are needed to perform the musical task at hand, while experience effects dominate when music-specific knowledge is needed to perform the task The goals of this pair of studies were to investigate the effects of age and familiarity on musical memory in the context of real pieces of music, and to compare a live concert experimental setting with a lab-based experimental setting. How They Did It Participants’ task was to click a button (or press the spacebar) when they heard the target theme in three pieces of music.  One was a Mozart piece and the others were original pieces commissioned for this study, one tonal and one atonal.  Participants heard the relevant theme three times before listening to a piece of music.  Participants also completed two short cognitive tests and filled out a questionnaire collecting demographic information and a hearing abilities self-assessment. What They Found We find a significant effect of familiarity and setting but not of age or musical training on recognition performance More specifically, performance is best for the familiar, tonal piece, moderate for the unfamiliar tonal piece and worst for the unfamiliar atonal piece.  Performance was better in the live setting than the lab setting. Wrap It Up The absence of an age effect provides encouraging evidence that music’s diverse cues may encourage cognitive scaffolding, in turn improving encoding and subsequent recognition.  Better performance in an ecological versus lab setting supports the expansion of ecological studies in the field. OK, that’s great, they’re saying the musical mind may be more immune to dementia if we boil it down but Imma say this plainly and clearly; I’ve been playing the guitar at a moderate to high level for decades and if I ask you your name, Imma forget it in 5 seconds. Guaranteed So take what you want out of that but, in all honesty, I think it’s awesome. If being a music lover can help stave off dementia, then I know a lot of folks that are gonna be just fine. Hopefully myself included.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.          Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY! The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.  Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger        The post Lumbar Disc Regression & Music’s Effect On Dementia appeared first on Chiropractic Forward.

  CF 340: Semaglutide And Kidneys & Trying To Target Just One Vertebra Today we’re going to talk about Semaglutide And Kidneys & Trying To Target Just One Vertebra But first, here’s that sweet sweet bumper music     Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable. We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel.  I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.  Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected] If you haven’t yet I have a few things you should do.  Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.  Like our Chiropractic Forward Facebook page,  Join our private Chiropractic Forward Facebook group, and then  Review our podcast on wherever you listen to it  Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com You have found yourself smack dab in the middle of Episode #340 Now if you missed last week’s episode, we talked about multivitamins effect on mortality and acupuncture effect on PTSD.  Make sure you don’t miss that info. Keep up with the class.    On the personal end of things….. I just got back from our MCM East Mastermind. Yes, Kevin Christie also has a MCM West Mastermind. Which is fine. We East members know who the OGs are, the real pioneers of the MCM Mastermind.  I’m really not a pioneer at all. I just know the value of masterminds and when Dr. Christie asked me when he very first considered setting one up, I was in. Easy yes. It’s surprising to me that so many others are not easy yeses to be honest. So many folks are really hesitant to invest in themselves and their abilities.  I get it. I used to be as well. I was on an island. I was just working, keeping my head down and getting through the day every day. Week after week.  It wasn’t until I was coaxed into my first mastermind that I figured it out. I found community. I found the potential to be so much better in the clinic and in business. That one was EXPENSIVE! That first mastermind cost $1,000/month plus the cost of staying at the Westin in Dallas every month with food and lots of drinks piled on top.  It was worth it though. I grew the clinic and I grew my abilities. And I grew my community.  Dr. Christies is around $8,000/year if I remember correctly. Then you have travel and hotels and meals and drinks but only once per quarter so 4 times per year. And it’s worth it. Each member can tell you where an idea they learned from a fellow Masterminder saved them over $8,000 per year and most have saved or grown much much much more than that.  So, again, get yourself a mastermind, won’t you?/ The East Mastermind still has 2 seats open for 2025 and I believe the West Mastermind has 5 or so open. So get hold of Dr. Christie today if that’s where you’re headed with your profession. It’ll help. Then you can thank your Ol’ Uncle Jeffro later. . Outside of that, we are still in the throws of replacing our nurse practitioner that will be leaving us in October. It’ll be good for all parties involved. The person we have on tap to come in is a long time friend and we can’t wait to make it work with her.   Remember this; in 26 years of practice, every big change that we had in our clinic, even when we thought it was terrible and catastrophic, always always turned out to be the best for the clinic and for me. Every single time. I don’t fear change. I just don’t like the uncertainty that comes with change. So the quicker I solve the problems that come with change, the sooner I have peace of mind and can proceed to the next thing on my list that day.  That’s what I’m trying to accomplish with this.  Item #1 The first one this week is called, “Study: Semaglutide Lowered Chronic Kidney Disease–Related Risks” by Anna Bock and published in JAMA on June 21, 2024. That’s got some serious sizzle! Remember, the citations can be found at chiropracticforward.com under this episode.  Bock A. Study: Semaglutide Lowered Chronic Kidney Disease–Related Risks. JAMA. 2024;332(3):188. doi:10.1001/jama.2024.10349 How They Did It The randomized, double-blind, parallel-group, placebo-controlled FLOW trial compared the effects of semaglutide to placebo as an adjunct to standard of care on kidney outcomes for prevention of progression of renal impairment and risk of renal and cardiovascular (CV) mortality. The study enrolled 3,533 participants with type 2 diabetes and chronic kidney disease. What They Found Findings showed treatment with semaglutide 1mg reduced the risk of kidney-disease progression as well as cardiovascular and kidney death by 24% compared with placebo.  Both the Chronic Kidney Disease and cardiovascular components of the composite endpoint contributed to the reduction in risk. Semaglutide was also found to be superior to placebo for the confirmatory secondary endpoints, which included annual rate of change in eGFR, time to occurrence of a major adverse cardiovascular event and time to occurrence of all-cause death. Wrap It Up “We are very excited about the results from FLOW showing that semaglutide 1mg reduces the risk of kidney disease progression,” said Martin Holst Lange, executive vice president for Development at Novo Nordisk. “Approximately 40% of people with type 2 diabetes have chronic kidney disease, so the positive results from FLOW demonstrate the potential for semaglutide to become the first GLP-1 treatment option for people living with type 2 diabetes and chronic kidney disease.”   Item #2 The second one today is called, “Spinal Manipulative Therapy for Nonspecific Low Back Pain: Does Targeting a Specific Vertebral Level Make a Difference?: A Systematic Review With Meta-analysis” by Sorensen et al and published in Journal of Orthopedic and Sports Physical Therapy in August of 2023.  Peter Westlund Sørensen, PT, MSc1, Casper Glissmann Nim, DC, PhD2,3,4, Erik Poulsen, DC, PhD1, Carsten Bogh Juhl, PT, PhD1,5 J Orthop Sports Phys Ther 2023;53(9):529-539. Epub: 28 July 2023. doi:10.2519/jospt.2023.11962   Why They Did It We aimed to examine whether targeting spinal manipulative therapy (SMT), by applying the intervention to a specific vertebral level, produces superior clinical outcomes than a nontargeted approach in patients with nonspecific low back pain.   How They Did It Systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE, Embase, CENTRAL, CINAHL, Scopus, PEDro, and Index to Chiropractic Literature were searched up to May 31, 2023. Randomized controlled trials comparing targeted SMT (mobilization or manipulation) to a nontargeted approach in patients with nonspecific low back pain, and measuring the effects on pain intensity and patient-reported disability.   What They Found Ten randomized controlled trials  There was moderate-certainty evidence of no difference between targeted SMT and a nontargeted approach for pain intensity at postintervention and at follow-up   For patient-reported disability, there was moderate-certainty evidence of no difference at postintervention and at follow-up  Adverse events were reported in 4 trials, and were minor and evenly distributed between groups.   Wrap It Up Targeting a specific vertebral level when administering SMT for patients with nonspecific low back pain did not result in improved outcomes on pain intensity and patient-reported disability compared to a non-targeted approach.  This is great news because there’s great research out there that shows us that we aren’t as specific as we like to think we are. We’re always moving more joint levels than we’re trying to move.  So it’s all good.  Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.  Store Remember the evidence-informed brochures and posters at chiropracticforward.com.    Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!   The Message I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health! Key Point: At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic! Contact Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. Connect We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. Website http://www.chiropracticforward.com Social Media Links https://www.facebook.com/chiropracticforward/ Chiropractic Forward Podcast Facebook GROUP https://www.facebook.com/groups/1938461399501889/ Twitter https://twitter.com/Chiro_Forward YouTube https://www.youtube.com/channel/UCtc-IrhlK19hWlhaOGld76Q iTunes https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM Link https://player.fm/series/2291021 Stitcher: https://www.stitcher.com/podcast/the-chiropractic-forward-podcast-chiropractors-practicing-through TuneIn https://tunein.com/podcasts/Health–Wellness-Podcasts/The-Chiropractic-Forward-Podcast-Chiropractors-Pr-p1089415/ About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger    The post Semaglutide And Kidneys & Trying To Target Just One Vertebra appeared first on Chiropractic Forward.