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    

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  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. 

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 & Vlogger

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