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. 

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.

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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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