CF 338: Psychologically Treating Prenatal Chronic Pain & GLP-1 Safety Today we’re going to talk about Psychologically Treating Chronic Pain & GLP-1 Safety 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 #338

Now if you missed last week’s episode, we talked about PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis

Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

As the clinic turns…..we are back on the right track to getting our team and our culture back in place and ready to grown. And then….which is my perfect luck since 2023 came along, our Nurse Practitioner turns in his notice and will be leaving us in October. 

Yeah…fun times. I’ve done too much and come much much too far to let this be anything BUT and opportunity rather than a set back. So, we will begin hiring another NP this week. 

Here’s how it’s going to be an opportunity, we have basically spa services like massage and acupuncture although acu is much more than a spa treatment. But, here’s where I’m going with it, if I bring in a female NP, we can augment those services and come in with a full blown medspa on that side of things, offering botox and all of that good stuff. 

So, we’ll lose some patients when our current NP leaves. Sure. But there’s an odd thing with him not wanting to have his picture taken so we’ll have someone in here that we can actualy effectively promote. Someone that we can make sure is invested in our clinic and ready to help us build it. 

Our current NP helped us figure it out and get it running. The second one will take us to the next level of where we’ve been trying to go. And….the improving culture can be re-inforced. 

We used to go bowling together and spend time with each other periodically outside of work. We enjoyed all working together. Sure people would come and go but only every 2-3 years. I had a manager for 11 years and another for about 6.5 years. Those were the days. 

Since 2023, it’s been non-stop turnover and turmoil and I’m struggling to just get that stability. A core group of staff that loves what we’re doing and sees the potential in being a strong team with a fun culture. 

So, the search continues but we have a new Medical Assistant starting on Friday. She’s going to be great. I just know it. And then the new NP will be the final piece of the puzzle. If we make the right pick there, we can be unstoppable. The bigger the practice, the bigger the problems I guess. As they say in the military, “Embrace the suck.”

So I am…. But make no mistake, though I’m positive and optimistic and moving forward, the suck has been real for a while now. 

What’s up with your Monday? Lol

Item #1

Our first one today is called, “Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy” by Cesta et al and published in JAMA Internal Medicine in December of 2023 and that’s just spicy enough. 

Remember, the citations can be found at chiropracticforward.com under this episode. 

Cesta CE, Rotem R, Bateman BT, et al. Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy. JAMA Intern Med. 2024;184(2):144–152. doi:10.1001/jamainternmed.2023.6663

Why They Did It

Is periconceptional use of glucagon-like peptide 1 (GLP-1) receptor agonists or other noninsulin second-line antidiabetic medications (ADMs) associated with increased risk of major congenital malformations?

Wrap It Up

Use of second-line noninsulin antidiabetic medications is rapidly increasing for treatment of type 2 diabetes and other indications, resulting in an increasing number of exposed pregnancies. 

Although some estimates were imprecise, results did not indicate a large increased risk of major congenital malformations above the risk conferred by maternal type 2 diabetes requiring second-line treatment. 

Item #2

Our last one this week is called, “Psychologically based interventions for adults with chronic neuropathic pain: a scoping review” by Oguchi et al and published in Pain Medicine in June of 2024, oushywawa! It’s hot!

Mayumi Oguchi, Michael K Nicholas, Ali Asghari, Duncan Sanders, Paul J Wrigley, Psychologically based interventions for adults with chronic neuropathic pain: a scoping review, Pain Medicine, Volume 25, Issue 6, June 2024, Pages 400–414, https://doi.org/10.1093/pm/pnae006

Why They Did It

As psychologically based interventions have been shown to have clinical utility for adults with chronic pain generally, a similar benefit might be expected in the management of chronic neuropathic pain (NeuP). 

However, to date, this has not been established, with existing systematic reviews on this topic being hampered by the scarcity of randomized controlled trials (RCTs). 

This review aimed to identify the type of psychologically based interventions studied for adults with chronic neuropathic pain. It also aimed to assess whether there are enough RCTs to justify undertaking an updated systematic review.

How They Did It

Seven databases and 2 clinical trial registries were searched for NeuP and psychologically based interventions from database inception to December 2021, and the search was updated in February 2023. 

The search was broadened by reviewing the reference list of included studies and contacting field experts. Predetermined study characteristics were extracted.

What They Found

Of 4,682 records screened, 33 articles (less than 1%) met the eligibility criteria. 

Four broad intervention approaches were observed, including cognitive-behavioral approaches, mindfulness/meditation, trauma-focused therapy, and hypnosis. 

Thirteen RCTs were identified, and of these, 9 retained 20 participants in each arm after treatment.

Wrap It Up

Cognitive-behavioral therapy was the most common therapeutic approach identified, whereas mindfulness/meditation was the most frequently used technique. 

Almost half to two-thirds of the studies reported significant improvements in pain, disability, or distress, which suggests that psychologically based interventions are potentially beneficial for adults with chronic NeuP. 

If you’re not up on centralized pain and the upregulated CNS folks, it’s the future of long term pain. We’ve been talking about it for years here and we just keep seeing more and more information confirming 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.

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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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