CF 329: The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) Today we’re going to talk about The WHO’s Sources For Opinion On Spinal Manipulative Therapy (Part 13) 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, 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 creekstonecare@gmail.com 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, 
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  • 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 #329 Now if you missed last week’s episode, we talked about current tendinopathy thoughts and chiropractic vs. medical costs.  Make sure you don’t miss that info. Keep up with the class. 

On the personal end of things…..

Well the week is already starting off with a bang and not in a great way either. First thing this morning, I found out one of my employee’s was abused by her ex over the weekend. Broke into her house, prevented her from leaving, and beat her while the 4-year-old was in the house. For a whole weekend.  You should see the girl’s leg. It’s insane. 

So, as an employer, what do you do? Believe it or not, this isn’t the first time we’ve had our go around with crap heads like this. I don’t understand some boys. I say boys because they’re not men. Men respect, support, and boost up women. They don’t do what this guy has been doing.  I can tell you what we do. We are pulling out all the stops to get this girl all of the help our area non-profits have to offer. We’re getting her a protective order.

We’re getting her housing. We’re getting her as far from danger as we can as quickly as we can.  I’ve put my staff on notice about this guy. He’s already called the office today, by the way. They all know his name and what he looks like and my cop friend says call 911 if he shows his face.  I have protection here should it come to that but it won’t.

This guy just likes to beat up and try to control and intimidate women that lack the confidence and support to do something about it. 

Well, she’s got that now and I think he’s going to have a hard time ever doing something like this again.  I tell you this because most of you listening are probably clinic owners yourself. In 26 years in practice, something similar with regards to being hyper aware of an individual that could come to the clinic, has happened maybe 3-5 times or so.

Once or twice it was a unstable patients. The other times, it’s been spouses, all male, all in need of hard-learned lessons. 

It’s stressful. It makes everyone in the office anxious. Being a business owner is hard and some things like this we just cannot control. But we can be aware and we can be vigilant. We can help our team mate make the best decisions and we can do our part to try to make sure she’s protected to the very best of our ability.  Like I said, my entire staff knows the plan, knows what he drives, knows his name, and knows exactly what he looks like. 

It’s a journey and this week is just a little different from our regular journey. But, we’re making it happen, getting patients better while our team helps walk her through this. 

Alright, on with the research. We are continuing our series we are doing every other week where we are trying to figure out what brand of crack the WHO was smoking when they chose and used citations to deem spinal manipulative therapy as being effective at ‘very low confidence’ recently. Two of those papers are covered in this episode. 

Item #1

Our first one today is called, “Short term trial of chiropractic adjustments for the relief of chronic low back pain“ by Waagen et al and published in Manual Medicine in 1986. This one is so old that it can hardly be found.

Literally, I had search and search Remember, the citations can be found at chiropracticforward.com under this episode. 

Waagen GN et al. Short term trial of chiropractic adjustments for the relief of chronic low back pain. Manual Med. 1986;2:63-67.

A double-blind study of the efficacy of spinal adjustive therapy delivered by chiropractors was designed and implemented at the clinic of a chiropractic college.  Nineteen patients with low back pain completed a nominal two-week period of treatment.  Nine patients in the experimental group received a series of chiropractic ‘adjustments’, while ten control patients received a comparable series of manual interventions.  Experimental patients had significantly more relief from pain than control patients immediately after being treated as measured on a 10 cm visual analogue scale.  After two weeks of treatments the experimental patients as a group exhibited significant overall pain relief, whereas improvement of patients in the control group was not significant.  Using a global index for the objective measurements of change in spinal mobility it was also concluded that experimental patients improved significantly compared to control patients  Because of the small sample size the results reported must be considered preliminary.  Modification in the research design from other trials studying manipulative therapy included the use of chiropractic adjustments as the form of manipulation, use of a realistic manual control treatment and use of a global index as an outcome measure.  So yes….it’s in our favor but….it’s a tiny sample size and it’s 38 years old. So why is the WHO using it? 

Item #2

Your second one this week is called, “Short-term usual chiropractic care for spinal pain: a randomized controlled trial” by Walker et al and published in Spine Journal 11 years ago back in 2013. 

Walker B.F et al. Short-term usual chiropractic care for spinal pain: a randomized controlled trial. Spine (Phila Pa). 2013;38(24):2071-2078. doi: 10.1097/01.brs.0000435032.73187.c7.

Why They Did It

The authors wanted to establish the short-term effectiveness of chiropractic therapy for spinal pain compared with a sham intervention and explore the predictors of chiropractic treatment satisfaction. Chiropractic treatment is widely used for spinal pain. However, a lack of sound evidence precludes conclusions about the effectiveness of chiropractic for spinal pain.

How They Did It

  • Participants were adults experiencing spinal pain, randomized to receive 2 treatments of chiropractic or sham therapy. 
  • Participants and outcome assessors were blinded to group allocation. 
  • Primary outcomes at 2 weeks were NRS and Functional Rating Index). 
  • Secondary outcomes were global change, minimum acceptable outcome, and treatment satisfaction. 
  • Treatment effects were estimated with linear mixed models for the primary outcomes. 
  • And they used logistic regression to identify differences in the secondary outcomes and explore for predictors of treatment satisfaction.

What They Found

  • One hundred eighty three participants were recruited and included in the analyses. 
  • Participants receiving chiropractic therapy reported greater improvements in pain, physical function, and were more likely to experience global improvement and treatment satisfaction. 
  • There was no between-group difference in achieving a minimally acceptable outcome. 
  • Awareness of treatment assignment and achieving minimally important improvement in pain intensity were associated with chiropractic treatment satisfaction.

Wrap It Up

Short-term chiropractic treatment was superior to sham; however, treatment effects were not clinically important. Awareness of treatment assignment and clinically important reductions in pain were associated with chiropractic treatment satisfaction

Alright, another puzzling episode of why does the WHO include garbage crap papers to decide if spinal manipulation is effective? I maintain that there is an agenda of some sorts that is bias against chiropractic. 

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!

Chiropractic evidence-based products

Integrating Chiropractors

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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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