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

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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.

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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 ...