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The Chiropractic Forward Podcast: Evidence-based Chiropractic AdvocacyA podcast addressing Chiropractic care today. Where chiropractors have been and where Chiropractic seems to be headed as well as how integrated chiropractic practices can play a part in the healthcare landscape today and tomorrow. Author: The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy Language: en-us Genres: Alternative Health, Health & Fitness Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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PRP For Knee OA & Diagnosing Cervical Arterial Dissection
Wednesday, 11 March, 2026
CF Ep. 386: PRP For Knee OA & Diagnosing Cervical Arterial Dissection Today we’re going to talk about PRP For Knee OA & Diagnosing Cervical Arterial Dissection 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, judgmental, elitist, puffing on a pipe, pretentious kind of research. We’re research talk over a couple of beers. So grab you a 6-er. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. I’m so glad you’re lending me your ear, spending your time with me and we’re learning this stuff together. Hiring Plug 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 Things You Should Do Go to Amazon and BUY my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. Easy to understand and easy to support everything you do. It’s on Amazon. Like our Chiropractic Forward Facebook page, Join our private Chiropractic Forward Facebook group, and then Review our podcast Check our website at chiropracticforward.com You have found yourself smack dab in the middle of Episode #386 Now if you missed last week’s episode, we talked about Tears In The Shoulder Are Waaayyy Normal & Adolescent Cannabis Use Is Dangerous Long Term Mentally. Make sure you don’t miss that info. Keep up with the class. On the Personal End of Things… Here we are, mid March in 2026. And what do I have going on? Well, a lot of the same as last week so let’s just hop into some advice based on what I’m currently focusing on in my life and career at 53 years old. The biggest advice to younger chiropractors is get a plan in advance. Don’t wait until you’re 48 to go, Hey, you know, at some point, I might want to retire. I had a buddy who was older than me that ended up getting cancer and passing away before he enacted any kind of retirement plan. His wife was left with a business that wasn’t worth anything with him gone, and all she could do was sell it for parts. I don’t know their finances at all. But if he hadn’t laid down some plans for her, that probably didn’t work out very good. Make plans early. I have another buddy… who ended up… having a heart attack and dying right there in his practice. He was in his 70s. Some people want to work that long, period. They love it that much. I love what I do for a living, but I don’t want to do it my whole life. I have another buddy who was in his 60s, and just a year or two ago, had a stroke, and can’t speak. So all of his patients had to go somewhere else, and he had to close down his shop and sell it off for parts. This all goes to say, for most of you, when you’re building your practice, build it to sell. Don’t name it after yourself. It’s hard to sell Williams Chiropractic to Joseph Salazar. Don’t make all of the marketing all about you. When it’s person-driven, your clinic is associated so strongly with YOU that it’s hard to remove yourself and turn it over to someone else. My practice is called Creek Stone Integrated Medical. It was Creek Stone Integrated Care before we added our medical branch. You can sell that to anybody. I think you get my point there. Build it to sell, plan early. Roth IRAs, compound interest. Maybe you get some inheritance along the way. And a side gig or two that you enjoy isn’t always the worst idea either. If you want to work your whole damn life, that’s OK. That’s just not what I want for my one and only trip on this rock. Alright, that’s it. I don’t have a lot more to share personally than that this week. I’m just getting ready for the QME test. Which will be in mid April. Once I hopefully pass that dude, one of my side gigs will be engaged, so cheers to that. Let’s get into the research. Item #1 Our first one today is called, “Validation of a Diagnostic Support Tool for the Early Recognition of Cervical Arterial Dissection in Primary Care” by Thomas et al published in December 2024, and it’s a hot potato, Remember, the citations can be found at chiropracticforward.com under this episode. Citation: L. Thomas, M. Fowler, L. Marsh, K. Chu, Claire Muller, A. Wong, Validation of a diagnostic support tool for early recognition of cervical arterial dissection in primary care, Clinical Neurology and Neurosurgery, Volume 247, 2024, 108627, ISSN 0303-8467, https://doi.org/10.1016/j.clineuro.2024.108627. (https://www.sciencedirect.com/science/article/pii/S0303846724005146) Why They Did It Cervical arterial dissection is one of the leading causes of stroke in young adults, and here’s the tricky part — it often shows up first looking just like everyday musculoskeletal pain. Neck pain, headache — things that walk through chiropractic and primary care doors every single day. The problem is, there are currently no validated tests to help clinicians identify it early. That means it can get missed, and a missed CeAD can mean a missed stroke. The goal of this research was to validate a diagnostic support tool that could help clinicians in primary care know when to refer urgently for imaging, when to monitor, and when it’s safe to proceed with treatment. How They Did It This was a prospective observational study. They took adults over 18 years old presenting to a tertiary metropolitan hospital with an initial diagnosis of headache or neck pain — sound familiar? Participants were split into those with radiologically confirmed CeAD and controls without CeAD. They crunched the diagnostic values, looked at sensitivity and specificity, and then refined the tool based on what they found. What They Found Thirty participants had confirmed CeAD and 261 were controls with non-CeAD causes of headache and neck pain. The original tool was an excellent predictor with an AUC of 0.83, but it had poor specificity — meaning too many false positives. So they refined it. The updated tool uses four simpler, equally-weighted criteria: acute or sudden onset of pain, unusual or unfamiliar headache or neck pain, recent trauma or infection, and neurological features. Each criterion scores 1 point for a total of 4. At a cut-off of 3 out of 4, the refined tool hit 100% sensitivity and 74% specificity Wrap It Up This is pretty important for us! The refined tool shows solid clinical utility at a cut-off of 3 or higher, and the recommendation is clear: at that score, refer for vascular imaging. The authors acknowledge that further validation in emergency departments and primary care settings is still needed, but the foundation is strong. For chiropractors, this is a practical screening tool. Sudden, unusual neck pain or headache plus any neurological features in a patient under 55 should be raising flags. Know the signs, use a tool like this, and refer when the score demands it. Stroke prevention starts in our offices. You don’t wanna be a dummy and end up in court and your name run down in your town. Item #2 The last one this week is called, “Efficacy and Safety of Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy for Knee Osteoarthritis: A Systematic Review and Meta-Analysis” by Gao, Ma, Tang, Zhang, and Zuo, published in the Archives of Orthopaedic and Trauma Surgery in September of 2024. New enough to smoke!! Remember, the citations can be found at chiropracticforward.com under this episode. Gao J, Ma Y, Tang J, Zhang J, Zuo J. Efficacy and safety of platelet-rich plasma and hyaluronic acid combination therapy for knee osteoarthritis: a systematic review and meta-analysis. Arch Orthop Trauma Surg. 2024 Sep;144(9):3947-3967. doi: 10.1007/s00402-024-05442-y. Epub 2024 Jul 7. PMID: 38972025 Why They Did It Knee osteoarthritis is one of the most common degenerative joint conditions out there, and it hammers quality of life. The traditional conservative options — corticosteroids, hyaluronic acid injections, NSAIDs — offer temporary relief at best and come with real side effects. Platelet-rich plasma, or PRP, has been generating a lot of buzz as a regenerative alternative. Hyaluronic acid has been a go-to injectable for years. But what happens when you combine them? That’s what this team wanted to know. Is PRP plus HA more effective and safer than either treatment alone? How They Did It This was a systematic review and meta-analysis, the gold standard of evidence-based research. They searched MEDLINE, the Cochrane Library, EMBASE, and Web of Science for articles published up through January 2024. They only included randomized controlled trials — the highest quality study design — that directly compared PRP plus HA combination therapy against PRP alone or HA alone. Primary outcomes were pain, functional outcomes, and adverse events. They followed PRISMA guidelines, used two independent researchers for data extraction, and applied fixed or random effects models based on heterogeneity. Ten RCTs involving 943 patients were included. What They Found The combination of PRP and HA produced more significant pain reduction and functional improvement compared to HA treatment alone. And here’s a clinically important piece — the combination therapy also appeared to have a higher safety profile than either PRP or HA used as monotherapy. In other words, you get better results AND fewer adverse events when you combine them. That’s a pretty compelling argument for combination therapy in the right patient population. Wrap It Up This meta-analysis adds meaningful evidence to the growing case for regenerative, non-surgical options for knee OA. PRP combined with hyaluronic acid outperformed HA alone on both pain and function, and the safety profile was favorable. For chiropractors and other conservative care providers, this is a reminder that our patients don’t have to choose between suffering and surgery. Orthobiologic options like PRP, especially in combination with HA, are showing real promise. This is the direction musculoskeletal medicine is heading — patient-centered, conservative, and regenerative. That’s our lane. Closing 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 & Social Media Links Website: http://www.chiropracticforward.com Facebook: 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/UCtcIrhlK19hWlhaOGld76Q iTunes: https://itunes.apple.com/us/podcast/chiropractic-forward-podcast-chiropractors-practicing/id1331554445?mt=2 Player FM: 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-Prp1089415/ 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 The post PRP For Knee OA & Diagnosing Cervical Arterial Dissection appeared first on Chiropractic Forward.
