What Causes Shoulder Pain? and How Can Chiropractic Help?

Posted on November 26, 2011 by admin

The shoulder is the most mobile joint in the human body. The joint includes four tendons that hold muscle to bone. Together, these four “rotator cuff” tendons stabilize the upper arm bone to the shoulder socket and allow a wide range of motion in the shoulder.
Shoulder pain is an extremely common complaint, and there are many common causes of this problem. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you are unsure of the cause of your shoulder pain, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of these conditions must be directed at the specific cause of your problem.
You should see a doctor if you experience the following:
1. Inability to carry objects or use the arm
2. Injury that causes deformity of the joint
3. Shoulder pain that occurs at night or while resting
4. Shoulder pain that persists beyond a few days
5. Inability to raise the arm
6. Swelling or significant bruising around the joint or arm
7. Signs of an infection, including fever, redness, warmth
8. Any other unusual symptoms
Types of shoulder pain:
Bursitis: The most common diagnosis in patients with shoulder pain is bursitis or tendonitis of the rotator cuff. Bursitis is an inflammation of a fluid-filled sac, or bursa, that lies between tendon and skin or between tendon and bone. Normally a bursa protects the joint and helps make movement more fluid.
Rotator Cuff Tendonitis: Tendonitis is when tendons become compressed under the rigid bony arch of the shoulder. The compressed tendons become inflamed or damaged and cause pain. This can occur from general wear and tear, as you get older, an activity that requires constant shoulder use like baseball pitching, or an injury.
Arthritis: Shoulder arthritis is less common than knee and hip arthritis, but when severe may require a joint replacement surgery. Arthritis is a gradual narrowing of the joints and loss of protective cartilage in the joints about the shoulder.
Rotator Cuff Tear: A Rotator cuff tear occurs when the tendons of the rotator cuff separate from the bone. Surgery is sometimes necessary for this condition.
Frozen Shoulder: Also called ‘adhesive capsuliitis,’ this is a common condition that leads to stiffness of the joint. Physical therapy and stretching are extremely important aspects for treatment.
Calcific Tendonitis: Calcific tendonitis is a condition of calcium deposits within a tendon — most commonly within the rotator cuff tendons. Treatment of calcific tendonitis depends on the extent of symptoms.
Labral Tear: A Bankart lesion is a type of labral tear most commonly due to dislocation of the joint. Bankart lesions cause problems of persistent instability.
Shoulder Instability: Instability is a problem that causes a loose joint. Instability can be caused by a traumatic injury (dislocation), or may be a developed condition.
Shoulder Dislocation: A dislocation is an injury that occurs when the top of the arm bone becomes disconnected from the scapula.
Shoulder Separation: Also called an AC separation, these injuries are the result of a disruption of the acromioclavicular joint. This is a very different injury from a dislocation!
SLAP Lesion: The SLAP lesion is also a type of labral tear. The most common cause is a fall onto an outstretched hand.
Biceps Tendon Rupture : A proximal biceps tendon rupture occurs when the tendon of the biceps muscle ruptures near the joint.
How can chiropractic help my shoulder pain?
The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment.

Your chiropractor looks at your overall health, focusing not only on your shoulder, but also on your lifestyle, such as diet and amount of daily exercise. This integrated approach helps determine the best treatment for your shoulder pain. To help identify the cause of your problem, you and your chiropractor will discuss your symptoms and previous injuries, your family health history, and your lifestyle, including recreational and work related physical activities.

Your chiropractor is uniquely qualified to restore the health of your spine and neck. Special chiropractic techniques may relieve the pressure that is causing your shoulder pain. After locating the misaligned vertebrae in your neck, your chiropractor manually applies gentle pressure and repositions the vertebrae. These adjustments can help restore alignment, improve mobility, and relieve pain and stiffness.

Your chiropractor may recommend other types of treatment for relieving your shoulder pain. These may include moist heat, ice packs, massage, traction, or stretching and strengthening exercises. Your chiropractor can discuss these with you.

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WHAT CAUSES HEADACHE ?

Posted on November 18, 2011 by admin

BACK OF HEAD HEADACHE

WHAT CAUSES HEADACHE is not an easy question to answers as there are multiple causes. So this is not an exhaustive treatise on the subject. For that I would have to write a book! But …

Some 80% of headaches are reckoned to be ‘tension headache’. This is not from stress / tension, but tension of the meninges surrounding the neck and brain.

The meninges – there are three layers – cover the brain and spinal cord which interestingly is really one organ. Anatomists have now discovered that the outermost layer in the neck is directly connected to one of the tiny muscles in the neck.

So anything that stretches the meninges – like whiplash – or causes that muscle to spasm, will directly give you a back of head headache.

WHAT CAUSES HEADACHE : Take a little test

Pick up something that weighs perhaps a kilogram, and hold it with bent elbow for a few minutes, WITHOUT MOVING YOUR ARM. Feel how the arm tires? Then the biceps starts to spasm. And then your arm says to you, put the damn thing down, won’t you!
See these tiny muscles at the top of your neck – one of them, never mind which, is directly connected to those meninges. That’s exactly what they start to say when you’ve been sitting too long at the computer – just like mine are saying right now! – or behind the wheel of the car. I’ts time to move! they are trying to tell us. So move.

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Benefits of Back Exercises

Posted on November 11, 2011 by admin

Exercise is one of the most effective ways of preventing and treating recurring or chronic back pain. Strengthening muscles that support the spine with exercises can prevent, reduce and in some cases eliminate chronic or recurring back pain. Stretching shortened muscles that are pulling the spine out of alignment can also relieve back pain.

Weak core muscles are often at the root of lower back pain. The muscles of the back, the abdomen, hips and buttocks (the core muscles) work together to support the spine. The core muscles are the spine’s main defense against gravity.

The core muscles help maintain proper posture and stabilize the spine (keep it firm in its natural alignment during movement – walking, running, lifting, exercising, etc. Improving core stability reduces the risk of injury to the spinal joints, discs, back muscles & ligaments during such activities. Exercises to increase strength, endurance and coordination of the core muscles improve core stability.

Strengthening the upper back muscles is also important to prevent slouching, which is a common cause of neck and shoulder pain. Strengthening the upper back and the back of the shoulders helps maintain upright posture, as muscles in the upper back help keep the shoulder blades down and back.
Strong quadriceps (front of thigh muscles) are important to prevent back injuries when lifting. Proper lifting techniques involve using your legs and if your legs are weak, you may end up using your back.

Shortened muscles can pull the spine out of alignment and contribute to back pain. Stretching exercises lengthen shortened muscles and can relieve back pain. Tight back muscles, tight chest muscles, tight buttocks muscles, tight muscles in the front of the hip can affect the alignment of the spine. Stretching the back also increases mobility of the joints of the spine.

Note: Exercise is not recommended for acute low back pain, although continuing with daily activities is usually recommended. If you have a back injury or current back pain consult a Chiropractor before starting any exercise program.

Aerobic exercise can also improve chronic or recurring back pain. Weight-bearing aerobic exercise (legs support weight of body) such as brisk walking improves bone density and muscular strength/endurance of the lower body. Aerobics also improve also relieves stress and improves sleep, which helps to reduce chronic pain. How successful an exercise program is in relieving back pain depends on whether other factors that are contributing to back pain have been corrected – particularly chronic poor posture, which increases stress on the back muscles, ligaments and discs. Posture awareness along with strong and flexible muscles help maintain proper posture.

NOTE: Starting out with exercises that are too difficult (for your current level of fitness) or doing too many can cause back pain. Strengthening the back with exercises must be done progressively. The body adapts to gradual increases in exercise, increasing exercise too quickly can cause injury and cause or increase back pain. Patience and restraint are needed to give exercise a chance

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Car Accidents and Low Back Pain

Posted on November 4, 2011 by admin

If you’ve recently been in a car accident, it’s quite possible you are experiencing lower back pain. As a matter of fact, automobile accidents are one of the leading causes of lower back pain. While some back pain will resolve itself within a week or two as symptoms and soreness related to the car accident subside, other cases of lower back pain will persist, and can make everyday activities—working, caring for your home and family, and enjoying sports and other leisure pursuits—difficult.

Treating Lower Back Pain

Common treatments for lower back pain include Chiropractic, P.T. heat and ice, over-the-counter pain medications, and stretching and exercising. While it may seem intuitive to stay in bed and rest, inactivity may cause additional stiffness and soreness, further exacerbating the situation.
When You Need More Treatment

If lower back pain persists more than three months after an accident, or appears to be getting worse, it’s important to see a chiropractor to determine a course of treatment. This Chiropractor may suggest a variety of treatments and therapies, including physical therapy, chiropractic care, prescription medication, or in some severe cases, surgery.

When it comes to receiving the right treatment, being able to afford treatment shouldn’t be a barrier to your well-being. If your insurance company doesn’t cover a certain therapy, treatment, or medication prescribed by your doctor, that doesn’t mean you should go without.
If someone else was responsible for the car accident that is causing your lower back pain, that person may be responsible for your medical treatment. The best way to find out whether someone else is responsible, and to ensure that responsible parties pay, is to secure the counsel of an experienced personal injury attorney.

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Chiropractic FAQ

Posted on October 30, 2011 by admin

• What is an adjustment?
• When should I see a chiropractor?
• What are some of the benefits of chiropractic care?
• Is chiropractic adjustment safe?
• Does chiropractic care require a referral from an MD?
• Can chiropractic care cure other ailments besides back pain?
• Are there many athletes who use chiropractic?
• Does chiropractic care require X-rays?
• How do you find a good chiropractor?
• What is chiropractic?

1. What is an adjustment?

An adjustment is a highly skilled and precise movement usually applied by hand to a joint of the body. Adjustment loosens the joint to restore proper movement and optimize function.

When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about.

Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor. Your chiropractor is well-trained to determine if your problem will respond to chiropractic care or if you require referral to another health care provider.

2. When should I see a chiropractor?

Eight out of ten Canadians will experience back pain at some point in their life, and at least one third of people in Ontario will have back pain at any given time. For many people, the pain can keep them away from work, school or even their day-to-day activities. If pain causes interruptions and restrictions in the activities of your daily life then you should consult a health care provider.

Chiropractors are regulated primary health care professionals, and they are one of only five classes of health care professionals in Ontario that are able to use the title Doctor, with its accompanying rights and obligations.

Chiropractors are highly educated and extensively trained to assess, diagnosis, treat and prevent conditions disorders of the spine, joints, muscle and nervous systems. These disorders may include back pain, neck pain, headaches, referring pain in your arms and legs, etc.

Many patients seek chiropractic treatment for wellness care. Others, like seniors, who find that treatment helps them to maintain mobility and good range of motion. Pain should never become a way of life, especially when there is qualified help available.

There are many reasons to seek chiropractic care: Work, accidents, sports injuries, household chores, even the stress of daily living can cause painful joint and spinal problems. Even if you do not have painful symptoms, chiropractic care can help you maintain healthy spine and joint function.

Here are some of the most common reasons why more than 4 million Canadians visit a chiropractor each year:
o Back pain
o Neck pain
o Headache
o Whiplash
o Strains and sprains from daily activities
o Repetitive strain injuries
o Work and sports-related injuries
o Arthritis
o Restricted movement in the back, shoulders, neck or limbs
o General health and well-being

3. What are some of the benefits of chiropractic care?

Chiropractic care can:
o Improve movement in your neck, shoulders, back and torso
o Improve your posture
o Provide relief from headaches, neck and back pain
o Help prevent work-related muscle and joint injuries
o Lead to enhanced athletic performance
o Improve your flexibility and range of motion
o Relieve pregnancy-related back ache
o Correction gait and foot problems

4. Is chiropractic adjustment safe?

Chiropractic is widely recognized as one of the safest, drug-free, non-invasive therapies available for the treatment of headache, and neck and back pain. It has an excellent safety record. However, no health treatment is completely free of potential adverse effects. Even common over-the-counter medicines carry a risk.

Most patients experience immediate relief following an adjustment, however, some may experience temporary pain, stiffness or slight swelling. Some patients may also experience temporary dizziness, local numbness, or radiating pain. However, adverse effects associated with spinal adjustment are typically minor and short-lived.

Informed consent
Prior to starting treatment, all health professionals are required by law to obtain informed consent to treatment from their patients. Health care consumers must receive adequate and accurate information to assist them in evaluating their health care choices, and in balancing the relative risks of treatment options with the benefits. The chiropractic profession takes this responsibility seriously and has been a leader in obtaining informed consent.

Ontario’s chiropractors are required in their Standards of Practice to obtain written informed consent prior to treating a patient.

Neck adjustment
Neck adjustment, particularly of the top two vertebrae of the spine, has on rare occasions been associated with stroke and stroke-like symptoms. This risk is considerably lower than those serious adverse events associated with many common health treatments such as long-term use of non-prescription pain relievers or birth control pills. While estimates vary, a range of one to two events per million neck adjustments is the ratio generally accepted by the research community.

An extensive commentary on chiropractic care, published in the February 2002 issue of the Annals of Internal Medicine, which is the journal of the American College of Physicians, reviewed more than 160 reports and studies on chiropractic. It states the following with regard to the safety of neck adjustment: “The apparent rarity of these accidental events has made it difficult to assess the magnitude of the complication risk. No serious complication has been noted in more than 73 controlled clinical trials or in any prospectively evaluated case series to date.”

A Canadian study, published in 2001 in the medical journal Stroke, also concluded that stroke associated with neck adjustment is so rare that it is difficult to calculate an accurate risk ratio. The study was conducted by the Institute for Clinical Evaluative Sciences (ICES) and the authors have stated: “The evidence to date indicates that the risk associated with chiropractic manipulation of the neck is both small and inaccurately estimated. The estimated level of risk is smaller than that associated with many commonly used diagnostic tests or prescription drugs.”

The most recent research into the association between neck adjustment and stroke is biomechanical studies to assess what strain, if any, neck adjustment may place on the vertebral arteries. The preliminary findings of this ongoing work indicate that neck adjustment is done well within the normal range of motion and that neck adjustment is “very unlikely to mechanically disrupt the VA [vertebral artery].”

There are many risk factors for stroke including blood clotting problems, hypertension, smoking, high cholesterol, birth control pills, heart problems and trauma such as blows to the head from car accidents, sports injuries or falls. Some strokes happen spontaneously with no obvious cause during activities of daily living such as backing up a car. A patient’s health history and activities have to be examined very carefully in order to determine the most probable cause of a stroke.

5. Does chiropractic care require a referral from an MD?

Chiropractors are legislated as primary contact health professionals in California. This means that patients can consult them directly. However, chiropractors often work closely with medical doctors, many of whom refer to chiropractors when they believe chiropractic treatment will help alleviate a patient’s condition. Similarly, chiropractors frequently refer to medical doctors when necessary.

6. Can chiropractic care cure other ailments besides back pain?

Chiropractic care cannot “cure” every ailment, but there is some evidence to indicate that adjustments may have a beneficial effect on a variety of conditions. Adjustment may alleviate some of the secondary or referred pain, arising from the response of the musculoskeletal structures to the primary cause.

7. Are there many athletes who use chiropractic?

Yes. Many amateur and professional athletes use chiropractic treatment as part of their overall health care, fitness and maintenance program. Chiropractic is often used to improve muscle and joint conditioning, which has a direct effect on an athletic performance. Treatment works to improve biomechanical function and enhance overall conditioning, important in situations where there is continuous repetitive movement. Chiropractic care also help athletes fine-tune their muscles and joints for high level performance, and may reduce long term wear and tear. Finally, treatment can be used to prevent, and sometime shorten, the healing time of injuries.

Athletes most often select treatment to improve their performance, where as the average consumer will select chiropractic care to help manage aches and pains. In some cases treatment will be similar, but in all cases a treatment plan will be developed according to the goals and condition of each patient. In the case of professional and elite athletes, chiropractors often work in conjunction with other health care professionals, including medical doctors and/or sports medicine doctors, massage therapists and physiotherapists.

8. Does chiropractic care require X-rays?

X-rays can play an important role in diagnosis and are taken when a need has been determined after taking a patient case history and conducting a physical examination. Chiropractors receive 360 hours of education in radiology covering a full range of topics from protection to X-ray interpretation and diagnosis. Governments in every province have recognized the training and competence of chiropractors to take and interpret X-rays and have granted them this right.

9. How do you find a good chiropractor?

o Word of mouth
o Friends, family and co-workers
o Referrals from other health care practitioners
o The chiropractor locator on the OCA’s website

10. What is chiropractic?

The word “chiropractic” comes from ancient Greek and means “done by hand.”

Adjustment of the joints of the body has been used in health care for many centuries and is at the heart of modern chiropractic care.

Chiropractors are specialists in manual adjustment of the vertebrae of the spine and other joints. Adjustment helps relieve pain and restore normal functioning to the spine, joints and supporting structures of the body – so you can enjoy your everyday activities again as quickly as possible.

Chiropractors are also trained to prescribe therapeutic exercise, provide nutritional counselling, and recommend rehabilitation and injury prevention strategies.

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Cervicogenic Headache

Posted on October 15, 2011 by admin

Headache is one of the most frequent reasons people seek medical advice and is the primary complaint of about 10% of chiropractic patients [3,4]. Headaches may have a ‘sinister’ cause, such as accidental injury, a space-occupying lesion in the brain or other disease process. In that case they are secondary headaches. However the great majority of headaches are ‘benign’, not linked to any specific injury or disease, and are known as primary headaches.

Benign does not mean mild – symptoms may be frequent and severe. The three most common types of primary headaches are migraine, tension-type headache (TT H) and cervicogenic headache (CGH) [5]. Back in the 1960s the various categories of primary headache were thought to be distinct. That thinking still influences much clinical practice and public perception. However by 1988, when the International Headache Society (IHS) published a new classification of headaches [6] it was known:

The diagnosis and classification of primary headaches were extremely confusing and difficult areas. A headache may have various causes – genetic, neurological, biomechanical, vascular, physiological, environmental (e.g. certain foods and drink). New findings were casting doubt on the peripheral nervous system as the main source of pain. The “most fundamental problem”, noted the IHS, was that there was “a complete absence of laboratory tests which can be used as diagnostic criteria for any of the primary headache forms”.

There was a continuum between what had been thought to be separate types of headache – migraine could convert to chronic TT H, episodic TT H could convert to chronic headache.

Movement abnormalities or dysfunctions in the cervical spine were a significant contributing factor to primary headaches. Where patients met the diagnostic criteria for migraine or TT H they might also have cervicogenic headache (CGH – headache born in the cervical spine).

Figure 1 gives the IHS criteria for CGH.

Figure 1. IHS Classification – Cervicogenic Headache (1988)

11.2.1 Cervical spine

Diagnostic criteria:

A. Pain localized to neck and occipital region. May project to forehead, orbital region, temples, vertex or ears.

B. Pain is precipitated or aggravated by neck movements or sustained neck posture.

C. At least one of the following:

1. Resistance to or limitation of passive neck movements

2. Changes in neck muscle contour, texture, tone or response to active and passive stretching and contraction

3. Abnormal tenderness of neck muscles

D. Radiological examination reveals at least one of the following:

1. Movement abnormalities in flexion/extension

2. Abnormal posture

3. Fractures, congenital abnormalities, bone tumours, rheumatoid arthritis or other distinct pathology (not spondylosis or osteochondrosis)
Comment: Cervical headaches are associated with movement abnormalities in cervical intervertebral segments. The disorder may be located in the joints or ligaments. The abnormal movement may occur in any component of intervertebral movement, and is manifest during either active or passive examination of the movement.

The 1972 quote from Frykholm that opens this article speaks to this diagnostic confusion and unfortunately remains valid in general practice today. [2]. While there is still much to learn there has been a wealth of new research since the early 1990s. With respect to CGH:

(a) Anatomical Basis. In 1995 Hack et al., dental researchers at the University of Maryland in Baltimore, presented new evidence of bridges of connective tissue between the posterior muscles and the pain-sensitive dura (myodural bridges) in the upper cervical spine that gave a much stronger anatomical basis for CGH [7]. See Figure 2 for details. These and other connective tissue and ligamentous bridges were confirmed by subsequent studies and surgeries.

(b) Definition. CGH, rather narrowly defined by the IHS as in Figure 1, received a wider definition from the North American Cervicogenic Headache Society (NAC HS), a multidisciplinary society promoting the study of CGH:

“Referred pain perceived in any region of the head caused by a primary noceceptive source in the musculoskeletal tissues innervated by cervical nerves”.

(c) Research. A systematic review from the respected Duke University Evidence-Based Practice Center in 2001 summarized the research evidence to that time concerning the safety and effectiveness of various physical and behavioral treatments for CGH and TT H. It found that, even on the narrow definition given by the IHS, CGH was one of the most common forms of headache, similar in prevalence to migraine, and that the one physical or behavioral treatment with proven effectiveness was manipulation. Manipulation had two distinct advantages over use of medication – first it targeted the source of pain rather than control of symptoms, and second it was safe with fewer side effects. With respect to TT H, the effectiveness of manipulation was “less clear” because there were only three randomized controlled trials (RCTs), none with a placebo or non-treatment group.

However the trials suggested effectiveness. The largest, by Boline et al. in the US, reported that chiropractic manipulation was superior to amitriptyline in terms of reduced headache frequency and severity [8]. How can manipulation be effective for patients with TT H? That question highlights the diagnostic and classification difficulties. Some patients diagnosed as having TT H, because they do not fall within the IHS definition of CGH – perhaps because they have no neck pain or headache provoked by neck movements, nonetheless have spinal joint dysfunctions – also known as subluxation in chiropractic practice.

When these mechanical restrictions are corrected with manipulation, associated muscle tension is resolved. In 2002, the year following the Duke University review, Spine published the first physiotherapy trial of manipulative therapy for patients with CGH. This also reported effectiveness.

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What You Should Know If You Have Been Involved In An Auto Accident

Posted on October 7, 2011 by admin

Did you know that one of the most stressful aspects of living in modern life is dealing with the problems that arise after an auto accident? Were you also aware that some auto accident injuries are hidden and are seldom detected for months or even years? As a result, two things can occur when an injury is not taken care of properly, or the accident victims settle their case with the insurance companies before getting evaluated from a Doctor trained in soft tissue injuries.

… This Could Be A Big Mistake.

Why? Because once you settle your case, you lose the right to have your insurance company pay for treatment if you need it. A good rule of thumb is to be informed of your rights and then make a decision. It is our position that if you were indeed injured, you should get the care you need to get you back to the way you felt and functioned just before the accident.

It is not the responsibility of the insurance company to pay for anything more than that. They are not responsibile for pre-existing injuries; only the injuries sustained from the accident. Even if you are just sore, you should get checked out immediately because you may experience pain, numbness, headaches, muscle stiffness, fatigue, and other problems including arthritis many months down the road. Remember, nothing is more important than your health, especially when you start to lose it.

Here’s where the problem begins… Most people who suffer from an auto accident have one thing on their mind: their automobile!

Common questions include:

“Who is going to fix my car?”
“What will I drive in the mean time?”
“Will my insurance rates go up?”
“Who is going to pay for it?”
And the last thing on their mind is: “Am I Really O.K.?”
Not only are auto accidents an inconvenience and a hassle, a common redundant complaint of auto accident victims is that they don’t feel like their normal selves. You may also be experiencing obvious pains and symptoms like muscle stiffness or spasm, neck pain, headaches, numbness and tingling, back pain, difficulty sleeping, irritability, memory loss, fatigue, difficulty concentrating and many other difficulties. Or worse than that, you may be injured and feel nothing at all.

Either way, did you know that auto accidents can cause post-traumatic osteoarthritis? Osteoarthritis can ruin your posture (giving you a slumped or hump back appearance). Osteoarthritis can cause the discs in your spine to degenerate and create scar tissue formation leading to chronic stiffness and the inability to move properly.

As a matter of fact…

Most Doctors Are Not Trained In The Detection Of These Hidden Injuries…
If you have been in an auto accident, you need a doctor who is trained in the biomechanics of the human body; someone who treats these injuries every day. In addition,x-rays can be taken to find out if there has been any structural damage. In our office, we evaluate auto accident victims and make any appropriate referrals to other health care providers if needed.
Our primary responsibility is giving you the care if you need It, and submitting the required medical reports to the insurance company so your rights are protected.

If we can’t help you, we will refer you to a doctor or facility that can.
If you have been in an auto accident recently, there are some important decisions you have to make, and if I were you, I’d make these decisions very carefully.

Q: Should I See An Attorney Before I See My Chiropractor?
A: It is important to get checked out by the doctor first. That way the findings from your exam will allow you the information you need in order to decide if an attorney is necessary. If necessary, we can refer you to a reputable and qualified attorney.

Q: What If My Car Sustained Only Minor Damage?
A: Documented studies done by Charles Carroll, M.D., Paul McAtee, M.D. and Lee Riley, M.D. revealed that: “The amount of damage to the automobile bears little relation to the force applied to the cervical spine (neck) of the occupants.”

In other words, the damage to the passengers is not necessarily directly related to the damage to the vehicle.

Q: If I Need Treatment For This Injury, Do I Have To Pay For It Myself?
A: No, only in very rare circumstances does the patient pay for his care as he goes. Our office provides care “on credit” when patients are represented by an attorney. Some car insurance policies have what is called “Med Pay.” This means that medical bills will be paid at 100% up to a certain limit. My office can assist you in obtaining this information.

Using your medical coverage should not raise your premiums.

Q: The Insurance Company Has Been Calling Me And Wants To Settle,What Should I Do?
A: Do not sign or settle until you have had us evaluate your injury for you. If you settle before your injury is fully resolved, you will be completely on your own and will have to pay out of pocket for your care.

Q: I’ve Been To The Hospital And My Medical Doctor, Do I Really Need to See a Chiropractor?
A: You need a doctor who focuses in the treatment and diagnosis of auto accident injuries. Usually hospitals will check vital signs, make sure there are no life-threatening conditions and release the patient with pain relief medication. They normally do not treat the underlying improper musculoskeletal biomechanics that can and often do lead to future pain. If you are still having problems, you should get a second opinion.

If your M.D. has given you pills, you must understand that pills do not correct structural or soft tissue damage. There are special therapies designed for that, and we offer these modalities at our office.

Q: Does Your Care Hurt?
A: Absolutely not. The care is very gentle and quite soothing. Most patients can hardly wait to get their care.

Q: Is The Care Safe?
A: Yes, extremely. Particularly when compared to the side effects from medication. I urge you to go to the patient testimonial tab to get a feel for what you can expect.

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Airbag Injuries

Posted on September 23, 2011 by admin

Think back to when you took drivers education in high school.
Did the instructor teach you to hold the steering wheel at the 10 and 2 o’clock positions?
Did he teach you to use the hand over hand method for turning?
Do you steer your vehicle with one hand on top of the wheel?

If your vehicle has an airbag you might want to think twice.
Back to the Basics?
Every car, SUV and light duty truck must come equipped with a driver and passenger airbag (see www.safercars.org). They are designed by engineers to save both the unbelted and the belted occupant. Insurance Institute for Highway Safety (www.highwaysafety.org) reports nearly 18,000 lives have been saved from airbags. Maximum effectiveness from the supplemental restraint airbag is accomplished by wearing your seatbelt. Seatbelts properly position the body during precrash braking, resulting in proper body position for airbag deployment.

Unbelted occupants are much more at risk from a deploying airbag injury. If a driver brakes a vehicle before it crashes, unbelted occupants in the front seat are likely to continue to move forward, closer to the airbag when it deploys. If the crash is complicated, with minor impacts before the airbag is deployed by a more significant impact, the same thing may happen. It is not suprizing that most airbag related fatalities were unbelted occupants and children. Airbags deploy at 100-200 mph in fractions of a second. Airbags are lubricated with cornstarch or talc powder. Wearing your seatbelt allows you to ride out the deploying forces of the supplemental airbag. Airbags do cause some injuries; however, a majority of the injuries are primarily minor injuries to the face, arms and the hands.

How to Hold the Steering Wheel
Several years ago, I took a performance driving class with professional driving instructors. Instructors were teaching law enforcement officers to drive their patrol vehicles with their hands at the 9 and 3 o’clock positions, not the 10 and 2. My thumbs were not to be locked inside the wheel, but rather kept on the outer ring of the wheel. While driving the vehicle around the driving course, I was instructed to smoothly shuffle steer (use the push-pull technique) the vehicle and not to do the hand over hand whenever possible.

Mitch Becker, Technical Consultant with ABRA Auto Body & Glass, teaches airbag and automotive safety designs to a number of automobile, I-CAR, and insurance groups. Mitch says that since the airbag deploys out of the center of the wheel, driving the vehicle with the hands or arms over the airbag would result in forearm injuries and injuries to the face. Changing the hands to the 9 and 3 would allow the driver to flex and bend at the elbow joint, allowing the driver’s upper body position to sit with a minimum 10 inches between the airbag and the center of the chest (sternum). This is particularly beneficial to shorter drivers, drivers of larger size, and pregnant persons, thus allowing the driver to sit back as far as possible from the drivers’ airbag.

The Hand Position Story
KMSP-TV Fox Channel 9, Reporter Jeff Ballion from in Minneapolis, became interested in airbag safety. Jeff indicated many drivers were unaware of the “new driving hand position.” We decided to put the 9 and 3 hand position to a demonstration. Jeff and his camera crew met Mitch and me at John’s Auto Parts in Blaine. We selected a 1992 Ford Taurus wagon and placed a Rescue Randy firefighting mannequin behind the steering wheel airbag. We painted the forearms orange and the thumb blue to illustrate the contact points with the thumbs in the contrast color.

On the first car, the hands were placed at the 10 and the 2 o’clock positions (true grip) with the thumbs inside the wheel. When the airbag deployed, the left arm rocketed off the wheel, striking the windshield pillar and then striking the left side glass. The paint was removed by the scraping of the airbag from the inner medial aspect of both forearms. The right arm stayed clamped to the wheel and was bent by the deploying airbag with great force. In a real person, something would have given and broken between the thumb and the forearm. The paint was removed from the entire inner surface of the arm and the top of the thumb and was deposited onto the airbag fabric. The plastic cover flaps of the airbag housing contacted the inner wrists of both arms with the force of the opening airbag.

On the second car, the hands were placed at the 9 and 3 o’clock positions with the thumbs on the outer rim of the wheel (false grip). When the airbag deployed, the left arm was knocked sideways into the side door panel. The right arm at the 3 o’clock position with the thumb on the outside of the rim was blown sideways and flew toward the seat cushions. There was 50% less paint removed from both inner forearms, there was no plastic cover flap mark on either wrists or arms from the airbag housing. There was no contact of the hands or the arms with the windshield pillar or the side door glass.

When driving, it is important to note that honking your horn at the moment of a crash can be dangerous too, because the horn button is often right in the center of the wheel – right where the airbag comes out! This can place the hands and the arms right over the airbag when it deploys, and the hands and forearm can be punched into the face. Some manufacturers are moving the horn and cruise controls to the sides of the wheel to avoid this scenario.

The 2006 edition of the Minnesota Drivers Manual on page 31, Airbag Safety Suggestions section says, “Try to maintain at least 10 inches between yourself and the steering wheel. Keep your hands on the 8 and 4 o’clock or 9 to 3 o’clock position on the steering wheel. Avoid the 10 and 2 o’clock position. Keep your thumbs turned out on the steering wheel.”

“Certainly drivers should avoid holding their hands in the airbag danger zone: over the top of the wheel, over the airbag cover, and on the bottom,” says Dr. David Roberts, Emergency Department physician at North Memorial Medical Center, who has been tracking airbag injuries. Dr. Roberts advocates that drivers follow this recommendation and keep their hands to the sides of the steering wheel for much of their driving. He also advocates that drivers always keep two hands on the wheel for critical maneuvering of the vehicle in any emergency situation.

Read Your Owners Manual on Airbags
Several vehicle owners’ manuals suggest to drivers to not hold their arms over the airbag. Some vehicle manufacturers have modified their steering wheel designs, encouraging drivers to adopt hand positions along the sides. Some manufacturers are also making the steering wheel less comfortable to grip at the top and at the 10 and 2 by making the thickness of the rim larger and with different material textures. Jeff Payne, Las Vegas based race car driver and President of www.DriversEdge.org, also recommends and teaches the 9 and 3 o’clock hand position for driving. The American Occupant Restraint Council (www.aorc.org) also advocates this driving hand position.

Be sure to check out your owner’s manual on airbags and supplemental restraint information for your vehicle. Remember, that our first priority is to drive the vehicle safely and to avoid all collisions. Buckle up for every trip, every ride, every item of equipment and every transport.

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car accident back injuries

Posted on September 17, 2011 by admin

Car accident back injuries can be sustained in many types of motor vehicle accidents. Whiplash is one of the most common types of car accident back injuries. Whiplash accounts for more than one million car accident back injuries each year. Ten percent of these car accident back injuries lead to long term disability. This type of car accident back injury occurs most often in rear end collisions and can also occur when a vehicle strikes a non-moving object or gets broad-sided by another vehicle.

Whiplash is sustained when a victim’s head is violently hurled forward (hyperextension) and then backward (hyperflexion). Whiplash injury can cause serious injury to the joints, discs, muscles, nerves, and ligaments of the neck and is most serious when a victim’s head is turned to the side during impact. Whiplash car accident back injuries, though common, are sometimes difficult to diagnose. Symptoms of these car accident back injuries can include muscle spasms in the neck and upper back area, increased neck pain with movement, and increasing pain in the base of the neck. There are a variety of other symptoms that a doctor can

Car accident back injuries can also result in a lumbar or lower back sprain or strain. These car accident back injuries result in serious and sometimes debilitating pain in the larger muscles of the lower back. These car accident back injuries can also be difficult to diagnose or may be misdiagnosed if there is an underlying disc injury that has not been identified. Pain from these car accident back injuries can occur on one or both sides of the lower back, may worsen with activity, or may cause nighttime muscle spasms.

Car accident back injuries also include spinal cord injuries. Spinal cord car accident back injuries can be caused by different kinds of trauma including bruising (contusion), excessive pressure (compression), lacerations, and specific damage to the corticospinal tracts in the cervical spinal cord area. Spinal cord car accident injuries can cause serious nerve damage resulting in paralysis, loss of feeling in certain areas of the body, loss of reflex function, and autonomic disturbances. Spinal cord car accident injuries can be very debilitating and can lead to secondary medical problems including infection, sexual dysfunction, muscle spasms, loss of bladder control, and centralized hypersensitivity or pain in certain areas of the body.

Chiropractic can help with all these injuries so do something before thay become chronic unsolvable problems.

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Chiropractic Care for Whiplash

Posted on September 12, 2011 by admin

If you have suffered a whiplash-type injury to the neck, chiropractic care is a good choice to reduce pain and return proper mechanics to the cervical spine.
To understand the chiropractic treatment of whiplash injuries, it is important to briefly review the nature of this type of neck injury. Whiplash is characterized as an injury to the muscles of the neck from the traumatic rapid forward and backward motion of the neck during an accident.

Chiropractic emphasizes a comprehensive picture of the mechanisms of neck sprain. As important as muscle injury is the response of the nervous system to trauma, and the injury to deeper tissues of the spine with resulting restriction or fixation of spinal joints.
The acute pain and restricted motion you experience after a whiplash injury is a product of injured tissue, and the protective response of the nervous system as it locks up spinal joints to protect you from possible injury to the spinal cord.

Chiropractic care emphasizes mobilizing restricted spinal joints and initiating rapid firing of neurological receptors using spinal manipulation, including non-force and flexion-distraction techniques. Your chiropractor will address the disturbed mechanics and the neurological responses that allow for treating the cause of neck injury and return a full functioning to injured spinal joints.
It is important to emphasize that spinal manipulation is introduced by your chiropractor only when the initial traumatic muscle injury is stabilized. Your chiropractor will be using various types of treatments depending on the stage of your whiplash injury.

The Stages of Whiplash Treatment
Shortly after the injury, in the acute phase, the chiropractor will concentrate on reducing inflammation with therapy modalities, such as ultrasound, and, if indicated, gentle stretching and manual therapies, such as muscle energy therapy. Ice will be recommended and sometimes a light neck support might be prescribed for a short period of time.
As the neck begins to be less inflamed and acute, the chiropractor will utilize gentle spinal manipulation, or adjusting, in order to return motion to spinal joints that have locked up and become restricted as a result of the injury. In some patients, non-thrusting and non-force methods are more appropriate, including Cox flexion-distraction technique.

Chiropractic Care and Whiplash
Chiropractors are doctors who specialize in the care of non-surgical conditions of the neck with gentle, time-saving approaches that address the mechanical and neurological causes of whiplash injury.
Chiropractors are rigorously trained to diagnosis the different types of neck injuries. Your chiropractor will take an extensive history and provide a comprehensive examination to determine what tissues have been injured in an accident and what spinal joints may be restricted in motion.
The goal of chiropractic care in treating whiplash injuries is to optimize motion in the spine, treat the spinal discs, reduce muscle spasm and improve muscular strength.
Chiropractors are specialists in spinal manipulation—an active, hands-on care that returns motion to the spine. The restricted motion and disturbed mechanics that characterize whiplash injuries are especially helped by spinal manipulation in patients who are considered good candidates for this approach.
How a Chiropractor Diagnoses Whiplash Injury
Even if you go to the chiropractor complaining of neck pain following an accident, he or she will evaluate your spine as a whole. The chiropractor will check your neck (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). It’s important to examine the entire spine because even though it’s just your neck that hurts, other regions of the spine may be affected.
Your chiropractor will determine areas of restricted joint motion, disc injury, muscle spasm, and ligament injury. One way the chiropractor does that is through motion and static palpation, diagnostic techniques unique to chiropractic. Motion and static palpation is an examination by means of touch. The chiropractor will feel for tenderness, tightness, and how well each spinal joint moves.
The chiropractor will also analyze how you walk and look at your overall posture and spinal alignment. Those details will help your chiropractor understand your body mechanics and how well your spine is working and moving.

You’ll also go through your past medical history with the chiropractor. Your chiropractor will have x-rays of your spine taken to evaluate possible degenerative changes, or an MRI if it is indicated.
After the examination, the chiropractor will be better able to create an effective treatment plan for your neck pain.
Possible Chiropractic Treatment Approaches for Treating Whiplash Injuries
The exact treatment plan depends on your diagnosis. Your chiropractor may use a type of spinal manipulation, or spinal adjustment, to improve joint motion and soft tissue health.
Some spinal manipulation techniques are:
• Specific spinal manipulation: The chiropractor identifies the joints that are restricted or show abnormal motion, also called subluxations, and returns motion to the joint with a gentle thrusting technique. This gentle thrusting rapidly stretches soft tissue and stimulates the nervous system to return normal motion to the spine.
• Flexion-distraction technique: This is a gentle, non-thrusting type of manipulation used to treat bulging or herniated discs with or without arm pain. (The whiplash injury may aggravate a bulging or herniated disc.) This treatment is still hands-on, utilizing a specialized table to assist the chiropractor, but uses a slow pumping action on the disc instead of direct force.
• Instrument-assisted manipulation: This is another non-thrusting technique. Using a hand-held instrument, the chiropractor can apply force without thrusting into the spine. This is especially appropriate in older patients with degenerative joint syndrome.
The chiropractor may also use manual therapy to treat injured soft tissues such as ligaments and muscles. Some examples are:
• Trigger point therapy: The chiropractor identifies specific hypertonic (tight), painful points on a muscle. He or she puts direct pressure (using the fingers) on these points to relieve the tension.
• Manual joint stretching and resistance techniques: Muscle energy therapy, an osteopathic technique, is is an example of a resistance manual joint therapy.
• Therapeutic massage
• Instrument-assisted soft tissue therapy: The chiropractor may use Graston technique, an instrument-assisted therapy to treat the injured soft tissue. Your chiropractor will perform gentle repeated strokes of the instrument over the area of muscle injury.
In addition to spinal manipulation and manual techniques, the chiropractor may use various therapy modalities to help reduce inflammation caused by whiplash. Some examples are:
• Interferential electrical stimulation: This uses a low frequency electrical current to stimulate your muscles in order to reduce inflammation.
• Ultrasound: By increasing blood circulation, ultrasound helps reduce muscle spasms, stiffness, and pain. It does this by sending sound waves deep into your muscle tissues, creating a gentle heat that enhances circulation and heating.
T
o reinforce the improved joint mechanics (return of normal spinal motion), your chiropractor will prescribe therapeutic exercises.
Chiropractors are “whole person” doctors who view neck pain as unique to each patient. Therefore, they don’t focus on just your neck pain. Chiropractic care includes nutrition, stress management, and lifestyle goals (because all of those can add to neck pain, so you need to address them if you really want to relieve your pain).
Chiropractors emphasize prevention as the key to long-term health—another example of chiropractors looking at the whole person, not just the painful problem. Keeping the neck and back healthy is vital to the chiropractic approach to care.

How Chiropractic Helps Patients with Whiplash Injuries
A chiropractor will help you return to your normal activities quickly so that you can enjoy your daily life without pain. He or she will work to address the underlying mechanical (how the spine moves) or neurological (nerve-related) causes of your whiplash injury.

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