Friday, March 30, 2012
Stand up: Your life could depend on it
Stand up: Your life could depend on it: Standing up more often may reduce your chances of dying within three years, even if you are already physically active, a study of more than 200,000 people shows.
Danger of grill brushes identified
Danger of grill brushes identified: Physicians have identified a number of cases of accidental ingestion of wire grill brush bristles that required endoscopic or surgical removal.
Meditation improves emotional behaviors in teachers
Meditation improves emotional behaviors in teachers: Schoolteachers who underwent a short but intensive program of meditation were less depressed, anxious or stressed -- and more compassionate and aware of others' feelings. The novel project blended ancient meditation practices with the most current scientific methods for regulating emotions.
With you in the room, bacteria counts spike -- by about 37 million bacteria per hour
With you in the room, bacteria counts spike -- by about 37 million bacteria per hour: A person's mere presence in a room can add 37 million bacteria to the air every hour -- material largely left behind by previous occupants and stirred up from the floor -- according to new research.
Health impact, interplay of diet soft drinks and overall diet unraveled
Health impact, interplay of diet soft drinks and overall diet unraveled: Are diet sodas good or bad for you? The jury is still out, but a new study sheds light on the impact that zero-calorie beverages may have on health, especially in the context of a person's overall dietary habits.
Standard test may miss food ingredients that cause milk allergy
Standard test may miss food ingredients that cause milk allergy: The standard test used to detect milk-protein residues in processed foods may not work as well as previously believed in all applications, sometimes missing ingredients that can cause milk allergy, the most common childhood food allergy, which affects millions of children under age 3, a scientist has reported.
Key component in mother's egg critical for survivial of newly formed embryo
Key component in mother's egg critical for survivial of newly formed embryo: Scientists have discovered that a protein, called TRIM28, normally present in the mother's egg, is essential right after fertilization, to preserve certain chemical modifications or 'epigenetic marks' on a specific set of genes. This newly published study paves the way for more research to explore the role that epigenetics might play in infertility.
Tuesday, March 27, 2012
Seeing movement: Why the world in our head stays still when we move our eyes
Seeing movement: Why the world in our head stays still when we move our eyes: When observing a fly buzzing around the room, we should have the impression that it is not the fly, but rather the space that lies behind it that is moving. After all, the fly is always fixed in our central point of view. But how does the brain convey the impression of a fly in motion in a motionless field? With the help of functional magnetic resonance imaging (fMRI) scientists have identified two areas of the brain that compare the movements of the eye with the visual movements cast onto the retina so as to correctly perceive objects in motion.
Why getting healthy can seem worse than getting sick
Why getting healthy can seem worse than getting sick: A new article helps explain why the immune system often makes us worse while trying to make us well.
Runner's high motivated the evolution of exercise, research suggests
Runner's high motivated the evolution of exercise, research suggests: Runners often extol the virtues of the runner's high, but now a team of researchers suggest that the runner's high could have evolved to motivate us to exercise as part of our early long-distance nomadic lifestyle.
Weight loss won't necessarily help teen girls' self-esteem
Weight loss won't necessarily help teen girls' self-esteem: Obese white teenage girls who lose weight may benefit physically, but the weight change does not guarantee they are going to feel better about themselves, according to a new study.
Friday, March 23, 2012
HOW CAN I DETERMINE THE EXTENT OF MY INJURIES?
To determine the extent of your injuries
and prevent their painful effects have an in-depth evaluation and
consultation with a chiropractor and accident and personal injury
specialist. Preferably, it should be one that's specially trained in
diagnosing and treating spinal problems as a result of an automobile
accident and can explain how much damage your body has sustained, as
well as recommend what treatment he or she feels would be necessary and
for how long.
A normal evaluation includes a complete examination including orthopedic and chiropractic testing, x-rays, computerized range of motion and muscle strength tests. If necessary, nerve conduction tests and diagnostic ultrasound tests are also performed to provide the most comprehensive diagnosis available.
If necessary, other diagnostic tests such as MRI and CAT Scans are performed as needed.
A normal evaluation includes a complete examination including orthopedic and chiropractic testing, x-rays, computerized range of motion and muscle strength tests. If necessary, nerve conduction tests and diagnostic ultrasound tests are also performed to provide the most comprehensive diagnosis available.
If necessary, other diagnostic tests such as MRI and CAT Scans are performed as needed.
HOW MUCH WILL IT COST TO DIAGNOSE AND TREAT MY INJURIES?
Essentially, it will cost you nothing!
Like any other health care service, care is covered completely under
the "medical benefits" section of your automobile insurance policy. All
fees for this evaluation and treatment will be sent directly to your
auto insurance company (or the person-at-fault's) for payment,
alleviating any direct financial burden to you.
CAN A MEDICAL DOCTOR DIAGNOSE MY INJURIES?
Yes, they can. However, diagnosing motor
vehicle accident injuries are best left to a chiropractor.
Chiropractors are trained to detect abnormal biomechanics of the
musculoskeletal system that can lead to arthritis. Most agencies have a
medical doctor on staff to insure that a more serious injury (such as
a fracture) has not occurred, and to ensure that it is safe for you
to engage in a program of physical rehab therapy that will follow. If
necessary, medication may be prescribed.
You should have the most comprehensive treatment available in the healthcare community in one location. In the majority of cases, a chiropractic and medical physician will both document and report your injury.
You should have the most comprehensive treatment available in the healthcare community in one location. In the majority of cases, a chiropractic and medical physician will both document and report your injury.
CAN MEDICATIONS AND PAIN PILLS HELP ME GET BETTER?
Medications may mask the pain for a few
hours, but they do not aid your body's ability to heal itself, and may
hinder the healing process. Medications cannot correct the soft tissue
damage that is caused by auto accidents. If you are only taking pills,
irritated nerves will continue to cause pain, suffering, and the
problems listed earlier. Therefore, the adverse effects of your
injuries will continue to plague you until you seek treatment. In
certain situations we will prescribe medication; however, pain
medications alone will only mask the symptoms and not treat the
problem.
CAN MY HEALTH BE COMPLETELY RESTORED?
Fortunately, health problems caused by
automobile accidents can be relieved or eliminated through a proper
program of restorative chiropractic care and physical rehab therapy.
The goal is to restore your spine to its condition prior to your Motor
Vehicle Accident. Many patients report that treatment has removed
many of their aches and pains that they had before their injury, which
their accident aggravated. Treatments can provide not only pain
relief, but also long term correction. This approach minimizes the
chance of spinal or nerve problems returning months or years later.
Your body, especially your head and neck, have likely suffered stress and trauma as a result of the collision. Here are some of the positive benefits to be gained from our program of restorative chiropractic care and physical rehab therapy.
Your body, especially your head and neck, have likely suffered stress and trauma as a result of the collision. Here are some of the positive benefits to be gained from our program of restorative chiropractic care and physical rehab therapy.
- Prevention of arthritis
- Relief from head and neck pain
- Stronger, more flexible muscles
- Increased nerve supply to all areas of your body
- Increased athletic ability
- Decreased chance of re-injury
- Increased overall health
SHOULD I SEE AN ATTORNEY BEFORE MY EVALUATION?
Patients have important legal as well as
health care needs that need to be addressed. In most cases, it is
important to be evaluated by a clinic first. That way the findings from
your exam will give you the information you need in order to decide on
which attorney is necessary.
If you already have an attorney, the office will send detailed reports to your attorney as you are undergoing treatment to keep your legal counsel apprised of your progress. Upon completion of treatment a final narrative report is then forwarded to the patient's attorney documenting any permanent damage or functional loss.
An attorney who specializes in injury accidents is a wise choice in these circumstances. They know the law and your rights and are better equipped to communicate with aggressive or intimidating insurance representatives to help you get the care and other benefits to which you are entitled. In these cases, the office can refer you to a reputable and qualified attorney.
If you already have an attorney, the office will send detailed reports to your attorney as you are undergoing treatment to keep your legal counsel apprised of your progress. Upon completion of treatment a final narrative report is then forwarded to the patient's attorney documenting any permanent damage or functional loss.
An attorney who specializes in injury accidents is a wise choice in these circumstances. They know the law and your rights and are better equipped to communicate with aggressive or intimidating insurance representatives to help you get the care and other benefits to which you are entitled. In these cases, the office can refer you to a reputable and qualified attorney.
WHAT IF THE INSURANCE COMPANY WANTS ME TO SETTLE?
It's recommended that you do not settle
your case before a thorough evaluation by our office. If you settle
before your injury is fully diagnosed and treated, you will be
responsible for any medical bills you incur in the future.
Our office will work directly with insurance companies to assure that your claim will be effectively documented during your treatment. We also bill the insurance directly to help reduce the burden on your part. It is important that you do not cash any checks that the insurance sends to your home. In many cases, this will release them from any further liability in your care and you will be personally responsible for your medical bills. If the insurance company is rushing you to settle then they are trying to reduce their liabilities and may leave you with all the bills. This could ruin your credit if you have medical bills that are unpaid. In these cases we can help you find a reputable attorney to help protect you from the insurance companies.
Our office will work directly with insurance companies to assure that your claim will be effectively documented during your treatment. We also bill the insurance directly to help reduce the burden on your part. It is important that you do not cash any checks that the insurance sends to your home. In many cases, this will release them from any further liability in your care and you will be personally responsible for your medical bills. If the insurance company is rushing you to settle then they are trying to reduce their liabilities and may leave you with all the bills. This could ruin your credit if you have medical bills that are unpaid. In these cases we can help you find a reputable attorney to help protect you from the insurance companies.
HOW MUCH TIME DO I HAVE TO REPORT AN INJURY FOLLOWING MY ACCIDENT?
The sooner you seek treatment following
your injury, the better. If you wait beyond 30 days following your
accident and then report an injury to the insurance company, they are
much less likely to pay for your care.
WHAT KIND OF TREATMENT WILL I RECEIVE?
At most health centers, chiropractic
care and physical rehab therapy are the foundation of treatment;
however, ultrasound, interferential current stimulation, traction, and
rehabilitation are also used.
If your problem is lower back related, go to a centre that utilizes the DRS System, a proven effective, non-surgical low back pain treatment. The staff also includes a Medical Pain Management Specialist, providing you with the most comprehensive treatment available. We also work with other health care professionals in the medical community and if we can't help you, a referral will be made.
If your problem is lower back related, go to a centre that utilizes the DRS System, a proven effective, non-surgical low back pain treatment. The staff also includes a Medical Pain Management Specialist, providing you with the most comprehensive treatment available. We also work with other health care professionals in the medical community and if we can't help you, a referral will be made.
DOES TREATMENT HURT?
Absolutely not. The treatments are very gentle and quite relaxing. Most patients look forward to their appointments.
HOW DO I MAKE AN APPOINTMENT?
For a personal evaluation and
consultation, call North Dallas Chiropractic or Irving Rehab and
Wellness and ask to schedule an appointment. In most cases, you can be
seen the same day. The sooner you receive treatment following your
accident, the better your body will respond to restorative care. You
will be glad you did!
972-392-4476
IrvingRehabandWellness.com
NDallasChiropractic.com
972-392-4476
IrvingRehabandWellness.com
NDallasChiropractic.com
EXTREMITY PAIN, NUMBNESS and TINGLING
Extremity
symptoms such as arm and hand pain, numbness and tingling are common
following motor vehicle accidents (MVA's). They are caused by thoracic
outlet syndrome, myofascial adhesions, muscular trigger points, and
spinal disc lesions. It's
important to note that these symptoms are commonly not experienced
until weeks or even months after the injury. A study, published in the
Britain Journal of Rheumatology, involved 37 motor vehicle injury
patients and found 35% had an onset of arm and hand symptoms (upper
extremity symptoms) beyond 3 months of the accident.
This reinforces the need for proper and full treatment of MVA injuries. Failure to receive appropriate treatment (where injured tissues are fully healed and tissue functioning is adequately restored) is a major contributor to the development of these symptoms.
This reinforces the need for proper and full treatment of MVA injuries. Failure to receive appropriate treatment (where injured tissues are fully healed and tissue functioning is adequately restored) is a major contributor to the development of these symptoms.
HEADACHES
Headaches
are the second most common complaint following motor vehicle
accidents (MVA's). Like the many other MVA symptoms, headache may not
be present immediately following the accident and may take several
weeks and often months to eventually surface. Most post-traumatic headaches
are thought to originate from the soft tissues and facet joints of
the neck as well as injury or irritation to the nerves of the upper
cervical spine.
The literature has shown there to be multiple types of headaches which can be experienced following a MVA. These include the following:
The literature has shown there to be multiple types of headaches which can be experienced following a MVA. These include the following:
- Cervicogenic Headaches
- Muscle Tension Headaches
- Migraine Headaches
- Myofascial Trigger Point Headaches
- Site-Of-Impact Headaches
- Drug-Induced Headaches (following excessive or prolonged analgesic use)
Disc Problems
Disc problems can occur from traumatic
incidents like Auto accidents, sports injuries and slips and falls.
These seem obvious to most.
However, many disc problems can be related to multiple micro-traumas over a long period of time. Types of work, hobbies, sports, exercise and lifestyle can all be contributing factors.
Combine one of the above with a traumatic incident and it’s easy to see that disc problems are not uncommon.
The best way to know if you have a problem in your disc is to have an MRI done of the area of complaint.
The good news is that an MRI will show exactly where and how big the "herniation” or bulge is."
The bad news is that it is an expensive test.
In our office we use X-Ray and orthopedic/ neurological tests to determine if a disc problem may exist.
Whether you use MRI technology or not the answer is almost always the same--CONSERVATIVE CHIROPRACTIC CARE to start. As long as you are progressing well as most of our patients do, an MRI is usually not needed. For the patients with more complicating factors a referral will be made for an MRI or other more detailed tests.
A combination of conservative safe Chiropractic care and therapies such as neck (cervical) and low back (lumbar) traction, or painless muscle stimulation with hot or cold packs can go a long way in controlling the symptoms of disc problems.
We are also always happy to read your MRI report for you in "plain English."
The Docs at North Dallas Chiropractic
However, many disc problems can be related to multiple micro-traumas over a long period of time. Types of work, hobbies, sports, exercise and lifestyle can all be contributing factors.
Combine one of the above with a traumatic incident and it’s easy to see that disc problems are not uncommon.
The best way to know if you have a problem in your disc is to have an MRI done of the area of complaint.
The good news is that an MRI will show exactly where and how big the "herniation” or bulge is."
The bad news is that it is an expensive test.
In our office we use X-Ray and orthopedic/ neurological tests to determine if a disc problem may exist.
Whether you use MRI technology or not the answer is almost always the same--CONSERVATIVE CHIROPRACTIC CARE to start. As long as you are progressing well as most of our patients do, an MRI is usually not needed. For the patients with more complicating factors a referral will be made for an MRI or other more detailed tests.
A combination of conservative safe Chiropractic care and therapies such as neck (cervical) and low back (lumbar) traction, or painless muscle stimulation with hot or cold packs can go a long way in controlling the symptoms of disc problems.
We are also always happy to read your MRI report for you in "plain English."
The Docs at North Dallas Chiropractic
What is Personal Injury Protection (PIP)
The
Texas Department of Insurance requires automobile insurance carriers
in our state to issue all automobile policies it writes at least
$2500 worth of coverage and you have this coverage unless you reject
it in writing. Most people are unaware of this coverage or even know
what it is and therefore very few people use it. You end up paying
for coverage that they don’t inform you about and you’re entitled to.
Why?
Insurance is not understood and most people rely on their agent and
claims adjusters to advise them on what to do after an accident.
Insurance is a multi-billion dollar industry and are in business to make
money. They keep their costs down, less payout, more profits and
bonuses at the end of the year. Good for them and not for you.
What is PIP?
PIP
is no fault coverage similar to health insurance but on your auto
policy for your injuries and your passengers injuries. This coverage is
available regardless who is at fault. Yes, you can be the cause of
the accident and you will still be covered. There’s no deductible and
no co-payment. There is other separate coverage that will cover the
other party if you were at fault. If you do not have PIP then you
could still be covered if you were in an accident in another state
besides Texas. You may also be covered if you were hit in a crosswalk
by a car or on a bicycle or borrowing someone else’s car.
What will a claim do to my insurance rates and policy renewal?
Under
section 5.7016 of the Texas insurance code, automobile insurance
carriers cannot non-renew you for filing one PIP claim in a 12 month
period. Also, it is unlikely that they would raise your rates for a sole
PIP claim.
Why doesn’t the other guy’s insurance pay for my medical expenses and why should I use my insurance?
Medical
treatment is expensive and you are liable for the costs. There is a
chance that the other party may never pay for your medical expenses
leaving you a financial burden. PIP gives you peace of mind that your
medical bills are covered. If you use your health insurance, you may
have to pay a deductible and co-pays to your doctor and if the health
insurance finds out that you were in an accident they could request
to be reimbursed. Some people get referred to a medical provider by
their attorney and the medical provider agrees to be paid months or
even years later. Since there are a limited number of medical
providers who agree to this arrangement, your choice and quality of
healthcare may be limited. The answer is to use your PIP coverage so
you will not have to pay for medical expenses out of your pocket and
get the best possible healthcare treatment available for you and your
family’s injuries caused by the accident.
There's still hope even if the Auto/Car Accident was your fault!
Personal Injury Protection (PIP)
The Texas Department of Insurance requires automobile insurance carriers in our state to issue all automobile policies it writes at least $2500 worth of coverage and you have this coverage unless you reject it in writing. Most people are unaware of this coverage or even know what it is and therefore very few people use it. You end up paying for coverage that they don’t inform you about and you’re entitled to.
Why? Insurance is not understood and most people rely on their agent and claims adjusters to advise them on what to do after an accident. Insurance is a multi-billion dollar industry and are in business to make money. They keep their costs down, less payout, more profits and bonuses at the end of the year. Good for them and not for you.
What is PIP?
PIP is no fault coverage similar to health insurance but on your auto policy for your injuries and your passengers injuries. This coverage is available regardless who is at fault. Yes, you can be the cause of the accident and you will still be covered. There’s no deductible and no co-payment. There is other separate coverage that will cover the other party if you were at fault. If you do not have PIP then you could still be covered if you were in an accident in another state besides Texas. You may also be covered if you were hit in a crosswalk by a car or on a bicycle or borrowing someone else’s car.
What will a claim do to my insurance rates and policy renewal?
Under section 5.7016 of the Texas insurance code, automobile insurance carriers cannot non-renew you for filing one PIP claim in a 12 month period. Also, it is unlikely that they would raise your rates for a sole PIP claim.
Why doesn’t the other guy’s insurance pay for my medical expenses and why should I use my insurance?
Medical treatment is expensive and you are liable for the costs. There is a chance that the other party may never pay for your medical expenses leaving you a financial burden. PIP gives you peace of mind that your medical bills are covered. If you use your health insurance, you may have to pay a deductible and co-pays to your doctor and if the health insurance finds out that you were in an accident they could request to be reimbursed. Some people get referred to a medical provider by their attorney and the medical provider agrees to be paid months or even years later. Since there are a limited number of medical providers who agree to this arrangement, your choice and quality of healthcare may be limited. The answer is to use your PIP coverage so you will not have to pay for medical expenses out of your pocket and get the best possible healthcare treatment available for you and your family’s injuries caused by the accident.
The Texas Department of Insurance requires automobile insurance carriers in our state to issue all automobile policies it writes at least $2500 worth of coverage and you have this coverage unless you reject it in writing. Most people are unaware of this coverage or even know what it is and therefore very few people use it. You end up paying for coverage that they don’t inform you about and you’re entitled to.
Why? Insurance is not understood and most people rely on their agent and claims adjusters to advise them on what to do after an accident. Insurance is a multi-billion dollar industry and are in business to make money. They keep their costs down, less payout, more profits and bonuses at the end of the year. Good for them and not for you.
What is PIP?
PIP is no fault coverage similar to health insurance but on your auto policy for your injuries and your passengers injuries. This coverage is available regardless who is at fault. Yes, you can be the cause of the accident and you will still be covered. There’s no deductible and no co-payment. There is other separate coverage that will cover the other party if you were at fault. If you do not have PIP then you could still be covered if you were in an accident in another state besides Texas. You may also be covered if you were hit in a crosswalk by a car or on a bicycle or borrowing someone else’s car.
What will a claim do to my insurance rates and policy renewal?
Under section 5.7016 of the Texas insurance code, automobile insurance carriers cannot non-renew you for filing one PIP claim in a 12 month period. Also, it is unlikely that they would raise your rates for a sole PIP claim.
Why doesn’t the other guy’s insurance pay for my medical expenses and why should I use my insurance?
Medical treatment is expensive and you are liable for the costs. There is a chance that the other party may never pay for your medical expenses leaving you a financial burden. PIP gives you peace of mind that your medical bills are covered. If you use your health insurance, you may have to pay a deductible and co-pays to your doctor and if the health insurance finds out that you were in an accident they could request to be reimbursed. Some people get referred to a medical provider by their attorney and the medical provider agrees to be paid months or even years later. Since there are a limited number of medical providers who agree to this arrangement, your choice and quality of healthcare may be limited. The answer is to use your PIP coverage so you will not have to pay for medical expenses out of your pocket and get the best possible healthcare treatment available for you and your family’s injuries caused by the accident.
Auto/Car Accidents and whiplash and the Necessity of Chiropractic Care
One of the most stressful events in life
is dealing with the issues that occur after an auto accident. The
first thing a person thinks about after the crash is the car. Most
people are not aware that some injuries are not detected for months or
even years. Two things result in these situations: an insurance
company settles with the victim without compensating for the pain and
treatment needed from these undiagnosed injuries, and the injury gets
worse over time due to the lack or delay of treatment. It is
absolutely imperative that anybody that is in an auto accident
immediately go see a Doctor trained in soft tissue injuries. While
whiplash is a common injury from auto accidents, another common
complaint of crash victims is that they don’t “feel like their normal
selves.” They may also experience other symptoms like dizziness, blurry
vision, headaches, back pain, muscle stiffness or spasms, neck pain,
numbness and tingling, fatigue, difficulty sleeping, irritability,
memory loss and difficulty concentrating.
Auto accidents can also cause post-traumatic osteoarthritis. This can damage your posture (producing a slumped or hump back appearance). Osteoarthritis can also cause the discs in the spine to degenerate and create scar tissue formation leading to chronic stiffness.
According to the Insurance Research Council, nearly 1/3 of all claimants injured in motor vehicle accidents seek treatment from doctors of chiropractic. That number is astounding when combined with the fact that the National Safety Council (NSC) has determined there to be more than 12 million accidents annually involving more than 20 million vehicles.
The reason people choose chiropractic care for treatment of injuries sustained in auto accidents is simple – chiropractic care is exceptional in the treatment of soft tissue injuries, especially of the spine. Since the most common injuries associated with these events are sprains and strains of the spinal muscles and ligaments, it’s only natural that chiropractic be the treatment of choice. Chiropractors are the primary care doctors trained specifically in dealing with injuries to the spine.
Much research has also found people injured in auto accidents prefer chiropractic care for the treatment of their injuries. One such study* evaluated 190 whiplash injury victims and found those who received chiropractic care reported treatment satisfaction of 100%.
One major concern individuals that have lived through the experience of an auto accident should be aware of is most medical doctors are not trained to detect the type of soft tissue or joint injury that does not show itself immediately. It is imperative that people involved in auto accidents consult with a doctor who is trained in the biomechanics of the human body; someone who treats these injuries every day.
Often, passengers can be hurt more than a driver, especially if it is a side wreck or T-bone. Children can suffer the same injuries as adults and should be given the same care despite a feeling by the parent that a child can’t be “that injured” if no bones are broken or there is no bruising to the skin. Put it this way: if damage was done to a vehicle that actually bent metal, the people inside the vehicle surely absorbed that force as well.
Due to our bodies producing adrenaline at the time of an accident, this hormone acts like a natural pain killer and allows us to muster the courage to move through the impact and “take care of business”. As mentioned above, it is often days or weeks later that the full impact of the crash is felt. A trained doctor of chiropractic can be a brilliant source of diagnosis and treatment of soft tissue and joint injuries.
In addition, x-rays or MRI (if indicated) will be used to check for any structural damage. In our office, we routinely evaluate auto accident victims and make any appropriate referrals to other health care providers if necessary. Our primary responsibility is providing the proper care and submitting the required medical reports to the insurance company or attorney (if one is involved) so the rights of the patient are protected.
If we can’t help the patient, we will refer them 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 it is critical to make the first decision be to be evaluated by a doctor of chiropractic and get under care immediately.
Auto accidents can also cause post-traumatic osteoarthritis. This can damage your posture (producing a slumped or hump back appearance). Osteoarthritis can also cause the discs in the spine to degenerate and create scar tissue formation leading to chronic stiffness.
According to the Insurance Research Council, nearly 1/3 of all claimants injured in motor vehicle accidents seek treatment from doctors of chiropractic. That number is astounding when combined with the fact that the National Safety Council (NSC) has determined there to be more than 12 million accidents annually involving more than 20 million vehicles.
The reason people choose chiropractic care for treatment of injuries sustained in auto accidents is simple – chiropractic care is exceptional in the treatment of soft tissue injuries, especially of the spine. Since the most common injuries associated with these events are sprains and strains of the spinal muscles and ligaments, it’s only natural that chiropractic be the treatment of choice. Chiropractors are the primary care doctors trained specifically in dealing with injuries to the spine.
Much research has also found people injured in auto accidents prefer chiropractic care for the treatment of their injuries. One such study* evaluated 190 whiplash injury victims and found those who received chiropractic care reported treatment satisfaction of 100%.
One major concern individuals that have lived through the experience of an auto accident should be aware of is most medical doctors are not trained to detect the type of soft tissue or joint injury that does not show itself immediately. It is imperative that people involved in auto accidents consult with a doctor who is trained in the biomechanics of the human body; someone who treats these injuries every day.
Often, passengers can be hurt more than a driver, especially if it is a side wreck or T-bone. Children can suffer the same injuries as adults and should be given the same care despite a feeling by the parent that a child can’t be “that injured” if no bones are broken or there is no bruising to the skin. Put it this way: if damage was done to a vehicle that actually bent metal, the people inside the vehicle surely absorbed that force as well.
Due to our bodies producing adrenaline at the time of an accident, this hormone acts like a natural pain killer and allows us to muster the courage to move through the impact and “take care of business”. As mentioned above, it is often days or weeks later that the full impact of the crash is felt. A trained doctor of chiropractic can be a brilliant source of diagnosis and treatment of soft tissue and joint injuries.
In addition, x-rays or MRI (if indicated) will be used to check for any structural damage. In our office, we routinely evaluate auto accident victims and make any appropriate referrals to other health care providers if necessary. Our primary responsibility is providing the proper care and submitting the required medical reports to the insurance company or attorney (if one is involved) so the rights of the patient are protected.
If we can’t help the patient, we will refer them 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 it is critical to make the first decision be to be evaluated by a doctor of chiropractic and get under care immediately.
When your body is involved in trauma, your neck is one of your most vulnerable areas.
When your body is involved in trauma,
your neck is one of your most vulnerable areas. Whiplash, the hard and
fast forward-backward movement of the neck, can cause pain that can
last well after other injuries have healed. To understand why your neck
is so sore, it helps to know the anatomy involved.
Whiplash can be a complicated diagnosis as the doctor tries to figure out exactly which parts of the spine have been affected. And there are a lot of complex parts to your cervical spine—the technical name for your neck. The cervical spine begins at the base of the skull. It contains seven small vertebrae (bones), which doctors label C1 to C7 (the 'C' means cervical). The numbers 1 to 7 indicate the level of the vertebrae. C1 is closest to the skull, while C7 is closest to the chest.
In between each vertebra are tough fibrous shock-absorbing pads called the intervertebral discs. (These discs are what slide back and forth during the trauma.) Each disc is made up of a tire-like outer band and a gel-like inner substance. The outer band is called the annulus fibrosus; the inner part is called the nucleus pulposus.
In addition to bones and discs, your cervical spine also includes the upper region of the spinal cord, eight nerve roots, an elaborate system of arteries and veins, 32 muscles for strength, and numerous ligaments. For such a small area, there is a lot to your neck. That means that there are a lot of parts that can be injured when you have whiplash.
Remarkably, the cervical spine supports the full weight of your head, which is usually about 8 pounds—yet no other region of the spine has such freedom of movement. The cervical spine can move your head in nearly every direction: 90° of forward motion, 90° of backward motion, 180° of side to side motion, and almost 120° of tilt to either shoulder.
Unfortunately, this flexibility makes the neck very susceptible to pain and injury, such as whiplash. In whiplash, those 15 pounds are dramatically tossed frontwards then backwards—that's one important reason to wear seatbelts properly and use airbags whenever possible.
spineuniverse.com
Whiplash can be a complicated diagnosis as the doctor tries to figure out exactly which parts of the spine have been affected. And there are a lot of complex parts to your cervical spine—the technical name for your neck. The cervical spine begins at the base of the skull. It contains seven small vertebrae (bones), which doctors label C1 to C7 (the 'C' means cervical). The numbers 1 to 7 indicate the level of the vertebrae. C1 is closest to the skull, while C7 is closest to the chest.
In between each vertebra are tough fibrous shock-absorbing pads called the intervertebral discs. (These discs are what slide back and forth during the trauma.) Each disc is made up of a tire-like outer band and a gel-like inner substance. The outer band is called the annulus fibrosus; the inner part is called the nucleus pulposus.
In addition to bones and discs, your cervical spine also includes the upper region of the spinal cord, eight nerve roots, an elaborate system of arteries and veins, 32 muscles for strength, and numerous ligaments. For such a small area, there is a lot to your neck. That means that there are a lot of parts that can be injured when you have whiplash.
Remarkably, the cervical spine supports the full weight of your head, which is usually about 8 pounds—yet no other region of the spine has such freedom of movement. The cervical spine can move your head in nearly every direction: 90° of forward motion, 90° of backward motion, 180° of side to side motion, and almost 120° of tilt to either shoulder.
Unfortunately, this flexibility makes the neck very susceptible to pain and injury, such as whiplash. In whiplash, those 15 pounds are dramatically tossed frontwards then backwards—that's one important reason to wear seatbelts properly and use airbags whenever possible.
spineuniverse.com
Monday, March 12, 2012
About Auto Injuries
According
to the Insurance Research Council, nearly 1/3 of all claimants injured
in motor vehicle accidents (MVA's) seek treatment from doctors of
chiropractic. This is an impressive number given that the National
Safety Council (NSC) has determined there to be more than 12 million
MVA's annually involving more than 20 million vehicles.
The reason individuals like yourself choose chiropractic care for treatment of injuries sustained in MVA's is simple - chiropractic care is superior in the treatment of soft tissue injuries, especially of the spine. Since the most common injuries associated with MVA's are sprains and strains of the spinal muscles and ligaments, it's only natural that chiropractic be the treatment of choice.
Many studies have also found individuals injured in MVA's prefer chiropractic care for the treatment of their injuries. One such study evaluated 190 whiplash injury victims and found those who received chiropractic care reported treatment satisfaction of 100%.
(Balla JI, Iansek R. Headaches arising from disorders of the cervical spine. In: Hopkins A, ed. Headache: Problems in Diagnosis and Management. London: WB Saunders; 1988.)
The reason individuals like yourself choose chiropractic care for treatment of injuries sustained in MVA's is simple - chiropractic care is superior in the treatment of soft tissue injuries, especially of the spine. Since the most common injuries associated with MVA's are sprains and strains of the spinal muscles and ligaments, it's only natural that chiropractic be the treatment of choice.
Many studies have also found individuals injured in MVA's prefer chiropractic care for the treatment of their injuries. One such study evaluated 190 whiplash injury victims and found those who received chiropractic care reported treatment satisfaction of 100%.
(Balla JI, Iansek R. Headaches arising from disorders of the cervical spine. In: Hopkins A, ed. Headache: Problems in Diagnosis and Management. London: WB Saunders; 1988.)
Time for Symptoms to Present
Symptoms arising from injuries sustained in motor vehicle accidents were once thought to present immediately following the accident. However, research and clinic experience now demonstrate that a delay of symptom onset seems to be the norm. Also, delay of symptom onset does not eliminate the possibility of severe injury.
Number of Disabilities from Automobile Accidents
Most experts have found that 10 percent of all motor vehicle accident victims become disabled.
Symptom Resolution Statistics
Many studies have found a significant number of individuals to be symptomatic for many months and even years after a motor vehicle accident. In one such study, 75 percent of individuals remained symptomatic 6 months after the accident.
Another study, published in the European Spine Journal, found that during the period of time between the first and second years following a motor vehicle accident over 20 percent actually had their symptoms worsen.
Number of Annual Motor Vehicle Accidents
According to the National Safety Council (NSA), there are more than 12 million motor vehicle accidents annually including more than 20 million vehicles. This results in over 5 million nonfatal accidents annually of which approximately 2 million are disabling injuries including approximately 1 million work-related auto disabling injuries.
Injury Severity in Motor Vehicle Accidents
A 1990 National Highway Traffic Safety Administration (NHTSA) study reported found that about 28 percent of occupants in motor vehicle accidents incur minor to moderate injury while 6 percent incur severe to fatal injuries.
Likelihood of being Involved in a Motor Vehicle Accident
The US Department of Transportation estimates that the typical driver will have a near automobile accident one to two times per month and all will be in a collision of some type on average of every 6 years.
Annual Costs of Motor Vehicle Accidents
According to a report released back in 1993, the total costs for motor vehicle accidents in the US was over $333 billion in 1988.
Who Pays for Injuries Sustained in Motor Vehicle Accidents?
According to the Insurance Research Council,
- 63 percent of injuries are paid by the injured individuals own automobile insurance company
- 55 percent of injuries are paid by the auto insurance company of another vehicle
- 36 percent of injuries are paid by health insurance
- 20 percent of injuries are paid by government programs
- 19 percent of injuries are paid workers' compensation insurance
WHAT TO DO POST-ACCIDENT
Schedule An Appointment If
you have been involved in a motor vehicle accident you will need to
make an appointment for a brief, but thorough, examination. Often,
individuals involved in motor vehicle accidents experience minimal or no
symptoms for the first few weeks and even months. It's important to
not only receive immediate and appropriate treatment for any injuries
sustained, but also to document the extent of the injuries, if present.
Failure
to obtain a timely evaluation or appropriate treatment for injuries
sustained in a motor vehicle accident may negate your ability to receive
monetary compensation for any future medical bills resulting from the
accident, negate your ability to receive pain and suffering
settlements, and negate compensation for work loss.
We Will Determine...
When you come in, we will determine:
Don't Delay, Call Today!
If
you or someone you know has been involved in an accident, call (or
have them call) our office immediately. The quicker you receive the
care you need, the quicker your injuries will heal and the faster you
can get on with your life. Don't delay, call today!
(972)215-7720 |
Correlating Crash Severity with Injury Risk, Injury Severity, and Long-term Symptoms in Low Velocity Motor Vehicle Collisions
Medical Science Monitor
October 2005; 11(10): RA316-321
Arthur C. Croft and Michael D. Freeman
These authors note: In the mid-1990s, a set of guidelines was published by a leading U.S. auto insurer instructing claims adjusters that injury claims resulting from motor vehicle crashes with less that $1,000 US in claimant's vehicle property are "unlikely to — or cannot cause significant or permanent injury" and should "be handled as a fraudulent claim," regardless of medical evidence of injury. The "claim goal was to close without payment."
The MIST (minor impact soft tissue) protocol uses vehicle property damage as a construct for injury, and all injury claims less than $1,000 US of vehicle property damage are considered to be false.
These authors "conducted a comprehensive best evidence synthesis of the existing medical and engineering literature to investigate the relationship between vehicular structural damage and occupant injury in motor vehicle crashes."
|
The key points noted in this article include:
October 2005; 11(10): RA316-321
Arthur C. Croft and Michael D. Freeman
These authors note: In the mid-1990s, a set of guidelines was published by a leading U.S. auto insurer instructing claims adjusters that injury claims resulting from motor vehicle crashes with less that $1,000 US in claimant's vehicle property are "unlikely to — or cannot cause significant or permanent injury" and should "be handled as a fraudulent claim," regardless of medical evidence of injury. The "claim goal was to close without payment."
The MIST (minor impact soft tissue) protocol uses vehicle property damage as a construct for injury, and all injury claims less than $1,000 US of vehicle property damage are considered to be false.
These authors "conducted a comprehensive best evidence synthesis of the existing medical and engineering literature to investigate the relationship between vehicular structural damage and occupant injury in motor vehicle crashes."
|
The key points noted in this article include:
A substantial number of injuries are reported in crashes of little or no property damage.
Property damage is an unreliable predictor of injury risk or outcome in low velocity crashes!
95% of rear impact injury crashes occur below 25 mph.
Rear-end collision injury severity and duration can be reduced with a head restraint closer to the occupant's head.
Well-done studies documented cases of injury with "almost no vehicle damage."
There is "no statistically significant associations between crash severity and the 6-month injury status."!
"Persons who were unaware of the impending crash were significantly more likely to have persistent symptoms."
"No
statistically significant relationships existed between measures
of crash severity in terms of calculated velocity change or maximum
deformation and long-term symptoms."
There are no significant correlations between crash severity and long-term symptoms.
There is a substantial injury risk in frontal and rear impact low speed crashes without sustaining appreciable vehicle damage.
"It
seems clear that property damage in low velocity motor vehicle crashes
does not provide a reliable means of assessing the validity of injury
claims and, provides no reliable means of prognosticating long term
outcome."
"A
substantial number of injuries are reported in crashes of
severities that are unlikely to result in significant property damage."
"Property damage is neither a valid predictor of acute injury risk nor of symptom duration."
"Based
upon our best evidence synthesis, the level of vehicle property damage
appears to be an invalid construct for injury presence, severity, or
duration."
"The MIST protocol for prediction of injury does not appear to be valid."
Auto/Car Accidents and whiplash and the Necessity of Chiropractic Care
One of the most stressful events in life is dealing with the issues
that occur after an auto accident. The first thing a person thinks
about after the crash is the car. Most people are not aware that some
injuries are not detected for months or even years. Two things result
in these situations: an insurance company settles with the victim
without compensating for the pain and treatment needed from these
undiagnosed injuries, and the injury gets worse over time due to the
lack or delay of treatment. It is absolutely imperative that anybody
that is in an auto accident immediately go see a Doctor trained in soft
tissue injuries. While whiplash is a common injury from auto accidents,
another common complaint of crash victims is that they don’t “feel
like their normal selves.” They may also experience other symptoms like
dizziness, blurry vision, headaches, back pain, muscle stiffness or
spasms, neck pain, numbness and tingling, fatigue, difficulty sleeping,
irritability, memory loss and difficulty concentrating.
Auto accidents can also cause post-traumatic osteoarthritis. This can damage your posture (producing a slumped or hump back appearance). Osteoarthritis can also cause the discs in the spine to degenerate and create scar tissue formation leading to chronic stiffness.
According to the Insurance Research Council, nearly 1/3 of all claimants injured in motor vehicle accidents seek treatment from doctors of chiropractic. That number is astounding when combined with the fact that the National Safety Council (NSC) has determined there to be more than 12 million accidents annually involving more than 20 million vehicles.
The reason people choose chiropractic care for treatment of injuries sustained in auto accidents is simple – chiropractic care is exceptional in the treatment of soft tissue injuries, especially of the spine. Since the most common injuries associated with these events are sprains and strains of the spinal muscles and ligaments, it’s only natural that chiropractic be the treatment of choice. Chiropractors are the primary care doctors trained specifically in dealing with injuries to the spine.
Much research has also found people injured in auto accidents prefer chiropractic care for the treatment of their injuries. One such study* evaluated 190 whiplash injury victims and found those who received chiropractic care reported treatment satisfaction of 100%.
One major concern individuals that have lived through the experience of an auto accident should be aware of is most medical doctors are not trained to detect the type of soft tissue or joint injury that does not show itself immediately. It is imperative that people involved in auto accidents consult with a doctor who is trained in the biomechanics of the human body; someone who treats these injuries every day.
Often, passengers can be hurt more than a driver, especially if it is a side wreck or T-bone. Children can suffer the same injuries as adults and should be given the same care despite a feeling by the parent that a child can’t be “that injured” if no bones are broken or there is no bruising to the skin. Put it this way: if damage was done to a vehicle that actually bent metal, the people inside the vehicle surely absorbed that force as well.
Due to our bodies producing adrenaline at the time of an accident, this hormone acts like a natural pain killer and allows us to muster the courage to move through the impact and “take care of business”. As mentioned above, it is often days or weeks later that the full impact of the crash is felt. A trained doctor of chiropractic can be a brilliant source of diagnosis and treatment of soft tissue and joint injuries.
In addition, x-rays or MRI (if indicated) will be used to check for any structural damage. In our office, we routinely evaluate auto accident victims and make any appropriate referrals to other health care providers if necessary. Our primary responsibility is providing the proper care and submitting the required medical reports to the insurance company or attorney (if one is involved) so the rights of the patient are protected.
If we can’t help the patient, we will refer them 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 it is critical to make the first decision be to be evaluated by a doctor of chiropractic and get under care immediately.
Auto accidents can also cause post-traumatic osteoarthritis. This can damage your posture (producing a slumped or hump back appearance). Osteoarthritis can also cause the discs in the spine to degenerate and create scar tissue formation leading to chronic stiffness.
According to the Insurance Research Council, nearly 1/3 of all claimants injured in motor vehicle accidents seek treatment from doctors of chiropractic. That number is astounding when combined with the fact that the National Safety Council (NSC) has determined there to be more than 12 million accidents annually involving more than 20 million vehicles.
The reason people choose chiropractic care for treatment of injuries sustained in auto accidents is simple – chiropractic care is exceptional in the treatment of soft tissue injuries, especially of the spine. Since the most common injuries associated with these events are sprains and strains of the spinal muscles and ligaments, it’s only natural that chiropractic be the treatment of choice. Chiropractors are the primary care doctors trained specifically in dealing with injuries to the spine.
Much research has also found people injured in auto accidents prefer chiropractic care for the treatment of their injuries. One such study* evaluated 190 whiplash injury victims and found those who received chiropractic care reported treatment satisfaction of 100%.
One major concern individuals that have lived through the experience of an auto accident should be aware of is most medical doctors are not trained to detect the type of soft tissue or joint injury that does not show itself immediately. It is imperative that people involved in auto accidents consult with a doctor who is trained in the biomechanics of the human body; someone who treats these injuries every day.
Often, passengers can be hurt more than a driver, especially if it is a side wreck or T-bone. Children can suffer the same injuries as adults and should be given the same care despite a feeling by the parent that a child can’t be “that injured” if no bones are broken or there is no bruising to the skin. Put it this way: if damage was done to a vehicle that actually bent metal, the people inside the vehicle surely absorbed that force as well.
Due to our bodies producing adrenaline at the time of an accident, this hormone acts like a natural pain killer and allows us to muster the courage to move through the impact and “take care of business”. As mentioned above, it is often days or weeks later that the full impact of the crash is felt. A trained doctor of chiropractic can be a brilliant source of diagnosis and treatment of soft tissue and joint injuries.
In addition, x-rays or MRI (if indicated) will be used to check for any structural damage. In our office, we routinely evaluate auto accident victims and make any appropriate referrals to other health care providers if necessary. Our primary responsibility is providing the proper care and submitting the required medical reports to the insurance company or attorney (if one is involved) so the rights of the patient are protected.
If we can’t help the patient, we will refer them 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 it is critical to make the first decision be to be evaluated by a doctor of chiropractic and get under care immediately.
Why an MVA can't always be Measured as to the extent of injury, But the Insurance company will try for their own Gain
Dynamic Chiropractic – January 15, 2010, Vol. 28, Issue 02
Study Confirms Flaws in Standard MVC Defense Strategy
By Arthur Croft, DC, MS, MPH, FACO
The seemingly complex, or perhaps even inscrutable, calculus of what practitioners term personal injury is, in truth, deceptively simple. However, while it keeps getting simpler, many practitioners and lawyers feel hopelessly wrapped around the axle of this puzzling system. The net result is abandonment of needful patients and clients, with a corresponding loss of revenue stream. Consider just a few facts. Motor vehicle collisions are a leading cause of injury in the U.S. and constitute one of our most burdensome public health dilemmas. With 3 million such injuries each year, a total recovery proportion of only about 50 percent, a permanent disability proportion of 10-12 percent, coupled with the fact that many of the injured are young and have many quality life years to lose, the $43 billion annual price tag is hardly surprising.1
Auto insurers make every reasonable effort to insulate themselves from their liability. Some would argue that they engage in efforts most of us would consider unreasonable, if not downright unsavory or unethical. Regardless of your personal judgment, most would agree that over the past two decades, the insurers’ concerted and very expensive campaign to limit claims has been fairly successful.
With Allstate taking the vanguard position with their now-famous three Ds – delay, deny, and defend – most major auto insurers have since instituted similar policies, and the plaintiff persona-injury bar has more often withered than weathered. With a loss of potential legal representation, plaintiffs have had fewer alternatives for compensation. This often has meant that needed health care resources are simply not available to them, which contributes further to the doleful outcome statistics mentioned above. Since inaugurating its get-tough policy in the mid-1990s, which was described by its consulting firm as a transition “from good hands to boxing gloves,” Allstate has reportedly posted surprising high profits.2 Other insurers have not failed to notice.
The Standard Defense and the Importance of Delta V
How could any of this possibly be simple? One need look no further than the essential game plan of most defense lawyers: deception, dissimilation and obfuscation. It requires a team of experts from the fields of medicine (including chiropractic), accident reconstruction and biomechanics who have collectively developed what I consider to be the standard defense strategy. It continues to be the most successful and widely used strategy today, having become the world standard.
This has fostered a small research industry dedicated to the production of pro-defense literature to aid in the cause. Most is junk science. Make no mistake, insurers have the best researchers money can buy and they know how to get published. As a result, even many clinicians remain split on critical issues depending on which brand of literature they rely upon. I note, with all due respect to the Insurance Institute for Highways Safety (IIHS) and members of the International Insurance Whiplash Protection Group (IIWPG), that their research activities are quite laudatory and most welcome. However, there is just a bit of schizophrenia in this industry when it comes to research. While the valid research of the IIHS and the IIWPG is squarely aimed at reducing the industry payout problem by reducing the number of actual injuries, the “other” research seems to be aimed at providing verisimilitude for company experts to wield in courtrooms to sway jurors toward defense theories.
The standard defense has three parts and is based on the ultimate playing field: a court of law, and, in particular, the biases and naivete (i.e., the normal lack of specific factual information in the field of crash traumatology) of jurors. Polls suggest that Americans are also divided on the question of whiplash injuries. As many as 60-70 percent consider it either definitively or very likely a non-injury, but merely an opportunity to bilk insurers at the expense of the rest of us policy-holders who subsidize the system through the increasing premiums we must pay. Thus, jurors are easily misled by the standard defense strategy because it merely reinforces that which they already believe.
The first and most fundamental part of this strategy is to demonstrate that the forces of the collision would not have been of a sufficient magnitude to cause injury. The common currency for this discussion is the plaintiff vehicle’s delta V or change in velocity. For this, an accident reconstructionist is usually employed. Because reconstructionists are rarely allowed to provide opinions as to injury risk, they are often followed by a biomechanist, who is granted more latitude to venture into the discussion of injury risk. In some cases, they are allowed to consider medical records, MRIs, etc., in forming their opinions. Finally, the defense physician (DC, DO or MD) adds the icing to the cake, testifying that either there was no injury or that there was a minor straining-type injury that has long since resolved.
When pre-existing conditions are present, the plaintiff’s complaints are often attributed to them rather than the injury. Company doctors will typically also be of the opinion that a large portion of the medical expenses claimed by the plaintiff are unnecessary, unreasonable,and represent unwarranted treatment and diagnostics. Note that low back injuries are virtually never admitted to be causally related to low-velocity collisions. I have written a paper on this subject which is available upon e-mail request at drcroft@san.rr.com .3
As I have so many times implored readers – and this fact is never contested even by my small army of industry-affiliated detractors – the entire defense mechanism just described is nothing more than a series of interlocking nonsequiturs. The accident reconstructions and biomechanists provide a very polished and seemingly airtight argument based on what appear to be sound mathematical principles and classical Newtonian physics. This is all very interesting, and would be even more so if it had the additional virtue of being true.
Delta V Not a Valid Gauge of Injury Risk?
But figures don’t always add up, which brings me back to the headline of this article. A new study that provides further compelling evidence that delta V, the keystone in the standard defense strategy, is not a valid gauge of injury risk.4 The authors recruited a total of 57 people within 48 hours of their MVCs. The subjects were recruited either from an engineer’s office for vehicle damage assessment or an ER. The whiplash grades ranged from 0-4 (0 indicating no claimed injury and 4 indicating fracture). The collision types included 13 frontal, 21 rear, 19 side, three multiple crashes and one rollover. There were 25 males and 32 females with a median age of 33.
In all cases a trained engineer determined the delta V by examining both crash vehicles. The VAS and Neck Disability Indexes (NDI) scores were tabulated. The authors found no significant correlation between NDI and delta V, no correlation between whiplash grade and delta V, and only a moderate correlation between VAS reported pain and delta V. However, the R2 value (coefficient of determination) for that correlation was only 0.30, which means that 70 percent of the proportion of the variability of pain severity was not explained by differences in delta V.
There was no lower threshold below which a large proportion would predictably not be injured, nor was there an upper threshold above which most would predictably be injured. This was because some people were injured in very low velocity crashes while others were not injured despite fairly high velocity crashes. The authors commented, “It can be concluded that delta V is an irrelevant predictive value for cervical spine injury after MVA [motor vehicle accident].”
Some specific findings include the following: Cervical spine fractures in frontal crashes occurred in delta Vs of 9.3, 19.9 and 31.1 mph. Fractures in side impacts occurred in delta Vs of 6.2 (z-joint fracture of C4), 9.9 (C7 with dislocation of C6-7), 19.9 (z-joint fracture of C2), 31.1 (C5 fracture with C5-6 dislocation and paraplegia), 32.3 (rupture of alar ligaments), 36.0 (atlantoaxial dislocation) and 36.6 mph (rupture of alar ligaments). There was a dens fracture in the one rollover with the delta V reported as 9.3 mph. This article is available for free download at www.ncbi.nlm.nih.gov/pmc/articles/PMC2657117.
A related component of the standard defense strategy is the property damage issue. Specifically, the argument goes, when the property damage is minor, an injury is very unlikely. We addressed this issue earlier in a meta-analysis of medical and engineering literature dating back as far as 1970 that failed to provide a clear link between property damage and any of three outcomes: risk for acute injury, degree of injury severity and risk for long-term symptoms.5 As I always caution readers, this lack of correlation considers the genre of collisions producing property damage that would be described as minor or non-severe. Clearly, when crash severity increases beyond this, there is an increased risk for injury or death.
A related interesting paper by Viano and Parenteau demonstrated that more than 60 percent of the National Automotive Sampling System case database for rear impacts are for crashes with delta Vs of under 15 mph. They noted, “In very low speed crashes, advanced age, stenosis and degeneration of the cervical spinal canal can lead to spinal cord injury and paralysis in crashes otherwise not causing injury in normal adults.”6 I would also note that it has been demonstrated rather conclusively that human variables (i.e., risk factors) are more determinative vis-a-vis injury risk than crash metrics in the lower crash-severity range.
In the end, when essential parts of the foundation of the defense strategy are tested, they repeatedly fail to hold up to the scrutiny of hard science. In a court of law, however, if the plaintiff and their experts cannot effectively present the real facts and rebut the junk science, 12 impressionable jurors will decide the outcome of the case based on their perception of the soundness of the arguments they heard. The simple fact is that more often than not, the plaintiff and their witnesses are simply not adequately prepared. Knowledge is power and information is the currency of success.
References
Zaloshnja E, Miller T, Council F, Persaud B. Comprehensive and human capital crash costs by maximum police-reported injury severity within selected crash types. Annu Proc Assoc Adv Automot Med, 2004;48:251-63.
Berardinelli DJ. From Good Hands to Boxing Gloves: The Dark Side of Insurance. Portland: Trial Guides, LLC, 2008.
Croft AC. Low back injuries in low velocity rear impact collisions. Forum, 2009;39(4):33-7.
Elbel M, Kramer M, Huber-Lang M, et al. Deceleration during “real life” motor vehicle collisions: a sensitive predictor for the risk of sustaining a cervical spine injury? Patient Saf Surg, 2009;3(1):5.
Croft AC, Freeman MD. Correlating crash severity with injury risk, injury severity, and long-term symptoms in low velocity motor vehicle collisions. Medical Science Monitor, 2005;11(10):RA316-21.
Viano DC, Parenteau CS. Serious injury in very low and very high speed rear impacts. SAE, 2008;2008-01-1485.
Study Confirms Flaws in Standard MVC Defense Strategy
By Arthur Croft, DC, MS, MPH, FACO
The seemingly complex, or perhaps even inscrutable, calculus of what practitioners term personal injury is, in truth, deceptively simple. However, while it keeps getting simpler, many practitioners and lawyers feel hopelessly wrapped around the axle of this puzzling system. The net result is abandonment of needful patients and clients, with a corresponding loss of revenue stream. Consider just a few facts. Motor vehicle collisions are a leading cause of injury in the U.S. and constitute one of our most burdensome public health dilemmas. With 3 million such injuries each year, a total recovery proportion of only about 50 percent, a permanent disability proportion of 10-12 percent, coupled with the fact that many of the injured are young and have many quality life years to lose, the $43 billion annual price tag is hardly surprising.1
Auto insurers make every reasonable effort to insulate themselves from their liability. Some would argue that they engage in efforts most of us would consider unreasonable, if not downright unsavory or unethical. Regardless of your personal judgment, most would agree that over the past two decades, the insurers’ concerted and very expensive campaign to limit claims has been fairly successful.
With Allstate taking the vanguard position with their now-famous three Ds – delay, deny, and defend – most major auto insurers have since instituted similar policies, and the plaintiff persona-injury bar has more often withered than weathered. With a loss of potential legal representation, plaintiffs have had fewer alternatives for compensation. This often has meant that needed health care resources are simply not available to them, which contributes further to the doleful outcome statistics mentioned above. Since inaugurating its get-tough policy in the mid-1990s, which was described by its consulting firm as a transition “from good hands to boxing gloves,” Allstate has reportedly posted surprising high profits.2 Other insurers have not failed to notice.
The Standard Defense and the Importance of Delta V
How could any of this possibly be simple? One need look no further than the essential game plan of most defense lawyers: deception, dissimilation and obfuscation. It requires a team of experts from the fields of medicine (including chiropractic), accident reconstruction and biomechanics who have collectively developed what I consider to be the standard defense strategy. It continues to be the most successful and widely used strategy today, having become the world standard.
This has fostered a small research industry dedicated to the production of pro-defense literature to aid in the cause. Most is junk science. Make no mistake, insurers have the best researchers money can buy and they know how to get published. As a result, even many clinicians remain split on critical issues depending on which brand of literature they rely upon. I note, with all due respect to the Insurance Institute for Highways Safety (IIHS) and members of the International Insurance Whiplash Protection Group (IIWPG), that their research activities are quite laudatory and most welcome. However, there is just a bit of schizophrenia in this industry when it comes to research. While the valid research of the IIHS and the IIWPG is squarely aimed at reducing the industry payout problem by reducing the number of actual injuries, the “other” research seems to be aimed at providing verisimilitude for company experts to wield in courtrooms to sway jurors toward defense theories.
The standard defense has three parts and is based on the ultimate playing field: a court of law, and, in particular, the biases and naivete (i.e., the normal lack of specific factual information in the field of crash traumatology) of jurors. Polls suggest that Americans are also divided on the question of whiplash injuries. As many as 60-70 percent consider it either definitively or very likely a non-injury, but merely an opportunity to bilk insurers at the expense of the rest of us policy-holders who subsidize the system through the increasing premiums we must pay. Thus, jurors are easily misled by the standard defense strategy because it merely reinforces that which they already believe.
The first and most fundamental part of this strategy is to demonstrate that the forces of the collision would not have been of a sufficient magnitude to cause injury. The common currency for this discussion is the plaintiff vehicle’s delta V or change in velocity. For this, an accident reconstructionist is usually employed. Because reconstructionists are rarely allowed to provide opinions as to injury risk, they are often followed by a biomechanist, who is granted more latitude to venture into the discussion of injury risk. In some cases, they are allowed to consider medical records, MRIs, etc., in forming their opinions. Finally, the defense physician (DC, DO or MD) adds the icing to the cake, testifying that either there was no injury or that there was a minor straining-type injury that has long since resolved.
When pre-existing conditions are present, the plaintiff’s complaints are often attributed to them rather than the injury. Company doctors will typically also be of the opinion that a large portion of the medical expenses claimed by the plaintiff are unnecessary, unreasonable,and represent unwarranted treatment and diagnostics. Note that low back injuries are virtually never admitted to be causally related to low-velocity collisions. I have written a paper on this subject which is available upon e-mail request at drcroft@san.rr.com .3
As I have so many times implored readers – and this fact is never contested even by my small army of industry-affiliated detractors – the entire defense mechanism just described is nothing more than a series of interlocking nonsequiturs. The accident reconstructions and biomechanists provide a very polished and seemingly airtight argument based on what appear to be sound mathematical principles and classical Newtonian physics. This is all very interesting, and would be even more so if it had the additional virtue of being true.
Delta V Not a Valid Gauge of Injury Risk?
But figures don’t always add up, which brings me back to the headline of this article. A new study that provides further compelling evidence that delta V, the keystone in the standard defense strategy, is not a valid gauge of injury risk.4 The authors recruited a total of 57 people within 48 hours of their MVCs. The subjects were recruited either from an engineer’s office for vehicle damage assessment or an ER. The whiplash grades ranged from 0-4 (0 indicating no claimed injury and 4 indicating fracture). The collision types included 13 frontal, 21 rear, 19 side, three multiple crashes and one rollover. There were 25 males and 32 females with a median age of 33.
In all cases a trained engineer determined the delta V by examining both crash vehicles. The VAS and Neck Disability Indexes (NDI) scores were tabulated. The authors found no significant correlation between NDI and delta V, no correlation between whiplash grade and delta V, and only a moderate correlation between VAS reported pain and delta V. However, the R2 value (coefficient of determination) for that correlation was only 0.30, which means that 70 percent of the proportion of the variability of pain severity was not explained by differences in delta V.
There was no lower threshold below which a large proportion would predictably not be injured, nor was there an upper threshold above which most would predictably be injured. This was because some people were injured in very low velocity crashes while others were not injured despite fairly high velocity crashes. The authors commented, “It can be concluded that delta V is an irrelevant predictive value for cervical spine injury after MVA [motor vehicle accident].”
Some specific findings include the following: Cervical spine fractures in frontal crashes occurred in delta Vs of 9.3, 19.9 and 31.1 mph. Fractures in side impacts occurred in delta Vs of 6.2 (z-joint fracture of C4), 9.9 (C7 with dislocation of C6-7), 19.9 (z-joint fracture of C2), 31.1 (C5 fracture with C5-6 dislocation and paraplegia), 32.3 (rupture of alar ligaments), 36.0 (atlantoaxial dislocation) and 36.6 mph (rupture of alar ligaments). There was a dens fracture in the one rollover with the delta V reported as 9.3 mph. This article is available for free download at www.ncbi.nlm.nih.gov/pmc/articles/PMC2657117.
A related component of the standard defense strategy is the property damage issue. Specifically, the argument goes, when the property damage is minor, an injury is very unlikely. We addressed this issue earlier in a meta-analysis of medical and engineering literature dating back as far as 1970 that failed to provide a clear link between property damage and any of three outcomes: risk for acute injury, degree of injury severity and risk for long-term symptoms.5 As I always caution readers, this lack of correlation considers the genre of collisions producing property damage that would be described as minor or non-severe. Clearly, when crash severity increases beyond this, there is an increased risk for injury or death.
A related interesting paper by Viano and Parenteau demonstrated that more than 60 percent of the National Automotive Sampling System case database for rear impacts are for crashes with delta Vs of under 15 mph. They noted, “In very low speed crashes, advanced age, stenosis and degeneration of the cervical spinal canal can lead to spinal cord injury and paralysis in crashes otherwise not causing injury in normal adults.”6 I would also note that it has been demonstrated rather conclusively that human variables (i.e., risk factors) are more determinative vis-a-vis injury risk than crash metrics in the lower crash-severity range.
In the end, when essential parts of the foundation of the defense strategy are tested, they repeatedly fail to hold up to the scrutiny of hard science. In a court of law, however, if the plaintiff and their experts cannot effectively present the real facts and rebut the junk science, 12 impressionable jurors will decide the outcome of the case based on their perception of the soundness of the arguments they heard. The simple fact is that more often than not, the plaintiff and their witnesses are simply not adequately prepared. Knowledge is power and information is the currency of success.
References
Zaloshnja E, Miller T, Council F, Persaud B. Comprehensive and human capital crash costs by maximum police-reported injury severity within selected crash types. Annu Proc Assoc Adv Automot Med, 2004;48:251-63.
Berardinelli DJ. From Good Hands to Boxing Gloves: The Dark Side of Insurance. Portland: Trial Guides, LLC, 2008.
Croft AC. Low back injuries in low velocity rear impact collisions. Forum, 2009;39(4):33-7.
Elbel M, Kramer M, Huber-Lang M, et al. Deceleration during “real life” motor vehicle collisions: a sensitive predictor for the risk of sustaining a cervical spine injury? Patient Saf Surg, 2009;3(1):5.
Croft AC, Freeman MD. Correlating crash severity with injury risk, injury severity, and long-term symptoms in low velocity motor vehicle collisions. Medical Science Monitor, 2005;11(10):RA316-21.
Viano DC, Parenteau CS. Serious injury in very low and very high speed rear impacts. SAE, 2008;2008-01-1485.
What do I do if I was involved in a Car/Auto accident?!
WHAT IF I WAS IN AN AUTO/CAR ACCIDENT ?
Unfortunately, studies show that most of us will be in an auto accident at some point in our lives. The only question remaining, is how bad will it be?
The following are important things to remember if you are involved in an auto accident:
1. Seek treatment as soon as possible.
If there is a chance you may be seriously hurt, you should go to the Emergency room at your local hospital. There they can rule out fractures and life threatening injuries.
2. If you are still experiencing pain and discomfort a few days to a couple weeks later, than you should come to our office to find out if you have any structural damage.
NOTE: The longer you wait after an accident to come to our office, typically the longer it takes to get you better.
3. Most auto insurance companies have what is called Personal injury Protection/Med Pay. This means that your bills will be paid up to 100% up to a certain limit. Our office can check that for you.
4. If the accident was not your fault. The other party's auto insurance should cover your health care expenses in our office. We do all of the paperwork for you.
5. At the accident scene, get as much information on the other driver or drivers as possible. An accident report by Police is always helpful, but not required to have a case.
6. You should never settle with an insurance company before 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.
7.Dealing with insurance companies can be difficult after an auto accident. We have a number of reputable and highly qualified Attorneys who we can refer you to for a complimentary consultation. Hiring a reputable Attorney essentially takes you out of the direct bargaining process with the insurance company and all the paperwork and phone calls associated with that and lets you concentrate on healing.
8. Injuries sustained after a car-accident if left untreated can lead to spinal degeneration and a host of other problems for years to come.
FINAL NOTE: We find that many people involved in an auto accident that WAS THEIR FAULT never get treatment.
This tends to be due to the fear that their insurance will go up after a claim is filed.
Your PIP (Personal Injury Protection) is why you have auto insurance in the first place.
Many insurance companies will not raise your rates after 1 or even 2 accidents in the same year.
THE INJURIES SUSTAINED IN AN AUTOMOBILE ACCIDENT CAN CAUSE A HOST OF PROBLEMS FOR YEARS TO COME, OR EVEN THE REST OF YOUR LIFE.
YOU OWE IT TO YOURSELF TO COME IN AND GET CHECKED.
Call our office today at (972) 215-7720.
Personal Injury Protection (PIP)
The Texas Department of Insurance requires automobile insurance carriers in our state to issue all automobile policies it writes at least $2500 worth of coverage and you have this coverage unless you reject it in writing. Most people are unaware of this coverage or even know what it is and therefore very few people use it. You end up paying for coverage that they don’t inform you about and you’re entitled to.
Why? Insurance is not understood and most people rely on their agent and claims adjusters to advise them on what to do after an accident. Insurance is a multi-billion dollar industry and are in business to make money. They keep their costs down, less payout, more profits and bonuses at the end of the year. Good for them and not for you.
What is PIP?
PIP is no fault coverage similar to health insurance but on your auto policy for your injuries and your passengers injuries. This coverage is available regardless who is at fault. Yes, you can be the cause of the accident and you will still be covered. There’s no deductible and no co-payment. There is other separate coverage that will cover the other party if you were at fault. If you do not have PIP then you could still be covered if you were in an accident in another state besides Texas. You may also be covered if you were hit in a crosswalk by a car or on a bicycle or borrowing someone else’s car.
What will a claim do to my insurance rates and policy renewal?
Under section 5.7016 of the Texas insurance code, automobile insurance carriers cannot non-renew you for filing one PIP claim in a 12 month period. Also, it is unlikely that they would raise your rates for a sole PIP claim.
Why doesn’t the other guy’s insurance pay for my medical expenses and why should I use my insurance?
Medical treatment is expensive and you are liable for the costs. There is a chance that the other party may never pay for your medical expenses leaving you a financial burden. PIP gives you peace of mind that your medical bills are covered. If you use your health insurance, you may have to pay a deductible and co-pays to your doctor and if the health insurance finds out that you were in an accident they could request to be reimbursed. Some people get referred to a medical provider by their attorney and the medical provider agrees to be paid months or even years later. Since there are a limited number of medical providers who agree to this arrangement, your choice and quality of healthcare may be limited. The answer is to use your PIP coverage so you will not have to pay for medical expenses out of your pocket and get the best possible healthcare treatment available for you and your family’s injuries caused by the accident.
Unfortunately, studies show that most of us will be in an auto accident at some point in our lives. The only question remaining, is how bad will it be?
The following are important things to remember if you are involved in an auto accident:
1. Seek treatment as soon as possible.
If there is a chance you may be seriously hurt, you should go to the Emergency room at your local hospital. There they can rule out fractures and life threatening injuries.
2. If you are still experiencing pain and discomfort a few days to a couple weeks later, than you should come to our office to find out if you have any structural damage.
NOTE: The longer you wait after an accident to come to our office, typically the longer it takes to get you better.
3. Most auto insurance companies have what is called Personal injury Protection/Med Pay. This means that your bills will be paid up to 100% up to a certain limit. Our office can check that for you.
4. If the accident was not your fault. The other party's auto insurance should cover your health care expenses in our office. We do all of the paperwork for you.
5. At the accident scene, get as much information on the other driver or drivers as possible. An accident report by Police is always helpful, but not required to have a case.
6. You should never settle with an insurance company before 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.
7.Dealing with insurance companies can be difficult after an auto accident. We have a number of reputable and highly qualified Attorneys who we can refer you to for a complimentary consultation. Hiring a reputable Attorney essentially takes you out of the direct bargaining process with the insurance company and all the paperwork and phone calls associated with that and lets you concentrate on healing.
8. Injuries sustained after a car-accident if left untreated can lead to spinal degeneration and a host of other problems for years to come.
FINAL NOTE: We find that many people involved in an auto accident that WAS THEIR FAULT never get treatment.
This tends to be due to the fear that their insurance will go up after a claim is filed.
Your PIP (Personal Injury Protection) is why you have auto insurance in the first place.
Many insurance companies will not raise your rates after 1 or even 2 accidents in the same year.
THE INJURIES SUSTAINED IN AN AUTOMOBILE ACCIDENT CAN CAUSE A HOST OF PROBLEMS FOR YEARS TO COME, OR EVEN THE REST OF YOUR LIFE.
YOU OWE IT TO YOURSELF TO COME IN AND GET CHECKED.
Call our office today at (972) 215-7720.
Personal Injury Protection (PIP)
The Texas Department of Insurance requires automobile insurance carriers in our state to issue all automobile policies it writes at least $2500 worth of coverage and you have this coverage unless you reject it in writing. Most people are unaware of this coverage or even know what it is and therefore very few people use it. You end up paying for coverage that they don’t inform you about and you’re entitled to.
Why? Insurance is not understood and most people rely on their agent and claims adjusters to advise them on what to do after an accident. Insurance is a multi-billion dollar industry and are in business to make money. They keep their costs down, less payout, more profits and bonuses at the end of the year. Good for them and not for you.
What is PIP?
PIP is no fault coverage similar to health insurance but on your auto policy for your injuries and your passengers injuries. This coverage is available regardless who is at fault. Yes, you can be the cause of the accident and you will still be covered. There’s no deductible and no co-payment. There is other separate coverage that will cover the other party if you were at fault. If you do not have PIP then you could still be covered if you were in an accident in another state besides Texas. You may also be covered if you were hit in a crosswalk by a car or on a bicycle or borrowing someone else’s car.
What will a claim do to my insurance rates and policy renewal?
Under section 5.7016 of the Texas insurance code, automobile insurance carriers cannot non-renew you for filing one PIP claim in a 12 month period. Also, it is unlikely that they would raise your rates for a sole PIP claim.
Why doesn’t the other guy’s insurance pay for my medical expenses and why should I use my insurance?
Medical treatment is expensive and you are liable for the costs. There is a chance that the other party may never pay for your medical expenses leaving you a financial burden. PIP gives you peace of mind that your medical bills are covered. If you use your health insurance, you may have to pay a deductible and co-pays to your doctor and if the health insurance finds out that you were in an accident they could request to be reimbursed. Some people get referred to a medical provider by their attorney and the medical provider agrees to be paid months or even years later. Since there are a limited number of medical providers who agree to this arrangement, your choice and quality of healthcare may be limited. The answer is to use your PIP coverage so you will not have to pay for medical expenses out of your pocket and get the best possible healthcare treatment available for you and your family’s injuries caused by the accident.
What is Peripheral Neuropathy?
NDallasChiropractic.com
Peripheral neuropathy describes damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body.
More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis. Impaired function and symptoms depend on the type of nerves -- motor, sensory, or autonomic -- that are damaged. Some people may experience temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness. Others may suffer more extreme symptoms, including burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction. Peripheral neuropathy may be either inherited or acquired. Causes of acquired peripheral neuropathy include physical injury (trauma) to a nerve, tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, and vascular and metabolic disorders. Acquired peripheral neuropathies are caused by systemic disease, trauma from external agents, or infections or autoimmune disorders affecting nerve tissue. Inherited forms of peripheral neuropathy are caused by inborn mistakes in the genetic code or by new genetic mutations.
Is there any treatment?
Chiropractic brain based therapy helps in adopting healthy habits -- such as maintaining optimal weight, avoiding exposure to toxins, following a physician-supervised exercise program, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption -- can reduce the physical and emotional effects of peripheral neuropathy. Systemic diseases frequently require more complex treatments.
There are therapies for many forms.
Peripheral neuropathy describes damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body.
More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis. Impaired function and symptoms depend on the type of nerves -- motor, sensory, or autonomic -- that are damaged. Some people may experience temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness. Others may suffer more extreme symptoms, including burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction. Peripheral neuropathy may be either inherited or acquired. Causes of acquired peripheral neuropathy include physical injury (trauma) to a nerve, tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, and vascular and metabolic disorders. Acquired peripheral neuropathies are caused by systemic disease, trauma from external agents, or infections or autoimmune disorders affecting nerve tissue. Inherited forms of peripheral neuropathy are caused by inborn mistakes in the genetic code or by new genetic mutations.
Is there any treatment?
Chiropractic brain based therapy helps in adopting healthy habits -- such as maintaining optimal weight, avoiding exposure to toxins, following a physician-supervised exercise program, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption -- can reduce the physical and emotional effects of peripheral neuropathy. Systemic diseases frequently require more complex treatments.
There are therapies for many forms.
Why should i be examined after a auto/car accident?
What are the symptoms of whiplash?
The most common symptoms related to whiplash include:
* neck pain and stiffness,
* headache,
* shoulder pain and stiffness,
* dizziness,
* fatigue,
* jaw pain (temporomandibular joint symptoms),
* arm pain,
* arm weakness,
* visual disturbances,
* ringing in the ears (tinnitus), and
* back pain.
In the more severe and chronic case of "whiplash associated disorder" symptoms can include:
* depression,
* anger,
* frustration,
* anxiety,
* stress,
* drug dependency,
* post-traumatic stress syndrome,
* sleep disturbance (insomnia),
* and
* social isolation.
How is whiplash diagnosed?
After an accident the patient may be taken to the hospital and/or a Chiropractor's office to be examined. The doctor will examine the patient to determine if they have any injuries that require treatment. Based on the symptoms and examination findings the doctor may place a collar on the neck for additional support. The doctor may also obtain x-rays of the neck to check for more serious injury. The most important first step is to make sure there is no major injury to the neck, head or the rest of the body requiring immediate treatment.
If the x-rays are normal but the patient continues to have neck pain, the doctor may keep the cervical collar in place and see the back in the office in about a week for an additional examination. At that time the doctor may obtain new x-rays to see if there have been any changes. If the doctor is still concerned about soft tissue injuries, he or she may obtain either x-rays with the head leaning forward and backwards (dynamic x-rays) or obtain an MRI (magnetic resonance imaging study). These dynamic x-rays or MRI scans are better able to detect injuries to the soft tissues of the neck, especially instability, that may not been seen with normal x-rays of the neck.
The most common symptoms related to whiplash include:
* neck pain and stiffness,
* headache,
* shoulder pain and stiffness,
* dizziness,
* fatigue,
* jaw pain (temporomandibular joint symptoms),
* arm pain,
* arm weakness,
* visual disturbances,
* ringing in the ears (tinnitus), and
* back pain.
In the more severe and chronic case of "whiplash associated disorder" symptoms can include:
* depression,
* anger,
* frustration,
* anxiety,
* stress,
* drug dependency,
* post-traumatic stress syndrome,
* sleep disturbance (insomnia),
* and
* social isolation.
How is whiplash diagnosed?
After an accident the patient may be taken to the hospital and/or a Chiropractor's office to be examined. The doctor will examine the patient to determine if they have any injuries that require treatment. Based on the symptoms and examination findings the doctor may place a collar on the neck for additional support. The doctor may also obtain x-rays of the neck to check for more serious injury. The most important first step is to make sure there is no major injury to the neck, head or the rest of the body requiring immediate treatment.
If the x-rays are normal but the patient continues to have neck pain, the doctor may keep the cervical collar in place and see the back in the office in about a week for an additional examination. At that time the doctor may obtain new x-rays to see if there have been any changes. If the doctor is still concerned about soft tissue injuries, he or she may obtain either x-rays with the head leaning forward and backwards (dynamic x-rays) or obtain an MRI (magnetic resonance imaging study). These dynamic x-rays or MRI scans are better able to detect injuries to the soft tissues of the neck, especially instability, that may not been seen with normal x-rays of the neck.
Neck and Mid Back Pain
Collisions that occur during sporting events, slips, falls or Automobile
crashes can all have a damaging effect on your neck and back. Reduction
of the normal neck (Cervical) curve, repetitive micro-traumas ie. long
hours on the computer, driving in traffic, traveling by car or plane,
lifting heavy or awkward objects or constant stress of work, family and
everyday life can also be directly related to neck and back pain.
Pain can be dull or sharp, boring or burning, constant or intermittent. As the problem progresses, numbness and or tingling can be felt in the upper back, arms and even in to the hands.
NOTE: Many patients who come in for Carpal Tunnel treatment are amazed to find out that the problem is actually a pinching of the nerves in the neck and NOT a wrist or hand problem.
Through careful evaluation of your neck and upper back, we can pinpoint the problem areas and have great success in correcting the CAUSE of our Patients symptoms.
The Docs at North Dallas Chiropractic
Pain can be dull or sharp, boring or burning, constant or intermittent. As the problem progresses, numbness and or tingling can be felt in the upper back, arms and even in to the hands.
NOTE: Many patients who come in for Carpal Tunnel treatment are amazed to find out that the problem is actually a pinching of the nerves in the neck and NOT a wrist or hand problem.
Through careful evaluation of your neck and upper back, we can pinpoint the problem areas and have great success in correcting the CAUSE of our Patients symptoms.
The Docs at North Dallas Chiropractic
Migraines and Headaches
MIGRAINES / HEADACHES
Migraines and headaches are NOT the result of an Aspirin shortage. They are NOT normal, and everyone does NOT have them.
A frequent and overlooked cause of Migraines and other headaches is the malfunction of the spinal bones in the neck and upper back.
When the bones of the spine lose their normal position or motion, sensitive nerves and blood vessels to the head can be affected. When spinal nerves and related tissues are stretched or irritated, they can produce Migraines and other types of headaches. Aspirin and other medications may cover up these warning signs, but do not correct the underlying structural CAUSE.
Many people experience correction and long term relief through Chiropractic care, without the short and long term side effects that accompany ALL pain medications.
Call our office to have your type of Migraine or Headache diagnosed and discover the life changing experience many of our Migraine / Headache patients have found.
The Docs at North Dallas Chiropractic
Migraines and headaches are NOT the result of an Aspirin shortage. They are NOT normal, and everyone does NOT have them.
A frequent and overlooked cause of Migraines and other headaches is the malfunction of the spinal bones in the neck and upper back.
When the bones of the spine lose their normal position or motion, sensitive nerves and blood vessels to the head can be affected. When spinal nerves and related tissues are stretched or irritated, they can produce Migraines and other types of headaches. Aspirin and other medications may cover up these warning signs, but do not correct the underlying structural CAUSE.
Many people experience correction and long term relief through Chiropractic care, without the short and long term side effects that accompany ALL pain medications.
Call our office to have your type of Migraine or Headache diagnosed and discover the life changing experience many of our Migraine / Headache patients have found.
The Docs at North Dallas Chiropractic
Low Back Pain
Low back pain is the cause of many patients who limp, hobble or even
crawl in to our office. Its not surprising to learn that Low back pain
results in millions of dollars of lost work and untold suffering every
day.
Low back pain usually falls in to one of the following categories:
1. Patients have experienced chronic long term pain or discomfort with multiple episodes of increased pain which come and go.
Many of these people either cover the pain with OTC or prescription medications, or decide to just live with it. The problem is that all medications have both short and long term side effects. Only in rare cases should this be considered as a long term treatment option to this typically correctable problem.
As far as just living with the pain, two areas must be considered.
First, pain is NOT normal, so there IS something wrong. Ignoring it, or just dealing with it allows the condition to progress undiagnosed and untreated. Lastly, why live with it and the effects it can have on your QUALITY of life, if you don't have to.
2. These patients are the limpers, hobblers and crawlers. Their pain started all at once and hit hard and fast. We typically hear something like "I just reached down to pick up a book and my back went out." Another common statement goes something like "I have never had low back pain before."
This type of condition can stop even the most determined and tough individual in their tracks and literally bring them to their knees. This can be a very scary time for those who have never experienced this before.
Typically our spinal examination reveals long time trauma or misalaignment of the Lumbar vertebrae, the sacrum or the hips. The body has gotten to a point where it is overcome by these conditions and literally stops functioning properly.
NOTE: There are a number of causes of low back pain. Most who seek out our office fall into the category of Chiropractic care to fix the CAUSE of the problem. We have great success with these patients. Occasionally, we find that the problem is not musculo-skeletal related and in these cases, they are referred to to another type of Doctor who specializes in their particular condition.
Dr Ewing - Dr. Soto - North Dallas Chiropractic
Low back pain usually falls in to one of the following categories:
1. Patients have experienced chronic long term pain or discomfort with multiple episodes of increased pain which come and go.
Many of these people either cover the pain with OTC or prescription medications, or decide to just live with it. The problem is that all medications have both short and long term side effects. Only in rare cases should this be considered as a long term treatment option to this typically correctable problem.
As far as just living with the pain, two areas must be considered.
First, pain is NOT normal, so there IS something wrong. Ignoring it, or just dealing with it allows the condition to progress undiagnosed and untreated. Lastly, why live with it and the effects it can have on your QUALITY of life, if you don't have to.
2. These patients are the limpers, hobblers and crawlers. Their pain started all at once and hit hard and fast. We typically hear something like "I just reached down to pick up a book and my back went out." Another common statement goes something like "I have never had low back pain before."
This type of condition can stop even the most determined and tough individual in their tracks and literally bring them to their knees. This can be a very scary time for those who have never experienced this before.
Typically our spinal examination reveals long time trauma or misalaignment of the Lumbar vertebrae, the sacrum or the hips. The body has gotten to a point where it is overcome by these conditions and literally stops functioning properly.
NOTE: There are a number of causes of low back pain. Most who seek out our office fall into the category of Chiropractic care to fix the CAUSE of the problem. We have great success with these patients. Occasionally, we find that the problem is not musculo-skeletal related and in these cases, they are referred to to another type of Doctor who specializes in their particular condition.
Dr Ewing - Dr. Soto - North Dallas Chiropractic
What to Do If Injured in an Accident and Suffer From Whiplash
The term "whiplash" was first used in 1928 to define an injury mechanism
of sudden hyperextension followed by an immediate hyperflexion of the
neck that results in damage to the muscles, ligaments and tendons –
especially those that support the head. Today, we know that whiplash
injuries frequently do not result from hyperextension or hyperflexion
(extension and flexion beyond normal physiological limits), but rather
an extremely rapid extension and flexion that causes injuries.
Due to their complicated nature and profound impact on peoples lives, few topics in health care generate as much controversy as whiplash injuries. Unlike a broken bone where a simple x-ray can validate the presence of the fracture and standards of care can direct a health care professional as to the best way in which to handle the injury, whiplash injuries involve an unpredictable combination of nervous system, muscles joints and connective tissue disruption that is not simple to diagnose and can be even more of a challenge to treat. In order to help you understand the nature of whiplash injuries and how they should be treated, it is necessary to spend a bit of time discussing the mechanics of how whiplash injuries occur.
The Four Phases of a Whiplash Injury
During a rear-end automobile collision, your body goes through an extremely rapid and intense acceleration and deceleration. In fact, all four phases of a whiplash injury occur in less than one-half of a second! At each phase, there is a different force acting on the body that contributes to the overall injury, and with such a sudden and forceful movement, damage to the vertebrae, nerves, discs, muscles, and ligaments of your neck and spine can be substantial.
Phase 1
During this first phase, your car begins to be pushed out from under you, causing your mid-back to be flattened against the back of your seat. This results in an upward force in your cervical spine, compressing your discs and joints. As your seat back begins to accelerate your torso forward, your head moves backward, creating a shearing force in your neck. If your head restraint is properly adjusted, the distance your head travels backward is limited. However, most of the damage to the spine will occur before your head reaches your head restraint. Studies have shown that head restraints only reduce the risk of injury by 11-20%.
Phase 2
During phase two, your torso has reached peak acceleration - 1.5 to 2 times that of your vehicle itself - but your head has not yet begun to accelerate forward and continues to move rearward. An abnormal S-curve develops in your cervical spine as your seat back recoils forward, much like a springboard, adding to the forward acceleration of the torso. Unfortunately, this forward seat back recoil occurs while your head is still moving backward, resulting in a shearing force in the neck that is one of the more damaging aspects of a whiplash injury. Many of the bone, joint, nerve, disc and TMJ injuries that I see clinically occur during this phase.
Phase 3
During the third phase, your torso is now descending back down in your seat and your head and neck are at their peak forward acceleration. At the same time, your car is slowing down. If you released the pressure on your brake pedal during the first phases of the collision, it will likely be reapplied during this phase. Reapplication of the brake causes your car to slow down even quicker and increases the severity of the flexion injury of your neck. As you move forward in your seat, any slack in your seat belt and shoulder harness is taken up.
Phase 4
This is probably the most damaging phase of the whiplash phenomenon. In this fourth phase, your torso is stopped by your seat belt and shoulder restraint and your head is free to move forward unimpeded. This results in a violent forward-bending motion of your neck, straining the muscles and ligaments, tearing fibers in the spinal discs, and forcing vertebrae out of their normal position. Your spinal cord and nerve roots get stretched and irritated, and your brain can strike the inside of your skull causing a mild to moderate brain injury. If you are not properly restrained by your seat harness, you may suffer a concussion, or more severe brain injury, from striking the steering wheel or windshield.
Injuries Resulting from Whiplash Trauma
As we discussed briefly in the introduction, whiplash injuries can manifest in a wide variety of ways, including neck pain, headaches, fatigue, upper back and shoulder pain, cognitive changes and low back pain. Due to the fact that numerous factors play into the overall whiplash trauma, such as direction of impact, speed of the vehicles involved, as well as sex, age and physical condition, it is impossible to predict the pattern of symptoms that each individual will suffer. Additionally, whiplash symptoms commonly have a delayed onset, often taking weeks or months to present. There are, however, a number of conditions that are very common among those who have suffered from whiplash trauma.
Neck pain
It is the single most common complaint in whiplash trauma, being reported by over 90% of patients. Often this pain radiates across the shoulders, up into the head, and down between the shoulder blades. Whiplash injuries tend to affect all of the tissues in the neck, including the facet joints and discs between the vertebrae, as well as all of the muscles, ligaments and nerves.
Facet joint pain is the most common cause of neck pain following a car accident. Facet joint pain is usually felt on the back of the neck, just to the right or left of center, and is usually tender to the touch. Facet joint pain cannot be visualized on x-rays or MRIs. It can only be diagnosed by physical palpation of the area.
Disc injury is also a common cause of neck pain; especially chronic pain. The outer wall of the disc (called the anulus) is made up of bundles of fibers that can be torn during a whiplash trauma. These tears, then, can lead to disc degeneration or herniation, resulting in irritation or compression of the nerves running through the area. This compression or irritation commonly leads to radiating pain into the arms, shoulders and upper back, and may result in muscle weakness.
Damage to the muscles and ligaments in the neck and upper back are the major cause of the pain experienced in the first few weeks following a whiplash injury, and is the main reason why you experience stiffness and restricted range of motion. But as the muscles have a chance to heal, they typically don’t cause as much actual pain as they contribute to abnormal movement. Damage to the ligaments often results in abnormal movement and instability.
Headaches
After neck pain, headaches are the most prevalent complaint among those suffering from whiplash injury, affecting more than 80% of all people. While some headaches are actually the result of direct brain injury, most are related to injury of the muscles, ligaments and facet joints of the cervical spine, which refer pain to the head. Because of this, it is important to treat the supporting structures of your neck in order to help alleviate your headaches.
TMJ problems
A less common, but very debilitating disorder that results from whiplash is temporomandibular joint dysfunction (TMJ). TMJ usually begins as pain, clicking and popping noises in the jaw during movement. If not properly evaluated and treated, TMJ problems can continue to worsen and lead to headaches, facial pain, ear pain and difficulty eating. Many chiropractors are specially trained to treat TMJ problems, or can refer you to a TMJ specialist.
Brain injury
Believe it or not, mild to moderate brain injury is common following a whiplash injury, due to the forces on the brain during the four phases mentioned earlier. The human brain is a very soft structure, suspended in a watery fluid called cerebrospinal fluid. When the brain is forced forward and backward in the skull, the brain bounces off the inside of the skull, leading to bruising or bleeding in the brain itself. In some cases, patients temporarily lose consciousness and have symptoms of a mild concussion. More often, there is no loss of consciousness, but patients complain of mild confusion or disorientation just after the crash. The long-term consequences of a mild brain injury can include mild confusion, difficulty concentrating, sleep disturbances, irritability, forgetfulness, loss of sex drive, depression and emotional instability. Although less common, the nerves responsible for your sense of smell, taste and even your vision may be affected as well, resulting in a muted sense of taste, changes in your sensation of smell and visual disturbances.
Dizziness
Dizziness following a whiplash injury usually results from injury to the facet joints of the cervical spine, although in some cases injury to the brain or brain stem may be a factor as well. Typically, this dizziness is very temporary improves significantly with chiropractic treatment.
Low back pain
Although most people consider whiplash to be an injury of the neck, the low back is also commonly injured as well. In fact, low back pain is found in more than half of rear impact-collisions in which injury was reported, and almost three-quarters of all side-impact crashes. This is mostly due to the fact that the low back still experiences a tremendous compression during the first two phases of a whiplash injury, even though it does not have the degree of flexion-extension injury experienced in the neck.
Recovery from Whiplash
With proper care, many mild whiplash injuries heal within six to nine months. However, more than 20% of those who suffer from whiplash injuries continue to suffer from pain, weakness or restricted movement two years after their accident. Unfortunately, the vast majority of these people will continue to suffer from some level of disability or pain for many years after that, if not for the rest of their lives.
Whiplash is a unique condition that requires the expertise of a skilled health professional specially trained to work with these types of injuries. The most effective treatment for whiplash injuries is a combination of chiropractic care, rehabilitation of the soft tissues and taking care of yourself at home.
Chiropractic Care
Chiropractic care utilizes manual manipulation of the spine to restore the normal movement and position of the spinal vertebrae. It is by far the single-most effective treatment for minimizing the long-term impact of whiplash injuries, especially when coupled with massage therapy, trigger point therapy, exercise rehabilitation and other soft tissue rehabilitation modalities.
Soft Tissue Rehabilitation
The term ‘soft tissue’ simply refers to anything that is not bone, such as your muscles, ligaments, tendons, nervous system, spinal discs and internal organs. During a whiplash injury, the tissues that are affected most are the soft tissues, the muscles, ligaments and discs in particular. In order to minimize permanent impairment and disability, it is important to use therapies that stimulate the soft tissues to heal correctly. These include massage therapy, electro-stimulation, trigger point therapy, stretching and specific strength and range of motion exercises.
Home Care
The most effective chiropractic care and soft tissue rehabilitation will be limited in its benefit if what you do at home or at work stresses or re-injures you on a daily basis. For this reason, it is important that your plan of care extend into the hours and days between your clinic visits to help speed your recovery. Some of the more common home care therapies are the application of ice packs, limitations on work or daily activities, specific stretches and exercises, taking nutritional supplements and getting plenty of rest.
Medical Intervention
In some severe cases of whiplash, it may be necessary to have some medical care as part of your overall treatment plan. The most common medical treatments include the use of anti-inflammatory medications, muscle relaxants, trigger point injections and, in some cases, epidural spinal injections. These therapies should be used for short-term relief of pain, if necessary, and not be the focus of treatment. After all, a drug cannot restore normal joint movement and stimulate healthy muscle repair. Fortunately, surgery is only needed in some cases of herniated discs, when the disc is pressing on the spinal cord, and in some cases of spine fractures.
Due to their complicated nature and profound impact on peoples lives, few topics in health care generate as much controversy as whiplash injuries. Unlike a broken bone where a simple x-ray can validate the presence of the fracture and standards of care can direct a health care professional as to the best way in which to handle the injury, whiplash injuries involve an unpredictable combination of nervous system, muscles joints and connective tissue disruption that is not simple to diagnose and can be even more of a challenge to treat. In order to help you understand the nature of whiplash injuries and how they should be treated, it is necessary to spend a bit of time discussing the mechanics of how whiplash injuries occur.
The Four Phases of a Whiplash Injury
During a rear-end automobile collision, your body goes through an extremely rapid and intense acceleration and deceleration. In fact, all four phases of a whiplash injury occur in less than one-half of a second! At each phase, there is a different force acting on the body that contributes to the overall injury, and with such a sudden and forceful movement, damage to the vertebrae, nerves, discs, muscles, and ligaments of your neck and spine can be substantial.
Phase 1
During this first phase, your car begins to be pushed out from under you, causing your mid-back to be flattened against the back of your seat. This results in an upward force in your cervical spine, compressing your discs and joints. As your seat back begins to accelerate your torso forward, your head moves backward, creating a shearing force in your neck. If your head restraint is properly adjusted, the distance your head travels backward is limited. However, most of the damage to the spine will occur before your head reaches your head restraint. Studies have shown that head restraints only reduce the risk of injury by 11-20%.
Phase 2
During phase two, your torso has reached peak acceleration - 1.5 to 2 times that of your vehicle itself - but your head has not yet begun to accelerate forward and continues to move rearward. An abnormal S-curve develops in your cervical spine as your seat back recoils forward, much like a springboard, adding to the forward acceleration of the torso. Unfortunately, this forward seat back recoil occurs while your head is still moving backward, resulting in a shearing force in the neck that is one of the more damaging aspects of a whiplash injury. Many of the bone, joint, nerve, disc and TMJ injuries that I see clinically occur during this phase.
Phase 3
During the third phase, your torso is now descending back down in your seat and your head and neck are at their peak forward acceleration. At the same time, your car is slowing down. If you released the pressure on your brake pedal during the first phases of the collision, it will likely be reapplied during this phase. Reapplication of the brake causes your car to slow down even quicker and increases the severity of the flexion injury of your neck. As you move forward in your seat, any slack in your seat belt and shoulder harness is taken up.
Phase 4
This is probably the most damaging phase of the whiplash phenomenon. In this fourth phase, your torso is stopped by your seat belt and shoulder restraint and your head is free to move forward unimpeded. This results in a violent forward-bending motion of your neck, straining the muscles and ligaments, tearing fibers in the spinal discs, and forcing vertebrae out of their normal position. Your spinal cord and nerve roots get stretched and irritated, and your brain can strike the inside of your skull causing a mild to moderate brain injury. If you are not properly restrained by your seat harness, you may suffer a concussion, or more severe brain injury, from striking the steering wheel or windshield.
Injuries Resulting from Whiplash Trauma
As we discussed briefly in the introduction, whiplash injuries can manifest in a wide variety of ways, including neck pain, headaches, fatigue, upper back and shoulder pain, cognitive changes and low back pain. Due to the fact that numerous factors play into the overall whiplash trauma, such as direction of impact, speed of the vehicles involved, as well as sex, age and physical condition, it is impossible to predict the pattern of symptoms that each individual will suffer. Additionally, whiplash symptoms commonly have a delayed onset, often taking weeks or months to present. There are, however, a number of conditions that are very common among those who have suffered from whiplash trauma.
Neck pain
It is the single most common complaint in whiplash trauma, being reported by over 90% of patients. Often this pain radiates across the shoulders, up into the head, and down between the shoulder blades. Whiplash injuries tend to affect all of the tissues in the neck, including the facet joints and discs between the vertebrae, as well as all of the muscles, ligaments and nerves.
Facet joint pain is the most common cause of neck pain following a car accident. Facet joint pain is usually felt on the back of the neck, just to the right or left of center, and is usually tender to the touch. Facet joint pain cannot be visualized on x-rays or MRIs. It can only be diagnosed by physical palpation of the area.
Disc injury is also a common cause of neck pain; especially chronic pain. The outer wall of the disc (called the anulus) is made up of bundles of fibers that can be torn during a whiplash trauma. These tears, then, can lead to disc degeneration or herniation, resulting in irritation or compression of the nerves running through the area. This compression or irritation commonly leads to radiating pain into the arms, shoulders and upper back, and may result in muscle weakness.
Damage to the muscles and ligaments in the neck and upper back are the major cause of the pain experienced in the first few weeks following a whiplash injury, and is the main reason why you experience stiffness and restricted range of motion. But as the muscles have a chance to heal, they typically don’t cause as much actual pain as they contribute to abnormal movement. Damage to the ligaments often results in abnormal movement and instability.
Headaches
After neck pain, headaches are the most prevalent complaint among those suffering from whiplash injury, affecting more than 80% of all people. While some headaches are actually the result of direct brain injury, most are related to injury of the muscles, ligaments and facet joints of the cervical spine, which refer pain to the head. Because of this, it is important to treat the supporting structures of your neck in order to help alleviate your headaches.
TMJ problems
A less common, but very debilitating disorder that results from whiplash is temporomandibular joint dysfunction (TMJ). TMJ usually begins as pain, clicking and popping noises in the jaw during movement. If not properly evaluated and treated, TMJ problems can continue to worsen and lead to headaches, facial pain, ear pain and difficulty eating. Many chiropractors are specially trained to treat TMJ problems, or can refer you to a TMJ specialist.
Brain injury
Believe it or not, mild to moderate brain injury is common following a whiplash injury, due to the forces on the brain during the four phases mentioned earlier. The human brain is a very soft structure, suspended in a watery fluid called cerebrospinal fluid. When the brain is forced forward and backward in the skull, the brain bounces off the inside of the skull, leading to bruising or bleeding in the brain itself. In some cases, patients temporarily lose consciousness and have symptoms of a mild concussion. More often, there is no loss of consciousness, but patients complain of mild confusion or disorientation just after the crash. The long-term consequences of a mild brain injury can include mild confusion, difficulty concentrating, sleep disturbances, irritability, forgetfulness, loss of sex drive, depression and emotional instability. Although less common, the nerves responsible for your sense of smell, taste and even your vision may be affected as well, resulting in a muted sense of taste, changes in your sensation of smell and visual disturbances.
Dizziness
Dizziness following a whiplash injury usually results from injury to the facet joints of the cervical spine, although in some cases injury to the brain or brain stem may be a factor as well. Typically, this dizziness is very temporary improves significantly with chiropractic treatment.
Low back pain
Although most people consider whiplash to be an injury of the neck, the low back is also commonly injured as well. In fact, low back pain is found in more than half of rear impact-collisions in which injury was reported, and almost three-quarters of all side-impact crashes. This is mostly due to the fact that the low back still experiences a tremendous compression during the first two phases of a whiplash injury, even though it does not have the degree of flexion-extension injury experienced in the neck.
Recovery from Whiplash
With proper care, many mild whiplash injuries heal within six to nine months. However, more than 20% of those who suffer from whiplash injuries continue to suffer from pain, weakness or restricted movement two years after their accident. Unfortunately, the vast majority of these people will continue to suffer from some level of disability or pain for many years after that, if not for the rest of their lives.
Whiplash is a unique condition that requires the expertise of a skilled health professional specially trained to work with these types of injuries. The most effective treatment for whiplash injuries is a combination of chiropractic care, rehabilitation of the soft tissues and taking care of yourself at home.
Chiropractic Care
Chiropractic care utilizes manual manipulation of the spine to restore the normal movement and position of the spinal vertebrae. It is by far the single-most effective treatment for minimizing the long-term impact of whiplash injuries, especially when coupled with massage therapy, trigger point therapy, exercise rehabilitation and other soft tissue rehabilitation modalities.
Soft Tissue Rehabilitation
The term ‘soft tissue’ simply refers to anything that is not bone, such as your muscles, ligaments, tendons, nervous system, spinal discs and internal organs. During a whiplash injury, the tissues that are affected most are the soft tissues, the muscles, ligaments and discs in particular. In order to minimize permanent impairment and disability, it is important to use therapies that stimulate the soft tissues to heal correctly. These include massage therapy, electro-stimulation, trigger point therapy, stretching and specific strength and range of motion exercises.
Home Care
The most effective chiropractic care and soft tissue rehabilitation will be limited in its benefit if what you do at home or at work stresses or re-injures you on a daily basis. For this reason, it is important that your plan of care extend into the hours and days between your clinic visits to help speed your recovery. Some of the more common home care therapies are the application of ice packs, limitations on work or daily activities, specific stretches and exercises, taking nutritional supplements and getting plenty of rest.
Medical Intervention
In some severe cases of whiplash, it may be necessary to have some medical care as part of your overall treatment plan. The most common medical treatments include the use of anti-inflammatory medications, muscle relaxants, trigger point injections and, in some cases, epidural spinal injections. These therapies should be used for short-term relief of pain, if necessary, and not be the focus of treatment. After all, a drug cannot restore normal joint movement and stimulate healthy muscle repair. Fortunately, surgery is only needed in some cases of herniated discs, when the disc is pressing on the spinal cord, and in some cases of spine fractures.
The truth about low impact injuries
Low Speed Auto Accidents
Thousands of car accidents occur everyday. And every day thousands are injured. Researchers note that the majority of auto accident injury claims occur at relatively low speeds of about 12 mph or less.
Car Accident Disputes
This causes tremendous disputes between injured parties and the insurance companies that are responsible for compensating them for their car accident claim. To insurers, there really is no speed at which they want to admit an injury could occur. For economic reasons they try to dismiss whiplash or car accident injuries entirely, as if they don’t exist.
Thanks to recent irrefutable research studies proving the existence and exact mechanism of whiplash car injuries, insurers are hard pressed to try the “whiplash is a hoax” defense nearly as much as in the past.
A more recent tactic is to claim the speed of the collision is too low to cause injury. Enter the “low speed collision” or “slow speed collision” defense. The defense often relies on their insured’s reports of how fast they were going when they ran into the back of the other party-obviously biased data.
Other times photographs of the vehicle damage is used to show a low speed car accident. Often, the photographs are shown to an Accident Reconstructionist who by merely looking at photographic damage of a car crash then renders an opinion on how fast the vehicles were traveling. They will even go so far to make statements such as “the evidence suggests there was insufficient force to cause human bodily injury…” This would be laughable if it didn’t cause so many problems for injured car accident victims. By the way, in most states Auto Crash Reconstructionists are only allowed to testify or ender an expert opinion as to vehicle damage. They are not trained to determine bodily injury.
The Truth
Here are but a few facts concerning motor vehicle injuries and their relationship to speed with supporting scientific evidence.
Three different studies (Panjabi, Panjabi and Cholewicki and Kaneoka) proved the mechanism by which the neck is injured by a rear impact force simulating a car accident. [1], [2], [3] The studies involved simulating a rear impact collision on live human test subjects and recording the results with cineradiography (high speed motion x-rays). The researchers found that the neck was injured by deforming into an “S- shaped” configuration within fractions of a second of the impact before the occupant is aware of the impact and before reflexes can protect them. All three of these studies found that this physical event occurred at speeds as low as 2.5 mph. In other words, when they simulated car crashes sufficient to cause the head to move in relationship to the body at a rate of 2.5 mph, injuries were recorded.
The radiographically proven human threshold for injury in a rear impact auto accident therefore is 2.5 mph. Other authors have disputed these figures and some insurance company sponsored studies have found the threshold to be closer to 5 mph.
For the sake of argument, let’s stipulate that the 5 mph threshold is correct. It still means that a collision of only 5 mph can cause damage to the neck.
Freeman et. al. in Spine, Vol. 23, Number 9, 1998, p. 1046 shows the damage thresholds for many cars. This is the minimum speed required to cause the car to show visible signs of damage. The smallest, lightest vehicle listed was the 1980 Toyota Tercel, which required a collision of 8.1 mph to become damaged. On the other end of the spectrum was the 1989 Chevrolet Citation, which required 12.7 mph. A Ford F-250 pick up required 11.7 mph.
Cars built today are equipped with rear bumpers designed not to show any damage below 5 mph. In an attempt to reduce repair costs shouldered by insurance companies, crash standards were adopted to mandate rear bumpers must withstand a 5 mph collision into a fixed barrier (wall, pole, etc) without any visible evidence of damage. It should be noted that this standard involves testing of “vehicle to barrier” crashes not “vehicle to vehicle” testing.
Hitting a pole as in “vehicle to barrier” testing yields more damage at lower speeds. The barrier does not move or absorb any energy.
In “vehicle to vehicle” crashes where the bumpers line up well, it takes considerably more force to cause visible bumper damage than a 5 mph collision. Some tests have shown that cars could be crashed repeatedly at 20 mph and not show outer damage. In a “vehicle to vehicle” crash it is estimated that the minimum speed to cause visible damage is approximately 15 mph.
What happens to the occupant in these collisions is what matters. If you are backing up in a parking lot and run into a pole at 6 mph. You will feel a crunch and a bump. You’ll be startled and upset about your bumper, but it is unlikley you’ll be injured.
On the other hand, if you are stopped in a parking lot waiting for a space and another vehicle strikes you at 12 mph (the average speed of a car in a parking lot) you will likely feel a tremendous jolt, hear a loud bang and your car will be pushed forward a few feet. It is probable that your neck will be injured, although it may not show up for hours or days, but your bumper may not even show a dent.
In the first scenario all the energy of the crash was absorbed by the bumper. In the second, some of the energy was bled off into the two vehicles, but much of it was transmitted into your body causing your neck to deform into the “S” configuration resulting in injury.
Another consideration is that while a bumper may look undamaged from the outside after a collision, inside under the skin, the foam or plastic may be crushed or cracked. This is not seen from the outside, so photographs would make it appear as if no damage was sustained. Still further, the bumper may appear intact, but on unibody vehicles, the unibody may be bent or deformed by a collision. This may not be apparent and some auto repair facilities may miss it.
So what does this mean? It means that if you are rear-ended and your bumper is cracked, dented, or misplaced at all, your collision involved speeds in excess of 15 mph. That’s 3 times the human threshold for injury if we use the 5 mph figure. In reality, the proven threshold is only 2.5 mph, so a collision of 15 mph is 6 times the threshold for injury.
Now let’s say your vehicle sustained no visible damage, but your neck hurts after the collision. Does that mean you weren’t really injured? No. It means that the vehicle’s threshold for damage was not exceeded. The impact could have been 10 mph. Too low for bumper damage, but still 4 times the threshold for human injury.
In a low speed collision, the kinetic forces that are transferred from the other vehicle into your vehicle are not dampened or bled off by your bumper. Instead, the force is transmitted through the vehicle, into your seat and to your neck resulting in injury. If your body or neck are jolted or jerked by the impact, an injury could occur.
Another aspect to consider is if your vehicle is moved forward by the impact. An average car weighs close to 4,000 lbs. Let’s say you are hit from behind and your car is pushed forward a few feet, but shows no signs of bumper damage. Is it possible to be hurt? Yes, of course. The force required to move a stationary 4,000 lb object is tremendous. Can you walk up to a car sitting at a red light with its brakes on and shove it forward even an inch? Not likely. A collision that is strong enough to propel a car forward by even inches is plenty enough force to cause a whiplash injury.
So, as you have now learned, there really shouldn’t be any dispute on whether a low speed car accident collision can cause injuries. It has been scientifically proven by several studies. It is also a fact that the speed required to cause bodily injury is quite low, a scant 2.5 mph. It has also been shown that any accident that causes damage to the rear bumper is likely to cause injuries and even in accidents where there is no outward physical damage to the vehicle, there may still be sufficient forces involved to cause bodily injuries.
About North Dallas Chiropractic
They are a car accident injury specialist. They specializes in back pain and neck pain from car accidents. Their opinion is often sought by other doctors, attorneys and insurance companies. You may contact North Dallas Chiropracitc at (972) 392-4476 for a Car Accident Severity consultation. North Dallas Chiropractic
References
Panjabi MM, Grauer JN (1997): “Whiplash produces a S-shape curvature of the neck with hyperextension at lower levels. ” Spine 22 (21): 2489-94.
Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): “[Biomechanics of whiplash injury].” Orthopade 1998 Dec; 27(12): 813-9.
Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). “Motion analysis of cervical vertebrae during whiplash loading.” Spine 24(8): 763-770
Characteristics of Specific Automobile Bumpers in Low Velocity Impacts, SAE 940916
Thousands of car accidents occur everyday. And every day thousands are injured. Researchers note that the majority of auto accident injury claims occur at relatively low speeds of about 12 mph or less.
Car Accident Disputes
This causes tremendous disputes between injured parties and the insurance companies that are responsible for compensating them for their car accident claim. To insurers, there really is no speed at which they want to admit an injury could occur. For economic reasons they try to dismiss whiplash or car accident injuries entirely, as if they don’t exist.
Thanks to recent irrefutable research studies proving the existence and exact mechanism of whiplash car injuries, insurers are hard pressed to try the “whiplash is a hoax” defense nearly as much as in the past.
A more recent tactic is to claim the speed of the collision is too low to cause injury. Enter the “low speed collision” or “slow speed collision” defense. The defense often relies on their insured’s reports of how fast they were going when they ran into the back of the other party-obviously biased data.
Other times photographs of the vehicle damage is used to show a low speed car accident. Often, the photographs are shown to an Accident Reconstructionist who by merely looking at photographic damage of a car crash then renders an opinion on how fast the vehicles were traveling. They will even go so far to make statements such as “the evidence suggests there was insufficient force to cause human bodily injury…” This would be laughable if it didn’t cause so many problems for injured car accident victims. By the way, in most states Auto Crash Reconstructionists are only allowed to testify or ender an expert opinion as to vehicle damage. They are not trained to determine bodily injury.
The Truth
Here are but a few facts concerning motor vehicle injuries and their relationship to speed with supporting scientific evidence.
Three different studies (Panjabi, Panjabi and Cholewicki and Kaneoka) proved the mechanism by which the neck is injured by a rear impact force simulating a car accident. [1], [2], [3] The studies involved simulating a rear impact collision on live human test subjects and recording the results with cineradiography (high speed motion x-rays). The researchers found that the neck was injured by deforming into an “S- shaped” configuration within fractions of a second of the impact before the occupant is aware of the impact and before reflexes can protect them. All three of these studies found that this physical event occurred at speeds as low as 2.5 mph. In other words, when they simulated car crashes sufficient to cause the head to move in relationship to the body at a rate of 2.5 mph, injuries were recorded.
The radiographically proven human threshold for injury in a rear impact auto accident therefore is 2.5 mph. Other authors have disputed these figures and some insurance company sponsored studies have found the threshold to be closer to 5 mph.
For the sake of argument, let’s stipulate that the 5 mph threshold is correct. It still means that a collision of only 5 mph can cause damage to the neck.
Freeman et. al. in Spine, Vol. 23, Number 9, 1998, p. 1046 shows the damage thresholds for many cars. This is the minimum speed required to cause the car to show visible signs of damage. The smallest, lightest vehicle listed was the 1980 Toyota Tercel, which required a collision of 8.1 mph to become damaged. On the other end of the spectrum was the 1989 Chevrolet Citation, which required 12.7 mph. A Ford F-250 pick up required 11.7 mph.
Cars built today are equipped with rear bumpers designed not to show any damage below 5 mph. In an attempt to reduce repair costs shouldered by insurance companies, crash standards were adopted to mandate rear bumpers must withstand a 5 mph collision into a fixed barrier (wall, pole, etc) without any visible evidence of damage. It should be noted that this standard involves testing of “vehicle to barrier” crashes not “vehicle to vehicle” testing.
Hitting a pole as in “vehicle to barrier” testing yields more damage at lower speeds. The barrier does not move or absorb any energy.
In “vehicle to vehicle” crashes where the bumpers line up well, it takes considerably more force to cause visible bumper damage than a 5 mph collision. Some tests have shown that cars could be crashed repeatedly at 20 mph and not show outer damage. In a “vehicle to vehicle” crash it is estimated that the minimum speed to cause visible damage is approximately 15 mph.
What happens to the occupant in these collisions is what matters. If you are backing up in a parking lot and run into a pole at 6 mph. You will feel a crunch and a bump. You’ll be startled and upset about your bumper, but it is unlikley you’ll be injured.
On the other hand, if you are stopped in a parking lot waiting for a space and another vehicle strikes you at 12 mph (the average speed of a car in a parking lot) you will likely feel a tremendous jolt, hear a loud bang and your car will be pushed forward a few feet. It is probable that your neck will be injured, although it may not show up for hours or days, but your bumper may not even show a dent.
In the first scenario all the energy of the crash was absorbed by the bumper. In the second, some of the energy was bled off into the two vehicles, but much of it was transmitted into your body causing your neck to deform into the “S” configuration resulting in injury.
Another consideration is that while a bumper may look undamaged from the outside after a collision, inside under the skin, the foam or plastic may be crushed or cracked. This is not seen from the outside, so photographs would make it appear as if no damage was sustained. Still further, the bumper may appear intact, but on unibody vehicles, the unibody may be bent or deformed by a collision. This may not be apparent and some auto repair facilities may miss it.
So what does this mean? It means that if you are rear-ended and your bumper is cracked, dented, or misplaced at all, your collision involved speeds in excess of 15 mph. That’s 3 times the human threshold for injury if we use the 5 mph figure. In reality, the proven threshold is only 2.5 mph, so a collision of 15 mph is 6 times the threshold for injury.
Now let’s say your vehicle sustained no visible damage, but your neck hurts after the collision. Does that mean you weren’t really injured? No. It means that the vehicle’s threshold for damage was not exceeded. The impact could have been 10 mph. Too low for bumper damage, but still 4 times the threshold for human injury.
In a low speed collision, the kinetic forces that are transferred from the other vehicle into your vehicle are not dampened or bled off by your bumper. Instead, the force is transmitted through the vehicle, into your seat and to your neck resulting in injury. If your body or neck are jolted or jerked by the impact, an injury could occur.
Another aspect to consider is if your vehicle is moved forward by the impact. An average car weighs close to 4,000 lbs. Let’s say you are hit from behind and your car is pushed forward a few feet, but shows no signs of bumper damage. Is it possible to be hurt? Yes, of course. The force required to move a stationary 4,000 lb object is tremendous. Can you walk up to a car sitting at a red light with its brakes on and shove it forward even an inch? Not likely. A collision that is strong enough to propel a car forward by even inches is plenty enough force to cause a whiplash injury.
So, as you have now learned, there really shouldn’t be any dispute on whether a low speed car accident collision can cause injuries. It has been scientifically proven by several studies. It is also a fact that the speed required to cause bodily injury is quite low, a scant 2.5 mph. It has also been shown that any accident that causes damage to the rear bumper is likely to cause injuries and even in accidents where there is no outward physical damage to the vehicle, there may still be sufficient forces involved to cause bodily injuries.
About North Dallas Chiropractic
They are a car accident injury specialist. They specializes in back pain and neck pain from car accidents. Their opinion is often sought by other doctors, attorneys and insurance companies. You may contact North Dallas Chiropracitc at (972) 392-4476 for a Car Accident Severity consultation. North Dallas Chiropractic
References
Panjabi MM, Grauer JN (1997): “Whiplash produces a S-shape curvature of the neck with hyperextension at lower levels. ” Spine 22 (21): 2489-94.
Panjabi MM, Cholewicki J, Nibu K, Grauer JN, Babat LB, Dvorak J, Bar HF (1998-12-01): “[Biomechanics of whiplash injury].” Orthopade 1998 Dec; 27(12): 813-9.
Koji Kaneoka, Koshiro Ono, Satoshi Inami and Koichiro Hayashi (99-04-15). “Motion analysis of cervical vertebrae during whiplash loading.” Spine 24(8): 763-770
Characteristics of Specific Automobile Bumpers in Low Velocity Impacts, SAE 940916
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