Tag Archives: car accident

Symptom of the Week – Whiplash

I’ve covered this topic a little bit here and there with other posts, but I thought that it is such a common theme that it deserves it’s own title.  Whiplash is essentially just rapid acceleration and deceleration of your head and neck. This kind of motion can happen in sports, or in play but is most commonly associated with car accidents.

Whiplash is named for the motion of a whip.  When the base of a whip is moved properly it only has to move a very slight amount yet the tip of that whip can reach beyond the speed of sound producing the crack that you hear.  In whiplash accidents the spine acts as the whip and the head is the end of that whip.  When the head moves in this uncontrolled manner, tendons muscles and ligaments (the soft tissues supporting the spine) are often injured as well as the joints themselves.  These injuries can cause unbalanced weaknesses and spasms.  Though at first you may feel fine, over the next days and weeks these imbalances cause increasing strain on your neck, back and head.  Symptoms can even develop weeks after the incident.  These symptoms are usually headaches, and achy stiffness in your back, neck and or shoulders.  However your doctor will want to rule out any serious neurological problems as well.

With whiplash the pain is usually the reason that patients come in for care.  The pain is usually only a small symptom compared to the whole.  When you visit your chiropractor after a car accident you may have already been to the Emergency Room and had x-ray’s taken.  Your chiropractor will likely want to see those films and may even take more of his own.  You will be able to see on the X-ray films a straightening of the cervical spine.  This is very predictable with these types of injuries. The joints have been moved out of place, and the muscle spasms will hold them there.  When your spine is missing it’s normal curve it is unable to absorb shock in the way it was designed, and the reduced range of motion can become chronic.  The sooner you begin treatment the better the outcome you are likely to have.

For more on what to expect at a chiropractic visit in the case of whiplash click here.

Headaches – An Informative Post

There are many different types of headaches, but of all the people with headaches out there 90% of them have cervicogenic (tension) headaches.  These are headaches caused by a poorly functioning neck.  These are usually described as tightness, stiffness, or a pressure.

There are other kinds of headaches, migraines for example are periodic, severe, throbbing headaches that usually last more than a few hours, but less than a day.  They can make the sufferer sensitive to light and sound, and cause nausea even vomiting.  Migraines affect women more often than men.  Migraines are commonly heard of and talked about because of their severity, but are much more rare than cervicogenic headaches.

Billions of dollars are spent on headaches each year in the United States.  Headaches are a major cause of lost productivity and time off work.  One of the top reasons for seeking treatment, headaches are big money for drug companies, and big losses to businesses.

People can end up with a headache from stress, a car accident, whiplash, or any kind of trauma.  Headaches can occur a day or even weeks after the initial injury due to the cumulative nature of those kinds of injuries.  Many people think their headaches come on for no reason at all, but if they think back they will remember an accident, increased stress, playing to hard on the weekend, or something a few days ago.

Treatment for headaches traditionally has been over the counter analgesics and NSAIDS, and even stronger medications for more severe symptoms.  These medications can cause serious side effects, and recent studies indicate that we as a country may be over using these to the extent that thousands of people have serious complications every year from these relatively safe drugs.  Many times these pain medications do not work, and can even cause what is termed “analgesic rebound headaches.”

Chiropractic has a great success rate with treating headaches.  It has been found to be better at providing pain relief (with less side effects) and reducing frequency than medication.  Chiropractic addresses the root cause rather than just the symptoms.  When treating your headaches your chiropractor (which could be me if you’re in Utah) should be addressing 3 major things: First reducing the pain, second improving neck function overall, and third proper strengthening of the neck to reduce future risk of re-injury.  While chiropractic is particularly good at resolving cervicogenic headaches it has also been shown to be effective with some types of migraines, and other headaches.

If you are experiencing headaches, don’t reach for that Aspirin bottle.  Reach for the phone and contact your chiropractor.  You will receive better, safer relief, and have less chance of recurrence.

When Should I Go To A Chiropractor?

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The primary thing that you should see a doctor of chiropractic for instead of a medical doctor is joint dysfunction, sometimes chiropractors will call this “subluxation.” The problem is the same with either term. “What is that?” Medical doctors and chiropractors use different terms so I’ll try to list some of the more common diagnoses terms and explain why and how a DC should be preferred over an MD for those conditions.

Back pain of any kind. I say this, knowing that there are causes of back pain that a chiropractor cannot treat. They should be a first line provider when it comes to back pain. The advantage of seeing a chiropractor first for back pain is that it is their expertise. They have had more class and clinical hours studying and treating the back than the average MD. So, even if they can’t treat it, they are better equipped to diagnose and refer to the right person. They can also treat most back pain generators. Even the studies with the worst outcomes show that chiropractic is at least as good as standard medical treatments (most show better results) for low back pain with higher patient satisfaction, and lower risk. The second reason to see a chiropractor is cost.  A full treatment plan with a chiropractor will cost about the same as the initial MRI at a hospital ER.

If you’ve been in a car accident, after visiting the ER, and in the absence of life threatening findings there you should proceed to your chiropractor. The ER doctors will often say something along the lines of well we can’t find anything on our tests, it looks like you have a little (fill in the blank…whiplash, sprain/strain, pulled muscles, bruising, etc…). They will usually send you home with a prescription for some pain medication. They don’t deny the pain or the injury, they just don’t have any medication to treat these injuries. These injuries are what chiropractors deal with. Like with MDs, DCs cannot cure a sprain or a strain, but they can improve healing time, and reduce pain without the risk/side effects that medication has.

Pregnancy back and muscle aches. This statement is not intended to negate medical monitoring of a pregnancy. Chiropractors should not be substituting for an OB/Gyn if that is the care you choose. With pregnancy however most medications are out, due to possible harm to the baby. In this circumstance you want your treatments to be as conservative as possible. Again, that is a chiropractors realm, conservative care.

Headaches are one of those areas that are middle of the road. Most headaches are just tension headaches, and chiropractic has a very high success rate treating them. The problem is most people don’t go to their doctor for the average tension headache, they go for chronic headaches, migraines, cluster headaches, etc… With these I wouldn’t say one was better than the other. Because the cause of headaches vary so much you could start either place. The big advantage that I would give chiropractic in this case is that it is more conservative, and they won’t start with drugs. If you aren’t seeing some results with a chiropractor within 2 weeks I would recommend looking into other things, and for that matter the chiropractor should be looking to refer you about that time.

Difficulty moving, such as when you bend down and can’t stand back up, or you can’t turn your head properly to back up your car. Stiffness or soreness is also something to go see a chiropractor about. Basically anytime you have a mechanical problem be it muscles, bones, or joint structures head to your chiropractor.

Repetative stress injuries, whether they be work related, sports related, performance related, or what ever. RSI’s are something that I’ve discussed in depth previously. See here for the start of the discussion series.

I’m sure that I’ve missed many, and I hope that my chiropractic friends will correct me with comments to this post, but I hope this is a good starting point for those of you who are looking for a way to judge who you should go see.

A chiropractor can be a primary care provider and at times are. You should be able to go see your chiropractor for any reason, and he should be able to help you either through chiropractic treatment or by referring you on to the person who you should see. However, if there is a medical doctor around you would save time by skipping the chiropractor and going straight to the MD if you have a fever, bowel and bladder problems, you are oozing fluids, or have cancer. Those are things chiropractors don’t usually deal with.

Do Chiropractors Practice in Hospitals

The full question was Are chiropractors allowed to practice in hospitals or use medical outpatient facilities? I think the real question is, why don’t chiropractors work in hospitals.

The answer is, some chiropractors do practice in hospitals, though they are few and far between. There are none here in Utah were I practice. Chiropractors have in their scope of practice the ability to order lab tests, MRIs, etc… Hospitals and labs across the nation honor this, and will perform medical outpatient procedures for chiropractors.

Here are some, of the many possible reasons chiropractors aren’t working in hospitals:

  • Doctors are trying to get out of hospitals. Hospitals tell you how you can practice even more than insurance companies do. They set your income, rather than your earnings being determined by your efforts. They set what you do and how much you will be paid for it, they are a business after all.
  • Politics of the past, medical doctors and chiropractors did not get along well. We are very near the end of that era, but there is still some animosity between the older generation on both sides, and it sometimes will trickle down into the younger doctors. That inhibits some from joining forces.
  • Hospitals don’t really know what to do with chiropractors. They have a structure, and chiropractors don’t fit well into it. Even if we did, they don’t know what we can do, or how to bill for it. It would take some effort to integrate a chiropractor into a medical system, and there aren’t really many models to work from.

Hospitals are always looking to improve patient satisfaction. Chiropractors have the highest patient satisfaction rating in healthcare. A way that we can improve that rating for a hospital is by offering relief and improvement where previously there was none. The two places I would begin is in the Emergency Room, and the Women’s and Children’s department.

The ER sees many cases where people just want to make sure things are not life threatening. The prime example is a car accident. Even if you don’t feel really bad after an accident it is a good idea to get checked out, just in case. When the ER finishes it’s tests and finds nothing broken or bleeding they usually send you away with serious pain killers to cover the pain of your “whiplash”. These are the kind of things that chiropractors deal with all of the time. We can reduce the healing time, and treat the issue without masking it with medication.

The same kind of thing is important for expecting mothers. They visit their OB in the hospital for their back pain. There isn’t much that they can take, medication wise, due to possible effects on the baby. This leaves the doctor with few options. Chiropractic is a proven medication free treatment that can relive the back pain of pregnant patients.

Hospitals can be a great help to chiropractors also. There are many times that chiropractors will find something that needs to be treated, but the pain that the patient is in is too much to allow chiropractic manipulation. Muscle relaxants and pain medication in these situations can allow a chiropractor to perform the needed procedures. Not to mention the many illnesses that chiropractors find that are out of their scope for treatment. Being in a hospital would allow them ready access to the best person for the job.

I think that hospitals incorporating chiropractic would be a great synergistic relationship. I hope that Utah hospitals will soon be open to this kind of opportunity. Things would improve, even if they just set up a working relationship with each other. They don’t have to be in the same building.