Tag Archives: Neck Pain

Is Chiropractic The Right Treatment After A Car Crash? | Square ONE

 Is Chiropractic The Right Treatment After a Car Crash?

Being involved in a motor vehicle collision (MVC) can be a stressful event for individuals involved.  Not only can the actual trauma and initial loses be stressful, but the recovery process including:  time involved with doctors visits and medical treatments, going pain and suffering, loss of income from missed work, medical expenses and possible permanent injuries or disabilities can weigh on the patient.

What Treatment Should I get?

With all the different treatment options available:  Chiropractors, Physical Therapist, Massage Therapist, Pain Managements Centers, Orthopedic Specialist, etc., who is the best provider to go to after being in a car crash?

While all of these providers have value and are appropriate at times, chiropractors play a role in the healing process that no other provider can.  To understand a chiropractors specific roll in the healing process one needs to understand what happens to tissues after injuries.

If Its Not Moving Its Dying

After an injury has occurred the spine splints because of the injury.  If this splinting is prolonged, fixations between normal spinal segments occur.  These fixations further decrease the overall range of motion (ROM) in the spinal joints and increases stress on damaged intersegmental units that are trying to heal.  By reducing these unnecessary fixations with spinal adjustments, we restore the spine to a more normal biomechanics and this in turn relieves the tension at injured segments, thereby, providing an environment more conductive to healing.

A study was published in Spine that illustrates one of the reasons spinal adjustments are needed.  In this study the researchers produced mechanical fixations in the spines of dogs.  They found that when they fixated one segment the segments above and below began to get disc degeneration and spondylosis (arthritic changes), and these irreversible changes occurred in only two months! (1)

This exact same thing happens to human spines that have fixated spinal segments.  Chiropractors and osteopaths are the only health care providers in this county licensed and trained to perform spinal manipulations, and many osteopaths do not practice manipulations and osteopaths training in adjusting the spine is usually quite brief in comparison.  In fact, chiropractors provide over 94% of the spine manipulations delivered in this country (2)

Another article published in the Clinical Biomechancis  states that immobilization not only causes arthritis but it delays the healing process.

“It (evidence) shows beyond a reasonable doubt that immobilization is not only a cause of osteoarthritis but that it delays healing.”

“If immobilization, irrespective of its cause, cannot be avoided, it would be therapeutically logical to take every possible step to limit its extent and duration.”

“Scar tissue begins to be deposited immediately upon immobilization and serve to further decrease mobility.  Within two weeks eburnation (bone depositing) in bone is detectable and radiographic evidence of joint space narrowing, osteophyte formation (bone spuring), and subchondral sclerosis is apparent.”  (2)

Importance Of Being Compliant With Care

Frequency of treatment is another topic that is often comes up.  Patients do not always realize the necessity of why they need to stick to a strict treatment schedule in the beginning of treatment and many attorneys, other health care professionals and insurance adjustors additionally may not understand why the frequency of treatment is required and also why the length of treatment may be necessary.

I have had countless attorneys tell patients that too much chiropractic care will hurt their case and I regularly receive letters from insurance adjustors stating that the patient just received a soft tissue injury they and they should completely heal in about 6 weeks. There is zero research to support such statements and claims and the research literature on clinical treatment guidelines actually state the opposite.

A paper published in the Journal of Manipulative Therapy (JMPT)  Structural rehabilitation of the spine and posture:  Rationale for treatment beyond the resolution of symptoms answers this.

“Chiropractic is primarily aimed at restoring proper spinal mechanics, which will, in turn, influence the function of the nervous system.”

“Because correct spinal mechanics and the health of the whole neuromusculoskeletal system are interdependent, chiropractic management involves the analysis of all sites of spinal joint dysfunction.  Consequently, chiropractic rehabilitation is driven by the restoration and rehabilitation of normal structure and function and not merely the relief of symptoms and/or pain.”

“Also, the regimen of care must proceed for a sufficient length of time so as to address the chronicity of the remodeling stage of the healing process (i.e. 3wk-12months or more).”

“To concentrate on pain or other symptoms as the primary method to assess efficacy of treatment is not only evidence of a superficial understanding of chiropractic principles, but is also evidence of a superficial understanding of the workings of the biological organism.”  (3)

Now I’m clearly not saying that chiropractic care is the only care needed to help individuals recover from injures related to a whiplash trauma or a motor vehicle collision but chiropractic certainly does play a vital roll in a patients recover from soft tissue injuries and a chiropractor trained in traumatology and biomechanics should certainly be consulted and be part of a patients health care team.

I’m going to post on the exact science of the healing process in subsequent post, so if you are interested to learn how the tissue actually heal over time stay tuned.

If you’ve been in a car crash and would like a FREE consultation call 970-207-4463 or click on the box bellow.

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By Dr Chris Gubbels D.C., C.C.W.P

(1)  Kahanovitz N, Arnoczky SP, Levine DB, Otis JP:  The effects of internal fixation on the articular cartilage of unfused canine facet joint cartilage.  Spine 9(3):268-272, 1984

(2)  Videman, T.  Experimental models of osteoarthritis: the role of immobilization.  Clinical Biomechanics 1987; 2 (also reviewed in Chiropractic Report)

(3)  Videman, T.  Experimental models of osteoarthritis: the role of immobilization.  Clinical Biomechanics 1987; 2 (also reviewed in Chiropractic Report)

 

This Common Car Crash Injury Leads To Bigger Problems

Sub failure Injuries

Whiplash Is Not A Diagnosis

Not a week goes by that a patient doesn’t come in and tell me that he/she has or had whiplash.  Whiplash is not an injury, it’s a mechanism of injury.  Saying you have whiplash would be like saying you have “fell on my back” or “slip and fall”.

So now that we understand that whiplash is not an injury, lets talk about one of the most common injuries whiplash can cause…Subfailure Injuries.

Subfailur Ligament Injuries

Ligaments are fiberous connective tissue that hold bony joints together.  They attach from bone-to-bone with the purpose of stabilizing joints and allowing them to move within their normal range of motion.  Unlike other connective tissue, such as muscles, they are not very elastic and do not stretch very well.  This is critical to understanding how these tissue get injured in car crashes.

Ligament Instabilities Defined

“The loss of the ability of the spine under physicologic loads to maintain relationships between vertebrae in such a way there is neither damage nor subsequent irritation to the spinal cord or nerve roots, and, in addition, there is not development of icapacitating deformity or pain due to structural changes.”

White AA, Panjabi MM:  The problem of clinical instability in the human spine:  a system approach.  Clinical Biomechanics of the Spine.  1978:192

The adult cervical spine is unstable when:

  1. a)  All the anterior or all the posterior elements are destroyed or unable to function.
  2. b)  More than 3.5mm horizontal displacement of one vertebra in relation to an adjacent vertebrae measured on lateral x-rays.
  3. c)  More than 11º or rotation difference to that of either adjacent vertebra measured on lateral cervical neutral or flexion-extension x-rays.
  4. d)  Cervical kyphosis.

Future Health Problems

Joint instabilities resulting from ligament injuries causes not only increased pain but may also lead to additional health problems including: disc derangement, degenerative changes, increased pain, nerve entrapment and spinal cored compression.

Proper Diagnosis Leads To Proper Treatment

Special evaluation of joint instabilities needs to be considered when determining the most appropriate treatment.  Frequently joint instabilities will not be detectable on neutral lateral and anterior x-rays, cervical flexion/extension and open mouth lateral bending films should be taken to determine the true integrity of the spinal ligaments.  If injuries to the lumbar spine are suspected; flexion/extension and lateral bending films of the lumbar spine are recommended.  Think about an athlete with a torn ACL; the knee and supporting ligaments may appear fine in the neutral position but when the knee is put under stress with pushing or pulling the lower leg, pain is created because the injured ligaments are stressed. Similarly many injures in the spine will only present themselves when the spine is stressed in flexion/extension or lateral bending.

Special consideration needs to be considered with treating injuries with instabilities because improper treatments and irritate and potentially make the instabilities worse.

To learn more about Square ONE visit www.squareonehealth.com

To schedule a FREE consultation call 970-207-4463 or fill out the box bellow.

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Best Posture Exercises for Neck and Back Pain


Hi this is Dr. Chris Gubbels Fort Collins chiropractor here at Square One giving you the square one healthy tip of the week. And this week I want to take a minute to show you some things that you some that sits at a computer your hands over a lot, this is some quick exercise that you can do and take a break to work on your posture.

So I call this YWT and I’m gonna show you from the front side. So first thing if you’re like this, one thing I’m gonna have you do is you gonna start by bringing your hands up like this your thumbs pointing back to we call this Y, while I’m doing this I’m gonna make sure that my head stays stuck with my chin down. So I’m not gonna let my head drop forward but the first you’re gonna do is go ahead make of Y you’re gonna point your chin in, and you’re gonna pull your shoulder weight together in the back and we gonna hold this for about 30 seconds and after 30 seconds you can bring your arms down into W just like this keeping your head take back you opening up here after after you hold out for about 30 seconds go ahead and bring your arms out like this you’re making a T from the side its gonna look like this and then after 30 seconds or so bring your arms down to an L to finish it like that.

That gives you a nice stretch appeared the shoulders for something back muscles and get your head backwards supposed to be. That’s a great thing that you can do just take a break once or twice a day when your seating in your desk and it will help you improve your real posture so Dr. Chris Gubbels from square one that is your square one help tip of the week.

Now if you’re someone that has any ongoing neck pain, upper back pain, headaches we always recommend that you get checked by a healthcare professional.

Just give us a call at 970-207-4463 to get a free consultation to know more about square one just visit our site: http://www.squareonehealth.com/