Various injuries can be caused by automobile crashes. One of the most frequent car accidents is the collision in which a vehicle is hit from behind. If you have been in these events you may be receiving neck pain therapy for a accident called whiplash that occurs when an occupant of this vehicle is thrust forth and back.
This injury may cause a herniated disc in the cervical (neck) area, in addition to a variety of other symptoms. A whiplash injury can include neurological impairment in mobility, joint aches, problems with concentration and chronic pain. Besides damaging the delicate tissues (muscles, tendons, and ligaments) that maintain the neck, it may also harm the cervical spine (the neck region of the backbone), inducing a herniated disc in the neck. The herniation can compress the nearby nerves, causing pain. Symptoms of a herniated disc in the neck may include tingling, numbness, and muscle weakness.
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Pain from Previously Existing Conditions
In a study published in the journal Spine, doctors found that disabling pain in the back following whiplash may be due to a previously disc in the spine. These conditions may present no symptoms that are apparent before the accident. The researchers further concluded that pain was successfully treated following microdiscectomies for these discs.
Symptoms from whiplash injuries cannot be necessarily resolved with neck pain treatment, and can be tricky to diagnose since the pain lower back and even in the shoulder region can radiate to other regions of the body. It can be especially challenging for the physician when symptoms are vague and non-localized.
When the natural reactions of the body don’t operate properly, injuries occur. In the normal state, a C-shape is maintained by the cervical spine. On an S-shape as the portion extends and the upper portion of this area flexes, the individual’s cervical spine takes upon impact from behind. This phenomenon risks herniating a disc or tearing a ligament. If the human body’s protective response is working correctly, it will recognize the impact and signal the cervical muscles and make a supportive scaffold for the cervical spine and ligaments.
Although pain can heal on its own it may often require therapy. A treatment program for a herniated disc in the neck may consist of anti-inflammatory pain medication, rest, and physical therapy. With these conservative treatments, the symptoms generally improve over time. But if imaging tests find out that the damaged disc is compressing nearby nerves and/or the spinal cord, or if symptoms persist despite the treatment, neck surgery may be considered.
There are a few things you can do in order to stop whiplash injuries requiring neck pain treatment and increased risk for pain . These include maintaining fitness and good posture. You can start focusing on those goals.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Chiropractor, Dr. Alexander Jimenez looks at the way this common injury shows itself.
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Introduction
Iliotibial band syndrome (ITBS) between the knee is frequently diagnosed in sport injury clinics. ITBS presents having an incidence rate of around 22% in most lower extremity running-related injuries (1) also has been said to be the second most common complaint amongst distance runners (2). ITBS has been given the expression ‘runner’s knee’.
Trainers like endurance runners who perform flexion and extension combined with loading are subjected to this illness. ITBS presents during the first two or three miles in running with no mechanism of injury, which can make identifying the cause more interesting. With plenty of factors having been considered within the literature, changes are often purported to be a cause of ITBS. But some biomechanical factors have been researched and have been found to have little or no effect in the start of ITBS. Therefore this text’s point would be to examine the biomechanical changes which may induce an individual to the beginning of ITBS. The research published reviewed is largely based on a current systematic review that was published in Physical Therapy in Sport in 2014 (3).
Anatomy & Function
The iliotibial band (ITB) encapsulates the tensor fascia latae (TFL) presenting with both deep and superficial fibre attachments at the pelvis (4). In addition to attaching to the TFL, approximately three-quarters of the gluteus maximus tendon also conjoins with the ITB (4). The ITB courses along the lateral aspect of the hip and passes the greater trochanter. The ITB maintains an attachment on the posterior ridge of the femur whilst attaching itself to the fascia. The ITB has a fixed attachment at the lateral femoral condyle where it then divides into three segments with the first being the lateral patella (3). The remaining two segments cross the knee joint to insert at the head of fibula and most distally at the infrapatellar tubercle also known as Gerdy’s tubercle on the tibia (3). Figure 1 illustrates the location of the ITB.
The ITB passively functions to resist hip adduction, hip internal rotation and internal rotation of the knee in accordance with its attachments at the pelvis, femur and tibia(3). The gluteus maximus functions, through its attachment, to increase stability through the hip and knee complex by increasing the tension of the ITB(4). It is possible to see, based on its attachments at both the knee and hip, how changes could bring about the onset of ITBS.
Studies have proposed that as the knee flexes and extends the ITB ‘slides or flicks’ over the lateral femoral condyle of the knee causing an irritation beneath. This notion was debated by Falvey and colleagues (5), who stated that it was highly unlikely that the ITB would flick or slide over the bone during knee flexion due to it not being a loose structure. But the authors did agree that the impact of compression on the richly innervated fat pad was pain’s cause but by strain of the ITB where pain presents crossing the lateral femoral condyle. Strain rate and strain magnitude were measured in a prospective study involving female runners (6). The results indicated that frequency of strain of the ITB at the lateral femoral condyle was greater that the strain magnitude. This implies that a runner might have the ability to run for a short period but then incur lateral knee pain because of the strain to the ITB.
MRI scans have ascertained the knee flexion angle of 30� elicited the greatest compression of the ITB at the point of heel strike, whereas others have said that maximal compression occurs between 20-30�(2,6). A knee flexion angle at the point of heel strike has been found to be significantly different with 20.6� in ITBS patients compared to 15.3� in the control(7). Downhill running produces a greater knee flexion angle at the point of heel strike eliciting a larger strain load to the ITB and therefore this is often a main precursor to ITBS (6). Although an elevated knee flexion angle at the point of heel strike has been considered to contribute to ITBS, it is essential to examine the lower extremity from the frontal and transverse planes too and not solely from the sagittal plane (2).
Rearfoot Eversion
It’s possible to envisage how rear foot eversion could contribute to ITBS causing internal rotation of the tibia resulting at the distal attachment in greater strain of the ITB. In contrast Ferber and colleagues (2) indicated that there was no significant difference in the peak eversion angle of the female subjects, who were previously diagnosed with ITBS but were now symptom free, compared to controls. In a similar study non-significant differences were found between the currently symptomatic ITBS patients and controls for rear foot eversion (8).
Louw & Deary(3) found that ITBS patients sometimes demonstrated decreased eversion angles, accompanied by decreased internal rotation of the knee, at the point of heel strike. Ferber and colleagues (2) noted an increased inversion moment in the ITBS group which was suggested to control and limit the eversion moment. By comparison, currently symptomatic ITBS patients demonstrated a substantial difference compared to a control group with twice the rear foot motion during running (9).
Knee Internal Rotation
Peak internal rotation angle of the knee was found to be significantly greater in the ITBS patients when compared with controls at the point of heel strike (2). This research was supported by other studies who also found a significant effect for increased internal rotation of the knee following a run of moderate intensity to physical exhaustion(7). With excessive rotation comes compression due to increased strain of the ITB at the attachment.
An explanation of increased internal rotation of the knee was attributed to excessive external rotation of the femur perhaps due to shortening of the piriformis, gemellus inferior and superior and the obutrator externus (8). The authors added that excessive rotation at the hip might result from muscular activity of the rotators that were hip being the medius, minimus and the tensor fascia latae. These studies(2,7) were retrospective in design in that they tested healthy runners with a history of ITB pain, whereas(8) was a prospective study of patients with ITBS at the point of testing.
Hip Adduction Angle & Hip Abductor Strength
The hip adduction angle during the stance phase has been suggested to be greater. Ferber and colleagues(2) found that the peak hip adduction angle was significantly greater in the ITBS cohort and stated that with 95% confidence. Increased angle results in increased stress to the ITB and consequently increased compression at the lateral femoral condyle when combined with increased internal rotation of the tibia.
Figure 2 illustrates, when peak hip adduction and internal rotation combine, how this may result in increased the compression of the ITB at the lateral femoral condyle. Louw and Deary(3), however, stated that it remained inconclusive whether the peak hip adduction angle was a substantial element. Additional research is therefore required to support Ferber and colleagues'(2) initial findings as this study was a retrospective study carried out on healthy female runners with a history of ITBS.
Hip Abductor Strength
It’s been proposed that an increased peak hip adduction angle may coincide with hip abductor activity involving the gluteus medius in this group. During the stance phase of gait the gluteus medius functions to keep stability. Research has indicated that during stance the adduction forces can exceed three times an individual’s body weight(3). What’s more, it was stated that these forces were beyond the metabolic capacity of the gluteus medius to main pelvic stability during the stance phase using just this muscle alone(3).
Louw and Deary (3) were not able to identify a heightened hip abductor moment in the ITBS patients with increased peak hip adductor angles and suggested that it was more of an issue of timing as opposed to the size of the hip abductors. Louw and Deary (3) stated that the research is yet to examine trunk and pelvic movements in ITBS patients and it is plausible to suggest that biomechanical changes from higher up the kinetic chain has the potential to be a contributing element in ITBS etiology.
A research study of 24 (14 female, 10 male) patients with ITBS undertook a six-week rehabilitation programme to increase the strength of the hip abductors(10). Following six weeks of hip abductor strengthening to running 22 patients reported being pain-free and had returned. The female patients reported an average hip abductor torque increase of 34.9% and the male patients found 51.4% increase. However this study used a hand held dynamometer to measure isometric strength and therefore Fedricson (10) findings should be viewed with caution.
A more recent study assessed the hip abductor strength of currently symptomatic patients with healthy controls in a fixed position(11). The results indicated that no substantial differences occurred for static and dynamic hip abductor strength between the groups. Further research should look into the EMG and strength of the hip abductors in the role of managing ITBS. Table 1 shows of significance in the some of the variables of the studies used in this text.
Rehabilitation programs, following periods of immobilization and during, should include gluteal exercises to provide stability to the leg that is involved. If active exercises for the gluteal muscles are provided in a manner that is secure and effective then this can influence the period of transition from non weight. It’s prudent based on the research provided to date to develop function although research is lacking in terms of quality and volume as to the biomechanical influences on the etiology of ITBS. This guarantees that once load bearing commences that the leg that is involved has the stability and control that is active to keep the beginning of load of the ITB.
Summary
The recent review published by Louw and Deary(3) indicates that much of the research published within the literature depending on the etiology of ITBS is inconclusive. The level of research is relatively low and is based on retrospective trials. The research does indicate that knee biomechanics and abnormal hip is involved in the occurrence of ITBS. The authors ascertain that muscle strength is involved as is foot biomechanics that are abnormal. It is recommended that future research should measure kinematic movements of the hip and knee during downhill running as this is a complaint of ITBS onset.
References
1.Clini J of Sports Med, May 2006,16, (3), 261-268
2.J of Sports Phys Therap, Feb, 2010, 40, 2, 52-58.
3.Phys Therap in Sport, 2014, 15, 64 e75.
4.Surgic and Radiologic Anatomy (Dec) 2004; 26, (6), 433 – 446
5.Scand J of Med & Sci in Sports, Aug 2010, 20 (4), 580-587.
6.Clini Biomech, 2008, 23, 1018-1025.
7.Gait Posture. 2007 Sep, 26 (3), 407-13
8.Clini Biomech, Nov 2007, 22 (9), 951-956.
9.Med Sci in Sport & Ex, 1995, 27, 951-960.
10.Clini J of Sports Med, 2000, 10:169�175.
11. Int J of Sports Med, Jul, 2008, 29 (7), 579-583.
If given the opportunity, a herniated disc can occur as a consequence of trauma and can create a plethora of problematic symptoms which might become chronic pain conditions. Whiplash is most frequently associated with car collisions, but can actually happen from any injurious procedure that snaps the neck forward or back beyond its normal selection of movement.
This informative article will detail the prevalence of herniated discs related to whiplash events. We’ll investigate how whiplash occurs and how the process can enact disc injury in the cervical or upper thoracic spinal regions.
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Whiplash Herniated Disc Incidents
Whiplash happens because of abrupt acceleration, or more commonly, sudden deceleration. Inertia is the force which can create harm to the spinal structures and the throat muscles at the neck and back.
The head is a really heavy weight that is supported by the slightly thinner and weaker vertebrae and intervertebral discs in the cervical spine. When inertia is applied to the entire body, the head will snap backwards or forward, causing both and typically hyperflexion or hyperextension. As it whips about causing an assortment of injurious events that are possible, including a herniated disc, this heavy weight places stress on the cervical spine.
Herniated Disc Pain and Discomfort
Whiplash typically occurs from severe trauma, such as an automobile accident, slip and fall, sports injury or act of violence. Any situation which causes the head to jolt abruptly back-and-forth, can cause whiplash.
Whiplash is a condition which sometimes occurs after an accident, but could also take some time to become apparent. The reasons for this time delay response vary, but are commonly linked to three possible causations:
First, it’s the pain relieving quality of adrenaline, which often fills the bodily systems during a crash. This can diminish the severity symptoms which might otherwise be debilitating when they occur. Second, is the psychological nocebo effect of the trauma, which could take some time to infiltrate and to come up within the subconscious mind. Finally, the secondary gain principle enacted by legal action having to do with the accident might causes time delay. It’s no coincidence that people begin to experience pain right around the time they seek professional help.
Whiplash & Herniated Disc Consequences
The vast majority of whiplash complaints are due to muscular injury, not damage to the spinal column. Neck muscle pain can be extremely severe, but is not a significant worry and should resolve with symptomatic treatment.
Extreme trauma or highly focused trauma can cause a bulging disc or even a ruptured disc in the neck or upper back. Symptoms are very likely to be painful for a number of weeks, but should resolve within 2 months, as is typical for practically any disc injury condition with the proper treatment and care.
Other less common effects of severe whiplash might incorporate a change in the natural curvature of the spine, a fractured or shattered vertebra or a torn ligament or tendon.
Whiplash Herniated Disc Guidance
A lot of men and women suffer whiplash traumas on a daily basis. These types of injuries are an inherent part of the fear we have towards spinal damage and are an integral component of litigation. Both of these factors make judging the actual degree of any whiplash neck injury complicated.
Pain is often worsened or perpetuated through psychosomatic or secondary gain factors, instead of structural anatomical problems. It is crucial, as a patient, to look past the psychological and legal implications of your injury and concentrate on your recovery.
The neck, like every other area of the human body, was made to heal, but will only do so in the event that you give it the mental and emotional support and trust it requires.
There isn’t anything more important than your health. Unfortunately, this is a lesson for those who endure a plethora of herniated disc treatments and eventual disc surgery simply to bolster a case that is legal. When the case is over, you might have some money, but is it really worth it to lose your freedom and functionality for the remainder of your life?
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
The accident-type most-associated with whiplash is being rear-ended. Let us take a glance at how this kind of accident happens. Most people think that when you could be rear ended, your head flies back. Although that is the logical way to consider the harm (it’s also how I will discuss it most of the time), it is not technically accurate.
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Process of Whiplash Injury
When you are rear-ended what happens is that your body is driven out from under your head. Although there is a great deal of soft tissue stretching that occurs in the soft tissues (LIGAMENTS, TENDONS, MUSCLES, and particularly FASCIA) as your body travels forward at a significantly higher velocity than your head; at some point, these “soft tissues” cannot stretch anymore. This is the first point at which microscopic tissue tearing occurs. Realize that this is the beginning of the injury process. The body will be gradually caught up to by the head, and subsequently overshoot it at an extremely accelerated velocity, all in a fraction of a second.
The head is now accelerating forward faster than your entire body. When the body comes to a stop (i.e. your vehicle slams into whatever is in front of it), the head will continue to travel forward. This is actually where the term “whiplash” comes from, and where it occurs. It’s exactly the principle of physics that results in the tip of a bullwhip to ‘crack’ as it breaks the sound barrier. If this type of ‘whipping’ motion occurs in the neck, it can result in a great deal of soft tissue damage and subsequent formation of fibrosis and scar tissue. Additionally, it may lead to a great deal of occult (hidden) brain and nerve system trauma.
When tissue tears, it ordinarily doesn’t tear like we think of things tearing, in half. As a matter of fact, when you take a look at pulled muscles, these are actually pulled, over-stretched, or microscopically torn fascia. Fascia is the thin membrane that tightly surrounds the muscle. Fascial tearing and the subsequent fascial adhesions present a double-edged sword as far as chronic pain is concerned.
Surround your neck with too much scar tissue, and there is no way your neck will move normally as it did before the motor vehicle accident. Unfortunately, degeneration is caused by abnormal motion, and abnormal joint motion is caused by degeneration. Repeat ad infinitum. Whether or not this cycle was launched by an MVA is immaterial at this stage. The process leads to chronic pain. People who are living inside of this vicious cycle know. Same evaluations, same results. If you’ve been involved in an automobile accident and are experiencing neck pain or other symptoms due to suspected cervical spine damage or injury, seek immediate medical attention.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Each year in america there are between 6.5 million and 7 million MVA’s affecting many individuals. Of those accidents, about three million involve some kind of bodily injury. About two thirds of these injuries, while not debilitating, are permanent. This means that if you play the odds, you’ll be during the course of your lifetime in 4 or 5 car accidents. They are undoubtedly the major cause although MVA’s are certainly not the sole cause of injuries, such as whiplash.
What is the significant whiplash sign we look for as far as imaging is concerned? A simple neutral lateral x-ray of the cervical spine is about as good as anything to demonstrate the extent of damage or injury.
When an individual experiences whiplash, their fascia is often damaged or injured as their head slams backwards. Sooner or later the individual begins to get neck pain, headaches, and a loss of range of motion in their neck. The problem is that a Fascial Adhesion in the SCM may be pulling on their neck. A restriction (Fascial Adhesion) in the SCM is going to pull the head forward.
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Normal Cervical Curves
Although you should not have spinal curves that run from 1 side of your body to the other (Scoliosis), it’s absolutely crucial to have the proper spinal curves that run from front to back. The normal front-to-back curve in your neck, should be the same as the front-to-back curve in your low back (lordosis) — the opposite of the curve in your mid back (kyphosis). Normal curves allow for normal motion, they act as shock absorbers. Think for a moment about it. A normal curve will dissipate much of the force, spreading it out like a spring when you walk down the sidewalk.
Abnormal Cervical Curves
Abnormal curves of the cervical spine (neck) come in two forms. You have the loss of cervical lordosis. This is the “Military Neck” you see in the first x-ray. Secondly, you get a complete reversal of the lordotic curve (second x-ray). These are some of the steps on the road to Degenerative Arthritis.
For those of you understanding the nature whiplash injury and the NEW MODEL of Repair and Tissue Healing, this picture of the PLATYSMA MUSCLE should help. The Platysma is a thin muscle that covers the entire front portion of the neck. It is likewise covered in Fascia. This is just one more piece of the puzzle so far as explaining the Chronic Pain people struggle with after a whiplash injury — by imaging which is always negative, pain that is not explained. And like SCM Muscles that are injured, it helps to explain the cervical curves. It pulls, as it restricts, and as it pulls, the head will come. Think that Forward Head Posture is no big deal? THINK AGAIN.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Automobile accidents are one of the leading causes of spine injuries and are responsible for more than 40 percent of injuries every year. That is a troubling statistic. Because automobile accidents cannot always be prevented, having the right understanding of spine injuries can allow people to recognize injury and seek proper treatment.
The spine is an intricate structure, but additionally it is delicate. The spine isn’t designed to withstand the harmful effects of an automobile accident. Regrettably, spine and neck injuries are common during auto collisions; the impact damages the muscles and the ligaments in the back, and the facet joints bear the brunt of the force. This could result in injuries, such as compression fractures, disk herniation, whiplash, and spondylolisthesis.
It is essential to be able to spot the symptoms of damage or injury, so if you or someone you love is hurt, its important to understand what steps you should follow for proper care. Some auto accidents may be made worse when the injured individual is moved. You should seek the assistance of a medical professional if you experience back or neck pain following an automobile collision. A muscle strain may heal by itself, but if neck or back pain persists due to a much more serious condition or injury, the affected individual could feel pain for months or years if left untreated.
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Identifying Damage or Injury
How do you know if back or neck pain is simply a muscle strain, or even a more significant injury or condition? Until you are evaluated by a healthcare specialist, you likely won’t know for certain, however there are a number of indications that may indicate that aid is needed. A few of the neck and back injuries include:
Whiplash
Whiplash is more common during rear-end collisions, as the force from impact suddenly pushes the head backward, then forward, much like the movement of hammering a whip. Front-end collisions generally do not result in whiplash, as the headrest often stops the motion of the head and neck. Symptoms of whiplash will appear within one day of the crash, and might include stiffness and pain in the neck, headaches which are often at the bottom of the skull, dizziness, blurred vision, and fatigue. Sometimes, an individual with whiplash may experience difficulty concentrating, memory problems, ringing in the ears, difficulty sleeping, and irritability.
Spinal Fractures
Compression fractures are common in the thoracic and cervical spine (middle and lower back) after a car crash. While the entire body is held in place with a seatbelt, during impact, the body may be thrown forward. This can pull on the vertebrae. As the vertebrae may rarely move, in some cases, spinal fractures may result in spinal cord injuries. Those with spinal cord injuries may experience tingling, numbness, weakness, or loss of bowel and bladder control, although the main symptom of a spinal fracture is mild to severe back pain that interferes with movement. When a fracture is suspected, it is important not to move the injured person; harm could be caused by motion.
Spondylolisthesis
Spondylolisithesis occurs when a vertebra shifts from place because of a stress fracture in bone. The bone that is displaced can press on the nerves or narrow the spinal canal, causing pain, numbness, or weakness in the buttock or leg, and trouble walking. In extreme cases, it may lead to loss of bladder or bowel control. Some people don’t experience symptoms until many years later, or experience no symptoms in any way.
Disc Herniation
Considering that the discs absorb the vast majority of the impact to the spine, it is possible to get a disc to herniate through an automobile crash. A disc is herniated if its tender core pushes through a little crack in the outside of the disc, irritating the nerves. Many people today experience no symptoms, but others might experience leg or arm pain, depending on the location of the herniated disc, and might experience tingling, numbness, or weakness in the region.
What to Do if You’ve Got a Spinal Injury
Should you encounter any back or neck pain at all following a car crash, you should be evaluated by a healthcare professional to rule out any severe injury. But, it is important to get medical care immediately in case you experience tingling, numbness, fatigue, or lack of bowel or bladder control. These are indications of a more serious injury that has to be addressed immediately.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Spinal cord injury (SCI) can have many causes. The way a person’s injury affects them can differ depending on the origin of SCI. SCI can generally be described as being ‘traumatic’ or due to a trauma, or ‘non-traumatic’ being due to other causes.
Spinal cord injuries occur in an assortment of ways. In adults, damage to the spinal column is usually involved and the cord is affected, bruised, stretched or compacted due to movement or an external force. Wear and tear on the spinal column, can lead to narrowing of the canal called stenosis. This results in pressure on the spinal nerves and the spinal cord, causing loss of function. In children, a spinal cord injury occurs by an over-stretching of the spinal cord.
Automobile accidents involving pedestrians or occupants, falls, sport-related accidents and diving into shallow water are considered to be the most common cause of traumatic SCI.
Spinal cord damage can be caused by the following kinds of injuries:
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Flexion Injuries
Flexion injuries occur when there is a forcible forward movement of the head. This results in injury to the vertebrae in the neck (cervical) area of the spinal column. The vertebrae then impact on the spinal cord, causing damage. Spinal ligaments are often torn. These types of injuries occur in auto accidents.
Rotation Injuries
Rotation injuries occur alongside an injury, often where there is rotation of the spinal column. This leads to an associated injury of the spinal cord. Ligaments are often torn where the side rotation injuries happen in automobile accidents. They can also occur with people in motorcycle accidents, and wearing lap seat belts.
Compression Injuries
Compression injuries occur in diving accidents, where the force is transmitted through the head; or falls from a height, where the force is transmitted through the base of the spine or limbs. Impact causes the vertebrae commonly in the cervical or lower thoracic and lumbar region, to fracture into pieces and protrude into the spinal canal, damaging the spinal cord. The discs may be displaced and protrude into the spinal canal.
Hyperextension Injuries
Hyperextension injuries occur during an incident, such as a fall, where the neck is extended in a backward direction, stretching the cord. The spinal cord is damaged by the opening up of the discs and stretching of the ligaments if there’s minimal damage to the spinal column. This injury is often seen in people, and those injured in assaults and auto accidents. Hyperextension of the neck is the way children damage their spinal cords. The force of the trauma causes stretching of the spinal cord, although there’s often no or little damage to the spinal column.
Penetrating Injuries
Penetrating injuries occur when the spinal cord is penetrated by an object such as a knife or bullet. This type of injury can occur at any level of the spinal column and is often not associated with column damage.
Whether an injury is caused by events that are traumatic or non-traumatic, a person with a SCI has the ability to benefit from a variety of treatment options and rehabilitation, performed by a qualified and experienced healthcare professional. Research has indicated that the outcomes for people with a SCI are better if they have rehabilitation in a specialist unit as opposed to a general rehabilitation unit.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
The cervical spine is C shaped, with its curve facing towards the rear of neck. The upper part of the spine in the neck is called the cervical spine and it’s composed of 7 cervical vertebra. A healthy cervical spine has a lordotic curve and it is anatomically important to bear the head’s weight.
Reduction of cervical lordosis can result in straightening of the cervical spine or in severe cases it may reverse the curve. The condition is also known as kyphosis. Loss of cervical lordosis may lead to stiffness and pain in the neck. It may also lead to referred pain in the hand, vertigo and many other symptoms.
Improper posture and muscular spasm are two important causes for reduction of cervical curvature. The problem is usually detected on X-rays of the cervical spine and it should be treated soon to prevent further deterioration and complications in the future.
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Causes of Loss of Cervical Lordosis
Loss of cervical curvature usually occurs in adults. Children suffer from this issue as well although it is rare. Both women and men are equally affected. The condition is associated with long standing spasms of muscles in the neck.
Poor neck posture is often the only cause in young individuals. Working on a computer for long periods or doing desk work for long time without taking break can strain the muscles of the neck. The muscles cause a pull on the cervical vertebra. Prolonged pull will automatically disturb the normal alignment of the cervical spine. Injury to cervical spine may also lead to loss of cervical lordosis. A whiplash injury from automobile accident trauma on the neck can contribute to muscle strain and loss of curvature of the cervical spine.
Osteoporosis is another important factor that might cause abnormality in cervical spine curvature. It is mostly seen among elderly individuals. In osteoporosis the bone density of the vertebrae is lost. The weight of normal wear and tear may put pressure on the spine. Obesity and hereditary skeletal disorders, such as achondroplacia, can also change the curvature of the spine. Other less common causes of loss of cervical lordosis include tumor of cervical spine, systemic disease such as ankylosing spondylitis etc.. Radiotherapy for cancer between can also cause loss of spine curvature.
Loss Of Cervical Lordosis Symptoms
Loss of cervical lordosis involves an ongoing gradual procedure. It is a phenomenon. In its start phase the condition remains silent. This means there are no symptoms. And it’s detected accidentally on X-ray meant for some other purpose. After months or years, the individual may present complaints such as pain and stiffness in the neck.
A normal cervical lordosis has a 30 to 40 degree curve. Once the curve gets lesser than 20 degrees, the patient may complain about neck pain. It may lead to tingling in hands and fingers and may lead to cervical disc degeneration. These symptoms aren’t exactly those from compression of cervical vertebra, but because of pinched nerve because of loss of lordosis.
Loss of cervical lordosis also results in tension in the spinal cord and carotid blood vessels which supply blood to the head. Improper blood flow in the brain can result in dizziness, headaches, confusion, tinnitus etc..
Treatment for Loss of Cervical Lordosis
Loss of cervical lordosis may be detected on physical examination from diagnostic tests such as X-ray and MRI of the cervical spine. These evaluations are important to know the magnitude of loss of lordosis and nerve damage.
Medical treatment is only required when pain and stiffness are present. Muscle relaxants and pain killers will help to reduce spasms and pain of neck muscles. This increase the variety of motion of neck and will alleviate the distress.
Once first acute symptoms are relieved patient should start physiotherapy exercises aimed at strengthening the neck muscles and improvement of posture. A simple neck exercise is to bend the head forward and backward. Second exercise is to turn the neck and head sideways five to six times in a day. Severe case of loss of cervical lordosis may require the individual to wear a neck brace during day time and support pillows while sleeping. Both will help to restore the altered curvature of the spine.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
The normal cervical lordosis is the natural curve of the neck when viewed from the side, the convexity is on the front and the concavity is on the back.
This curve starts to form as early as 10 months of development and is cemented during adolescence and infancy. Holding a child’s head in extension is quite important for infants as it encourages the normal curvature of the neck. Loss of lordosis can begin in early childhood, however, whiplash from automobile accidents, stress, injuries from falls and sports injuries can cause this issue in adulthood. Unfortunately, many of our “normal” daily tasks may also decrease the cervical lordosis, like viewing low lying computer screens (below eye level), sleeping with two pillows, as well as sitting in a recliner.
Many studies are demonstrating a clear causal connection between loss of lordosis and neck complaints, including neck stiffness and pain, headaches, premature degeneration, disc herniation, and numbness/tingling or weakness in the arms. A study from 1974 showed that a sharp reversal of the curve would lead to degenerative changes in 60 percent of patients. Literally, a reversed curve causes arthritis in the neck. A study from 2005 in the Journal of Manipulative and Physiologic Therapeutics found:
“The odds that a patient with cervical pain had a lordosis of 0 degrees or less was 18 times greater than for a patient having a non-cervical complaint. Patients with cervical pain had less lordosis and this was consistent over all age ranges” The authors of this study went so far as to recommend “Maintenance of a lordosis could be a clinical goal for chiropractic treatment”
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Effects of Loss of Cervical Lordosis
But why neck pain? What does loss of the curve do to cause pain? Tingling? Numbness? Headaches? It’s actually very simple. Where they would not bear weight weight bearing stress is placed by A lack of lordosis onto joints at the neck. This causes muscle spasm, stiffness, and inflammation to stabilize the region. Muscles in the upper part of the neck then irritate nerves that travel up and over your head into the scalp. Supporting ligaments in the back of the neck stretch and those in front contract, working to further stabilize the neck in this unnatural posture, as time progresses. Weight is born mainly on the lower segments of the neck (C5-7), which then typically degenerate first. Arthritic spurring progresses in these dysfunctional segments, which could then impinge the exiting nerve roots and cause symptoms in the arms and hands like tingling, numbness, electrical shocks, and fatigue.
Tension After Auto Accident
As the curve becomes kyphotic, other neurologic complaints can attest. The spinal cord is tethered at the top by its attachment to the brain, and in the bottom by the lumbar nerve roots and meningeal attachment to your tailbone. The spinal cord is tractioned and forced against the back of the bodies of the vertebrae in the neck when the ordinary throat curve is reversed. This can cause sensory difficulties anywhere in the body as the pathways for sensation are located in the rear of the cord, and thus are affected by traction. The motor pathways are in the front of the cord and are compressed rather than stretched. Compression of a nerve is never a good thing, particularly when it’s the cord.
What many folks do not know is that most nerve fibers are insulated by a fatty layer called “myelin.” This layer works to allow the signal the nerve creates to travel at faster speeds than it could. Compression of a nerve may result in the death of those cells which maintain this layer; causing the signal the nerve carries to be permanently slower and thus not produce its intended effect. An animal study from 2005 hunted to replicate demyelination (a common diagnostic criteria for Multiple Sclerosis) via cervical kyphosis in Japanese small game fowls. That study’s results were startling. The authors concluded:
“Progressive kyphosis of the cervical spine resulted in demyelination of nerve fibers in the funiculi and neuronal loss in the anterior horn due to chronic compression of the spinal cord. These histologic changes seem to be associated with both continuous mechanical compression and vascular changes in the spinal cord.”
Treatment for Loss of Cervical Lordosis
In short, the reversed curve caused changes in the spinal cord indicative of progressive neurologic conditions. The cervical kyphosis was obtained using methods, but like any symptom of a cause, there are levels of dysfunction. The mechanical methods would hold true, although the methods used in this trial prevent duplication in humans as a result of obvious implications. It’s a fascinating area of research and one I hope continues to grow. To reiterate, the researchers showed that a cervical kyphosis (loss of cervical curve) causes changes in the spinal cord that lead to progressive neurologic degeneration. As Chiropractors, we’ve argued this for generations.
Chiropractic focuses on alignment of the spine so that the nervous system can function optimally. Research is showing a lack of adequate cervical lordosis is a element in a broad variety of conditions, some of which are severe.
If you are experiencing any of these symptoms–headache, stiff neck, neck pain, numbness, tingling, or weakness of your hands, or you’d like to get yourself or your family checked, make sure to seek help from a qualified and experienced healthcare professional to fix the cause.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Whiplash has been difficult to study because its pathoanatomy has remained poorly known, however, the facet joints have been recently isolated as a site of pain in many people that are whiplash-injured.
In a typical rear-end collision, the occupant’s pelvis, chest, and head are hastened forward in rapid succession. The massive inertia of the head leads to a horizontal translation (retraction) of the initially stationary head relative to the forward-accelerating torso, and this movement induces compression, shear, and ultimately tension in the cervical spine.
Recent studies have localized the chronic pain of several whiplash patients to the facet joints. Subsequent experiments involving both human subjects and cadaveric cells have demonstrated that harm to the capsular ligaments may play a part in the pathoanatomy of whiplash injury.
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Kinematics of Whiplash Injuries
Biomechanical studies of whiplash injury have used human subjects, animals, cadavers, and mathematical models to investigate possible mechanisms of whiplash injury. Researcher ignorance of the tissues responsible for the pain has often limited the insights. Recent studies, however, has identified a candidate tissue for whiplash injury, and it has provided a focus for research into the mechanics of whiplash injury.
The comprehension of injury mechanics begins with an appreciation of how individuals respond to the kinds of perturbations that create whiplash injury. Rear-end collisions, where an occupant’s vehicle is struck from behind and hastened forward, have been associated with an increased risk of whiplash injury and a higher frequency of symptoms compared to other crash directions. As a result, perturbations that simulate a collision have been used by most biomechanical experiments conducted to investigate whiplash injury. Many research groups have studied subjects exposed to whiplash perturbations, and despite differences in subjects, vehicles, seats, and the crashes used with these groups, a stereotyped reaction has been observed in normally seated subjects.
The pelvis is hastened forward, due to a combination of occupant posture and seat compliance, acceleration of the torso lags behind acceleration of the pelvis. This difference in motion between the pelvis and upper torso produces a small rotation of the torso and leads to an initial flexion of the neck, despite the fact that the head is still effectively stationary at this stage in the induced kinematic response. As the torso accelerates forward relative to the head, a horizontal translation develops between the base of the head and the spine, causing the lower vertebrae of the spine to extend. The horizontal shear stiffness of the upright spine is inadequate to overcome the rotational and transitional inertia of the head, and because of this, the upper cervical segments bend. The changing configuration of the vertebrae results in the cervical spine being better able to encourage horizontal forces, and these forces both accelerate the bottom of the skull forward and establish a rearward rotation (expansion) of the head.
In the presence of a properly positioned head restraint, both the head extension angle and the horizontal translation between the torso and head (retraction) are arrested and reversed by the combination of an external force applied to the head from the head restraint and inner forces developed by both the ligamentous cervical spine and the reflex contraction of the cervical muscles.
Larger extension and retraction motions occur, and head motion could be arrested and reversed by inner ligamentous and muscle forces if no head restraint is present or if there exists a gap between the back of the head and the head restraint. The positions of the head and head restraint at effect can therefore have a substantial influence on the magnitude of the head and neck kinematics, and ultimately on the size of the loads applied to the tissues of the cervical spine.
After the interaction with the seat back and head restraint, the head and chest rebound forward. Forward torso motion could be limited by a seatbelt, whereas forward motion of the mind seems to be controlled by sustained activation of the posterior neck muscles.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, are frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. The sheer force of an impact can cause damage or injury to the cervical spine, as well as to the rest of the spine. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. Fortunately, a variety of treatments are available to treat automobile accident injuries.
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