Back Clinic Conditions Treated. Chronic Pain, Auto Accident Care, Back Pain, Low Back Pain, Back Injuries, Sciatica, Neck Pain, Work Injuries, Personal Injuries, Sports Injuries, Migraine Headaches, Scoliosis, Complex Herniated Discs, Fibromyalgia, Wellness & Nutrition, Stress Management, and Complex Injuries.
At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we are focused on treating patients after debilitating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities.
If Dr. Alex Jimenez feels you need other treatment, then you will be referred to a clinic or Physician that is best suited for you. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, and premiere rehabilitation providers to bring El Paso the top clinical treatments to our community. Providing the top non-invasive protocols is our priority. Clinical insight is what our patients demand in order to give them the appropriate care required. For answers to any questions you may have please call Dr. Jimenez at 915-850-0900
These assessment and treatment recommendations represent a synthesis of information derived from personal clinical experience and from the numerous sources which are cited, or are based on the work of researchers, clinicians and therapists who are named (Basmajian 1974, Cailliet 1962, Dvorak & Dvorak 1984, Fryette 1954, Greenman 1989, 1996, Janda 1983, Lewit 1992, 1999, Mennell 1964, Rolf 1977, Williams 1965).
Clinical Application of Neuromuscular Techniques: Piriformis
Assessment of Shortened Piriformis
Test (a) Stretch test. When short, piriformis will cause the affected side leg of the supine patient to appear to be short and externally rotated. With the patient supine, the tested leg is placed into flexion at the hip and knee so that the foot rests on the table lateral to the contralateral knee (the tested leg is crossed over the straight non-tested leg, in other words as shown in Fig. 4.17). The angle of hip flexion should not exceed 60� (see notes on piriformis in Box 4.6).
Figure 4.17 MET treatment of piriformis muscle with patient supine. The pelvis must be maintained in a stable position as the knee (right in this example) is adducted to stretch piriformis following an isometric contraction.
The non-tested side ASIS is stabilised to prevent pelvic motion during the test and the knee of the tested side is pushed into adduction to place a stretch on piriformis. If there is a short piriformis the degree of adduction will be limited and the patient will report discomfort behind the trochanter.
Test (b) Palpation test (Fig. 4.18) The patient is side-lying, tested side uppermost. The practitioner stands at the level of the pelvis in front of and facing the patient, and, in order to contact the insertion of piriformis, draws imaginary lines between:
ASIS and ischial tuberosity, and
PSIS and the most prominent point of trochanter.
Where these reference lines cross, just posterior to the trochanter, is the insertion of the muscle, and pressure here will produce marked discomfort if the structure is short or irritated.
Figure 4.18 Using bony landmarks as coordinates the commonest tender areas are located in piriformis, in the belly and at the attachment of the muscle.
If the most common trigger point site in the belly of the muscle is sought, then the line from the ASIS should be taken to the tip of the coccyx rather than to the ischial tuberosity. Pressure where this line crosses the other will access the mid-point of the belly of piriformis where triggers are common. Light compression here which produces a painful response is indicative of a stressed muscle and possibly an active myofascial trigger point.
Piriformis Strength Test
The patient lies prone, both knees flexed to 90�, with practitioner at foot of table grasping lower legs at the limit of their separation (which internally rotates the hip and therefore allows comparison of range of movement permitted by shortened external rotators such as the piriformis).
The patient attempts to bring the ankles together as the practitioner assesses the relative strength of the two legs. Mitchell et al (1979) suggest that if there is relative shortness (as evidenced by the lower leg not being able to travel as far from the mid-line as its pair in this position), and if that same side also tests strong, then MET is called for. If there is shortness but also weakness then the reasons for the weakness need to be dealt with prior to stretching using MET.
Box 4.6 Notes on Piriformis
Piriformis paradox. The performance of external rotation of the hip by piriformis occurs when the angle of hip flexion is 60� or less. Once the angle of hip flexion is greater than 60� piriformis function changes, so that it becomes an internal rotator of the hip (Gluck & Liebenson 1997, Lehmkuhl & Smith 1983). The implications of this are illustrated in Figures 4.17 and 4.19.
This postural muscle, like all others which have a predominence of type l fibres, will shorten if stressed. In the case of piriformis, the effect of shortening is to increase its diameter and because of its location this allows for direct pressure to be exerted on the sciatic nerve, which passes under it in 80% of people. In the other 20% the nerve passes through the muscle so that contraction will produce veritable strangulation of the sciatic nerve.
In addition, the pudendal nerve and the blood vessels of the internal iliac artery, as well as common perineal nerves, posterior femoral cutaneous nerve and nerves of the hip rotators, can all be affected.
If there is sciatic pain associated with piriformis shortness, then on straight leg raising, which reproduces the pain, external rotation of the hip should relieve it, since this slackens piriformis. (This clue may, however, only apply to any degree if the individual is one of those in whom the nerve actually passes through the muscle.)
The effects can be circulatory, neurological and functional, inducing pain and paraesthesia of the affected limb as well as alterations to pelvic and lumbar function. Diagnosis usually hinges on the absence of spinal causative factors and the distributions of symptoms from the sacrum to the hip joint, over the gluteal region and down to the popliteal space. Palpation of the affected piriformis tendon, near the head of the trochanter, will elicit pain and the affected leg will probably be externally rotated.
The piriformis muscle syndrome is frequently characterised by such bizarre symptoms that they may seem unrelated. One characteristic complaint is a persistent, severe, radiating low back pain extending from the sacrum to the hip joint, over the gluteal region and the posterior portion of the upper leg, to the popliteal space. In the most severe cases the patient will be unable to lie or stand comfortably, and changes in position will not relieve the pain. Intense pain will occur when the patient sits or squats since this type of movement requires external rotation of the upper leg and flexion at the knee.
Compression of the pudendal nerve and blood vessels which pass through the greater sciatic foramen and re-enter the pelvis via the lesser sciatic foramen is possible because of piriformis contracture. Any compression would result in impaired circulation to the genitalia in both sexes. Since external rotation of the hips is required for coitus by women, pain noted during this act could relate to impaired circulation induced by piriformis dysfunction. This could also be a basis for impotency in men. (See also Box 4.7.)
Piriformis involvement often relates to a pattern of pain which includes: pain near the trochanter; pain in the inguinal area; local tenderness over the insertion behind trochanter; SI joint pain on the opposite side; externally rotated foot on the same side; pain unrelieved by most positions with standing and walking being the easiest; limitation of internal rotation of the leg which produces pain near the hip; and a short leg on the affected side.
The pain itself will be persistent and radiating, covering anywhere from the sacrum to the buttock, hip and leg including inguinal and perineal areas.
Bourdillon (1982) suggests that piriformis syndrome and SI joint dysfunction are intimately connected and that recurrent SI problems will not stabilise until hypertonic piriformis is corrected.
Janda (1996) points to the vast amount of pelvic organ dysfunction to which piriformis can contribute due to its relationship with circulation to the area.
Mitchell et al (1979) suggest that (as in psoas example above) piriformis shortness should only be treated if it is tested to be short and stronger than its pair. If it is short and weak (see p. 110 for strength test), then whatever is hypertonic and influencing it should be released and stretched first (Mitchell et al 1979). When it tests strong and short, piriformis should receive MET treatment.
Since piriformis is an external rotator of the hip it can be inhibited (made to test weak) if an internal rotator such as TFL is hypertonic or if its pair is hypertonic, since one piriformis will inhibit the other.
Box 4.7 Notes on Working and Resting Muscles
Richard (1978) reminds us that a working muscle will mobilise up to 10 times the quantity of blood mobilised by a resting muscle. He points out the link between pelvic circulation and lumbar, ischiatic and gluteal arteries and the chance this allows to engineer the involvement of 2400 square metres of capillaries by using repetitive pumping of these muscles (including piriformis).
The therapeutic use of this knowledge involves the patient being asked to repetitively contract both piriformis muscles against resistance. The patient is supine, knees bent, feet on the table; the practitioner resists their effort to abduct their flexed knees, using pulsed muscle energy approach (Ruddy�s method) in which two isometrically resisted pulsation/contractions per second are introduced for as long as possible (a minute seems a long time doing this).
Figure 4.19 MET treatment of piriformis with hip fully flexed and externally rotated (see Box 4.6, first bullet point).
Figure 4.20 A combined ischaemic compression (elbow pressure) and MET side-lying treatment of piriformis. The pressure is alternated with isometric contractions/stretching of the muscle until no further gain is achieved.
MET Treatment of Piriformis
Piriformis method (a) Side-lying The patient is side-lying, close to the edge of the table, affected side uppermost, both legs flexed at hip and knee. The practitioner stands facing the patient at hip level.
The practitioner places his cephalad elbow tip gently over the point behind trochanter, where piriformis inserts. The patient should be close enough to the edge of the table for the practitioner to stabilise the pelvis against his trunk (Fig. 4.20). At the same time, the practitioner�s caudad hand grasps the ankle and uses this to bring the upper leg/hip into internal rotation, taking out all the slack in piriformis.
A degree of inhibitory pressure (sufficient to cause discomfort but not pain) is applied via the elbow for 5�7 seconds while the muscle is kept at a reasonable but not excessive degree of stretch. The practitioner maintains contact on the point, but eases pressure, and asks the patient to introduce an isometric contraction (25% of strength for 5�7 seconds) to piriformis by bringing the lower leg towards the table against resistance. (The same acute and chronic rules as discussed previously are employed, together with cooperative breathing if appropriate, see Box 4.2.)
After the contraction ceases and the patient relaxes, the lower limb is taken to its new resistance barrier and elbow pressure is reapplied. This process is repeated until no further gain is achieved.
Piriformis method (b)1 This method is a variation on the method advocated by TePoorten (1960) which calls for longer and heavier compression, and no intermediate isometric contractions.
In the first stage of TePoorten�s method the patient lies on the non-affected side with knees flexed and hip joints flexed to 90�.The practitioner places his elbow on the piriformis musculotendinous junction and a steady pressure of 20�30 lb (9�13 kg) is applied. With his other hand he abducts the foot so that it will force an internal rotation of the upper leg.
The leg is held in this rotated position for periods of up to 2 minutes. This procedure is repeated two or three times. The patient is then placed in the supine position and the affected leg is tested for freedom of both external and internal rotation.
Piriformis method (b)2 The second stage of TePoorten�s treatment is performed with the patient supine with both legs extended. The foot of the affected leg is grasped and the leg is flexed at both the knee and the hip. As knee and hip flexion is performed the practitioner turns the foot inward, so inducing an external rotation of the upper leg. The practitioner then extends the knee, and simultaneously turns the foot outward, resulting in an internal rotation of the upper leg.
During these procedures the patient is instructed to partially resist the movements introduced by the practitioner (i.e. the procedure becomes an isokinetic activity). This treatment method, repeated two or three times, serves to relieve the contracture of the muscles of external and internal hip rotation.
Piriformis method (c) A series of MET isometric contractions and stretches can be applied with the patient prone and the affected side knee flexed. The hip is rotated internally by the practitioner using the foot as a lever to ease it laterally, so putting piriformis at stretch. Acute and chronic guidelines described earlier are used to determine the appropriate starting point for the contraction (at the barrier for acute and short of it for chronic).
The patient attempts to lightly bring the heel back towards the midline against resistance (avoiding strong contractions to avoid knee strain in this position) and this is held for 7�10 seconds. After release of the contraction the hip is rotated further to move piriformis to or through the barrier, as appropriate. Application of inhibitory pressure to the attachment or belly of piriformis is possible via thumb, if deemed necessary.
Piriformis method (d) A general approach which balances muscles of the region, as well as the pelvic diaphragm, is achieved by having the patient squat while the practitioner stands and stabilises both shoulders, preventing the patient from rising as this is attempted, while the breath is held. After 7�10 seconds the effort is released; a deeper squat is performed, and the procedure is repeated several times.
Piriformis method (e) This method is based on the test position (see Fig. 4.17) and is described by Lewit (1992). With the patient supine, the treated leg is placed into flexion at the hip and knee, so that the foot rests on the table lateral to the contralateral knee (the leg on the side to be treated is crossed over the other, straight, leg). The angle of hip flexion should not exceed 60� (see notes on piriformis, Box 4.6, for explanation).
The practitioner places one hand on the contralateral ASIS to prevent pelvic motion, while the other hand is placed against the lateral flexed knee as this is pushed into resisted abduction to contract piriformis for 7�10 seconds. Following the contraction the practitioner eases the treated side leg into adduction until a sense of resistance is noted; this is held for 10�30 seconds.
Piriformis method (f) Since contraction of one piriformis inhibits its pair, it is possible to self-treat an affected short piriformis by having the patient lie up against a wall with the non-affected side touching it, both knees flexed (modified from Retzlaff 1974). The patient monitors the affected side by palpating behind the trochanter, ensuring that no contraction takes place on that side.
After a contraction lasting 10 seconds or so of the non-affected side (the patient presses the knee against the wall), the patient moves away from the wall and the position described for piriformis test (see Fig. 4.17) above is adopted, and the patient pushes the affected side knee into adduction, stretching piriformis on that side. This is repeated several times.
Dr. Alex Jimenez offers an additional assessment and treatment of the hip flexors as a part of a referenced clinical application of neuromuscular techniques by Leon Chaitow and Judith Walker DeLany. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Acupuncture is a safe and effective alternative to pain medications for some emergency room patients, a new study reports.
“While acupuncture is widely used by practitioners in community settings for treating pain, it is rarely used in hospital emergency departments,” said study lead investigator Marc Cohen. He is a professor in the School of Health and Biomedical Sciences at RMIT University in Melbourne, Australia.
The study — billed as the world’s largest randomized, controlled trial of acupuncture in the emergency department — included 528 patients.
The study participants were seen at four Australian emergency departments for acute low back pain, migraines or ankle sprains. Patients who said their level of pain was at least 4 on a 10-point scale received one of three treatments: acupuncture alone; acupuncture with painkillers; or painkillers alone.
One hour after treatment, less than 40 percent of all patients had significant pain reduction, meaning at least a 2-point decline on the 10-point scale. More than 80 percent still had a pain rating of at least 4, the findings showed.
But two days later, most patients were satisfied. Overall, nearly 83 percent of acupuncture-only patients said they would probably or definitely repeat their treatment, compared with about 81 percent in the combined group, and 78 percent who took painkillers alone.
“Emergency nurses and doctors need a variety of pain-relieving options when treating patients, given the concerns around opioids such as morphine, which carry the risk of addiction when used long-term,” Cohen said in a university news release.
The study results suggest acupuncture would be especially beneficial for patients who can’t use standard pain-relieving drugs because of other medical conditions, Cohen added.
But he noted that more research is needed because some patients remained in pain no matter what treatment they received.
The study was published June 18 in the Medical Journal of Australia.
Seeing a doctor of chiropractic, otherwise referred to as DC, chiropractic physician or a chiropractor, can be a beneficial step towards effectively treating low back pain. Below is a quick description of how they help patients resolve their low back pain and what chiropractors do.
What to Expect from a Chiropractor
Chiropractors use a number of treatments made to manipulate joints, the back, and tissues of the body to relieve pain and improve functional ability. Normally, this could be referred to as spinal manipulative therapy (SMT), but you will find several other chiropractic treatment approaches.
A chiropractor tailors her or his treatment strategy depending on the individual needs of a patient, using a traditional philosophy of starting off together with the more natural, less-invasive treatments before moving on to even more aggressive techniques.
At every stage through the procedure, chiropractors preserve a rigorous emphasis on proactively communicating together with the patient exactly what’s going to happen. The chiropractor makes certain the patient comprehends everything that occurs during evaluation, an investigation, and also the proposed procedures, so that you can instruct the patient and receive direct acceptance to start the treatment process.
This emphasis on informed consent is essential because some chiropractic techniques may carry material hazard, which means there could a danger, however, trivial, that an injury could be maybe caused by a particular process.
Nevertheless, a chiropractor also informs a patient of the potential risks attached to abstaining in the process, entirely. Nevertheless, none of this is meant to scare a patient. Make sure that the patient, who has full control over his / her body can make an informed choice and constantly it’s simply thought to remove mistakes.
Chiropractic Procedures
A chiropractor will examine a patient thoroughly prior to making any type of identification or treatment plan. The evaluation can include various aspects, including:
Health history
Look in the characteristics of the pain, keeping an eye out for “red flags,” which suggest that additional diagnostic testing ought to be ran in order to exclude any potentially serious medical problems that may be connected with neck or low back pain-like neurological disorders, fractures, diseases, and tumors.
You will find lots of reasons why low back pain happens. A chiropractor will find out those motives to configure the most appropriate treatment.
Physical examination, including orthopedic and neurological evaluations
Analyze sensory nerves, the reflexes, joints, muscles, as well as other areas of the body.
Advanced Diagnostic Testing
Lab and imaging evaluations aren’t recommended for nonspecific LBP, however they might be required if there are signs of a serious underlying condition.
Severity and Duration of Afflictions
A chiropractor looks at the symptoms and afflictions of sickness or an injury and rationally classifies them based by how serious they are, and the way long they continue.
Symptoms are subdivided into levels of severity: mild, moderate, or serious. In terms of duration, pain (and other symptoms) might be referred to as:
Acute – lasts for less than 6 weeks
Subacute – persists between 6 and 12 weeks
Long-Term – persists for at least 12 weeks
Perennial/flare up – the same symptom(s) reoccurs sporadically or because of exacerbating the original harm
In case a patient is suffering from acute or subacute low back pain, a normal chiropractic therapeutic trial is 2 to 3 weekly sessions over the course of 2 to 4 weeks, going up to 12 complete sessions per trial. Often, this can be sufficient to entirely solve the pain. Other times, additional treatments may be necessary, especially if a patient is struggling with other issues.
Result measurements certainly are a useful tool to get a chiropractor since they could help determine in the event the treatments are showing significant progress.
Some ways a chiropractor can quantify the outcomes of the treatments include:
Having a patient speed the pain
So a patient can characterize the positioning and nature of the pain, using a pain diagram
Searching for increases (or declines) in day-to-day living practices, as in the capacity to work (employment), exercise and sleep.
Testing practical capacity, such as weightlifting ability, strength, flexibility, and endurance
Some patients’ low back pain may have lasted into and beyond the 12-week mark, which makes it long-term pain. During assessment, chiropractors will look for signs to determine if a patient is at an increased risk of developing long-term pain- the “yellow flags” of chronicity so to speak.
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: What is Chiropractic?
Chiropractic care is an well-known, alternative treatment option utilized to prevent, diagnose and treat a variety of injuries and conditions associated with the spine, primarily subluxations or spinal misalignments. Chiropractic focuses on restoring and maintaining the overall health and wellness of the musculoskeletal and nervous systems. Through the use of spinal adjustments and manual manipulations, a chiropractor, or doctor of chiropractic, can carefully re-align the spine, improving a patient�s strength, mobility and flexibility.
After a long day of work, it�s not uncommon for people to experience symptoms of pain and discomfort throughout their body. In today�s world, however, everyday activities, such as typing and texting, can often cause more than temporary soreness on the extremities. The repetitive movements of the wrist over time may irritate the surrounding tissues, leading to damage, injury, and even the development of uncomfortable conditions like carpal tunnel syndrome.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a frequently diagnosed medical condition, characterized by pain, numbness and tingling sensations in the hand and arm. The well-known condition develops when one of the major nerves which runs through the hand, medically referred to as the median nerve, is compressed or impinged as it travels through the carpal tunnel, a narrow passageway within the wrist that is surrounded by rigid tissues, making it minimally capable of stretching or increasing in size.
The median nerve originates from a bundle of nerve roots found in the neck. These roots merge into a single nerve in the arm, where it then travels down the arm and forearm, passing through the carpal tunnel at the wrist and into the hand. This main nerve functions to provide feeling in the thumb and index, middle and ring fingers. The median nerve is also in charge of controlling the muscles around the base of the thumb.
Carpal tunnel syndrome is a common condition which may occur due to a variety of factors. With constant overuse of the hand and wrist, the repeated motions or activities may result to irritation on the tendons in the wrist, causing inflammation and swelling to begin applying pressure against the nerve. Additionally, participating in activities which involve an excessive flexion or extension of the hand and wrist for extended periods of time can also increase pressure on the median nerve. On occasion, hormonal changes brought on by pregnancy can cause swelling. In other cases, the presence of previous conditions like rheumatoid arthritis or diabetes, among other, can also be closely associated with median nerve compression. Furthermore, carpal tunnel syndrome is believed to be caused by hereditary traits. For some people, the carpal tunnel passage may be smaller than average and/or other anatomical differences can in turn change the amount of space between the narrow passageway and the median nerve, leaving people at risk of developing carpal tunnel syndrome. Research shows that women and older individuals have a higher chance of developing this uncomfortable condition.
Fortunately, whether you plan to prevent the development of carpal tunnel syndrome or you�ve been recently diagnosed with the condition, there are several effective treatment options available to relieve the painful symptoms and restore the individuals original hand, wrist and arm function.
Chiropractic and Carpal Tunnel Syndrome
Chiropractic care is one of the most common forms of treatment for carpal tunnel syndrome. Foremost, a doctor of chiropractic, or DC, will evaluate the extent of the condition as well as diagnose the individual to determine any underlying cause behind the condition. After diagnosis, the chiropractor will follow up with an appropriate treatment regimen for the individual, according to their specific needs. Through a series of chiropractic adjustments and manual manipulations, the structures surrounding the hand, wrist and arm can be slowly adjusted to gradually reduce the pressure around the median nerve, ultimately reducing the individual�s symptoms. The chiropractor may also recommend a set of stretches and exercises to carefully restore the individual�s mobility and rehabilitate them back into their original state of well-being.
The repetitive movements of the wrist over time may irritate the surrounding tissues, leading to damage, injury, and even the development of uncomfortable conditions like carpal tunnel syndrome. For more information, please feel free to contact us at (915) 850-0900.
Automobile accidents are the most common cause of whiplash. Any type of accelerated motion that thrusts the head forward and then backwards with extreme force can lead to whiplash. Sports accidents can also cause whiplash-associated injuries. An unpredicted head jolt can damage the complex structures of the cervical spine, leaving tendons and ligaments intensely irritated and inflamed. The tendons and ligaments as well as other tissues of the neck may become overly stretched and torn.
A whiplash type injury may be suspected if the individual involved in an�automobile accident experiences�the following symptoms: neck pain and stiffness; worsening pain with movement; loss of range of motion in the neck; headaches, most often starting at the base of the skull; tenderness or pain in the shoulder, upper back or arms; tingling or numbness in the arms, fatigue and dizziness. Other individual�s may experience: blurred vision; ringing in the ears; sleep disturbances; irritability; difficulty concentrating; memory problems; and even depression. While these are some of the most common symptoms of whiplash, they may also suggest the presence of another type of injury or condition resulting from the automobile accident.
Thus, it�s essential to visit a qualified healthcare professional who can properly identify a whiplash injury and offer the required treatment to eliminate the resulting pain and symptoms.
Apart from assessing the doctor�s experience and qualifications, the victim of an automobile accident must primarily consider their geographical location and the type of insurance they are covered by when deciding on the type of doctor to visit following a whiplash type injury. Other factors that should influence the affected individual�s decision include whether they are represented by an attorney and whether they are living in a state where PIP, or personal injury protection, is mandatory.
Whiplash Injury Practitioners
People who�ve sustained injuries from auto accidents fail to receive the kind of medical care they require. It has been previously determined that the outcome of the patient�s rehabilitation depends on the type of doctor they receive care from.
Many individuals who�ve been involved in an automobile accident, regardless of the severity of the collision, will generally visit the emergency room, or ER, to have their injuries evaluated. The majority of ERs are designed to take patients out of life threatening situations. First, they immediately assess any visible injuries, such as open wounds and broken bones, treating them effectively on the spot. They may even prescribe medications to temporarily relieve the painful symptoms following a�traffic collision. However, many victims are not treated for their whiplash injuries. The trained specialists from the ER, provide first-aid, X-rays and medications to remove individuals from life-threatening situations but they don�t readily treat soft-tissue injuries like whiplash. From there, patients are sent to see their primary care physician, or PCP, to assess the rest of their injuries, yet, they may still face hardships to finally receive the proper care they deserve for their injuries.
Primary Care Injury Specialists and Whiplash
Many primary care physicians do not have the full qualifications in treating automobile accident injuries. Many of these doctors may even deny patients treatment. Whiplash associated disorders have been misunderstood in the medical field and many doctors believe whiplash is not a legitimate injury. However, those whom are suffering from whiplash can account for how painful it really is.
Other doctors refuse treatment to whiplash patients because they may not accept any kind of 3rd�party billing, a paying method where the doctor seeing the car accident victim has to bill the party at fault�s insurance company or utilize PIP or med pay to receive compensation.�This is a commonly well-known reason for denial of treatment as a large number of primary care physicians, or PCPs, still don�t have the required authorizations to accept 3rd�party billing.
Besides primary care physicians, medical doctors, orthopedics, chiropractors and physical therapists are several types of qualified healthcare professionals that specialize on treating automobile accident injuries such as whiplash. Among these, chiropractic treatment is the most popular, alternative treatment option for treating various soft tissue injuries or conditions.
Chiropractic Treatment for Car Wrecks
Many people from the legal and medical industry dismiss seeking a chiropractor for auto accident injury treatment. However, the fact is that a chiropractors are some of the only doctors who offer therapeutic treatments to accident victims. Treatment offered by medical doctors might include the use of drugs, although in many cases, they may also recommend physical therapy. This automatically highlights the importance of chiropractic care for whiplash victims because chiropractic care and physical therapy are very similar forms of treatment.
Whenever an individual who�s been involved in an automobile accident visits a chiropractor and complains of pain in the neck, the medical specialist will carry out a series of tests to determine whether the patient has suffered whiplash. Instead of focusing solely on the specific injury, chiropractors are trained to inspect the affected individual�s entire spine. Aside from soft tissue injuries like whiplash, chiropractic doctors may also check for: disc trauma or injury, tightness or tenderness, restricted mobility, muscle spasms, joint injuries, ligament injuries, posture and spinal alignment. They may also analyze the patient�s gait.
Besides checking for the above, chiropractors might also request X-rays and MRI of the patient�s spine in order to find out whether the spine features any degenerative changes which might have developed before the accident. To offer the best possible treatment, it is extremely important to determine which problems existed prior to the accident and which ones resulted from the accident. In most cases, insurance companies may argue that every single injury in the victim�s body is preexisting. This makes the role of the chiropractor considerably important as they will make sure to document all the previous and new injuries separately to ensure the insurance company pays for the patient�s treatment. In addition, the evaluation performed by the chiropractor also allows them to create the most effective treatment plan for each individual whiplash victim.
Main Stages of Care
The leading concern for chiropractors who treat whiplash-associated disorders involve alleviating inflammation in the neck. Chiropractors often recommend ice therapy, or the application of ice pack against the affected area, multiple times a day. This remedy is capable of reducing both pain and inflammation. Once the inflammation subsides, they often carry out a variety of manual therapeutic techniques to restore and increase the individual�s strength, flexibility and mobility.
The kind of chiropractic treatment the individual will require depends largely on the severity of the whiplash encountered. However, it has been previously determined that the majority of individual�s with whiplash find spinal manipulations useful. The most common chiropractic treatment techniques involve, spinal adjustments and manual manipulations, to carefully re-align the structures of the spine and help reduce symptoms. The following spinal techniques are also used to treat whiplash injuries: Instrument-assisted treatment, which involves the use of handheld instruments to provide a gentle massage by applying force onto the spine without utilizing any kind of thrust.
Instrument-assisted chiropractic therapy is used mostly to treat older patients with degenerative joints; flexion-distraction, this technique involves the use of a non-thrusting motions, best described as a slow pumping action; specific spinal manipulation, this therapy involves the use of a mild thrusting technique and is mostly used for restoring motion to the affected joints. Specific spinal manipulation helps stretch the soft tissues, which makes the job of restoring motion to the affected areas of the spine easier; instrument-assisted chiropractic therapy, also known as the Graston Technique, is used during this form of chiropractic therapy to perform repetitive strokes on the injured body part; therapeutic massage, performed to ease muscle tension and stress in the injured region; interferential electrical stimulation, where a patient undergoing this type of therapy will see the chiropractor passing electrical current at a very low frequency through their body. This low frequency current helps stimulate the muscles and reduces inflammation; trigger point therapies, as the name suggests, involves the application of direct pressure onto specific points to alleviating muscle tension; and finally ultrasound therapy, capable of decreasing stiffness, pain, and muscle spasms in the affected areas. When ultrasound is passed through the patient�s muscle tissues, it warms up the treated region and increases blood circulation.
Neck Trauma and Auto Injury
Chiropractic Treatments
Ultimately, chiropractors can help victims of whiplash in many ways. These health care providers can ensure that an individual� whiplash and its associated symptoms may subside completely. They always make sure to create a patient-specific treatment plan to make the process of recovery simpler for every individual.
Other than recommending immediate treatment for reducing the acute pain and inflammation, the chiropractor might additionally recommend a series of stretches and exercises, to help speed up the rehabilitation process as well as help increase the individual�s strength, flexibility and mobility.
Whiplash injuries, when left untreated, can cause severe complications. If you or a loved one have been involved in an automobile accident, visit a chiropractor immediately. By being prompt, you can even reduce your recovery time significantly. That�s not all; the chiropractor will also provide the required assistance to your lawyer, proving that the injury resulting from the accident wasn�t a preexisting injury or condition.
When you are injured in a car accident, you must get acquainted with your rights as soon as possible to receive the proper compensation and treatment for your specific situation. There is no such thing as a simple car crash.
Certain injuries or conditions which may have developed following an automobile accident may become chronic or permanent if left untreated. If an individual is experiencing neck stiffness or headaches after a traffic collision, it�s absolutely wrong to assume that this will subside in a few days. A minor discomfort could turn out to be a more serious complication.
Often, people injured in auto accidents develop scar tissue that remains with them throughout the rest of their lives and without the necessary treatments or exercises, these can become stiff and greatly limit an individual�s ability to move properly. The above issues generating from a car accident show how important it is for people to seek immediate legal and medical help. Chiropractors are known for their expertise in managing soft tissue injuries and the resulting chronic and traumatic pain; as a result, they are often considered to be the best healthcare professionals to consult�after a car accident.
Auto accidents can create enormous confusion and frustration. Most injuries associated with car accidents include trauma to the cervical spine. Dr. Jimenez discusses treatment options and procedures used in assisting patients reach optimal recovery. Choosing the right clinical team is always important. Many legal experts agree that a specialist focusing on soft tissue injuries is a search requiring great insight and assistance. Doctors of chiropractic and physical therapy along with surgical experts are best suited in assisting patients find the correct treatment options. If you have more questions please feel free to call 915-850-0900 in order to speak to Dr. Alex Jimenez.
While automobile accidents are the most common cause of whiplash, it must be noted, that these aren�t the only possible incidents behind the well-known injury. Any type of accelerated motion which thrusts the head forward and then backwards with extreme force from the entire body can lead to whiplash. Accidents from sports can also cause whiplash-associated injuries but auto accidents are the most prevalent.
The unexpected jolt of the head can damage the complex structures of the cervical spine, leaving the tendons and ligaments within the neck intensely irritated and inflamed. Furthermore, the tendons and ligaments as well as other tissues of the neck may become overly stretched and torn.
A whiplash type injury may be suspected if the individual involved in an automobile accident experiences the following symptoms: neck pain and stiffness; worsening pain with movement; loss of range of motion in the neck; headaches, most often starting at the base of the skull; tenderness or pain in the shoulder, upper back or arms; tingling or numbness in the arms, fatigue and dizziness. Other individual�s may experience: blurred vision; ringing in the ears; sleep disturbances; irritability; difficulty concentrating; memory problems; and even depression. While these are some of the most common symptoms of whiplash, they may also suggest the presence of another type of injury or condition resulting from the automobile accident.
Thus, it�s essential to visit a qualified healthcare professional who can properly identify a whiplash injury and offer the required treatment to eliminate the resulting pain and symptoms.
Apart from assessing the doctor�s experience and qualifications, the victim of an automobile accident must primarily consider their geographical location and the type of insurance they are covered by when deciding on the type of doctor to visit following a whiplash type injury. Other factors that should influence the affected individual�s decision include whether they are represented by an attorney and whether they are living in a state where PIP, or personal injury protection, is mandatory.
Whiplash Specialists
A large number of people who�ve suffered injuries from auto accidents fail to receive the kind of medical care they require, occurring more frequently in the case of whiplash victims. It has been previously determined that the outcome of the patient�s rehabilitation depends on the type of doctor they receive care from.
Many individuals who�ve been involved in an automobile accident, regardless of the severity of the collision, will generally visit the emergency room, or ER, to have their injuries evaluated. The majority of ERs are designed to take patients out of life threatening situations. First, they immediately assess any visible injuries, such as open wounds and broken bones, treating them effectively on the spot. They may even prescribe medications to temporarily relieve the painful symptoms following a traffic collision. However, many victims are not treated for their whiplash injuries. The trained specialists from the ER, provide first-aid, X-rays and medications to remove individuals from life-threatening situations but they don�t readily treat soft-tissue injuries like whiplash. From there, patients are sent to see their primary care physician, or PCP, to assess the rest of their injuries, yet, they may still face hardships to finally receive the proper care they deserve for their injuries.
Primary Care Physicians and Whiplash
Unfortunately, many primary care physicians are not specifically qualified to treat automobile accident injuries and many of these may even deny patients treatment. For many years, whiplash-associated disorders have been misunderstood in the medical field. Many doctors believe whiplash is not a legitimate injury, however, those whom are suffering from whiplash can account for how painful it could really be.
Other doctors refuse treatment to whiplash patients because they may not accept any kind of 3rd party billing, a paying method where the doctor seeing the car accident victim has to bill the party at fault�s insurance company or utilize PIP or med pay to receive compensation.�This is a commonly well-known reason for denial of treatment as a large number of primary care physicians, or PCPs, still don�t have the required authorizations to accept 3rd party billing.
Besides primary care physicians, medical doctors, orthopedics, chiropractors and physical therapists are several types of qualified healthcare professionals that specialize on treating automobile accident injuries such as whiplash. Among these, chiropractic treatment is the most popular, alternative treatment option for treating various soft tissue injuries or conditions.
Chiropractic Care for Whiplash
A wide number of people belonging to the legal and medical industry will disregard the idea of visiting a chiropractor to treat auto injuries. However, the fact is that a chiropractors are some of the only doctors who offer therapeutic treatments to accident victims. Treatment offered by medical doctors might include the use of drugs, although in many cases, they may also recommend physical therapy. This automatically highlights the importance of chiropractic care for whiplash victims because chiropractic care and physical therapy are very similar forms of treatment.
Whenever an individual who�s been involved in an automobile accident visits a chiropractor and complains of pain in the neck, the medical specialist will carry out a series of tests to determine whether the patient has suffered whiplash. Instead of focusing solely on the specific injury, chiropractors are trained to inspect the affected individual�s entire spine. Aside from soft tissue injuries like whiplash, chiropractic doctors may also check for: disc trauma or injury, tightness or tenderness, restricted mobility, muscle spasms, joint injuries, ligament injuries, posture and spinal alignment. They may also analyze the patient�s gait.
Besides checking for the above, chiropractors might also request X-rays and MRI of the patient�s spine in order to find out whether the spine features any degenerative changes which might have developed before the accident. To offer the best possible treatment, it is extremely important to determine which problems existed prior to the accident and which ones resulted from the accident. In most cases, insurance companies may argue that every single injury in the victim�s body is preexisting. This makes the role of the chiropractor considerably important as they will make sure to document all the previous and new injuries separately to ensure the insurance company pays for the patient�s treatment. In addition, the evaluation performed by the chiropractor also allows them to create the most effective treatment plan for each individual whiplash victim.
Stages of Treatment
The primary concern for chiropractors treating individuals who�ve experienced whiplash-associated disorders involves alleviating the inflammation in the neck, one of the main sources of pain for victims. Chiropractors often recommend ice therapy, or the application of ice pack against the affected area, multiple times a day. This remedy is capable of reducing both pain and inflammation. Once the inflammation subsides, they often carry out a variety of manual therapeutic techniques to restore and increase the individual�s strength, flexibility and mobility.
The kind of chiropractic treatment the individual will require depends largely on the severity of the whiplash encountered. However, it has been previously determined that the majority of individual�s with whiplash find spinal manipulations useful. The most common chiropractic treatment techniques involve, spinal adjustments and manual manipulations, to carefully re-align the structures of the spine and help reduce symptoms. The following spinal techniques are also used to treat whiplash injuries:
Instrument-assisted, this treatment involves the use of handheld instruments to provide a gentle massage by applying force onto the spine without utilizing any kind of thrust. Instrument-assisted chiropractic therapy is used mostly to treat older patients with degenerative joints; flexion-distraction, this technique involves the use of a non-thrusting motions, best described as a slow pumping action; specific spinal manipulation, this therapy involves the use of a mild thrusting technique and is mostly used for restoring motion to the affected joints. Specific spinal manipulation helps stretch the soft tissues, which makes the job of restoring motion to the affected areas of the spine easier; instrument-assisted chiropractic therapy, also known as the Graston Technique, is used during this form of chiropractic therapy to perform repetitive strokes on the injured body part; therapeutic massage, performed to ease muscle tension and stress in the injured region; interferential electrical stimulation, where a patient undergoing this type of therapy will see the chiropractor passing electrical current at a very low frequency through their body. This low frequency current helps stimulate the muscles and reduces inflammation; trigger point therapies, as the name suggests, involves the application of direct pressure onto specific points to alleviating muscle tension; and finally ultrasound therapy, capable of decreasing stiffness, pain, and muscle spasms in the affected areas. When ultrasound is passed through the patient�s muscle tissues, it warms up the treated region and increases blood circulation.
Neck Pain and Auto Injury
Chiropractic Recovery
Ultimately, chiropractors can help victims of whiplash in many ways. These health care providers can ensure that an individual� whiplash and its associated symptoms may subside completely. They always make sure to create a patient-specific treatment plan to make the process of recovery simpler for every individual.
Other than recommending immediate treatment for reducing the acute pain and inflammation, the chiropractor might additionally recommend a series of stretches and exercises, to help speed up the rehabilitation process as well as help increase the individual�s strength, flexibility and mobility.
Whiplash injuries, when left untreated, can cause severe complications. If you or a loved one have been involved in an automobile accident, visit a chiropractor immediately. By being prompt, you can even reduce your recovery time significantly. That�s not all; the chiropractor will also provide the required assistance to your lawyer, proving that the injury resulting from the accident wasn�t a preexisting injury or condition.
When you are injured in a car accident, you must get acquainted with your rights as soon as possible to receive the proper compensation and treatment for your specific situation. There is no such thing as a simple car crash.
Certain injuries or conditions which may have developed following an automobile accident may become chronic or permanent if left untreated. If an individual is experiencing neck stiffness or headaches after a traffic collision, it�s absolutely wrong to assume that this will subside in a few days. A minor discomfort could turn out to be a more serious complication. Often, people injured in auto accidents develop scar tissue that remains with them throughout the rest of their lives and without the necessary treatments or exercises, these can become stiff and greatly limit an individual�s ability to move properly. The above issues generating from a car accident show how important it is for people to seek immediate legal and medical help. Chiropractors are known for their expertise in managing soft tissue injuries and the resulting chronic and traumatic pain; as a result, they are often considered to be the best healthcare professionals to consult after a car accident.
Neuropathy means damage to the nerves, which transmit messages from the spinal cord to the brain. Neuropathy often causes numbness and tingling in the hands and feet, called peripheral neuropathy. Physical injury or trauma to nerves most often causes neuropathy; between 60 to 70 percent of diabetics also have neuropathy, ranging from mild to severe, according to the National Institute of Neurological Disorders and Stroke. A number of diseases, acute infections and toxins can also cause neuropathy. Many people turn to herbs for relief — but do not take herbs for neuropathy without your doctor�s approval.
Cayenne Pepper
Cayenne pepper contains capsaicin, a topical pain reliever that can help reduce discomfort from neuropathy. Capsaicin works by depleting substance P, a pain-causing chemical, from nerve receptors. Applying cayenne pepper in a topical solution initially stimulates the release of substance P but then depletes it, which decreases pain. Several over-the-counter topical pain relievers containing cayenne pepper approved for use by United States Food and Drug Administration are available. They appear to help at least some people with neuropathies from shingles; trigeminal neuralgia, which causes facial neuropathy; and diabetic retinopathy, the Diabetes Self-Management website reports. In some cases, topical application of this herb can worsen pain. Wright State University pharmacy suggests starting with the weakest concentration of the herb and increasing over time. It can take one to two months to work up to the strongest dose.
A systematic review of studies conducted by the University of Oxford reported on study findings in the April 24, 2004 issue of the �British Medical Journal.� L. Mason and colleagues, of the Pain Research and Nuffield Department of Anaesthetics, reported that capsaicin had poor to moderate effectiveness overall in six separate studies.
Evening Primrose Oil
Evening primrose oil, also called EPO, contains an omega-6 essential fatty acid, gamma-linolenic acid. In some studies, EPO showed benefit for use in diabetic retinopathy. A 2003 article published in �The Journal of the American Board of Family Practice� by Kathleen M. Halat and pharmacist Cathi E. Dennehy of the University of California�San Francisco reviewed studies done on the effectiveness of EPO in treating diabetic neuropathy without causing adverse effects on blood glucose levels. The authors concluded that EPO may have benefit in treating mild diabetic neuropathy, but that patient compliance with the number of pills required, 8 to 12 per day, might be problematic.
St. John’s Wort
Antidepressants are often used as treatment for polyneuropathy, neuropathy that affects number of areas rather than just one. St. John�s wort, an herb that has antidepressant properties, is also used to treat neuropathy in some patients. A 2001 study reported in �Pain� by Soren Sindrup, M.D., of the University of Southern Denmark found no improvement of polyneuropathy in patients given St. John�s wort compared to placebo.
Ginkgo Biloba
In an animal study reported by Yee Suk Kim, M.D., and colleagues of the Catholic University of Seoul and published in the June 2009 issue of �Anesthesia and Analgesia,� ginkgo biloba was found to decrease neuropathic pain in rats. Ginkgo may also prove valuable for use in humans, the study concluded.
Characterized by pain, tingling sensations and numbness, damage or injury to the nerves can alter the function of the nervous system. Neuropathy can interrupt the communication of the nerves between the brain, spinal cord and the central nervous system. Several treatments have been found to improve the symptoms of neuropathy and a herbal treatment containing several specific herbs can help improve the condition.
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