Back Clinic Personal Injury Chiropractic Team. Injuries from an accident can not only cause physical harm to you or a loved one, being involved in a personal injury case can often be a complicated and stressful situation to handle. These types of circumstances are unfortunately fairly common and when the individual is faced with pain and discomfort as a result of trauma from an accident or an underlying condition that has been aggravated by the injury, finding the right treatment for their specific issue can be another challenge on its own.
Dr. Alex Jimenez’s compilation of personal injury articles highlights a variety of personal injury cases, including automobile accidents resulting in whiplash, while also summarizing various effective treatments, such as chiropractic care. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
There are many factors that play a role in the dynamics of collisions. These include vehicle design and type, speeds, angles of approach, kinetic & potential energy, momentum, acceleration factor, friction… the list is quite long. There are a few constants in which we are curious. These constants are the building blocks of the planet and they make the world of collisions quantifiable and predictable.
Within this two-part series we will explore the factors which have the most influence in low speed collisions and how these factors are associated with injury. Note: nothing about these writings is inclusive, there is too much material to explore in depth. The objective of these writings is to present the concepts.
Conservation of Momentum & Auto Accidents
In this writing the subject of exploration is conservation of momentum and how it relates to low speed collisions and bodily injury of the occupant. Conservation of momentum is built on Sir Isaac Newton’s third law. Newton’s third law says “For every action there’s an equal and opposite reaction”.
In the interest of exploring conservation of momentum in a simple format, we aren’t likely to investigate and explain the history and physics of momentum; for this conversation, we’ll concentrate on the relationship to crash dynamics. It is momentum to speed collisions’ relationship that helps enlighten and is the causal factor of the injuries people who have held tight to the argument that is deceptive that no damage = no injuries.
While there is a formula and derivation, neither is needed just yet. For now, we’ll simply use the concept as follows: The momentum going into a collision can be accounted for in the outcome or the energy going in to the accident, must be accounted for at the end of the incident and that and what was exposed to and/or absorbed that energy.
Let’s apply some perspective to this notion with the following example.
Let us say we are standing at around a pool table and we are going to try the winning shot of the eight ball into a corner pocket. Following the cue ball is struck, we have and another. After the cue ball strikes the ball, then it stops moving and the eight ball begins moving. In this scenario the cue ball before the collision’s momentum is the same as the momentum of the eight ball after the collision[1]. The eight ball rolls to the corner pocket.
The transfer is extremely efficient due in part to the fact that neither pool balls can deform. Some of the energy would be used to perform this and less if either pool ball could deform. The National Highway Transportation Highway Safety Administration (NHTSA) mandates minimum performance standards for passenger vehicle bumpers. Vehicle bumpers are tested with 2.5 mph (3.7 fps)[2] impact equipment that has the same mass as the test vehicle. The test vehicle is struck with its brakes disengaged and the transmission in neutral. There’s no offset between the automobile and the barrier.
Performance Standards for Vehicle Safety
The NHTSA outlines acceptable damage to your vehicle’s various systems after the tests. Successful completion of these tests mandate operation of systems that are particular. The factory adjustment of the vehicle’s braking, steering, and suspension must be unaltered. In other terms, in order for a vehicle to pass these tests it canhave no change in its structure. If changes did occur the system that is braking, steering, and suspension would be out of factory adjustment.
The NHTSA isn’t alone in low rate bumper testing. The Insurance Institute for Highway Safety (IIHS) also conducts low rate bumper tests. The IIHS’s test rates are conducted at 6 mph (8.8 fps)[3] and the goal is to determine which vehicles have the least damage and therefore cost the least to repair. The vehicle ratings are proportional to the estimated cost of repair. The more costly the repair, the lower the rating.
While the vehicles used in the IIHS testing all show signs of contact with the barrier, none of the vehicles suffer harm which deforms the structure of the vehicle. Don’t have any change in its structure affecting the system, steering, and suspension, just as with the NHTSA the vehicles tested by the IIHS.
The lack of change in the structure (deformation) drives a test vehicle to accept the momentum transfer in the testing equipment. Further, the test vehicle is free to move after being destroyed. This testing scenario is like that of the cue ball and eight ball.
If a vehicle doesn’t deform during a low speed collision, then it will experience a change in speed (or velocity) very quickly; Consequently, the occupant(s) also experience this exact same change in speed. The key factor in these examples is that the mass of testing equipment and their vehicles involved, but what happens when the masses change?
Conclusion
When the mass of one vehicle changes the momentum also changes, the more mass the more momentum the vehicle can bring to the event and the greater the injury potential to the occupant. There are many complicating factors that now must be considered regarding injuries beyond the Laws of Momentum when determining trauma like the height, weight, muscle mass, occupant position, kind of seat belt used, etc.. However, the first step is to decide if there was enough energy as an initiating factor in low speed crashes to cause those injuries and to overcome no crash = no injury misconceptions and have a health expert in low speed injuries confirm relationship.
In the next installment, part II, we’ll discuss this in detail and it will necessary for the later subject of occupant injuries.
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 .�
REFERENCES:
Insurance Institute for Highway Safety. (2010, September). Bumper Test Protocol. Retrieved from Insurance Institute for Highway Safety: www.iihs.org
National Highway Transportation Safety Administration. (2011, October 1). 49 CFR 581 – BUMPER STANDARD. Retrieved from U.S. Government Publishing Office: www.gpo.gov
Additional Topics: Weakened Ligaments After Whiplash
Whiplash is a commonly reported injury after an individual has been involved in an automobile accident. During an auto accident, the sheer force of the impact often causes the head and neck of the victim to jerk abruptly, back-and-forth, causing damage to the complex structures surrounding the cervical spine. Chiropractic care is a safe and effective, alternative treatment option utilized to help decrease the symptoms of whiplash.
Not only do tires play a vital role in the performance of your car or truck, but a lot of information can be garnered about what happened before, during, and after a crash. Tire marks will be explored by us and, generally, what those marks tell us.
First let us discuss where the marks come from. Skid marks are created by the extreme thermal relationship of a tire against the roadway surface during extreme stresses put on the tire, a simpler way to say this is, a tire will “mark” when it nears, or exceeds, the limits of its relationship with the roadway. These marks occur because the oils in the roadway and/or the tire(s) are brought to the surface and “melted or burnt” into the roadway. If a tire is heated enough since the surface of the tire will have changed, it’ll be obvious, it is going to have a spot and obvious abrasions.
Kinds of Skid Marks.
There are three specific kinds of marks we will talk about, these are the most typical four wheeled car and light duty truck marks. (Other vehicles, such as motorcycles, have different specific marks).
Light to Dark or Dark to Light
All marks can be placed into two categories when referencing the management of the vehicle which made them. Light to dark marks (in the direction the vehicle was traveling) support a vehicle making the marks through some kind of deceleration (extra points if you wanted to read “negative acceleration”). Dark to light marks (again, in the direction the vehicle was traveling) support a vehicle making the marks through some form of acceleration, usually excessive wheel spin.
Darker from the Middle, Darker on the Outsides, or Uniform
Marks that are darker in the center indicate a tire that’s overinflated, conversely marks that are darker on the outside edges indicate a tire which is underinflated. Indicate a tire.
ABS Versus Regular Marks
ABS (Anti-lock Brake System) marks are lighter than conventional marks and have more tire tread definition in them, Non-ABS marks rarely have tread definition inside them. ABS marks are also shorter when compared to non ABS marks from a vehicle traveling in precisely the speed.
What else can skid marks tell us?
As you have already found skid marks may tell us about the tires inflation, ABS or non-ABS braking, and direction of travel. Marks can also tell us something when and in which the decision to brake occurred. This is the most under-utilized and under explored aspect even more so in speed crashes. Some basic calculations can be made, using a variety of aspects of the skid marks, to determine where the driver made the decision.
Why is this so important? Consider the following illustration.
This drawing is a timeless teaching example used to demonstrate the value of skid marks. Consider this situation, the blue car says he had the green light and was hit at the intersection. The car says so that that he braked hard he also had the light and saw the car. There isn’t any other evidence or witnesses.
Now the student would be asked to calculate the position of the cars once the decision to brake was created using the beginning of the skid marks, ultimately this would place the vehicles in the place labeled 1.
Now the apparent problem with the red car’s situation now that we have used the skid marks to ascertain where he determined to brake, a construction blocks his view of the blue car (position 1 for both vehicles). This begs the question as to why did he decide then to brake? The answer, the light was red for the red car and the driver was braking for traffic lighting, not the blue car making the red car culpable in this situation as the physical evidence affirms the “at fault” party.
Another valuable piece of advice is that rubber is biodegradable and there are naturally occurring nitrogen based bacteria that “eat” rubber. These bacteria are competitive and will eat rubber in most environments, therefore if you’re trying to determine causality and the “at fault” party, it is in your best interest to take pictures of the roadway whenever possible. Skid marks are gone in a brief amount of time.
Skid marks are a valuable item of evidence and a great tool for determining many facets in a collision; it is extremely important none of them are overlooked or underestimated.
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 .�
Additional Topics: Weakened Ligaments After Whiplash
Whiplash is a commonly reported injury after an individual has been involved in an automobile accident. During an auto accident, the sheer force of the impact often causes the head and neck of the victim to jerk abruptly, back-and-forth, causing damage to the complex structures surrounding the cervical spine. Chiropractic care is a safe and effective, alternative treatment option utilized to help decrease the symptoms of whiplash.
There are several reasons engineering and accident reconstruction reports are problematic. Let’s address the biggest and first issue, cost. Many attorneys won’t realize the real value of cases if they deal with doctors who do not know how to document the patient’s injuries correctly, leading to issues related to poor documentation management.
This is a massive benefit to the insurance company who have banked on the sloppiness and ignorance of the entire medical-legal community. However, there is a growing number of doctors and attorneys who do know.
In this sense, the insurance carrier knows they’ll pay, a vast majority of this time, a minimum amount for a collision even if the case needs to have a much greater value due to the nature of the injuries. The insurance companies know this for a number of reasons, but the biggest reason is cost, not for them but you.
Accident Reports and Insurance Companies
For the sake of discussion let’s say the average case settles for $15,000. If the collision specialist costs $2,000 to $5,000 (along with the doctors and the other experts), this is an expense which cannot or chooses not to be absorbed by solo attorney’s, smaller and even bigger legal firms. This is known by the insurance company and use it whenever it presents itself.
Why can a “deep pocketed” insurance company afford to pay a specialist on a smaller case? There are few reasons but the two are the insurance companies can absorb the expense of the consultants AND a smaller instances will perform the work, as good faith towards the client, pro bono, in some cases.
Obviously, if the attorney cannot make any money they will not take the situation and paying for a collision professional is a substantial factor in this decision, especially if the defense already has you. This greatly reduces the attorney’s costs per case while making you more valuable as a resource AND affords the attorney the chance to take on cases.
Identifying Inaccuracies
The cost concerns cause a second problem, identifying inaccuracies. I have yet to meet an crash engineering defense pro who will explain the shortfall of a case because it is going to expose their inaccuracies and will not bode well for them regarding referrals. MANY low speed collisions have gaps which must be filled in with information that is vetted and carefully selected. Using generalized data (that is the standard in the industry to work with) is quite dangerous as it makes the difference for results reliability too wide. The results will have margin for error and that margin of error is the difference between being or prevailing on the side and all accepted as accurate, but is not.
In this section we discuss why time is a critical element. In the picture above, we illustrate a train, which collides with a barrier at 100 miles per hour and crushes. The related math demonstrates how increasing the time decreases acceleration (see circled numbers). There is not any room for doubt regarding injury as its speed and acceleration is beyond accepted thresholds. What if the speeds change so they are very close to those injury thresholds?
Consider the second example, here the speed of the train represents final approach to a stop hurdle in which the engineer is a little careless and bumps the cease hurdle. What’s important to notice about this visual is the moment. If we double the time (from .05 to .1) the last g force is halved (resulting in 2.267 g’s). What if there were studies that we could cite which say the time necessary to stop for a train is .075 seconds? The first time value of .05 would be too brief, the second value of .1 would be too big, and both do not fit the cited studies.
In this case the period variable changes a tiny amount but the resulting change in the g forces may no longer be sufficient to substantiate a claim for injury. This is the reason the justification for any values is so significant. If you don’t understand they were selected and why the variables are there, they you do not know if they’re accurate or not. A deviation is often the arbiter in determining if there were sufficient transference of forces needed for 27, in a case for failure or success.
Conclusion
Cost and inaccuracies are a couple of the problems commonly faced by attorneys regarding collision reconstruction. For doctors, there’s now a recognized course to offer you the training to be an collision engineer/reconstructionist and for the attorney, when there is a defense engineer, you should have someone dissecting the math to ensure accuracy because usually the “guestimates” used will work against you in settlement or litigation.
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 .�
Additional Topics: Weakened Ligaments After Whiplash
Whiplash is a commonly reported injury after an individual has been involved in an automobile accident. During an auto accident, the sheer force of the impact often causes the head and neck of the victim to jerk abruptly, back-and-forth, causing damage to the complex structures surrounding the cervical spine. Chiropractic care is a safe and effective, alternative treatment option utilized to help decrease the symptoms of whiplash.
There is an assortment of questions which centered around police reports and accident scenes. We’ll address reports exist, how conclusions are made, and what exactly you should take from the role of the police officer and a report as an investigator. This topic can be broken down into lots of classes; here we will concentrate on collision analysis and general reporting.
Why do police take general reports? The brutal answer is because nobody will recall the facts in just two days, much less two decades and they’ll argue it but it’s also because a third party who should be an impartial fact evaluator is needed by society. “Should” is emphasized, but we need to describe what an impartial evaluator of reality is at the context of the writing. We are currently assuming the officer / deputy has training that is sufficient to ascertain what evidence plays into the circumstance. Imagine if you went into a call for attack involving wife and a husband. Upon arrival you are told that the husband is using drugs and sexually assaulting a young child by the wife. When you question the husband he denies the claim and also has the wife’s prescription bottle in his hand — the medicine’s listed side effect is “hallucinations”. This is relevant evidence that the law enforcement officer should weigh in her or his choice.
We are also likely to assume that the officer / deputy doesn’t have any bias or stereotype towards the parties involved OR they perform however recognize it and adjust accordingly. Imagine if the officer went through a tough divorce and from above is female. Does her life have an impact on thinking the husband? What exactly does should she do about it, if it does?
Police Reports After Auto Accidents
Authorities write collision reports for the nation (in which they operate) departments of transportation. The report is designed to collect information regarding roadway design, operator error, alcohol and /or drug use, etc.. One of the concerns that are final is for the report to record for the parties, while significant.
With utilizing report templates, expertise, training, and bias may significantly impact collision reports. Why?
There are many reasons police have errors in their accounts, but by far, the main reason is lack of coaching. To be able to make a police officer, candidates attend an academy that averages some are more. Collision investigation for recruit training is less than a day’s worth of training. In this time the educator should cover everything from scene safety to general hazards to traffic patterns. In reality, unless the student after graduation and into his or her livelihood chooses to attend further training there will be refreshers no updates, upgrades, or continuations to the academy foundation.
Specialty training is imperative to understand the concepts as well as the physics behind a motor vehicle collision and these aren’t part of this basic academy curriculum. Therefore, when determining specifics of the injury it’s critical to determine the extent of training of the police officer.
To address the last point, what you ought to take away from a collision report, we will go over a true case brought to me by one of you.
A while back I was contacted by a physician, his family member had been involved in a collision where she had been rear ended by a truck in heavy traffic; double. The officer their vehicle was launched with the truck behind it in a lane of travel was told by the family member. The vehicle struck on the vehicle while in traffic. The truck driver told the investigating officer he didn’t understand where the vehicle he broke was, but he was coming onto the road through an “on ramp” and thought the vehicle tried to pass him at the shoulder and cut in front of him that is why he broke it.
The investigating officer admitted there were not any marks at the roadway to establish where the event happened but he didn’t write the report in favor of this truck driver. When I inquired about his foundation he told me and his reasoning:
“I wrote that the report in favor of the truck driver based on the damage to the vehicles although I had no formal training on harm interpretation and event correlation and couldn’t establish through signs, in which the vehicles were in the lanes of travel.” In this case the municipality who uses him would be the main problem while the gut reaction would be to blame the officer. This agency has failed to train the officer and also supply guidelines to function inside to him.
All that can be taken away from the crash itself would be the vehicle rear ended the vehicle and it likely occurred as the vehicle driver described in which the vehicle driver admitted not knowing where the vehicle was supposed to begin with.
Conclusion
So what do you remove a police crash report? Those facts that can be verified soundly proof, or by witness reasoned by them both. The police are fact gatherers, not “causality arbiters” and must be utilized as such. The caveat is that there are police specialists who have advanced training in accident reconstruction, crash dynamics and accident investigation. My training makes me to be adept in all those disciplines, but the average police officer is not and shouldn’t be considered as a person.
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 . �
Additional Topics: Weakened Ligaments After Whiplash
Whiplash is a commonly reported injury after an individual has been involved in an automobile accident. During an auto accident, the sheer force of the impact often causes the head and neck of the victim to jerk abruptly, back-and-forth, causing damage to the complex structures surrounding the cervical spine. Chiropractic care is a safe and effective, alternative treatment option utilized to help decrease the symptoms of whiplash.
When the aberrant sequela to victims in car crashes has been investigated, providers often overlook and concurrently underestimate the tissue pathology and resultant biomechanical failures of spinal ligamentous damages commonly known as �strain � sprain.� In addition, the courts have been �blinded� by rhetoric in allowing this pathology to be deemed transient. There is an ever growing body of scientific literature that verifies strain – sprain as permanent pathology, which is the standard being taught in today�s medical and chiropractic academia.
In addition, strain � sprain as sequela to whiplash, renders a 25% whole person impairment based upon the American Medical Association�s Guide to the Evaluation of Permanent Impairment fifth and sixth editions.
Whiplash Associated Disorder Sequela Injuries
Juamard, Welch and Winkelstein (2011) reported:
��Rear end accelerations have been used to study the response of a variety of soft tissues in the cervical spine, including the facet capsular ligament. For simulations of whiplash exposures, the strains in the capsular ligament were found to be two � five times greater than those sustained during physiological motions of the cervical spine. In a similar but separate study, the facet joints of the cervical spine�s that were previously exposed to a whiplash injury ridden exercise under low � level tension and found to undergo elongations nearly 3 times greater than on exposed ligaments for the same tensile loads. Those capsular ligaments were also found to exhibit greater laxity after the purported injury. Since increased laxity may be linked to a reduction in the joints ability to stabilize the motion segment during sagittal motion, this finding suggests that whiplash exposure may alter the structure of the individual�s tissues of the facet, such as the capsular ligament, and/or the mechanotransduction processes that could maintain and repair the ligamentous structure. Accordingly, such an injury exposure could initiate a variety of signaling cascades that prevent a full recovery of the mechanical properties of the tissues of the facet joint.� (Pg 15)
Simply put, if we focus on the last sentence above, this �prevents a full recovery of the mechanical properties of the tissues of the facet joint,� which is referencing the ligaments of the spine that make up the tissues of the facet joint. In lay terms; it means that once injured, a joint is permanently damaged and it is demonstrable on x-rays with an extension and flexion view that does not have to show a full dislocation. Therein lies the core of the issue. Most radiologists are not trained in the latest literature on biomechanical tissue failures and therefore underreport the pathology.
Last month I attended a presentation by Michael Modic MD, Neuroradiology, a nationally renowned educator in neuroradiology who focuses on spondylolisthesis (vertebral segmental abnormal movements) and I asked a simple question �why don�t radiologist report more on abnormal positioning due to biomechanical failure as a result of ligament pathology� and his answer was �because their training focuses more on disease pathology.� Although I agree that is critical, so are biomechanical failures that lead to chronic degeneration, which is epidemic in our society. Simply look at the posture of our elderly for verification and much of that started with a simple �fender bender� years ago where the strain-sprain was either undiagnosed or deemed transient and not treated.
Ligament Pathology Diagnosis and Prognosis
The above scenario is why the American Medical Association values ligament pathology at 25% whole body impairment. There is also a growing body of doctors who are trained and credentialed in Spinal Biomechanical Engineering that understand how to create a diagnosis and prognosis, along with treatment plans around ligament pathology and fully understand the long-term effects of damaged facet joint tissues. These doctors are currently educating, based upon the current scientific literature their respective radiology communities to be able to diagnose and document the full extent of the injuries sustained.
We must also recognize that there is a significant amount of evidence in the scientific literature that verifies ligamentous damage as permanent and refutes the rhetorical claim of �transient.� In the end, it must be the facts of human physiology verified by science that sets the standards of healthcare and not deceptive rhetoric at any level.
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 .�
References:
Cocchiarella L., Anderson G., (2001) Guides to the Evaluation of Permanent Impairment, 5th Edition, Chicago IL, AMA Press
Juamard N., Welch W., Winkelstein B. (July 2011) Spinal Facet Joint Biomechanics and Mechanotransduction in Normal, Injury and Degenerative Conditions, Journal of Biomechanical Engineering, 133, 1-31
Additional Topics: Weakened Ligaments After Whiplash
Whiplash is a commonly reported injury after an individual has been involved in an automobile accident. During an auto accident, the sheer force of the impact often causes the head and neck of the victim to jerk abruptly, back-and-forth, causing damage to the complex structures surrounding the cervical spine. Chiropractic care is a safe and effective, alternative treatment option utilized to help decrease the symptoms of whiplash.
Ohio Attorney General Mike DeWine is suing five makers of opioid painkillers for their role in the state’s opioid epidemic.
The five companies named in the suit are Purdue Pharma, Johnson & Johnson, Teva Pharmaceuticals, Endo Health Solutions and Allergan.
This is the second suit of its kind brought by a state, after Mississippi.
Ohio attorney general sues 5 pharma companies over their role in the opioid epidemic��
Ohio Attorney General Mike DeWine is suing five makers of opioid painkillers for their role in the state’s opioid epidemic.
The suit, which DeWine said is the second by a U.S. state, after Mississippi, claims the drugmakers violated multiple state laws, including the Ohio Corrupt Practices Act, and committed Medicaid fraud.
Purdue Pharma, Johnson & Johnson and its Janssen Pharmaceuticals unit, Teva Pharmaceuticals and its Cephalon unit, Endo Health Solutions and Allergan are all named in the suit.
“In 2014 alone, pharmaceutical companies spent $168 million through sales reps peddling prescription opioids to win over doctors with smooth pitches and glossy brochures that downplayed the risks” of the medicines,” DeWine said at a press conference Wednesday. Last year, he said, 2.3 million people in Ohio, or about a fifth of the state’s population, were prescribed opioids.
In a statement, a spokesman for Purdue Pharma, which manufactures OxyContin, said the company shares the attorney general’s concerns about the opioid crisis and that it is “committed to working collaboratively to find solutions.”
“OxyContin accounts for less than 2% of the opioid analgesic prescription market nationally, but we are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone � all important components for combating the opioid crisis,” he said.
Allergan declined to comment, as did a Teva spokeswoman, who said, “We have not completed review of the complaint.”
J&J’s Janssen unit said the company believed the allegations in the lawsuit were “both legally and factually unfounded.”
“Janssen has acted appropriately, responsibly and in the best interests of patients regarding our opioid pain medications, which are FDA-approved and carry FDA-mandated warnings about the known risks of the medications on every product label,” said Jessica Castles Smith, a Janssen spokeswoman.
Endo officials weren’t immediately available to comment.
The Ohio action follows suits from counties and cities seeking to hold accountable the industry that produces, markets and distributes opioid painkillers. DeWine said the Ohio suit, filed Wednesday morning in Ross County, “would compel these companies to clean up this mess through several remedies,” including an injunction to stop “continued deception and misrepresentation in marketing,” damages paid to the state for money spent on the crisis, and repayment to consumers.
Sales of prescribed opioids � including oxycodone, hydrocodone and methadone � almost quadrupled in the U.S. between 1999 and 2015, according to the Centers for Disease Control and Prevention, contributing to a more than quadrupling of deaths from prescription opioids in that same period. Almost 2 million Americans either abused or were dependent on prescription opioid painkillers in 2014, according to the CDC.
“We understand what we’re taking on: five huge drug companies,” DeWine told reporters Wednesday. “I don’t want to look back 10 years from now and say we should have had the guts to file. � It’s something we have to do.”
According to the harshness of your whiplash symptoms, your doctor may prescribe drugs and/or spinal shots to manage the pain. To stress this point: they won’t help heal the injury, although the medications will help relieve your pain. Instead, medicines and/or spinal injections lessen your pain so which you can work on curing the soft tissue injuries (through physical therapy, for example).
Again depending on the seriousness of your pain, you could begin with over-the-counter medicines. If those don’t work to relieve your pain, the physician may prescribe stronger drugs. The doctor may imply shots if prescription drugs don’t work. The progression of treatment depends upon your individual symptoms and pain level.
Over-the-Counter Medications for Neck Injuries
Acetaminophen: Tylenol is a good example of an acetaminophen, a form of medicine that has turned out to be a great pain reliever. Most people refer as painkillers to acetaminophen medicines, although your doctor may call this an analgesic. They don’t help reduce inflammation, though. Acetaminophen works by essentially blocking your brain’s awareness of pain, and it is good for those pain flare-ups that will come with DDD.
Over the counter NSAIDs (non-steroidal anti-inflammatory drugs): These will reduce swelling (or inflammation) while relieving your pain. In whiplash, you could have inflammation from your soft tissue injury. If an over the counter NSAID is a choice that’s best for you personally, you have lots to select from. You can use ibuprofen (Advil), aspirin, or Aleve.
By taking an NSAID, you are really building up an anti inflammatory effect in the body, so that it’s essential to choose it for awhile. Which is, NSAIDs won’t be as effective if you take them only when you have pain. Before you notice an important impact on your pain, because they work to limit inflammation and build up in your body, you might have to take NSAIDs for several weeks.
Prescription Drugs for Neck Injuries
If over-the-counter drugs don’t deal with your pain enough, the doctor may prescribe something more powerful. The precise sort of drugs depends upon your symptoms, but the doctor may have you attempt:
Muscle Relaxants: You will need a muscle relaxant, which ought to help stop the spasms if you have muscle spasms brought on by the whiplash injury. Muscle relaxants may also enable you to sleep. Valium is an example of a muscle relaxant.
Opioids (Narcotics): In the most extraordinary cases, and just under careful supervision, you physician might prescribe an opioid, such as for instance codeine or morphine. Vicodin and Percocet are instances of narcotics.
Prescription NSAIDs: NSAIDs that are stronger can be taken by you than the over-the-counter variety, in case your physician believes this is best for your pain. For instance, she or he may recommend a COX-2 Inhibitor (Celebrex is an example). That is a kind of NSAID, but it will not cause gastrointestinal side effects as other prescription NSAIDs can.
Injections and Shots for Whiplash Associated Disorders
Shots for whiplash are most powerful when coupled with exercise plan or a physical therapy which assists you to work on strengthening the neck muscles. The shot should give pain relief to you so that you could turn your focus on curing the specific injury. Several kinds of injections useful for whiplash are:
Epidural Steroid Injection: This is only one of the very common injections. An epidural steroid injection (ESI) targets the epidural space, which will be the space enclosing the membrane that covers the spine and nerve roots. Nerves go through the epidural space and after that branch out to different parts of your own body, for example your arms. If your nerve root has become compressed (pinched) in the epidural space because of a whiplash injury, you could have pain that goes down your neck and perhaps into your arms (a symptom called radiculopathy).
An epidural steroid injection sends steroids�which are very powerful anti-inflammatories� to the nerve root that’s inflamed. This really is a pain management therapy, so that it is far better have a well-trained pain management specialist do the injection. You will likely need 2-3 shots; generally, you should not have more than that because of the potential side effects of the steroids.
Facet Joint Injection: Also called facet blocks, facet joint injections are useful in case pain is being caused by your facet joints. Facet joints in your spine assist you to supply and move stability. You’ll have pain, should they get inflamed, though, because of how your cervical spine affected human body. The joint will be numbed by a facet joint injection and can diminish your pain.
Trigger Point Injection: In extreme cases of whiplash, trigger point shots are a wise decision. (Trigger points are knots of muscle underneath the skin that form when muscles usually do not relax.) The shot has a local painkiller that occasionally features a corticosteroid to decrease the inflammation.
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: Neck Pain and Auto Injury
After being involved in an automobile accident, the sheer force of the impact can often cause whiplash, a common type of neck injury resulting from the sudden, back-and-forth motion of the head against the body due to a car wreck, or other incident. Because of this, many of the complex structures found within the neck, including the spine, ligaments and muscles, can be stretched beyond their normal range, causing injury and painful symptoms.
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