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.
Remote doctor appointments could be coming soon to the school nurse’s office.
Starting Sept. 1, a new law will allow physicians to get paid for seeing children over a sophisticated form of video chat, as long as the student is at school and enrolled in the state’s Medicaid program for the poor and disabled. The law’s supporters say it could lead more schools around the state to set up nurse’s offices equipped to handle remote doctor visits — and save parents time and money.
They say adults shouldn’t have to take time off work and kids shouldn’t have to miss school to get routine health care, like when a child has an ear infection or skin rash, because modern technology allows a remote doctor to get high-quality, instantaneous information about patients. An electronic stethoscope allows the doctor to hear a child’s heartbeat, for example, and a digital otoscope offers a look into the child’s ear — all under the physical supervision of a school nurse.
Then, if the doctor makesa diagnosis, parents can pick up their child’s prescription from the pharmacy on their way home from work, said state Rep. Jodie Laubenberg, a Republican of Parker and the bill’s author.
“You want to talk about access? You want to talk about affordability? This is their access,” Laubenberg said. “We can treat the child, have him ready to go, and we can leave him here.”
“You don’t have to take off work,” she said. “He doesn’t have to leave school. It’s less disruptive.”
Texas is not the first state to pay doctors for school-based telemedicine for Medicaid patients. Georgia and New Mexico have similar laws on the books, according to the American Telemedicine Association.
Laubenberg said she wrote the bill to support programs like one put on with Children’s Health hospital system in North Texas. There, children from 27 grade schools in the Dallas-Fort Worth region have electronic access to three health care providers — one doctor and two nurse practitioners — while school nurses sit in on the visits. A spokesman for Children’s said the program will soon expand to 30 more schools.
In that program, school nurses — health care workers who don’t necessarily hold a nursing degree — can examine children, and, if they have an apparent health problem, send their information to Children’s to schedule an appointment. The program is currently funded by a five-year pot of mostly federal money.
Children’s says the new law will allow its program to remain financially viable when that funding source goes away, and allow similar programs to take hold across the state.
“Children’s Health in our programming is not going to be the [primary care provider] for every kid that walks through the door, so in order to sustain the program, we needed to be able to bill for that service,” said Julie Hall Barrow, senior director of healthcare innovation and telemedicine for the hospital system.
Other programs may follow suit. Texas Tech University’s medical school has partnered with the school district in Hart to run a school-based telemedicine clinic for more than a decade. That, supporters say, has expanded access to health care in the rural community north of Lubbock.
“Ninety percent of what you would see in a general pediatric clinic, we can handle it by telemedicine,” said Richard Lampe, chairman of the Department of Pediatrics at the Texas Tech University Health Science Center. He said that included sports injuries, strep throat — and among middle and high school students especially, mental illnesses like anxiety and depression.
But there are still questions under the new law about how schools will decide which students are eligible to have virtual doctor visits. The state will only pay doctors for seeing kids if they’re enrolled in the Medicaid program.
“I think the question goes to, what happens if the kid gets sick and they don’t have Medicaid?” said Quianta Moore, a researcher at Rice University’s Baker Institute for Public Policy, who has written about school-based telemedicine.
That could raise questions about equity and access, Moore said, because doing “health intervention in school is actually very effective.”
Critics said expanding remote doctor visits into schools could lead to more doctors practicing medicine inappropriately on children.
“You’ll end up sometimes with a doctor that’s not adequately informed as to the patient’s history or allergies,” said Lee Spiller, the policy director for the Texas branch of the Citizens Commission on Human Rights, a nonprofit mental health watchdog. “How can you expect a kid to really be aware of risks, their allergies, medical history?”
Spiller also said he worried parents who signed blanket consent forms at the beginning of the school year would not fully understand what they were signing their children up for.
In Dallas, at Uplift Peak Preparatory, health office aide Ruby Jones said some parents chose not to sign consent forms, but if their children got sick and came to visit her, she would try to talk to them about the “amazing tool” of telemedicine.
Said Jones: “There’s nothing more rewarding when … you see a scholar walking down the hall and they say, ‘Thanks, Ms. Jones. I feel better.’”
Throughout August, The Texas Tribune will feature 31 ways Texans’ lives will change because of new laws that take effect Sept. 1. Check out our story calendar for more.
The Texas Tribune is a nonpartisan, nonprofit media organization that informs Texans — and engages with them – about public policy, pol itics, government and statewide issues.
Texas has some of the nation�s most affordable workers� compensation coverage, according to a 2016 study, which found that the Lone Star State had the 10th lowest rates among all states.
The study by the Oregon Department of Consumer and Business Services ranks all 50 states and Washington, D.C., based on premium rates that were in effect January 1, 2016. Texas, with premiums at $1.45 per $100 of payroll, ranked No. 10, four spots higher than the previous study in 2014.
�It�s great to see evidence of the progress we�ve made in affordability,� said Texas Commissioner of Workers� Compensation Ryan Brannan. �Lower injury rates, better return-to-work outcomes for injured employees, and reduced medical costs per claim are a big factor, but the results of the Oregon study are also proof that we�re becoming more efficient, proactive, and transparent.�
Texas Workers’ Compensation Rates
Texas� workers� compensation premium rates are about 21 percent lower than the median for all states, according to the study. California has the most expensive rates in the nation, at $3.24 per $100 of payroll. Rates in Texas are also favorable compared with other high-population states, such as Florida, Illinois, and New York. North Dakota had the least expensive rates, at 89 cents per $100 of payroll.
�The Texas workers� compensation system has been a model for other states in many ways,� Brannan said. �And we�re going to keep improving. We�re working on several efforts to keep our costs low. We�re cutting data storage costs by digitizing records, reducing prescription drug costs with a closed formulary, and eliminating waste and fraud with a new in-house fraud unit. We�ve also launched a statewide effort to streamline the dispute resolution process.��
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
Injured workers in Texas have better access to physicians who can treat them more quickly than they did 15 years ago, according to a September 2016 study by the Texas Department of Insurance�s Research and Evaluation Group (REG). The study found 84 percent of injured workers received initial care in seven days or less in 2015, compared to 76 percent in 2000.
�That�s significant because improved timeliness means workers have a much better chance of getting back to work, and the cost for their care will be much lower,� said Workers� Compensation Commissioner Ryan Brannan.
Effective Workers’ Compensation System
The study measures the effectiveness of the workers� compensation system to deliver timely and appropriate medical care to injured employees. It found that injured workers who aren�t treated within seven days have an average of about 40 percent more in medical costs over the first six months of an injury. In 2015, about half of injured workers saw a physician in one day or less. The average wait was 4.5 days.
�In terms of timeliness, when REG�s results are compared to the NCCI study of 35 states, Texas appears to be among the faster states.� Brannan said. �We have ongoing recruiting efforts to increase physician participation, and any issues with physician access are primarily due to a low number of physicians practicing in specific areas, not a low rate of physicians treating workers� compensation patients in Texas.�
The number of physicians in Texas who treated injured workers increased 6 percent from 2000 to 2015. During that same period, there was an 11 percent drop in the number of workers� compensation claims filed.
The decrease in claims also means injured workers in most of the state have options when searching for a physician.
In 2000, each physician who participated in workers� compensation treated an average of 21 patients. By 2015, that figure had dropped to 15, a decrease of 26 percent.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
After a successful pilot project, the Texas Division of Workers� Compensation rolled out a statewide program in October 2016 that has helped speed up the resolution of some disputes.
The program splits up related claim issues so that a hearing officer can decide the most far-reaching issue first. This can clear the way for secondary issues to be resolved sooner. In the pilot program, the approach helped speed resolution of many workers� compensation disputes.
�We�re always looking for ways to stay on the cutting edge of workers� compensation, and this process is a great example of finding a way to improve efficiency in the system,� said Workers� Compensation Commissioner Ryan Brannan. �From what we�ve seen in the pilot project and in the statewide roll-out, the two-step approach to deciding some of the most complex issues in a dispute is a good option for system participants in many cases.�
Two-Step Program Introduced for Workers’ Comp
When an injured employee has a dispute about a claim, it often involves three issues: extent of the injury, the date that the employee reached maximum medical improvement and the impairment rating for the injury.
According to Deputy Commissioner for Hearings Kerry Sullivan, even though extent of injury is a �threshold issue� that can affect the other issues, it�s often addressed at the same time as the other issues in the dispute process.
�It can be challenging to come into a hearing and know there are so many alternatives for the hearing officer to address,� Sullivan said.
Parties in a dispute may base their arguments about impairment ratings and dates of maximum medical improvement on what they think the extent of injury should be. If the hearing officer decides a different extent of injury, then parties will often have to request more time to adjust those recommendations.
The new two-step program is voluntary, and the existing system is still used in many cases. The option to participate is presented by the presiding officer at the initial benefit review conference for cases that may benefit from the approach. The two-step approach is used only if both parties agree to it.
�The presiding officer usually knows going into the dispute whether a decision on extent of injury will move things along,� Sullivan said. �Deciding the extent of injury issue first can lead to a better outcome, a more efficient hearing, and more agreements. We�re pleased it�s been working out so well.�
The two-step program started at DWC�s Weslaco office in May 2015 and soon was expanded to Dallas. It�s now available at all 20 offices statewide.
For more information, call (512) 804-4010.�
Further information on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
The Texas Division of Workers� Compensation is taking a promising pilot program statewide to help simplify and speed resolution of some disputes.
A pilot started last year splits up related claim issues so that a hearing officer can decide the most far-reaching issue first. This can clear the way for secondary issues to be resolved sooner. So far, about half of the disputes accepted for the program have had a hearing, and a third of those have resulted in full agreement to resolve the dispute.
Workers� Compensation Commissioner Ryan Brannan said he is encouraged by the outcomes.
�The division has a number of tools in its toolkit to manage claims disputes,� Brannan said. �The two-step approach to deciding some of the most complex issues in a dispute can be a good option for system participants in certain cases.�
Solving Common Disputes for Workers
When an injured employee has a dispute about a claim, it often involves three issues: extent of the injury, the date that the employee reached maximum medical improvement, and the impairment rating for the injury. Deputy Commissioner for Hearings Kerry Sullivan said even though extent of injury is a �threshold issue� that can affect the other issues, it was addressed at the same time as the other issues in the dispute process.
�It can be very challenging to come into a hearing and know there are so many alternatives for the hearing officer to address,� he said.
Parties in a dispute may base their recommendations for impairment ratings and dates of maximum medical improvement on what they think the extent of injury should be. If the hearing officer decides a different extent of injury, parties often request more time to adjust those recommendations.
The program is voluntary. The option to participate is presented by the presiding officer at the initial benefit review conference for cases that may benefit from the approach. The two-step approach is used only if both parties agree to it.
�The presiding officer usually knows going into the dispute whether a decision on extent of injury will move things along,� Sullivan said. �Deciding the extent of injury issue first can lead to a better outcome, a more efficient hearing, and more agreements.�
Dallas-Fort Worth area attorney Daniel Morris, of the Morris Law Firm, said several of his clients who are injured employees have opted to have their disputes handled under the two-step approach. He said there is a benefit to examining issues separately.
�When you�ve got four or five different combinations of possibilities for the extent of a worker�s injuries, it allows everybody to weigh their options before getting to the other issues,� Morris said.
Jeremy Lunn, who represents insurance carriers for the Silvera Law Firm in Dallas, said he agreed that some proceedings are slowed as attorneys try to guess what a hearing officer will decide on the extent of injury issue.
�This is a good thing that the division is trying to deal with delays in certain cases,� Lunn said. �DWC management really has been reaching out to attorneys and asking us to help it work.�
The two-step program started at the division�s Weslaco office in May 2015 and soon was expanded to Dallas. It�s now available at all 20 offices statewide.�
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
Texas employers are invited to join the Division of Workers� Compensation in Austin for the Texas Safety Summit on May 9-11. The 21st annual workplace safety and health conference offers important information for everyone who plays a role in safeguarding employees, from the beginner to the seasoned safety professional.
Employers will hear from top safety experts about some of the most critical safety and health issues facing Texas businesses. Attendees will learn practical tools and techniques to use in their workplaces to better protect their employees.
�The Safety Summit is a proactive way for us to help Texas businesses,� says Commissioner of Workers� Compensation, Ryan Brannan. �Not only does it help foster a positive safety culture for your company and its employees, it ultimately helps reduce costs associated with on-the-job injuries and illnesses.�
What to Expect
Presentations from experts at the National Safety Council, the Occupational Safety and Health Administration (OSHA), and many more.
Interactive exhibits on transportation safety.
Great networking opportunities with safety professionals from across the state.
Early-bird registration is $375 through April 17, 2017. The cost is $400 after that date.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Preventing Work Disability with Chiropractic
After being involved in an unfortunate accident at work, injuries and aggravated conditions resulting from the incident can often lead to a variety of painful symptoms and complications, if left untreated, along with missed days at work and lost wages. A new research study showed that workers who received regular chiropractic care experienced less work-related injuries.
Does Neck Curvature Protect You In a Car Accident?
Does the curvature of your cervical spine play a determinant in the severity of injury sustained in a motor vehicle accident?
We asked Chiropractic Biophysics, Dr. Deed Harrison to comment on this subject matter.
Unfortunately, many people can relate to having been involved in a car crash or motor vehicle collision (MVC) at some point in their lives. Whether it was a major accident or a minor one, MVC�s are no fun and can cause a variety of minor to serious injuries to those persons in the vehicles. These injuries are commonly and collectively referred to as �Whiplash Injuries�. The financial implications of a MVC, as well as interruption of your daily routine due to whiplash are also other major detriments of car crashes that may take years to recover from.
With more distracted drivers texting and speaking on their phones, MVC�s are on the rise, making for much more dangerous roadways. While we cannot control other people�s behaviors, we can certainly drive more cautiously and defensively to hopefully avoid being in a car accident. Unfortunately, MVC�s do happen despite our best efforts, so being prepared and having a plan in mind is key to recovering quickly and getting back on our feet again.
More serious car accidents mean more serious injuries, ranging from cuts and bruise to broken bones, brain damage, and even death. At first, less serious MVC�s however, may not seem like a big deal, with victims often walking away without a scratch, believing they have escaped the crash unscathed. Others may only complain of a slight headache, neck pain, stiff or kinked neck while resorting to taking over the counter pain killers, or wearing a neck brace to assist with their recovery � something that is far from addressing the true cause of the injury.
What most lay people (and even many physicians) don�t realize is the extent to which the CERVICAL LORDOIS (curvature in your neck from the side) plays a role in both: 1) the extent of the initial injury to the occupant(s) and 2) the long term pain and suffering from whiplash injury to the occupants. Furthermore, the MVC itself will damage the cervical lordosis.
1. Concerning the extent of initial injury, researchers have found that having a well preserved cervical lordosis actually prevents neck tissue damage to the sensitive cervical spine ligaments.1 In the figure at the top, the right hand image demonstrates what a normal cervical curve looks like when viewed from the side and the person facing to the right. In contrast, the same researchers identified that straightened cervical curves and worse yet, reversed (kyphotic) cervical curves predisposed to more severe cervical spine tissue injuries due to more extreme forces acting on the neck during the exact same MVC circumstances. The x-rays above at the far left and the middle show abnormal neck curves where more severe injury to the person is likely to result should they be involved in an MVC.
Thus, if you already have an abnormal cervical curvature prior to any MVC, it is in your best interest to rehabilitate the shape and amount of your cervical lordosis. If you do not, you�re at a higher risk of having more serious injuries should you be involved in a MVC.
2. In terms of long term pain and suffering, several research studies have identified that the patients who experience long term whiplash injuries and suffering are in fact the ones that have abnormal cervical lordosis. Straightened, S-curves, and Reversed cervical curvatures have been found to pre-dispose to the following conditions after MVC.
� Neck pain and stiffness,
� Headaches,
� Arm pain,
� Thoracic outlet symptoms,
� Dizziness,
� Lack of concentration,
� Degenerative arthritis in the cervical spine,
� Disc herinations.
What many whiplash injured subjects don�t realize is that a slight headache or neck pain is a true sign of a much more serious injury to your cervical lordosis and underlying neck tissues. Spinal misalignments as a result of the sudden jolt of the MVC may manifest immediately, or not become evident at all for a long period of time. But this doesn�t mean the spine is healthy or that no injury was sustained.
The fact is that MVC�s statistically damage the shape of your cervical lordosis. Researchers from Chiropractic BioPhysics have identified that the average patient exposed to a MVC will lose 10 degrees of their cervical lordosis, develop a mid cervical kyphosis, and have increased forward head posture as a result of the MVC.
A misaligned cervical curvature as a result of a MVC is a serious health condition. Altered cervical curves will cause nerve interference � hindrance of critical nerve energy that is responsible for every function of our organs, and every movement of our limbs. Ignoring the cervical spinal misalignment can manifest into pain and discomfort, fatigue, sleep disorders, organ dysfunction, depression, and eventually disease.
If you have been in a minor or major car accident, please see a corrective care chiropractor immediately for a full assessment of the health of your spine, even if you don�t feel any discomfort whatsoever. A small misalignment can only get worse with time, so addressing this injury quickly can mean a faster recovery time and less health problems in the future.
Corrective methods using Chiropractic BioPhysics��or CBP� Technique extension traction procedures and devices are the only true evidence based methods that have been shown to statistically and clinically improve the amount of cervical lordosis without the use of surgery. This has been documented in several clinical trials and case reports.8-11 Other conservative methods may restore the cervical lordosis in selected cases, but these have never been proven in clinical trials and are thus, at best, hit and miss. If you are suffering from an altered cervical lordosis as a result of a MVC, use the procedures that are truly scientifically supported.
Chiropractic Treatments for Whiplash
Whiplash Video
Because each individual case of whiplash is different, it is not possible to generalize about the chiropractic whiplash treatment.
The appropriate chiropractic treatment is unique to each whiplash injury and is directed at the primary dysfunctions detected during the chiropractic exam.
However, chiropractors commonly employ different chiropractic treatments for whiplash, often including:
Manipulation
Muscle relaxation and/or stimulation
Various exercises
Ergonomic and lifestyle changes.
This article explains when, why and how chiropractors may employ these whiplash treatments for neck pain, shoulder pain, back pain and other related symptoms.
Chiropractic Manipulation for Whiplash
The primary whiplash treatment for joint dysfunction, spinal manipulation involves the chiropractor gently moving the involved joint into the direction in which it is restricted.
Also known as a chiropractic adjustment, spinal manipulation may involve the application of a short thrust in that direction. In many cases, instead of a thrust, a slow mobilizing movement is used by the chiropractor.
The chiropractor’s primary whiplash treatment for related muscle dysfunction, muscle relaxation and/or stimulation consist of gentle stretches to the muscle that has excessive tension or repeated contractions of the muscle that is inhibited.
If the muscle is very tight, a more vigorous stretch may be applied by the chiropractor. Gentle finger pressure techniques may be applied to trigger points to relieve the pain associated with the tight muscles.
McKenzie Exercises and Stabilization/Sensorimotor Activities
View Chiropractic Videos
Chiropractors may employ different types of exercises, including McKenzie exercisesand/or stabilization and sensorimotor exercises, to help treat patients with whiplash injuries.
McKenzie exercises are specifically designed to reduce disc derangement related to a whiplash injury. They consist of simple movements that are initially done in the office but make for an easy transition to self-care at home. McKenzie exercises also help the patient take an active role in his or her own recovery
Stabilization and sensorimotor exercise approaches are designed to correct faulty movement patterns in routine activities and everyday life. Such whiplash treatment trains the nervous system to better coordinate and control movement patterns, and improves the ability of the neck muscles to maintain stability of the neck.
These exercises are designed to help in a major trauma, such as a fall or whiplash during a motor vehicle accident, or in “micro trauma” from simple things such as being jostled in a crowd, playing sports or performing occupational or home jobs that require physical effort.
Chiropractic Advice on Ergonomic and Lifestyle Changes
These whiplash treatment suggestions stress improvements for performing everyday activities with minimal strain to the body. The chiropractic advice addresses factors in an individual�s work, home or recreational activities that perpetuate the dysfunctions that result from the whiplash accident.
Additionally, spine care professionals at the chiropractic clinic may teach the patient better “use of self” and, if necessary, stress reduction methods to help chiropractic problems.
Whiplash Treatment in Chiropractic Care
Chiropractic On Cervical Spine Video
The whiplash treatment plan developed by the chiropractor for each specific problem may include one or more of these approaches and may involve others as well.
See Chiropractic Manipulation for the Cervical Spine
In addition to his or her whiplash treatment plan, the doctor of chiropractic might give a referral to another health professional, such as a medical specialist, if it is deemed appropriate.
�WHIPLASH, A SOFT TISSUE INJURY TO THE NECK, is also called neck sprain or neck strain. It is characterized by a collection of symptoms that occur following damage to the neck, usually because of sudden extension and flexion,� according to the National Institutes of Health.1
Approximately two-thirds of people involved in motor vehicle accidents develop symptoms of whiplash. The symptoms usually do not develop until two to 48 hours after the injury. Whiplash can also occur from falls, sports injuries, work injuries and other incidents.
Patients with whiplash injury may complain of pain and stiffness in the neck, extending into the shoulders and arms, upper back and even the upper chest. Two-thirds of patients suffer with headaches, especially at the base of the skull. Patients may also experience dizziness, difficulty swallowing, nausea and even blurred vision after injury, but these symptoms tend to resolve quickly.
According to Marshall, 45 percent to 85 percent of people who suffer a whiplash injury have the symptoms five years after the accident, and 82 percent had a straightening or reversal of their cervical curvature.2 “Many authors regard a straightening or reversal of the normally lordotic curvature to be one of the most significant changes of a whiplash injury.� 3
�The initial injury is due to damage of cervical muscles, ligaments, disks, blood vessels and nerves. The actual injury to soft tissues happens so rapidly that normal protective muscle reflexes cannot respond in time to decrease or prevent the injury,� according to a 2006 case report in the Journal of the American Chiropractic Association.3
The Diagnosis
To diagnose whiplash, a DC must first take a thorough history of the injury and the patient�s previous medical history. Pre-existing conditions, such as arthritis, may increase the severity of the whiplash. The DC should give the patient an in-depth physical examination with concentration on the neuromusculoskeletal system.
Similar to asking about whiplash injuries from motor vehicle accidents, DCs should ask the patient questions that reveal the details of a sports-related incident. DCs must ask patients with vehicular accident injuries, �Where was the impact from? Were you moving at the time? Did you have a seatbelt on? What type of seatbelt? Were you braced for impact? Did you hit anything in the vehicle?� says Dr. Alan Sokoloff, team chiropractor for the Baltimore Ravens. �You have to do the same for sport-related neck injuries, too,� he says.
Dr. Sokoloff explains that he �encounters doctors that say, �I do not treat sports injuries,� but if you are treating injuries from auto accidents and really dig into the mechanism of the injury with all of its details, it�s pretty much the same.�
Advanced Imaging
In some cases, advanced imaging may be necessary to make a proper diagnosis. A cervical CT scan is ordered if a DC suspects cervical spine trauma, such as a vertebral fracture, if the patient complains of paresthesia of the hands, if the patient is unconscious or has severe pain together with neurological deficits, explains Jerrold Simon, DC, president of the ACA Rehab Council.
�A cervical MRI is ordered when the whiplash patient complains of neck pain with radicular symptoms, such as a tingling sensation radiating down the arms or if there is suspected cervical spine trauma and the clinical findings suggest ligamentous damage. A cervical MRI may be ordered as a follow-up to normal cervical CT scan if the above symptoms are present,� says Dr. Simon.
Treatment
In treating whiplash injury, patients should be reminded to stay active, unless immobilization is necessary due to serious injury. �A cervical foam collar may be needed during the first few days following the incident if the cervical trauma is severe. However, in general, cervical collars are not recommended,� says Dr. Simon.
Immediately after the whiplash injury, Dr. Simon applies an ice compress to the posterior para-cervical spine musculature for about 10 minutes on a periodic basis. Ice compresses are generally only used for the first 48 hours after an injury.4
�A nutritional intervention for pain should include d-Phenylalanine 250 mg/day, dl-Phenylalanine 750 mg/day, L-tryptophan 3 g/day, and instruct the patient to to avoid coffee and other caffeinated beverages,� he says.
In addition, chiropractic care is beneficial. A retroactive study by Woodward et al. published in Injurydemonstrated that chiropractic treatment benefited 26 of 28 patients suffering from chronic whiplash syndrome.5 Chiropractic care in this study included spinal manipulation, proprioceptive neuromuscular facilitation stretching and cryotherapy [ice-pack therapy].
A neck adjustment works to improve the mobility of the spine to increase range of motion, while also enhancing movement of the adjoining muscles. This will eventually eliminate pain, soreness and stiffness and allow a patient to painlessly turn and tilt the head. In addition to adjustments, a treatment plan of mobilization, massage or rehabilitative exercises may speed up the recovery process.
�Cervical rehabilitation procedures should be considered after the initial pain and inflammation have substantially subsided,� says Dr. Simon. �Then a functional capacity evaluation with focal attention to the cervical spine should be performed to assess the magnitude and degree of upper spinal functional deficiency.�
Following this test, a DC can decide if the patient should receive a treatment of isometric cervical flexion, extension and lateral flexion against resistance exercises, a proprioceptive rocker board, wobble board and/or gym ball exercises and vibration therapy.
�Every person is different, and everyone�s ability to heal is different, so how we treat patients is very individualized,� says Dr. Sokoloff. �We will use modalities initially, if indicated. We will use soft-tissue techniques, if indicated. We will usually use a chiropractic adjustment, if indicated. But the one procedure we always use is progressive rehabilitative exercises, in office and home recommendations.�
Home recommendations include proper computer and phone ergonomics, range-of-motion exercises and icing, to name a few.
�Treatment plans that do not hold the patient responsible for helping themselves cheat everyone,� says Dr. Sokoloff. �The more a patient is informed about home icing instructions, home exercise and activity of daily living modifications, the better the outcomes are for everyone.�
What many whiplash injured subjects don�t realize is that a slight headache or neck pain is a true sign of a much more serious injury to your cervical lordosis and underlying neck tissues.�Because each individual case of whiplash is different, it is not possible to generalize about the chiropractic whiplash treatment.�For Answers to any questions you may have please call Dr. Jimenez at�915-850-0900
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