Back Clinic Treatments. There are various treatments for all types of injuries and conditions here at Injury Medical & Chiropractic Clinic. The main goal is to correct any misalignments in the spine through manual manipulation and placing misaligned vertebrae back in their proper place. Patients will be given a series of treatments, which are based on the diagnosis. This can include spinal manipulation, as well as other supportive treatments. And as chiropractic treatment has developed, so have its methods and techniques.
Why do chiropractors use one method/technique over another?
A common method of spinal adjustment is the toggle drop method. With this method, a chiropractor crosses their hands and pressed down firmly on an area of the spine. They will then adjust the area with a quick and precise thrust. This method has been used for years and is often used to help increase a patient’s mobility.
Another popular method takes place on a special drop table. The table has different sections, which can be moved up or down based on the body’s position. Patients lie face down on their back or side while the chiropractor applies quick thrusts throughout the spinal area as the table section drops. Many prefer this table adjustment, as this method is lighter and does not include twisting motions used in other methods.
Chiropractors also use specialized tools to assist in their adjustments, i.e., the activator. A chiropractor uses this spring-loaded tool to perform the adjustment/s instead of their hands. Many consider the activator method to be the most gentle of all.
Whichever adjustment method a chiropractor uses, they all offer great benefits to the spine and overall health and wellness. If there is a certain method that is preferred, talk to a chiropractor about it. If they do not perform a certain technique, they may recommend a colleague that does.
George Lara, now a retired construction contractor, experienced a back injury 20 years ago which affected his original state of well-being. Although he was promptly treated at the time of the incident, Mr. Lara suffered another back injury which manifested into sciatic nerve pain. George Lara had been greatly affected by his back injury, fortunately, he found Dr. Alex Jimenez, a back pain specialist, who restored his quality of life. Mr. Lara expresses his gratitude towards Dr. Alex Jimenez’s services and he greatly recommends chiropractic care as the non-surgical choice for alleviating back pain and sciatica.
Sciatic nerve pain�is a medical condition characterized by radiating pain down the leg from the lower back. Onset is often sudden following tasks like heavy lifting, even though slow onset may also occur. Normally, symptoms are only on one side of the body. Certain triggers, however, could lead to pain on both sides. Weakness or numbness may occur in a variety of areas of the affected leg and foot. About 90 percent of the time sciatica is due to a spinal disc herniation pressing on the lumbar or sacral nerve roots. Other problems that may bring about sciatica comprise of spondylolisthesis, spinal stenosis, piriformis syndrome, pelvic tumors, and compression.
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Volleyball Injury: James Hill is a school teacher and father of two older sons and his youngest daughter Madison Hill. As a part of an athletic family, Madison has been involved in sports since a young age, however, she experienced many injuries as a result. Fortunately, James Hill and his daughter Madison Hill met Dr. Alex Jimenez and he’s helped her get back up on her feet ever since. They both have learned to believe in chiropractic care due to Dr. Alex Jimenez’s innovative treatment methods and techniques. Mr. Hill expresses how much Dr. Alex Jimenez’s knowledge in sports injury treatment has expanded his overall understanding of the human body’s recovery process. After Madison suffered a recent ankle sprain, she was immediately reassured by Dr. Alex Jimenez regarding how much faster she could return-to-play with chiropractic care. James Hill and Madison Hill highly recommend Dr. Alex Jimenez and his staff as the non-surgical choice for volleyball sports injuries and other types of injuries.
Each year, millions of teenagers take part in high school sports. However, when an injury to a young athlete occurs, it can be disappointing to them and the family as well as to the coaches. The pressure to continue participating in their specific sport or physical activity can cause the young athlete to avoid receiving proper treatment, which could then lead to further injury with long-term effects. Sports injuries among young athletes fall into two primary categories: overuse injuries and acute injuries. Both kinds include injuries to the soft tissues (muscles and ligaments) and bones. Whether an injury is acute or due to overuse, a young athlete who develops a symptom that persists or that impacts their athletic performance ought to be examined by a healthcare professional. Sports injuries that are untreated could lead to permanent disability or damage. Many high school sports injuries can be avoided through proper conditioning, training, and gear.
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Chiropractic care is extremely beneficial for many different conditions; some obvious while others are more obscure. Structural issues that affect the knees are often very responsive to chiropractic treatment. In the case of chondromalacia patellae and other knee problems, it has proven to reduce pain and help improve the condition considerably, providing the patient with increased mobility and flexibility.
Chondromalacia Patellae (aka Runner�s Knee)
Approximately 40 percent of injuries that runners experience are knee injuries. These injuries fall under the umbrella term of �runner�s knee.� This includes chondromalacia patellae which may also be referred to as patellofemoral pain syndrome (PFMS).
Other runner�s knee injuries include iliotibial band syndrome, and plica syndrome. Chondromalacia patellae is one of the more common forms of runner�s knee, along with PFMS. Rest and ice are typical remedies, but when that doesn�t work or when the pain and mobility difficulties return once the patient returns to normal activities, chiropractic care is often a good treatment option.
Chondromalacia Patella
The knee is a marvelous piece of machinery. It is constructed to take the impact of the body�s weight, bending, and moving. Under the kneecap is a layer of cartilage which acts as a natural shock absorber. Injury, overuse, aging, or other conditions can cause damage to that cartilage.
This condition causes pain and impaired mobility, most commonly when the knees are in use such as walking up or down stairs. The pain may decrease with rest and ice, but sometimes that simply isn�t enough. Traditional treatments include physical therapy, medication for pain, and surgery.
Symptoms
The most common symptom of chondromalacia patellae is pain in the front of the knee. It is often described as a dull ache that is deep in the knee. This pain is often made worse when the patient sits with their knee bent for a long time, when they squat or kneel, or when they walk up and down stairs.
The more the patient uses the knee, the worse it is. However, rest and ice can work fairly quickly to help relieve the pain. If the pain persists even with rest and ice, then more aggressive care is usually advised. While traditionally doctors prescribe medication and even surgery, more patients are gravitating to drug free, less invasive treatments for knee pain. Chiropractic is a viable option.
Causes & Risk Factors
The exact cause of chondromalacia patellae is not known. Doctors have been able to link the condition to several factors. Overuse of the knee places repetitive stress on the joint. This is commonly seen in sports or activities that involve a lot of jumping or running.
Poor muscle control is another common factor. The muscles that surround the knee and hip don�t function properly so that tracking of the kneecap is �off.� Injury is another common factor with chondromalacia patellae. When the kneecap endures a trauma such as fracture or dislocation.
There are several factors that may increase a person�s risk of developing chondromalacia patellae. Age is often noted in young adults and adolescents. Older individuals with knee pain are usually experiencing effects of arthritis.
Gender is another risk factor. Women develop the condition twice as often as men. Doctors theorize that this is due to the skeletal structure of a woman � the pelvis is wider which increases the angle where the bones of the knee joint meet.
Individuals who participate in certain sports, such as those that involve a lot of jumping and running, are at an increased risk of developing the condition. This is particularly true if they suddenly increase their level of training.
Chiropractic Treatment
Successful chiropractic treatments for chondromalacia patellae include nutritional intervention as well as adjustments and stretches. The treatment is designed to stretch shortened hamstrings and adjust the sacroiliac joint.
The point of much of the treatment is to improve tracking of the kneecap and increase motor control. Some practitioners use soft tissue work to help patients with knee pain. The whole body approach that chiropractic care offers not only provides relief from knee pain, but often cures or reduces the condition itself.
If you or a loved one are suffering from knee pain, give us a call. Our Doctor of Chiropractic will do a thorough exam to determine the proper treatment protocol for your condition. You don�t have to live with pain. Again, give us a call. We�re here to help!
A migraine is a neurological condition commonly characterized by an intense, debilitating headache. Approximately 12 percent of the population in the United States suffers from migraines. Other symptoms may include: nausea, vomiting, difficulty speaking, numbness or tingling, and sensitivity to light and sound. Several factors can trigger a migraine. These include: stress, lack of food or sleep, exposure to light, hormonal changes in women and anxiety. Although healthcare professionals have yet to understand the true source of migraines, doctors of chiropractic have concluded that a spinal misalignment, or subluxation, may be associated with different types of headaches. The purpose of the following article is to demonstrate the results of a case of chronic migraine remission after a 72-year-old woman with a 60-year history of migraine headaches received chiropractic care.
A Case of Chronic Migraine Remission After Chiropractic Care
Abstract
Objective: To present a case study of migraine sufferer who had a dramatic improvement after chiropractic spinal manipulative therapy (CSMT).
Clinical features: The case presented is a 72-year�old woman with a 60-year history of migraine headaches, which included nausea, vomiting, photophobia, and phonophobia.
Intervention and outcome: The average frequency of migraine episodes before treatment was 1 to 2 per week, including nausea, vomiting, photophobia, and phonophobia; and the average duration of each episode was 1 to 3 days. The patient was treated with CSMT. She reported all episodes being eliminated after CSMT. The patient was certain there had been no other lifestyle changes that could have contributed to her improvement. She also noted that the use of her medication was reduced by 100%. A 7-year follow-up revealed that the person had still not had a single migraine episode in this period.
Conclusion: This case highlights that a subgroup of migraine patients may respond favorably to CSMT. While a case study does not represent significant scientific evidence, in context with other studies conducted, this study suggests that a trial of CSMT should be considered for chronic, nonresponsive migraine headache, especially if migraine patients are nonresponsive to pharmaceuticals or prefer to use other treatment methods.
Migraine is a prevalent and debilitating condition which affects about 12 percent of the population in the U.S.� Furthermore, migraine affects more women than men. While the causes and symptoms of migraine headache pain have been identified, many healthcare professionals believe that a spinal misalignment, or subluxation, may often lead to various types of headaches. Chiropractic care utilizes spinal adjustments and manual manipulations to carefully correct the alignment of the spine, restoring proper structure and function. According to the research study below, chiropractic can be an effective migraine headache treatment. Chiropractic care is a safe and effective alternative treatment option for patients with migraine who seek a natural method and technique to reduce their symptoms without the use of drugs and/or medications.
Introduction
Migraine remains a common and debilitating condition.[1,2] It has an estimated incidence of 6% in males and 18% in females.[2] A study in Australia found the cost to industry to be an estimated $750 million.[3] Lipton et al found that migraine is one of the most frequent reasons for consultations with general practitioners, affecting between 12 million and 18 million people each year in the United States.[4] The estimated cost in the United States is $25 billion in lost productivity due to 156 million full-time work days being lost each year.[5] Recent information has suggested that these older figures above are still current, but also underestimated, because of many sufferers not stating their problem because of a perceived poor social stigma.[6]
The Brain Foundation in Australia notes that 23% of households contain at least one migraine sufferer. Nearly all migraine sufferers and 60% of those with tension-type headache experience reductions in social activities and work capacity. The direct and indirect costs of migraine alone would be about $1 billion per annum.[3]
The Headache Classification Committee of the International Headache Society (IHS) defines migraines as having the following: unilateral location, pulsating quality, moderate or severe intensity, and aggravated by routine physical activity. During the headache, the person must also experience nausea and/or vomiting, photophobia, and/or phonophobia.[7] In addition, there is no suggestion either by history or by physical or neurologic examination that the person has a headache listed in groups 5 to 11 of their classification system.[7] Groups 5 to 11 of the classification system include headache associated with head trauma, vascular disorder, nonvascular intracranial disorder, substances or their withdrawal, noncephalic infection, or metabolic disorder, or with disorders of cranium, neck, eyes, nose, sinuses, teeth, mouth, or other facial or cranial structures.
Some confusion relates to the �aura� feature that distinguishes migraine with aura (MA) and migraine without aura (MW). An aura usually consists of homonymous visual disturbances, unilateral paresthesias and/or numbness, unilateral weakness, aphasia, or unclassifiable speech difficulty.[7] Some migraineurs describe the aura as an opaque object, or a zigzag line around a cloud; even cases of tactile hallucinations have been recorded.[8] The new terms MA and MW replace the old terms classic migraine and common migraine, respectively.
The IHS diagnostic criteria for MA (category 1.2) is at least 3 of the following:
1) One or more fully reversible aura symptoms indicating focal cerebral cortex and/or brain stem dysfunction.
2) At least 1 aura symptom develops gradually over more than 4 minutes or 2 or more symptoms occurring in succession.
3) No aura symptom lasts more than 60 minutes.
4) Headache follows aura with a free interval of less than 60 minutes.
Migraine is often still nonresponsive to treatment.[9] However, several studies have demonstrated statistically significant reduction in migraines after chiropractic spinal manipulative therapy (CSMT).[10-15]
This article will discuss a patient presenting with MW and her response after CSMT. The discussion will also outline specific diagnostic criteria for migraine and other headaches relevant to chiropractors, osteopaths, or other health practitioners.
Case Report
A 72-year�old 61-kg white woman presented with migraine headaches that had commenced in early childhood (approximately 12 years old). The patient could not relate anything to the commencement of her migraines, although she believed there was a family history (father) of the condition. During the history, the patient stated that she suffered regular migraine headaches (1-2 per week) with which she also experienced nausea, vomiting, vertigo, and photophobia. She needed to cease activities to alleviate the symptoms, and she often required acetaminophen and codeine medication (25 mg) or sumatriptan succinate for pain relief. The patient was also taking verapamil (calcium ion antagonist, for essential hypertension), calcitriol (calcium uptake, for osteoporosis), pnuemenium on a daily basis, and carbamazipine (antiepileptic, neurotropic medication) twice daily.
The patient reported that an average episode lasted 1 to 3 days and that she could not perform activities of daily living for a minimum of 12 hours. In addition, a visual analogue scale score for an average episode was 8.5 out of a possible maximum score of 10, corresponding to a description of �terrible� pain. The patient noted that stress or tension would precipitate a migraine and that light and noise aggravated her condition. She described the migraine as a throbbing head pain located in the parietotemporal region and was always left-sided.
The patient had a previous history of a pulmonary embolism (2 years before treatment) and had a partial hysterectomy 4 years before treatment. She also stated she had hypertension that was controlled. She was a widow with 2 children, and she had never smoked. The patient had tried acupuncture, physiotherapy, substantial dental treatment, and numerous other medications; but nothing had changed her migraine pattern. She stated that she had never had previous chiropractic treatment. The patient also stated that she had been treated by a neurologist for �migraines� over many years.
On examination, she was found to have very sensitive suboccipital and upper cervical musculature and decreased range of motion at the joint between the occiput and first cervical vertebra (Occ-C1), coupled with pain on flexion and extension of the cervical spine. She also had significant reduction in thoracic spine motion and a marked increase in her thoracic kyphosis.
Blood pressure testing revealed she was hypertensive (178/94), which the patient reported was an average result (stage 2 hypertension using the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 7 guidelines).
Based on the IHS Headache Classification Committee classification and diagnostic criteria, the patient had an MW�category 1.1, previously called common migraine (Table 1). This appeared secondary to moderate cervical segmental dysfunction with mild to moderate suboccipital and cervical paraspinal myofibrosis.
The patient received CSMT (diversified chiropractic �adjustments�) to her Occ-C1 joint, upper thoracic spine (T2 through T7), and the affected hypertonic musculature. Hypertonic muscles were released through gentle massage and stretching. An initial course of 8 treatments was conducted at a frequency of twice a week for 4 weeks. The treatment program also included recording several features for every migraine episode. This included frequency, visual analogue scores, episode duration, medication, and time before they could return to normal activities.
The patient reported a dramatic improvement after her first treatment and noticed a reduction in the intensity of her head and neck pain. This continued with the patient reporting having no migraines in the initial month course of treatment. Further treatment was recommended to increase her range of motion, increase muscle tone, and reduce suboccipital muscle tension. In addition, monitoring of her migraine symptoms was continued. A program of treatment at a frequency of once a week for a further 8 weeks was instigated. After the next phase of treatment, the patient noted much less neck tension, better movement, and no migraine. In addition, she no longer used pain-relieving medication (acetaminophen, codeine, and sumatriptan succinate) and noted that she did not experience nausea, vomiting, photophobia, or phonophobia (Table 2). The patient continued treatment at 2-weekly intervals and stated that, after 6 months, her migraine episodes had disappeared completely. In addition, she was no longer experiencing neck pain. Examination revealed no pain on active neck movement; however, a passive motion restriction at the C1-2 motion segment was still present.
The patient is currently having treatment every 4 weeks, and she still reports no return of her migraine episodes or neck pain. The patient has now not experienced any migraines for a period of more than 7 years since her last episode, which was immediately before her having her first chiropractic treatment.
Discussion
Case studies do not form high levels of scientific data. However, some cases do present significant findings. For example, cases with long (chronic) and/or severe symptomatology can highlight alternative treatment options. With case studies such as this, there is always a possibility that the symptoms spontaneously resolved, with no effective from the treatment. The case presented highlights a potential alternative treatment option. A 7-year follow-up revealed that the person had still not had a single migraine episode in this period. The patient was certain that there had been no other lifestyle changes that could have contributed to her improvement. She also noted that the migraines had stopped after her first treatment.
The average frequency of her migraines before treatment was 1 to 2 per week, with episodes that always included nausea, vomiting, photophobia, and phonophobia. In addition, the average duration of each episode was 1 to 3 days before her receiving CSMT. The person also noted that the use of her pain-relieving medication was also reduced by 100% (Table 3).
Table 3: Summary of key changes for this case.
Migraines are a common and debilitating condition; yet because they have an uncertain etiology, the most appropriate treatment regime is often unclear.[16] Previous etiological models described vascular causes of migraine, where episodes seem to be initiated by a decreased blood flow to the cerebrum followed by extracranial vasodilation during the headache phase.[8] However, other etiological models seem connected with vascular changes related to neurologic changes and associated serotonergic disturbances.[9] Therefore, previous treatments have focused on pharmacological modification of blood flow or serotonin antagonist block.[17]
Studies examining the role of the cervical spine to headache (ie, �cervicogenic headache�) have been well described in the literature.[18-30] However, the relation of the cervical spine to migraine is less well documented.[10-15] Previous studies by this author have demonstrated an apparent reduction in migraines after CSMT.[10,11] In addition, other studies have suggested that CSMT may be an effective intervention for migraine.[14,15] Although, previous studies have some limitations (inaccurate diagnosis, overlapping symptoms, inadequate control groups), the level of evidence gives support for CSMT in migraine treatment.[11] However, practitioners need to be critically aware of potential overlap of diagnoses when reviewing migraine research or case studies on effectiveness of their treatment.[18-22] This is especially important in comparison of migraine patients who may be suitable for chiropractic manipulative therapy.[23-28]
Between 40% and 66% of patients with migraine, particularly those with severe or frequent migraine attacks, do not seek help from a physician.[29] Among those who do, many do not continue regular physician visits.[30] This may be due to patients’ perceived lack of empathy from the physician and a belief that physicians cannot effectively treat migraine. In a 1999 British survey, 17% of 9770 migraineurs had not consulted a physician because they believed their condition would not be taken seriously; and 8% had not seen a physician because they believed existing migraine medications were ineffective.[30] The most common reason for not seeking a physician’s advice (cited by 76% of patients) was the patients’ belief that they did not need a physician’s opinion to treat their migraine attacks.
The case was presented to assist practitioners making a more informed decision on the treatment of choice for migraines. The outcome of this case is also relevant in relation to other research that concludes that CSMT is a very effective treatment for some people. Practitioners could consider CSMT for migraine based on the following:
1) Limitation of passive neck movements.
2) Changes in neck muscle contour, texture, or response to active and passive stretching and contraction.
3) Abnormal tenderness of the suboccipital area.
4) Neck pain before or at the onset of the migraine.
5) Initial response to CSMT.
As with all case reports, results are limited in application to larger populations. Careful clinical decision making should be used when applying these results to other patients and clinical situations.
Conclusion
This case demonstrates that some migraine sufferers may respond well with manual therapies, which includes CSMT. Therefore, migraine patients who have not received a trial of CSMT should be encouraged to consider this treatment and assess any potential response. Where there are no contraindications to CSMT, an initial trial of treatment may be warranted. Following evidence-based medicine guidelines, medical practitioners should discuss CSMT with migraine patients as an option for treatment.[31,32] Subsequent studies should address this issue and the role that CSMT has in migraine management.
In conclusion, a�migraine is a debilitating and intense type of headache which is often accompanied by a variety of other symptoms. Although still misunderstood today, doctors of chiropractic have shown that a spinal misalignment, or subluxation may trigger migraine headaches. According to the article above, chiropractic care may effectively help individuals who suffer from migraine headaches. However, further research studies are required.�Information referenced from the National Center for Biotechnology Information (NCBI). The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
1.�Bigal M.E., Lipton R.B., Stewart W.F. The epidemiology and impact of migraine.�Curr Neurol Neurosci Rep.�2004;4(2):98�104.�[PubMed]
2.�Lipton R.B., Stewart W.F., Diamond M.L., Diamond S., Reed M. Prevalence and burden of migraine in the United States: data from the American Migraine Study 11.�Headache.�2001;41:646�657.�[PubMed]
3.�Alexander L.�Migraine in the workplace. Brainwaves.�Australian Brain Foundation; Hawthorn, Victoria: 2003. pp. 1�4.
4.�Lipton R.B., Bigal M.E. The epidemiology of migraine.�Am J Med.�2005;118(Suppl 1):3S�10S.[PubMed]
5.�Lipton R.B., Bigal M.E. Migraine: epidemiology, impact, and risk factors for progression.�Headache.�2005;45(Suppl 1):S3�S13.�[PubMed]
6.�Stewart W.F., Lipton R.B. Migraine headache: epidemiology and health care utilization.�Cephalalgia.�1993;13(suppl 12):41�46.�[PubMed]
7.�Headache Classification Committee of the International Headache, Society Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain.�Cephalgia.�2004;24(Suppl. 1):1�151.[PubMed]
8.�Goadsby P.J., Lipton R.B., Ferrari M.D. Migraine�current understanding and treatment.�N Engl J Med.�2002;346:257�263.�[PMID 11807151]�[PubMed]
9.�Goadsby P.J. The scientific basis of medication choice in symptomatic migraine treatment.�Can J Neurol Sci.�1999;26(suppl 3):S20�S26.�[PubMed]
10.�Tuchin P.J., Pollard H., Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine.�J Manipulative Physiol Ther.�2000;23:91�95.�[PubMed]
11.�Tuchin P.J. The efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment of migraine�a pilot study.�Aust Chiropr Osteopath.�1997;6:41�47.�[PMC free article]�[PubMed]
12.�Tuchin P.J., Bonello R. Classic migraine or not classic migraine, that is the question.�Aust Chiropr Osteopath.�1996;5:66�74.�[PMC free article]�[PubMed]
13.�Tuchin P.J., Scwafer T., Brookes M. A case study of chronic headaches.�Aust Chiropr Osteopath.�1996;5:47�53.�[PMC free article]�[PubMed]
14.�Nelson C.F., Bronfort G., Evans R., Boline P., Goldsmith C., Anderson A.V. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache.�J Manipulative Physiol Ther.�1998;21:511�519.�[PubMed]
15.�Parker G.B., Tupling H., Pryor D.S. A controlled trial of cervical manipulation for migraine.�Aust NZ J Med.�1978;8:585�593.�[PubMed]
16.�Dowson A.J., Lipscome S., Sender J. New guidelines for the management of migraine in primary care.�Curr Med Res Opin.�2002;18:414�439.�[PubMed]
17.�Ferrari M.D., Roon K.I., Lipton R.B. Oral triptans (serotonin 5-HT1B/1D agonists) in acute migraine treatment: a meta-analysis of 53 trials.�Lancet.�2001;358:1668�1675.�[PubMed]
18.�Sjasstad O., Saunte C., Hovdahl H., Breivek H., Gronback E. Cervical headache: an hypothesis.�Cephalgia.�1983;3:249�256.
19.�Vernon H.T. Spinal manipulation and headache of cervical origin.�J Manipulative Physiol Ther.�1989;12:455�468.�[PubMed]
20.�Sjasstad O., Fredricksen T.A., Stolt-Nielsen A. Cervicogenic headache, C2 rhizopathy, and occipital neuralgia: a connection.�Cephalgia.�1986;6:189�195.�[PubMed]
21.�Bogduk N. Cervical causes of headache and dizziness. In: Greive G.P., editor.�Modern manual therapy of the vertebral column.�2nd ed. Edinburgh; Churchill Livingstone: 1994. pp. 317�331.
22.�Jull G.A. Cervical headache: a review. In: Greive GP, editor.�Modern manual therapy of the vertebral column.�2nd ed. Edinburgh; Churchill Livingstone: 1994. pp. 333�346.
23.�Boline P.D., Kassak K., Bronfort G. Spinal manipulations vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial.�J Manipulative Physiol Ther.�1995;18:148�154.[PubMed]
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27.�Jull G., Trott P., Potter H., Zito G., Shirley D., Richardson C. A randomized controlled trial of exercise and spinal manipulation for cervicogenic headache.�Spine.�2002;27:1835�1843.�[PubMed]
28.�Bronfort G, Nilsson N, Assendelft WJJ, Bouter L, Goldsmith C, Evans R, et al. Non-invasive physical treatments for chronic headache (a Cochrane review). In: The Cochrane Library Issue 2 2003. Oxford: Update Software.
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18 Wheeler Accident: Jesus Rabelo earns a living as a truck driver in El Paso, TX. After being involved in an accident, however, Mr. Rabelo sufferered from shoulder and back pain which affected his personal life and work, forcing him to have to start over again. In regards to a highly valued recommendation, Jesus Rabelo found Dr. Alex Jimenez, chiropractor in El Paso, TX. Mr. Rabelo describes receiving excellent service from the staff and he highly recommends Dr. Alex Jimenez.
In 2013, 54 million people sustained injuries from traffic collisions. This resulted in 1.4 million deaths in 2013, up from 1.1 million deaths in 1990. Auto accidents can be classified into different types, including head-on, road departure, rear-end, side collisions, and rollovers. Psychological issues may occur due to automobile accidents. A range of injuries and conditions can result from the blunt force trauma caused by a collision, including whiplash and back pain.
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Each year in America there are between 6.5 million and 7 million Motor Vehicle Accidents or�(MVA’s)�that affect many. Of those accidents, about three million involve some form of bodily injury. About two thirds of these injuries, while not debilitating, are permanent. When you are rear-ended your body is driven out from under your head. Although there is a great deal of soft tissue stretching that occurs in the soft tissues (LIGAMENTS, TENDONS, MUSCLES, and FASCIA), as your body travels forward at a significantly higher velocity than your head; at a certain point, these “soft tissues” cannot stretch anymore. This is the first point at which microscopic tissue tearing occurs. This is the beginning of the injury process.
The head is now accelerating forward faster than the entire body. When the body comes to a stop (i.e. your vehicle slams into whatever is in front of it), the head will continue to travel forward. This is actually where the term “whiplash” comes from, and where it occurs. It’s exactly the principle of physics that results in the tip of a bullwhip to ‘crack’ as it breaks the sound barrier. If this type of ‘whipping’ motion occurs in the neck, it can result in a great deal of soft tissue damage and subsequent formation of fibrosis and scar tissue. Additionally, it may lead to a great deal of occult (hidden) brain and nerve system trauma.
Dr. Alexander Jimenez D.C.
Study Design:
An experimental study of motor/sensory function and psychological distress in subjects with acute whiplash injury.
Objective:
Characterizing acute whiplash injuries in terms of motor/sensory systems dysfunction and psychological distress. This involves comparison of subjects with higher and lesser levels of pain and disability.
Summary Of Background Data:
Motor system dysfunction, sensory hypersensitivity, and psychological distress are present in chronic whiplash associated disorders (WAD), but little is known of such factors in the acute stage of injury. As higher levels of pain and disability in acute WAD are accepted as signs of poor outcome, further characterization of this group from those with lesser symptoms is important.
Materials And Methods:
Motor function (cervical range of movement[ROM], joint position error [JPE]; activity of the superficial neck flexors[EMG] during a test of cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds, and responses to the brachial plexus provocation test), and psychological distress (GHQ-28, TAMPA, IES) were measured in 80 whiplash subjects (WAD II or III) within 1 month of injury, as were 20 control subjects.
Results:
Three subgroups were identified in the cohort using cluster analysis based on the Neck Disability Index: those with mild, moderate, or severe pain and disability. All whiplash groups demonstrated decreased ROM and increased EMG compared with the controls (all P < 0.01). Only the moderate and severe groups demonstrated greater JPE and generalized hypersensitivity to all sensory tests (all P < 0.01). The three whiplash subgroups demonstrated evidence of psychological distress, although this was greater in the moderate and severe groups. Measures of psychological distress did not impact on between group differences in motor or sensory tests.
Conclusions:
Acute whiplash subjects with higher levels of pain and disability were distinguished by sensory hypersensitivity to a variety of stimuli, suggestive of central nervous system sensitization occurring soon after injury. These responses occurred independently of psychological distress. These findings may be important for the differential diagnosis of acute whiplash injury and could be one reason why those with higher initial pain and disability demonstrate a poorer outcome.
Sterling M1,�Jull G,�Vicenzino B,�Kenardy J.
Author Information
Whiplash Research Unit, Department of Physiotherapy, The University of Queensland, Brisbane, Australia. m.sterling@shrs.uq.edu.au
Neck Pain Treatment: Shane Scott was involved in a car accident and suffered injuries which manifested into debilitating headaches and lower back pain. As a recent father, Shane Scott must rely on his overall health and wellness to take care of his daughter. Shane Scott became a car accident treatment patient with Dr. Alex Jimenez and his symptoms improved dramatically within a matter of time. Shane Scott highly recommends Dr. Alex Jimenez as a non-surgical choice to help improve auto accident whiplash injuries and their symptoms.
Whiplash is a non-medical term used to describe a range of injuries to the neck caused by or associated with a sudden distortion of the neck related to extension, although the specific injury mechanisms remain unknown. “Cervical acceleration–deceleration” (CAD) describes the mechanism of this injury, while the term “whiplash associated disorders” (WAD) refers to the harm sequelae and symptoms. Whiplash is often related to auto accidents, typically when the vehicle has been hit in the rear nonetheless, the injury could be sustained in a number of different ways. Whiplash is one of the most often claimed injuries on auto insurance policies.
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