Back Clinic Whiplash Chiropractic and Physical Therapy Team. Whiplash is a collective term used to describe injuries to the cervical spine (neck). This condition often results from an automobile crash, which suddenly forces the neck and head to whip back and forth (hyperflexion/hyperextension). Almost 3 million Americans are hurt and suffer from whiplash annually. Most of those injuries come from auto accidents, but there are other ways to endure a whiplash injury.
The symptoms of whiplash may include neck pain, tenderness and stiffness, headache, dizziness, nausea, shoulder or arm pain, paresthesias (numbness/tingling), blurred vision, and in rare instances difficulty swallowing. Soon after it happens at the acute phase the chiropractor will focus on reducing neck inflammation utilizing various therapy modalities (eg, ultrasound).
They might also use gentle stretching and manual therapy techniques (eg, muscle energy therapy, a type of stretching). A chiropractor may also recommend you apply an ice pack to your neck and/or light neck support to use for a short time period. As your neck gets less inflamed and the pain diminishes, your chiropractor will execute spinal manipulation or other techniques to restore normal movement to your neck’s spinal joints.
Motor vehicle accidents, sports injuries, work injuries, and falls are a few causes of whiplash. It is a condition that affects over 1.5 million individuals. It can cause serious side effects that can last for months and sometimes years. If not treated, the symptoms can worsen and lead to chronic conditions and pain.
Mild Whiplash
Mild whiplash can last around three months. During this time individuals might notice other symptoms other than neck pain that includes:
In certain cases, these symptoms happen immediately or they can be delayed.
Severe Whiplash
Severe whiplash means symptoms last longer than three months. The side effects can progressively go away or may not disappear at all. Severe whiplash falls in the whiplash classification of three to four. This indicates that there is a:
Loss of motion
Neurological problems
Fracture/s
Taking time off work for a whiplash injury depends on how severe the condition is. For mild symptoms, individuals are recommended to take about a month off to fully recover. If the condition is extreme, it could take a few years. For some individuals, the injury prevents them from working, and they have to leave their job.
Tinnitus
After a whiplash injury, some individuals develop tinnitus. This is a condition that results from the jolted ligaments and can irritate the surrounding nerves. This can cause an irritating ringing noise in the ears. How long tinnitus lasts depends on the severity of the injury. It can present every so often or could remain for several months even years.
Recovery Time
For most individuals, it takes around 4-6 weeks for a full recovery. This could last longer if the injury is not healed properly.
Chronic whiplash can present shooting pain throughout the body and prevents individuals from living a normal life. For chronic conditions chiropractic and physical therapy are highly recommended. Treatment could be difficult at first, but improvements will follow as long as the individual stays consistent with the therapy to completely heal the injury.
Treatment Options
The first recommendation will be to rest the body. This gives the body time to recover and also prevents worsening the injury. Ice packs and heating pads can help reduce swelling and pain.
Chiropractic
Chiropractors are experts in the musculoskeletal system. They inspect the whole body looking and feeling for misalignments, knotted muscles, swollen tendons, and ligaments that were stretched/pulled beyond their normal range. Various types of adjustments can be used. The most common are flexion-distraction and instrument-assisted.
Flexion-Distraction adjusting requires the chiropractor’s hands. They feel around the problem area and press their hands to slide the joint back in place.
Instrument-Assisted – utilizes a special tool, like an activator. The device helps the chiropractor delve deeper into the area than their hands. This helps them locate problems that could be hidden.
Anti-Inflammatory Diet
Adding more anti-inflammatory foods to the diet will reduce and alleviate inflammation and swelling. Some of these foods include:
Avocados
Blueberries
Mushrooms
Olive oil
Salmon
Strawberries
Turmeric
Vitamins
A full recovery can take longer if the body lacks essential nutrients. These nutrients are what helps the body create enzymes that repair the damaged tissues, bones, tendons, etc. If the body does not have enough it will not heal properly. Essential vitamins to take for injuries include:
These can be taken in supplement form or through food sources.
Body Composition
The body loses muscle every minute of life. This is because the muscles, like the other tissues in the body they depend on cell turnover and protein synthesis. This means that the body continually breaks down the protein in the muscles and rebuilds them. This is how the body is supposed to function and part of what keeps it alive. Skeletal muscle can be grown and developed with proper nutrition. This includes eating sufficient protein to provide the necessary amino acids and regular physical activity.
The reverse is also true becoming less physically active and the individual’s diet no longer supports the development of increased muscle tissue the body enters a catabolic/tissue-reducing state known as muscle atrophy.Muscles that are partially used meaning using less than 20% of their maximum force begin to atrophy over time. Muscles that are completely unused, like when bedridden with very little movement, can degrade around 1/8th of strength per week.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
Car accidents, even minor ones, can cause musculoskeletal problems, especially in the neck and shoulder area. Depending on the severity, it can be dangerous. When whiplash symptoms do not present immediately, this is known as delayed whiplash. Delayed symptoms can appear anywhere from twenty-four hours to months after the accident. The body is masking the symptoms to react to a traumatic event. Symptoms like:
Pain
Stiffness
Headache
Anxiety
Present within 24 hours, but this is not always the case.
Delayed Symptoms
With delayed whiplash, symptoms typically don’t appear until 24 hours after the accident. But there are cases of symptoms being delayed up to six months. Whether immediate or delayed, symptoms include:
Medical treatment should be sought out immediately if any of the below symptoms are experienced:
Weakness in the arms
The neck pain spreads to the shoulders and arms
Unbearable pain
Loss of vision
Causes of Delayed Whiplash
The most common cause of whiplash is automobile accidents. Even a slow-speed tap can cause delayed whiplash symptoms if the head snaps quickly, and it is not only being hit from behind in automobile accidents that cause whiplash. Rear-end, front-end, and side collisions can cause whiplash and delayed whiplash symptoms. Any time the neck snaps in a quick fashion in any direction there is potential for a neck injury. Some less common causes include:
Specific types of falls where the head quickly snaps around
Cycling accidents
Skating/skateboarding accidents
Skiing/snowboarding accidents
Symptoms Can Get Worse With Time
Determining whether to seek medical attention if there is no pain or symptoms after the event can be difficult. However, symptoms can get worse over time and cause serious problems in the neck:
Small fractures
Ruptured discs
Pinched nerves
Untreated Whiplash
Whiplash can get worse with time when they are not treated. This is why seeking medical care after the event is significant. As a doctor, a chiropractor can diagnose if any serious issues are present and develop the best plan to deal with pain and symptoms. When left untreated chronic whiplash and neck pain can develop. Chronic whiplash is rare but does happen, even with injuries considered not severe. Medical professionals will use X-Rays, MRIs, or CT scans to examine the damage’s extent and prevent the symptoms from worsening.
Treatment Options
Wearing a neck brace immediately following a neck injury can be an option but there is evidence that some movement of the neck and head should be incorporated, as it is beneficial for the healing process. If the pain is unbearable, wearing a brace could be implemented into a treatment plan.
Ice and Heat
Ice and heat will help with stiffness and pain.
Ice will help relieve pain and should be used in 15-minute intervals.
Heat packs and ointments can help soothe the area, loosen up the muscles, and promote optimal healing.
Non-Steroidal Anti-Inflammatory Meds
Advil or Ibuprofen can be taken for pain and inflammation. These meds help the symptoms, but should not be the only pain reliever.
Ginger
Ginger tea can help those suffering from nausea and dizziness.
It contains anti-inflammatory properties.
Supplements include green tea, turmeric curcumin, fish oil, and sage.
CBD Oil and Ointment
CBD oil or ointments can help relieve pain and relax muscles.
Stretching
Gentle stretches can help the healing process and keep the neck muscles loose.
Chiropractic
Chiropractic can treat whiplash utilizing several different techniques. They will perform tests to diagnose the extent of the injuries and determine what type and the best treatment plan. The plan can include the following:
Inflammation reduction and Pain relief
Heat, ice, ultrasound, and laser therapy can help reduce pain and inflammation.
Spinal Adjustments
Spinal adjustments will help relieve pain from pinched nerves, bulging discs, and strained muscles.
Massage
Massage is a common practice in whiplash cases. It helps to kickstart the healing process by:
Promoting proper blood and nerve energy circulation
Loosens the muscles
Flushes out the toxins
Stretches and Tips
A chiropractor will train the patient on specific stretches/exercises and pain-relief tips at home. These can include:
Physical therapists can help by focusing on the muscles in the affected area.
They will teach the individual stretches and exercises to stretch and strengthen the strained muscles.
They can also utilize heat and ice therapy, ultrasound, and laser therapy.
Body Composition
Hot Yoga and Metabolic Rate
Both internal and external temperatures influence the body’s metabolic rate. The body’s chemical reactions happen more quickly if the temperature is higher. This is because the body works harder to restore average temperature balance. Brief exposure to heat is not enough to increase metabolism. To raise BMR, more prolonged exposure to heat is necessary. This is where hot yoga comes in. Hot yoga involves performing a sequence in a studio that is 105 degrees Fahrenheit with a humidity rate of 40%. It is an intense workout that involves sweating. The high heat:
Increases blood flow
Warms the muscles for deep stretching
Helps the lymphatic system release toxins
Raises the body’s Basal Metabolic Rate
References
Balla, J I. The late whiplash syndrome. The Australian and New Zealand Journal of surgery vol. 50,6 (1980): 610-4. doi:10.1111/j.1445-2197.1980.tb04207.x
Fitz-Ritson D. Phasic exercises for cervical rehabilitation after “whiplash” trauma. Journal of Manipulative and Physiological Therapeutics. 1995 Jan;18(1):21-24.
Seferiadis, Aris, et al. A review of treatment interventions in whiplash-associated disorders. The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 13,5 (2004): 387-97. doi:10.1007/s00586-004-0709-1
Whiplash is one of the most devastating cervical/neck spinal injuries. Rapid acceleration and deceleration can be so powerful that it bruises, tears the muscles, ligaments, soft tissue, and herniates the neck’s discs. Chiropractic relief can take care of initial and late-onset symptoms. As symptoms develop, they typically take the form of radiculopathy pain. Depending on the severity of the whiplash the types of symptoms that can occur include:
Swelling of the face
Neck pain
Shoulder and arms aching and pain
Hands can swell and ache
Loss of mobility
Numbness or complete loss of feeling
Symptoms can get worse indicating progressive nerve damage
If left untreated the individual can face long-term, chronic spine problems. Injury Medical Chiropractic Relief focuses on treating the whiplash, radiculopathy, and herniated discs at the source. After assessing the symptoms and the severity we can develop the most optimal treatment plan for the individual.
Radiculopathy
Radiculopathy is the result of a pinched nerve. This sends pain signals throughout the entire length of the nerve. With the neck’s nerve bundles, this means the pain travels as far as the face and hands. Tracing the extent of the radiculopathy informs the chiropractor as to which specific vertebrae have been affected. For example, if the nerve bundle in C7, which is the lowest neck vertebrae gets pinched, it can present in the arms. Another example, if chronic and persistent headaches or cheek pain are presenting, then C3-C4 will be the focus. The key is to look past the site of the pain and find its point of origin. Tracing referred pain quickly will allow the chiropractor to get a handle on the symptoms, even after the accident.
Herniated discs
A major factor in radiculopathy is a herniated disc. Displaced discs are how nerve compression and signal disruption begins. Until the disc/s are realigned, corrected, and reset, the affected nerves will continue to suffer.
The Connection
Make mention of any vehicle accidents throughout life. This can help the chiropractor immensely in diagnosis. A severe case of whiplash can occur even if the airbag does not deploy. The rocking motion of the cervical spine is strong, meaning whiplash can happen at collisions as slow as 5 miles per hour. Whether a minor car accident, a roller coaster ride, or sports, the condition frequently presents long after the accident.
Chiropractic Relief and Realignment
A chiropractor must put together the clues of a condition to hypothesize the cause. If experiencing pain symptomatic with recent neck trauma, it is essential to get checked. Injury Medical Chiropractic Clinic will address the condition before symptoms progress to a chronic condition.
Body Composition
The Function of Skeletal Muscle
Skeletal muscle is one of three major types of muscles in the body. The others are smooth and cardiac muscle. These muscles are attached to the bone by tendons. Skeletal muscles consist of nerves and blood vessels along with connective tissue to operate properly. These muscles consist of cells that come together and form bundles of skeletal muscle fibers.
Strength training stimulates the muscle fibers and combined with proper nutrition causes the muscles to grow. Muscles contract and shorten pulling on the bone and joints. This is what causes body movement. The nervous system sends signals to the nerves in the muscle and trigger contractions. Besides movement, skeletal muscle helps maintain posture, generate body heat, and stabilizes the bones and joints.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Rodriquez, Arthur A et al. �Whiplash: pathophysiology, diagnosis, treatment, and prognosis.��Muscle & nerve�vol. 29,6 (2004): 768-81. doi:10.1002/mus.20060
Whiplash injuries very rarely call for surgery. But with those rare occurrences, that are severe cases, surgery is considered appropriate when neck or shoulder pain worsens. Doctors recommend patients go through 4 to 6 weeks of non-surgical treatment. If there is no improvement or the condition is worsening then a doctor could recommend whiplash surgery as the best option.
A spine surgeon will recommend the best procedure for the specific injury. Ask all the questions you have to fully understand the exact process, the outcome, and the recovery time. Surgery is an individual’s decision. The surgeon can recommend it, but the patient has the final say. The procedure depends on what area/s the cervical spine is injured/damaged.
Disc Herniation
Depending on the type of trauma individuals can rupture or herniate the intervertebral disc/s, located between the vertebrae. This can generate constant pain, numbness, and weakness. With cases like this sometimes removal of the disc is necessary.
A surgeon will remove all or portion of the damaged disc through a process called a discectomy. After the discectomy, a doctor may have to permanently stabilize the area. This is because the spine becomes unstable and can move in abnormal ways. This increases the risk of a serious neurological injury. Therefore a discectomy is usually followed with a re-stabilization of the spine. Spinal stabilization techniques used:
Artificial Disc Replacement
Cervical artificial disc replacement also known as ADR could be performed instead of standard discectomy combined with spinal fusion. An artificial disc is implanted into the empty space following the procedure. Artificial disc replacement preserves or restores movement of the neck.
Fusion and Spinal Instrumentation
This form of spine stabilization can be done on its own or in combination with decompression surgery. The bones in the spine fuse together over time usually several months or longer depending on how the surgeon set up the fusion process. The surgeon will use a bone graft or a biological chemical that stimulates bone growth. A surgeon could use spinal instrumentation. These are:
Interbody device/s
Screws
Rods
Plates
These all are used to increase stability and help fuse the bones properly. The fusion prohibits movement between the vertebrae for long-term stability.
Stenosis
Whiplash surgery could also be necessary if the injury caused the spinal canal in the neck to narrow. Here a cervical corpectomy could be performed to remove part of the vertebra and intervertebral disc/s. This reduces the added pressure on the spinal cord and nerves.
A surgeon could also do a laminectomy or a laminoplasty. Both focus on the lamina, which is the bony plate at the back of each vertebra. The lamina protects the spinal cord and canal. The lamina could also present added pressure on the spinal cord. This is where the surgeon will create extra space for the cord by removing all or part of the lamina. This is a laminectomy.
A laminoplasty re-shapes the lamina to create more room for the spinal cord. If there is a narrowing of the space where the nerve exits the canal, a cervical foraminotomy could be utilized. The foramen is the area where the nerve roots exit the spinal canal. This is removed to allow for more space for the nerves to move through. A larger pathway is less likely to pinch/compress the nerve.
Complications
A doctor will discuss all the potential risks before being asked to sign a surgical consent form. Complications can include:
Injury to the spinal cord, nerves, esophagus, carotid artery, vocal cords
Pain and swelling in the leg veins known as phlebitis
Blood clots in the lung
Urination problems
Complications could lead to more surgery, so make sure there is a complete understanding of the surgery and the risks before proceeding. The final decision is up to the individual.
Whiplash Surgery Recovery
After surgery, things might not be great right away. More than likely individuals are out of bed within 24 hours, and on pain meds for 2 to 4 weeks. Individuals will receive instructions on how to sitting down, and standing up. The body needs time to heal, so the doctor will recommend restricting certain activities that involve moving the neck too much. Avoid sports, twisting, or heavy lifting during recovery. And report any problems like fever increased pain, or infection right away.
Whiplash Massage Therapy
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Gale Grijalva was a victim of a car crash. As a result, she started to experience severe pain symptoms which tremendously affected her ability to perform her regular tasks. Gale Grijalva describes the conditions that resulted in the auto accident as well as how her symptoms that are specific began to manifest after the incident. Gale Grijalva visited Dr. Alex Jimenez, chiropractor, to receive chiropractic care for her car crash injuries and she was grateful to get the pain relief she deserved. Chiropractic care is an effective and secure, alternative treatment option which focuses on the identification, prevention, and treatment of many different injuries and/or conditions. Gale Grijalva highly recommends Dr. Alex Jimenez as the noninvasive choice for car accident injuries and whiplash, among other problems.
Chiropractic Treatment
We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.
As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused on treating patients after frustrating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility and agility programs tailored for all age groups and disabilities.
We want you to live a life that is fulfilled with more energy, positive attitude, better sleep, less pain, proper body weight and educated on how to maintain this way of life. I have made a life of taking care of every one of my patients.
I assure you, I will only accept the best for you�
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Whiplash Injuries: If you have ever had to deal with the pain of whiplash, you know how it can impact every aspect of your life. Whiplash can cause chronic pain and keep you from doing many activities you enjoy. Daily tasks can be painful or even impossible to carry out. Even milder cases can make turning your head from side to side complex.
Chiropractic is a very effective treatment for whiplash injuries that helps with pain management and enables you to heal faster. Your chiropractor can recommend exercises you can do at home between treatments and other lifestyle changes that will facilitate your healing and improve flexibility.
Whiplash Injuries
What Is Whiplash?
Whiplash is a term that describes an injury that is typically focused on the neck and spine. It is caused when the head and neck are thrown in one direction unexpectedly and quickly, then thrust in the opposite direction. The head is rapidly whipped, usually front to back. It can be whipped from side to side, though.
Most people associate whiplash with car accidents, but even turning one way while a child tugs your arm in another direction can cause it. Anything that jerks your head suddenly can cause whiplash.
What Damage Does Whiplash Cause?
The damage that is caused by whiplash is called vertebral subluxation. This type of subluxation is caused by injury, and a chiropractor can diagnose the injury and treat it. It is the most common source of discomfort and pain caused by injuries due to whiplash. There are different kinds caused by tension and emotional stress, poor sleeping, lousy posture, weak muscles, and inadequate diet.
The injury from whiplash is in the neck and spine, but the pain can extend to the head, arms, shoulders, hips, and legs. You can experience frequent headaches, numbness, and tingling in your hands and have difficulty walking or moving about. The pain can range from stiffness and soreness to stabbing and sharpness. The injury can affect various nerves, causing blurred vision, dizziness, low back pain, ear ringing, and even problems with your internal organs.
Chiropractic Treatment For Whiplash
Chiropractors will use different techniques to relieve the pain of whiplash and help with healing.
Chiropractic Adjustment The chiropractor performs spinal manipulation to move the joints into alignment gently. This will help to align the body to relieve pain and encourage healing.
Muscle Stimulation and Relaxation This involves stretching the affected muscles, relieving tension, and helping them relax. Finger pressure techniques may also be combined with trying to alleviate pain.
McKenzie Exercises These exercises help with disc derangement that whiplash causes. They are first performed in the chiropractor’s office, but the patient can be taught how to do them at home. This helps the patient have some degree of control in their healing.
Each whiplash case is different. Instances of varying whiplash have various symptoms. A chiropractor will evaluate the patient and determine the appropriate treatment case-by-case basis. The chiropractor will determine the best course of treatment that will relieve your pain and restore your mobility and flexibility.
Whiplash can be far more severe than you may realize. Any accident that causes whiplash injuries can result in the vertebrae moving out of alignment. This can damage and irritate the spinal nerves. Even whiplash from years ago can still affect you if you never saw a chiropractor. Your spine can still be out of alignment, and injury or trauma from years ago can cause problems that seem unrelated.
Injury Medical Clinic: Accident Treatment & Recovery
Whiplash Massage: Sandra Rubio describes how whiplash-associated disorders resulting from an automobile accident can cause symptoms of neck pain. An injury to the cervical spine can damage the complex structures of the neck, including vertebrae, intervertebral discs and soft tissues like tendons, ligaments and muscles. Dr. Alex Jimenez, doctor of chiropractic, is a non surgical choice which provides several treatment methods, such as deep-tissue massage, which can help improve neck pain associated with whiplash from an auto accident.
Massage therapy�is the evaluation and manipulation of cells and joints of the human body to effect a curative response in the�prevention and treatment of physical dysfunction. It may be curative or preventative, helping to rehabilitate, to preserve, strengthen bodily function or relieve pain. Massage therapy has established its function as it achieves outcomes that were undeniable, as a wellness option used to alleviate an assortment of physical discomforts.
Massage helps alleviate the soft tissue discomfort associated with everyday stress, muscular overuse and lots of chronic pain syndromes. Massage treatment can decrease the development of painful muscular patterning if used early enough after accidents involving trauma and injury.
Whiplash Massage Therapy
Neck pain can come from various structures in the neck including: vascular, nerve, airway, digestive, and musculature or it can originate from other areas of the human body. Although the causes are many, most are easily rectified by either assistance or using self help suggestions and techniques. Treatment of neck pain is dependent upon the reason. For the vast majority of individuals, neck pain may be treated conservatively. Recommendations in conservative treatment include applying cold or heat. Other frequent treatments could include chiropractic care, physical therapy, body mechanics training, reform that is ergonomic, and drugs and/or medication.
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