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Spinal Alignment Pain Relief for Motor Vehicle Injuries

Spinal Alignment Pain Relief for Motor Vehicle Injuries

by | Auto Accident Injuries, Car Accident Specialist, Chiropractic, Lawyers, Med-Legal Corner, Personal Injury

Chiropractic Care: A Comprehensive Solution for Motor Vehicle Accident Injuries

Spinal Alignment Pain Relief for Motor Vehicle Injuries

Motor vehicle accidents (MVAs) are a leading cause of musculoskeletal injuries, nerve damage, and chronic pain, particularly in the back and neck. These injuries can disrupt daily life, limit mobility, and lead to long-term health complications if not addressed promptly. Chiropractic care, combined with integrative medicine, offers a holistic, non-invasive approach to treating these injuries by restoring function, reducing inflammation, and promoting overall well-being. Dr. Alexander Jimenez, a chiropractor and nurse practitioner based in El Paso, Texas, exemplifies this approach through his evidence-based protocols, advanced diagnostics, and patient-centered care. This blog post examines how chiropractic care accelerates recovery from motor vehicle accident (MVA)-related injuries, delving into Dr. Jimenez’s clinical observations, the role of integrative medicine, and the importance of timely intervention.

The Impact of Motor Vehicle Accidents on the Body

MVAs subject the body to sudden, intense forces that can cause a range of injuries, from soft tissue damage to spinal misalignments and nerve compression. Common injuries include:

  • Whiplash: A rapid back-and-forth motion of the neck, often leading to muscle strains, ligament sprains, and nerve irritation. Symptoms include neck pain, stiffness, headaches, and dizziness (The Winchester Institute, n.d.).
  • Back and Neck Pain: Spinal misalignments or disc herniations can result from the impact, causing acute or chronic pain (Miami Chiropractors, n.d.).
  • Musculoskeletal Injuries: Strains, sprains, and tears in muscles, tendons, and ligaments are prevalent due to the body’s attempt to brace during a collision (Pacific Coast Injury Group, 2025).
  • Nerve Injuries: Compression or irritation of spinal nerves can lead to radiating pain, numbness, or weakness, as seen in conditions like sciatica (Jimenez, 2025).

These injuries often manifest days or weeks after the accident, making early intervention critical to prevent chronic complications (MVAMVP, n.d.). The 72-hour window following an accident is particularly important, as prompt care can help reduce inflammation and improve recovery outcomes (Cesak Chiropractic, n.d.).

References

Chiropractic Care: A Cornerstone of Recovery

Chiropractic care focuses on restoring the body’s natural alignment and function, addressing the root causes of pain and dysfunction. By combining spinal adjustments, soft tissue therapies, and rehabilitation exercises, chiropractors help patients recover faster and reduce the risk of long-term issues.

Spinal Adjustments

Spinal adjustments are the hallmark of chiropractic care. These precise, manual manipulations correct misalignments (subluxations) in the spine, relieving pressure on nerves and improving joint mobility. For MVA patients, adjustments are particularly effective for:

  • Reducing Pain: By realigning the spine, adjustments alleviate nerve compression, reducing pain in the neck, back, and extremities (Brookdale Health, n.d.).
  • Restoring Range of Motion: Adjustments enhance joint flexibility, counteracting stiffness caused by whiplash or muscle spasms (DeBruin Chiropractic, n.d.).
  • Decreasing Inflammation: Proper alignment improves blood flow, reducing swelling and promoting tissue healing (Quantum Chiropractic, n.d.).

A 2020 study in the Spine Journal found that spinal manipulative therapy significantly reduces pain and disability in patients with chronic low back pain, supporting its efficacy for MVA-related injuries (Rubinstein et al., 2020).

Soft Tissue Therapies

Soft tissue injuries, such as muscle strains and ligament sprains, are common in motor vehicle accidents (MVAs). Chiropractors use various therapies, including massage, myofascial release, and trigger point therapy, to achieve the following goals:

  • Break Up Scar Tissue: Massage therapy disrupts adhesions, improving muscle flexibility and reducing pain (DeBruin Chiropractic, n.d.).
  • Relieve Muscle Tension: Targeted techniques relax tight muscles, alleviating spasms and discomfort (Square One Health, n.d.).
  • Enhance Circulation: Improved blood flow delivers oxygen and nutrients to injured tissues, accelerating healing (Pacific Coast Injury Group, 2025).

Rehabilitation Exercises

Rehabilitation exercises are tailored to each patient’s needs, focusing on strengthening muscles, improving flexibility, and preventing re-injury. These exercises may include:

  • Stretching Routines: To restore flexibility and reduce stiffness in the neck and back (Apex Orthopedic Spine & Neurology, n.d.).
  • Core Strengthening: To stabilize the spine and prevent future injuries (Jackson Healing Arts, n.d.).
  • Proprioceptive Training: To improve balance and coordination, especially for athletes or active individuals (Jimenez, 2025).

References

Dr. Alexander Jimenez’s Clinical Approach in El Paso

Dr. Alexander Jimenez, a dual-licensed chiropractor and board-certified nurse practitioner, has over 25 years of experience treating MVA victims in El Paso, Texas. His practice, Injury Medical & Chiropractic Clinic, integrates chiropractic care, functional medicine, and advanced diagnostics to address both the symptoms and underlying causes of injuries (Jimenez, 2025).

Advanced Diagnostics and Imaging

Dr. Jimenez emphasizes the importance of accurate diagnosis in creating effective treatment plans. His clinic employs:

  • X-rays and MRIs: To identify spinal misalignments, disc herniations, and fractures (El Paso Back Clinic, n.d.).
  • Functional Lab Testing: To assess metabolic, hormonal, and nutritional status, which can influence recovery (Jimenez, 2025).
  • Dual-Scope Procedures: Combining chiropractic and nurse practitioner expertise, Dr. Jimenez conducts comprehensive evaluations that bridge physical and systemic health (Jimenez, 2025).

Advanced imaging is crucial for correlating patient symptoms with objective findings, particularly in personal injury cases where detailed legal documentation is required. For example, an MRI can reveal a herniated disc causing sciatica, providing evidence for both treatment and insurance claims (Jimenez, 2025).

Legal Documentation

In personal injury cases, thorough documentation is essential for insurance claims and legal proceedings. Dr. Jimenez’s detailed intake process includes:

  • Multipage Questionnaires: To capture the mechanism of injury, biomechanics, and medical history (El Paso Back Clinic, n.d.).
  • Diagnostic Reports: Combining imaging results, neurological assessments, and physical evaluations to create a comprehensive treatment plan (Jimenez, 2025).
  • Collaboration with Specialists: Dr. Jimenez works with radiologists and other professionals to ensure accurate diagnoses and robust legal support (Personal Injury Doctor, n.d.).

This meticulous approach ensures that patients receive appropriate care while meeting the evidentiary needs of their cases.

References

Integrative Medicine: Enhancing Recovery

Integrative medicine combines chiropractic care with nutrition, lifestyle interventions, and other therapies to promote holistic healing. Dr. Jimenez’s protocols include:

Functional Medicine

Functional medicine addresses the root causes of pain and dysfunction, including inflammation, hormonal imbalances, and nutritional deficiencies. Key components include:

  • Nutritional Counseling: Anti-inflammatory diets rich in omega-3 fatty acids, antioxidants, and whole foods can help reduce swelling and support tissue repair (Jimenez, 2025).
  • Hormone Optimization: Addressing cortisol dysregulation, which can exacerbate pain, improves healing outcomes (El Paso Back Clinic, n.d.).
  • Metabolic Assessments: Blood panels identify deficiencies that may delay recovery, allowing for targeted supplementation (Jimenez, 2025).

A 2019 study linked cortisol imbalances to chronic pain syndromes, highlighting the importance of addressing systemic factors (Hannibal et al., 2019).

Health Coaching

Dr. Jimenez’s clinic offers in-person and virtual health coaching to support long-term wellness and overall well-being. Coaching sessions focus on:

  • Stress Management: Techniques such as mindfulness and breathing exercises can reduce tension and improve mental health (Jackson Healing Arts, n.d.).
  • Exercise Plans: Customized routines enhance strength and mobility, preventing re-injury (El Paso Back Clinic, n.d.).
  • Sleep Optimization: Guidance on sleep hygiene improves recovery by supporting tissue repair and reducing pain (Jimenez, 2025).

Other Therapies

Additional therapies complement chiropractic care, including:

  • Acupuncture: Reduces pain and promotes relaxation by stimulating specific points on the body (Jimenez, 2025).
  • Electro-Acupuncture: Enhances pain relief by applying mild electrical currents to acupuncture needles (El Paso Back Clinic, n.d.).
  • Transcutaneous Electrical Nerve Stimulation (TENS): Reduces pain by stimulating nerves with low-voltage currents (1st Health Inc., n.d.).

References

The Importance of Timely Intervention

Seeking chiropractic care within 72 hours of a motor vehicle accident (MVA) can significantly improve outcomes. Delayed treatment increases the risk of chronic pain, reduced mobility, and complications like scar tissue formation (MVAMVP, n.d.). Chiropractic care offers several benefits during this critical window:

  • Reduced Swelling: Early adjustments and therapies minimize inflammation, preventing further tissue damage (Apex Orthopedic Spine & Neurology, n.d.).
  • Faster Recovery: Prompt intervention accelerates healing, reducing the need for invasive treatments (Miami Chiropractors, n.d.).
  • Prevention of Chronic Issues: Addressing misalignments early prevents long-term nerve compression and pain (Cesak Chiropractic, n.d.).

Even minor injuries should be evaluated, as hidden issues like soft tissue damage or spinal misalignments can worsen over time (Miami Chiropractors, n.d.).

References

Case Studies and Patient Outcomes

Dr. Jimenez’s clinic has documented numerous success stories, particularly in personal injury cases in El Paso. Patients with whiplash, sciatica, and chronic back pain have reported significant improvements through his integrative approach (Jimenez, 2025). For example:

  • Case Study 1: A 35-year-old female involved in a rear-end collision presented with neck pain and headaches. After six weeks of spinal adjustments, massage therapy, and nutritional counseling, she reported a 90% reduction in symptoms and improved range of motion (El Paso Back Clinic, n.d.).
  • Case Study 2: A 50-year-old male with sciatica post-MVA underwent spinal decompression and functional medicine assessments. Within three months, his pain decreased from 8/10 to 2/10, and he resumed normal activities (Jimenez, 2025).

These outcomes highlight the effectiveness of combining chiropractic care with integrative medicine for comprehensive recovery.

References

Conclusion

Chiropractic care, combined with integrative medicine, offers a powerful solution for recovering from injuries sustained in motor vehicle accidents. By addressing musculoskeletal injuries, nerve damage, and back and neck pain through spinal adjustments, soft tissue therapies, and rehabilitation exercises, chiropractors like Dr. Alexander Jimenez help patients restore function and prevent chronic complications. His use of advanced imaging, dual-scope procedures, and functional medicine ensures accurate diagnoses and personalized treatment plans, while his meticulous documentation supports legal and insurance needs. Integrative approaches, including nutrition and health coaching, promote long-term wellness, making chiropractic care an essential part of post-MVA recovery. If you’ve been in an accident, consult a chiropractor promptly to start your journey to a pain-free, active life.

References

Physical Therapy Exercises After Motor Vehicle Accidents

Physical Therapy Exercises After Motor Vehicle Accidents

by | Auto Accident Injuries, Fitness, Lawyers, Personal Injury, Physical Rehabilitation, Whiplash

Recovering from Motor Vehicle Accidents: A Comprehensive Guide to Healing with Chiropractic and Integrative Medicine

Physical Therapy Exercises After Motor Vehicle Accidents

Motor vehicle accidents (MVAs) can leave a lasting impact on your body, causing injuries that range from minor aches to severe, life-altering conditions. Whether it’s a fender-bender or a major collision, the forces involved can disrupt the body’s natural alignment, leading to indirect trauma, nerve injuries, back and neck pain, and even intestinal damage. These injuries often manifest as musculoskeletal joint pain, which limits mobility and affects quality of life. Fortunately, chiropractic care, integrative medicine, and targeted physical therapy can play a pivotal role in recovery, helping individuals restore function, reduce pain, and prevent long-term complications. This blog post explores the science behind MVA-related injuries and the role of chiropractic and integrative medicine in healing, offering practical exercises to aid recovery. It draws on insights from Dr. Alexander Jimenez, a renowned chiropractor and nurse practitioner in El Paso, Texas.

Understanding the Impact of Motor Vehicle Accidents

MVAs subject the body to sudden, high-impact forces that can disrupt the musculoskeletal system, nervous system, and even internal organs. Common injuries include:

  • Whiplash and Neck Pain: Caused by the rapid back-and-forth motion of the head, whiplash strains neck muscles and ligaments, leading to pain and stiffness (Carroll et al., 2008).
  • Back Pain: The spine, particularly the lumbar and thoracic regions, can suffer from herniated discs, muscle strains, or subluxations due to impact (Jimenez, 2024).
  • Nerve Injuries: Compression or irritation of nerves, such as in sciatica or radiculopathy, can result from spinal misalignments or soft tissue damage (Advance Orthopedic and Physical Therapy, n.d.).
  • Intestinal Damage: Less commonly discussed, the force of an MVA can cause visceral trauma, leading to gastrointestinal issues like irritable bowel syndrome or motility disorders (Jimenez, 2024).

These injuries often lead to musculoskeletal joint pain, where joints become stiff, inflamed, or misaligned, hindering movement and daily activities. Without proper intervention, these conditions can progress into chronic pain syndromes, affecting long-term health and well-being (IS Rehab, n.d.).

References:

The Role of Chiropractic Care in MVA Recovery

Chiropractic care is a cornerstone of MVA recovery, focusing on restoring spinal alignment, reducing nerve compression, and alleviating pain through non-invasive techniques. Dr. Alexander Jimenez, DC, APRN, FNP-BC, a board-certified chiropractor and nurse practitioner in El Paso, Texas, is a leading expert in this field. His dual licensure allows him to combine chiropractic adjustments with advanced medical diagnostics, offering a holistic approach to healing. (Jimenez, 2025).

Key Chiropractic Techniques

  1. Spinal Adjustments: These precise manipulations correct misalignments (subluxations) in the spine, relieving pressure on nerves and restoring joint mobility. A 2020 study found that spinal manipulative therapy significantly reduces pain and disability in chronic low back pain cases (Rubinstein et al., 2020).
  2. Manual Therapy: Techniques such as myofascial release and trigger point therapy help relax strained muscles and improve soft tissue flexibility. (Maxwell Therapy, n.d.).
  3. Decompression Therapy: This method gently stretches the spine to alleviate disc pressure, which is beneficial for individuals with herniated discs and sciatica. (Jimenez, 2024).

Dr. Jimenez’s clinic, Injury Medical & Chiropractic Center, integrates these techniques with advanced diagnostics, including MRI, CT scans, and electromyography (EMG), to accurately assess injuries and tailor treatment plans. His approach not only addresses physical symptoms but also supports legal documentation for personal injury cases by providing objective evidence of injury progression (Jimenez, 2024).

References:

Integrative Medicine and Functional Medicine Approaches

Integrative medicine combines conventional and alternative therapies to address the root causes of health issues, promoting overall well-being. Dr. Jimenez’s practice is grounded in functional medicine, which focuses on identifying underlying dysfunctions—such as inflammation, hormonal imbalances, or nutritional deficiencies—that contribute to MVA-related symptoms (Jimenez, 2024).

Functional Medicine Strategies

  1. Nutritional Counseling: Anti-inflammatory diets rich in omega-3 fatty acids, antioxidants, and whole foods can reduce pain and support tissue repair. For example, turmeric may help alleviate inflammation caused by MVAs (Jimenez, 2019).
  2. Lifestyle modifications, including stress management, sleep optimization, and ergonomic adjustments, can prevent injury recurrence and support recovery. (El Paso Back Clinic, n.d.).
  3. Metabolic Assessments: Blood panels and other diagnostic tools identify systemic issues, such as gut dysbiosis, that may exacerbate pain or delay healing (Jimenez, 2024).

These strategies are particularly effective for addressing intestinal damage, which can result from the stress and trauma of an MVA. By restoring gut health, functional medicine enhances overall recovery and reduces systemic inflammation (Jimenez, 2024).

References:

Physical Therapy and Sports Training for Recovery

Physical therapy (PT) is crucial for restoring mobility, alleviating pain, and regaining strength after a motor vehicle accident (MVA). When combined with sports training principles, physical therapy (PT) can help individuals return to their pre-accident level of function and prevent long-term issues. (Sports Physical Therapy Centers, n.d.).

Key Physical Therapy Techniques

  1. Therapeutic exercises include stretching, range-of-motion exercises, and bodyweight activities such as squats and push-ups, designed to improve flexibility and strength. (Procare Medical Center, n.d.).
  2. Neuromuscular reeducation retrains the brain and muscles to work together, thereby improving coordination and balance. (Maxwell Therapy, n.d.).
  3. Nerve Mobilization: Exercises that gently stretch and mobilize nerves can reduce tingling, numbness, and pain caused by nerve compression. (Advance Orthopedic and Physical Therapy, n.d.).

Safe Exercise Progression

Starting exercise too soon after an MVA can worsen injuries, so it’s crucial to follow a gradual progression under professional guidance:

  • Week 1-2: Focus on light stretching and range-of-motion exercises, such as neck rotations or shoulder rolls, to maintain mobility without straining tissues (GTAKG, n.d.).
  • Weeks 3-4: Introduce bodyweight exercises, such as squats, lunges, or modified push-ups, while maintaining pain-free movements. (Procare Medical Center, n.d.).
  • Week 5+: Incorporate low-impact strength training, such as resistance band exercises, to rebuild muscle and joint stability (Sports Physical Therapy Centers, n.d.).

Dr. Jimenez emphasizes the importance of individualized exercise plans, tailored to the patient’s injury severity and stage of recovery. His clinic’s PUSH-as-Rx system integrates functional fitness and agility training to optimize recovery (Jimenez, 2024).

References:

Dr. Jimenez’s Clinical Approach: Bridging Medical and Legal Needs

Dr. Jimenez’s unique dual licensure as a chiropractor and nurse practitioner enables him to provide comprehensive care that addresses both medical and legal aspects of MVA recovery. His clinical reasoning is rooted in advanced diagnostics and evidence-based protocols, ensuring accurate injury assessment and effective treatment (Jimenez, 2025).

Advanced Diagnostics

  • Imaging: MRI and CT scans reveal soft tissue damage, disc herniations, and spinal misalignments that may not be visible on X-rays (Jimenez, 2024).
  • Electromyography (EMG): This assesses nerve function, identifying compression or damage that contributes to pain or numbness (Jimenez, 2024).
  • Functional Movement Screens: These evaluate mobility and strength deficits, guiding exercise prescriptions (Jimenez, 2024).

Legal Documentation

In personal injury cases, accurate documentation is critical for securing fair compensation. Dr. Jimenez’s clinic provides detailed reports on injury progression, pain scales, and functional limitations, which serve as objective evidence for attorneys and insurance companies. His dual-scope approach ensures that medical findings are correlated with symptoms, strengthening legal claims (Jimenez, 2024).

References:

Practical Exercises for Post-MVA Recovery

Exercise is a powerful tool for managing musculoskeletal joint pain and promoting recovery. Below are safe, beginner-friendly exercises recommended for MVA survivors, based on Dr. Jimenez’s protocols and industry standards (Jimenez, 2024; Procare Medical Center, n.d.).

Stretching Exercises

  1. Neck Rotations:

    • Sit or stand with a straight spine.
    • Slowly rotate your head to the right, hold for 5 seconds, then return to center.
    • Repeat on the left side. Perform 10 reps per side.
    • Benefits: Improves neck mobility and reduces stiffness.

  2. Cat-Cow Stretch:

    • Begin by positioning yourself on all fours, maintaining a neutral spine.
    • Inhale, arch your back (cow pose), lifting your head and tailbone.
    • Exhale, round your spine (cat pose), tucking your chin and pelvis.
    • Repeat for 8-10 cycles.
    • Benefits: Enhances spinal flexibility and relieves back tension.

Range-of-Motion Exercises

  1. Shoulder Rolls:

    • Stand with arms relaxed at your sides.
    • Roll your shoulders forward in a circular motion for 10 reps, then backward for 10 reps.
    • Benefits: Loosens shoulder joints and reduces upper back pain.

  2. Ankle Circles:

    • Sit with one leg extended and lift your foot off the ground.
    • Rotate your ankle clockwise for 10 circles, then counterclockwise.
    • Switch legs and repeat.
    • Benefits: Restores ankle mobility, especially after lower limb injuries.

Bodyweight Strength Exercises

  1. Wall Push-Ups:

    • Stand at arm’s length from a wall, and place your hands at shoulder height.
    • Bend your elbows to lower your chest toward the wall, then push back.
    • Perform 2 sets of 10-12 reps.
    • Benefits: Strengthens chest and arms without straining the spine.

  2. Bodyweight Squats:

    • Stand with feet shoulder-width apart.
    • Lower your hips as if sitting in a chair, keeping your knees behind your toes.
    • Return to standing. Perform 2 sets of 8-10 reps.
    • Benefits: Builds leg and core strength, improving stability.

Safety Tip: Always consult a healthcare provider before starting exercises, especially if you experience pain or discomfort (Sports Physical Therapy Centers, n.d.).

References:

Preventing Long-Term Complications

Untreated MVA injuries can lead to chronic conditions like degenerative disc disease, fibromyalgia, or persistent nerve pain (Solutions Physical Therapy, n.d.). Chiropractic care, integrative medicine, and physical therapy work together to:

  • Restore Alignment: Correcting spinal and joint misalignments prevents uneven wear and tear (Jimenez, 2024).
  • Reduce Inflammation: Nutritional and manual therapies lower systemic inflammation, reducing pain and promoting healing (Jimenez, 2019).
  • Enhance Resilience: Strength and flexibility exercises build a robust musculoskeletal system, reducing the risk of re-injury (Sports Physical Therapy Centers, n.d.).

Dr. Jimenez’s holistic approach ensures that patients not only recover physically but also maintain long-term health through lifestyle changes and preventive care (Jimenez, 2025).

References:

Conclusion

Recovering from a motor vehicle accident requires a multifaceted approach that addresses the physical, neurological, and systemic effects of trauma. Chiropractic care, led by experts like Dr. Alexander Jimenez, restores spinal alignment and alleviates pain, while integrative medicine addresses underlying causes through targeted nutrition and lifestyle modifications. Physical therapy and sports training rebuild strength and mobility, empowering individuals to return to their daily activities and prevent chronic issues. By combining advanced diagnostics, personalized treatment plans, and legal documentation, Dr. Jimenez’s practice provides a comprehensive model for MVA recovery. If you’ve been in an accident, consult a qualified healthcare provider to start your healing journey today.

References

Spinal Adjustments in the Presence of Herniated Discs

Spinal Adjustments in the Presence of Herniated Discs

by | Chiropractic, Herniated Disc, Spinal Decompression Treatments

Title: Spinal Adjustments are Safe in the Presence of Herniated disc with the Absence of Cord Compression

Abstract: The objective was to explore the use of MRI to increase the efficacy and safeness of adjusting the cervical spine in the presence of a disc herniation when there is no evidence of cord compression on MRI.

Introduction:  A 30 year old male patient presented to the office on 1/8/14 with injuries from a motor vehicle accident.  The motor vehicle accident had occurred 3 weeks prior to his first visit.  The patient was the restrained front seat passenger.  The car he was travelling in struck another car and the patient�s car was flipped over onto its roof.  While the car remained on its roof the patient was able to crawl out and awaited medical attention.  The patient was taken by ambulance to the hospital where he was examined and testing was ordered.  The patient had multiple CT scans of the head and X-rays of the cervical and lumbar.  The CT of the head revealed a nasal fracture and the patient underwent immediate surgery to repair his broken nose.

Safe and Effective Chiropractic Adjustment Study

The patient presented three weeks post-accident with persistent and progressive daily occipital headaches, neck pain into the shoulders bilaterally, upper back pain and lower back pain that radiates into the legs and down into the feet bilaterally. He has swelling at the left anterior knee and bandages around the right elbow and two black eyes.

The patient states that he was having difficulty with regular activities of daily living including walking for more than 15-20 minutes, long periods of standing, more than an hour of sitting, any bending or lifting and any regular daily chores.  The patient also states he was having difficulty getting a restful night�s sleep due to the pain.  The patient�s visual analog scale rating was 10 out of 10.

History: The patient denied any prior history of neck or back pain.  No reported prior injuries or traumas.

Objective Findings:  An examination was performed and revealed the following:

Range of Motion: 

Cervical Motion Studies:

Flexion: Normal=60                      Exam-   25 with pain  with spasm

Extension: Normal=50                  Exam-   20 with pain  with spasm

Left Rotation: Normal=80             Exam-   35 with pain  with spasm

Right Rotation: Normal=80           Exam-   35 with pain  with spasm

Left Lat. Flex: Norma=-40             Exam-   15 with pain  with spasm

Right Lat. Flex: Normal=40           Exam-   15 with pain  with spasm

 

Dorsal-Lumbar Motion Studies:

Flexion: Normal=90                  Exam-   35 with pain   with spasm

Extension: Normal=30              Exam-   10 with pain  with spasm

Left Rotation: Normal=30         Exam-   10 with pain  with spasm

Right Rotation: Normal=30       Exam-   5 with pain  with spasm

Left Lat. Flex: Normal=20         Exam-   5 with pain  with spasm

Right Lat. Flex: Normal=20       Exam-   5 with pain  with spasm

 

Orthopedic Testing

The orthopedic testing revealed the following positive orthopedic tests in the cervical spine: Valsalva�s indicating the presence of a disc at L4-S1 and the lower cervical region, foraminal compression indicating radicular pain in the lower cervical region, Jackson�s compression , shoulder depressor and cervical distraction all indicating pain in the lower cervical region.  The lumbar testing revealed a positive Soto-Hall with pain at the L4-S1 level, Kemps positive with pain from L4-S1, Straight Leg raiser with pain at 60 degrees, Milgram�s with pain at the L5-S1 level, Lewin�s with pain at L5-S1, and Nachlas eliciting pain in the L5-S1 region.

Neurological Testing

The neurological exam revealed bilateral upper extremity tingling and numbness into the shoulder on the left and down the right arm into the hand. The lower extremity revealed tingling and numbness into the gluteal�s bilaterally with left sided radicular pain in to the leg into left foot.  The pinwheel revealed hypoesthesia at C7 bilaterally and L5 bilaterally dermatome level. The patient was unable to perform the heel-toe walk

The chiropractic motion palpation and static palpation exam revealed findings  at C 1,2 , 5, 6, 7 and T 2,3,4,9, 10  and L 3,4,5 as well as the sacrum.

X-Ray Result Study

The hospital had cervical x-rays and a CT of the head on the day of the accident. Thoracic and lumbar studies were needed as a result of the positive testing and the patients history and complaints The x-ray studies revealed a reversed cervical curve and misalignment of the C1,2,5,6,7 and the lumbar studies revealed a mild IVF encroachment at L5-S1 with rotations at L3,4,5.

The results of the exam were reviewed.  The patient�s positive orthopedic testing, neurological deficits coupled with the decreased range of motion and positive chiropractic motion and static palpation indicated the necessity to order both cervical[1]and lumbar[2]  MRI�s4.

 MRI Results

The MRI images were personally reviewed.  The cervical MRI revealed a right paracentral disc herniation at the level of C5-6 with impingement on the anterior thecal sac.  There is also a C6-7 disc bulge impinging on the anterior thecal sac. The lumbar MRI revealed an L5-S1 disc herniation.  There are disc bulges at from L2-L4.

CERVICAL MRI STUDIES

LUMBAR MRI IMAGES

Safe and Effective Treatment Plan

After reviewing the history, examination, prior testing, x-rays, MRI�s and DOBI care paths3 it was determined that chiropractic adjustments6  wereclinically indicated

The patient was placed on a treatment plan of spinal manipulation with modalities including intersegmental traction, electric muscle stimulation and moist heat.  Diversified technique was used to adjust the subluxation diagnosed levels of C1,2,5,6,7 and L3,4,5.  Although there were herniated and bulging discs present in the cervical and lumbar spine there was no cord compression. Therefore; there was no contraindication to performing a spinal adjustment.  As long as there is enough space between the cord and the herniation or bulge then it is generally safe to adjust.5

The patient responded quite favorably to the spinal adjustments and therapies over the course of 6 months of treatments.  Initially, the patient was seen three times a week for the first 90 days.  The patient demonstrated subjective and objective improvement and his care plan was adjusted accordingly and reduced to two visits per week for the next 90 days of care.  His range of motion returned to 90% of normal:

Range of Motion: 

Cervical Motion Studies:

Flexion: Normal=60                      Exam-   55 with no pain

Extension: Normal=50                  Exam-   40 with mild tenderness

Left Rotation: Normal=80             Exam-   75 with mild tenderness

Right Rotation: Normal=80           Exam-   75 with mild tenderness

Left Lat. Flex: Norma=-40             Exam-   35 with no pain

Right Lat. Flex: Normal=40           Exam-   35 with no pain

 

Dorsal-Lumbar Motion Studies:

Flexion: Normal=90                  Exam-   80 with tenderness

Extension: Normal=30              Exam-   25 with tenderness

Left Rotation: Normal=30         Exam-   25 with no pain

Right Rotation: Normal=30       Exam-   25 with no pain

Left Lat. Flex: Normal=20         Exam-   20 with no pain

Right Lat. Flex: Normal=20       Exam-   20 with no pain

 

The patient had decreased spasm, decreased pain, increased ability to perform ADL�s and his sleep had returned to normal. The patient states that he was no longer having the same difficulties with regular activities of daily living.  He was now able to walk for 45 minutes to 1 hour before the lower back pain flared up, he is able to stand for 1-2 hours before the lower back pain begins, he is able to sit for an hour or more before the lower back pain flares up. When the patient bends or lifts he has learned to use his core and lifts less than 20-30 pounds to avoid exacerbating his low back.  The patient also states he was no longer having difficulty getting a restful night�s sleep.  The patient�s visual analog scale rating was 3 out of 10.

Conclusion

The patient presented 3 weeks post trauma with cervical and lumbar pain as well as headaches.  The symptoms were progressing and the pain was radiating into the upper and lower extremities.  The history and exam indicated the presence of a herniated disc in the lower lumbar and cervical region.  Cervical and lumbar MRI�s were ordered to identify the presence of the herniated disc as well as to determine whether or not the patient should be adjusted.  The MRI results of both the cervical and lumbar MRI revealed herniated discs, however, because these discs were not causing cord compression it was safe to adjust the cervical and lumbar spine5.

Competing Interests:  There are no competing interests in the writing of this case report.

De-Identification: All of the patient�s data has been removed from this case.

The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 . Green-Call-Now-Button-24H-150x150.png

References

  1. New England Journal of Medicine; Cervical MRI, July 28, 2005, Carette S. and Fehlings M.G.,N Engl J Med 2005; 353:392-399MRI for the lumbar disc, March 14  2013, el Barzouhi A., Vleggeert-Lankamp C.L.A.M., Lycklama � Nijeholt G.J., et al., N Engl J Med 2013; 368:999-1000 http://www.state.nj.us/dobi/pipinfo/carepat1.htm -16.7KB
  2. New England Journal of Medicine; Cervical-Disk HerniationN Engl J Med 1998; 339:852-853September 17, 1998DOI: 10.1056/NEJM199809173391219
  3. Is It Safe to Adjust the Cervical Spine in the Presence of a Herniated Disc? By Donald Murphy, DC, DACAN, Dynamic Chiropractic, June 12, 2000, Vol. 18, Issue 13
  4. Treatment Options for a Herniated Disc;  Spine-Health, Article written by:John P. Revord, MD

 

Additional Topics: Chiropractic Helps Patients Avoid Back Surgery

Back pain is a common symptom which affects or will affect a majority of the population at least once throughout their lifetime. While most back pain cases may resolve on their own, some instances of the pain and discomfort can be attributed to more serious spinal conditions. Fortunately, a variety of treatment options are available for patients before considering spinal surgical interventions. Chiropractic care is a safe and effective, alternative treatment option which helps carefully restore the original health of the spine, reducing or eliminating spinal misalignment which may be causing back pain.

 

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