Whiplash Facts

Whiplash Facts: Part II

Whiplash if not treated properly can lead to ongoing pain and disability...even in mild cases. Of special concern are children who are often overlooked because they do not complain much. Anyway, last month we were unable to cover all the important whiplash facts you should know...here are the rest:
 1. Much has been published on the association between ongoing whiplash symptoms and litigation. There is now plenty of evidence that ongoing whiplash injury related symptoms occur regardless of the presence or absence of litigation.
2. The concept of a delay in symptoms means minimal injury is dispelled. In fact, it’s considered “the norm” that symptoms are delayed.
3. Mild traumatic brain injury (MTBI) or post-concussive syndrome can occur as a result of whiplash trauma. The good news is that, in most cases, recovery occurs within the first 3 months.
4. In the European Spine Journal, a recent study reported that between 1 and 2 years after a whiplash injury, 22% of patients’ conditions worsened. Condition deterioration at the 2 year mark has also been reported in other studies.
5. More detailed studies that followed whiplash patients through time, reported that 45% remain symptomatic at 12 weeks (3 months) and 25% at 6 months. Others reported the recovery time in most “minor cases” is 8 weeks (2 months), time to stabilization (not recovery) in the more severe cases was 17 weeks (4 months), and in the most severe category, 20.5 weeks (5 months). Hence, the concept that whiplash, like all other injuries heal in 6-12 weeks is challenged (note, there is little support for this common myth).
6. Each year, approximately 1.99 million Americans are injured in motor vehicle collisions.
7. Since 1990, a mean of 40% of a pool of whiplash patients from all vectors of collision (that is, rear, front or side impacts) were still symptomatic at a 2 year follow up. 59% of ONLY rear-end collision patients remained symptomatic at a 2 year follow-up.
8. Although these estimates vary, approximately 10% of WAD (whiplash associated disorders) injured subjects become disabled to a point of not being able to continue working.
9. Children who sustain whiplash injuries display sleep disturbances, nightmares, difficulty talking to parents and friends (brain injury), mood changes, poor academic performance and fears of participating in higher impact sports. Moreover, children tend to be overlooked in the evaluation and treatment process since they tend to complain less.
10. If the size of the 2 impacting vehicles is the same, an 8 MPH impact produces 2 times the force of gravity. When the bullet vehicle is larger than the target vehicle, the difference increases dramatically. 

Natural Relief for Neck Pain from Arthritis

If you have ever had neck pain or headaches, and you’ve gone to see you doctor, they may have told you that either “your X-rays are normal” or “you have arthritis in your neck, but it’s part of the normal aging process.”
So let me ask you this... if arthritis of the neck is the normal aging process, why don’t all your joints have arthritis? Are your shoulders or your hips fine? Aren’t they the same age as your neck?
I see a lot of X-rays, and arthritis of the neck is one of the most common findings in patients over age 40. Also called cervical arthritis, it's basically wear and tear, or degeneration of the vertebrae (bones) in the neck.
What Causes Arthritis of the Neck?
Have you ever been in a fender bender? You know, one of those "minor" accidents that really didn't cause too much damage? Maybe you had a little dent in the bumper or the fender of your car, but you were OK?
If you have arthritis in your neck and have ever been in a fender bender, there's a good chance that slight accident started the problem you are experiencing now.
No one ever told you that, did they?
Any accident that has enough force to damage your car, will damage your spine. But because we "feel OK" afterwards, we tend to ignore it and not get it checked out.
When you are in a car that is hit, the impact throws your head either forward, backward, or to the side. Since your head weighs about as much as a bowling ball, the entire injury puts a lot of strain on the delicate neck, and can cause the curve that gives your neck strength and stability to straighten out.
Once that happens, you are pretty much guaranteed to have arthritis in your neck 10-20 years down the road. Unless you fix it.
You can also get arthritis if you have bad posture, where your head juts forward and your shoulders are rolled forward. This puts excess pressure on the spine, and causes it to wear out faster.
Think of it this way... try holding a bowling ball in your hands with your arms straight out in front of you. Hard to do, right? That's because there is more strain on your arms with the weight out in front of you.
The same thing happens with your neck. Your head should be right over your shoulders. If it's too far forward, it puts extra pressure on the spine, and can cause arthritis if left that way.
Symptoms of arthritis in the neck

• Neck stiffness
• Headaches
• Numbness, tingling, pain or weakness in the hands
• Spasms in the neck muscles, shoulders, and upper back
• Pain in the lower back or legs (especially if your spinal cord is being pushed on)
• Strange, unexplained symptoms anywhere in the body (again, if the spinal cord is being impinged anywhere)

A mild case of arthritis can be helped with non-invasive treatments like chiropractic care, or osteopathy. Acupuncture can help arthritis pain as well, especially if yours is a mild case. Find a practitioner who is comfortable teaching you exercises that will help restore the proper curve to your neck, and who will address your posture to correct anything there that is contributing to the extra strain.
Moderate to severe cases are harder to treat with non-invasive treatments, but can still be successfully helped; it just takes a little longer.
If there are bone spurs and the discs have thinned, we may be able to drop pain levels, but we won't be able to fix the bone spurs. With the proper home traction tools, you may be able to help heal your discs a bit, depending on how thin and dried out they are.


Traditional Medical Management of Arthritis
The traditional medical management of arthritis of the neck usually consists of NSAID's for inflammation and pain, and muscle relaxers to help the spasms. These osteoarthritis drugs can have some serious side effects, so take them with caution, and they were not designed for long term use.
If medications don't work, the next step is often cortisone injections into the neck. While the cortisone will help with inflammation, it may only be temporary (I've had people tell me they had relief for only 12-24 hours). A side effect of cortisone injections is that they will cause the stabilizing tissues of the spine (ligaments and tendons) to wear out faster, ultimately leading to a more unstable neck and further arthritis!
If you have arthritis of the neck, there is hope. If it's mild case, you may be able to reverse some of the damage, and you can definitely fix the postural distortions that are making it worse.

Can Chiropractic Help Knee Pain?

You don't have to be a world-class athlete to struggle with knee pain. Many normal daily stresses can cause knee discomfort, difficulty walking, and a decrease in your quality of life right here in Peoria. This helps to explain why more than half a million Americans undergo knee replacement surgery every year.

The knee is essentially a hinge joint, which means that it only moves in two directions, open and closed (compared to your shoulder, which can move in all directions). However, it is certainly not a simple joint.

The knee joint is made of four bones: the femur (thigh bone), the tibia (shin bone), the patella (kneecap), and the fibula (ankle bump). All four bones are dynamically involved in knee movement and proper function. But since most of these bones are long bones, knee pain is often caused clinically by problems in other joints: the ankle, the hip, and the low back. Dysfunction in those other joints change the way the knee operates, and knee pain can arise.

Suppose you sprain an ankle. You're unable to bear weight on that foot, so you begin to limp, putting your body weight on your other leg. You also lean to the other side, changing the angle of the weight as it presses down on your knee. The knee is unable to adapt so quickly to such a drastic change in stress. Although your limp will become less gradual over the weeks as your ankle sprain heals, your knee has already paid the price.

Knee pain can be caused by a wide variety of muscles, ligaments, menisci, nerves, and bones in the leg. Knee pain can also be caused by nerve problems and disc problems in the lower back. It is important to have your knee examined by a physician, since your knee condition can only be properly treated once it is identified.

How We Can Help Your Knee Pain

The chiropractic adjustment is designed to add motion into joints in order to affect the nervous system. The knee tends to respond in remarkable ways to the chiropractic adjustment.

- Osteoarthritis, a common form of arthritis, is most commonly found in the knee. Chiropractic adjustments have been found effective in reducing symptoms and improving knee function in patients with osteoarthritis of the knee.
- The nerves which supply the muscles around the knee arise in the low back. Chiropractic adjustments to the low back may directly affect the behavior of the thigh muscles, improving recovery times.
- Chiropractic management oulined in the Activator Methods protocol ensures that your knees, ankles, and hips are checked for dysfunction at every visit. This is especially important for athletes such as runners, joggers, and walkers, given the complex relationship between these joints.
- The Activator instrument has proven effective in multiple anecdotal and recorded meniscus tear cases by reducing the stress placed on the meniscus, allowing the meniscus to repair and heal itself.

Dr. Payrovan will perform a thorough examination of your lower extremity and spine. After an appropriate diagnosis is reached, he may suggest chiropractic adjustments, postural changes, nutritional supplements, footwear alterations, or additional therapies.

Before deciding on knee replacement surgery, consider pursuing non-invasive conservative care for your knee pain. The decision on treatment is yours.

Is Chiropractic Safe?

I just received a question from a blog reader asking "If Chiropractic Was Safe?"...so I decided to write a post about it. I have read that the chances of getting struck by lightning are greater than suffering a stroke from a chiropractic adjustment (a rare event)...which is what most are concerned about.
Heck...more people have strokes while driving or getting their hair shampooed at a hair salon than in a chiropractic office. Having a stroke is more about risk factors and lifestyle choices than chiropractic adjustments.
My malpractice insurance which is for the highest of limits is only $2000 per year. And we all know that insurance rates are based on incidence statistics.
Sure...it's possible to get sore from chiropractic adjustments...after-all it is physical. I try to reduce the odds of soreness by always starting out light and building up the intensity slowly per patient tolerance. We use ice at at the clinic and at home to reduce the likelihood of soreness.
We are also careful to consider the age, over-all physical condition, and pain levels of the individual patient. Patient comfort is a primary concern of ours. In fact...our chiropractic patients tell us they really look forward to their adjustments...especially the warm-up stretches and massage.
Yes, there is always the chance someone can get really sore...but it is the exception and not the rule.
Heck...if you start a new exercise program you can get sore. But if you are smart, you start off easy and build up the intensity slowly over time giving your body a chance to adapt. We apply these same rules to chiropractic adjustments. We never try to force anything...even if the patient wants us to...it's just not worth it.
So YES...chiropractic is safe. It's also very gentle and effective...and affordable too.
Chiropractic is also very efficient. A typical chiropractic patient will usually have multiple areas of concern...such as neck pain, low back pain, and shoulder pain. A chiropractor can work on all three areas at the same time. This is why chiropractic patients are often amazed when they first discover chiropractic. Amazed that so many seemingly unconnected chronic ailments can start to feel so much better so quick.

Consumer Reports ranks chiropractic #1 for Back Pain.

Bottom Line: It's normal to wonder if chiropractic is safe...and it's smart to do your homework. Hopefully this information can help you make an informed decision. Do yourself and your family a favor...consider chiropractic...it's the smart thing to do!

Carpal Tunnel Syndrome: What is it?

Carpal Tunnel Syndrome (CTS) is a condition that results from pressure applied to the median nerve on the palm side of the wrist that causes numbness, tingling, weakness, and/or muscle damage affecting the thumb side of the hand and fingers, including the thumb, index, 3rd and thumb side of the 4th finger. There is literally a tunnel through which 9 tendons and their sheaths, some blood vessels, and most importantly, the median nerve travel through to get to the thumb and fingers. As these tendons slide back and forth in their sheaths, friction can build up, leading to swelling when fast, repetitive finger related work is performed, such as working on a computer, especially for prolonged time frames without proper ergonomics and rest periods.  The “syndrome” starts when the swelling occurs and the numbness/tingling/weakness complaints begin.
            There are many causes of CTS.  Most commonly, CTS occurs in people whom perform fast, repetitive motions including (but not limited to):  typing on a computer keyboard, using a computer mouse, sewing, driving, assembly line work, painting, writing, use of hand tools, sports such as racquetball or handball, and playing musical instruments. Many of these tasks involve bending or twisting of the wrists (think of a violin or flute player and you get the picture). CTS most often occurs in people 30-60 years old, affects women more than men and, can be either caused or contributed by other conditions such as fracture/trauma to the wrist or hand, arthritis of the wrist, diabetes, alcoholism, hypothyroid, kidney failure and dialysis, menopause, premenstrual syndrome (PMS), and pregnancy, infections, obesity, rheumatoid arthritis, SLE, and others.
            Symptoms most commonly include numbness or tingling in the thumb-side palm, thumb, 2nd, 3rd, and thumb half of the 4th fingers. The symptoms can extend to the elbow or higher to the neck or shoulder, can affect both hands (but one is usually worse than the other), and can interfere with daily activities such as buttoning shirts, opening jars, holding onto the steering wheel, riding a bike, working with the hands, etc.
            During an initial examination, we will often check your sensation with a sharp pointed object, percuss (tap) over the palm-side wrist, ask you to hold your hands back to back and palm to palm while counting the seconds to numbness, test grip strength, and also check the neck, shoulder and elbow as these areas refer pain back and forth. Sometimes, he or she will order an EMG to test the nerve’s damage. Conservative chiropractic treatment is highly effective and DEFINITELY should be done FIRST, before injections, medications, or surgery!
It's also important to know that the median nerve, which is the nerve involved with CTS, originates in the neck. Pressure on the median nerve (roots) in the neck can cause the same symptoms as true carpal tunnel syndrome. This is why a true carpal tunnel expert will always examine you from the neck to the finger tips on both sides. The reality is...true CTS is rare...the primary cause of most carpal tunnel symptoms are pinched nerves in the neck.

Do Chronic Sinus Problems Cause Headaches?

During this time many of our patients have had sinus related headaches.  You know, these are the headaches that hurt over the sinuses (above the eyes or in the cheek bones next to your nose) and, when you blow your nose, it’s not pretty!  Sinus infections often lead to sinus headaches – wouldn’t you say that’s a true statement?

            A recent November 2011 study begs to differ. Researchers took 58 patients with a diagnosis of “sinus headache” made by their primary care physician and asked them the following questions:

1. Have you had a previous diagnosis of migraine or tension-type headache?
2. Is their clinical evidence of a sinus infection during the past 6 months?
3. Is there the presence of  “mucopurulent secretions” (that’s the “not so pretty stuff” when we blow our nose)?

            All 58 patients clearly seemed to have chronic sinusitis with an acute flair up and were given complete thorough examinations by a neurologist and an ears, nose, throat specialist (otolaryngologist) on a monthly basis for 6 months during treatment. The surprising results showed that final diagnosis in these 58 cases were 68%, 27% and 5% of the patients really had migraine, tension-type headache and chronic sinusitis with recurrent acute episodes, respectively. Treatment during the 6 months included antibiotic therapy in 73% of the patients with tension-type headache and 66% with migraine. Sinus endoscopy (taking a look up the sinuses with a scope – ouch!) was performed in 26% of the patients, and therapeutic nasal septoplasty (surgery!) was performed in 16% of the migraine patients and 13% of patients with tension-type headache (a pretty BIG mistake, wouldn’t you say?).  The conclusion was that many patients with self-described or primary care physician diagnosed “sinus headaches” have no sinonasal abnormalities, but instead, met the criteria for migraine or tension-type headache.
            So, what does this mean?  Well, for one thing, too many antibiotics are prescribed for tension-type or migraine headaches and have no place in the treatment process of these two common headache categories.  Side effects of antibiotics include (but are not limited to):  stomach and intestinal irritation, nausea, and if one is allergic to the antibiotic, a potentially life-threatening condition call anaphylactic shock.  Let’s not forget to mention that sinus surgery was performed in 29% of the cases where the sinuses were NOT causing the headaches and we all know the risks of undergoing anesthesia and surgery can include death and infections, among other problems.
            Chiropractic was reported to be a wise choice in the treatment of headaches by several publications, one of which provided a large review of the literature on the “Effectiveness of manual therapies: the UK evidence report,” released in 2010 (http://chiromt.com/content/18/1/3). In this report, both migraine and cervicogenic-type (headaches that start in the neck) headaches were found to have strong research support for manipulation or, chiropractic adjustments. In this day and age, you can be very confident that choosing chiropractic services for headache treatment is a wise, safe, and very cost-effective approach for a very disabling condition.

            We realize that you have a choice in where you choose your health-care services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Your Chronic Back Pain: Are You Attached To It?

Is your chronic back pain  giving you something to do? After all...now you can talk about your back pain. You can avoid things you don't want to do because of your low back pain or your neck pain.
You don't have to exercise because it makes your back pain worse. And food is really the only pleasurable activity you can handle...so you can justify the extra weight you are carrying around because of your chronic back pain.
But when it comes to treatment...your just not sure what to do. You go from doctor to doctor and your back pain history is now a short story. You do everything but take action to make it better. If this sounds like you...You May Be Mentally Attached To Your Back Pain. 
If you could only make a decision...you need to do more research. You need to talk to your medical doctor. You need to talk to your insurance company. You need to think about it. You need to do everything but what you should be doing...and that's taking action to get better.
I believe at least half the battle of getting rid of chronic back pain is making the decision to get rid of it...then following through with your decision.
Not only do I believe this...I know this to be true from 7 years of experience as a practicing chiropractor in Dallas. The bottom line is this...Nothing Happens Until Something Moves. What needs to move is YOU...into action.

Will A Herniated Lumbar Disc Heal On It's Own?

I have been treating herniated discs in Dallas for over 7 years now.
I have helped hundreds of herniated disc patients return to more normal lifestyles...some have had complete recoveries.
During this time...one of the most common questions I have been asked is...
Will my herniated lumbar disc heal by itself?
And, this is a great question...and the answer is...maybe. Some do-some don't.
Heck...there are people every day that suffer herniated discs in the low back and never even know it.
It's the patients that know they have herniated discs that are not responsive to conventional treatment methods that are the problem. They are a small subset of the overall pool of people who have a herniated disc.
Why is this? Well...I guess it's just the way the disc is positioned in the spinal canal or nerve channels. The disc fragments can get lodged in there in such a way that the body is unable to heal itself. This traps the nerve roots or puts pressure on the spinal cord, which can cause severe low back pain, sciatica, and all kinds of other problems.   
Sometimes, traditional chiropractic can be very effective treatment for lumbar disc herniations. But sometimes it does nothing. 
At my office, we incorporate Chiropractic and Active Release Techniques (ART) to successfully manage most lumbar disc syndromes. 
So yes, herniated discs do repair themselves when they can...but when they can't they need some help...and it doesn't have to be back surgery either. In fact...some say back surgery is a thing of the past. I don't know about that...I think we need both surgical and nonsurgical treatments for everything.