Alarming Escalation of Fusion Surgery – What Can be Done?

Alarming Escalation of Fusion Surgery – What Can be Done?
Ron Feise, DC

IN THE UNITED STATES, SPINAL SURGERY rates over the last few decades have risen dramatically. Between 1993 and 2008, cervical fusion surgery increased 625.8 percent, and lumbar fusion surgery increased 773.6 percent.1-3 These increases accelerated when fusion cages were approved, but artificial disc replacement has not demonstrated a clinical superiority over fusion.4-7 The most common primary diagnosis for cervical and lumbar fusion is degenerative disc disease.8,9 Yet, as explained below, degenerative disc disease is not a pathologic process automatically necessitating treatment.

Spinal surgical procedures are expensive. Between 2001 and 2010, an estimated 3.6 million spinal fusions were performed in the United States accounting for more than $287 billion in total hospital charges, excluding charges associated with readmissions, rehabilitation, prescription drugs, professional fees or indirect costs associated with loss of productivity.9-11 Make no mistake; spinal surgery is big business. But is it good for patients and the U.S. healthcare system?

Double the Rates of Other Countries

The United States has the highest rate of cervical and lumbar spine surgery in the world. The spinal surgical rate in the United States is roughly twice that in New Zealand, Australia, Canada, Norway and Finland, and it is more than triple the United Kingdom’s rate.3,12,13 There is no reason to believe that there are biological differences from country to country, and epidemiological studies suggest that rates of back pain are similar among geographic areas.14,15 Compared with other developed countries, the surgical rates in the United States may be explainable: fee-for-service and easy access to care are thought to encourage spinal surgery in the United States.

Factors Behind the U.S. Surge in Spinal Surgery

• Irrelevant Imaging Findings Drive Surgery

Degenerative changes and disc herniation of the spine are biological realities, but pain and disability do not necessarily accompany these conditions. A major problem with imaging is that it can reveal issues that are alarming but irrelevant. An international research team found no evidence demonstrating that disc degeneration is a risk factor for neck pain.16 The American College of Physicians and the American Pain Society reached a similar conclusion for back conditions.17

A systematic review estimated the prevalence by age of common degenerative spine conditions on imaging in asymptomatic individuals.18 Thirty-three articles reporting imaging findings for 3,110 asymptomatic individuals revealed that about 30 percent of 20-year-olds and more than 80 percent of 80-year-olds have disc degeneration or bulge without any symptoms. This study found that imaging findings of degenerative changes, such as disc degeneration, disc bulge and disc protrusion, are generally part of the normal aging process rather than pathologic processes requiring intervention. These findings have been affirmed by numerous medical research teams for both neck and back conditions.19-39 Perhaps most important, the relationship between imaging findings and surgical outcomes has not been established.40,41

Recent scientific research has found that herniated discs can be resolved after conservative treatment or even after no treatment.42 The probability of low-back herniated disc regression without surgical treatment but after conservative treatment, such as spinal manipulation, exercise, physical therapy or NSAIDS, is 70 percent for disc extrusion and 41 percent for disc protrusion. According to medical research, active conservative treatment produces a satisfactory outcome even for patients with obviously extruded discs or marked neurological deficits.43-46

● Serious Adverse Events Ignored

Serious adverse events caused by spinal surgery are remarkably common. Several published studies conducted by independent medical research teams found that the reoperation rate (i.e., failure rate) for spinal surgery is greater than 22 percent.47-52 Serious postoperative pain and disability were experienced by more than 29 percent of patients following total lumbar disc replacement.53,54 Death rates following spinal surgery are about 5 per 1,000 operations,9,55-57 and blindness following spinal surgery is estimated at more than 1 per 1,000 operations.58-60 Despite these serious and catastrophic occurrences, it is well known that spinal surgeons routinely underreport adverse events.61

● Surgery for Non-Serious Symptoms

You would think that risky spinal surgery is reserved for serious cases with high levels of pain and high levels of dysfunction. Unfortunately, it is not. Many of the research subjects undergoing surgery have only mild to moderate pain and dysfunction,62-71 and many have never been screened for depression, anxiety or catastrophizing.72-81 Yet, many of these patients have these psychological co-morbidities, which amplify pain and dysfunction and thereby increase the probability that the pain condition will persist over an extended period of time.82-103 Many spinal surgical clinical trials do not even require a minimum amount of pain intensity or dysfunction before surgery is administered. Among trials that include pain intensity or dysfunction inclusion criteria, most establish very low entry requirements.49,104-114 This promotes the use of surgical procedures in patients with non-serious symptoms who are better suited for nonsurgical approaches.

● Misleading Informed Consent

The International Society for Study of the Lumbar Spine has developed a research-based informed consent sheet for spinal surgery outlining the odds of occurrence for various complications, with appropriate emphasis on “serious or frequently occurring risks.”115 The document is a good first step, but it is incomplete, because it fails to provide risks and benefits for alternatives to surgery, fails to include a crucial summary statistic — the probability that at least one of the listed adverse events will occur (the risk is 30 percent) — and omits some serious adverse events, such as the risks of death and blindness. In most cases, patients should consider spinal surgery optional, and they should have information to assess the risks and benefits of their treatment alternatives. Shockingly, most spinal surgeons do not even provide the industry-established informed consent to their patients. [Editor’s Note: Informed consent documents by law do not have to report the risks and benefits of alternatives to the therapy being offered, only that alternatives exist.]

• Spinal Surgeons Resist Placebo Trials

Randomized, double-blind, placebo-controlled trials are the gold standard for evaluating interventions and are routinely used to assess medical therapies.116,117 But spinal surgeons have been reluctant to use imitation surgery as a placebo control in the evaluation of spinal surgery.118,119 It is well-known that even an ineffective surgery can carry a larger placebo effect than nonsurgical treatments.120-124 So the question remains: Could the supposed benefits attributable to spinal surgery just be placebo? [Editor’s note: Placebo surgeries are ethically difficult to do and few have been done in the modern era.]

Conclusions

● Medicare and all insurance companies should refuse all payments for cases that have a diagnosis associated with disc herniation/degeneration and/or spinal arthritis.

● State medical boards, medical societies and insurance companies should require that all potential surgery patients receive a written informed consent that outlines all possible adverse events, similar to the document from the International Society for Study of the Lumbar Spine. The document should be revised to include a summary adverse event statistic, as well as the risks and benefits for alternative strategies.

● All patients should be required to be screened (and treated, as necessary) by a psychologist for depression, anxiety and catastrophizing. All patients (i.e., especially patients with mild to moderate pain/dysfunction) should be treated for 12 to 24 months with nonsurgical interventions, such as spinal manipulation, physical therapy and spinal rehabilitation, before considering surgery.

● Qualified researchers from both surgical and nonsurgical camps should conduct at least two quality randomized, double-blind, placebo-controlled trials to assess the efficacy of spinal surgery.

References

[Editor’s Note: Due to the large amount of references and space limitations, the references are available online at http://www.acatoday.org/content_css.cfm?CID=5797.%5D

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Acute Neck Pain (Torticollis), Disability and Chiropractic: Patient Satisfaction Results

Acute Neck Pain (Torticollis), Disability
 and Chiropractic:
Patient Satisfaction Results

The overall patient satisfaction rate was 94%

By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP

“Acute neck pain means immediate neck pain.  Neck pain that just started. This type of pain comes on suddenly and affects the ability to properly move your head in its proper range of motion. One serious type of acute neck pain iswhiplash – the sudden jarring motion of your head going backwards and forward. This often occurs with a rear end collision. Acute neck pain can also be the result of a fall, sleeping awkwardly, a trauma or even a fall.. Often times when someone has just strained or irritated their neck in some way the pain is most severe. There is usually inflammation, immobility, and muscle tenderness. Often with acute neck pain, the muscles or ligaments are involved” (The Neck Pain Relief Shop, n.d., http://www.neckpainreliefkit.com/acuteneckpain).

The “real life” issue for the patient who either wakes up with this debilitating pain or is in an accident that causes it, is that taking drugs without narcotics is insufficient for relieving the pain. With the narcotics, one can be severely hampered and may not be able to go about his/her life. It is often a double-edged sword; take strong drugs and compromise your life or don’t take drugs, receive no chiropractic care and suffer.

A 2006 study examined “…the extent to which a group of patients with acute neck pain managed with chiropractic [adjustments]…and the degree to which they were subsequently satisfied…A total of 115 patients were contacted, of whom 94 became study participants, resulting in 60 women (64%) and 34 men. The mean age was 39.6 years…The mean number of visits was 24.5…Pain levels improved significantly from a mean of 7.6…before treatment to 1.9…after treatment…The overall patient satisfaction rate was 94%” (Haneline, 2006, p. 288).

“There were reductions in disability recorded during the study that were statistically significant. Approximately 84% of the patients related that their activities were restricted before chiropractic treatment because of their neck pain, whereas only 25% still had activity restrictions at the time of the interview. Furthermore, 57% of those with physical restrictions described their disabilities as moderately severe or greater before treatment, whereas at the time of the interview, just 12% did (Haneline, 2006, p. 294).

“When comparing trauma with no-trauma cases, Trauma cases received more than 3 times as many visits. This difference may be related to tissue damage that often accompanies trauma, which, many times, heals imperfectly. In addition, patients with this type of problem may have ensuing long-term pain and physical impairment, which further shows that trauma complicates the recovery of acute neck pain (Haneline, 2006, p. 294).

This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to acute neck pain and returning to a normal life. For More information visit http://www.ChiroRehabClinics.com

References

1.  The Neck Pain Relief Shop. (n.d.). Acute neck pain. Retrieved from http://www.neckpainreliefkit.com/acuteneckpain
2.  Haneline, M. T. (2006). Symptomatic outcomes and perceived satisfaction levels of chiropractic patients with a primary diagnosis involving acute neck pain. Journal of Manipulative and Physiological Therapeutics, 29(4), 288-296.

Chronic Neck Pain and Chiropractic: A Comparative Study with Massage Therapy

Chronic Neck Pain and Chiropractic:
A Comparative Study with Massage Therapy

By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP

Neck pain is a very common problem, second only to low back pain in its frequency in the general population and in doctors’ offices treating musculoskeletal injuries. “The musculoskeletal system is an organ system that gives [humans] the ability to move using their muscular and skeletal systems” (Wikipedia, ,2010, http://en.wikipedia.org/wiki/Musculoskeletal). “Estimates of the prevalence of chronic neck pain vary. In a Swedish population 18.5% of females and 13.2% of males had neck pain for longer than 6 months; however, when continuous chronicity was rated, these figures were reduced to 10% and 7%, respectively. A Finnish study reported chronic neck pain in 13.5% of females and 9.5% of males. A Norwegian studyreported an overall rate of 13.8% for neck pain greater than 6 months duration; however, for subgroups with age greater than 43, the rate rose above 20%. It would appear that approximately 15% of females and 10% of men have chronic neck pain at any one time. Chronic neck pain produces a high level of morbidity by affecting occupational and avocational activities of daily living and by affecting quality of life” (Vernon, Humphreys & Hagino, 2007, p. 215).

“Manual therapy [chiropractic adjusting] is a generic therapeutic category that is composed of a variety of procedures directed at the musculoskeletal structures in the treatment of mechanical pain. Two major subcategories exist that divide these therapies into those which produce joint motion and those which do not. The first subcategory includes manipulation, mobilization, and manual traction. The second subcategory involves both generalized soft tissue therapies, such as the many types of massage, and focal soft tissue therapy, such as trigger point therapy, shiatsu, and acupressure. For this review, we used the separate therapy categories of manipulation, mobilization, manual traction, massage, and pressure techniques” (Vernon, Humphreys & Hagino, 2007, pp. 215-216).

There are numerous systematic reviews of the treatment of neck pain by manual therapy. With few exceptions, they have included studies of manual therapies for acute, subacute, and chronic neck pain. They have also included studies of subjects with neck pain due to whiplash-type injury as well as those in which whiplash-associated disorder (WAD) was not involved. These reviews have also included studies of subjects with or without concomitant headaches and/or arm pain…Finally, these reviews have included studies where manual therapies have been combined with other therapies such as exercises, relaxation therapy, etc (so-called ‘multimodal therapy’). The most recent reviews by Gross et al, Bronfort et al and the Canadian Chiropractic Association Clinical Practice Guideline have brought the evidence base up to date but are similarly broad in scope” (Vernon, Humphreys & Hagino, 2007, p. 216).

The results of these research studies included studies that  provided information of long-term outcomes, meaning they continued their study up to at least 52 weeks, with one going as high as 104 weeks (2 years) in order to determine the validity over a long period of time confirming the non-recurrence of the pain. The results of one long-term study that examined the effects of chiropractic treatment on the recovery of clinical trial patients found that approximately 70% of the patients showed full recovery. However,100% of the patients in five studies that varied in length had positive changes. It was also reported that 0%, or none of the massage therapy patients had positive outcomes at the 6 week period.

This study along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to neck pain. For More Information visit http://www.ChiroRehabClinics.com

References

1.  Wikipedia, The Free Encyclopedia. (2010, July). Human musculoskeletal system. Retrieved from http://en.wikipedia.org/wiki/Musculoskeletal

  1. Vernon, H., Humphreys, K., & Hagino, C. (2007). Chronic mechanical neck pain in adults treated by manual therapy: A systematic review of change scores in randomized clinical trials, Journal of Manipulative and Physiological Therapeutics, 30(3), 215-227.

 

Neck Pain, Headaches and Chiropractic


By

William J. Owens DC, DAAMLP

Mark Studin DC, FASBE(C), DAAPM, DAAMLP

A recent study on chiropractic and conditions concluded that 18.7% of patients present with initial complaints of neck pain, making neck pain the 3rd most common reason for a chiropractic visitation7.  Bogduk and Aprillhypothesized that one of the most common causes of neck pain is related to mechanical dysfunction of the cervical spine”1. Additional reasons can be herniatedintervertebral disc or pinched nerves.

 

It has been found that spinal manipulative therapy is one of the most used therapies in the management of mechanical neck disorders. There is more and more research published that shows that neck pain and headache related to mechanical dysfunction in the neck responds well to chiropractic care. Your doctor of chiropractic has the training to determine whether your pain is coming from a mechanical source. If you have to take pain killers to get through your day, experience headaches and have limited range of motion in your neck or shoulders, chiropractic care is a safe and effective treatment.

 

The following studies were recently published on the topic of chiropractic and neck pain treatment.

 

“…a single cervical manipulation was more effective in reducing neck pain at rest and in increasing active cervical range of motion than a control mobilization procedure in subjects suffering from mechanical neck pain”1

 

“Findings give preliminary support for the benefit of larger doses, 9 to 12 treatments, of chiropractic care for the treatment of cervicogenic headache.”2

 

“According to a recent survey of complementary and alternative therapy use, chiropractic was frequently selected for the relief of head and neck pain,’ accounting for 18 to 38 million manipulations performed annually” 2

 

“The overall results demonstrated improvement in mechanical neck pain and LBP of patients while under chiropractic care”3

 

“The best evidence indicates that cervical manipulation for neck pain is much safer than the use of NSAIDs, by as much as a factor of several hundred times. There is no evidence that indicates NSAID use is any more effective than cervical manipulation for neck pain”.4

 

“In patients with chronic spinal pain syndromes, spinal manipulation (chiropractic adjustments,) if not contraindicated, may be the only treatment modality of the assessed regimens that provides broad and significant long-term benefit” 6

 

For More Information visit http://www.ChiroRehabClinics.com

 

 

 

 

 

 

 

 

 

REFERNENCES:

  1. Raquel Martinez-Segura, PT, DO, Cesar Femandez-de-las-Penas, PT, Mariana Ruiz-Saez, PT, CO, Cristina Lopez-Jimenez, PT, DO, and Cleofas Rodnguez-Blanco, PT, DO. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther 2006;29:511-517.
  2. McMorland G; Suter E. Chiropractic management of mechanical neck and low-back pain: a retrospective, outcome-based analysis. J Manipulative Physiol Ther 2004;27:547-553.
  3. Mitchell Haas, D C Elyse Groupp, PhD, Mikel Aickin, PhD,Alisa Fairweather, MPH, Bonnie Ganger, Michael Attwood, Cathy Gummins, DC,and Laura Baffes, DC. Cevicogenic headache and associated neck pain: A randomized pilot study. Journal of Manipulative & Physiological Therapeutics, 2000 Jun; 23(5)
  4. Dabbs V; Lauretti WJ.A risk assessment of cervical manipulation vs. NSAIDs for the treatment of neck pain. J Manipulative Physiol Ther 1995; 18:530-6
  5. Reinhold Muller, PhD,” and Lynton G.F. Giles, DC,PhD. Long-term follow-up of a randomized clinical trial assessing the efficacy of medication, acupuncture, and spinal manipulation for chronic mechanical spinal pain syndromes. J Manipulative Physiol Ther2005;28;3-ll
  6. Bradley S. Polkinliorn, DC, and Christopher J. Colloca, DCChiropractic Treatment of Postsurgical Neck Syndrome With Mechanical Force, Manually Assisted Short-Lever Spinal Adjustments.J Manipulative Physio Ther Volume 24 • Number 9 •November/December 2001.
  7. Andrew McHardy, MChiro, Wayne Hoskins, MChiro, Henry Pollard, DC, MSportSc, PhD, Rorey Onley, MChiro, and Ross Windsham, MChiro. Chiropractic treatment of upper extremity conditions: a systematic review. J Manipulative Physiol Ther 2008;31:146-159

 

Shoulder Pain, Neck Pain and Chiropractic

1

By 
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

Many people experience pain in the upper back area between the bottom of the neck and the shoulders.  There is a very large muscle there called the trapezius muscle.  Doctors of chiropractic have long understood the relationship between the nervous system and the rest of the body.  In this area, the part of the nervous system that controls the trapezius is actually found in the neck.  A research paper was presented that sought to determine whether a chiropractic adjustment to the neck at specific levels of the spine would result in reduced sensitivity to pain in the shoulders.  What they found was VERY interesting.

The authors stated, “Our results suggest that a cervical spine manipulation [chiropractic adjustment] directed at the C3 through C4 segment induced changes in pain sensitivity…in the upper trapezius muscle” (Ruiz-Sáez, Fenández-de-las-Peñas, Blanco, Martínez-Segura, & García-Léon, 2007, p. 578). What this means is that stimulation and/or correction of the nervous system in the neck can effect the shoulders! This is important because many of the things that we do on a daily basis increase the demand on the vertebral column found in the neck.  This in turn can create problems in the shoulders.   While helping to reduce symptoms is important, only doctors of chiropractic are specifically trained to look to the CAUSE of the problem, essentially to find the SOURCE of your pain.

More and more research is coming out on a daily basis that shows what chiropractic patients have known for years; CHIROPRACTIC WORKS.  If you are suffering from pain in the shoulders, especially the type that increases throughout the day, speak with a doctor of chiropractic today. According to this research article, you will be happy you did!

 

For More Information visit www.ChiroRehabClinics.com

References:

1.  Ruiz-Sáez, M., Fenández-de-las-Peñas, C., Blanco, C. R., Martínez-Segura, R., & García-Léon, R. (2007). Changes in pressure pain sensitivity in latent myofascial trigger points in the upper trapezius muscle after a cervical spine manipulation in pain-free subjects. Journal of  Manipulative and Physiological Therapeutics, 30(8), 578-583.

 

Prediction of Outcomes with Chiropractic Care and Cervical Pain

Prediction of Outcomes with Chiropractic Care and Cervical Pain
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP

updated 12-4-2013

 

Pain located in the neck is a very common condition. Neck pain can come from a number of activities, disorders and diseases in the neck, such as degenerative disc disease, neck strain, whiplash, a herniated disc, or a pinched nerve. It can also come from overuse, sports injuries, and everyday home and work related activities. Usually, there is an underlying instability or problem in the neck that is a precursor to the pain. Neck pain is also referred to as cervical pain.

“Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and gland swelling” (MedicineNet.com, 2008, http://www.medicinenet. com/neck_pain/article.htm).

“There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs, and nearby pass the nerves of the neck” (MedicineNet.com, 2008, http://www.medicinenet.com/neck_pain/article.htm).

“Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury” (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430).

“The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear” (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430).
Further detailed explanations of some of the causes of neck pain are:

“Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting “rebound” in the opposite direction is known as whiplash. The sudden “whipping” motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most common cause of whiplash” (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430).

“Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.

– Osteoarthritis, a common joint disorder, causes progressive deterioration of cartilage. The body reacts by forming bone spurs that affect joint motion.

– Spinal stenosis causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally.

– Degenerative disc disease can cause reduction in the elasticity and height of intervertebral discs. Herniated discs are NOT an effect of growing older and are a direct effect of trauma, but can also cause similar reduction in elasticity and height of the intervertebral disc, but have the potential to cause more serious problems.

“Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms” (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430).

When considering solutions for neck pain, you must look at what will help you and how long it will take to get better. Like with any malady, the progression of treatment should be drugless first, involve drugs second and have surgery as a final option. A significant factor must be the scientific evidence that predicts the outcome of any treatment. A cancer patient or a heart disease patient, prior to undergoing chemotherapy or open heart surgery, will ask the doctor what the percentage of success is for the treatment. The same question should be asked of every doctor for every treatment and chiropractic is no different.

In 2008, Thiel and Bolton studied 19,722 patients that were treated for a variety of symptoms, most of which were pain or stiffness in the neck, shoulder or arm region. The purpose of the study was to determine the outcome of chiropractic care in patients with nonspecific musculoskeletal disorders, including mechanical neck disorders. The results revealed that 71.6% of females and 67.9 % of males had immediate improvement. This shouldn’t be confused with the overall satisfaction rate of 94% of patients treated with acute neck pain as reported by Haneline (2006), asThiel and Bolton (2008) examined immediate improvement, not improvement over time as Haneline did.

Since statistics can be manipulated in many different ways, let’s examine those patients who experienced immediate worsening. The Thiel and Bolton (2008) study revealed that 95.2% of females and 96.2% of males reported no immediate worsening, rendering an overwhelming predictor of a successful outcome. Predictable outcomes are critical in guiding both the public and the doctor in realizing a successful treatment plan.

These studies, along with many others, conclude that a drug-free approach of chiropractic care is one of the best solutions to treat neck pain. For More information visit http://www.ChiroRehabClinics.com

References:

1. MedicineNet.com. (2008, January). Neck pain. Retrieved from http://www.medicinenet.com/neck_pain/article.htm
2.  American Chiropractic Association. (n.d.). Chiropractic and neck pain: Conservative care of cervical pain, injury.Retrieved from http://www.acatoday.org/content_css.cfm?CID=2430
3.  Thiel, H. W., & Bolton, J. E. (2008). Predictors for immediate and global responses to chiropractic manipulation of the cervical spine. Journal of Manipulative and Physicological Therapeutics, 31(3), 172-183.

 

Whiplash Disorders and Neck Pain

Whiplash Disorders and Neck Pain

By 
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
In car accidents and other trauma related causes, whiplash, formally known as WAD (Whiplash Associated Disorders), has the potential to create significant problems to the neck area or cervical spine. The treatment of these disorders ranges from rest or no care to non-invasive care such as chiropractic, acupuncture or physical therapy to invasive care starting with drugs and leading to surgery. Every one of these treatment modalities is indicated based upon the individual diagnosis of the condition and requires the care from a doctor who is experienced and credentialed in trauma related care.

The problem with whiplash is that it affects the ligamentous attachments that connect the bones to one another and creates hypermobility (too much movement or laxity). It often results in compression of the nerves causing pain and resultant premature degeneration. The biggest problem is that ligaments, as reported in a 2006 study, never heal or wound repair.They stay impaired for a lifetime, which affects different people in different ways.

Symptoms from whiplash include:2

  1. Neck pain and stiffness
  2. Headaches, most commonly at the base of the skull
  3. Dizziness
  4. Blurred vision
  5. Fatigue
  6. Difficulty concentrating
  7. Memory problems
  8. Ringing in the ears
  9. Sleep disturbances
  10. Irritability
  11. Pain spreading to your shoulders or arms
  12. Painful head movement
  13. Numbness, tingling or weakness in your arms

When analyzing and comparing non-invasive modalities for care, interventions involving mobilization (chiropractic) were more effective than usual care. Multimodal treatment including manual therapy, which included relaxation therapy, led to a quicker return to work and increased satisfaction with recovery.3

With whiplash and resultant damage to ligaments, one the solutions is quick intervention where the joints are mobilized or put back in their normal position with a chiropractic adjustment before adhesions (internal scar tissue) can create a chronic (long term) problem. By getting the area “adjusted” after a conclusive diagnosis is one of the best approaches to treat whiplash disorders.

These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for pregnant patients with back pain. For More Information visit http://www.ChiroRehabClinics.com

References:

1.  Tozer, S., & Duprez, D. (2005). Tendon and ligament; Repair and disease. Birth Defects Research (Part C) 75, 226-236.

  1. Mayo Clinic Staff. (n.d.). Whiplash, symptoms. MayoClinic.com. Retrieved from http://www.mayoclinic.com/health/whiplash/ds01037/dsection=symptoms
  2. Hurwitz, E. L., Carragee, E. J., van der Velde, G., Carroll, L. J., Nordin, M., Guzman, J., Peloso, P. M.,…Haldeman, S. (2009). Treatment of neck pain: Noninvasive interventions: Results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders.  Journal of Manipulative and Physiological Therapeutics, 32(Suppl. 2), S141-S175.