Archive for whiplash

Melatonin for Chronic Whiplash Syndrome

I must admit that this seems like quite a novel approach, even coming for a nutrition-oriented physician that treats whiplash patients frequently. A certain percentage of whiplash patients will experience a syndrome, sometimes referred to as post-concussive syndrome; a constellation of symptoms including fuzzy thinking, diffuse headache and poor sleep. I do know that sleep is an essential part of the healing process, and that patients in severe pain to not usually sleep well. This approach may end up being another tool in the toolbox of effectively treating patients after trauma.

Read entire article here

Categories : whiplash
Comments (0)
Jul
10

Whiplash Injury Changes Everything

Posted by: | Comments (0)

whiplash injury Mesa AZAs a chiropractor, I have an opinion on this one. Whiplash injuries are common & so is the patient whose chronic neck pain has been present “since that accident.”

Whiplash occurs when the head gets thrown back and forth as a result of a sudden change in momentum of the head relative to the neck, resulting in strains affecting the bones, discs, muscles, nerves, or tendons of the neck.

We used to call them hyperflexion / hyperextension injuries, but more careful evaluation showed that the neck does not always go beyond it’s normal range of motion.  Rather, small regions of the cervical spine undergo too much flexion and too much extension.  Consider an “S” shaped spring getting crunched down from the top–there will be areas of the spring that get scrunched and areas that get stretched.  This is closer to what we understand happens during a whiplash type of injury.

Because of this type of injury, studies have identified multiple problems with patients who suffer this type of injury.  Fat deposits in the muscles.  Change in the muscular coordination of the neck.  Jaw pain.  Chronic pain.  All are potential outcomes following a whiplash type injury.

This particular study continues to paint a depressing picture for those who have had this type of injury.  Researchers found changes in those who are suffering from chronic whiplash pain during exercise.

Normally, exercise stimulates the release of built in pain relievers (endogenous).  Everyone’s heard of the experience known as “runner’s high” when these opioid-like compounds are released by the body.  However, in the chronic whiplash patients, they did not experience the pain reduction associated with exercise like the normal patients did.  They were more likely to have an increase in pain after they exercise rather than improvement.

So what is the solution?  I’ve already mentioned my bias.  I can tell you, from personal experience over 15 years of practice, that when patients get in to our office for treatment within hours of an accident, they never seem to get to the severe levels of pain that we see when compared to patients who come in days or weeks after the injury.

Regardless of where you go for treatment, make sure that all of the potentially injured tissues (ligaments, tendons, fascia, joints, etc..) are treated.  Just exercising or just adjusting or just medications will likely not fully address the nature of the tissue damage that occurs in a whiplash type of injury.  Only treatments that encompass both the joints (adjusting) and the soft tissues that are injured is likely to be successful at preventing your injury from becoming chronic.

If you have had a whiplash injury in the past, what did you do to fully recover?  Or do you still deal with chronic pain?

Categories : neck pain, whiplash
Comments (0)

Fatty Infiltration in the Cervical Extensor Muscles in Persistent Whiplash-Associated Disorders: A Magnetic Resonance Imaging Analysis

As a chiropractor, I’ve obviously got some unique perspectives on this issue. It is well documented that a large percentage of patients who experience whiplash type injuries have significant pain 10 yrs later. I firmly believe this is the result of imcomplete treatment following the injury. Strengthening and stretching as done by standard physical therapy procedures will NOT address pathology within the muscles, and adjusting alone will also not impact the muscles either. Full recovery requires a strong approach to both the joints and the muscles.

This article probably won’t show up on the desks of insurance adjusters; many would have their injured patients believe they should be all healed up in a few visits.

Read entire article here

Comments (0)

Comparison of Sensorimotor Disturbance Between Subjects With Persistent Whiplash-Associated Disorder and Subjects With Vestibular Pathology Associated With Acoustic Neuroma

As a chiropractor, I find it unfathomable that a patient involved in a motor vehicle accident would not seek chiropractic care. The known involvement of the facet joints coupled with altered signals being sent up to the brain from the receptors around the joints produces a condition that ONLY manipulation will impact. Rehab exercises, medications, interferential, ultrasound, massage–these will not affect the proprioceptive input to the brain like an adjustment.

This article further supports the idea that dysfunction of the facet joints following whiplash-type injuries are real, and need to be addressed to prevent long term dysfunction.

Read entire article here

Categories : whiplash
Comments (0)

A distinct pattern of myofascial findings in patients after whiplash injury

As a chiropractor that specializes in soft tissue treatment, studies like this confirm my decision to practice in this manner. Too often following whiplash type injuries patients will seek the care of a PT, their PCP or a DC. The statistics linking long term problems from whiplash injuries is frighteningly high, but I believe this is because few approaches attack the comprehensive nature of these injuries. The joints, soft tissues and the psychological impacts of the injury all need to be addressed. Without this comprehensive approach, it is likely that patients will fall into that category of long term neck pain.

Read entire article here

Categories : neck pain, whiplash
Comments (0)
Oct
18

DID YOU GET THIS AFTER A WHIPLASH?

Posted by: | Comments (0)

As a chiropractor, I obviously have seen many whiplash patients.  And sooner is always better.  I’ve found that the sooner I see a patient after the trauma (even the same day of the accident) that better the outcome.  But not everyone seeks care after an accident.

There are multiple reasons why not seeing a chiropractor after trauma is a bad idea.  The obviously one is that the damage from the trauma needs to be controlled and then the healing process needs to be guided.  There are clearly long term problems that occur following improperly treated whiplash injuries.  These include:

 Even if you do not have more than some minor stiffness after the accident, it is still wise to get an evaluation.  This does not mean that you need extensive care, but a few visits can go a long way towards fixing any imbalance that occurred as a result of the trauma. 

If someone does not seek an evaluation after trauma, it is possible that problems will creep up months later, again because of an imbalance created.  This particular study lends support to this idea.

The jaw (temporomandibular joint, or TMJ) generally does not get directly injured in a car accident.  However, it is very susceptible to imbalance between the muscles in the back of the neck (injured during whiplash) and the muscles that open the jaw. 

24% of the patients in this small study developed jaw pain some time after the accident.  Even more interesting, those who experienced low-speed accidents were more likely to suffer jaw pain.  Is this because they chose NOT to get care immediately after the trauma??

Comments (0)
Aug
21

May 4, 2009 Research Update

Posted by: | Comments (0)

James Bogash,D.C.Mesa,AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Effects of Intensive Glucose Lowering in Type 2 Diabetes.

This study demonstrates what is likely the most profound mistake in research that occurs. There is a concept called “surrogate end markers.” The idea is that, for Disease X, patients with lower values of Blood marker B live longer or are less likely to get the disease. So, we create a drug that lowers Blood marker B synthetically, thinking that we will have an impact on Disease X. We don’t measure Disease X directly, because that would take too long. The mistake here is that, what if Blood marker B being low and leading to lowered rates of Disease X is a reflection of the health of the patient, and NOT because Blood marker B itself is low? Time and time again we see that the use of surrogate end markers in research leads to WORSE outcomes when we artificial lower Blood marker B. The ACCORD trial here is no different. Basically, in diabetics, we want HbA1C levels to be between 7 and 7.9%. In this large trial, the patients used aggressive insulin therapy to artificially drive that number down to below 6%. Sounds like a good thing, right? The trial was halted because there was a 22% increased risk of death in the intervention group. Now, we can bet that, with lifestyle changes lowering A1C levels to 6% that there would’ve been nothing but reduced death. Welcome to medical research. Read More.

Increased Colorectal Epithelial Cell Proliferation and Crypt Fission Associated with Obesity and Roux-en-Y Gastric Bypass.

The concept of bariatric surgery has become so accepted that many now view this as a procedure with only positive outcomes. However, messing with the way our bodies digest and assimilate food is never a good thing, and the long term safety of these procedures have never been demonstrated. We have, however, seen a variety of research studies finding adverse outcomes following bariatric procedures. This study adds to the weight of this evidence, suggesting that, after this procedure, there is an increased risk of colorectal cancer. Read More.

The Relationship of Coffee Consumption with Mortality.

While the idea of a protective mechanism of coffee on chronic disease is not a big surprise given the low calorie and high polyphenol content, the risk reductions for all cause mortality were a little higher than I would have expected and demonstrated somewhat of a parabolic curve, with higher intakes have less protection. In men, greater than 6 cups / day led to a large 20% reduction in death. In women, 4-5 cups / day led to an 26% reduction, while greater than 6 cups / day led to a reduced (but still great) 17% reduction. These are pretty large numbers for something that had been viewed as detrimental for many years. So much for dogma. Read More.

Effect of Soy Nuts on Adhesion Molecules and Markers of Inflammation in Hypertensive and Normotensive Postmenopausal Women.

Here’s another one of those article talking about how dangerous that deadly soy is. Seriously though, I remain confused as to how many websites talk about how dangerous soy is for our health, and yet, from a research standpoint, the outcomes are overwhelmingly positive. This particular study adds further weight to the positive evidence, finding that the addition of soy nuts resulted in improvement in markers of the health of our blood vessels. Keep in mind that, when we talk about soy we are NOT talking about veggie burgers and tofu hot dogs and tofu turkey, but rather less processed forms of soy like soy nuts, soy milk and tofu. Read More.

A distinct pattern of myofascial findings in patients after whiplash injury.

As a chiropractor that specializes in soft tissue treatment, studies like this confirm my decision to practice in this manner. Too often following whiplash type injuries patients will seek the care of a PT, their PCP or a DC. The statistics linking long term problems from whiplash injuries is frighteningly high, but I believe this is because few approaches attack the comprehensive nature of these injuries. The joints, soft tissues and the psychological impacts of the injury all need to be addressed. Without this comprehensive approach, it is likely that patients will fall into that category of long term neck pain. Read More.

Effect of Long-term Corticosteroid Use on Bone Mineral Density in Children.

This study look at the use of chronic and short burst use of inhaled steroids in children w/ mild to moderate asthma. Frighteningly, this pattern of use was associated with reduction in bone mineral accrual at a very important time of there bone forming years. I guess the frustrating aspects of this study is that asthma treatment in children rarely takes a comprehensive course. You can bet that, in many of these children, both food allergies and poor gut health are contributing if not causative factors. Prolonged courses of antibiotics without any thought of the importance of normal, healthy flora, will lead to imbalances of immune function and Th2 dominance of cytokine expression (consistent w/ asthma and allergies). Add into this nasty mix the new research that gut inflammation negatively impacts bone health and you’ve got a recipe for diminished bone health. Read More.

Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring.

Wow. At some point we will really, really stand up and start to realize the critical importance of the in utero environment on the short and long term health of that developing infant. Some effects won’t be realized for decades after birth; some noted within a few years. This particular study, while small, showed a massive 63% reduction in asthma and an 87% reduction in allergic asthma in pregnant women given 2.3 g of omega 3 fatty acids during pregnancy. These number may be even lower because they were compared to an olive oil group, and olive oil might be expected to have a positive impact on asthma development as well. Talk about a simple, safe intervention that could have a massive impact on healthcare utilization. Too bad the mass healthcare media isn’t interested in prevention. Read More.

Short- and Long-Term Safety of Weekly High-Dose Vitamin D3 Supplementation in School Children.

It is funny to be in the middle of the research on just how much vitamin D we really need for optimal health. The research is incredibly supportive on the safety and efficacy of dosages in the 1,000-4,000 IU / day range, and yet the RDA sits solidly at 400 IU. I wonder just how long it will take before those numbers start to budge. 1 year? 10? 20? This will be a great indicator of just how delayed implementation of the research is at the public health level. Read More.

Low Serum 25-Hydroxyvitamin D Levels Associated With Falls Among Japanese Community-Dwelling Elderly.

This is another of those no-brainers. Vit D has been shown to help with bone mass as well as preventing falls. And yet this hormone is still kept at the above mentioned 400 IU dosage recommendations despite volumes of research on efficacy and safety. In addition, the costs of the liquid forms of Vit D are incredibly inexpensive, usually on the range of only a few dollars per month, if that. What I have not seen, however, is the mechanism by which Vit D contributes to increase musculoskeletal performance and reduce falls. Read More.

Differential effect of sulfonylureas on production of reactive oxygen species and apoptosis in cultured pancreatic ß-cell line, MIN6.

This is not the first study to find damaging effects of the class sulfonylureas on the beta cells of the pancreas. The information has probably been known for at least 5 years now, and yet this class of drugs for diabetes is widely used. How many diabetics were informed that the drug their doctor gave them will ultimately increase the risk for them to be on insulin? I can’t say I’ve ever come across one in my office or in the community. All of this points to the overwhelming conclusion that lifestyle changes are the ONLY answer to managing this deadly condition. Every pharmaceutical approach has risks that can outweigh the benefits. This is NOT the case with lifestyle changes. Read More.

 

Aug
19

September 1, 2008 Research Update

Posted by: | Comments (0)

James Bogash,D.C.Mesa,AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

Dysbiosis in inflammatory bowel disease: a role for bacteriophages?

There is very strong evidence of the contribution to altered bacterial flora in the development of inflammatory bowel disease like Crohn’s and Ulcerative Colitis. However, the role of probiotics in the treatment of IBD is not as clear cut. It basically appears that, once the alterations from improper flora are present, the physiology has a real time correcting itself. Which brings us back to what alters the flora in the GI tract in the first place. The answer begins at delivery. We know that infants born vaginally have a much different flora then C-section babies. Couple this with the 90-something percent of infants that have antibiotics by the time they’re 2 and you’ve got a recipe for physiological disaster. At some point pediatricians have to crack open a medical journal and realize the massive level of harm we are causing by indiscriminate antibiotic use for largely self-limiting conditions. I have a 2 1/2 year old that’s never even breathed the fumes of the ink off an antibiotic prescription. It’s not that difficult to maintain healthy toddlers–you just can’t follow the status quo. Make the right decisions and you can help protect your child from adult diseases. Read More.

Cell phone use and risk of benign and malignant parotid gland tumors.

Few people who log in more hours on the phone per month than they do sleep actually take the time to think that cell phone use might be dangerous. Personally, I think that the links between conditions like cancer are very real. It is always hard to come to conclusions when the amount of money companies stand to lose is substantial–much like it was with cigarette smoking. It took decades for the dissenting opinion that cigarette smoking was bad for you to make it to popular opinion. We know how the rest of the story goes. In the meantime, children should absolutely only use a cell phone in case of an emergencies (given that it seems that every junior high and high school student owns one, this is a problem). If you must use a cell phone, keep the antenna as far from you as possible (i.e. flip phones, blue tooth, headsets–but only with clips on the wires to absorb EMF radiation, otherwise the headsets actually concentrate the signal!!) and minimize it’s use. Avoid wearing on the hip as well. Maybe the data will finally come out that there is no harm. This is probably NOT the case, but what have you got to lose by following some simple precautions? Read More.

Whole Body Vibration vs Conventional Physiotherapy for Parkinson’s Disease.

WBV is a therapeutic procedure gaining ground. Hopefully, the clinics advertising its using for weight loss will go out of business (not very effective here) and the legitimate uses of WBV will be promoted. Improvements in bone density, lean body mass, balance / fall prevention, circulation (varicose veins, peripheral neuropathy) just to name a few. In addition, the use of WBV sends a mass of “proprioceptive input” up to the cerebellum–signals from every receptor around every joint–that can help with a variety of other problems. Given these effects, the benefits of WBV in conditions like Parkinson’s are multifactorial. Given the safety, this is a treatment modality that should be implemented in every patient. Read More.

Comparison of Sensorimotor Disturbance Between Subjects With Persistent Whiplash-Associated Disorder and Subjects With Vestibular Pathology Associated With Acoustic Neuroma.

As a chiropractor, I find it unfathomable that a patient involved in a motor vehicle accident would not seek chiropractic care. The known involvement of the facet joints coupled with altered signals being sent up to the brain from the receptors around the joints produces a condition that ONLY manipulation will impact. Rehab exercises, medications, interferential, ultrasound, massage–these will not affect the proprioceptive input to the brain like an adjustment. This article further supports the idea that dysfunction of the facet joints following whiplash-type injuries are real, and need to be addressed to prevent long term dysfunction. Read More.

The Basis for Recommending Repeating Epidural Steroid Injections for Radicular Low Back Pain.

It is not unusual for the “typical” low back pain patient to be referred out by their PCP for epidurals when the 1 wk trial of ibuprofen didn’t work or when physical therapy has failed. There are a large number of ESIs done in this country in patients that have never been sent to a chiropractor for treatment. There is even evidence that suggests that patients referred for an epidural have a higher likelihood of progressing to back surgery (which is again, of questionable benefit with much risk). But what the heck…it’s only $12K or so….who cares if it works? Now that $300 course of chiropractic care–THAT we need to keep an eye on. Read More.

Gamma-tocopherol Supplementation Alone or in Combination with alpha tocopherol in Metabolic Syndrome.

We’ve talked before about the differentiation between the tocopherols, and that while Mother Nature provides primarily gamma tocopherol, man sees fit to give almost exclusively the alpha form. The gamma, form, however, according to most of the research, packs a much stronger punch when it comes to protection from oxidative stress then does the alpha form. This is likely why we have not seen a strong response (and some small evidence of harm) in the clinical trials using high dose alpha tocopherol alone. This study compares the alpha and the gamma form together and separately on biomarkers for metabolic syndrome and found that the combination of the two was the most effective. Read More.

Early differences in fecal microbiota composition in children may predict overweight.

The factors contributing to the increasing levels of obesity in our children are unquestionably multifactorial. Some of these risk factors are always modifiable–exercise, high energy / low phytonutrient diet, stress. Some, however, may not be modifiable as the child ages. These, to a certain degree, may weigh heavier because the importance of identifying the risks BEFORE they produce obesity is the only strong method of modification. So where does that leave the overuse of antibiotics in infants? Do pediatricians really understand the Pandora’s box they create with even one short duration of antibiotics in an infant or toddler? Can we blame pediatricians to some degree on the obesity epidemic in our children? Maybe not in the past, but going forward from here the knowledge is known–antibiotic use may very well contribute to alteration of gut flora, subsequent altering of gut derived hormonal signals, and developing obesity. Read More.

Alkaline diets favor lean body mass in older adults.

Sarcopenia–the age associated loss in lean body mass–is generally viewed as an inevitable consequence of getting older. This is just not true. While the ability to gain muscle mass with exercise is retained in the elderly, it is the increased breakdown that becomes a factor. Increased muscle breakdown occurs with inflammation, sedentary lifestyles, stress, etc… Anything we can do to retain muscle mass as we age is going to have a very clear cut, positive impact on quality of life and risk of chronic disease. This particular study gives us additional knowledge in how to support our lean body mass by switching to an alkaline, plant-based diet. Read More.

Pharmacokinetics of a single large dose of cholecalciferol.

Patients are frequently concerned with what they consider “high” dosages of Vitamin D. They look at their bone formulas, multivitamins and Vitamin D and think that they are going to overdose. While overdose is possible, the window of safety is very large with Vitamin D and usually requires dosages over 10,000 IU / day for several months before an issue MAY arise. In this particular study they used a dosage of 100,000 IU at one time and found no notable side effects, with the authors recommending this level of dosage to be given every 2 months. Kind of makes you less worried about that whopping 400 IU in your calcium supplement your doctor recommended, huh? Read More.

Geographic variation and risk of skin cancer in US women.

The popular press has been somewhat excited about the increase in melanoma incidence in our children and immediately cast blame on over sun exposure. As if our kids weren’t sitting inside all day on the computer or XBox or wearing SPF 90 to walk to the car. It is very obvious that our children are getting much less sun exposure than the previous generation, and yet melanoma risk is going up. If the sun exposed areas of the country do not have a disproportionately high rate of melanoma as this study suggests, then the blame needs to rightfully fall elsewhere. Low intakes of healthy fats. Low phytonutrient intake. Too LITTLE rationale sun exposure (sun exposure can actually be protective against some melanomas!!). Instead of focusing on sun exposure, we need to point to the elephant in the room and allow the right choices to be made to lower risk of melanomas. Read More.

 

The statistics on the persistance of neck pain following a whiplash-type injury are pretty disheartening.  Depending on the study you read, up to 90% of patients may experience some type of symptoms 10 years later.  This leads to a few comments from me.

First, I think this stresses just how important it is to address both the soft tissue AND the articular components of any type of injury.  Physical therapists stress exercises to strengthen the muscles injured.  Chiropractors generally address the movement of the joints in the neck following the injury.  Quite frankly, as someone who addresses the fascial, muscular and tendonous as well as the joint problems that occur after an injury, I feel that almost all cases are not treated with a comprehensive approach that addresses all aspects.  If all a chiropractor does is adjust, you miss the soft tissue component.  If all that is done is strengthening, you miss the articular component as well as the soft tissue pathology that occurs!!  (strengthening does NOT address the problems that develop in the fascia as a result of the injury).

The other aspect of this is that you should never, ever wait to get treatment after an injury.  The longer you wait, the more difficult that problem is going to be to fix. 

This particular study confirms what anyone that deals with residual problems from a car accident.  If you do the right tests, you do indeed find problems.  Researchers found increased activity in the area of the 2nd cervical vertebrae that indicated inflammation was present.  This was years after the injury.

If you’ve had an injury recently, or have been dealing with a problem that started years ago, find a chiropractor that has a strong

Categories : neck pain, whiplash
Comments (0)
Lifecare Chiropractic • 1830 S. Alma School Rd • Bldg 7, Ste 135 • Mesa, AZ 85210 • 480-839-2273SitemapRSSDisclosures