Whiplash Injuries

Monday, February 17th, 2014

Whiplash injuries are a significant public health problem. Not only do they cause significant pain and time off from work and leisure activities, there is also a general effect on quality of life. A study in the European Spine Journal compared female patients with whiplash of the neck to patients with low back pain and another group with rheumatoid arthritis. The researchers looked at pain levels (how high or low) and how quality of life was affected. In the whiplash group, the pain levels were the highest. Overall health status was also more affected in the whiplash group, with changes mostly in social issues, vitality, emotional, and mental wellbeing.

A study in the journal Spine looked at how medical and chiropractic doctors differed in their approach to patients with whiplash. Medical doctors were more likely to have negative feelings about treating patients who have whiplash. They were also more likely to believe that there was nothing physically wrong with many patients with chronic whiplash. In terms of treatment, most medical doctors believed that nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants were effective in acute whiplash. This is despite the significant scientific evidence of problems of safety with long -term consumption of NSAIDs (e.g. stomach bleeding). In addition to questions of safety, there is virtually no evidence that these types of medications actually improve patients’ pain or overall quality of life.

The chiropractic approach to whiplash is much different from that of medical doctors. First, there is a general acceptance that the injuries are real and are not made-up by the patient. Biomechanical study of auto accidents confirms the injuries are real and mostly consist of sprain and subluxation of the joints of the neck. The spinal ligaments, muscles and disks are all affected in whiplash injury. When trauma to these tissues occurs, the sensitive nerves that go between these structures are also irritated, resulting in pain and changes in balance (e.g. dizziness, and position sense). Over time, the patient may have significant effects on their quality of life.

One study of chiropractic care in the journal Injury looked at the results in patients with chronic (i.e., long-term) whiplash injuries-which occurs in about 43% of cases. Twenty-eight patients were studied and of these 93% (n=26) had improved following chiropractic treatment.

There are important differences in your treatment when you compare the chiropractic to the medical approach to whiplash.

Does Neck Surgery Improve Long-Term Outcomes?

Monday, April 22nd, 2013

How many times have you heard, “I have a pinched nerve in my neck and have to have surgery.” Though there certainly are cases where surgical intervention is required, surgery should ONLY be considered after ALL non-surgical treatment approaches have been tried first (and failed). It is alarming how many cases of cervical radiculopathy (i.e., “pinched nerve”) end up being surgically treated with NO trial of non-surgical care. Hence, the focus of this month’s article will look at research (“MEDICAL EVIDENCE”) that clearly states neck surgery DOES NOT improve the long term outcomes of patients with chronic neck pain.

Chronic neck pain (CNP) is, by definition, neck pain that has been present for a minimum of three months. This category of neck pain is very well represented, as many neck pain sufferers have had neck pain, “…for years” or, at least longer than three months. Depending on the intensity of pain and it’s effect on daily function, many patients with CNP often ask their primary care provider, “…is there anything surgically that can be done?” The desire for a “quick fix” is often the focus of those suffering with neck pain. Unfortunately, according to recent studies, there may not be a “quick fix” or, at least surgery is NOT the answer. The December 2012 issue of The European Spine Journal reports that spine surgery did NOT improve outcomes for patients with CNP. Moreover, they pointed to other studies that showed some VERY STRONG REASONS NOT to have spine surgery unless everything else has failed. One of the reasons was a higher hospital readmission rate after spine surgery. Another reported that most studies on surgical vs. conservative [non-surgical] care showed a high risk of bias, suggesting the research on surgical intervention was biased in the research approach used. They further reported, “The benefit of surgery over conservative care is not clearly demonstrated.” It is important to point out that the research analyzed studies that included patients with and without radiculopathy (radiating arm pain from a pinched nerve), and myelopathy (those with pinching of the spinal cord creating pain, numbness, weakness in the legs, and/or bowel / bladder dysfunction).

In February of 2008, the Neck Pain Task Force published overwhelming evidence that research supports the use of cervical spinal manipulation in the treatment of both acute and chronic neck pain with or without radiculopathy. Bronfort published similar findings in 2010 in a large UK based study that looked at the published evidence supporting different types of treatment for various conditions. They found cervical spine manipulation was effective for neck pain of ANY duration (acute or chronic). Chiropractic utilizes manipulation, manual traction, mobilization, muscle release techniques, home cervical traction, exercise, as well as a multitude of physiotherapy modalities when managing patients with CNP. Given the overwhelming research evidence that surgical intervention for CNP is NOT any better than non-surgical care, the greater amount of negative side-effects, and the obviously long recovery time post-surgically, chiropractic treatment of anyone suffering from CNP should be tried FIRST.

We realize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for neck pain, 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.