Neck Injury in a Motor Vehicle Collision and Future Neck Pain

The objective of this population-based cohort study was to investigate the association between a lifetime history of neck injury from a motor vehicle collision and the development of troublesome neck pain. The current evidence suggests that individuals with a history of neck injury in a traffic collision are more likely to experience future neck pain. However, these results may suffer from residual confounding. Therefore, there is a need to test this association in a large population-based cohort with adequate control of known confounders.

A cohort of 919 randomly sampled Saskatchewan adults with no or mild neck pain in September 1995 were formed. At baseline, participants were asked if they ever injured their neck in a motor vehicle collision. Six and twelve months later, we asked about the presence of troublesome neck pain (grade II–IV) on the chronic pain grade questionnaire. Multivariable Cox regression was used to estimate the association between a lifetime history of neck injury in a motor vehicle collision and the onset of troublesome neck pain while controlling for known confounders. The follow-up rate was 73.5% (676/919) at 6 months and 63.1% (580/919) at 1 year.

A positive association between a history of neck injury in a motor vehicle collision and the onset of troublesome neck pain after controlling for bodily pain and body mass index was found. The analysis suggests that a history of neck injury in a motor vehicle collision is a risk factor for developing future troublesome neck pain. The consequences of a neck injury in a motor vehicle collision can have long lasting effects and predispose individuals to experience recurrent episodes of neck pain.

A study published in the British Journal of Orthopaedic Medicine (1999)22(1):22-25 reported that chiropractic is the only proven effective treatment in chronic cases of whiplash injury. The study was prompted by a previous article in the journal Injury which demonstrated that chiropractic treatment had benefited 26 out of 28 patients suffering from chronic whiplash syndrome.

Reference: Nolet P.S., Côté P., Cassidy J.D., Carroll L.J. The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study. European spine journal 2010(MAR 7).

Dr. David P. Chen
Chiropractor in Laurel, MD 20708
Laurel Regional Chiropractic

What Triggers Headaches?

Whether you’re a headache sufferer or not, you probably know someone who is. Many simply reach for a pain reliever and try to put their headache behind them. Headaches may be common, but they’re not normal! In my chiropractic office in Greenbelt, MD our patients benefit from safe, natural chiropractic care.

Common Headache Triggers

Stress – Hectic lives, work schedules and insufficient sleep are common culprits

Sleep – Either too much or too little can trigger headaches in some people. Try to keep a regular sleep schedule.

Diet – Certain foods, such as chocolate, red wine, MSG, aged cheeses, caffeine and processed foods can bring one on.

Smells – Strong odors, such as nail polish, smoke, paint, perfume, and cleaning products can cause headaches in certain people.

Injury – Headaches are a primary symptom of whiplash and whiplash associated disorder (WAD).

Eyestrain – If you stare at a computer monitor all day or squint because you need glasses, you might experience frequent headaches.

Subluxation/Joint Fixation – If you have hunched shoulders, a restricted cervical curve, restricted movement in your neck or hear grinding sounds, it may be the underlying cause of your headaches.

Chiropractic care has shown impressive results in helping those who get frequent headaches.

Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD

Diagnose headaches with cervical flexion-rotation test

Headache is one of the most common presenting complaint of chiropractic patients. A recent study compared the findings and identified the diagnostic accuracy of the cervical flexion-rotation test (FRT) between subjects with probable cervicogenic headache (CGH), migraine without aura (Migraine), and multiple headache forms (MHF).

Sixty subjects were evaluated: 20 with CGH, 20 with Migraine, and 20 with MHF. The average range of unilateral rotation to the most restricted side was 25 degrees, 42 degrees and 35 degrees for groups CGH, Migraine and MHF, respectively. Range of rotation was significantly reduced in the CGH group when compared to groups Migraine and MHF. The study found that “An experienced examiner using FRT was able to make the correct diagnosis 85% of the time (P<0.001)…”

This recent research continues to confirm the importance of a simple flexion rotation test (FRT) in the differential diagnoses of headaches. Many headache cases are often similar in terms of presenting symptom and the FRT has demonstrated in multiple research studies to be highly sensitive to identifying cervicogenic headache from migraine and multiple headache forms.

Reference: Hall TM, Briffa K, Hopper D, Robinson K. Comparative analysis and diagnostic accuracy of the cervical flexion-rotation test. J Headache Pain. 2010 May 28.

Dr. David P. Chen
Chiropractor in Laurel Maryland
Laurel Regional Chiropractic

Chiropractic had the highest perceived benefit for back pain

A study published in the Journal of the American Board of Family Medicine reports on interviews with 31,044 individuals who used complementary and alternative medicine (CAM) for low back pain (LBP). The results are as follows:

The top 6 CAM therapies for LBP, starting with the most-used approaches are: chiropractic, massage, herbal therapy, acupuncture, yoga/tai chi/qi gong, and relaxation techniques.

Chiropractic use (76% of respondents) was larger than all the other 5 therapies combined.

Of those who used CAM modalities for back pain, 27% used it because conventional medicine did not help, 53% used it in conjunction with medical care, and 24% used it because their medical provider recommended it.

Chiropractic users scored the highest on their satisfaction and clinical benefits out of all 6 approaches. This reconfirms earlier findings from the Archives of Physical Medicine & Rehabilitation 2005, which reported that spinal manupulative therapy (SMT) provided the greatest pain relief scoring higher than nerve blocks, opioid analgesics, muscle relaxants, acupuncture, or NSAIDs.

Reference: Kanodia AK, Legedza ATR, Davis RB, et al. Perceived benefit of complementary and alternative medicine (CAM) for back pain: a national survey. J Am Board Fam Med. 2010;23(3):354–362.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

-This very interesting Sweedish study illustrates that the effects of whiplash can sometimes occur in body areas or systems that seem uncommon to most patients. In my chiropractic clinic in Greenbelt, MD, we focus on the body as a whole, not just the symptoms. As a specialist in whiplash related disorders, I strive to help patients overcome all aspects of this growing epidemic.
-Dr. C

Cardiovascular and muscle activity during chewing in whiplash-associated disorders (WAD).

Kalezic N, Noborisaka Y, Nakata M, Crenshaw AG, Karlsson S, Lyskov E, Eriksson PO.

Centre for Musculoskeletal Research, University of Gavle, Sweden; Sports Medicine Unit, Umea University, Sweden.


OBJECTIVE: The present study aimed to elucidate possible physiological mechanisms behind impaired endurance during chewing as previously reported in WAD. We tested the hypothesis of a stronger autonomic reaction in WAD than in healthy subjects in response to dynamic loading of the jaw-neck motor system.

DESIGN: Cardiovascular reactivity, muscle fatigue indicies of EMG, and perceptions of fatigue, exhaustion and pain were assessed during standardised chewing. Twenty-one WAD subjects and a gender/age matched control group participated. Baseline recordings were followed by two sessions of alternating unilateral chewing of a bolus of gum with each session followed by a rest period.

RESULTS: More than half of the WAD subjects terminated the test prematurely due to exhaustion and pain. In line with our hypothesis the chewing evoked an increased autonomic response in WAD exhibited as a higher increase in heart rate as compared to controls. Furthermore, we saw consistently higher values of arterial blood pressure for WAD than for controls across all stages of the experiment. Masseter EMG did not indicate muscle fatigue nor were there group differences in amplitude and mean power frequency. Pain in the WAD group increased during the first session and remained increased, whereas no pain was reported for the controls.

CONCLUSION: More intense response to chewing in WAD might indicate pronounced vulnerability to dynamic loading of the jaw-neck motor system with increased autonomic reactivity to the test. Premature termination and autonomic involvement without EMG signs of muscle fatigue may indicate central mechanisms behind insufficient endurance during chewing.


Dr. Louis S. Crivelli II
Chiropractor
Greenbelt, MD

Foot Orthotics and Chiropractic care in Temple Hills, MD

For decades, Foot Levelers has enthusiastically

supported and promoted chiropractic research.

Twenty-two years ago in our Success Express

magazine, we announced the commitment of a

quarter of a million dollars to fund the Greenawalt

Chair for Research at Northwestern College of

Chiropractic (now Northwestern Health Sciences

University).1 By that time Foot Levelers was

already an established financial backer of the

Foundation for Chiropractic Education and

Research (FCER), and we encouraged the readers

of our magazine—as well as other chiropractic

suppliers—to join us in giving to the profession’s

“primary source of financial support for chiropractic

research and postdoctoral research training of

doctors of chiropractic.”2-4

In the late 1990s, Foot Levelers teamed up with

New York Chiropractic College to establish “the

nation’s first gait research center in a chiropractic

setting” at NYCC’s Seneca Falls campus.5

Heeding Dr. Reed Phillips’ call to “be supportive

of chiropractic research in any way possible,”6

the partnership between Foot Levelers and NYCC

“sparked research that may reveal how the body’s

gait can disrupt chiropractic adjustments, which

could lead to the identification of ways an

adjustment can best be preserved, such as

through the use of orthotics.”7

This research booklet

is proof that “Foot Levelers’ products are a

beneficial adjunct to chiropractic care.”8 Here is

peer-reviewed research by some of the finest

academicians in the chiropractic profession,

including work done at NYCC’s Biomechanics/

Gait Research Laboratory in Seneca Falls.

The future of chiropractic research is limited only

by the support it receives from those who form

the chiropractic community of professionals,

staff, and suppliers. Foot Levelers pledges to

continue sponsoring and promoting chiropractic

research, and to share the benefits of that

research with our Partners In Progress.

References

1. [No author]. Chair for research announced. Success Express 1985; 9(2):59.

2. Rossman E. FCER’s role in chiropractic research. Success Express 1985;

9(3):57-61.

3. [No author]. Are your suppliers supporting chiropractic research? Success

Express 1985; 9(4):55-59.

4. [No author]. Chiropractic research…key to the future. Success Express

1988;12(1):45-47.

5. [No author]. NYCC and Foot Levelers team up to establish gait research

program. Success Express 1998; 18(3):28.

6. Phillips RB. A lesson in history: the need for research. Success Express

1988; 12(1):25-29.

7. [No author]. Foot Levelers gait research program is helping advance field

of chiropractic. Success Express 2000; 20(2):11.

8. [No author]. ACC conference highlights orthotics research. Success

Express 2004; 24(3):5.

Aekta Erry, D.C.

Chiroprator, Temple Hills, MD

Study shows little evidence of benefit for spinal fusion surgery

More Medicare patients are having complex back surgery even when there’s often an easier, less risky and less costly fix, according to a study in the Journal of the American Medical Association. The rate of complex fusion surgery for spinal stenosis, which causes lower back pain, increased 15-fold from 2002 to 2007, according to the study.
The study and an accompanying editorial suggest that aggressive marketing by implant makers, and greater physician compensation for high-tech procedures, may be influencing treatment. Meanwhile, taxpayers bear the expense, and patients face increased risks.

There are non-surgical approaches and treatments for spinal stenosis or degenerative disc disease. The symptoms can be treated with exercise, weight loss, chiropractic, and physical therapy. A study in the BMC Musculoskeletal Disorders concluded that distraction manipulation (DM) and neural mobilization (NM) are viable alternative to surgery for patients with lumbar spinal stenosis (LSS), and compares favorably with other non-surgical approaches that have been studied. The study further suggest that “As the efficacy of surgery does not appear to decrease if it is delayed in favor of a non-surgical trial, most patients with LSS should be treated non-surgically for a period of time before considering operation. DM and NM may be one non-surgical option that can be offered to patients.”

References:
Murphy, DR, Hurwitz, EL. Gregory, AA, Clary, R. A non-surgical approach to the management of lumbar spinal stenosis: A prospective observational cohort study. BMC Musculoskelet Disord. 2006; 7: 16.

Deyo, RA, Mirza, SK, Martin, BI, Kreuter, W, Goodman, DC, Jarvik, JG. Trends, Major Medical Complications, and Charges Associated With Surgery for Lumbar Spinal Stenosis in Older Adults. JAMA. 2010;303(13):1259-1265.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com

Chiropractic usage by intercollegiate athletes

It's estimated that more than one-third of the American public uses the services of doctors of chiropractic and other complementary and alternative medicine (CAM) providers each year. Among those who take full advantage of CAM's benefits are professional athletes; in fact, many pro sports teams now have chiropractors and other CAM providers as part of their medical or training staff. A new study shows that chiropractic and other types of CAM are extremely popular among athletes on the college level as well.

In this study, researchers gave a survey to more than 300 college athletes attending a Division I school in Hawaii. The survey asked the athletes about their use of different types of CAM in the previous year, along with their use of traditional medical care. Fifty-six percent of the athletes reported using some type of CAM within the past 12 months, with more women using CAM than men. Chiropractic was the second most popular form of CAM, just behind massage; 29 percent of the athletes said they had used chiropractic at least once in the past year.

While considerable evidence suggests chiropractic can improve the performance of elite athletes, there's just as much evidence which shows chiropractic care is effective for a variety of everyday problems, too. Back pain, neck pain and migraine headaches are just a few of the many conditions that can be treated by a well-trained doctor of chiropractic.

Source: Nichols AW, Harrigan R. Complementary and alternative medicine usage by intercollegiate athletes. Clinical Journal of Sport Medicine May 2006;16(3):232-7.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Study Shows Chiropractic Helps Headaches

A study published in the February 2010 issue of The Spine Journal provided additional evidence demonstrating the effectiveness of chiropractic for cervicogenic headaches.

In this study, 80 patients with chronic cervicogenic headaches were divided into three groups. Two of the groups received various forms of chiropractic adjustments, which the study authors called Spinal Manipulative Therapy (SMT), and one group received just a light massage so as to be able to compare the results. Results were calculated using standard pain scales. Data from the subjects was collected every 4 weeks for a 24 week period.

The researchers found that the groups that received chiropractic treatment showed significantly greater improvement in pain scores as compared to the group that got just light massage. Those receiving the chiropractic care were more likely to have a 50-percent improvement in their pain. The two groups of patients who received chiropractic care were only given either 8 or 16 chiropractic sessions. The study did see a slightly better response for the group receiving more adjustments, but due to the study parameters, no data was available beyond 16 visits.

In conclusion it states, “Our pilot study adds to an emerging picture of spinal manipulative therapy dose for the treatment of headache. It showed that a plateau in intervention effect might be found in the range of eight to 16 treatment sessions, although a dose effect at these treatment levels cannot be ruled out. The study also adds to the support of spinal manipulative therapy in moderate doses as a viable option for the treatment of chronic cervicogenic headaches.”

Source: Haas M, Spegman A, Peterson D, Aickin M, Vavrek D. Dose Response and Efficacy of Spinal Manipulation for Chronic Cervicogenic Headache: A Pilot Randomized Controlled Trial. Spine J. 2010(Feb);10(2):117-128.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Repetitive Stress Injury & Chiropractic Care for Musicians

Musicians are similar to athletes in that they put their efforts in perfecting their skills through endless practice. These sessions entail long hours of pushing the arm and hand muscles to exhaustion. Some may dismiss this as simply fatigue and with a few hours of rest will solve the problem. However, if the pain is persistent and you experience a stabbing pain in the forearm accompanied clumsiness and numbness of hand, then it is possible that you have a repetitive stress injury (RSI) due to prolonged training without sufficient breaks to properly rest the muscles. The National Institute of Occupational Safety and Health said that roughly 50% of the work force suffers from different forms of RSI. Musicians comprise a part of this statistic as they overuse their muscles in unidirectional movement patterns such as a guitarist. Other musicians commonly affected by such condition are flute and string players, and keyboardists. This condition is a horror story for any musician as this may dictate the end of their professional career.

Slight discomfort while playing an instrument may seem trivial at first, but for musicians this should not be neglected. Tell-tale signs should be considered with utmost concern because if RSI is treated in its early stage, your muscle will definitely heal faster. Always remember that in order to keep your music playing, a dose of chiropractic care is all you need.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
http://www.laurelregionalchiropractic.com/

Effects of resistance training and chiropractic treatment in women with fibromyalgia

A recent study has found that resistance training is more helpful for women with fibromyalgia if it is combined with chiropractic treatment.

The randomized controlled study aimed to evaluate resistance training and resistance training combined with chiropractic treatment on the impact and functionality of fibromyalgia in women. 21 women with fibromyalgia, who had an average age of 48 years, took part in the study. They were randomly assigned to either resistance training or resistance training combined with chiropractic treatment, with 10 women in the first group and 11 in the second. Both groups completed 16 weeks of resistance training consisting of 10 exercises performed two times per week. The group assigned to receive both resistance training and chiropractic treatment also received chiropractic treatment two times per week.

The results showed that both groups increased upper and lower body strength and there were similar improvements in fibromyalgia impact in both groups as well as the strength domains of the functionality assessment. However, only the group receiving resistance training combined with chiropractic treatment significantly improved in the pre- to post-functional domains of flexibility, balance and coordination, and endurance.

One factor in the beneficial effects of the chiropractic treatment may have been that many chiropractors perform some myofascial release as part of their treatments. Myofascial pain is a common problem with fibromyalgia and it can cause exercise to be more painful and less effective.

Original article by: Panton LB, Figueroa A, Kingsley JD, Hornbuckle L, Wilson J, John NS, Abood D, Mathis R, Vantassel J, McMillan V. Effects of Resistance Training and Chiropractic Treatment in Women with Fibromyalgia. J Altern Complement Med. 2009 Mar;15(3):321-8.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
http://www.laurelregionalchiropractic.com/

The Benefits of Stretching

The muscles tighten as a person ages which can lead to a decrease in range of joint movements. That is why as the person grows older, bending or flexing becomes more limited. This is why stretching regularly, as part of a routine is very important. Simple stretches can be done everyday and can be easily incorporated in your daily activities. It does not require much of your time. So how can stretching help with your overall health?

Regular stretching exercises can lengthen the muscles and the tendons which can help in increasing the range of your movement. Stretching can prevent injury to joints, tendons, and muscles. When the muscles and tendons are well-flexed, they are considered in good working order. The muscles of the body will be able to take more exhausting and rigorous movements with less probability of being injured. If the muscles are given their regular exercises and stretching, it is less likely that they will contract. This will definitely relieve you of any muscle pain or problems.

A research article appeared in the October 2009 issue of the American Journal of Physiology-Heart and Circulatory Physiology suggests that flexibility, as defined by how far you can reach while sitting down, may be linked to the stiffness of your arteries. It’s known that arterial stiffness often precedes life-threatening cardiovascular disease. Researchers don’t know why flexibility might be linked to arteries. One theory is that people who are more flexible do stretching exercises that help slow down stiffening of the arteries. So give your tight muscles a good stretch as it could help your heart!

At Laurel Regional Chiropractic, we not only help our patients learn the proper stretching techniques but we also tailor stretches and exercises to each individual patient in regards to what they do all day.

Dr. David Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
http://www.laurelregionalchiropractic.com/

Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study.

Objective
The specific aims of the study were to study the effectiveness of Biofreeze combined with chiropractic adjustments on acute low back pain (LBP) compared with chiropractic care only. The hypothesis was that Biofreeze enhances the effect of chiropractic adjustments on acute LBP.

Methods
The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. For at-home care, subjects were instructed to apply Biofreeze 3 times a day as follows: Using a 5-g sample pack, subjects were instructed to apply Biofreeze to the low back once in the morning and 2 times in the afternoon. For evening application, subjects were instructed to apply once in the late afternoon, once in the evening, and once at bedtime. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity.

Results
A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups.

Conclusion
Biofreeze combined with chiropractic adjustment showed significant reduction in LBP. Biofreeze cooling gel gives rise to the cooling sensation without lower skin temperature because of the unique characteristic of menthol, which is one of the main ingredients. It is clear that the cooling effect of Biofreeze is different from the application of cold. It is possible that menthol stimulates the peripheral sensory receptors to inhibit pain through the gate control mechanisms.

Original article by: Zhang J, Enix D, Snyder B, Giggey K, Tepe R. J Chiropr Med. 2008 Jun;7(2):59-65.

Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland

Exercising Into 2010

Exercising is one of the most important activities you can do for your health. However, just as your diet, variety is the key. It’s important to vary your exercise routine in order to get the absolute best results.

Your muscles simply get used to the same activity and they require a level of muscle confusion if they are to continue to improve and grow stronger.


Four Principles of Exercise


Your body is an efficient machine, and if you do the same type of exercise day after day, you’ll become quite good at it. However, when exercise becomes easy to complete, it’s a sign you need to work a little harder and give your body a new challenge.

So when you’re planning your exercise routine, make sure it incorporates the following types of exercise:


1. Aerobic: Jogging, using an elliptical machine, and walking fast are all examples of aerobic exercise. As you get your heart pumping, the amount of oxygen in your blood improves, and endorphins, which act as natural painkillers, increase. Meanwhile, aerobic exercise activates your immune system, helps your heart pump blood more efficiently, and increases your stamina over time.

2. Interval (Anaerobic) Training: Research is showing that the BEST way to condition your heart and burn fat is NOT to jog or walk steadily for an hour. Instead, it’s to alternate short bursts of high-intensity exercise with gentle recovery periods. This type of exercise, known as interval training or burst type training, can dramatically improve your cardiovascular fitness and fat-burning capabilities.

Another major benefit of this approach is that it radically decreases the amount of time you spend exercising, while giving you even more benefits. For example, intermittent sprinting produces high levels of chemical compounds called catecholamines, which allow more fat to be burned from under your skin within the exercising muscles. The resulting increase in fat oxidation increases weight loss. So, short bursts of activity done at a very high intensity can help you reach your optimal weight and level of fitness, in a shorter amount of time.

3. Strength Training: Rounding out your exercise program with a 1-set strength training routine will ensure that you're really optimizing the possible health benefits of a regular exercise program.

You need enough repetitions to exhaust your muscles. The weight should be heavy enough that this can be done in fewer than 12 repetitions, yet light enough to do a minimum of four repetitions. It is also important NOT to exercise the same muscle groups every day. They need at least two days of rest to recover, repair and rebuild.

4. Core Exercises: Your body has 29 core muscles located mostly in your back, abdomen and pelvis. This group of muscles provides the foundation for movement throughout your entire body, and strengthening them can help protect and support your back, make your spine and body less prone to injury and help you gain greater balance and stability.

Exercise programs like pilates and yoga are great for strengthening your core muscles. Focusing on your breath and mindfulness along with increasing your flexibility is an important element of total fitness.

So do it and do it right by exercising your way into 2010

Dr. John Rosa
Chiropractor
Rockville, MD

Chiropractic for Headaches in Temple Hills, MD

Chiropractic Manipulation: A New Study Regarding Headaches

Email

Written by Vegas_Chiropractor on Dec-27-09 10:08pm

From: DrMichaelReissBlog.com

Headaches are a common complaint in patients presenting for professional care, including chiropractic management. Patients with headaches seek chiropractic care because they find manipulation or adjustments applied to the cervical spine and upper back region are highly effective in reducing the intensity, frequency and duration of the headache pain. This is because the cervical spine / neck, is often the origin of the headache as the three nerves in the upper neck (C1, 2 and 3) pass through the thick, overly taught neck muscles in route to the scalp / head. When the muscles of the neck are in spasm, the nerves get “pinched” or squeezed by the overly tight muscles resulting in headache pain. Each nerve runs to a different part of the head and therefore, pain may be described as “…radiating over the top of head (sometimes into the forehead and eyes),” or, into the head and over the ear, sometimes reaching the temple. Also, an area located in the back and side of the head is the area where the C1 nerve innervates, so pain may also be reported in that location. When more than one of the C1-3 nerves is pinched, the whole side to the top of the head may be involved.

In the October 2009 issue of The Spine Journal, Western States Chiropractic College, Center for Outcomes Studies, reported benefits are obtained with the utilization of spinal manipulation in the treatment of chronic cervicogenic headaches. The word “chronic” means at least 3 months of headache pain has been present. This new study compared 2 different doses of therapy using several outcome measures including the pain grade, the number of headaches in the last 4 weeks and the amount of medication utilized. Data was collected every 4 weeks for a 24 week period and patients were treated 1-2 times/week and separated into either an 8 or a 16 treatment session with half the group receiving either spinal manipulative therapy or a minimal light massage (LM) control group.

The results of the study revealed the spinal manipulation group obtained better results than the control group at all time intervals. There was a small benefit in the group that received the greater number of treatments with the mean number of cervicogenic headaches reduced by 50% in both pain intensity and headache frequency.

The importance of this study is significant as there are many side effects to medications frequently utilized in the treatment of headaches. Many patients prefer not taking medications for this reason and spinal manipulation therapy (SMT) offers a perfect remedy for these patients. Couple SMT with dietary management, lifestyle modifications, stress management, and a natural, vitamin/herbal anti-inflammatory (such as ginger, turmeric, boswellia) when needed, a natural, holistic approach to the management of chronic headaches is accomplished.

We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and look forward in serving you and your family presently and in the future.

Aekta Erry, D.C.

Chiropractor, Temple Hills, MD

Whiplash Injury Prevention

This is a great article regarding the distance of your headrest and whiplash injury. At Laurel Regional Chiropractic, we analyze our patient's headrests and advise them as to the correct distances to minimize injury.


Ivancic PC, Sha D, Panjabi MM. Whiplash injury prevention with active head restraint. Clin Biomech 2009 Nov;24(9):699-707.

Abstract

BACKGROUND: Previous epidemiological studies have observed that an initial head restraint backset greater than 10 cm is associated with a higher risk of neck injury and persistent symptoms. The objective of this study was to investigate the relation between the active head restraint position and peak neck motion using a new human model of the neck.
METHODS: The model consisted of an osteoligamentous neck specimen mounted to the torso of a rear impact dummy and carrying an anthropometric head stabilized with muscle force replication. Rear impacts (7.1 and 11.1g) were simulated with and without the active head restraint. Physiologic rotation was determined from intact flexibility tests. Significant reductions (P<0.05)>0.3 and P<0.001).
FINDINGS: The active head restraint significantly reduced the average peak spinal rotations, however, these peaks exceeded the physiologic range in flexion at head/C1 and in extension at C4/5 through C7/T1. Correlation was observed between the head restraint backset and the extension peaks at C4/5 and C5/6.
INTERPRETATION: Correlation between head restraint backset and spinal rotation peaks indicated that a head restraint backset in excess of 8.0 cm may cause hyperextension injuries at the middle and lower cervical spine. The active head restraint may not be fully activated at the time of peak spinal motions, thus reducing its potential protective effects.

Dr. Louis Crivelli and Dr. Paul Tetro

WEBMD advocates Chiropractic care

This slideshow explains facts and myths about low back pain, as well as lifelong preventative guides to living healthier and painfree through chiropractic care.


Dr. Aekta Erry
Chiropractor in Temple Hills, MD.

Study Finds the Availability of Chiropractic Care Improves the Value of Health Benefits Plans

Foundation for Chiropractic Progress commissions landmark report delivers incremental impact on population health and total health care spending

Carmichael, CA - October 20, 2009 - A report, prepared by a global leader for trusted human resources and related financial advice, products and services, finds that the addition of chiropractic care for the treatment of low back and neck pain will likely increase value-for-dollar in US employer-sponsored health benefit plans. Authored by Niteesh Choudhry, MD, PhD, and Arnold Milstein, MD, the report can be fully downloaded at:

Full Report Download

Accordingly, this report was commissioned by the Foundation for Chiropractic Progress (www.f4cp.com) to summarize the existing economic studies of chiropractic care published in peer-reviewed scientific literature, and to use the most robust of these studies to estimate the cost-effectiveness of providing chiropractic insurance coverage in the US.

According to Gerard Clum, DC, spokesperson for the Foundation for Chiropractic Progress and President of Life Chiropractic College West, ?While some studies reflect cost efficiencies and others clinical efficiencies, these findings strongly support both for chiropractic care of neck pain and low back pain.?

Executive Summary:

Low back and neck pain are extremely common conditions that consume large amounts of health care resources. Chiropractic care, including spinal manipulation and mobilization, are used by almost half of US patients with persistent back-pain seeking out this modality of treatment.

The peer-reviewed scientific literature evaluating the effectiveness of US chiropractic treatment for patients with back and neck pain suggests that these treatments are at least as effective as other widely used treatments. However, US cost-effectiveness studies have methodological limitations.

High quality randomized cost-effectiveness studies have to date only been performed in the European Union (EU). To model the EU study findings for US populations, researchers applied US insurer-payable unit price data from a large database of employer-sponsored health plans. The findings rest on the assumption that the relative difference in the cost-effectiveness of low back and neck pain treatment with and without chiropractic services are similar in the US and the EU.

The results of the researchers' analysis are as follows:

-Effectiveness: Chiropractic care is more effective than other modalities for treating low back and neck pain.

Total cost of care per year:

-For low back pain, chiropractic physician care increases total annual per patient spending by $75 compared to medical physician care.

-For neck pain, chiropractic physician care reduces total annual per patient spending by $302 compared to medical physician care.

Cost-effectiveness: When considering effectiveness and cost together, chiropractic physician care for low back and neck pain is highly cost-effective, represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds.

These findings, in combination with existing US studies published in peer-reviewed scientific journals, suggest that chiropractic care for the treatment of low back and neck pain is likely to achieve equal or better health outcomes at a cost that compares very favorable to most therapies that are routinely covered in US health benefits plans. As a result, the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in US employer-sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve.

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About F4CP

A not-for-profit organization, the Foundation for Chiropractic Progress (F4CP) embraces a singular mission to promote positive press for the profession in national, regional and local media. Through effective and ongoing initiatives, the Foundation?s goal is to raise awareness to the many benefits provided by doctors of chiropractic. The F4CP relies upon strategic marketing campaigns that span prominent spokespersons, monthly press releases, public service announcements, and advertisements in high-profile media outlets. To learn more about the Foundation, please visit us on the web at www.foundation4cp.com or call 866-901-f4cp.








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Cost-Effectiveness of Chiropractic Care for Musculoskeletal Disorders

New Pilot on Quality Shows Cost-Effectiveness of Chiropractic Care for Musculoskeletal Disorders


A new pilot program shows that conservative heath care, including chiropractic, may reduce overall health care costs in patients with musculoskeletal disorders, such as back and neck pain. The pilot, conducted by Wellmark Blue Cross and Blue Shield to measure quality of patient care for its members in Iowa and South Dakota, also shows promising outcomes for the patients choosing chiropractic and other conservative care.

“The cost-effectiveness and safety of chiropractic has been documented in several studies. ACA is pleased that insurance companies are starting to recognize the value that doctors of chiropractic and other conservative providers can offer to their members,” said ACA President Glenn Manceaux, DC. “Especially during the health care reform debate, it’s important that chiropractic and other conservative care methods are taken into serious consideration as a cost-effective alternative to the utilization of expensive surgery and hospital-based care,” he added.

Wellmark conducted the Physical Medicine Pilot on Quality in 2008 for Iowa and South Dakota physical medicine providers. A total of 238 chiropractors, physical therapists and occupational therapists provided care to 5,500 members with musculoskeletal disorders. According to Wellmark, data from participating clinicians show that 89 percent of the patients treated in the pilot reported a greater than 30-percent improvement in 30 days.

The pilot compared data for Wellmark members who received care from doctors of chiropractic or physical therapists with a member population with similar demographics who did not receive such services. The comparison showed that those who received chiropractic care or physical therapy were less likely to have surgery and experienced lower total health care costs, according to Wellmark.

Chiropractic is widely recognized as one of the safest non-invasive therapies available for the treatment of back pain, neck pain, headaches and other neuromusculoskeletal complaints. A significant amount of evidence shows that chiropractic care for certain conditions can be more effective and less costly than traditional medical care. Recent research includes:

A study published in the October 2005 issue of the Journal of Manipulative and Physiological Therapeutics (JMPT) found that chiropractic and medical care have comparable costs for treating chronic low-back pain, with chiropractic care producing significantly better outcomes.
A March 2004 study in JMPT found that chiropractic care is more effective than medical care at treating chronic low-back pain in patients’ first year of symptoms.
A study published in a 2003 edition of the medical journal Spine found that manual manipulation provides better short-term relief of chronic spinal pain than do a variety of medications.
The American Chiropractic Association is the nation’s leading chiropractic organization representing more than 15,000 doctors of chiropractic and their patients. To find a chiropractor near you, visit www.acatoday.org.