The Zen Corner

Science, Art, and Philosophy of Chiropractic


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Guide to Whiplash Injury

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No one asks for a whiplash injury-they are nearly always a surprise and rarely the fault of the victim. But they are very common. In fact, over 1 million rear-end collisions occur every year in the U.S. Most cases of whiplash are minor and heal within a few weeks with the proper care. Unfortunately, a small number of patients, about 20-30% with whiplash cases, becomes chronic and lead to long-term discomfort. Whiplash consists of some classic symptoms. Sometimes these symptoms occur immediately after the crash and other times they may take weeks or even months to appear. Common symptoms are the following:

  • A headache
  • Neck Pain
  • Dizziness
  • Shoulder Pain
  • Jaw Pain
  • Arm Pain

Many people might think that they only had a minor car accident that was with speed of only 5-10 mph.

Dr. Cailliet stated:

“Simulated impacts have been studied extensively and essentially confirm that a low-speed impact with minimal or no damage to the impacted vehicle can and does cause significant musculoskeletal injury to the drivers or occupant’s head and neck.”

Dr. Macnab reported in his article, “Acceleration Extension Injuries of the Cervical Spine,” said:

“Acceleration depends on the force applied and the inertia of the vehicle that has been struck. The force is dependent upon the weight and speed of the striking vehicle so that a streetcar traveling at 3 mph can apply as much force and initiate the same degree of acceleration as a compact car traveling at 40 mph.”

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The key to recovering quickly from your whiplash injury is to understand how this happened. It is hard to sort out the truth from the myth about whiplash. This guide is to help you understand how you were injured and how to get well again.

Your Spine: How it is built

Your spine supports your body weight, aids in movement, and serves as a passageway for your spinal cord and nervous system. The spine is made up of 24-26 vertebrae, that are individually designed for specific roles. Each vertebra is separated by a tough disc that cushions the bones and allows flexibility and movement. The spine as a whole, with many bones and disc, is capable of very large motions. But each individual joint by itself allows only a few degrees of movement.

Neck Movements

The neck is the most flexible part of the spine. It allows your head to move in practically any direction. But, its flexibility also makes it the area of the spine that is most vulnerable to injury.

In addition to the disc for flexibility and movement of the cervical spine (neck region) also has what is the known as the facet joint. The facet joint is the part of each neck vertebrae, and it allows the bones to glide smoothly over each other. All of these neck facet joints moving together making it possible for the head to nod forward or backward. In a typical segment of the neck region, the spine has 4 facet joints and two-disc joints.

How Collisions can hurt your body:

The bottom line on whiplash is this: your body was not designed for the abnormal motions that occur during a collision. Normally when your head moves forward and backward, all of the vertebrae participate equally and safely in the motion. Whiplash, however, is not normal motion. During a collision, which takes place in a split second, your head is thrown backward so forcibly and quickly that your body does not even have a chance to respond. As we mentioned earlier, the facet joints allow smooth, controlled forward and backward movement motion of the head and neck. And each joint moves equally to aid this motion.

Different Phases of Whiplash Motion:

Watching each spinal segment in a live human being during a whiplash type collision is not an easy task. What these scientists did was to subject a volunteer to a simulated rear-end collision, while videotaping the spinal motion with x-ray video camera at very high speeds (about 500 frames per second). Whiplash injuries occur in about a tenth of a second so that the entire occupant motion would take up just three frames with a regular video camera with a rate of 30 frames per second.

These researchers found that the smooth motions that they saw when looking at the overall motion during whiplash were much more complex when they examined and analyzed the motions of individual segments.

The Whiplash motion looks like the following:

Phase 1: Upright spine before collisionnormal-cervical-curve1

Phase 2: Immediately after the impact, the car seat pushes the torso forward while the head remains stationary. At the same time, the torso “ramps” up the seat, compressing the cervical spine.

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Phase 3: Torso is accelerated by the vehicle seat and may start to ramp up the seat. The lower neck is then pulled forward by the accelerated torso/seat. The head rotates and extends rapidly rearward hyper-extending the neck. The vehicle seat begins to spring forward, and torso continues to accelerate forward.

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Phase 4: The spine forms an S-shaped curve before the musculature of the neck has a chance to react. This S-shape curve results in bending and damaging ligaments in several of the spinal segments.motor-accident-2

Head and torso are accelerated forward. The neck is “whipped” forward rotating and hyper-flexing the neck forward. The head accelerates due to neck motion and moves ahead of the seat back.

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The latest study on this issue shows that the joint capsule and disc undergoes excessive stress in just a few segments of the spine. So much stress that the joint capsules and disc can be torn or the cartilage of the joint itself can be “pinched,” resulting in tissue damage and pain.

Why your body is in pain?

All of the most common symptoms of whiplash can be traced either directly or indirectly to the trauma in your neck that you experience the auto injury. There are 5 major types of injury that whiplash can cause, these are muscle, ligament/tendons, nerve, facet joint injury, and fractures.

  1. Muscle Injury:
    • Most whiplash pain involves muscle tissue since it is the easiest to damage in a collision. During the impact, the muscles in your neck are stretched beyond what they normally experience. Muscle damage is accompanied by swelling and tenderness of the muscles in the neck and shoulders. Fortunately, muscle injuries heal quickly and usually don’t require extensive lengthy treatment.
  2. Ligament/Tendon Injury:whiplash-injury-recovery
    • Now a new study has looked more closely at what happens to the neck, but this time by studying the anterior ligaments of the spine. Previous studies have shown that some patients experience injuries to the anterior longitudinal ligament (ALL) after whiplash. This new report by leading whiplash researchers used a sophisticated mathematical analysis (based upon experimental anatomical and crash data) to see what happens to the ALL during a crash.The ALL runs along the front of the human neck, providing stability for the vertebrae of the spine. The added hypermobility may lead to spinal disorders such as early degeneration of the connected intervertebral disc or vertebrae. In addition, segmental hypermobility can lead to long-term instability. Catastrophic failure of the ALL in a whiplash injury will almost inevitably result in simultaneous injury to the intervertebral disc requiring Chiropractic intervention with specific and scientific analysis to prevent further damage and degeneration.
  3. Nerve Injury:
    • Just as muscles, ligaments/tendons are stretched during rapid motion of whiplash, so our nerves. Most nerves are able to handle such motion. But if your head is turned, head restraint wasn’t adjusted properly, having neck instability, to begin with, a nerve can be damaged and stretched too far or pinched. Nerve injuries can be slightly more difficult to heal than muscle and ligament damage. Nerves that are trapped by misalignment of the vertebra require chiropractic adjustments to restore normal functional capacity.
  4. Facet Joint Injury:
    • Facet joint injury can show itself in a variety of ways. Pain in the area of the joint is the most common symptom. Facet damage can also result in pain that is felt elsewhere in the body. Shoulder and arm pain are common whiplash complaints that may be related to facet joint injury.        Healing of joint damage can be more difficult for many reasons. First, the joint itself does not have a good supply of blood, which makes it hard for the tissues to heal. Secondly, the constant motion of the joint and swelling can irritate the injury. Thirdly, misalignment of the vertebra called subluxation is the culprit cause of this problem causing loss of motion in a damaged vertebra in the lower neck area and creating too much instability in the upper neck.
  5. Fractures:PE-SpinalFractures_Figure2b
    •  Fractures in the neck may also occur during motor vehicle accidents when the head is violently jerked either backward or forwards. The most common type of spine fracture is a vertebral body compression fracture. Sudden downward force shatters and collapses the body of the vertebrae. If the force is great enough, it may send bone fragments into the spinal canal, called a burst fracture. Abnormal slipping and rubbing motions can cause pain and damage the spinal nerves or spinal cord. Stable fractures can usually be treated with bracing and rest. Unstable fractures usually require surgery to realign the bones and prevent spinal cord or nerve injury.when more pressure is put on a bone than it can stand, it will break. People affected by osteoporosis, tumors, and certain forms of cancer that weaken bone are prone to vertebral compression fractures (VCF). The fracture appears as a wedge-shaped collapse of the vertebra.

Effective Healing Methods:

The goal of healing and stability is to help the damaged tissues from the injury. This may take time, depending upon the extent of the damage.

First, it’s very important that you stay active and continue to keep your daily activities. Don’t take excessive time off work or recreation, as this can make it harder for you to get back into the daily lifestyle. The more you make an effort to stay active, the easier it will be for you if you have a legal case later on.

Chiropractic with Whiplash:

Chiropractors work to correct the biomechanical problem causing the symptoms related to whiplash. An approach that will only emphasize on pain or other symptoms will not correct the problem. One report examined 10,382 articles on a neck injury and found traditional techniques for whiplash (collars, injections, ultrasound, medication) were largely ineffective. Several studies point to the success of chiropractic for whiplash sufferers. One found 26% were completely pain-free after chiropractic intervention and the other 74% were significantly improved. Another found 93% improvement.

Patients who undergo chiropractic care are found to have the natural curve of their necks restored, whereas patients who do not undergo chiropractic care tend to be left with a straightened or even reverse curve in their neck. Through research from the Cervical Spine Research Society conducted by Dr. Hohl, he has been shown that after an average of 7 years post-auto accident, an acceleration of degenerative disc disease following whiplash injuries occurred. By that amount of time, auto insurance will not cover the damage of auto injury.

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Dr. Gonstead’s Experience with Whiplash

According to Dr. Gonstead, whiplash usually causes a lower neck problem, but the gonstead and spinemajor problem is often the upper neck problem. He often found damage in the front of the neck bone in the case where a lower neck problem is involved. When there is a very bad whiplash case, he often saw atrophy of the thumb muscles and they couldn’t bring the thumb and index finger together. Dr. Gonstead always wanted to adjust the whiplash as early as possible after the accident. Dr. Gonstead used soft collars for TV and driving purposes if they couldn’t hold up their neck and also make sure that after the Chiropractic adjustment the neck will heal in the best posture as possible. Dr. Gonstead stated that traction for whiplash is to be avoided along with cervical collar. Ice will help reduce the sensation of pain but heat will make the muscle inflammation worse and increase the pain. Typically whiplash damages start to degenerate after 6 months of stagnant lack of care to the spine.

In the Future:

When the whiplash injury is cared for with Chiropractic adjustments, the whiplash will stabilize and heal properly with a series of Chiropractic adjustments. There will be no fear of reoccurring symptoms, a progression of degeneration, and less medical bills to pay for in the future. Not just any Chiropractic adjustment will do. The Chiropractor has to be specific, objective, and creating a future plan of how to keep their spine strong and stable. Dr. Gonstead had the most experience with all kinds of whiplash injuries and his Chiropractic system has been tested throughout time. There are all kinds of whiplash injuries that involve the muscles, ligaments, nerves, and bones so finding a good Chiropractor is very important and if they perform Chiropractic adjustment like Dr. Gonstead.

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Good, Bad, and the Ugly. Crack My Neck for Relieving Pain.

There are many situations where your spine will crack on its own or intentionally cracking them. The cracking of the spine in any different situations has an effect that can be good, bad, or ugly.

Good:

After a certain time period of a Chiropractic adjustment, the spine tends to realign the other vertebra on their own. Most likely the other vertebra was not in the right position are starting to go in the right position by themselves. When your body introduces any kind of force, such as when you are doing light stretching, turning, bending the spine realign. There is nothing to fear but to let your Chiropractor know what happened. Check out the former blog about this topic: https://zenchiropractic.wordpress.com/2012/11/29/what-happens-when-my-spine-goes-pop/

Bad:IMG_0006

When your spine pops and pain follows immediately then the joint became unstable and causing inflammation and muscle spasm. Even if you didn’t put much stress or any motion on the spine something pops and then the muscles around are creating spasms and sharp pain. Often times these situations are the vertebra was already starting to fall out of place and it was a matter of time when it went out of position. In this case, put ice on the area and get to a Chiropractor that will use x-ray, neurological exams, and education on what has happened and properly adjust that vertebra.

Ugly:

The unprofessional person intentionally twisting of the neck or low back of themselves or to others may create the cracking noise but then they will cause tendon and ligament to tear and create more instability. Over twisting the neck without proper examinations and professional skill then people are at risk possibly damaging artery integrity that is already weakened and may cause cardiovascular problems in the brain. The mistake is to think that by over twisting the joint the crack is more intense and the better you feel.

26real_450That cracking noise is not what Chiropractic is defined by but that is a very big misunderstanding. Cracking in your joints creates an endorphin response that gives you a euphoria for a moment but does not solve the actual joint problem. Properly correcting your spine takes a long training from a graduate level school and getting a state license. A grand total of 4485 hours of clinic hours with health science education. Many people attempt cracking their neck and low back themselves or ask others that are not professionals to crack their spine.

There are many other professional and non-professionals that try to say that they do chiropractic. Professionals such as massage therapists, physical therapists, sports therapists, and even some medical doctors to copy chiropractic because they know how effective Chiropractic care is. Non-professionals such as your friends, families, people you meet at the bar or parties, or any individual that offer to crack your spine or neck on the street. This is why people have an incidence of having a very bad experience with cracking their neck or back because they think it is just cracking is what helps the person. People could get damage to their muscles and ligaments, and damage to the artery structure in the neck.

gonstead and spine

Dr. Gonstead’s Story:

Dr. Gonstead once had a farmer couple come to his office. The wife of this farmer was in a lot of back pain. Dr. Gonstead found the problem after careful analysis and adjusted the spine and told them to come back next week. The former couple did not come back. In fact, they didn’t come back for months. Then the farmer couple came back and the wife of the farmer was in a lot worse back pain. Dr. Gonstead analyzed again and it was much worse condition than before, so he asked the wife what happened. The farmer’s wife confessed that her husband tried to copy Dr. Gonstead after watching him adjust his wife after they went back home. They thought they could do the adjustment themselves not knowing how much science and careful skill that Chiropractic adjustment involved.

Summary:

There are many occasions were your spine will crack on its own. Some are fine because it is the process of our body to correct and heal itself. Some are bad because the spine got very unstable and finally went out of place. The worse is just because you want to feel the euphoria and cracking your neck or low back and causing a major set back of unstable joints does not help yourselves or the person you are trying to help. You could even cause serious damage to yourself or to others. It is not about cracking your neck and it is not about being a crack dealer for people. If it is about helping people, you should become a Chiropractor or go seek one to help your friend. They will find the cause and stabilize the situation.


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What is Chiropractic Treatment?

Chiropractic care is always misunderstood with medical care. Once the symptoms are gone, then the client tends to think that they have no need of care. This is a medical understanding of Chiropractic care. Chiropractic is originally was more concerned about the function of the body and the cause of the symptoms. Chiropractic should not be misunderstood as treatment care or therapy because they remedy the symptoms. Chiropractic is all about finding the cause and finding solutions instead of covering up the symptoms. Chiropractic doesn’t treat symptoms but rather they observe the cause of the symptoms and when the cause is gone then there is no need to do any chiropractic adjustments.

What are they really looking for? Chiropractors are looking for the cause of the symptoms which is subluxations. Subluxations are slight dislocation of the spinal segment that chokes the nerve and limits or interrupts the communication and function of individual nerves that connects to muscles movements, heart functions, and many more! Once these subluxations are gone, there is nothing to change. If there are signs of subluxations then that is what Chiropractors adjust and restore and monitor. If there are signs of subluxations then the Chiropractic adjustments continue.

How do Chiropractors monitor subluxations? Many Chiropractors do a physical examination of a range of motion, pain scale questionnaire, orthopedic tests to measure that the symptoms are gone. Although this method is still only measuring symptoms so in this set of examination they are only looking to cover up the symptoms. There are Chiropractors that go further and take radiological examinations and have x-ray films to see the spine and re-take x-ray films after a certain amount of time. The public and normal people are not educated in looking at x-ray films and anatomy of our skeletal structures. That means we are at the mercy of the Chiropractor to tell us if we are progressing well. Most often times they say that there is progress and we just agree because we don’t want to look like we have no idea what they are saying. There are also other assessments for subluxations such as monitoring spinal thermographs, a static electromyograph, electrocardiographs, and many more assessment tools.

X-rays:normal-cervical-curve1

Some chiropractors use x-rays mostly as a scare tactic to make you fearful of your condition and sign up for chiropractic adjustments and never use them. Very caring, objective and scientific Chiropractors are always looking at them when the client comes in and analyzing and comparing the x-rays to the client as a reference. Most of the time Chiropractors want to see if there are specific conditions such as fractures, malformation of the bone structures, and degeneration. This will help to specify the Chiropractic adjustments for more efficient structure in the body so that adaptation to stress is more efficient. When x-rays are taken, many Chiropractors are not being careful of positioning the client and sometimes create scoliosis like an appearance to the x-ray. Which means they are adjusting the spine thinking there is scoliosis but there really was a misinterpretation.

The most important part of using x-ray in the progress of care is to see if the Chiropractic adjustments are improving degeneration, changing the structure of the spine, and further specify the chiropractic adjustments for the clients.

Neurological/Physical Examination:

hc_epilepsy_diagnosis_neurological_exam_articleMany Chiropractors check for pain levels, sensations on different areas of your arms, feet, orthopedic tests, neurological reflexes, checking the range of motion of the neck or low back. Many times these tests are necessary for very severe conditions and not always accurate for subluxations. Most of these tests are orthopedic medical doctor’s procedures and is not designed for assessing subluxations. Often times these exams are initially examined but it is not too often that the results are re-examined again. The results are not explained and do not correlate very well with the client’s problems. Many health insurances require the Chiropractors to do these tests for insurance to cover the chiropractic adjustments.

Computerized Neurological Examination:

There are many emerging assessment technologies for subluxations to make the chiropractic adjustments to be specific and have the better idea of the progress of the personal health. Subluxation Station from Chiropractic Leadership Alliance has been in the industry for more than 20 years. Most common assessment has been measuring heat patterns of the spinal areas called Spinal thermography. Subluxations have inflammation of the nerve and the spinal thermography detect areas of subluxations and the conditions and progress of each nerve. Another common assessment is measuring the state of muscle spasms with static electromyograph. Subluxations cause muscle spasms with imbalanced contraction of muscles. By using the static electromyographs we can see the how new or old the subluxations are. After a number of chiropractic adjustments, the muscle condition can show us how our body is adapting to our stressful environments. A recent technology has been used for assessing subluxation is electrocardiographs. This is measuring the variability of our heart rate to assess how our body is adapting to the environment. Our body is dynamic and constantly adapting to different environments. Electrocardiographs will help chiropractors to assess their chiropractic adjustments are getting rid of the subluxations and helping people to have their body to adapt to the environment.

Before-Muscle1

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Chiropractic Adjustment:

In the media, the chiropractic adjustment is often confused with twisting the neck or low back quickly and making a cracking noise that reduces the pain. First ever chiropractic adjustment was not as such. D.D. Palmer investigated the medical history of a partially deaf man, Harvey Lillard. Lillard informed Palmer that while working in a cramped area seventeen years earlier, he felt a ‘pop’ in his back, and had been nearly deaf ever since. Palmer’s examination found a sore lump which he believed was a spinal misalignment and a possible cause of Lillard’s poor hearing. Palmer claimed to have corrected the misalignment and that Lillard’s hearing improved. Two important things from this D. D. Palmer: Chiropractic was not discovered to help back pain, Chiropractic was discovered because chiropractic adjustment helped restored the function of the body.

Chiropractic adjustment and Osteopathic Manipulation Therapy

Often times Chiropractic adjustment is confused with osteopathic manipulation therapy. Chiropractic has always been about restoring spinal misalignment and correcting subluxation only. Osteopathic manipulation therapy is a broader spectrum of therapeutic options in addition to thrust techniques, among which are myofascial release, muscle energy, counterstrain, visceral manipulation, prescribe medication, and surgery.

Chiropractic Adjusting Devices vs. Chiropractic Manual Adjustments

Chiropractic adjustments have various techniques and some useful tools to adjust the spine. Traditionally, chiropractic adjustment was performed by hand only. In the latest century, there were many devices innovated to do the adjustment such as an activator, adjustor, and much more is out there. Many people prefer the chiropractic devices because they seem safer. Although, there are controversies whether the chiropractic devices help people. With Chiropractor’s adjusting manually by hand only, the experience is the best indicator of getting best results for clients with specific conditions. Younger the chiropractor doesn’t mean less experience because some people will practice and discipline themselves to learn how to sharpen their skills.

Specific Chiropractic Technique websites such as Gonstead Clinical Studies Society shows the Gonstead technique practitioners when they attended the last seminars and how many years they are in practice. This may not always be the best indicator of how much practice and skill a chiropractor has. If anyone is looking for a skilled chiropractor, please contact the office.

Office:952-500-8733

http://www.zenchiropracticinc.com