How Long Does it Take to Recover From Whiplash?

One of the most common questions asked by anyone suffering from whiplash or another auto injury is, “How long do I need to recover?”

The answer to that question depends largely on the severity of your injury, as well as individual characteristics like age, mental health, and occupation. For instance one new study suggests that patients with grade I or II whiplash injury can expect to experience significant relief of their symptoms within a year of their injury. However, other research has shown that up to half of whiplash patients develop chronic problems.

To clarify the matter, researchers from France recently conducted a study of  173 patients with whiplash and 207 individuals with mild injuries. One year after the injury, 56% of whiplash patients still had not fully recovered, compared to 43% of more mild injury cases. The biggest factor in predicting poor quality of life was post-traumatic stress disorder. Earlier studies have also indicated the PTSD increases the likelihood that whiplash patients will suffer from chronic symptoms.

The term “chronic” typically refers to any painful symptoms that are experienced for longer than three months. Unfortunately, the lingering effects of chronic whiplash can last for up to a decade after the injury, according to previous research.

So if you’re suffering from whiplash now, it’s important to be evaluated by a chiropractor or other spinal specialist who can assess the damage and grade of injury. Mild cases of whiplash may be resolved with a few chiropractic adjustments and at-home treatments, while more severe cases will require longer-term care. Seeking adequate treatment now will prevent chronic pain later.

References

Asenlöf P, et al. The clinical course over the first year of Whiplash Associated Disorders (WAD): pain-related disability predicts outcome in a mildly affected sample. BMC Musculoskeletal Disorders 2013;14(1):361. doi: 10.1186/1471-2474-14-361.

Hours M, et al. One year after mild injury: comparison of health status and quality of life between patients with whiplash versus other injuries. Journal of Rheumatology 2013. 

Written by: Marissa Luck 

Chiropractic Support During Pregnancy

Chiropractic & Pregnancy Recently, there has been increased attention given to the harmful effects of acetaminophen for women during pregnancy. In a report published in the current issue of JAMA Pediatrics, researchers from the UCLA Fielding School of Public Health show that taking acetaminophen during pregnancy is associated with a higher risk of Attention Deficit/Hyperactivity Disorder among children. Jeff Chap MD, director of maternal fetal medicine at Cleveland Clinic is quoted, "We really should start looking at non-pharmacological ways to deal with pain." Chiropractic and massage therapy provide a conservative treatment for pregnant women during pregnancy, after years of providing this service for moms to be it is nice to know that we can help them because chiropractic care is gentle and effective for relief of moms symptoms.  Especially when not much else is available without side effects. Lower back pain is very common during pregnancy, but so are many other complaints that chiropractic and massage may be able to help you with: Musculoskeletal complaints related to pregnancy can include:

The Pain Relief Centre will be able to give you advice on many areas that will help to make your pregnancy as enjoyable as possible including exercises and stretches to help you through your pregnancy. If your not sure if we can help then please do not hesitate to call us today and speak to one of our staff members at 904-823-8833.  We will be happy to answer any of your questions. We have specific equipment that will ensure that your visit is comfortable:

90% of Herniated Discs Improve with Chiropractic

A new study confirms the vast majority of patients with lumbar disc herniation can find relief with chiropractic care. The findings show that 90% of patients report substantial improvements within three months of receiving their first chiropractic adjustment.

The results are encouraging, since more research is raising questions about the safety and effectiveness of epidural steroid injections for the long-term management of lumbar disc herniation (LDH) and sciatica. The study, published in the Journal of Manipulative and Physiologic Therapeutics, shows that both chronic and acute herniated discs can be effectively treated by chiropractors.

Researchers conducted a study of 148 patients with MRI-confirmed lumbar disc herniation causing back pain, sciatica, and radiating leg symptoms. The majority of patients (79) suffered from chronic LDH, lasting longer than three months. Thirty seven patients had LDH for fewer than four weeks at the start of the study.

Chiropractors treated the patients with specific spinal manipulations based on individual characteristics, including results from the MRI that demonstrated the area and type of herniated disc. After two weeks, most patients (70%) had significantly improved disability and pain. By the three-month mark, 90.5% had substantial improvements in disability and pain, and that percentage stabilized at the six-month and one-year evaluations.

The researchers pointed out that these improvements cannot be attributed to natural history alone. Earlier studies have suggested that that typical prognosis for acute disc herniation is favorable, with 36% showing significant improvements after two weeks. However the acute patients in this study had faster improvements, with 80% significantly improved after two weeks, and 94.5% after three months.

Other studies have shown that chiropractic care can also assist patients suffering from recurrent lumbar disc herniation also called failed back pain surgery syndrome. Cumulatively this research suggests that patients can benefit from chiropractic for LDH, regardless whether their herniated disc is acute, chronic, or recurrent.

 Reference

Lee, Serafin. Outcomes of acute and chronic patients with magnetic resonance imaging-confirmed symptomatic lumbar disc herniation receiving high-velocity, low-amplitude spinal manipulation therapy: a prospective observational cohort study with one year follow-up. Journal of Manipulative and Physiologic Therapeutics 2014. doi 10.1016/j.jmpt.2013.12.011.http://www.jmptonline.org/article/S0161-4754(14)00034-7/abstract.

Written by: Marissa Luck 

Spinal Adjustments Beat Placebo for Back Pain

New research shows once again that there’s more to chiropractic than the placebo effect. A recent study suggests that the pain alleviation experienced after a spinal adjustment is a result of the treatment rather than patient expectations alone.

Several studies have documented the effectiveness of a common treatment delivered by chiropractors for back pain called spinal manipulation therapy (SMT), sometimes referred to as a chiropractic adjustment or a spinal adjustment. In particular, research shows that SMT decreases the pain sensitivity experienced by people with chronic pain. However, placebo treatments have also been shown to reduce pain sensitivity. Researchers from the University of Florida wanted to test whether patients who were informed of their treatment would have better results than patients blinded to treatment.

In the study, published in the Journal of Pain, the researchers divided patients with low back pain into three groups: SMT, placebo SMT, or “enhanced” placebo SMT. During a session of enhanced SMT,  a practitioner told the patient, “The manual therapy technique you will receive has been shown to significantly reduce low back pain in some people.” Patients received 6 treatments over the course of two weeks. Mechanical and thermal pain sensitivity was measured before and after treatment.

Although enhanced placebo treatment produced better results than the placebo treatment alone, the patients receiving actual SMT had superior treatment results. By the end of two weeks, the patients in the SMT group had significantly greater reductions in pain sensitivity compared to the placebo and enhanced placebo groups.

The researchers concluded their results show that the outcomes after SMT are unrelated to expectations but to “the modulation of dorsal horn excitability and lessening of central sensitization. This suggests potential for SMT to be a clinically beneficial intervention.”

Central sensitization contributes to the development and progression of chronic pain. This occurs when the nervous system becomes overly sensitized and disrupts your ability to process pain normally. Treatments that can decrease pain sensitivity, such as chiropractic adjustments, may disrupt the pattern of chronic pain for those with whiplash, fibromyalgia, and lower back pain.

References

 Bialosky, JE. Spinal manipulation therapy-specific changes in pain sensitivity in individuals with low back pain 2014. 15 (2): 136-148.

Spinal manipulation therapy lessens central pain sensitization. American Pain Society. Press Release. February 25, 2014. 

Written by: Marissa Luck on March 13, 2014.

Exercise Prevents Need for Hip Surgery

Exercise therapy could prevent the need for total hip replacement surgery, according to a new study. In patients with hip osteoarthritis, an educational and exercise program resulted in a 44% decrease in the need for surgery compared to a control group, according to researchers at Oslo University Hospital.

For those who eventually opted for a hip replacement, patients in the exercise program delayed the need for surgery by 5.4 years, compared to 3.5 years in the control group.

“Our finding, that exercise therapy enhances the survival of the native hip to [total hip replacement], is therefore important for healthcare consumption and for patients who may avoid surgery and its potential complications,” stated lead author Ida Svege, MD, and his colleagues.

The number of hip replacement operations has increased in the past 40 years, at a significant cost to the healthcare system. Exercise has proven to be successful for adults with knee osteoarthritis. Last year a study suggested physical therapy was effective as surgery for knee OA. However, few studies have examined the effects of exercise therapies for osteoarthritis in the hip.

Svege and his colleagues compared the effects of exercise to education for hip osteoarthritis in 109 adults. Every patient received education hip OA,  but half were randomly assigned to an exercise group. Those patients participated in 2-3 exercise sessions per week for four months. Exercise sessions included symptom-targeted therapies.

The exercise group had a significantly better physical functioning than the control group, but were similar in terms of pain and stiffness. Still, the overall survival rate of the native was substantially improved by exercise therapy.

“We argue that for patients with a tolerable pain who are able to maintain their desired activity level and who are relatively young, postponing surgery is appropriate and may reduce the future need for THR [total hip replacement] or repetitive THR revision surgery,” the authors wrote.

Chiropractic care is another non-invasive treatment option for patients with hip osteoarthritis.Studies suggest that a combination of exercise therapies and chiropractic adjustments can offer lasting OA relief.

Reference

Sveg I, et al. Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: a long-term follow-up of a randomized trial. Annals of Rheumatic Diseases 2013; doi:10.1136/annrheumdis-2013-203628.

Walsh N. Exercise delays need for new hips in OA. Medpage Today. November 22, 2013. 

Written by: Marissa Luck 

Chiropractic speeds sciatica recovery

Many people with sciatica find the pain to be so debilitating that they are forced to miss work and social gatherings. Among patients with lower back pain, those with sciatica experience the highest level of disability.1 According to public health records in Norway, patients with sciatica are disabled for an average of 72 days a year.

A recent study offers hope to patients suffering from sciatica pain. The new research suggests that chiropractic treatments may speed sciatica recovery, enabling patients to return to work faster.2 The researchers evaluated 44 Norwegian workers who had visited the hospital with severe sciatic pain. Most of the participants had been experiencing pain for at least three weeks before visiting the hospital.

In the hospital, a chiropractor evaluated each patient’s posture, gait, range of motion, and palpation of the lumbar spine. The chiropractor then performed joint adjustments to the spine, in addition to other joints that had been injured as patients compensated for the pain. Soft tissue soreness was relieved with ice treatment. Patients received daily treatments while in the hospital, and then three times a week for a period of two weeks. Some patients also underwent additional follow-up treatments, but most did not receive more than 14 treatments.

Within 21 days, 91% of patients had returned to work full-time. An additional 2 patients were back at work part-time. The researchers concluded that the study demonstrates the potential benefit of chiropractic care for sciatica patients.

Arana E, Marti-Bonmati L, Vega M, et al. Relationship between low back pain, disability, MR imaging findings and health care provider. Skeletal Radiology 2006;35(9):641-7.

Orlin JR, Didriksen A. Results of chiropractic treatment of lumbopelvic fixation in 44 patients admitted to an orthopedic department. Journal of Manipulative and Physiological Therapeutics 2007;30:135-139.

Written by: Megan Churchwell on July 9, 2012.on March 12, 2013.

Chiropractic for Post-Surgery Spinal Pain

It’s estimated that between 15-61% of patients continue to suffer from back pain after spinal surgery, and nearly two-thirds of all chronic pain patients suffer from failed back surgery syndrome. While many of these patients are encouraged to have revision surgery, a growing body of research suggests that chiropractic care can improve symptoms without the risks and costs of another operation. A recent case report published in the Journal of Chiropractic Medicine outlined three successful cases.
Case 1
A 31-year-old man had experienced initial relief after undergoing surgical spinal decompression and laminectomy disc herniation 2.5 years earlier. However, his symptoms of lower back pain and leg pain resurfaced while he was lifting firewood. The patient received flexion-distraction mobilization and an at-home exercise program. After four weeks of treatment, his pain dropped from a 6 out of 10 at best to a 4 out of 10 at best. Although he continued to have numbness on his left leg and foot, and nerve tension while straightening his leg, the patient’s lumbar range of motion had improved and his leg symptoms had decreased.
Case 2
A 47-year-old man suffering from pain in the upper back and neck experienced a deep, throbbing ache that impeded his ability to work and engage in daily activities. The man had previously been treated with trigger point injections, painkillers, and surgery. He was treated with high-velocity, low-amplitude (HVLA) adjustments and myofascial release. The patient had improved cervical spine range of motion and ability to complete activities of daily living. Since his initial treatment three years later, the patient periodically experienced an exacerbation in symptoms, which are relieved by 2-3 chiropractic adjustments.
Case 3
A 60-year-old man presented at a chiropractic clinic with low back pain and right lower extremity symptoms. The man had received a L3-5 laminectomy 27 years after experiencing disc herniation. Since then, he continued to experience periodic flare ups in pain that prevented him from sitting for more than 15 minutes, driving long distances, or walking for more than 100 yards. He rated his pain as 7 out of 10 at best and 10 out of 10 at worst. A chiropractor treated the patient with side-lying HVLA chiropractic adjustments and flexion-distraction mobilization. After five weeks of treatment, the man had minimally decreased pain but significant functional improvements. He was able to drive for 600 miles without an exacerbation in symptoms and reported satisfaction with treatment.
Chiropractic for Failed Back Pain Surgery Syndrome
Earlier studies have shown that spinal mobilization and manipulation are effective for back and neck pain, but most clinical trials fail to include patients suffering from post-operative spinal pain. These case studies show how chiropractic care can improve function and reduce symptoms in patients suffering from ongoing symptoms after spinal surgery.
Reference
Coulis, CM and Lisi AL. Chiropractic management of postoperative spine pain: a report of 3 cases. Journal of Chiropractic Medicine 2013. 12:168–175.

Written by: Marissa Luck on March 5, 2014.on March 4, 2014.

Chiropractic Effective for Neck Pain in Seniors, Study Finds

A recent study shows that not only are neck adjustments safe for the elderly, they’re extremely effective for neck pain when combined with exercise. Although earlier studieshave shown the benefits of chiropractic for neck pain, there have been no randomized clinical trials on the treatment specifically for the elderly.

The study, published in The Spine Journal, included 241 patients over the age of 65 years who suffered from persistent neck pain. Patients were randomly assigned to one of three treatment groups:  spinal manipulation therapy delivered by a chiropractor, plus home exercise (SMT+HE); supervised exercise plus home exercise (SRE+HE); or  home exercise alone (HE).

After 12 weeks of treatment, over 60% of chiropractic patients had at least a 75% improvement in pain, compared to approximately 25% of patients in the SRE+HE group, and nearly 20% of the HE only group. These significant differences were less pronounced at the one year follow-up however.

Still, the researchers pointed out that any decrease in pain greater than 50% is considered a clinically meaningful and substantial change for neck pain. Additionally the chiropractic patients had greater reductions in medication usage. They wrote that the “lack of serious adverse events, tolerability, and high adherence to care suggest the combination of SMT with home exercise is an effective treatment in seniors with chronic NP.”

Chiropractic care included a diversified, thrust technique, mobilization, and a low-velocity type of joint oscillation, for a maximum of 20 sessions. The force and type of SMT was individualized, and adjunct therapy included heat and ice therapy, massage, and assisted stretching. Home exercise consisted of simple exercises for balance, coordination, and flexibility taught by a chiropractor or exercise therapist. Supervised exercise consisted of 20, one-hour sessions monitored by an exercise therapist.

Neck pain affects an estimated 20% of adults over the age of 70. Unfortunately, many elderly patients suffer from coexisting conditions, and because of the possibility of drug interference, cannot use prescription painkillers. Others may wish to use drug-free treatments out of personal preference. This makes conservative treatments like chiropractic care all the more important for the management of neck pain in the elderly.

 References

Maiers M, et al. Spinal manipulative therapy and exercise for seniors with chronic neck pain. The Spine Journal 2013; doi10.1016/j.spinee.2013.10.035.

Written by: Marissa Luck on February 25, 2014.