Pain Relief Chiropractic

Whiplash is caused by the rapid back and forth motion that occurs in the classic rear-end collision, in some sports, and during slip and falls. The initial symptoms associated with whiplash often include muscle tightness and pain. But where is the pain coming from?

First, the mechanism of injury that is involved in a rear-end collision is important to understand. In the first 50-100 milliseconds, the body below the neck is pushed forward in relation to the neck, resulting in straightening of the neck. Between 100-200 msec, the lower half of the neck extends while the upper half flexes, after which the head accelerates backwards, where it is hopefully stopped by the head rest. This is followed by a forward rebound where the head and neck accelerate forward, hopefully limited by the seat belt and/or air bag. This entire event is completed within 300msec, which is faster than what we can voluntarily brace or guard against, even if we see it coming!

Factors that contribute to injury that are more difficult to calculate include the angle and springiness of the seat back, the position of the headrest, the build of the person (tall slender females are at greater risk than a husky male), whether the head was turned at the point of impact, the slipperiness of the road, the size of the two vehicles, etc.

So what’s causing your pain? Is it muscles, ligaments, or something else? There are many symptoms associated with whiplash and hence the term ‘whiplash associated disorders’ or WAD that is applied to these cases. There are four categories of WAD: 1) few symptoms/no exam findings; 2) more symptoms/positive exam findings but no nerve pain; 3) nerve pain—numb/tingling and/or muscle weakness; and 4) fracture/dislocations.

The term “cervical sprain/strain” refers to ligament/muscle injury, respectively. Muscles move bones and joints and are more elastic while ligaments firmly hold two bones together at a joint. The muscles attach to bone by tendons, and a strain refers to a muscle and/or tendon injury. Both sprains (ligaments) and strains (muscle/tendon) are graded as one, two, and three or, mild, moderate, and severe, respectively, depending on how much tearing occurs. The rate of healing is dependent on the amount of tearing and how “nice” you are to it after injury. Pain can last a long time if you keep “picking at the cut” or in other words, not respecting the healing process.

What makes the neck so unique are the many layers of muscles that exist. Like an onion, there are layers upon layers of muscles that do different jobs, but unlike an onion, these muscles run in many different directions. The muscles on the outside tend to be long, large, and strong while the deep ones are short, small, and are important with fine motor control and coordination. The deep muscles are NOT voluntary (the larger/stronger outside muscles are), so to exercise them, we have inhibit the outside muscles to get the deep ones to work. The deep neck flexor muscles are always weak in those of us with neck pain (from any cause) and need to be isolated and strengthened in order to feel and function better.

Doctors of chiropractic are trained to teach you these important, specific exercises in addition to others as well as provide you with pain relief with treatment, education, and job/work modifications.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Even though whiplash or whiplash associated disorders (WAD) is very common, it remains poorly understood. Recent studies report that up to 60% of people may still have pain six months after their injury. Why is that?

Investigations have shown there are changes in the muscle and muscle function in the neck and shoulder regions in chronic WAD patients. Symptoms often include balance problems as well as increased sensitivity to a variety of stimuli including pressure, light vibration, and temperature.

Interestingly, this hypersensitivity not only occurs in the injured area, but also in areas away from the neck such as the front of the lower leg or the shin bone. This can only be explained by some type of neurobiological processing of pain within the central nervous system, which includes the spinal cord and brain.

It’s not surprising that when pain continues for lengthy time frames, people with these symptoms may also experience psychological distress. The confusing thing is that not every WAD injury case has this “central sensitization” and when it’s present—its intensity is highly variable.

Current research into WAD is focused on the following: 1) developing better treatments in the early or acute whiplash injury stage with the goal to PREVENT development of these chronic symptoms; 2) determining what factors can PREDICT slower recovery following a WAD injury; 3) investigation into how the stress response associated with motor vehicle crashes influence pain, other symptoms and recovery, and how to best address and MANAGE the stress response; 4) research into the effect a WAD injury has on daily life function; and 5) developing improved assessment methods for healthcare providers so that EARLY treatments can be more targeted and effective.

A Swedish study is currently looking at the importance of reducing the acceleration of the occupant during an automobile collision by redesigning the body of the vehicle and its safety systems. In rear-end crashes, the main issue is to design a seat and head restraint that absorbs energy in a controlled way and gives support to the whole spine. In frontal crashes, the air bag, seat belt pretensioner, and load limiter must work together in a coordinated way to reduce the acceleration between the vertebrae of the spine and occupant.

What is known is that a “wait and watch” approach may NOT be appropriate in a lot of cases. It appears there is a relatively short window of time, the first three months, when treatment seems to be most effective. Doctors of chiropractic are trained to identify and treat these types of injuries, so PLEASE, don’t delay your initial visit—time is truly of the essence.  Don’t waste it!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Are you of the belief that you have to hit your head in order to have a concussion or that concussions are easily diagnosed and managed? If so, then you are not alone! In fact, traumatic brain injury (TBI)—the proper term used when bleeding occurs within the skull occurs—and mild traumatic brain injury (mTBI)—the term applied when no bleeding occurs—remains poorly understood by many healthcare providers. This is partly due to not having any definitive method of testing that yields an accurate diagnosis.

Another problem is the under-reporting of concussion, as close to 40% of people who experience an mTBI do not report it to their doctor. Because of the significant negative consequences regarding the outcome and whole life ramifications associated with concussion, the importance of improving on the ability to diagnose or identify and treat concussion is huge!

We know that mTBI results from the transfer of energy from environmental forces to the brain by a sudden acceleration followed by a sudden deceleration that literally slams the brain into the inside bony skull.

The clinical work-up must include a review of body systems, with a special emphasis on the nervous system, including cognitive and behavioral symptoms. A partial list of post-concussion syndrome symptoms includes headache, balance problems, nausea and/or vomiting, vision problems, dizziness, brain fog (problems with attention, concentration, and speed of mental processing), memory problems, fatigue/drowsiness, light/noise sensitivity, and more.

The good news is that many mTBI sufferers fully recover, but the bad news is up to 25% do not! Promising newer technologies such as Diffuse Tensor Imaging can identify injury to the neural structures (axonal shearing) in those who’ve experienced a head trauma (such as from a car accident, sports injury, or slip and fall). The Sports Concussion Assessment Tool 2 (SCAT2) has been adopted by numerous sports leagues and others, but many healthcare practitioners do not utilize a structured tool such as this.

One promising tool is a blood test that measures brain-derived neurotrophic factors (BDNF)—a chemical hormone that helps maintain the health of neurons (nerve cells)—which can help diagnose mTBI conclusively and with good reproducibility! Blood levels of BDNF typically are low in patients with TBI or mTBI, and studies have shown patients with very low levels of BDNF are more prone to an incomplete recovery.

Put simply, this type of blood test can help a doctor diagnose, determine the severity, and determine the likelihood of recovery of TBI/mTBI! Doctors of chiropractic are frequently sought out by those with mTBI and understand the importance of careful management of this common and often poorly identified condition.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

 This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

You may have heard the comment, “If there’s no damage to the car, then there’s no injury.” Unfortunately, that does not always seem to be the case.

There are MANY factors that affect the dynamics of a collision and whether or not injury occurs. A short list includes: vehicle type and design, speed, angle of collision, momentum, acceleration factors, friction, kinetic and potential energy, height, weight, muscle mass, seat back angle and spring, head position upon impact, etc.

Consider Sir Isaac Newton’s Third Law of Motion: “For every action there is an equal and opposite reaction.” This law applies to a car accident at any speed. Using the analogy of hitting a pool ball into the corner pocket straight on, when the cue ball stops, its momentum is transferred to the target ball which accelerates at the same speed…hopefully into the corner pocket!

This example is not quite the same as an automobile collision because the energy transfer is very efficient due in part to the two pool balls not deforming (crushing or breaking) on impact with one another. If either ball did deform, more energy absorption would occur and the acceleration of the second ball would be lower.

In fact, in the United States, vehicle bumpers are tested at 2.5 mph with impact equipment of similar mass with the test vehicle’s brakes disengaged and the transmission in neutral. National Highway Transportation Highway Safety Administration (NHTSA) vehicle safety standards demand that no damage should occur to the car in this scenario.

However, energy transfer occurs very quickly and with a greater amount of force when there is no vehicle deformation (damage). As a result, a greater amount of energy (described as G-force) is directly transferred to the occupants inside the vehicle—increasing the risk of injury. A 1997 Society of Automobile Engineers article provided an example in which the same 25 mph (12 m/s) collision resulted in a five-times greater force on the occupants of the vehicle when the crush distance of the impact fell from 1 meter to .2 meters.

So be aware that even low-speed impacts can still place quite a bit of force on your body, even if the bumper of your car doesn’t have a scratch on it.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Is texting while driving any different than drinking and driving? One might argue that because there is no alcohol involved, “it’s okay.” But is it? Here are some SOBERING FACTS about texting and driving:

1. Believed to contribute to 1.6 million crashes/year. (National Safety Council)
2. Linked to an estimated 330,000 injuries per year. (Harvard Center for Risk Analysis Study)
3. Associated with eleven teen deaths EVERY DAY. (Insurance Institute for Highway Safety Fatality Facts)
4. Texting contributes to nearly 25% of ALL car accidents.
5. Texting while driving carries the same risk as driving after drinking four beers. (National Highway Transportation Safety Administration)
6. It’s the number one driving distraction (as reported by teen drivers).
7. The MINIMUM amount of attention time taken away from the road (like being blindfolded) is five seconds, which is EQUAL to traveling 100 yards, or the length of a football field, when traveling 55 mph.
8. The likelihood of increased risk by cell phone use: 1.4 times more when reaching for the phone, 1.3 times greater than talking or listening, 2.8 times more when dialing, but 23 times more when texting!
9. Of drivers involved in crashes between age 18-20, 13% admitted to texting or talking on their cell.
10. When surveyed, 34% admit to texting & driving; 82% of 16-17 year old teens own cell phones; 52% say they have talked on their phone when driving; 77% are “very” or “somewhat confident” that they can safely text while driving; 55% of young adults claim it’s easy to text and drive!
11. When teens text & drive, approximately 10% of driving time is spent OUTSIDE of their lane.
12. In ADULTS: 48% of kids age 12-17 say they’ve been in a car while the driver was texting, have seen a parent talk and drive, 15% have seen their parent text and drive, and 27% of adults have sent or received text messages while driving.
13. One in five drivers (all ages) confess to ‘surfing the web’ while driving and justify it with: “…reading a text is safer than composing and sending one;” holding the phone near the windshield makes it safe, “…I increase my distance from the car ahead,” “…I only text at a stop sign or red light.”
14. Laws: Ten states and Washington D.C. prohibit ALL drivers from using handheld cell phones; 32 states and Washington D.C. prohibit novice drivers from using cell phones; 39 states and Washington D.C. prohibit ALL drivers from texting.
15. What can parents of teen drivers do… Install a drive cam, download the app such as AT&T Drive Mode (Android & Blackberry) or DriveID by Cellcontrol ($129 works on all phones). At textinganddrivingsafety.com, teens and parents can take a “text-free-driving pledge. Social media options: Facebook/Twitter  – @RayLaHood, @DistractionGov, @NHTSAgov, @DriveSafely. Blogs: FromReidsDad.Org, RookieDriver.wordpress.com, ctdrive.blogspot.com, EndDD.org.

We all can improve our driving habits, and with this awareness and given the weight of the current evidence, do we really have a choice? STOP DRIVING WHILE INTEXTICATED!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.

Whiplash, or WAD (Whiplash Associated Disorders), refers to a neck injury where the normal range of motion is exceeded, resulting in injury to the soft-tissues (hopefully with no fractures) in the cervical region. There are a LOT of factors involved that enter into the degree of injury and length of healing time. Let’s take a closer look!

Picture the classic rear-end collision. The incident itself may be over within 300 milliseconds (msec), which is why it’s virtually impossible to brace yourself effectively for the crash as a typical voluntary muscle contraction takes two to three times longer (800-1000 msec) to accomplish.

In the first 50 msec, the force of the rear-end collision pushes the vehicle (and the torso of the body) forwards leaving the head behind so the cervical spine straightens out from its normal “C-shape” (or lordosis). By 75-100 msec, the lower part of the neck extends or becomes more C-shaped while the upper half flexes or moves in an opposite direction creating an “S” shape to the neck. Between 150-200msec, the whole neck hyper extends and the head may hit the head rest IF the headrest is positioned properly. In the last 200-300 msec, the head is propelled forwards into flexion in a “crack the whip” type of motion.

Injury to the neck may occur at various stages of this very fast process, and many factors determine the degree of injury such as a smaller car being hit by a larger car, the impact direction, the position of the head upon impact (worse if turned), if the neck is tall and slender vs. short and muscular, the angle and “springiness” of the seat back and relative position of the headrest, dry vs. wet/slippery pavement, and airbag deployment, just to name a few.

Some other factors that can predict recovery include: limited neck motion, the presence of neurological loss (nerve specific muscle weakness and/or numbness/tingling), high initial pain levels (>5/10 on a 0-10 scale), high disability scores on questionnaires, overly fearful of harming oneself with usual activity and/or work, depressive symptoms, post-traumatic stress, poor coping skills, headaches, back pain, widespread or whole body pain, dizziness, negative expectation of recovery, pending litigation, catastrophizing, age (older is worse), and poor pre-collision health (both mental and physical).

Research shows the best outcomes occur when patients are assured that most people fully recover and when patients stay active and working as much as possible. Studies have shown it’s best to avoid prolonged inactivity and cervical collars unless under a doctor’s orders. It’s also a good idea to gradually introduce exercises aimed at improving range of motion, postural endurance, and motor control provided doing so keeps the patient within reasonable pain boundaries. Chiropractic manipulation restores movement in fixed or stuck joints in the back and neck and has been found to help significantly with neck pain and headaches, particularly for patients involved in motor vehicle collisions. A doctor of chiropractic may also recommend using a cervical pillow, home traction, massage, and other therapies as part of the recovery process.

It is important to be aware that fear of normal activity and not engaging in usual activities and work can delay healing and promote chronic problems and long-term disability. It’s suggested patients avoid opioid medication use due to the addictive problems with such drugs. Ice and anti-inflammatory herbs or nutrients (like ginger, turmeric, and bioflavonoids) are safer options. Your doctor of chiropractic can guide you in this process!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.