Car Crashes And Back Pain
If a person is involved in an automobile crash, they may very well experience sudden pain in their neck or back. Some individual's pain will heal naturally, on its own. Others may require treatment to bring pain relief. What may not be apparent is that those involved in a motor vehicle collision may be more likely to have spinal pain in the future. This article discusses auto crash spinal injuries, some recent research about the subject and possible treatment options.
There are various types of motor vehicle collisions. Some are where an unaware person's vehicle is struck from behind and they suffer the classic "whiplash" injury to the neck. Others may be where the driver and occupants are aware of an impending impact, they brace themselves but spinal injuries to the neck and back still occur. Regardless of the type of accident it is possible that those involved will experience some spinal pain.
When the human body is subjected to trauma from an automobile crash several mechanisms of spinal injury occur. Let's discuss what happens on an anatomical level. Ligaments are tough, fibrous tissues that attach from one bone to another. They allow movement of the bones but should not allow excess movement. If one imagines a guy wire stabilizing a utility pole this would be a good analogy to the human body's ligamentous structures.
In an automobile accident, ligaments can be sprained. A sprain is simply tearing of fibers. Sprains are mild tearing, moderate tearing or severe tearing with a ligament is fully ruptured. If ligaments are damaged, they may not heal with normal tissue but, may partially heal albeit with weaker scar tissue embedded in the ligamentous structure.
Weak, damaged ligaments allow excess motion between the bones of the spine which are also called vertebrae. Excess movement between two bones is called hypermobility. Hypermobility over months and years causes wear and tear which is known as spinal degeneration.
On an x-ray, spinal degeneration shows as bone on bone narrowing of disc spaces and bone spurs. This is a classic, objective sign of degeneration of the spine.
A recent scientific journal, Accident Analysis & Prevention, May 2020 noted systematic research review discovered that individuals involved in a motor vehicle collision may be more likely to develop back pain in the future than those who have not been in a car accident.
Doctors of chiropractic, are trained to evaluate and effectively treat musculoskeletal injuries caused by motor vehicle accidents. Upon visiting a chiropractor, the patient can expect to be asked questions about their injuries, pain, and the details about the car crash itself. Next a physical examination will determine if a patient has objective signs such as muscle spasm, range of motion limitations of the neck or lower back and other neuromusculoskeletal tests. Many times, imaging such as x-rays and MRIs are obtained.
If it is determined that chiropractic care is appropriate, the chiropractor will commence with the necessary treatment to best help the patient recover from their neck and back discomfort. Chiropractic care may make the difference between successful back and neck pain relief and long-term healing of the spine, versus those developing chronic, painful, spinal pain from not receiving proper care.
How Do Chiropractors Provide Shoulder Pain Relief
When people find I am a chiropractor they usually imagine me helping neck pain and back pain. Research strongly supports chiropractic care for back and neck pain relief. But what about chiropractic care for shoulder pain relief?
This article will provide information for those suffering from shoulder pain. The anatomy and function of the shoulder will be discussed, research noting scientific evidence for treatment of pain of the shoulder will be introduced and chiropractic care for the evaluation and treatment of shoulder pain will be presented.
When evaluating for shoulder pain it is important to examine the whole person. The human shoulder is a complex mechanism. To be accurate we should consider the entire shoulder girdle which is made up of three different joints. The first is the ball and socket joint which is called the glenohumeral joint. It consists of the bone of the upper arm called the humerus and the wing bone which is called the scapula. The second is the acromioclavicular or AC joint. It is on the top of the shoulder and when significantly damaged the diagnosis is a "separated shoulder." Last is the scapulothoracic joint which is the movement of the scapula/wing bone along the back of the rib cage.
Additionally, it is prudent to perform analysis of the spinal bones of the neck and upper back. Misalignments and improper movement of the spinal bones are commonly associated with those with shoulder pain complaints.
Chiropractors look to restore normal movement and function to the joints of the shoulder and spine by use of various manipulative and mobilization techniques. Chiropractic care may also include exercise training focused on restoring motion, strength and stability of the muscles and soft tissues surrounding the shoulder region.
In 2010 and 2014 the United Kingdom published research of various forms of treatment for musculoskeletal problems. These reviews noted there is favorable scientific evidence for the use of chiropractic treatment with regards to shoulder related problems including rotator cuff pain, shoulder girdle pain/dysfunction and adhesive capsulitis (frozen shoulder).
Many times, in my practice, patients suffering from shoulder pain will come to me after they've seen other providers. Frequently, these providers are specialists. Since they only specialize in evaluation of the shoulder their focus is narrow in the only concentrate on the glenohumeral joint. As mentioned earlier, evaluation needs to be expanded in the whole person must be taken into consideration. When this approach is taken success can usually be achieved in providing relief of shoulder pain.
Conservative Hip Pain Relief
As a chiropractor, when I ask people to point to their hip pain it is very interesting to see the vast number of places where people point-- the low back, the hip pocket area, the side of the pelvis, in the groin and more!
This article will provide information about the human hip, some sources of pain of the hip and introduce ideas pertaining to conservative hip pain relief treatment.
The true hip joint is a ball and socket joint located on either side of our pelvis. The ball part of the joint is from the top of the thigh bone, called the femur. The socket part of the joint is an indentation of the side of the pelvis. The hip joint is the largest joint of the body. It is one of the few joints that moves in every direction.
The ball of the joint is held into the socket by strong ligaments. It is also held against the socket by a structure called the labrum. The labrum is a rubbery tissue that forms a rim around the outer edge of the socket. Sometimes hip pain can be attributed to a tear of the labrum. This may be seen on an MRI. However just because the MRI shows a tear, it doesn't necessarily determine it is the source of pain of the hip. In fact, a research study showed that 66% of a group of people having no hip pain, who underwent MRIs were diagnosed by certified radiologists as having labral tears. Again, these people had no hip pain!
Closely associated with the hip joint are the bones of the pelvis. The pelvis is not just one bone, but is made up of three. The two outside "wing" bones are called the iliac bones. The centrally located "tailbone" is called the sacrum. The joints between the sacrum and either iliac bone are called the sacroiliac joints. These joints are gliding joints, but sometimes they can become misaligned or move improperly. This can cause the pelvis to have improper, altered alignment and/or movement biomechanics. This can cause pain of the sacroiliac joints and can cause associated pain in the hip joints.
Some orthopedic hip specialists may only focus on the hip joint itself when the patient has pain in this area. However, doctors of chiropractic, look at the entire person having hip pain. Chiropractors are trained to identify the origins of hip pain which may arise from the lower back, pelvis, hip, or possibly the knee, ankle and foot. Utilizing information from a careful history, examination, imaging (when appropriate), and functional tests, allow chiropractors to offer a noninvasive, nonsurgical, safe, conservative approach to relief of hip pain.
I Can't Believe My Shoulder Bursitis Is Coming From My Neck!
As her treatment progressed and her shoulder bursitis improved, Linda a patient in my chiropractic office, said: "I can't believe my shoulder bursitis is coming from my neck." She was surprised that chiropractic adjustments to correct misalignments of the spinal vertebrae in her neck was helping her chronic shoulder bursitis to improve. While Linda was the first patient to express herself in the way she did, she was by no means the first patient I'd had whose shoulder problem was improved by correcting spinal problems in the neck.
This article will discuss how chiropractic care can help shoulder problems, such as bursitis to improve. It will also introduce scientific research detailing a recent study of patients experiencing shoulder pain who benefited from chiropractic care.
A short, simple discussion of the anatomy of the shoulder will be helpful in understanding the condition of shoulder bursitis. To begin, a bursa is analogous to a water-filled balloon with a tough skin. We have bursas in many areas of our body. Correspondingly, they come in various shapes and sizes. Bursas keep two structures of the body from rubbing against each other. The bursa in the shoulder is called the subacromial bursa. It keeps a tendon from directly rubbing against a bone. Under normal conditions the bursa does its job day in and day out without causing any pain. However, when the bursa gets irritated it becomes inflamed. When something in the body is inflamed we use the suffix "-itis." This is how the term "bursitis" is derived.
Chiropractors are always interested in what might be the cause of a particular health condition. It is very uncommon for a shoulder bursa to spontaneously become inflamed. So, it is important that we look at several other areas of the body as to the source and cause of the shoulder bursitis. Anything that would cause an abnormal pressure, compression or wear of the shoulder bursa might be the culprit.
We all know that there are many muscles involved with the movements of the shoulder joint. If those muscles are causing improper movement of the joint of the shoulder it can create an abnormal wear and strain of the subacromial bursa. However, once again, we must ask what might be causing the muscles to malfunction. This is where we can track the source of the problem back to the neck. The bones of the neck are called the cervical spinal vertebrae. These vertebrae protect the nerves of the spinal cord and allow spinal nerves to exit the spine to various areas of the body including the muscles of the shoulder.
If the spinal vertebrae are misaligned and moving improperly it can irritate or pinch spinal nerves. Those nerves innervate the muscles of the shoulder joint. If the nerves are sending improper signals to the muscles those muscles can cause the shoulder joint to move improperly and abnormally. This can create abnormal stress and wear upon the shoulder bursa, which leads to bursitis.
A scientific research study in the Journal of Back in Musculoskeletal Rehabilitation, September 2019 notes that when subacromial impingement syndrome occurs it can lead to pain, weakness and reduced range of motion in the shoulder. In a study involving 26 patients with acute subacromial impingement syndrome, researchers observed that those treated with manual therapy for four weeks experienced a significant improvement with respect to pain, function and range of motion.
Doctors of Chiropractic tend to look at the whole picture. Chiropractors examine not only the shoulder but the entire shoulder girdle and the cervical spine. Sometimes specialists such as an orthopedic practitioner might be too specific and only look at the shoulder joint. I've seen many cases where an orthopedic specialist gave a steroid injection into the shoulder bursa to reduce inflammation. A significant amount of the time this will give short-term pain relief but once the medication wears off the pain returns because the cause of the condition has not been corrected.
When misalignments or improper movement of the cervical spinal vertebrae are present, they must be corrected to eliminate the cause of the problem and commence healing. As a chiropractor I provide gentle, safe adjustments to the cervical spine to correct abnormalities. I will also utilize physical therapies such as electrical muscle stimulation, cold pack therapy and rehabilitative exercises to assist the bursa and the shoulder girdle to heal as quickly as possible.
By looking at the big picture and examining all significant aspects of a patient, chiropractors are able to help the majority of those suffering from shoulder bursitis.
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