Whiplash – The Cause of Pain

To download a copy of this newsletter, please click here.

Houston Chiropractor Comments: Many patients ask the question: “…why do I hurt so much now, and hardly hurt at all right after the accident?”  Another common question is: “…why neck pain after a minor car collision can last so long?”

 

Whiplash Cause of PainA study that investigated chronic pain and dysfunction in whiplash cases reported a soft tissue origin for injuries associated with low-speed collisions. This means the pain comes from the muscles, ligaments, joint capsules, the disk, but not from a pinched nerve that would send pain down the arm and/or create hand numbness or grip weakness.  The study also reported the point at which the neck buckles would only take one fifth to one-fourth of the weight of the person’s head (approximately 2.5 to 3 pounds) if one were to remove all of the supporting muscles, ligaments, and joint capsules.  With the muscles and soft tissues intact, there is a very complex buckling pattern that occurs in the neck during most rear-end collisions where the lower half of the neck bends opposite to that of the upper half creating an S-shaped curve (when looking at the neck from the side).  When this occurs, the vertebrae in the lower half of the cervical spine extend backwards while the upper half flex forwards, stretching the ligaments beyond the maximum elastic point and tissue tearing occurs. When ligaments stretch or strain, microscopic tearing starts at only 3-5% of tissue strain and when the strain reaches 7-8%, the ligament begins to lose its load carrying capacity and more significant tearing occurs.  Unfortunately, none of this can be seen on a standard x-ray and usually goes undiagnosed.

 

Many variables exist that make assessing the amount of tissue damage difficult to predict or understand.  One of these variables is the strength and amount of elasticity of a ligament prior to tearing. Also, the age, gender, and phenotype – that is, skinny, normal, or over weight – makes a difference.  Generally, due to a reduced muscle mass in a female compared to most males, women are at greater risk of injury.  The position of the person in the car, whether a seatbelt was used or not, if the head was turned before impact, if the collision was anticipated prior to impact, the speed at which one person compared to another can voluntarily contract a muscle are all additional factors affecting the degree of injury and corresponding pain.  Another factor is the size of the spinal canal (the place where the spinal cord runs from the brain to the low back) as some people are born with narrow canals, making them more susceptible to injury. Other neurological variables include the degree of the excitability of the nervous system as the more excitable, the lower the pain threshold and pain is perceived more quickly. The type of pain from the deep tissues (ligaments, joint capsules, etc) is different than pain arising from superficial tissues as the former lasts longer and doesn’t follow known neurological pathways into an arm.  Also, over time, if pain becomes chronic (pain lasting >3 months), a significantly lower pain threshold is found in these cases vs. normal control subjects.

 

Hence, when discussing your case with our office, it is important that you share your history of the accident, the time it took after the impact for symptoms to be initially noted, whether it is gradually worsening over time, and any other symptom that is unique to your situation that may not have been discussed here.

 

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with the best chiropractor in Houston or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!

 

 

Oh, My Aching…Leg?

NASA Area Chiropractor Comments: Certain low back conditions give rise to more than just low back pain. For example, leg pain can be more intense than low back pain, even though the cause of the leg pain is coming from the low back.  When this happens, many patients complain that they have “sciatica,” which refers to radiating pain that starts in the low back and extends down into the leg.  When the intensity of leg pain is worse than the low back, it can make patients wonder, “…where is my problem really coming from?”

Leg Pain

To understand this better, a short “anatomy lesson” is appropriate. The spine can be divided into two halves, front and back. The structures in the front half include the larger, heavier bones called vertebral bodies and the shock absorbing cushions that lie between the vertebral bodies called the intervertebral disks.  The disk is like a jelly donut where the center is liquid-like and the outer portion is a tough, criss-cross pattern cartilage arranged like the rings on a tree stump. There are also ligaments that hold the vertebrae and disks tightly together. The back half of the spine includes the spinal cord, nerve roots, as well as the small joints of the back called facet joints.  Every movable joint has a joint capsule that helps lubricate the joint and limits the amount of movement, along with surrounding ligaments.  The larger, heavier vertebral bodies and shock absorbing disks carry the majority of the weight (approximately 80%) while the smaller facet joints carry much less weight (only 20%) but are more responsible for guiding the movements of our back.

 

When leg pain is present, it can be caused by either a pinched nerve, or, an inflamed facet joint.

 

When a nerve is pinched, the cause is usually from the intervertebral disk where the jelly-like center leaks out and presses on the nerve that goes down the leg, commonly referred to as a “herniated disk with sciatica.” This type of pain is quite specific, easy to describe and often extends below the knee to the ankle or foot.  It can include muscle weakness, numbness in certain areas of the leg, and bending forward increases low back and leg pain while bending backwards reduces the leg pain (and sometimes the LBP).

 

When a facet joint capsule tears (technically, called a “sprain”), the pain is “referred” down the leg in a generalized, non-specific manner, usually described as a “deep ache,” often hard to describe and usually does not go below the level of the knee. Here, it feels better to bend forward and worse to bend backwards, of which neither movement changes or affects the leg in a specific way.  Disk related leg pain carries a potential for surgery if all non-surgical approaches fail, while facet joint referred leg pain rarely requires invasive treatments or surgery.

 

The good news is that both of these sources of low back and leg pain are very treatable with chiropractic care!  The important point to remember is that obtaining prompt treatment, when symptoms first appear is best – as waiting and hoping it will subside on its own often results in a longer treatment course and is less satisfying for all concerned.

 

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!

Headaches and Posture

To download a copy of this week’s newsletter, please click here.

Houston Area Chiropractor Comments: Have you ever glanced at your reflection in a storefront window or mirror as you walked by and noticed your posture?  Scary, isn’t it?  We all know that we should stand up straight but we soon forget when we get busy and stop thinking about it.

Poor posture is often due to years of standing slouched and this bad “habit” usually starts at a young age.  Just look around when you’re in an airport or shopping mall and notice the many people Headaches Posturehave poor posture.  In fact, people’s posture may reflect their attitude – if they’re happy, sad or depressed.  Poor posture may be related to self-consciousness, especially during adolescence.  It is also genetic as we frequently see a “trait” throughout family members with similar postural tendencies.

The most common postural fault associated with headaches is the forward based head and shoulders.  From the side, it appears that the head is significantly forward relative to the shoulders, the upper back is rounded forward and the shoulders are rolled forwards and rotated inward.  One exercise that helps reduce this postural bad habit is tucking in the chin and pretending a book is balancing on top of the head.  The objective is to not allow the book to slide forward off your head and land on your toes!

It takes approximately 3 months of CONSTANT self-reminding before the new “good habit” posture becomes automatic, so be patient.  Soon you’ll “catch yourself doing it right” without thinking about it.

Frequently, posture is faulty lower down the “kinetic chain.” The first link of the chain is the feet and the last link is the head. Since we stand on two feet, any change in that first link or the feet, can alter the rest of the chain, especially areas furthest away – the head, resulting in headaches. For example, if one leg is short, the pelvis drops, the spine shifts (scoliosis), the shoulder drops and the head shifts trying to keep the eyes level. A short leg usually needs to be managed with a heel lift, an arch support or combination of both to properly treat the headache patient.

Most health care providers EXCEPT Chiropractic Physicians typically ignore these issues. Chiropractic Doctors are specifically trained to analyze posture and correct it. You can depend on our clinic for up-to-date treatment approaches such as these.

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!

Headaches and Different Management Options

To download a copy of this newsletter, please click here.

Houston Chiropractor Comments: Headaches are one of the more common conditions that enter the offices of primary care physicians, including chiropractors.  The standard medical treatment revolves around the use of medications and/or injections.  The standard chiropractic treatment approach includes manual therapies that may include spinal manipulation or adjustments, manual or mechanical cervical traction, mobilization techniques, trigger point therapy, physical agents or modalities such as electrical stimulation, ultrasound, etc., and nutritional counseling.  While both approaches have their pros and cons, there are far less side effects associated with the chiropractic treatment option.headache management

Headaches can generally be classified as primary or secondary. Primary Headaches include Migraine, Tension, and Cluster. Secondary headaches occur because another condition or injury is present such as after a car accident or slip and fall injury, due an infection, a sinus, jaw, and/or dental condition, a vascular injury such as stroke, a medication side effect, psychiatric disorder and others.

Treatment for patients with headaches is dependent on the cause.  Choosing a type of health care service for the treatment of headache can be a difficult choice.  When considering the use of complementary and alternative medical approaches available to patients with chronic tension-type headaches, a recent report revealed that 40% of 110 patients surveyed utilized some form of an alternative/complementary medical approach.  The most frequently utilized was chiropractic (21.9%), followed by acupuncture (17.8%), and massage therapy (17.8%).

If you find yourself frequently utilizing over-the-counter medications such as an anti-inflammatory drugs (ibuprofen: Advil, Nuprin; Naprosyn such as Aleve) or Tylenol, it is probable that the chiropractic management approach will benefit your headache condition.

Frequently, in patients with headaches, the vertebrae in the upper neck lose their normal range of motion and the muscles in that region that attach to the base of the skull become overly tight and squeeze or compress the nerves that feed into the head.  This results in radiating pain over the top or around the head, sometimes into the eyes.  Chiropractic care can make it easier for you to move your head and neck forwards, back, rotate or twist, and side bend.  This, in turn reduces the muscle tension and nerve pinching, which reduces headache pain.

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!