Understanding Whiplash Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance.  The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.  The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  Join us next month when we specifically take a closer look at the treatment and prevention of whiplash injuries.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

The Chiropractic Patient Experience

By Dr. John A. Papa, DC, FCCPOR(C)

 

In last week’s article “An Introduction to Chiropractic Care”, we specifically focused on the training and education of chiropractors, regulation of chiropractic, and the scope of chiropractic care.  This article will focus on the chiropractic patient experience written specifically from the author’s perspective of what patients experience at his private practice.  Individual chiropractic experiences may vary in different chiropractic settings dependent on practitioner interests, experience, education, and training.

 

Chiropractors provide diagnosis, treatment and management of disorders arising from the musculoskeletal system (joints, muscles, tendons, nerves, and bones), such as back pain and neck pain.  Before any treatment is commenced on a prospective chiropractic patient, there are several steps that are taken to ensure the case is one that can be helped with chiropractic care.

 

First, a thorough Medical History is taken which documents an individual's specific complaint and may also include questions concerning past surgeries and illnesses, medication use, general and family health history.  Second, a Physical Examination is performed consisting of orthopedic, neurological, and range of motion testing.  X-rays may also be ordered to help determine the source of pain or dysfunction.  Third, a Diagnosis and Prognosis is provided to the patient to let them know if their complaint(s) can benefit from chiropractic care.  If the complaint will not benefit from chiropractic care, a referral is made to the appropriate health discipline.

 

For all complaints that may benefit from chiropractic care, a proposed treatment plan is communicated to the patient, including type of treatment and duration.  Factors taken into consideration when developing a treatment plan for a particular individual include age, sex, severity and duration of complaint, lifestyle and environmental factors, physical health and fitness, medication use, and any other relevant health conditions.  In addition, factors relating to patient concerns and preferences are also taken into account, because patients always have a choice as to the type of care they wish to receive.

 

Chiropractors are trained to offer multi-modal physical therapy incorporating the use of different techniques commonly employed in combination with each other to decrease pain, stimulate healing, and restore overall function.  Chiropractic adjustments and mobilizations are just one mode of therapy utilized by chiropractors (but not with every patient), to restore normal motion and functioning in joints.  Soft tissue therapy is used to alleviate muscle spasm, decrease scar tissue, and increase pain free ranges of motion.  Electrotherapy involves the application of relaxing therapeutic electrical current or sound waves to the area of injury, dysfunction, or pain (i.e. TENS, interferential current, ultrasound).  Acupuncture can be used to promote healing, decrease pain, and control inflammation.  Rehabilitative exercise prescription may also be used to improve balance, coordination, strength, flexibility, and posture.

 

Contemporary chiropractic care provides many options for prospective and current patients seeking effective and safe therapy for their musculoskeletal complaints.  Additional chiropractic resources can be found at:  (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

 

Prepare To Avoid A Fall

By Dr. R. Greg Lusk, DC

As a father of 2 young children, aged 5 and 2, you can imagine that my house is always tidy and perfect.  Wait a second, that's only what it looked like in that magazine I was reading.  Instead, you will more realistically see dinky cars and dolls scattered across the floors and over furniture.  Often it feels like a mine field where I'm tip-toeing around items to avoid suddenly performing the splits after planting my foot on a car that blasts off as if in a drag race.  While I may, at least in my mind, still possess cat-like reflexes, the reality is that I'm getting a year older every year and my athletic prime is behind me.  With that in mind, I'm aware that falling is becoming a more likely possibility.

 

Particularly if you are over the age of 65, falling is common as one in three Canadians in this age group falls annually.  Often a serious injury results such as a wrist or hip fracture and these injuries can create a cascade of other health issues, in addition to a loss of independence.  Fortunately, there are a number of things you can do to reduce your risk.

 

Modifying your environment is a place to start, especially your home as that is where most falls occur.  Bathrooms, not surprisingly, pose risk due to wet surfaces and the transfers that occur in and out of the tub or on and off the toilet.  Investing in non-slip mats, grab bars, and a raised toilet seat can go a long way.  In the kitchen, swapping out loose mats for those with non-slip backing is helpful.  It is important to not use chairs or stools as an unstable ladder but instead have a footstool handy.  Better yet, keep everyday items in low cupboards and easily accessible so you don't need to use one at all.  Remember, your agility is likely not what it used to be.

 

The stairs are also a common problem area.  Keep them free of clutter, ensure there is no loose carpeting, and consider installing non-slip strips at the edge of each step.  Hand rails on either side are advisable and having ample lighting is important to increase awareness of any trip hazards.  Be careful when carrying items, such as full laundry baskets, as they reduce your visibility and steal at least one hand away from the handrails.  To make things easier, consider more trips with smaller loads.  It may take a little longer but if you change your mindset, you can become appreciative of the extra exercise.

 

An increased need to use the washroom, particularly at night, is another common reality of getting older.  Therefore, it is important that the path from your bedroom to the bathroom is clear and well lit with nightlights.  Finally, when outside the house, having salt or sand handy for dealing with ice and keeping paths clear of debris is recommended.

 

Taking care of yourself is also very important.  This can include improving your strength and balance with regular exercise, having eye and ear exams every 1-2 years, reviewing medications/supplements with your MD or pharmacist for potential side effects or interactions, eating and drinking regularly to minimize episodes of dizziness and weakness, and wearing good shoes and slippers with non-slip soles.

 

Having a fall doesn't need to be part of your aging experience.  Take action to improve your confidence.  This article is for general information purposes only and is not to be taken as professional medical advice.

Understanding Neck Pain

By Dr. John A. Papa, DC, FCCPOR(C)
 

Neck pain is a widespread experience among the general population, with 30-50% of adults reporting pain symptoms at any given time.  Once an episode of neck pain happens, most individuals will find it is a persistent or recurrent condition.  The purpose of this article is to outline our current scientific understanding of neck pain.

 

The cause of neck pain is usually multi-factorial, meaning that there is usually no single cause.  Factors such as overall physical and mental health, along with work and daily activities are just a few factors that can contribute to the development of neck pain.  Most causes are not the result of serious injury or disease.

 

Neck pain can affect people in different ways and is usually classified into the following categories:

 

GRADE 1: Neck pain with no signs or symptoms suggestive of major structural pathology, and little or no interference with daily activities.

 

GRADE 2:  Neck pain with no signs or symptoms suggestive of major structural pathology that limits daily activities.

 

GRADE 3:  Neck pain with no signs or symptoms suggestive of major structural pathology, with presence of neurologic signs of nerve compression (i.e. radiculopathy or "pinched nerve") and may include pain, weakness and/or numbness in the arm.

 

GRADE 4:  Neck pain with signs or symptoms suggestive of serious structural pathology (i.e. tumor, fracture, infection, systemic or visceral disease).

 

Evaluation of neck pain should include a proper medical history, along with a physical examination consisting of inspection, range of motion testing, and palpation for tenderness, along with strength, neurological, orthopaedic and functional testing.  Diagnostic tests such as x-rays, CT or MRI scans are only required in a minority of cases.

 

The majority of neck pain is classified as Grade 1 or 2.  There is scientific evidence to support the following treatments for Grades 1 and 2 neck pain: education, exercise, mobilization, manipulation, acupuncture, soft tissue therapy, and analgesics.  Conservative treatment of Grade 3 neck pain should proceed with caution.  The majority of Grade 4 neck pain will require specialty medical management.

 

Due to the persistent and recurring nature of neck pain, individuals need to have realistic expectations when addressing their symptoms as pain relief is often modest and short-lived.  The scientific literature does not identify any “best” treatment that is effective for everyone.  Trying a variety of therapies or combination of therapies may be required to find relief and help manage neck pain.  It is important that individuals play an active role in managing their symptoms by participating in their usual daily activities as tolerated, exercising, and reducing mental stress.

 

Most people can expect to experience some neck pain in their lifetime that may or may  not limit daily activities.  For those with neck pain that may be interfering with their activities of daily living, a qualified health professional can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Understanding Whiplash Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance.  The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.  The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  Join us next month when we specifically take a closer look at the treatment and prevention of whiplash injuries.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

The Chiropractic Patient Experience

By Dr. John A. Papa, DC, FCCPOR(C)

 

In last week’s article “An Introduction to Chiropractic Care”, we specifically focused on the training and education of chiropractors, regulation of chiropractic, and the scope of chiropractic care.  This article will focus on the chiropractic patient experience written specifically from the author’s perspective of what patients experience at his private practice.  Individual chiropractic experiences may vary in different chiropractic settings dependent on practitioner interests, experience, education, and training.

 

Chiropractors provide diagnosis, treatment and management of disorders arising from the musculoskeletal system (joints, muscles, tendons, nerves, and bones), such as back pain and neck pain.  Before any treatment is commenced on a prospective chiropractic patient, there are several steps that are taken to ensure the case is one that can be helped with chiropractic care.

 

First, a thorough Medical History is taken which documents an individual's specific complaint and may also include questions concerning past surgeries and illnesses, medication use, general and family health history.  Second, a Physical Examination is performed consisting of orthopedic, neurological, and range of motion testing.  X-rays may also be ordered to help determine the source of pain or dysfunction.  Third, a Diagnosis and Prognosis is provided to the patient to let them know if their complaint(s) can benefit from chiropractic care.  If the complaint will not benefit from chiropractic care, a referral is made to the appropriate health discipline.

 

For all complaints that may benefit from chiropractic care, a proposed treatment plan is communicated to the patient, including type of treatment and duration.  Factors taken into consideration when developing a treatment plan for a particular individual include age, sex, severity and duration of complaint, lifestyle and environmental factors, physical health and fitness, medication use, and any other relevant health conditions.  In addition, factors relating to patient concerns and preferences are also taken into account, because patients always have a choice as to the type of care they wish to receive.

 

Chiropractors are trained to offer multi-modal physical therapy incorporating the use of different techniques commonly employed in combination with each other to decrease pain, stimulate healing, and restore overall function.  Chiropractic adjustments and mobilizations are just one mode of therapy utilized by chiropractors (but not with every patient), to restore normal motion and functioning in joints.  Soft tissue therapy is used to alleviate muscle spasm, decrease scar tissue, and increase pain free ranges of motion.  Electrotherapy involves the application of relaxing therapeutic electrical current or sound waves to the area of injury, dysfunction, or pain (i.e. TENS, interferential current, ultrasound).  Acupuncture can be used to promote healing, decrease pain, and control inflammation.  Rehabilitative exercise prescription may also be used to improve balance, coordination, strength, flexibility, and posture.

 

Contemporary chiropractic care provides many options for prospective and current patients seeking effective and safe therapy for their musculoskeletal complaints.  Additional chiropractic resources can be found at:  (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Understanding Whiplash Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

 

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance. The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.  The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  Join us next time when we specifically take a closer look at the treatment and prevention of whiplash injuries.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

The Chiropractic Patient Experience

By Dr. John A. Papa, DC, FCCPOR(C)

In last week’s article “An Introduction to Chiropractic Care”, we specifically focused on the training and education of chiropractors, regulation of chiropractic, and the scope of chiropractic care. This article will focus on the chiropractic patient experience written specifically from the author’s perspective of what patients experience at his private practice. Individual chiropractic experiences may vary in different chiropractic settings dependent on practitioner interests, experience, education, and training.

Chiropractors provide diagnosis, treatment and management of disorders arising from the musculoskeletal system (joints, muscles, tendons, nerves, and bones), such as back pain and neck pain. Before any treatment is commenced on a prospective chiropractic patient, there are several steps that are taken to ensure the case is one that can be helped with chiropractic care.

First, a thorough Medical History is taken which documents an individual's specific

complaint and may also include questions concerning past surgeries and illnesses, medication use, general and family health history. Second, a Physical Examination is performed consisting of orthopedic, neurological, and range of motion testing. X-rays may also be ordered to help determine the source of pain or dysfunction. Third, a Diagnosis and Prognosis is provided to the patient to let them know if their complaint(s) can benefit from chiropractic care. If the complaint will not benefit from chiropractic care, a referral is made to the appropriate health discipline.

For all complaints that may benefit from chiropractic care, a proposed treatment plan is communicated to the patient, including type of treatment and duration. Factors taken into consideration when developing a treatment plan for a particular individual include age, sex, severity and duration of complaint, lifestyle and environmental factors, physical health and fitness, medication use, and any other relevant health conditions. In addition, factors relating to patient concerns and preferences are also taken into account, because patients always have a choice as to the type of care they wish to receive.

Chiropractors are trained to offer multi-modal physical therapy incorporating the use of

different techniques commonly employed in combination with each other to decrease pain, stimulate healing, and restore overall function. Chiropractic adjustments and mobilizations are just one mode of therapy utilized by chiropractors (but not with every patient), to restore normal motion and functioning in joints. Soft tissue therapy is used to alleviate muscle spasm, decrease scar tissue, and increase pain free ranges of motion. Electrotherapy involves the application of relaxing therapeutic electrical current or sound waves to the area of injury, dysfunction, or pain (i.e. TENS, interferential current, ultrasound). Acupuncture can be used to promote healing, decrease pain, and control inflammation. Rehabilitative exercise prescription may also be used to improve balance, coordination, strength, flexibility, and posture.

Contemporary chiropractic care provides many options for prospective and current patients seeking effective and safe therapy for their musculoskeletal complaints. Additional chiropractic resources can be found at: (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).

This article is a basic summary for educational purposes only. It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.