Short North Accident Injury Care

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Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call 614 299 9797 to make an appointment.

In my  Short North, Columbus,this discussion is designed to address the soft tissue personal injury case and to offer what we consider are reasonable points of view which are supportable in the literature when possible.
In our experience, failure to follow a reasonable approach often leads to close scrutiny of the claim. It is our hope this discussion will bring the two different levels of expectation a bit closer and result in a higher level of cooperation between the two sides.
Additionally, if the case you manage as the treating practitioner can pass through the medical/legal system, your relationship with the plaintiff attorney can only flourish.
However, if the attorney representing the patient loses a potential award as a result of many of the topics mentioned in this article, how likely could an expanding relationship be?

Scope of Care in Personal Injury Cases
Obviously, the correct diagnosis is paramount in treating any patient following trauma. We will assume, for the purposes of this discussion, the case being treated represents an uncomplicated soft tissue injury. Specifically, injuries that are absent fractures neurological deficits, dislocations, disc herniations or vascular complications.
Treatment rendered for these injuries should represent the standard of care for the geographic area serviced.
The “scope of practice” or treatment rendered should be designed to make passage through the medical/legal system easier. For example, performing reflexology on a patient’s feet for cervical spine injuries will draw more attention than the well accepted treatment course of manipulation, moist heat, ice, ultrasound, and other therapies.
This is not to say that payment will be denied, but the road to reimbursement and settlement would be much easier if a more traditional approach to care is rendered.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call 614 299 9797 to make an appointment.

An Introduction to Outcome Assessment(Part 3)
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Mark van Hemert, DC, DACS

In my  Short North, Columbus,1992, David Chapman Smith, commission counsel to the Mercy guidelines, stated: “There must be a better method of judging whether a patient’s condition or health status has changed, one that has scientific credibility, can withstand scrutiny by others, and provides strong evidence of good outcomes appropriateness and quality of care.”

The use of outcome assessments is imperative for the practicing clinician. Only by objective documentation of improvement can the attending physician prove that his care was therapeutically necessary; thereby staving off the onslaught of critical opinions by claims adjudicators of third party payers, insurance medical examinations, retroactive governmental utilization reviews and defense attorneys.

The Mercy Conference guidelines defines “outcome assessment” as a procedure or method of measuring a change in patient status over time, primarily to evaluate the effect of the treatment.

The Mercy guidelines go on to list the benefits of implementing outcome assessment into one’s practice procedures for they can:
•    document improvement to the patient, doctor, and third parties;
•    consistently evaluate the effect of care over time;
•    suggest modifications of the goals of treatment if necessary;
•    help indicate the point of maximum therapeutic improvement;
•    justify the type, dose, and duration of care.

(Mercy, chapter 10, page 8.)
This list closely mirrors the points the IME focuses on in delivering his professional opinion. The accumulation of the patient’s objective outcome assessment data during the course of care, will provide the information necessary to make these critical clinical determinations in the medical legal case.

This will individualize you opinion concerning the course of care and the length of care. Treating every patient plan as a continual living, analyzing and ongoing evaluation process.

The RAND study, “Appropriateness of Spinal Manipulation for Low-Back Pain,” makes this statement on treatment duration: “No scientific evidence in the literature supports any of the treatment durations for different indications that have been proposed.”

Using objective outcome assessment data that Mercy rates as established and necessary in your clinical examinations, will result in clinical decisions that are defensible against review professional opinion will determine the therapeutic necessity of care rendered.

My vision is to give the practicing chiropractor the knowledge and expertise to provide to every patient the care they deserve, and to provide objective evidence for every patient and their third-party carrier for reasonable and necessary care; thereby creating an analysis system that is fair to all concerned parties.

In future articles, we will discuss how to use the latest technology to gather objective data. It is important to use the guidelines as an authority not only to guide your practice, but to insist that the IME also follow the same standard.

Mark van Hemert, DC, DACS

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

Whiplash Accidents Injuries Treated,  Short North, Columbus, Ohio Call 614 299 9797 to make an appointment.

In my  Short North, Columbus,it is reasonable to assume the injured tissues will necessitate a higher frequency of care during the initial stages of injury. This is due to the fact that the patient’s subjective complaints are often at or near their zenith during the first week after the accident.

The injured tissues swell to their greatest degree during this time; thus, the level of the patient’s complaints. As the injuries enter the subacute and chronic stages, it is reasonable to assume the treatment frequency would decrease and correlate with the clinical gains being made.

Since the goal of all treatment is to return the patient to their pre-injury status, a well managed case will include decreased treatment frequency while occupational and daily activities are slowly reintroduced.

In our experience, we have found a constant treatment frequency maintained from the onset of care can lead to problems for the plaintiff attorney as they have to explain this apparent inconsistency.

Consider how they will attempt to explain the following questions: First, how can an accurate prognosis of the patient’s future medical/chiropractic condition be measured if the treatment has remained the same?

Secondly, how could the patient reach their preinjury status if the normal occupational and daily stressors were not introduced while under treatment? An unreasonable approach to treatment frequency complicates settlement.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call 614 299 9797 to make an appointment

In my  Short North, Columbus Office, I see many older (and sometimes younger) patients in who have been diagnosed with osteoporosis.  Osteoporosis is an insidious  disease.

Initially it develops without any clear symptoms, affecting the skeletons’ bone density.  Osteoporosis is usually discovered by special testing or bone weakening that leads to fractures which can result in falls, back pain, neck pain, etc.

I am always surprised that those diagnosed with osteoporosis know so little about it.  I did a search on line and found the following article that is worth reading.

Osteoporosis is a disease of bone leading to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old sex-matched healthy person average) as measured by DXA; the term “established osteoporosis” includes the presence of a fragility fracture.[1] Osteoporosis is most common in women after the menopause, when it is called postmenopausal osteoporosis, but may develop in men and premenopausal women in the presence of particular hormonal disorders and other chronic diseases or as a result of smoking and medications, specifically glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP).

Osteoporosis can be prevented with lifestyle advice and medication, and preventing falls in people with known or suspected osteoporosis is an established way to prevent fractures. Osteoporosis can be treated with bisphosphonates and various other medical treatments.

Osteoporosis itself has no specific symptoms; its main consequence is the increased risk of fracture. Osteoporotic fractures are those that occur in situations where healthy people would not normally break a bone; they are therefore regarded as fragility fractures. Typical fragility fractures occur in the vertebral column, hip and wrist.
The symptoms of a vertebral collapse (”compression fracture”) are acute back pain, often with radiculopathic pain (shooting pain due to compression of a nerve) and rarely with spinal cord compression or cauda equina syndrome. Multiple vertebral fractures lead to a stooped posture, loss of height, and chronic pain with resultant reduction in mobility.

Fractures of the long bones acutely impair mobility and may require surgery. Hip fracture, in particular, usually requires prompt surgery, as there are serious risks associated with a hip fracture, such as deep vein thrombosis and a pulmonary embolism, and increased mortality.

The increased risk of falling associated with aging leads to fractures of the wrist, spine and hip. The risk of falling, in turn, is increased by impaired eyesight due to any cause (e.g. glaucoma, macular degeneration), balance disorder, movement disorders (e.g. Parkinson’s disease), dementia, and sarcopenia (age-related loss of skeletal muscle). Collapse (transient loss of postural tone, with or without loss of consciousness, leads to a significant risk of falls; causes of syncope are manifold but may include cardiac arrhythmias, vasovagal syncope, orthostatic hypotension and seizures. Removal of obstacles and loose carpets in the living environment may substantially reduce falls. Those with previous falls, as well as those with a gait or balance disorder, are most at risk.

Osteoporosis requires special considerations in our office.  Chiropractic techniques involving little or no force have to be utilized to ensure patient safety.  In addition to variations in technique, nutritional suppliments are also encouraged, especially mineral supplimentation.  Osteoporosis treatment requires a multifaceted approach in order to see improvements.  Patients also must show patience with treatment as results are usually only seen with prolonged periods of care.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call 614 299 9797 to make an appointment.

There are approximately 3 million whiplash injuries sustained in the U.S. every year. Many cases of whiplash are unreported or go untreated due to the seemingly minor low speed collision or minimal, or any, amount of damage to the involved vehicles. It is also estimated that 45% of people who suffer from chronic neck pain do so as a result of a previous whiplash injury.

Although whiplash is the most commonly thought of injury with auto accidents, it is very common for people to receive injuries to the hips, knees, shoulders, back, and ribs to name a few.
It is very common, especially with low speed collisions, for there to be no pain immediately after the accident. Often it takes several days or longer for any pain to appear. Most people believe that if they do not have pain immediately following the accident, or if it’s a week or two after the accident before they start having pain, then they can’t receive treatment for it, or have any treatment included in the insurance claim. This is completely false.
It is routine for auto accident patients to begin care weeks or months after the accident, despite what your insurance company may lead you to believe.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call 614 299 9797 to make an appointment.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call 614 299 9797 to make an appointment.

In my Short North,Columbus, there are approximately 3 million whiplash injuries sustained in the U.S. every year. Many cases of whiplash are unreported or go untreated due to the seemingly minor low speed collision or minimal, or any, amount of damage to the involved vehicles. It is also estimated that 45% of people who suffer from chronic neck pain do so as a result of a previous whiplash injury.

Although whiplash is the most commonly thought of injury with auto accidents, it is very common for people to receive injuries to the hips, knees, shoulders, back, and ribs to name a few.

It is very common, especially with low speed collisions, for there to be no pain immediately after the accident. Often it takes several days or longer for any pain to appear. Most people believe that if they do not have pain immediately following the accident, or if it’s a week or two after the accident before they start having pain, then they can’t receive treatment for it, or have any treatment included in the insurance claim. This is completely false.

It is routine for auto accident patients to begin care weeks or months after the accident, despite what your insurance company may lead you to believe.
Another myth related to car accidents is that if there is no damage to the vehicle, then there can be no injury, and therefore insurance companies will not cover any type of treatment. This is also false.
There is overwhelming scientific evidence that injuries can occur without there being any damage to the vehicle. The insurance companies know this, but they bank on the fact that you do not. In fact, low speed collisions with little or no damage to the vehicles make up a significant portion of the cases handled and paid out by auto insurance companies.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call

614 299 9797

to make an appointment.

Whiplash Accidents Injury Headaches Treated, Short North Columbus, Ohio
Call 614 299 9797 to make an appointment.

In my Short North, Columbus Chiropractic office I see and successfully treat patients with headaches, there are five general kinds of headaches – tension, toxic, sinus, cluster as well as migraine – so you can have a better understanding of what kind of headache you have.

Read about Headache and the Various Types of Headaches

Whiplash from a car accident is a common reason for headaches to start happening, and whiplash headaches respond very well to Chiropractic treatments.

A general practitioner will give medicine to relieve the headache briefly, but this doesn’t do anything to fix the reason for the headache. Chiropractic care,  will fix the reason for many kinds of headaches quickly, and save you from taking painkillers, which can cause other types of headaches and definitely cause other health problems.

Whiplash Accident Headaches Treated, Short North Columbus, Ohio
Call 614 299 9797 to make an appointment.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio Call 614 299 9797 to make an appointment.

How long has it been since you were involved in an auto accident?

If so, did you get evaluated by a chiropractor?  If not, you should have.  It is never too late.

My Columbus Chiropractic Office treats many individuals for neck pain, back pain and headaches that are related to auto accidents.  While many of our patients are treating for accidents that occurred recently, in many cases the auto accidents in question occurred years earlier and the initial symptoms were not taken seriously.

I have always found it a bit odd that in general people don’t take the time to seek treatment for themselves yet they scramble to get their cars fixed.

I don’t know why so many of us carry these kinds of thought processes.  In the case of auto accident injuries, the little bit of neck pain or the headaches or the low back pain is often overlooked or dismissed and minimized as being un-important.  This is flawed thinking.  Imagine if we treated other health conditions with such disregard.

The injury mechanisms in whiplash type accidents are complex.  Muscles are stretched and torn, ligaments can sometimes partially tear or rupture, discs can become herniated and spinal fractures can occur.  These injuries can lead to a number of different symptoms that can cause neck pain or back pain that ranges in intensity from a slight irritation all the way to severe disability.  Back pain and neck pain are bad enough in the short term and much worse in a long-term chronic situation.

While the mechanism of injury in whiplash cases is complex, the typical resulting spinal injuries follow a well-established path.  Initially, the muscles and ligaments in the injured area are irritated.  This irritation leads to inflammation.  Inflammation is not only responsible for many of the initial symptoms that you experience but it is also responsible for scar tissue formation which can make your symptoms permanent or chronic.

Statistically, 25% of auto injury victims will continue to suffer from ongoing symptoms related to their accident.  I see this statistic play out in my Columbus chiropractic office on a regular basis.

Chiropractors are experts in dealing with the types of neck pain, back pain and headaches that occur as a result of auto accidents.  The best way to insure that you are not a member of this group of 25% that never fully recover from their auto accident injuries is to get an examination and treatment as recommended by your chiropractor.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio
Call 614 299 9797 to make an appointment.

In my Short North, Columbus office during this time of year, we start getting calls from both established and new patients regarding aches and pains related to auto accidents. During a rainy commute, the number of auto accidents can be 4 to 5 times the number that occurs on dry roads. My Chiropractic office in Columbus has seen hundreds of auto accident / personal injury victims over the last 15 years.

The most common injury resulting from auto accidents is the classic neck injury termed whiplash.

Whiplash is a traumatic neck injury that results from a sudden, forceful backward / forward snapping movement of the head. The head is heavy compared to the size of the muscles that help turn and tilt your head. Because of the violent acceleration and deceleration of the head, the soft tissues of the neck are overwhelmed with the stresses of the gravitational forces. Ligament damage, pinched nerves, muscle tearing, spasm and spinal misalignment are typical results of whiplash.

Whiplash can become a nagging, intolerable condition if left untreated. Many people make the mistake of judging the amount of injury to their body’s based on the force of impact or the amount of damage to the car. This is poor judgment. There are many factors that determine how a person is rear-ended by a second vehicle traveling 60 mph walks away unhurt while an apparently light tap on the bumper in a parking lot can cause enough pain to ruin your summer. Factors including the angle of the impact, speed of the impact, occupant awareness of the impending impact, head tilt or rotation, use of seatbelts and area of impact all play a role in why some people are injured in accidents and some are not.

Many people do believe that only high speed impacts can cause injury, however even a low-speed impact in an auto accident can cause serious whiplash injuries. Whiplash symptoms can occur instantly but typically take days, weeks, or even months to develop.

Neck pain is by far the most common whiplash symptom, along with headaches, muscle spasms, shoulder pain, dizziness, ringing in the ears (tinnitus), arm pain and tingling, and insomnia. The constant presence of symptoms can make whiplash a debilitating problem, even resulting in clinical depression.

A common problem associated with whiplash is the misalignment of the vertebrae in the neck. If left untreated, these vertebrae will remain misaligned, causing chronic neck problems in the future, including loss of range of motion, chronic headaches and arthritis.

A 1998 Canadian study on whiplash examined more than 10,000 cases of neck injuries and concluded that chiropractic adjustments are one of the only proven treatments for whiplash injuries. This study also concluded that “accepted’ treatments such as neck collars, muscle relaxers, immobilization, and rest were not helpful for whiplash victims.

Whiplash Accidents Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.