Anyone involved in an auto accident should seek medical attention right away and follow up with chiropractic care. Chiropractors will evaluate the spine and check for any injuries that may not be causing pain. The sooner these injuries are caught the easier it is to treat and heal from them.
If there are no obvious injuries, why should people seek medical attention immediately after being involved in an auto accident?
Dr. Luke Stringer: Yeah. Great question Liz, and this is a really important one for a lot of people that we treat in the office. Immediately after you’ve been in a car accident, a massive amount of hormones are released, particularly cortisol and adrenaline. When cortisol and adrenaline are in the system, it kind of takes over all the other hormones, and essentially what it does is it blocks the nociceptor receptors in the body so it kind of masks pain. Then what happens is over a number of either hours, maybe even days, weeks, as those hormones dissipate, then the body really starts to kind of let us know that we’re in a lot of pain. So, if you have been involved in a car accident and you don’t feel pain immediately, that doesn’t mean there isn’t going to be pain down the road. Those hormones again are really going to kind of interfere with how you’re feeling.
Second of all, there’s a great study out of Yale recently that said, if you’re involved in a car accident and you’re either traveling, or the car or object that’s hit you is traveling 8.2 miles an hour or greater, the spine absorbs the majority of the force, and it can shift out of alignment. So again, even if it’s a fender bender, you’ve already been hit at 10 miles an hour, things are going to shift out of alignment. And when things shift out of alignment, our bodies are great at compensating. So, we’ll figure it out at its infancy, but over time, those misalignments are going to slowly break us down. It’s going to beat up the spine, beat up the soft tissue. We’re going to create compensatory patterns.
If you have been in a car accident, you want to make sure that you’re getting checked out early on because it’s going to essentially allow us to address things in the acute phase, in the early phase. If you leave it weeks, months, even years, over time, that shift, it’s just going to create issues down the road. And obviously the more issues we have, the more time, energy, and effort we’re going to have to put into getting those issues fixed. So, if you’ve been in a car accident, even if it’s a fender bender, do your thing, make sure you reach out to your local chiropractor just to have your spine evaluated, and it will go a long way in kind of saving you a lot of time, energy and effort down the road.
Should auto accident victims see a chiropractor after going to the emergency room or seeing a medical doctor? And what would the chiropractor find that a medical facility might’ve missed?
Dr. Luke Stringer: Yeah, great question. And I would do all the above. If you’ve been in a car accident, we work with a lot of people in the personal injury space, the first thing you need to do is obviously get it on record, right? So, file that police report because you’re going to need to do that for, obviously, filing a complaint to your insurance.
Now, after, I’d highly recommend going to the emergency room or the urgent care and visiting a medical doctor. Why? Because obviously they’re versed in trauma, particularly those emergency room doctors. So, allow them to perform an examination of the area that’s been injured, even if you don’t feel that you’re injured, and they’re going to be able to find any sort of pathology. So, sprains, strains, breaks, fractures. Then obviously they can perform any imaging that they may need to perform, for example when you concuss you probably should get a CT scan. Have you got eight plus ten out of pain in your lower back or your arm? Let’s get an X-ray.
From there, the medical doctors, usually what happens, will perform the evaluation. If they find any issues then they’ll obviously proceed with the necessary treatment, but if they don’t, usually what happens is they’ll give you a script to manage the pain and then they’ll send you on home. However, just because there’s no breaks or fractures or any damage to the disc in your spine, or even your brain, doesn’t mean things haven’t shifted.
What chiropractors focus their training on is the neuromusculoskeletal system. So, essentially the spine specifically, and then all the soft tissue that works within the body. So, after you’ve been to see your primary or the ER, I would recommend seeing your chiropractor because they are going to be able to evaluate function within the spinal joints and alignment within the spinal joints, and they’re going to be able to pick apart things that medical providers aren’t necessarily trained within that specific space may have missed.
What are the most common injuries sustained in a minor motor vehicle accident? And how long does it take for symptoms of these type of injuries to be felt?
Dr. Luke Stringer: Honestly, it really depends on the person, right? We had a patient recently that was in a really small collision. He was depositing some money in the bank, was rear ended, probably no faster than five miles an hour yet he ruptured a ligament in his wrist, he ruptured a ligament in his elbow, he damaged some discs in his neck and he’s in a massive amount of pain. My other patients that have been hit at 40, 50 miles an hour only have soft tissue injuries.
It’s all going to depend on the mechanism of injury and the patient. The classic injuries that we see in minor vehicle accidents are those soft tissue injuries, so sprains and strains within the neck or within the lower back. And again, there’s symptoms depending on the severity of the injury. Soft tissue injuries can take anywhere from four to six weeks to clear up, as long as you go through the right treatment protocols and you work with a good chiropractor who’s going to be able to help you get over that soft tissue injury.
Could you describe some of the chiropractic treatments used to treat these injuries?
Dr. Luke Stringer: Absolutely. So, in the first phase it is your acute phase. People who’ve been in car accidents are usually in a lot of pain, really high pain generators, seven plus out of ten. All forms of movement are difficult, basic function, getting dressed in the morning, sleeping, are an issue. So, goal one is to essentially decrease the inflammation, decrease the pain levels and then improve the range of motion. So, that’s going to come through kind of more passive modalities. We’re going to use light adjustments with instruments. We’re going to use what we call some e-stim, we put an electrical current into the tissue, helps the tissue to recover, and then we’re going to use lots of ice. And then once the patient starts improving both in how they feel, so, “I have less pain, it’s less often.”, then you see some improvement in the function. They start to move better and then you can really start ramping up the protocols of treatment.
So, the second phase will be to start working on the damaged soft tissue and the misalignments within the spine. And you’ll do that through physical therapy and chiropractic work. Then once we start seeing some big improvement in the pain generators and their function they say “I can sleep better. I can sit for longer.” Then you can really start ramping up the chiropractic and the physical therapy protocols and get a little bit more functional, working them towards getting back to pre-accident status. So, a lot more dynamic movements, things that they wouldn’t have been able to do at the beginning of the accident.
What is involved in a typical chiropractic treatment plan following an auto accident?
Dr. Luke Stringer: Yeah. Great question. At Advanced Health, we do a lot of personal injury, people who’ve been in motor vehicle accidents. Again, it all starts with a thorough evaluation, a history of the accident, going through the mechanism of injury, and then a thorough evaluation of the spine and the soft tissue. We do an orthopedic examination, and then a neurological examination. We make sure the joint affected and/or the spine isn’t showing any red flags. We then shoot some X-rays. From there we’ll be able to kind of diagnose the issue and then build out the treatment plan. And again, similar to our last question, in the early phase, it’s the acute phase. People in a lot of pain, there’s a lot of inflammation, just basic functions are a challenge. Our goal is to essentially do exactly the opposite of that, so decrease the pain levels, decrease the inflammation and then start improving function.
So, how would we do that at Advanced Health Chiropractic? We’d adjust the spine, but we tend to start with kind of instruments on the lighter side of adjustment. We’ll do lots of what we call stim and ice, so apply electrical current into the muscle, it helps muscle recovery, and then ice helps with the inflammation. Usually it can take anywhere from three to six visits, we start seeing some improvement, how patients are feeling. “I have less pain. I can get dressed easier in the morning, sleep easier at night” Then we can start adding in treatment protocols.
The first protocol is to improve range of motion, that’s a prerequisite for healthy joints. Improve, restore range of motion. So, that could be lots of soft tissue work, lots of stretching, lots of mobility work and some kind of basic stability work.
As we start seeing improvement in range of motion, less pain, improvement in the function, then we can obviously start ramping up the PT protocols. We’ll move into a manual adjustment, start them with spinal traction and then really start working them through the PT aspect of it. And the second and third phase goals for us is to improve stability within the joint and the spine, and once the stability is there, then we’ll start improving the strength of the joint and the spine and obviously just progress them through. And then obviously by the time they’re finished with the treatment, they should be back to MMI, Maximum Medical Improvement.
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