Texas employers are invited to join the Division of Workers’ Compensation in Austin for the Texas Safety Summit on May 9-11. The 21st annual workplace safety and health conference offers important information for everyone who plays a role in safeguarding employees, from the beginner to the seasoned safety professional. Employers will hear from top safety…
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After a successful pilot project, the Texas Division of Workers’ Compensation rolled out a statewide program in October 2016 that has helped speed up the resolution of some disputes. The program splits up related claim issues so that a hearing officer can decide the most far-reaching issue first. This can clear the way for secondary…
Workers’ Compensation System Participants Annual Change to the Medical Fee Guideline Conversion Factors as Established in Title 28 Texas Administrative Code (TAC) §134.203 The purpose of this bulletin is to inform workers’ compensation system participants of the annual change to the Medical Fee Guideline conversion factors as established in 28 TAC §134.203. Under Labor Code…
The Texas Division of Workers’ Compensation is taking a promising pilot program statewide to help simplify and speed resolution of some disputes. A pilot started last year splits up related claim issues so that a hearing officer can decide the most far-reaching issue first. This can clear the way for secondary issues to be resolved…
Since its establishment five months ago, the new in-house fraud unit at the Division of Workers’ Compensation has opened more than 40 investigations and hired additional fraud investigators to extend its reach. “It’s a huge benefit to have a fraud unit that is 100 percent dedicated to workers’ compensation,” said Commissioner of Workers’ Compensation Ryan…
Injured workers in Texas have better access to physicians who can treat them more quickly than they did 15 years ago, according to a September 2016 study by the Texas Department of Insurance’s Research and Evaluation Group (REG). The study found 84 percent of injured workers received initial care in seven days or less in…
Texas has some of the nation’s most affordable workers’ compensation coverage, according to a 2016 study, which found that the Lone Star State had the 10th lowest rates among all states. The study by the Oregon Department of Consumer and Business Services ranks all 50 states and Washington, D.C., based on premium rates that were…
A current study conducted by the U.S. Chamber of Commerce’s Institute for Legal Reform, or ILR, determined that several of the most expensive ads under popular search terms on Google, including phrases such as “Top personal injury lawyers” and “El Paso accident lawyer”, costed personal injury lawyers approximately $700 every time a possible client clicked…
FUELING THE PERSONAL INJURY LAWSUIT MACHINE
Just as the way some iconic advertising campaigns might create among us a unique cultural bond, TV watchers and internet surfers today share a common experience. We’re all aware of – and annoyed by – personal injury lawyer advertisements, “If you’ve ever been injured, call now for a free consultation…”
Personal injury lawyer advertising is a huge presence on our TV screens and computer searches. It’s also the most visible element of the vicious cycle of lawsuit abuse in this country. Where does the money come from for these ads? Personal injury lawyers get rich filing lawsuits that are often weak on facts or fueled by imbalanced laws. The bounty they reap from these lawsuits goes into the huge volume of injury ads that we see constantly, so they can recruit more plaintiffs for more questionable lawsuits.
About $900 million was spent last year on personal injury ads on TV alone, according to a U.S. Chamber Institute for Legal Reform report. Online, more than 90 percent of the top 25 most expensive Google search terms are related to litigation, according to the report, and the high prices are bid up by high advertiser demand.
Why advertise 24/7 for lawsuit plaintiffs? To create “class members” for personal injury lawyers to bring mass tort lawsuits. What happens to the millions of plaintiffs signed up by the ads and web links? They are bought and sold by the lawsuit generators as if they were cattle or corn futures. Who regulates these ads to make sure they are truthful and ethical? As you might have guessed from looking at the ads, they are barely regulated at all – but they should be!
This aggressive plaintiff recruitment comprises just part of the cycle of lawsuit abuse – lawsuit friendly laws make personal injury lawyers rich as they file more and more lawsuits, and lawsuit riches buys nearly a billion in TV ads to gin up more plaintiffs and wealth-producing lawsuits. The rest of the cycle of lawsuit abuse is the personal injury lawyers putting their money into political campaigns and supporting pro-lawsuit politicians who help to preserve the imbalanced laws – and try to create new ones. Seem a little complicated? It’s not, and we’ve laid it out with a few graphics here.
So the next time you see a personal injury ad that is giving you advice about what to do, remember these three things:
You shouldn’t believe everything you see in the largely unregulated world of personal injury lawyer advertising.
Personal injury lawyer advertising can mislead and scare consumers on important issues, such as their health care.
Personal injury lawsuits are often about making those lawyers rich, not making victims whole.
ANYTHING GOES WITH PERSONAL INJURY ADS
While our country has regulatory agencies whose mission it is to ensure that advertisements are accurate and straightforward for American consumers, one group evades advertising regulation: personal injury lawyers. This group is flooding the airwaves and internet with ads making unsubstantiated or hyperbolic claims to lure potential plaintiffs into lawsuits that make these personal injury lawyers millions.
We’re all familiar with the ominous ads that warn about health dangers or a long list of side effects and promising cash compensation to patients. Yet these sensationalized lawsuit ads do not disclose the low probability of experiencing an adverse health effect. That’s because lawsuit ads are not subject to the same level of oversight for accuracy and disclosure as advertising for other industries.
The disparity is clear when you look at how strictly other ads discussing health treatments are regulated. The Federal Trade Commission (FTC) regulates all consumer product ads that where company’s product can affect consumers’ health, insisting that these ads must:
be truthful and non-deceptive
have evidence to back up claims
not be unfair, and
include only accurate testimonials that disclose any information that might influence buyers
None of these requirements exist for lawsuit ads, which largely can say whatever they want about the effects of health treatments or products. Without regulation, personal injury lawyers can dramatize product risks while acknowledging none of the benefits.
Additionally, the Federal Drug Administration (FDA) requires that product claim ads must present the benefits and risks of a prescription drug in a balanced fashion. Companies are required to list the most significant risks of the drug. Similar to the FTC, the FDA requires that these ads must not be false or misleading in any way.
These restrictions do not apply to lawsuit ads, which are often intentionally misleading. There is a rigorous testing and claim substantiation that drugs must go through for all marketable claims, but no such process exists for lawsuit ads. Thus, we see ads with unsubstantiated claims from studies personal injury lawyers may have commissioned or from doctors who are on their payroll. That simply doesn’t seem balanced.
Even cosmetic ads are regulated more strictly than lawsuit ads. Cosmetic ads are subject to the same advertising regulations that the FTC uses for other industries (i.e., fair, backed by evidence, non-deceptive, etc.) These regulations exist for a reason, and personal injury lawyer ads should be held to the same standards as demanded of other advertisers.
There is harm in allowing lawsuit ads to continue to make misleading claims – it can be can be dangerous for consumers, who are repeatedly hearing these wild, unregulated proclamations. American consumers are inundated with personal injury lawyer advertisements – we can’t escape them. In fact, nationwide, personal injury lawyers spend up to $75 million each month on this advertising.
As a result of this onslaught of panic-inducing ads, patients are increasingly discontinuing health care treatments that their physician believes would provide them with significant benefits and pose little risk. Americans are listening to unregulated ads instead of their doctors, which has doctors concerned. That’s why the American Medical Association, an organization representing more than 200,000 physicians and medical students, recommended that lawsuit advertisements come with a warning that patients should first consult with a physician before discontinuing medications.
These advertising tactics are intended to generate lawsuits and enrich personal injury lawyers. Consumers deserve, and should demand, greater responsibility and disclosure in lawsuit advertising. For now, consumers must recognize that these ads are not always accurate, and personal injury lawyers have a vested interested in scaring audiences into lawsuits. Don’t fall for it, and don’t get trapped in their web.
How Big Data Is Big Bucks for Personal Injury Lawyers
Texans Against Lawsuit Abuse shared our take on big data and the increase in certain lawsuits in a recent letter to the editor in the Dallas Morning News. It also serves as a good reminder: “Don’t Let a Lawyer Be Your Doctor.”
Texas trial lawyers have a history of searching for ways to make millions of dollars at the expense of our health care system, ultimately reducing access to health care, driving up the cost of consumer goods and limiting job creation.
The recent story, “Health insurers fear Texas trial lawyers are seeking billions, but attorneys say that’s hype” (March 30), shows how the combination of big data and health care can create a gold mine for personal injury lawyers.
So, when sick or injured consumers get a call from a lawyer, not a doctor, Texans Against Lawsuit Abuse is urging caution through a new Sick of Lawsuits (www.sickoflawsuits.org) campaign. The public needs to be aware of the millions spent on misleading television and online advertising.
“Don’t let a lawyer be your doctor,” is sage advice and something TALA is working to ensure that Texans hear and act on. What lawsuit ads don’t say can be harmful. When it comes to lawsuits involving a person’s health, consumers should examine the source carefully.
Jennifer Harris, Austin, Texans Against Lawsuit Abuse (as published by the Dallas Morning News)
A group of Texas doctors are speaking out against personal injury lawsuit ads after a statewide study found an alarming number of physicians are increasingly concerned about legal advertisements targeting their patients for medical lawsuits.
Conducted on behalf of the Texans Against Lawsuit Abuse (TALA) organization, researchers found that more than eight in ten doctors across the state now believe some of the ads can lead patients to stop taking their medications as prescribed to them by their doctors.
Physicians also expressed concern that at least some of the advertisements can be misperceived as factual, medical information, even ultimately steering patients away from their doctors to lawyers for medical advice.
One of those taking the strongest stand is Dr. Christine L. Canterbury, an Obstetrics & Gynecology specialist at the Corpus Christi Women’s Clinic and president of the Bay City Area Citizens Against Lawsuit Abuse organization.
She recently penned a widely-circulated op-ed condemning the growing practice of personal injury lawsuit ads being passed off as actual medical advice offered by licensed professionals.
The TALA survey came as a direct response to an outbreak of personal injury lawyer advertising designed to recruit patients into medical lawsuits. In Texas, the issue is particularly pressing given a recent U.S. Chamber of Commerce Institute for Legal Reform study found several nearby cities placed in the top of national rankings for personal injury lawyer advertising spending.
“The amount of personal injury lawyer advertising on television and, even more so, online continues to skyrocket,” Jennifer Harris, executive director and spokesperson for TALA, told the Record. “That’s why Citizens Against Lawsuit Abuse organizations have joined forces to raise awareness among consumers about this type of advertising. As a doctor, that’s something that troubles me greatly.”
Like Canterbury, medical authorities across the state openly lament the way all the easily flowing misinformation can lead to patients doubting the treatment they are receiving or even electing to alter the way they take their medications without first consulting a doctor.
Collectively, 66 percent of Texas doctors surveyed agreed that personal injury lawsuit ads can lead to patients doubting their treatments in one form or another and three in ten indicated they know of instances where patients have suffered negative consequences stemming from personal injury lawsuit ads.
Estimates are personal injury attorneys across the country now spend as much as $900 million on annual advertising, much of it, some contend, concentrated on unproven theories and misinformation disseminated via lawyer-funded websites disguised as factual health information sources.
“These sorts of ads can be highly deceiving, and that’s why we’re concerned,” added Harris. “Consumers may not realize that doctors are not the ones dispensing the information, offering the publications or providing advice.”
While stressing that patient adherence is critical to the recovery process for all patients, Canterbury also insisted that many doctors are now perturbed with the way some personal injury lawyers have taken to the business of offering medical advice without being bound by any of the professional obligations that put the patient’s health above all else that all licensed physicians are.
“We’re hoping our education and outreach efforts will elevate the attention to this issue among lawmakers and regulators,” said Harris. “We also hope it makes patients and consumers more aware of this type of possibly deceptive advertising. We’ll certainly be watching to see what sort of legislative or regulatory fix might be proposed and how we can support reforms.”
In the end, Harris stresses that TALA’s message of “don’t let a lawyer be your doctor” is clear.
Scroll through the list of the most expensive Google search terms and you’ll find phrases like “Top personal injury lawyers” and “El Paso accident lawyer.” A recent study conducted by the U.S. Chamber of Commerce’s Institute for Legal Reform, or ILR, found that some of these ads cost personal injury lawyers nearly $700 every time someone clicks on it.
This large cost is indicative of a growing trend that should trouble any Texan who values the integrity of our civil justice system. The increasing volume of misleading personal injury lawyer advertising is putting greed ahead of justice. Furthermore, this devious practice can clog courts with questionable lawsuits, delaying or denying justice for those with legitimate legal claims.
According to the ILR study, personal injury lawyers in the U.S. were projected to spend a total of $892 million in television advertising in 2015, up from $531 million in 2008. The vast sums invested in these largely unregulated ads prove that lining the pockets of personal injury lawyers is paramount to consumer safety and well-being.
People are injured in car crashes every year in the US, and even the minor collisions result in long-term symptoms and disability. Research shows that a significant number of people have pain from a crash even 10-15 years later.
Chiropractic is one of the best ways to treat and heal from these types of injuries, as it works by restoring the normal function of your spine, allowing the tissues to heal becoming pain-free.
If You’ve Suffered An Auto Injury Chiropractic can help:
1. Reduces Inflammation
During an accident, ligaments & muscles in your spine can become stretched creating micro-tears. X-rays or MRI scans usually aren’t sophisticated enough to diagnose these kinds of injuries, but this tissue damage causes the area to become inflamed. Many times, an auto injury patient won’t feel much discomfort immediately after the crash, but they wake up the next morning to a stiff and painful neck. This is caused by the body’s inflammation response to these micro-lesions.
A study found chiropractic treatment helps the body release anti-inflammatory Interleukin 6 (IL-6). This is an important substance created by your body that is used to help heal injuries.
2. Restores Motion
Inflammation is when the tissues become immobile, which slows the healing process. Ligaments of the spine don’t get many nutrients or blood supply normally, and this becomes even more difficult when inflamed and injured.
A chiropractic adjustment allows the joints of your spine to mobilize and increase blood flow and healing nutrients to the area.
3. Reduces Scar Tissue
Your body heals injuries by creating scar tissue. Scar tissue in an injured area is made up of the same kind of cells as the original tissue, but it’s laid down rapidly and randomly as a temporary “patch” on top of the damaged area.
Scar tissue on a large muscle, can be uncomfortable unless you stretch it out. However, it shouldn’t cause any long-term problems. Scar tissue in the ligaments of your neck or back, however, can be much more debilitating, since we can’t stretch it out ourselves. Your chiropractor focuses the adjustments on these specific vertebral joints that are fixated, effectively stretching them and breaking up the scar tissue in the joint.
4. Relieve Localized Pain
In 20 years, studies have shown that chiropractic adjustments are safe and effective in reducing pain. In fact, a 2013 study found that 94% of patients experienced neck pain relief with manipulation!
5. Reduces Pain in Your Whole Body
Auto injury patients develop widespread pain after a crash, especially if the original injury wasn’t treated promptly. A 2014 study reported that people who received a chiropractic adjustment had increased levels of pain-reducing hormones in their bloodstream.
6. Relieves Stress
A auto accident can be very stressful. When your body is exposed to trauma, it goes into a flight or fight response, which can result in anxiety, depression, and stress. A 2011 study used PET scans to look at the brains of people who received chiropractic adjustments for neck pain. They found that those patients had reduced brain activity in the parts of the brain responsible for pain processing and stress reactions. They also had significantly lower levels of cortisol, indicating reduced stress. Participants also reported lower pain scores and a better quality of life after treatment. Reducing your overall level of stress is important, because, left untreated, stress can also slow recovery time and increase your risk of developing chronic pain.
7. Chiropractic Care Is Bona Fide
Researchers realize chiropractic helps people recover from auto injuries. In 1996, British researchers found that 93% of auto injury patients with neck pain experienced dramatic improvement with chiropractic care.
In 2015, an Ontario, Canada government group agreed that spinal manipulation, combined with staying active and continuing to work, are the most important factors in recovering quickly from car crash injuries.
8. Chiropractic Care Can Prevent Chronic Pain
From 2000 and 2003 studies found auto injury patients who received early care recovered faster and had fewer residual symptoms from the crash. Chiropractic does this: a chiropractic adjustment gets the joints in your spine moving the way they’re supposed to, helping to prevent chronic pain.
If you’ve been injured in a car crash, you don’t have to suffer from chronic pain. Chiropractic is a great way to help your body heal from all kinds of injuries.
By Dr. Alex Jimenez
Auto Accidents & Back Injuries
The spine is a complex structure that consists of bone, muscle, tendons, ligaments, nerves and other tissues. Spine fitness is essential towards maintaining the body’s optimal performance as it functions to support an upright posture, provides flexibility to allow the body to bend and twist freely, and protect the spinal cord. While a healthy back can easily be taken for granted, a back injury or other type of complication may result in long-lasting consequences that could alter an individual’s aspect of daily life.
Unfortunately, back injuries are among the most common types of complications suffered after an automobile accident. Each day, thousands of individuals are involved in head-on, side-impact, and rear-end auto collisions, often leading to spinal injuries even during minor car crashes. Depending on the force of the impact, a single or multiple areas of the back may be affected. Automobile injuries can range from mild sprains and bruises to fractured vertebrae and spinal cord damage.
If you’ve had a car accident, it’s essential to take note of any symptoms of back pain, as there are a variety of spine complications which could result after experiencing an auto collision.
One type of spine injury among individuals who have suffered from an auto accident is a herniated disc, or a slipped/ruptured disc. Discs are small, sponge-like structures found within the spinal column which function as cushions to separate and protect the vertebrae from the others while providing the spine with smooth flexibility. The force from an auto accident impact can damage a disc, causing it to break or deform, affecting its ability to cushion the bones of the spine.
Furthermore, a damaged disc can also place unnecessary pressure directly on the nerves surrounding it, leading to symptoms of pain, numbness and weakness on the region of the body where the affected nerve travels to.
Disc injuries to the lower back frequently lead to a group of symptoms commonly referred to as sciatica, which is characterized by radiating pain, numbness and tingling sensations in the leg and/or buttock on either side, or occasionally, in both sides, depending on the type of injury. The symptoms associated with sciatica can be impairing and may worsen over time if left untreated.
Auto Injury Back Pain
Spinal Cord Distress
Spinal cord injuries occur from the impact of an automobile accident. It sends a direct blow to the spine, that damages the delicate bundle of nerves within it. The spinal cord is the most important structure between the body and the brain. It is a vital link between the brain and the body, functioning to carry essential information back-and-forth from the brain to the central nervous system, facilitating motor control and sensory function. Spinal cord injuries impair the brain’s ability to communicate effectively with the rest of the body, resulting in paralysis and/or lack of sensation in all or part of the body. The more severe an injury to the spinal cord is, the more of the body will be affected.
Compression Fracture aka Bone Break
Car accidents can also cause compression fractures. Compression fractures or cracks in the bones of the spine may cause the vertebrae to collapse and deform. This can permanently alter the shape and structure of the spine.
Symptoms of a compression fracture include pain and postural changes as well as breathing difficulties. Due to the fact that compression fractures are common among older adults, many individuals mistake the symptoms for signs of aging or arthritis. An estimated two-thirds of compression fractures go undiagnosed.
While cars are built to withstand the great force of a collision, the human body is not. The complex structures of the body, especially the spine, are vulnerable even in low speed collisions, resulting in injuries or conditions more often than not. An individual who’s been injured in an accident should seek immediate medical attention in order to diagnose any possible injuries or conditions as early as possible to begin treatment. Chiropractic care can effectively treat a variety of spinal complications, including auto injuries. Through the use of spinal adjustments and manual manipulations, a chiropractor can gradually help restore the individual’s natural mobility and flexibility, as well as progressively strengthen the structures surrounding the spine to relieve the symptoms and restore the individual’s lifestyle.
Sourced through Scoop.it from: www.elpasochiropractorblog.com
After being involved in an automobile accident, injuries inflicted to the spine can be a common complication for many individuals. From herniated discs to compression fractions, the force of an auto collision can place great amounts of stress on the complex structures of the spine, often leading to damage, injuries and even aggravate an existing condition.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
The Clinic & Crossfit:
A Clients Story
Jacqulyn Quevas is up on her feet a lot as a hair stylist and she was searching for and overall become healthier and once she found Push-as-Rx ®™, her amazing journey began. The motivation and enthusiasm of the trainers at Push as Rx has greatly influenced Jacqulyn.
The clinic and PUSH-as-Rx ®™ system is leading the field with laser focus supporting our youth sport programs. The PUSH-as-Rx ®™ System is a sport specific athletic program of reactive agility, body mechanics and extreme motion dynamics. Through detailed and continued assessments of the athletes in motion and under stress loads offer a clear scientific picture of body dynamics. This system also has helped many athletes come back from injury faster, stronger, and ready to safely return to their sport without losing a beat after recovery. Results demonstrate clear improved agility, speed, decreased reaction time and advantageous postural-torque mechanics. PUSH-as-Rx ®™ offers specialized extreme performance enhancements to our athletes no matter the age.
By Dr. Alex Jimenez
Chiropractic: A Safer Strategy than Opioids
“Auto Injuries: Neck Pain & Chiropractic Treatment
Automobile accidents are the most common cause of whiplash. Any type of accelerated motion that thrusts the head forward and then backwards with extreme force can lead to whiplash. Sports accidents can also cause whiplash-associated injuries.
An unpredicted head jolt can damage the complex structures of the cervical spine, leaving tendons and ligaments intensely irritated and inflamed. The tendons and ligaments as well as other tissues of the neck may become overly stretched and torn.
A whiplash type injury may be suspected if the individual involved in an automobile accident experiences the following symptoms: neck pain and stiffness; worsening pain with movement; loss of range of motion in the neck; headaches, most often starting at the base of the skull; tenderness or pain in the shoulder, upper back or arms; tingling or numbness in the arms, fatigue and dizziness. Other individual’s may experience: blurred vision; ringing in the ears; sleep disturbances; irritability; difficulty concentrating; memory problems; and even depression. While these are some of the most common symptoms of whiplash, they may also suggest the presence of another type of injury or condition resulting from the automobile accident.
Thus, it’s essential to visit a qualified healthcare professional who can properly identify a whiplash injury and offer the required treatment to eliminate the resulting pain and symptoms.
Apart from assessing the doctor’s experience and qualifications, the victim of an automobile accident must primarily consider their geographical location and the type of insurance they are covered by when deciding on the type of doctor to visit following a whiplash type injury. Other factors that should influence the affected individual’s decision include whether they are represented by an attorney and whether they are living in a state where PIP, or personal injury protection, is mandatory.
Whiplash Injury Practitioners
People who’ve sustained injuries from auto accidents fail to receive the kind of medical care they require. It has been previously determined that the outcome of the patient’s rehabilitation depends on the type of doctor they receive care from.
Many individuals who’ve been involved in an automobile accident, regardless of the severity of the collision, will generally visit the emergency room, or ER, to have their injuries evaluated. The majority of ERs are designed to take patients out of life threatening situations. First, they immediately assess any visible injuries, such as open wounds and broken bones, treating them effectively on the spot. They may even prescribe medications to temporarily relieve the painful symptoms following a traffic collision. However, many victims are not treated for their whiplash injuries. The trained specialists from the ER, provide first-aid, X-rays and medications to remove individuals from life-threatening situations but they don’t readily treat soft-tissue injuries like whiplash. From there, patients are sent to see their primary care physician, or PCP, to assess the rest of their injuries, yet, they may still face hardships to finally receive the proper care they deserve for their injuries.
Primary Care Injury Specialists and Whiplash
Many primary care physicians do not have the full qualifications in treating automobile accident injuries. Many of these doctors may even deny patients treatment. Whiplash associated disorders have been misunderstood in the medical field and many doctors believe whiplash is not a legitimate injury. However, those whom are suffering from whiplash can account for how painful it really is.
Other doctors refuse treatment to whiplash patients because they may not accept any kind of 3rd party billing, a paying method where the doctor seeing the car accident victim has to bill the party at fault’s insurance company or utilize PIP or med pay to receive compensation. This is a commonly well-known reason for denial of treatment as a large number of primary care physicians, or PCPs, still don’t have the required authorizations to accept 3rd party billing.
Besides primary care physicians, medical doctors, orthopedics, chiropractors and physical therapists are several types of qualified healthcare professionals that specialize on treating automobile accident injuries such as whiplash. Among these, chiropractic treatment is the most popular, alternative treatment option for treating various soft tissue injuries or conditions.
Chiropractic Treatment for Car Wrecks
Many people from the legal and medical industry dismiss seeking a chiropractor for auto accident injury treatment. However, the fact is that a chiropractors are some of the only doctors who offer therapeutic treatments to accident victims. Treatment offered by medical doctors might include the use of drugs, although in many cases, they may also recommend physical therapy. This automatically highlights the importance of chiropractic care for whiplash victims because chiropractic care and physical therapy are very similar forms of treatment.
Whenever an individual who’s been involved in an automobile accident visits a chiropractor and complains of pain in the neck, the medical specialist will carry out a series of tests to determine whether the patient has suffered whiplash. Instead of focusing solely on the specific injury, chiropractors are trained to inspect the affected individual’s entire spine. Aside from soft tissue injuries like whiplash, chiropractic doctors may also check for: disc trauma or injury, tightness or tenderness, restricted mobility, muscle spasms, joint injuries, ligament injuries, posture and spinal alignment. They may also analyze the patient’s gait.
Besides checking for the above, chiropractors might also request X-rays and MRI of the patient’s spine in order to find out whether the spine features any degenerative changes which might have developed before the accident. To offer the best possible treatment, it is extremely important to determine which problems existed prior to the accident and which ones resulted from the accident. In most cases, insurance companies may argue that every single injury in the victim’s body is preexisting. This makes the role of the chiropractor considerably important as they will make sure to document all the previous and new injuries separately to ensure the insurance company pays for the patient’s treatment. In addition, the evaluation performed by the chiropractor also allows them to create the most effective treatment plan for each individual whiplash victim.
Main Stages of Care
The leading concern for chiropractors who treat whiplash-associated disorders involve alleviating inflammation in the neck. Chiropractors often recommend ice therapy, or the application of ice pack against the affected area, multiple times a day. This remedy is capable of reducing both pain and inflammation. Once the inflammation subsides, they often carry out a variety of manual therapeutic techniques to restore and increase the individual’s strength, flexibility and mobility.
The kind of chiropractic treatment the individual will require depends largely on the severity of the whiplash encountered. However, it has been previously determined that the majority of individual’s with whiplash find spinal manipulations useful. The most common chiropractic treatment techniques involve, spinal adjustments and manual manipulations, to carefully re-align the structures of the spine and help reduce symptoms. The following spinal techniques are also used to treat whiplash injuries: Instrument-assisted treatment, which involves the use of handheld instruments to provide a gentle massage by applying force onto the spine without utilizing any kind of thrust.
Instrument-assisted chiropractic therapy is used mostly to treat older patients with degenerative joints; flexion-distraction, this technique involves the use of a non-thrusting motions, best described as a slow pumping action; specific spinal manipulation, this therapy involves the use of a mild thrusting technique and is mostly used for restoring motion to the affected joints. Specific spinal manipulation helps stretch the soft tissues, which makes the job of restoring motion to the affected areas of the spine easier; instrument-assisted chiropractic therapy, also known as the Graston Technique, is used during this form of chiropractic therapy to perform repetitive strokes on the injured body part; therapeutic massage, performed to ease muscle tension and stress in the injured region; interferential electrical stimulation, where a patient undergoing this type of therapy will see the chiropractor passing electrical current at a very low frequency through their body. This low frequency current helps stimulate the muscles and reduces inflammation; trigger point therapies, as the name suggests, involves the application of direct pressure onto specific points to alleviating muscle tension; and finally ultrasound therapy, capable of decreasing stiffness, pain, and muscle spasms in the affected areas. When ultrasound is passed through the patient’s muscle tissues, it warms up the treated region and increases blood circulation.
Neck Trauma and Auto Injury
Ultimately, chiropractors can help victims of whiplash in many ways. These health care providers can ensure that an individual’ whiplash and its associated symptoms may subside completely. They always make sure to create a patient-specific treatment plan to make the process of recovery simpler for every individual.
Other than recommending immediate treatment for reducing the acute pain and inflammation, the chiropractor might additionally recommend a series of stretches and exercises, to help speed up the rehabilitation process as well as help increase the individual’s strength, flexibility and mobility.
Whiplash injuries, when left untreated, can cause severe complications. If you or a loved one have been involved in an automobile accident, visit a chiropractor immediately. By being prompt, you can even reduce your recovery time significantly. That’s not all; the chiropractor will also provide the required assistance to your lawyer, proving that the injury resulting from the accident wasn’t a preexisting injury or condition.
When you are injured in a car accident, you must get acquainted with your rights as soon as possible to receive the proper compensation and treatment for your specific situation. There is no such thing as a simple car crash.
Certain injuries or conditions which may have developed following an automobile accident may become chronic or permanent if left untreated. If an individual is experiencing neck stiffness or headaches after a traffic collision, it’s absolutely wrong to assume that this will subside in a few days. A minor discomfort could turn out to be a more serious complication.
Often, people injured in auto accidents develop scar tissue that remains with them throughout the rest of their lives and without the necessary treatments or exercises, these can become stiff and greatly limit an individual’s ability to move properly. The above issues generating from a car accident show how important it is for people to seek immediate legal and medical help. Chiropractors are known for their expertise in managing soft tissue injuries and the resulting chronic and traumatic pain; as a result, they are often considered to be the best healthcare professionals to consult after a car accident.
“Doctor, are chiropractic adjustments safe?”
This is one of the most common questions asked by people seeking or considering chiropractic care along with
“What are the risks?”
“Can I receive spinal adjustments without the chiropractor adjusting my neck?”
“Do chiropractic adjustments cause arthritis or even strokes?”
With media scrutiny over natural health procedures, specifically chiropractic and cervical adjustments, these are very important and serious questions, especially when one’s health is a priority. As a practicing chiropractor, I welcome the opportunity to address these questions. Chiropractic care is profoundly safe, and this article summarizes the current research, providing answers to these common questions and misconceptions.
Myths vs. Facts
In 1990, when I started working in the chiropractic profession, a common concern that patients had about chiropractic care was that “too many adjustments would cause arthritis.” Years later, science has affirmed what chiropractors have always seen and known to be true in clinical practice – that in fact chiropractic care is not only one of the most popular forms of care for people with arthritic conditions but one of the most effective.1,2
Unfortunately, for hundreds of years, health care practices have been permeated by folklore, sometimes known as “old wives tales.” The trend continues today. A 2010 study of over 1,000 board-certified American pediatricians found that over 75% of the doctors subscribe to at least one known health care myths.3 These include the myths that eating chocolate causes acne, listening to Mozart will make a baby smarter, and swimming within 30 minutes of eating is not safe. Many doctors in this study were also found guilty of not knowing the expected protocols for treating burns, healing wounds, administering Aspirin to children, and safely dealing with seizures.
A review of the current literature indicates that frequent or extreme complications of chiropractic care should also be included in the list of the most common medical myths prevalent even in our medical offices.
Spinal Care vs. Chiropractic Care
The spinal column’s role in overall health cannot be undermined as it houses the brainstem, spinal cord, and central nerve system. Thus, for optimal health the spinal column must be examined and cared for by a skilled doctor.
Specifically, the foundation of chiropractic care teaches that damage to the spine, and misalignments of the vertebrae (subluxations) create interference in the nerve system, which are therefore reduced and corrected through specific chiropractic adjustments.4,5
On that basis, chiropractic adjustment techniques have historically been rooted in precision and accuracy. Although there are now many unique chiropractic techniques taught in professional schools and in continuing education, these techniques commonly focus on the evaluation and measurement of subluxation patterns in the spine and the specific protocols used to reduce the areas of misalignment. In contrast, most other health care practices addressing the spine, never mind non-medical procedures attempted at home, are for the most part, generalized treatments of pain, global mobilizations of joints, and overall tractions of entire regions of the spinal column.
Receiving a specific chiropractic adjustment to reduce a subluxation is immensely different from receiving any form of “treatment” on the spine. Admittedly, I did not understand this practice in my first 20 years of receiving chiropractic adjustments. Until I attended chiropractic school and learned the techniques and analyses used in chiropractic science, I thought that chiropractic adjustments were all one-of-the-same. I can understand how the general public might also construe this misconception – I did and I grew up in a chiropractic family. Subluxations and adjustments are specific; the more extensive the analysis used by the chiropractor, the more precise the adjustment, and thus the better improvement in the patient’s health.
In my experience, the majority of the “chiropractic horror stories” shared in folklore, and even many of the cases cited by medical research, fall into one of two categories:
(a) The case of a the patient receiving care without extensive and correct analysis
(b) A person receiving spinal care incorrectly identified as “chiropractic care” administered by someone other than a licensed Doctor of Chiropractic
In fact, a 1995 report in the Journal of Manipulative and Physiological Therapeutics revealed that many “manipulations,” incorrectly attributed to chiropractors, had been rendered by non-chiropractic professionals including GPs, osteopaths, and physiotherapists, and even laypeople including a wife, a Kung-Fu practitioner, a blind masseur, and an Indian barber.6,7 Therefore before someone suggests they were hurt or injured by a “chiropractor,” it is imperative to learn more about their experience. In all likelihood some level of scrutiny was overlooked – or they weren’t seeing a licensed chiropractor at all.
Modern chiropractors use advanced technological analyses such as X-ray, surface electromyography (sEMG), thermography, and digital postural analysis, along with traditional chiropractic methods of motion and static palpation, leg length analysis, and visual postural inspection to make a diagnosis and determine the appropriate adjustment. Naturally, to use layman’s terminology, if a patient presented to the chiropractor with a low left hip, and the chiropractor adjusted the left hip “even lower,” the patient would get worse. For this reason, your Doctor of Chiropractic is not only highly trained but expected under every state and provincial law to thoroughly assess your spine and condition prior to making recommendations or giving adjustments.
What about stroke?
Since the 1990s, the most extreme fallacy about chiropractic care is that “adjustments of the cervical spine cause strokes.” As a practitioner, I am pleased to observe greater inter-professional cooperation between physicians and chiropractors, but I am disappointed by the increasing number of patients who have consulted me following a discussion with their medical doctor and told to “not get their necks adjusted.”
A basic understanding of the origins of chiropractic care, and the critical function, anatomy, and physiology of the central nerve system demonstrates why the suggestion that patients should “not get their necks adjusted” is absurd. While chiropractors are concerned with the reduction of nerve system stress caused by spinal subluxations throughout the entire spine, one must understand that all spinal nerves first pass through the upper cervical spine. Therefore, interference to the nerves passing from the brain through the spinal cord to any area of the body could occur either at the associated spinal segment where the peripheral nerve exits the spinal column, or at any place higher, including the upper cervical spine. Historically, Dr. B.J. Palmer, who developed the modern chiropractic profession, focused the majority of his research and efforts into the reduction of upper cervical spine subluxations, expressing that upper cervical subluxations were the foremost cause of disease and dysfunction compared to other subluxations in the spine.8 Years later, science continues to affirm the importance of upper cervical alignment. It has been demonstrated that abnormal cervical alignment is a leading cause and an almost universal finding related to not only cervicogenic pain and headaches, but also the development of scoliosis9,10 and even sudden infant death syndrome (SIDS).11.12,13 This awareness of the basic physiology of the nerve system is enough to understand the utmost importance of reducing subluxations in the cervical spine, above all other areas of the nerve system.
The “stroke hypothesis” stems from the theory that the irritation of the vertebral arteries, which pass through the cervical vertebrae, could lead to an ischemic stroke by causing accumulated plaque in the arteries to be dislodged. As strokes may cause serious, permanent impairments in a person’s health, there has naturally been much interest and research in this topic.
Consider how plaque develops in the arterial system of the body. Exposure to the known risks of poor diet, alcohol consumption, and smoking over a period of many years may cause molecular plaquing in the arteries, and it is true that when those molecules become dislodged, they can affect the brain, which is known as a stroke. Unfortunately, your family doctor or your chiropractor can’t prevent this from happening – you would need immediate emergency medical attention in hospital to prevent this from occurring.
Warning signs that a stroke may be about to occur include upper back pain, neck pain, and headaches. Naturally, people dealing with these symptoms may consult their chiropractor, hoping for a resolution of pain. Many may also consult their MDs and/or other trusted health care providers. Unfortunately, such pre-stroke symptoms as back pain, neck pain, and headaches may not explicitly appear to be the early stages of a vascular incident without the “red-flag” accompanying symptoms of blurred vision, dizziness, slurred speech, facial drooping, and lack of coordination. Therefore, as it is not standard practice for chiropractors or medical physicians to refer every case of back pain or headaches to the emergency room, patients may receive chiropractic or medical intervention without knowing that a stroke is ensuing.
When is a chiropractor or medical doctor negligent? If a patient visits the doctor’s office with neck pain and headaches while showing the classic signs of stroke (slurred speech, dizziness, poor coordination, etc.), the doctor is obligated to identify this and ensure that a stroke is not about to happen. If, after examination, a doctor identifies that a stroke may be forthcoming, the doctor must see that the patient receives the necessary immediate medical attention. Doctors who do not rule out the possibility of an imminent stroke or do not ensure necessary medical attention if a stroke is indeed forthcoming, would indeed be negligent – but this is very far from “causing” the person’s stroke, whether or not any treatment was rendered.
In fact, although a chiropractic adjustment would not slow down the incidence of the stroke, 2008 research shows that it would no more accelerate it than a visit to the medical doctor. In an article published in SPINE, a multi-disciplinary team of researchers found that while strokes are very rare events in the general public, there was only an increased correlation between chiropractic visits and the occurrence of stroke, due to patients with headaches and neck pain seeking care before their stroke.14 Notably, the correlation of medical visits and strokes matched that of chiropractic visits and strokes; neither form of care was shown to increase the risk of stroke. In either case, the unfortunate patient was headed for a vascular incident. The occurrence of a stroke after a visit to the chiropractor (or the medical doctor) provides no association of cause, only correlation.15
Is your chiropractor required to warn you about the possibility of a stroke with a chiropractic adjustment? Interestingly, Dr. Christopher Kent, who is an attorney, independent researcher, and president of the Foundation for Vertebral Subluxation, has expressed that “such informed consent must be based on appropriate information and since there is no scientific evidence that chiropractic adjustments or neck manipulations actually cause strokes, it is inappropriate to require a doctor to suggest that such a risk exists.”16 Nevertheless, most state and provincial laws require Doctors of Chiropractic to disclose a remote risk of stroke to their patients, for this is common practice for “material risks” even when the likelihood of occurrence is very small.17
Long-term Benefits of Chiropractic Care
Rather than study isolated reports of adverse incidences which may (or may not) occur within one visit to the chiropractor, it is more revealing to measure the long-term benefits of chiropractic care. Ultimately, studies consistently demonstrate that a healthier spine relates to a healthier person.
Beyond symptomatic relief, a growing number of chiropractors place emphasis on corrective care and spinal hygiene, to maintain and promote the health of the spinal column and nerve system.
Without maintenance of spinal health, we now know through numerous studies that posture misalignment not only affects neurology but also the vascular system. A 2004 study revealed that older men and women with hyperkyphotic postures have increased rates of death, specifically associated with increased atherosclerosis.18 With atherosclerosis increasing the incidence of an ischemic stroke, it is only logical for health-conscious individuals trying to prevent strokes to maintain healthy posture through chiropractic care.
Further, whereas a 2005 study showed that the reversal of the normal cervical curvature results in vascular changes in the spinal cord,19 the maintenance of this proper alignment should be of highest importance to those interested in the prevention of vascular incidents.
Statistically, the incidence rates favour those individuals receiving chiropractic care. In 1995, the Journal of Manual and Physiological Therapeutics published the risk of fatal stroke associated with chiropractic cervical adjustments. Although no cause was shown in the article, the correlation is estimated to be 1 in 400,000 or 0.00025%.20 Newer studies suggest the risk may be as low as 1 in 6 million, 0.00002%.21 Notably, the National Center for Health Statistics indicates the mortality rate from stroke in the general population is more than twice the rate of the most conservative estimates correlating chiropractic. The risk in the general population is 1 in 175,000 or 0.00057%.22
Not only is the risk of death from stroke after a cervical adjustment substantially less than the risk of fatal stroke in the general population, other long-term studies of chiropractic patients have shown:
Improved lung capacity, athletic ability, and vision23
Better functional capacity, and reduced relapse of prior disability24
Better overall health and greater activity levels25
Enhanced DNA repair and enzyme activity; reduced impact of oxidative stress26
Fewer hospital visits, reduced pharmaceutical costs, and medical expenditures27
Improvement in health, wellness, and quality of life28,29
The Final Verdict: Malpractice Claims
Lastly, as it is always possible that research could be slanted based on who was conducting it, perhaps the best measures of safety are the malpractice insurance costs for chiropractors and the actual frequency and success of claims filed against them. No one pays closer attention to injury statistics than Malpractice Insurance carriers.
According to the Canadian Medical Protective Association, annual malpractice rates for Ontario medical doctors range from $1,572 for the family physician and $7,332 for the neurologist, to $44,520 for the Obstetrician.30 By comparison, the Canadian Chiropractic Protective Association’s standard rate for chiropractic malpractice insurance is less than $1,300 per year. Notably, the first-year doctor of chiropractic is extended a new member discount of approximately 50% (as opposed to an increased premium), not reflecting any greater risk for a patient seeing a doctor with less experience.31
American rates reflect the inter-professional differences to an even greater degree. Whereas the U.S. physician could pay $25,000 to $50,000 per year for malpractice coverage, U.S. chiropractors pay annual rates less than $5,000.32,33 The chiropractic profession has a well-established record of safety and efficacy, and the chiropractor’s malpractice insurance rates remain among the lowest across health professions.34 The varying rates are directly related to the risk involved in the doctors’ procedures, the claims filed against them, and the likelihood of future lawsuits.35
Although they are sensationalized in the media when they do occur, claims against chiropractors are very rare. Your chiropractor’s office consistently proves itself to be one of the safest health care facilities you can choose for your family.
Unquestionably, there have been decades of misinterpretations, and unfortunately chiropractic myths have been passed down through generations. Certainly, professional bias has also played a role in the public’s misunderstanding of the safety and efficacy of chiropractic care. (The U.S. Court of Appeals determined in 1990 that the American Medical Association had engaged in a “lengthy, systematic, successful and unlawful boycott” designed to restrict cooperation between medical doctors and doctors of chiropractic.36) Fortunately, we are long past that day. What you would hope to find in the 21st century are cooperative teams of health care professionals working together for your benefit.
My personal recommendation is to seek a chiropractor who not only uses current technology and techniques to analyze and render care to his or her patients, but also is willing to engage in dialogue with your other health care providers. I recommend the same when choosing an M.D.
With this better understanding of chiropractic myths and the benefits of maintaining a healthy spine, I trust that you can comfortably move forward, integrating chiropractic care into your wellness lifestyle.
CHIROPRACTORS HAVE CLAIMED FOR YEARS THAT WE CAN BE MORE COST-EFFECTIVE. BCBS HAS THE DATABASE THAT WOULD PROVE OUR THESIS, BUT THERE SEEMS TO BE A RELUCTANCE TO ALLOW OUR PROFESSION TO ACCESS THE DATA THAT WOULD PROVE US RIGHT.
In August 1999, Blue Cross/Blue Shield (BCBS) of Kansas presented a study titled “Lumbago Treatment.” This data was made available from a new program installed by BCBS called the McKesson Episode Profiler.
This program gave BCBS the ability to sort data according to specific diagnoses and compared the costs, frequency, and other factors between peer groups.
The data revealed that while less than eight percent of the study group were chiropractors, 38 percent of the patients chose to seek chiropractic care rather that allopathic medicine. This fact indicates that patients desire and are satisfied with the management techniques of the chiropractor.
The study did not include any hospitalization costs for surgery or any fees paid to orthopedists or neurosurgeons for costs associated with surgery. If the data included costs for these procedures, the savings for chiropractic would have been much greater.
When sorted by the average cost per episode, chiropractic is more cost-effective than anesthesiology; neurosurgery; neurology; registered physical therapy; orthopedic reconstructive surgery; physical medicine and rehabilitation; and rheumatology.
The greatest cost-effectiveness of chiropractic is demonstrated when one considers the global cost of allopathic care. The physical therapist can only receive referrals from an allopathic provider. An allopath can only write prescriptions. The allopathic provider primarily orders surgeries, nerve conduction tests MRIs, and CT scans. Hospitalization charges are totally allopathic charges that cannot be associated with chiropractic. When these charges are considered, the tremendous economy of chiropractic management becomes indelibly clear.
The majority of chiropractic charges were associated with the basic office-treatment-related services performed. Eighty-nine percent of the chiropractic charges were for services related to the treatment, while only 45 percent of the family practice costs were related to treatment of the condition. The remainder of the costs were for expensive diagnostics.
Patients who visit the family practice provider have about a 15 percent chance that they will have a MRI or CAT scan. These services cost an average of over $1,000 and provide no treatment, only a diagnosis.
For each 100 episodes, the chiropractor provided 265 modalities. For each 100 episodes, the registered physical therapist provided 885 modalities: over three times as many units of physical therapy provided by RPTs than chiropractors. This is a cost that has to be globally charged to the family practice providers, since patients cannot access RPTs without a referral from a medical doctor.
Registered physical therapists provided 303 office visits per 100 episodes, compared to 255 by the chiropractor. When RPTs are combined with the other allopathic portals, there are 598 office visits per 100 episodes. Therefore, the myth claiming chiropractors treat the patient more than the allopathic portals is obviously just diversionary, and not based on facts.
Patients had a willingness to return to the chiropractor that was 22 percent greater than the combined totals of allopathic portals. This indicates a level of satisfaction that is demonstrated by the patient’s willingness to return, based on results and confidence.
The BCBS lumbago study demonstrates that chiropractic is not only cost-effective but also quality effective. Adding chiropractic services would only decrease the cost to the plan. What is hard to explain is the prejudice against chiropractic in the design of BCBS plans, and their reluctance to push the study and analysis of the data to the next level. It almost seems as though there is a fear that exists in the minds of those in positions of power, preventing them from presenting the cost comparisons with the global cost of allopathic portals to chiropractic. Chiropractors have claimed for years that we can be more cost-effective. BCBS has the database that would prove our thesis, but there seems to be a reluctance to allow our profession to access the data that would prove us right.
I guess the million-dollar questions are “Why?” and “What are they afraid of?” Perhaps it is the fear of knowing how to handle the data once it proved that chiropractic was more cost-effective. Perhaps it is getting past the mindset that adding chiropractic benefits is going to increase reimbursement levels. Perhaps they cannot see that there would not be a cost increase but a cost savings from directing patients to more cost-effective portals. Allowing osteopaths to treat broken arms did not increase the number of fractures; it simply shifted the point of access to treatment. Likewise, allowing patients to freely access chiropractic services would not increase the number of spinal related injuries; it would simply allow the patient access to desired and more cost-effective services.
I imagine that BCBS of Kansas regrets releasing the amount of information they already have. There seems to be a reluctance to push the analysis of the data to the next level. It is now up to the profession to “hold their feet to the fire” and push for more data to support the fact that chiropractic can be more cost-effective.
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