Friday, November 15, 2013
Car Accident Injuries: Conservative treatments

I am a firm believer that you should be entitled to the treatment that you want. You should also be given treatment options that are best suited for your injuries and not based on a doctors biases or archaic opinions when they don’t understand other providers treatment benefits. An example would be a medical doctor who only believes in prescribing pills or just a small amount of physical therapy leaving you to fend for yourself. Discuss options with your medical doctor or chiropractor or go to someone who doesn’t have such a big ego that they won’t refer you out to another provider to give you the help that you need. So what are some of your options from a conservative standpoint?

Medication - This is obvious from a societal standpoint in that almost every M.D. will do this. If you are in severe and excruciating pain, this could be very appropriate for a short period of time. Taking it over a long period of time will only cover up the injury and cause improper healing not to mention side effects and addiction to pain killers. While I strongly believe and support the medical doctors I refer to for injuries I see in my practice, I also know what prolonged use of N.S.A.I.D.S. (non-steroidal anti-inflammatory’s) can do to the stomach and intestinal tract over time ( a separate discussion in and of itself) and what vicodin, norco and other opiates can do (addiction).

Injections - Cortisone injections for inflammation can be effective, but keep in mind that most good doctors will be conservative with this as it destroys and weakens surrounding tissues and can de-mineralize surrounding bone. If it helps then great, you just have to be conservative with them. Injections by pain management or orthopedic M.D.'s can be diagnostic and help source where pain might be coming from, but this would be for a more serious injury or for someone who has already undergone conservative hands on treatments that aren't working. 

Chiropractic - While this is second nature in cultures who come from other countries that treat their bodies more naturally, many have never tried chiropractic or think it’s something that its not. Chiropractic is safer then most types of medical care because it IS natural. Since the spine houses and protects the most vital and delicate system in the body (the spinal cord and nerve roots that keep us alive). It would be common sense to at least acknowledge the fact that if you’ve had an injury to the spine that causes subluxation (spinal misalignment and dysfunction) then maybe addressing this would be helpful if done prudently. There are so many new and exciting techniques that are very gentle and safe and do not require high force. National polls show that between 80-90% of the population is satisfied with the outcome of chiropractic. 

Physical Therapy - There are different types of physical therapy. Electrical muscle stimulation, ultrasound, diathermy, infra-red heat, heating pads, ice and paraffin baths are all geared toward acute or chronic inflammation and spasmodic type conditions.Then there is stretching, strengthening and core based physical rehabilitation that utilizes different types of exercises and equipment to do this. This would be more for the second phase of healing from your injury after you’ve gotten out of the acute phase and your body can handle it. I would not throw a highly acute patient into physical rehab too soon or before it’s time. I am a definite advocate of good physical therapy. 

Pilates Based Physical Rehabilitation - This is the new wave of physical therapy that is gaining a great deal of popularity. Initially I knew very little about pilates. My wife Audrey danced for the Sacramento Ballet when she was young and had been using pilates for over 30 years. We decided to add this to my practice after she became certified in the Body Arts and Science International Method. Since it incorporated all of the principles of stretching, strengthening, increased flexibility while utilizing the core stabilizers during movement, it became evident we should let my injury patients try it. I was very impressed with the results and now refer 80% of my injury patients to the pilates department. Now our staff attends the annual ‘Pilates on Tour’ symposium that is strictly geared toward rehabilitating injury patients. And guess who attends? Half of the attendees are pilates instructors and half are physical therapists who are convinced that pilates is a great rehabilitation method. We now receive referrals from many of the local physicians. I finally started pilates myself which has not only helped my own back pain but has given me a greater appreciation for the levels of difficulty. Now my orthopedic surgeon friend is doing it after referring many of his patients to me. Another unique benefit of pilates is the attention to detailed movement with our one-on-one instruction that teaches individuals how to engage the appropriate muscles correctly and translate that into everyday activities. 

Massage Therapy - Muscle work is really essential if you want the best possible healing. Finding a skilled massage therapist also makes a huge difference. There are many techniques, but I find that the one’s geared toward myofascial release are best and very appropriate for these types of injuries. 

Acupuncture - One thing I like about acupuncture is it is also safe and has gained a great deal of respect in the medical community. Many of my M.D. friends prescribe this to their patients so this could be a help for some as well. 

Surgery - On occasion, surgery is needed particularly for disc and facet joint injuries. One advantage I have in my 25 years of practice and working with thousands of injury patients and many M.D.’s is knowing who the good surgeons are. It’s also very helpful to know who accepts liens because if you’ve been in an auto accident and you don’t have health insurance, then there are only a handful of M.D.’s who will perform surgery on a lien (this is where a doctor get’s paid through your attorney). Sometimes surgery is just the way to go but make sure you utilize conservative treatment options first.

Article written by Dr. Kit Langstroth D.C. 916-925-2007
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Nephesh Chiropractic - Sacramento Injury Chiropractor