Health Update: Whiplash

Interesting Facts
About Whiplash

We all know the most common causes of “whiplash” are injuries that typically arise from automobile accidents or, motor vehicle collisions (MVC’s) although whiplash can also occur from slip and fall and virtually, any injury where your head is whipped backwards. But there are many things about whiplash you may not be aware of, which is the reason for this month’s Heath Update on whiplash.

For example, did you know the effect whiplash has on public health (in general) is tremendous? The number of cases occurring annually is frequently quoted as 1,000,000 per year, but this is based on an outdated (1971) and incomplete dataset. A more recent figure of 3 million per year is considered to be more accurate because it’s based on several governmental databases and it accounts for the expected number of unreported cases by the NHTSA (National Highway Traffic Safety Administration).  That’s a huge difference!  The updated figure accounts for whiplash victims not attended to by emergency medical services. In less catastrophic accidents, the injured party may not appear to be significantly injured at the scene of the MVC and decline emergency care and hence, the MVC will to unreported to a governmental data collection center.

Video: Whiplash Health Update




Another interesting study surveyed over 3500 chiropractors who were asked if they commonly applied cervical (neck) spinal manipulation to patients who had known herniated discs or protruded discs (in their neck). Over 90% of the chiropractors indicated they found it safe and effective to utilize cervical adjustments (manipulation) in this patient population. It is VERY important for you to know this as frequently, you may be told by your medical doctor (or next door neighbor), “…don’t let anyone crack your neck!” Now, you can rest assured that in the experience of MANY chiropractors (not just me), significant benefits can be achieved by this treatment approach.  Moreover, the sooner neck adjustments are applied, the better the results - so don’t wait to get a chiropractic treatment after an MVC!

Another interesting study investigated the “proper” or “best” seated position in a car during a rear-end collision, based on an analysis of many previously published studies on this topic.  Because the seated position of the person involved in a MVC is related to the degree of the injury, the factors studied included the angle of the seat back, seat-bottom angle, the density of the foam in the seatback, the height above the floor [of the knees], and the presence of armrests in cars.  They found that the seat back angle of 110-130 degrees reduced disc pressure and low back muscle activity but 110 degrees – MAX. – was found to minimize the forward positioning of the head. A 5 degree downwards tilt of the seat bottom further reduced the pressure in the low back discs and muscle activity as measured by an EMG Test (electromyography).  The use of armrests and the use of a lumbar support were also found to be important to reduce injuries associated with MVCs.  This combination was reported to be optimum for all of us to use in order to minimize the bodily injury in a rear-end MVC. Other important factors included firm dense foam in the seat back, an adjustable seat bottom (for angle, height, and front to back distance), horizontal and vertical lumbar support adjustments (…best if they pulsate to reduce the static load encountered in a crash), seat shock absorbers, and seat adjustments for front to back to adjust for different patient heights.

We hope this information is helpful. We realize you have a choice in where you go for your health care needs.  We truly appreciate your consideration in allowing us to help you through this potentially difficult process.

Visit us at www.newjerseypainmanagement.net or call us directly 732.719.8148 for more information and a Free consultation.

Health Update: Low Back Pain

Would Traction Help My Back Pain?

Traction is a common form of treatment for patients with low back pain.  By definition, traction is the “act of pulling a body part.”  That basically means traction can be applied to an arm, leg, finger, toe…..virtually any body part that one can get a hold of.  Here, the focus of traction is being applied to the lower part of the spine and the primary objective is for pain relief and restoring function.  Traction “works” by applying a force that separates and increases the space between joints.  It also stretches the surrounding soft tissues, including ligaments, joint capsules, muscles and tendons.  Spinal traction can be applied manually (with the hands) or by a device with either the use of complicated computerized equipment or, by a gravity assisted means such as using the body’s weight and gravity as the traction force.

Common conditions of the spine for which traction is often utilized include low back sprains and strains, disk herniations (“slipped disks”), and spinal stenosis.  Spinal stenosis occurs when there is a narrowing of the hole or canal through which a nerve root exits the spine or where the spinal cord travels, often caused by arthritic spurs.  Hence, it is most common after the age of 60 years old.  Traction has been shown to improve circulation, reduce inflammation, and by movement of the joints, it may also reduce the nerve’s excitability, resulting in pain reduction.

The “dose” of traction from a clinical experience standpoint, is determined by patient comfort.  It must “feel good” to be safe.  Remember, too much of anything changes it from being beneficial to being potentially harmful.  Therefore, when determining the dose of traction for the first time, we advise the patient to pay careful attention to the way they feel during the time traction is being applied. Often, it feels good at first but may become uncomfortable as time passes. If there is sharp pain, radiating pain (such as down a leg), or, if it is just not comfortable, traction should be discontinued and the recovery time should be reported.

A “typical” dose is 10-15 minutes of time, and the traction force can be continuous or intermittent, kind of like turning on a water faucet and leaving it running vs. turning it on and off.  With intermittent traction, we can vary the time that the force is applied such as 30 seconds on and 10 seconds off.  Generally, the total treatment time can be longer with intermittent traction (such as 15 minutes) compared to continuous traction, where 10 minutes may be utilized.  The traction weight or force can be gradually increased, depending on tolerance and individual patient response to the prior weight.

The Cochrane Report found traction is most effective for cases of sciatica or nerve root pressure creating leg pain. Also, it’s best when used in conjunction with other treatment approaches.  In a chiropractic setting, manual traction (where the doctor uses their hands to apply the force) is often utilized along with side to side or figure-8 movements to achieve better results.  Spinal manipulation, muscles massage, myofascial release techniques, exercise training for both stretch and strengthening purposes and patient education such as teaching proper bend/lift/pull/push techniques are often utilized to achieve the most satisfying results when managing patients with low back pain.

We realize that you have a choice in where you choose for your health care services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.      
                                                                              
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597.

Health Update: Low Back Pain

Why Does My Back Always Hurt?

Low back pain is a very common problem affecting 80-90% of all of us at some point in our lifetime.  Why is that you ask?  There are many reasons. One of the biggest reasons is that we are 2-legged animals carrying 2/3rds of our weight above our waist.  Studies have shown deterioration or arthritis occurs much sooner in us vs. our 4-legged animal counterparts. A 180 lbs man carries roughly 120 lbs above the waist.  This means, every time he bends over, in order to stand upright, he needs to lift 120 lbs PLUS whatever he is lifting.  Hence, the argument of, “…but I only bent over to lift a pencil and my back went out,” seems on the surface as impossible but in reality, the man in our example is lifting the pencil plus 120 lbs. Now, let’s add to that the point that a 5 pound weight equals 50 pounds when held out in front with the arms stretched out straight.  Now, if that’s not bad enough, now, let’s assume all of this is happening from a bent forward position, with a twist at the waist, with out stretched arms, while lifting a 20 pound object.  Get the idea?  It’s amazing our back doesn’t get injured every day as we lift 2 bags of groceries into the far end of a car trunk, or, when lifting our 30 pound child in and out of a car seat, height chair, or when they are screaming and pushing away from us as we try to lift them!


In order to further appreciate why the lower back is so vulnerable to injury, some basic understanding of anatomy is needed.  When we’re born, the back is made up of 33 segments of which 5 fuse by the time we’re about 18 years old to make up the sacrum (bottom of the spine) and 4 fuse to make up the coccyx (tail bone), leaving 5 lumbar (low back), 12 thoracic (mid-back) and 7 cervical (neck) vertebra.  These are stacked up on top of each other like building blocks and are connected to each other by a shock absorbing disk in the front and two smaller facet joints in the back, acting like a tripod.  In the low back, we’re supposed to bear about 80% of our weight in the front and 20% in the back but, if our abdominal muscles are a bit out of shape and the pelvis rotates forwards, the curve in the low back increases and overloads the back of the vertebra (facets) making them vulnerable to injury.  The disk becomes injured when we bend/lift/twist. This can tear the outer tough fibers of the disk, allowing the central more liquid-like material to leak out.  If this happens, the leaking or "herniated disc" can put pressure on the nerve that exits the spine and travels down our leg.  If the pain pattern includes the back of the leg, it’s commonly referred to as “sciatica.”

OK, enough about anatomy.  What can we do to reduce the chances of having periodic low back pain? Obviously, staying in shape is very important. Certain muscles of the body must be tight to keep us upright or standing.  These muscles need to be stretched on a regular basis. For example: the hamstring muscle.  We’ve all had to perform hurdler types of exercises and remember how tight they feel!


We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.  

FOR A FREE NO-OBLIGATION CONSULTATION CALL  732-984-9597  OR VISIT US AT ADVANCED-WELLNESS.NET

Health Update: Low Back Pain

I Slipped a Disc – What Is That Exactly?

“I was digging a hole in my garden and hit a rock with the shovel. After clearing the dirt from around the rock, I bent over and reached into the hole. I couldn’t get a good grip on the rock and had to twist my body to get my arm under it. As I started to move the rock, I felt something ‘give out’ in my low back and felt immediate low back pain, but it wasn’t terrible. Like a fool, I gave it another try but this time, the pain in my back was really sharp when I twisted to reach under it. Then, it felt like a knife stabbing me when I tried to stand up. Since then, I can’t stand up straight and pain is shooting down my left leg.”

The intervertebral disk is like a shock-absorber located between each vertebra in our spine extending from the tail bone to the upper neck. When healthy, your disks truly do function as shock absorbers. There are two parts to the disk – the inner part (called the nucleus) which is the liquid-like center and the outer part (the annulus), which is tough, laminated and rubber-like whose job is to hold the nucleus in the center of the disk. The annulus has concentric rings which look similar to the rings of an oak tree trunk and the strength of these laminated rings is due to the fibers crisscrossing, creating a self-sealing, secure border for the nucleus center. In spite of this great anatomical structure, our disks degenerate and can crack or tear allowing the more liquid-like nucleus to leak out of the annulus creating the classic “slipped disk” (technically referred to as a herniated or ruptured disk). When the herniated disk presses into the nerve that goes down the leg, pain is felt along its course and can radiate all the way to the foot. There are five vertebrae and disks with a pair of nerves that go into each leg and depending which disk ruptures, pain will follow a different course down the leg, which is why we ask you if you feel the pain more in the back or in the front of the leg. When the disk tears prior to both disk herniation and leg pain, low back pain occurs because the nerve fibers that are normally only located in the outer third of the disk grow into the central portion of the disk, making it generate more pain.

So now for the important question, “…what can I do for it?” When you visit our office, we will ask you about how you injured your back. Often, the cause of a herniated disk can be the accumulation of multiple events over time. It certainly can happen after one major event, like our example of lifting a rock out of a hole, but that is usually the “straw that breaks the camel’s back” and not the sole cause. Many researchers have reported it is rare for a healthy disk to herniate. Rather, disk degeneration with tears already present sets up the situation where a bend plus a twist, “…finishes the job.” The orthopedic and neurological examination will usually clearly identify the level of herniation. Chiropractic treatment often includes traction types of techniques, some form of spinal manipulation or mobilization, extension exercises, physical therapy modalities like electric stimulation, low level laser, or ultrasound, and ice therapy. Core / trunk strengthening and posture management are also commonly applied and, proper bending/lifting/pulling/pushing techniques are taught. We realize that you have a choice in where you choose for your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

What is spinal decompression therapy?

Spinal decompression is a non-invasive, non-surgical treatment for certain types of chronic back pain.  Mechanical decompression works by slowly and gently stretching the spine, taking pressure off compressed discs and vertebrae. Spinal decompression is one of the most exciting medical treatments developed in many years, since it demonstrates good statistical results for long term pain relief.

The most common spinal condition treated with decompression treatment is a herniated disc. Spinal compression can cause disc herniations to expand, putting pressure on surrounding spinal nerve roots Decompression treatment takes the pressure off these damaged discs so that the disc bulge will shrink back closer to its original size.

Degenerative disc disease is also a common condition treated with decompression therapy. Loss of disc height can be exacerbated by spinal compression, causing the vertebral bodies to move closer together. This can cause nerve compression and other forms of common back pain. Decompression eliminates the overwhelming pressure on degenerated discs reducing or eliminating painful symptoms.

Facet joint syndrome is yet another condition treated with spinal decompression. Facet syndrome causes pain due to arthritic changes in the vertebral bones. Decompression helps to create more space between the vertebrae, hopefully reducing painful symptoms.

In order to determine if you are a candidate for spinal decompression a thorough history, exam and review of diagnostic tests including MRI’s will be necessary.  Once accepted a typical decompression program is 4 to 8 weeks in duration.  Over this period 12 to 20 treatment sessions are performed.  Each treatment session is approximately one hour long and includes any necessary physical therapy services.

A spinal decompression program may be covered by health insurance plans.  Each plan must be verified and discussed with patients on an individual basis.  It is important to choose a practice that has both expertise in spinal decompression and utilizes the most advanced spinal decompression technology.  The DRX 9000 and the Vax D are the industry leaders in this technology.

Dr. Cilea is the president of Advanced Wellness.  Advanced Wellness has been a leader in spinal decompression in Central New Jersey with over a thousand patients treated over the past 5 years.  They utilize the DRX 9000 technology.  To learn more about spinal decompression visit www.AdvancedDRX.com or call 732-984-9594 for a free consultation.

Herniated Disc? Now what?

Not so long ago a diagnosis of a herniated disc often had you heading for an open surgery with a long recovery. This is no longer the case. In fact, it is most important to always verify the true cause of your pain or symtoms. For example, in many instances it may not be the disc causing the problem. We now know many people have disc herniations and are totally asymptomatic. There are many techniques and methods to determine and verify the true cause of your pain. The good news is there are many minimally invasive procedures such as spinal decompression, such as the DRX9000 or endoscopic disectomies that have patients regain their lives. It is important to make sure you seek out conservative options first prior to undergoing more invasive procedures.