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Two viable options for Sciatica

Sunday, October 2nd, 2011

Manipulation or Microdiskectomy for Sciatica?
A Prospective Randomized Clinical Study
This section is compiled by Frank M. Painter, D.C.

FROM:   J Manipulative Physiol Ther. 2010 (Oct);   33 (8):   576–584

Gordon McMorland, DC, Esther Suter, PhD, Steve Casha, MD, PhD, FRCSC, Stephan J. du Plessis, MD, R. John Hurlbert, MD, PhD, FRCSC, FACS 

Gordon McMorland, DC, National Spine Care, #300, 301 14th Street N.W., Calgary, AB, Canada T2N 2A1.
gmcmorland@nationalspinecare.com

OBJECTIVE:   The purpose of this study was to compare the clinical efficacy of spinal manipulation against microdiskectomy in patients with sciatica secondary to lumbar disk herniation (LDH).

METHODS:   One hundred twenty patients presenting through elective referral by primary care physicians to neurosurgical spine surgeons were consecutively screened for symptoms of unilateral lumbar radiculopathy secondary to LDH at L3-4, L4-5, or L5-S1. Forty consecutive consenting patients who met inclusion criteria (patients must have failed at least 3 months of nonoperative management including treatment with analgesics, lifestyle modification, physiotherapy, massage therapy, and/or acupuncture) were randomized to either surgical microdiskectomy or standardized chiropractic spinal manipulation. Crossover to the alternate treatment was allowed after 3 months.

RESULTS:   Significant improvement in both treatment groups compared to baseline scores over time was observed in all outcome measures. After 1 year, follow-up intent-to-treat analysis did not reveal a difference in outcome based on the original treatment received. However, 3 patients crossed over from surgery to spinal manipulation and failed to gain further improvement. Eight patients crossed from spinal manipulation to surgery and improved to the same degree as their primary surgical counterparts.

CONCLUSIONS:   Sixty percent of patients with sciatica who had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention. Of 40% left unsatisfied, subsequent surgical intervention confers excellent outcome. Patients with symptomatic LDH failing medical management should consider spinal manipulation followed by surgery if warranted.

From the FULL TEXT Article

Discussion 

Most health care providers would agree that first-line treatment of radiculopathy secondary to LDH should consist of nonoperative care in the form of lifestyle modification and analgesia for pain control. Additional options include careful use of antiinflammatory medications, physiotherapy, massage therapy, local injections, acupuncture, and chiropractic treatment. However, it is when these modalities fail over a period of 6 to 12 weeks that the more invasive and expensive option of surgery is often considered. Perhaps it is the attraction of immediate anatomical restoration and ensuing pain relief that sets surgical intervention apart from other treatment modalities, or perhaps it is recognition of the attendant and relatively unique risks associated with operative intervention. Whatever the reason, surgery is generally regarded as the final solution in what is in many cases a very long journey through failed medical management.

The purpose of this pilot study was to compare clinical outcomes among patients failing nonspecific conservative care (in which the common denominator was time elapsed from onset of symptoms) who were then subjected to a regulated spinal manipulation regimen or to a traditional surgical microdiskectomy. To our knowledge, this is the first study to directly compare the efficacy of surgery against a standardized nonsurgical treatment.

It is well established that the failure rate of microdiskectomy in the relief of radiculopathy secondary to LDH is in the order of 10% to 20%. [32, 33, 34] Our observed surgical failure rate of 15% is in keeping with these previously published findings. Similarly, our observed spinal manipulation failure rate of 40% lies within the published range of 5% to 50%. [5, 7, 14, 35, 36] It is notable that our study is the first to report on manipulation treatment effects on a group of patients failing other medical management and with symptoms of more than 1 to 3 weeks in duration. Hence, it is not surprising for our patients to be perhaps more refractory to spinal manipulation therapy.

There is a large range of treatments that fall under the umbrella of “conservative” or “nonoperative” treatment. In this study’s patient population, only 2 of the 120 screened had received spinal manipulation before presentation. Although guidelines have been established outlining appropriate care pathways for this patient population, our experience has been that standardized treatment approaches are not followed. The nature of conservative treatment for patients presenting for this study was largely passive in nature, consisting of medication and rest. Those patients who had undergone a course of physiotherapy had received treatment focused on pain relief (ie, modalities) as opposed to active rehabilitation. Of those patients reporting some attempts at active rehabilitation in their previous treatments, all related that any attempts at performing rehabilitative exercises were limited by pain. None of the 120 patients screened for this study had received intraspinal injections.

Using objective clinical indicators tested for validity and reliability, this study has found by intent-to-treat analyses that a relatively high number (60%) of patients failing initial medical management and deemed appropriate for surgical intervention can gain a similar amount of pain relief through spinal manipulative treatment as they might have gained from surgery. This observation appears to hold true for both rate and magnitude of recovery. Changes in clinical status were reflected in each of the measurement tools used. This consistency between the outcomes measured lends credibility to the reliable nature of the data and attest to the extremely small likelihood of study results being contaminated by random chance.

Although 40% of patients referred to spinal manipulative therapy for LDH-induced sciatica may fail to achieve satisfactory relief, the obvious risk and cost profile of operative care argues for serious physician and patient consideration of spinal manipulative therapy before surgical intervention. In the present study, 8 patients who failed primary spinal manipulative care and went on to surgical decompression ultimately benefited with clinical outcomes indistinguishable from the treatment successes. There was no evidence that delay in definitive treatment adversely affected degree of improvement. Nonetheless, further study is warranted to better identify factors predictive of spinal manipulative success and failure.

Finally, it appears that those patients who fail surgery do not benefit from further spinal manipulation intervention. Despite the small number of patients in this category, the results from the present study have shown a consistent failure of improvement in all clinical outcome measures with strong statistical significance. This observation tends to reinforce a general clinical impression that the surgical “failed back” tends to be a chronic condition refractory to other forms of intervention.

It can perhaps be argued that clinical improvement in both treatment groups was confounded by the benefits of natural history (ie, spontaneous improvement with time). However, all patients in this study had failed at least 3 months of conservative care. Approximately 80% of participating subjects (n = 32) experienced symptoms for greater than 6 months, whereas 65% (n = 26) of them experienced symptoms for greater than 1 year. These figures suggest that most of the patient population in this study were not likely to improve from natural history alone.

Limitations 

The main limitation of this study is its relatively small sample size (n = 40). However, statistical techniques have demonstrated it to be adequately powered in the ability to detect clinically significant differences between treatment groups. Nonetheless, for more robust conclusions with respect to the patients who failed surgical microdiskectomy, a larger sample size would be preferable. In addition, this trial was not designed to incorporate a “nontreatment” (natural history) control group; hence, the hypothesis that both surgery and spinal manipulation treatments are no different than the natural history of symptomatic LDH was not tested. Although follow-up in the present study was less than 2 years after final treatment, it is unlikely that any further significant changes would have been observed between 1- and 2-year follow-up points based on the experience of other recent prospective randomized trials. [15, 17]

Conclusions 

Most of the patients who were considered surgical candidates for the treatment of radiculopathy from LDH improved with standardized spinal manipulative care to the same degree as those who had undergone surgery. Of those who failed spinal manipulation treatment, subsequent surgical intervention provided excellent outcome. In contrast, the 3 patients who failed microdiskectomy did not benefit from further spinal manipulative care. Therefore, patients with symptomatic LDH failing medical management (failed at least 3 months of nonoperative management including treatment with analgesics, lifestyle modification, physiotherapy, massage therapy, and/or acupuncture) should consider chiropractic spinal manipulative treatment as a primary treatment, followed by surgery if unsuccessful.

Practical Applications 

  • Based upon this randomized clinical study, 60% of patients with sciatica and had failed other medical management benefited from spinal manipulation to the same degree as if they underwent surgical intervention.

  • Of the 40% of patients that showed unsatisfactory results with spinal manipulation, subsequent surgical intervention conferred excellent outcome.

  • The 3 patients who failed surgical treatment and crossed over to spinal manipulation did not gain further improvement.

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Is living next to fast food restaurants and convenience stores making you fat?

Sunday, October 2nd, 2011

Exploratory study: High BMI linked to proximity to convenience stores

BUFFALO, N.Y. — Researchers at the University at Buffalo conducting a neighborhood-scaled exploratory study that tested the association between the food environment, the built environment and women’s body mass index (BMI) have found that women with homes closer to a supermarket, relative to a convenience store, had lower BMIs, and that the greater the number of restaurants within a five minute walk of a woman’s home, the higher her BMI.
The study, “Food Environment, Built Environment and Women’s BMI: Evidence from Erie County, New York,” involved 172 participants and was published in the April issue of the Journal of Planning Education and Research. It was led by Samina Raja, PhD, UB professor of urban and regional planning.
The study team comprised several UB researchers: Li Yin, PhD, assistant professor of urban and regional planning; James Roemmich, PhD, associate professor of pediatrics; Leonard Epstein, PhD, professor of pediatrics; Changxing Ma, PhD, assistant professor of biostatistics; and graduate students Pavan Yadav and Alex Brian Ticoalu.
“In particular, three findings are significant,” says Raja.
“First, a greater number of restaurants within a five-minute walk of a subject’s house was associated with a greater BMI, holding other factors constant,” she says.
“Second,” she says, “on average, women who live within relative proximity to supermarkets and grocery stores (as opposed to convenience stores) tend to have lower BMIs.
“Third, and perhaps most important,” Raja says, “the interaction of the food environment and the built environment in a neighborhood carries significant consequences for obesity. For example, a diverse land-use mix, while beneficial for promoting physical activity, is tied to a net increase in BMI when that land is dominated by restaurants.”
She says future research on the built environment and health must take into account the role of the food environment on women’s health, and the study offers suggestions for how food environments may be improved using planning strategies.
Raja is a nationally regarded community-based scholar in the fields of food security planning and community health whose
work supports and is supported by UB’s Civic Engagement and Public Policy research initiative.
She points out that more than one-third of U.S. adults were reported to be obese in 2006, with the prevalence of obesity slightly greater among women than men.
“The prevalence of obesity is a significant public health concern because it places indi-viduals at a risk for a variety of diseases,” she says, “and the role of environmental factors in contributing to obesity has received a lot of attention. We have attempted here to explain the paradox of high BMI rates among women living in highly walkable inner city neighborhoods.
Raja says the study has several limitations, among them, the fact that the researchers did not know where their subjects shopped for food, only what outlets were closest geographically. The also were not able to classify restaurants based on their quality — fast-food and sit-down restaurants were treated as a single category, even though they know that quality varies widely across different types of restaurants.
“The study raises several questions to be addressed in future research,” she says, “and suggests that innovative research designs will be necessary to develop greater evidence of causality — perhaps longitudinal studies that look at how moving one’s residence (thus changing exposure to a particular food, food type or built environment) affects physical activity, eating behavior and health outcomes.”
The study identifies planning strategies and tools available to improve community food and built environments to support healthy eating behavior.
“Comprehensive plans, regulatory mechanisms and financial incentives can be used individually or in concert to improve food environments,” the study says, and cites recent efforts in Madison and Dane County, Wis.; Marin County, Calif.; Harrison County, Miss.; special regulations adopted in New York City that offer zoning incentives (e.g. allowing denser development and reduction in parking requirements) for development projects that dedicate a greater store floor area to fresh foods in underserved neighborhoods; and Pennsylvania’s Fresh Food Financing Initiative

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Rebuttal to Readers Digest view of cervical manipulation

Sunday, October 2nd, 2011

Foundation for Chiropractic Progress responds to ‘Reader’s Digest’ article

logo-main-rdSeptember 30, 2011 — When the FCA was contacted by members last week about a negative article in the October 2011 issue of the Reader’s Digest, they immediately contacted the Foundation for Chiropractic Progress (F4CP) to seek a rebuttal.

The F4CP responded via a letter by Gerard W. Clum, DC. The letter stated:

“The comments by Peter Lipson, MD, in your recent article ‘When Alternative Medicine Goes Wrong’ (Reader’s Digest, October 2011) related to chiropractic care were inaccurate and misleading to say the least.

“In 2008, an article published by Cassidy et al in the journal SPINE detailed the largest, most inclusive and in-depth study on the occurrence of vertebral artery dissection in history. The study included a review of nearly 110 million person-years for the occurrence of vertebral artery dissection in the province of Ontario, Canada. The researchers, using comprehensive provincial health records data, found no greater likelihood of a patient experiencing a vertebral artery dissection after seeing a chiropractor than after seeing their primary care physician.”

In response to: “When Alternative Medicine Goes Wrong,” (Reader’s Digest, October 2011 Issue)

Dear Editor,
The comments by Peter Lipson, M.D. in your recent article “When Alternative Medicine Goes Wrong”
(Reader’s Digest, October 2011) related to chiropractic care were inaccurate and misleading to say the
least.
In 2008, an article published by Cassidy et al in the journal SPINE detailed the largest, most inclusive and
in-depth study on the occurrence of vertebral artery dissection in history. The study included a review of
nearly 110 million person-years for the occurrence of vertebral artery dissection in the province of
Ontario, Canada. The researchers, using comprehensive provincial health records data, found no greater
likelihood of a patient experiencing a vertebral artery dissection after seeing a chiropractor than after
seeing their primary care physician.
Dr. Lipson’s view is an out-of-date anecdotal perspective that is contradicted by the findings of the
Cassidy study. Current thinking with respect to vertebral artery dissection is that rather than being
“caused” by the primary care physician or the chiropractor or any other provider, it is more likely that the
patient is in the process of dissection when they presented for care.  A dissection in process produces
neck pain and headache – the reason they initially sought healthcare.
The “take-away” message is not for patients to avoid cervical spine adjustment by a chiropractor, rather
that all providers should be more alert to the possibility that neck pain and headache in rare cases may
be the result of a vertebral artery dissection in process.

Gerard W. Clum, D.C.
Spokesperson, Foundation for Chiropractic Progress

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Breast Cancer prevention TIPS

Sunday, October 2nd, 2011

October is Breast Cancer Awareness Month: tips for breast cancer prevention

nbcam_25yrs_web_logoOctober 1, 2011 — October is Breast Cancer Awareness Month, a time when much attention is focused on the rising incidence of breast cancer and the benefits of screening and early detection of this condition.

In the U.S., there is a large amount of fear surrounding the subject of cancer, yet the disease is more predominant in the U.S. than in other Western countries. The media perpetuates this, and the anxiety associated with cancer can wreak havoc on our immune systems.

So how do we approach breast cancer awareness in a positive way, and without fear? Chicago Healers practitioner and holistic physician Dr. Marilyn Mitchell, MD, offers three positive perspectives to help take charge of your health and protect yourself as far as cancer is concerned:

Physical health

Screen DIY first. Screening is an important aspect of breast health awareness. Begin with breast self exam (BSE), a systematic palpation of the breast performed once per month. Women often ignore their breasts, and a regular self exam can be performed with an attitude of bringing positive energy and appreciation to the breasts.

Don’t forget your doctor. A doctor can offer you a technological breast screening, which should be scheduled every one to two years. There are several types of technological screenings for breast health:

  1. Mammogram - The standard screening tool for detecting breast cancer and benign breast disease. Mammograms are able to detect masses before they are palpable.
  2. Ultrasound – Helpful in imaging cysts. This device is usually an adjunct to mammogram, as it does not image solid tumors as clearly as fluid-filled ones.
  3. MRI – This is sometimes used as a follow up to mammogram.
  4. Thermogram - A screening exam that accesses the heat or thermal changes in the breast (reflecting blood flow). This does not involve radiation or compression of the breast. There is much interest growing around this technology, but it is not yet in widespread use, and the long term data and success at detection is not yet determined.

Take your vitamins. Certain natural supplements and antioxidants taken on a regular basis can help the body fight off cancerous cells.

Toss the burnt popcorn. Carcinogens are often linked to cancer, so it is important to distance oneself from carcinogens and other irritants as much as possible. That said, you can have a summer barbecue, but try not to grill out too often.

Evaluate your risk factors. Do you have a family history of ovarian cancer? Don’t wait to find this out before it’s too late – knowing this information can help you take the necessary steps to decrease your risk of having cancer.

Don’t forget the basics. Sleep, exercise, and a healthful diet are all building blocks for a healthy life.

Emotional health

Build your support system. Strong relationships with friends and family boost the immune system and lead to a long, healthy life. These people will be there for you to rely on, both in sickness and health.

Teamwork counts. Encourage friends and family to make healthy changes to their lifestyle as well. This will make healthy habits easier and more fun to adopt.

Spiritual health

Think positively. Surrounding yourself with positive thoughts and eliminating negative thoughts can be very beneficial in eliminating stress. This will significantly affect your well-being for the better.

Nurture yourself. Self-compassion is a key ingredient to a sound mind and body. Practice self-love by treating yourself to bubble baths, a nice book…things that make you happy.

Limit your media intake. Overdosing on TV and sensational media can be a source of negativity and stress that you don’t need. Think about cutting down on this and replacing the time you would spend watching the news with a positive activity you enjoy.

Be grateful. Nothing beats negative energy quite like counting your blessings. By regularly thinking about what you are grateful for in life, this will make you in good spirits which is also good for your body.

If you get a diagnosis of breast cancer, be sure to build a team of support around you and a holistic plan of care. Make sure you have medical, emotional, nutritional support, as well as supportive relationships.

Seek out a support group or therapist if you need it. Be sure to choose positive thought patterns to support you. Become empowered to be the leader in your healthcare.

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Military General becomes a spokeswoman for Chiropractic

Sunday, October 2nd, 2011

Halstead to address Logan College of Chiropractic student body

September 21, 2011 — Retired Army General Rebecca Halstead, a national spokeswoman for Foundation for Chiropractic Progress (F4CP) will speak to the student body of Logan College of Chiropractic/University Programs on Sept. 30 about her own personal battle in overcoming physical pain to achieve her career goals.

The presentation is scheduled at 9:15 a.m. in the William D. Purser, DC, Center on the Logan campus. Logan President Dr. George A. Goodman will introduce General Halstead at the event, which is sponsored by Logan’s Student American Chiropractic Association.

General, Halstead, a 1981 graduate of the United States Military Academy, holds the distinction of being the first female graduate of West Point to be promoted to General Officer and the first female in U.S. history to command in combat at the strategic level.  General Halstead served 27 years in the U.S. Army before her retirement in 2008.

“Logan students are extremely fortunate to have the opportunity to hear General Halstead speak about her positive

experience with chiropractic and how it contributed to her successful military career,” said Megan Lindsey, Logan’s SACA legislative representative.

The program schedule is as follows:

  • 9:15 a.m.         Presentation of the colors
  • 9:20 a.m.         Gary Cuneo, FCP welcome
  • 9:30 a.m.         Dr. George Goodman introduces Gen. Halstead
  • 9:35 a.m.         Gen. Halstead presentation
  • 10:50 a.m.        Question-and-answer session with Gen. Halstead
  • 11:05 a.m.        Removal of the colors

Chiropractic physicians provide a holistic approach to maintain or increase a person’s quality of life and ability to age successfully without the use of drugs or surgery.   Doctors of chiropractic can assist with complaints beyond neck and back pain, including issues of carpal tunnel, headaches, fibromyalgia, osteoarthritis, and osteoporosis. In addition, chiropractors educate patients about healthy lifestyle choices including sleeping habits, nutrition, and custom exercise regimens.

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Chiropractic School offers free chiropractic care for First-responders

Sunday, October 2nd, 2011

Logan College of Chiropractic marks first-year anniversary of free chiropractic care for first responders

September 24, 2011 — In September 2010, Logan College of Chiropractic/University Programs instituted a First Responders Chiropractic Care Program to offer complimentary chiropractic care to first responders who work in the St. Louis area, including police officers, firefighters, emergency medical ambulance technicians, and returning military soldiers (since 9/11).

At its one-year anniversary, Logan President George A. Goodman, DC, FICC, has announced that the program, offered through the school’s suburban health centers, is a major community service success.

“Over the past year, Logan health centers have treated 577 first responder patients through their 9,468 patient visits to our clinics in Chesterfield, south St. Louis County and St. Charles County,” said Goodman. “Logan is extremely proud to provide this free health care community service to first responders who are so deserving of our respect and admiration because of their public service and personal sacrifice.”

As part of the program, the initial clinic visit by a first responder includes a consultation and review of patient health history, physical examination, five X-ray views and interpretation (if indicated), urinalysis and complete blood count (if indicated) and a report of findings with treatment recommendations. In addition to the chiropractic adjustment and office visit, first responders are also able to take advantage of Logan’s  wellness program services.

Chiropractic physicians provide a holistic approach to maintain or increase a person’s quality of life and ability to age successfully without the use of drugs or surgery.  Doctors of chiropractic can assist with complaints beyond neck and back pain, including issues of carpal tunnel, headaches, fibromyalgia, osteoarthritis, and osteoporosis.

In addition, chiropractors educate patients about healthy lifestyle choices including sleeping habits, nutrition, and custom exercise regimens.

There are approximately 255 senior interns currently working through the Logan health centers system. Patients receive direct care that is provided by these highly trained students who are familiar with the newest discoveries in chiropractic health care and work under the direct supervision of experienced clinicians who are doctors of chiropractic and members of the teaching faculty at Logan College of Chiropractic.

Logan’s participating centers and their locations include: Montgomery Health Center, 1851 Schoettler Road on the Logan campus in Chesterfield (636-227-0903); Bogey Hills Health Center at 2067 Zumbehl Road in St. Charles (636-947-4770); St. Peters Health Center, 263 Salt Lick Road at Highway 79 Crossing (636-397-3545); and Southfield Health Center, Logan’s newest clinic, at 5422 Southfield Center 5422 Southfield Center near Lindbergh Blvd. and Baptist Church Road in south St. Louis County (314-849-3800).

To make an appointment, first responders should contact the individual health center that is most conveniently located for them. The health centers are open Monday through Thursday from 11:30 a.m. to 7 p.m., Friday from 11:30 a.m. to 6 p.m., and Saturday from 9 a.m. to noon.

Please note: first responders who have injuries that result in a personal injury claim, such as a car accident, or injuries that are of an on-the-job nature and fall under worker’s compensation will incur normal Logan fees in accordance with insurance regulations. Patients should discuss these injuries with representatives at Logan’s health centers prior to any treatment.

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Doctors of chiropractic are a key part of our military health care system

Sunday, October 2nd, 2011

Senate panel to Pentagon: Increase services provided DCs among troops

September 30, 2011 — The American Chiropractic Association (ACA) and the Association of Chiropractic Colleges (ACC) applauded a Senate proposal calling for greater utilization of the services provided by doctors of chiropractic within the Department of Defense (DoD).

ar120520089135932The U.S. Senate Committee on Appropriations recently filed a report to accompany fiscal year 2012 spending legislation for Pentagon operations, which included language urging DoD to expand the use of services delivered by doctors of chiropractic to troops in combat settings.

The language, included in Senate Report 112-77, specifically urges DoD to address musculoskeletal injuries, prevalent in the forward combat areas, by “increasing the use of chiropractic care” and “to expand the utilization of alternative medical treatment options such as chiropractic health care services at military treatment facilities to help mitigate these injuries.”

“I am encouraged that the subcommittee recognizes that the services provided by doctors of chiropractic are vital to the well-being of our troops and that we are an essential part of the recovery process for many,” said ACA President Keith Overland, DC.  “I want to especially thank committee Chairman Daniel Inouye for including this language in the report.”

The report’s pro-chiropractic language was largely in response to various media reports, including one earlier this year that received nationwide attention, stating that musculoskeletal injuries are twice as prevalent as combat injuries among deployed troops, and that musculoskeletal injuries among deployed troops have increased tenfold in the last several years.

The services provided by doctors of chiropractic are available at 60 military treatment facilities worldwide. ACA and ACC are hopeful that the subcommittee’s support for the services provided by doctors of chiropractic will spur further expansion of chiropractic’s presence in both the DoD and the Department of Veterans Affairs (VA).

“The Association of Chiropractic Colleges welcomes this strong endorsement from the Senate Appropriations Committee for the vital role that chiropractic care can continue to play in addressing musculoskeletal injuries to our troops,” said Richard Brassard, DC, President of the ACC. “Studies have shown what the chiropractic profession and the Department of Defense have known for years, that doctors of chiropractic are a key part of our military health care system that cares for our soldiers, sailors, airmen and marines in times of war both here and overseas. We are honored to be a part of the DoD health care provider team.”

While the congressional report’s language does not have the force of law and does not compel DoD to take action, such report language often initiates federal departments and agencies to take action based on congressional findings and requests. Learn more about ACA’s action regarding federal initiatives at www.acatoday.org.

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Watch out for those intersections!

Friday, September 30th, 2011

Intersection Auto Accidents

Intersection auto accidents are among one of the most difficult types of auto accidents to prove liability in. Serious questions will arise in these accidents about the actions and contributory negligence of each party.


Intersection auto accidents are among one of the most difficult types of auto accidents to prove liability in. Serious questions will arise in these accidents about the actions and contributory negligence of each party. If your injuries are minor, fault will not matter in a no-fault state like Oregon or Florida, but when your injuries are serious and result in medical bills beyond your PIP coverage, it is crucial to have a great chiropractor and attorney who can help establish fault after the fact.

Knowing this, insurance companies will actively discourage you from hiring an auto accident attorney. They know that if they can prevent you from hiring legal representation, they can minimize the amount of money they will have to pay for your damages.

Injuries in Intersection Auto Accidents

The injuries sustained in intersection auto accidents are often severe. Common injuries in these accidents include:

- Sprain/Strains

- Side Whiplash injuries (sometimes leaving you with chronic pain)

- Broken bones

- Neck and back injuries

- Brain injuries

- Spinal cord injuries

- Death

These injuries may require both emergency and ongoing medical care, and can significantly reduce your quality of life and ability to provide for yourself and your family. Dealing with insurance alone will almost certainly result in inadequate compensation, making an experienced auto accident attorney necessary to ensure you are treated fairly, and provided with the full compensation you are due.

Why Hire an Attorney and Chiropractor

When you are involved in an accident, you need an advocate on your side who will thoroughly investigate the cause of your accident, and help establish liability. In Oregon, even if you were partially to blame for your accident, you may still be entitled to recover a portion of your damages. Your attorney will be able to determine where fault should lie, and pursue the full amount of compensation you are entitled to. Your attorney will also deal with your insurance company, making sure you are not intimidated or coerced into accepting a settlement that is less than you deserve.

A good PI Chiropractor can document your injuries in such a manner to show decreased range of motion, loss of use, decrease in ADL’s, permanent residual pain, and or show the need for pain management, surgery, or physical therapy.  They are trained specialist in handling whiplash injuries, lower back pain, and the alternative therapies often get you back to work much faster then just medication and physical therapy alone.

Without an attorney, you may be forced to accept a settlement that leaves you responsible for a large portion of your damages. You deserve better. An aggressive car accident attorney will assess the total extent of your damages, and work to get you the full compensation you deserve.

If you live in or around West Linn, Oregon and have been involved in an intersection auto accident, please visit the website of the West Linn Pain Relief Clinic at Linn City Chiropractic & Spinal Decompression and Trusted Hands Massage Therapy to see how we can help you get as much pain relief as you deserve.

 

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Auto Accident statistics

Thursday, September 29th, 2011

EARLY EDITION 2009 Motor Vehicle Crash Data from FARS and GES

This chapter presents statistics about police-reported motor vehicle crashes according to the most severe injury in the crash: Fatal, Nonfatal Injury (Injury), and Property Damage. The tables and figures are presented in four groups: Time, Location, Circumstances, and Alcohol. Below are some of the crash statistics you will find in this section:

More than 5.5 million police-reported motor vehicle crashes occurred in the United States in 2009. Twenty-eight percent of those crashes (1.52 million) resulted in an injury, and fewer than 1 percent (30,797) resulted in a death.

Midnight to 3 a.m. on Saturdays and Sundays proved to be the deadliest 3-hour periods throughout 2009, with 1,024 and 1,072 fatal crashes, respectively.

Sixty-one percent of fatal crashes involved only one vehicle, as compared with 32 percent of injury crashes and 32 percent of property-damage-only crashes.

Nearly one-half of all fatal crashes in 2009 occurred on roads with posted speed limits of 55 mph or more, as compared with 23 percent of injury crashes and 23 percent of property-damage-only crashes.

Collision with another motor vehicle in transport was the most common first harmful event for fatal, injury, and property-damage-only crashes. Collisions with fixed objects and noncollisions accounted for only 19 percent of all crashes, but they accounted for 46 percent of fatal crashes.

Thirty-two percent of all fatal crashes involved alcohol-impaired driving, where the highest blood alcohol concentration (BAC) among drivers involved in the crash was .08 grams per deciliter (g/dL) or higher. For fatal crashes occurring from midnight to 3 a.m., 66 percent involved alcohol-impaired driving.

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Injured in an Auto Accident? Pain relief in West Linn is here for you..

Thursday, September 29th, 2011

Auto accidents disrupt your life, mess up your car and add more demands on your already stressed-out daily life. Unfortunately, this can also include physical pain as well. Dr. LoGiudice of Linn City Chiropractic understands and is here to help. Chiropractic’s gentle approach to care comforts and relieves many West Linn residents’ pain.

chiropractic treatmentOur chiropractic care for auto accident recovery involves very gentle chiropractic non-surgical spinal manipulation (Chattanooga Triton DTS) to open the spinal canal area, reduce pressure on the spinal nerves, and drop pressures within the disc itself. These bio-mechanical changes help you. West Linn Pain Relief Clinic knows you want safe, gentle care, and we offer that.

Now, check out these interesting facts about older (70+ years) drivers’ and middle-aged drivers’ (35-54 years) involvement in
  • Non-Fatal Auto Accidents: 27% fewer in older drivers vs. 16% fewer in middle-aged
  • Fatal Accident Survival: 37% of older drivers vs. 23% middle aged drivers
  • Property Damage Auto Accidents: 10% fewer older drivers were involved while 1% more middle-aged drivers found themselves in a property damage accident.

Motorcycle, car, truck… It doesn’t matter the motor vehicle-type when it comes to injury. You’re hurt. Take all the precautions you can to avoid Oregon motor vehicle accidents - helmets, later-age driver’s license rules, speed limits - but there is a reason they call them accidents. Don’t worry about why or how.  You can concentrate on getting back together with Linn City Chiropractic’s help!

Speaking of precautions, turn signals and brakes and mirrors and no-cell-phones are all great. Have you heard about helmets being good for motorcyclists? They make sense and have been proven to prevent head injury and reduce fatality in road crashes. Dr. LoGiudice of Linn City Chiropractic is aware of this, so we will keep that in mind in our careful examination of you. We find your source of pain.

Linn City Chiropractic & Spinal Decompression welcomes victims of motor vehicle accidents. You may experience whiplash or new neck pain or back pain or arm pain or leg pain like you never had before. We’ve seen it before and helped many West Linn, Lake Oswego, Oregon City residents recover from auto accident injuries.

Check out these articles, then contact Linn City Chiropractic, your West Linn chiropractic auto accident recovery center.

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