Special Tests
The use of special imaging and diagnostic procedures are becoming more popular in the clinical management of patients. Attorneys will be placed in the position of justifying the expense and use of these tests to the claims adjustor or judge. The doctor should consider the following questions before ordering such tests:
1. What is the clinical criteria for performing the test? If based solely on the patient's subjective complaints, this represents a very poor criteria.
2. Is the test both sensitive and specific for the condition? Computerized Axial Tomography (CAT) and Magnetic Resonance Imaging (MRI), for example, represent procedures which are both sensitive and specific. However, their use is often inappropriate in an uncomplicated soft tissue injury. Thermography, in comparison, is very sensitive, yet due to vast testing and interpretation variables, often renders the use of this test questionable.
3. Is the testing procedure well accepted in the scientific literature? For example, the timely use of paraspinal EMGs producing $900 to the incurred bills, in our experience, will bring the settlement process to a halt. The treating doctor may contend that the use of this special procedure was clinically necessary, but the insurance carrier will only reimburse those procedures proven in the clinical and literary arenas.
4. How will a "positive" or "negative" test alter the form of care rendered? A "positive" paraspinal EMG finding, in our experience, has never produced a change in the type of care rendered. For that matter neither has a "negative" result.
5. Is the test timely? The thermogram, for example, would be expected to be "positive" on the first days following the trauma, thus, negating the clinical criteria for performing said test during the acute stages of injury.
For the above reasons, plus the high fees associated with these procedures, we feel the improper use of these tests often produces prolonged reimbursement to all parties; patients, attorneys, and doctors
Narrative Reports
In our experience, this is far and away the greatest downfall in the well managed soft tissue case. We, as a profession, have become dependent on the computer generated narrative report. In our opinion, and that of the legal community as well, these types of reports often do not represent original thought or an accurate depiction of the patient's condition. The various legal arenas involved in personal injury suits take a very dim light as to the veracity of these types of reports.
The narrative report must also be an accurate reflection of the treatment rendered. All sections of the report should correlate to eliminate inconsistencies, and above all should represent accurate and original work. Remember, the attorney will use the report as a settlement tool. It should contain answers, not new problems. The quality and accuracy of the narrative report should not be underestimated. It alone represents months of care, the patient's basis for future medical considerations, prognosis, and most important of all, reimbursement for the services rendered. "He who botches the report, botches the case."
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Friday, January 29, 2010
Tuesday, January 19, 2010
How Your Posture Affects Back Pain and Neck Pain
Stand Up Straight - How Your Posture Affects Back Pain and Neck Pain
Have you ever wondered how you can develop back pain or neck pain without doing anything strenuous. It is amazing that humans don't sustain even more back pain and neck pain, given the structure of our bodies and the physical demands.
In my California chiropractic practice, I frequently treat office workers who experience chronic and severe back and neck pain tied to easy-to-fix ergonomic issues in their workspace. In my Columbus Ohio chiropractic business, I treat clients frequently who work in an office and could benefit from better ergonomics.
Anyone can experience back or neck pain at any time. I treat individuals regularly who experienced back and neck injuries from improper lifting, machinery usage, sports, falls, and auto accidents. The majority of patients think that chiropractic issues stem from lifting heavy sacks of concrete but are surprised to find that most are due to postural stress.
The "silent killer" of our spinal health is postural stress. Postural stress is experienced either while sitting or standing on one's feet. Postural stress is felt whenever the natural curve of the spine is altered or if the spine moves past its natural balance point.
As you sit at a computer, hunched over the keyboard or peering at the screen, your neck experiences postural stress. This posture, in which your head and neck are extended in front of your body, reverses the normal curvature of your spine and neck, and shifts your head away from its balance point.
The stability that is part of our structure when our postural boundaries are respected is lost when we assume postures that cause stress to our spines. Stress from the way we hold ourselves (either sitting or standing) opens our ligaments and muscles up to long periods of being stretched (perhaps incorrectly) which leads to muscle fatigue, irritation, inflammation, back and neck pain, and even arthritis over the long run.
A combination of therapies may be required to effectively treat back pain and neck pain from postural stress. Using this method of chiropractic care in conjunction with stretching and nutritional support relieves pain and stiffness and restores normal, full joint movement.If you have endured pain for a long time or if your symptoms are particularly acute, the road to recovery will not be short or easy. Don’t expect a quick fix.
Chiropractic care alone will not alleviate the problem; you must eliminate or change the causes of the postural stress. Have your workstation analyzed to highlight any ergonomic issues that could cause postural stress. Applying ice packs for neck pain and back pain for around twenty minutes at a time is also sometimes effective for relief.
Talking to your chiropractor is the first step in starting your treatment.
Chiropractors are medically trained to deal with postural stress problems and the neck pain that occurs as a result. At our chiropractic clinic in Columbus, we treat patients with a holistic approach using chiropractic care and enhanced with a regimen of stretching and exercise.
In order to facilitate the healing process we encourage the proper nutritional support.
You need to be aware of the importance of eliminating the source of the postural stress in addition to seeking treatment, regardless of which approach you take to relieve the pain of postural stress.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Have you ever wondered how you can develop back pain or neck pain without doing anything strenuous. It is amazing that humans don't sustain even more back pain and neck pain, given the structure of our bodies and the physical demands.
In my California chiropractic practice, I frequently treat office workers who experience chronic and severe back and neck pain tied to easy-to-fix ergonomic issues in their workspace. In my Columbus Ohio chiropractic business, I treat clients frequently who work in an office and could benefit from better ergonomics.
Anyone can experience back or neck pain at any time. I treat individuals regularly who experienced back and neck injuries from improper lifting, machinery usage, sports, falls, and auto accidents. The majority of patients think that chiropractic issues stem from lifting heavy sacks of concrete but are surprised to find that most are due to postural stress.
The "silent killer" of our spinal health is postural stress. Postural stress is experienced either while sitting or standing on one's feet. Postural stress is felt whenever the natural curve of the spine is altered or if the spine moves past its natural balance point.
As you sit at a computer, hunched over the keyboard or peering at the screen, your neck experiences postural stress. This posture, in which your head and neck are extended in front of your body, reverses the normal curvature of your spine and neck, and shifts your head away from its balance point.
The stability that is part of our structure when our postural boundaries are respected is lost when we assume postures that cause stress to our spines. Stress from the way we hold ourselves (either sitting or standing) opens our ligaments and muscles up to long periods of being stretched (perhaps incorrectly) which leads to muscle fatigue, irritation, inflammation, back and neck pain, and even arthritis over the long run.
A combination of therapies may be required to effectively treat back pain and neck pain from postural stress. Using this method of chiropractic care in conjunction with stretching and nutritional support relieves pain and stiffness and restores normal, full joint movement.If you have endured pain for a long time or if your symptoms are particularly acute, the road to recovery will not be short or easy. Don’t expect a quick fix.
Chiropractic care alone will not alleviate the problem; you must eliminate or change the causes of the postural stress. Have your workstation analyzed to highlight any ergonomic issues that could cause postural stress. Applying ice packs for neck pain and back pain for around twenty minutes at a time is also sometimes effective for relief.
Talking to your chiropractor is the first step in starting your treatment.
Chiropractors are medically trained to deal with postural stress problems and the neck pain that occurs as a result. At our chiropractic clinic in Columbus, we treat patients with a holistic approach using chiropractic care and enhanced with a regimen of stretching and exercise.
In order to facilitate the healing process we encourage the proper nutritional support.
You need to be aware of the importance of eliminating the source of the postural stress in addition to seeking treatment, regardless of which approach you take to relieve the pain of postural stress.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Saturday, January 9, 2010
Chronic Pain Relief San Diego
Define Chronic pain
Chronic pain is defined as pain that persists longer than 90 days beyond the course of the natural expected healing time. As a chiropractor in San Diego, I get calls from both new and established patients on a regular basis who complain of back pain, neck pain, etc. One of the factors that comes into play when planning a chiropractic treatment program is the duration of the patients pain. In genereral, the longer that a patient suffers with a painful condition, the longer / more intense the treatment is needed in order to fix it. Acute or recent episodes of pain respond much quicker than do chronic conditions.
Pain is very difficult to quantify by any practitioner. Pain is subjective in nature and completely defined by the person experiencing the symptoms, the fact that chronic pain can exist without an obvious cause makes it much more difficult to treat.
I see the difficulties that my chronic pain patients have with their conditions on a daily basis. Aside from the actual pain that they experience, those who suffer with chronic pain often limit their activities for fear of exacerbating their conditions. They also have a much harder time focussing on mental tasks as the pain is a constant source of distraction. The more severe the pain, the more difficulties these people have with attention demanding tasks.
While we strive to avoid pain, pain is a wonderful tool of the nervous system. Pain lets us know of actual or potential tissue damage with an unpleasant sensation that directs our attention to the affected area so that we can either immediately take action to stop the process or focus on healing the injured body parts. Chronic pain sensations are a bit more insideous.
Chronic pain often involves a decrease in the sensativity of the nerve fibers that send messages of pain from the damaged area. With a decreased sensativity (threshold), the nerve is much more likely to transmit painful sensations to the brain then a healthy nerve / tissue combination. This activity within the nervous system is know as a wind up phenomenon and it is very difficult to stop once it has been established. In some other cases, nerve fibers that normally don’t carry painful sensations not only begin to transmit pain signals but it is thought that they may actually generate the signals themselves.
In my office, chronic pain is often the result of untreated sprain / strain type injuries of the joints. In untreated or under-treated sprain / strain injuries, the joint or the muscles that move the joint are laden with scar tisuue that acts to either limit or alter motion of that joint. With time, the awkward, unnatural biomechanics of the scar tissue laden joint results in irritation, inflammation and finally pain and spasm. While chiropractic care is often successful at re-establishing “clean” biomechanics of a joint, it is always better to get the care in the beginning of an injury versus waiting for that injury to become chronic, with a requiring more care with a decreasing chance of complete recovery.
Because of the possibility of an acute painful condition becoming a chronic one, I always encourage my patients to take care of themselves immediately when they first start to experience pain. I have practiced chiropractic care for almost two decades now and I can say that chronic painful conditions of the spine are devastating. Not only do they make you expereince pain, but in most instances they limit your physical activities creating a situation that can easily degrade from inactivity secondary to pain, to deconditioning and eventually to obesity and ill health in general leading to a dissatisying lifestyle.
The bottom line on chronic pain is this – avoid it if you can. Don’t ignore your pain. Painful acute conditions that are left untreated can easily spiral into a chronic condition that has the potential to alter your lifestyle in a negative way.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Chronic pain is defined as pain that persists longer than 90 days beyond the course of the natural expected healing time. As a chiropractor in San Diego, I get calls from both new and established patients on a regular basis who complain of back pain, neck pain, etc. One of the factors that comes into play when planning a chiropractic treatment program is the duration of the patients pain. In genereral, the longer that a patient suffers with a painful condition, the longer / more intense the treatment is needed in order to fix it. Acute or recent episodes of pain respond much quicker than do chronic conditions.
Pain is very difficult to quantify by any practitioner. Pain is subjective in nature and completely defined by the person experiencing the symptoms, the fact that chronic pain can exist without an obvious cause makes it much more difficult to treat.
I see the difficulties that my chronic pain patients have with their conditions on a daily basis. Aside from the actual pain that they experience, those who suffer with chronic pain often limit their activities for fear of exacerbating their conditions. They also have a much harder time focussing on mental tasks as the pain is a constant source of distraction. The more severe the pain, the more difficulties these people have with attention demanding tasks.
While we strive to avoid pain, pain is a wonderful tool of the nervous system. Pain lets us know of actual or potential tissue damage with an unpleasant sensation that directs our attention to the affected area so that we can either immediately take action to stop the process or focus on healing the injured body parts. Chronic pain sensations are a bit more insideous.
Chronic pain often involves a decrease in the sensativity of the nerve fibers that send messages of pain from the damaged area. With a decreased sensativity (threshold), the nerve is much more likely to transmit painful sensations to the brain then a healthy nerve / tissue combination. This activity within the nervous system is know as a wind up phenomenon and it is very difficult to stop once it has been established. In some other cases, nerve fibers that normally don’t carry painful sensations not only begin to transmit pain signals but it is thought that they may actually generate the signals themselves.
In my office, chronic pain is often the result of untreated sprain / strain type injuries of the joints. In untreated or under-treated sprain / strain injuries, the joint or the muscles that move the joint are laden with scar tisuue that acts to either limit or alter motion of that joint. With time, the awkward, unnatural biomechanics of the scar tissue laden joint results in irritation, inflammation and finally pain and spasm. While chiropractic care is often successful at re-establishing “clean” biomechanics of a joint, it is always better to get the care in the beginning of an injury versus waiting for that injury to become chronic, with a requiring more care with a decreasing chance of complete recovery.
Because of the possibility of an acute painful condition becoming a chronic one, I always encourage my patients to take care of themselves immediately when they first start to experience pain. I have practiced chiropractic care for almost two decades now and I can say that chronic painful conditions of the spine are devastating. Not only do they make you expereince pain, but in most instances they limit your physical activities creating a situation that can easily degrade from inactivity secondary to pain, to deconditioning and eventually to obesity and ill health in general leading to a dissatisying lifestyle.
The bottom line on chronic pain is this – avoid it if you can. Don’t ignore your pain. Painful acute conditions that are left untreated can easily spiral into a chronic condition that has the potential to alter your lifestyle in a negative way.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
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