Doctor Higginson’s Blog

One of the most common symptoms experienced after a motor vehicle accident, is head and neck pain especially when the occupant is struck from behind. Neck injuries associated with auto accidents have been studied for many years, recently a new study published in the prestigious medical journal Spine, was released that helped to explain the cause of this pain.

The impact experienced by an occupant in an auto accident produces a large amount of force over a very short period of time, lasting only milliseconds. A new research study explains that it is may be the short time frame that may play a larger role in neck injuries than once thought. When an occupant is struck from behind, the force travels from the back of the car through the occupant finally exiting through the front. In order to protect the body, the body muscles of the neck contract to prevent injury. The muscles have been shown to fire at 100 milliseconds post impact which is 25 milliseconds after the majority of damage has occurred to the ligaments in the neck. (1)
The conclusion of the study: The muscles of the neck fire to late in a rear end collision to prevent injury to the spine and ligaments.
Ligaments heal very slowly because they lack the blood supply that muscles have. Ligaments in the neck also do not get the rest needed due to the demands on the neck at we go about our daily activities. The muscles of the neck are required to support a greater portion of the weight of the head and therefore become tired and sore while supporting this weight.
When structures of the neck are injured, the once healthy tissue is replaced with scar tissue. This new tissue is not nearly as strong or flexible as its predecessor. Encouraging proper healing of these tissues requires maintaining the mobility through spinal manipulation and stretching. Once the injured areas become less painful, it is imperative to strengthen the supporting muscles that have been injured. These muscles will be responsible for supporting the neck and preventing exacerbations or flare ups.
Injuries in the neck can also produce symptoms of pain in areas other than the location of the injury, this is called referred pain. For example and injury that occurs in the neck from a motor vehicle collision can present at pain in the shoulder blade. Referral pain patterns have been mapped out in the neck by injecting a stimulus to a specific area in the spine with a stimulating agent and the patient is asked to identify any symptoms they are experiencing outside of the location of the injection.
1. Vasavada AN, Brault JR, Siegmund GP. Musculotendon and fascicle strains in anterior and posterior neck muscles during whiplash injury. Spine 2007;32(7):756-765.

In a pilot study conducted at the University of Chicago a one time specialized chiropractic adjustment, delivered to patients suffering from high blood pressure and misaligned C1 vertebra, resulted in significant reductions in diastolic and systolic blood pressure compared to controls. According to a press release from the University of Chicago medical center, office of public affairs, a decrease in blood pressure was equivalent to that seen with concurrent administration of two blood pressure drugs. None of the patients took in the hypertensive medications during the study period.

Fifty percent of the patients received a specific chiropractic adjustment, while the remaining received a sham procedure, carefully designed to mimic the actual adjustment in order to ensure blinding.  Eight weeks from the intial adjustment, blood pressure was measured in the two groups.  There was a significant decrease in the blood pressure of the group that received the adjustment when compaired to the group that received the sham adjustment.
The study authors emphasize that “while the mechanism as to why this improvement in blood pressure occurs is unknown and cannot be determined by the study… the data presented, however, raises a number of important questions including a) How does misalignment of C1 effect hypertension; and b) If there is a cause-and-effect relationship between C1 and hypertension, is now position of C1 an additional risk factor for the development of hypertension?” A larger clinical trial is being planned to address these questions.

Western States Chiropractic College in Portland has been awarded one of the largest grants in the history of chiropractic medicine to study treatment of one of the most common ailments for which Americans seek care: lower back pain. The grant is the largest given to a single-study project by the complementary medicine arm of the National Institutes of Health, the nation’s foremost independent source of funding for biomedical health research.
The $2.8 million federal grant is aimed at giving chiropractors more specific treatment plans, patients a firmer idea of how long it will take before they feel better, and insurance companies guidelines on how many visits to cover.
Four hundred volunteers from the Portland area who suffer from lower back pain will be recruited, beginning after the first of the year. There will be no financial obligation to participants in the drug-free study.
For further information and/or to volunteer for the study on low back pain, call the Research Department at 1-800-678-9072.
Funded by:
The National Center for Complementary and Alternative Medicine of the National Institute of Health: http://nccam.nih.gov.

Even though Autism is more prevelant than many well-known pediatric conditions such as diabetes, spina bifida or Down syndrome, most people have little or no understanding of the disease.  Autism affects 1 in every 166 births in the United States, and boys outnumber girls 4 to 1.  Little is known about the cause of Autism and less is known about the treatment. Each child with Autism is very different, which complicates the treatment.  What works for one child might not work for another.

In order to create an awareness around Autism, Robert Wright, the chairman and CEO of NBC Universal, founded Autism Speaks in 2005 for the purpose of finding a cure for autism, according to the Web site.  The website contains a video that provides a unique perspective of the difficulties families face when coping with autism. The site also provides a lot of information for those eager to learn more about autism.

For more information about Autism and to view the video - Autism Speaks

For the full Article : CNN.com
Dr. Bryan Bingham
Highland Chiropractic

A study published in the Journal of the American Medical Association this month looked at the side effects associated with acetaminophen (Tylenol) usage.

The Tylenol group was given the maximum suggested dose of tylenol (8 extra-strength Tylenol per day) for two weeks. Liver enzymes were checked before and after this two-week period. Researchers found that 40% of the people in the Tylenol group had abnormal liver enzymes.

The following is an excerpt from the Harvard Medical School News Review:

“A colleague’s sister had back pain that she was self-treating with over-the-counter products. She was taking the maximum dose of acetaminophen and, without knowing it, other back pills that also contained acetaminophen. She was not eating because of the pain, but kept taking the medications.”

“She became confused and was taken to the emergency room by a friend. She had acute liver failure caused by acetaminophen toxicity that could not be reversed.”

Over the counter medications are meant to be taken for a short duration to help ease acute pain. Unfortunately many people use them to treat long-term chronic conditions.

If you or someone you know is taking Tylenol or other pain medications on a regular basis, explain the harmful side effects and inform them of the alternatives.

For the full article click here
Dr. Bryan Bingham
Highland Chiropractic

For many years back pain was thought to run its course in 6 to 8 weeks and leave the patient pain free following a flare-up.  This understanding of back pain came from a very large study that was done over twenty years ago in England.  Researchers determined that workers in England recovered from back pain in 6 to 8 weeks following a flare-up.  In determining the course of a back pain flare-up, researchers used the date a patient returned to work to determine when the patient had “recovered”.

It became obvious that these statistics were flawed, but unfortunately this idea of a 6 to 8 week natural history of back pain stuck in the mind of many healthcare providers. This explains the typical medical approach to back pain, i.e. take these pills and wait for the pain to go away.

Medical research produced as early as 1993 started to change this view of back pain. Back pain was being viewed not as an isolated incident, but as a chronic condition with periodic flare-ups similar to asthma.  It was found that the number one predetermining factor for back pain was a previous episode of back pain.  It became obvious that people who had experienced back pain in the past did not completely recover from the episode; instead the symptoms subsided and the patient went back to life as usual until another flare-up occurred.

As a chiropractor, I cannot tell you the number of times that I have heard something to the effect of “I just reached over to pick up my socks and my back went out”.  The back is extremely strong; it has the ability to withstand the weight of a sock, trust me.

What happens in these situation goes back to the straw that broke the camel’s back. For example let us imagine that you have a thin piece of metal in your hands that you are able to bend back and forth.  You bend this piece of metal back and forth twenty times and you set it down.  A couple days later you come back to the piece of metal and you bend it once and it breaks.  You think, “This must be really cheap metal if it broke with only one bend,” all the time forgetting about the twenty bends you put in the metal only a couple days ago.

Without proper treatment of back pain, combined with an effective rehabilitation program, periodic flare-ups are to be expected.  Back pain is the second most common reason for people to miss work, next to the common cold.  It is obvious that our view of back pain needs some updating.  It is important to find a practitioner that not only provides you with proven care for your symptoms, but also teaches you how to strengthen your back to prevent a recurrence.

Dr. Bryan Bingham
Highland Chiropractic

A study published in the Annals of Internal Medicine this month showed the cardiovascular benefits of eating a mediterranean-style diet.

The study looked at the short term benefits of eating a mediterranean diet compared to a low-fat one.  Subjects ate either a low-fat diet or a mediterranean type diet from October 2003 to March 2004.  The study looked at blood glucose levels, cholesterol, blood presure and C-reactive protein.

Compared to the low-fat group, the group eating a mediterranean style diet supplemented with olive oil and nuts had beneficial effects on cardiovascular risk factors.
Annals of Internal Medicine. July 4, 2006; Volume 145, Iss. 1, p 1-11

A recent study presented at the annual meeting of the American Diabetes Association (ADA) found an increase in type 2 diabetes with the use of antidepressants like Prozac.

The study looked at 3,000 people in all. One group was given lifestyle intervention, another a placebo, and the third group was given the diabetes drug metfomin (Glucophage).

The risk of type 2 diabetes increased two to three times in the third  group that took antidepressants. A reason for the link is unknown at this point.

Dr. Bryan Bingham
Highalnd Chiropractic

The original study that discussed the cardiovascular risks (heart attack and stroke) associated with the painkiller Vioxx, published in March of 2005, claimed that the risk appeared after 18 months of use.  A new study published in the New England Journal of Medicine earlier this week reported heart attacks and strokes were more prevalent in patient populations who had taken Vioxx for as few as 4 months.

Merck faces over 13,000 lawsuits for Vioxx, the blockbuster arthritis drug until it was pulled from the market in September 2004.

This raises the growing concern about the FDA’s ability to manage drug safety.  The Government Accountability Office published a report that the agency (FDA) lacks the inability to monitor and handle drug safety issues.  A full version of the report can be viewed at http://www.gao.gov/new.items/d06402.pdf.

Dr. Bryan Bingham
Highland Chiropractic

It might seem absurd to question whether the medication that is most widely used to treat headaches can actually cause them.  Researchers set out to answer that question.

A causal relationship between the discontinued use of these medications and decreased frequency of headache has been noticed in patients who have entered headache clinics.
A study published in the medical journal Headache in 2003 concluded that there is a direct relationship between analgesic use and chronic daily headaches, also known as rebound headaches.

Does Chronic Daily Headache Arise De Novo with Regular Use of Analgesics. Headache: The Journal of Head and Face Pain, Volume 43, Number 3, March 2003, pp 179-190 (12)