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Posted on 01-27-2014

More on Croft Guidelines for Whiplash Treatment in Baltimore, MD

In my last blog post I referenced the Croft Guidelines. These are industry accepted guidelines for the length of treatment usually required by people involved in auto accidents that are injured and require auto accident treatment (in Baltimore and across the country). Dr. Croft notes that no two people are the same, so it is acceptable to deviate from these guidelines if need be, but in general they should be adhered to. Once patients begin requiring treatment in excess of the Croft Guidelines it is generally a good idea to get a medical specialist on board to co-treat the patient.

Dr. Croft classifies injury severity into 5 different categories and then gives treatment guidelines depending upon which category a patient falls into:

1. Grade 1: Minimal Severity. No limitation in ROM, no ligamentous injury, no neuro findings

2. Grade 2: Slight Severity. Slight limitation in ROM, no ligamentous injury, no neuro findings

3. Grade 3: Moderate Severity. Moderate limitation in ROM, some ligamentous injury, possible neuro findings

4. Grade 4: Moderate-to-Severe. Limitation in ROM, some ligamentous injury, neurological findings present, probable hard tissue damage (fracture) and/or disc derangement

5. Grade 5: Severe. Requires surgical management/stabilization.

Of note, I would say that the vast majority of Baltimore auto accident injuries present with severity grades 1-3, with grade 2 being the most common.

Using these grading classifications Baltimore auto accident chiropractors such as myself can put together an effective treatment plan for recovery and can keep in mind how much time and treatment may be required.

If you look at table 12.3 here you will see that even patients with grade 1 injuries that have No ROM limitation, no ligamentous injury and no neurological findings still fall into the category of allowing for daily care for a week, 3x/week for 1-2 weeks, 2x/week for 2-3 weeks, 1x/week for less than 4 weeks for a total treatment duration of less than 11 weeks with 21 or fewer total treatments.

Although the research by Dr. Croft and his colleagues dictate that even grade 1 patients may require treatment of around 11 weeks duration, it is interesting to note that most third party payers (insurance companies) generally look to disallow care following 12 weeks, thinking that "everyone is healed by then." I can tell you from my 5 years experience treating auto accident patients (of which I have seen more than 1000 different cases) in Baltimore and Las Vegas that it is not the case. Often the Croft Guidelines are a useful tool to reference to justify to insurance companies the need for continued care for my patients.

If you, or someone you know, has suffered from a Baltimore auto accident and has experienced whiplash and want help to recover, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be glad to help!

Dr. Gulitz

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