NSAIDs and Ibuprofen Have No Significant Effect on Back Pain
NSAIDs and Ibuprofen Have No Significant Effect on Back Pain
As a Baltimore Chiropractor that spends his clinical time treating patients with headaches, neck pain, and back pain, I have nearly 9 years worth of experience treating patients with back pain. Although as a chiropractor I can not and do not recommend the use of medication to treat mechanical lower back pain, I routinely discuss with patients the alternatives to medication for their acute lower back pain. We discuss stretches, exercise, moist heat, yoga, swimming, and of course, chiropractic manipulation therapy. Baltimore is a blue collar town with lots of my patients working in construction, as police officers, or in restaurants as back of the house staff. Routinely I am told by these patients that even though chiropractic care feels great on their necks and backs, they often have to depend on NSAIDs (non-steroidal anti inflammatory drugs) such as ibuprofen to get through a shift and make it through the day.
Recent research indicates that the NSAIDs and ibuprofen that they take just to get through the day offer little, if any, clinical pain relief for these patients. Research conducted by Professor Manuel Ferreira from the University of Sydney seem to suggest that not only do these drugs offer only very limited short term relief of pain that is “arguably not of any clinical significance” but “when you factor in the side effects which are very common, it becomes clear that these drugs are not the answer to providing pain relief to the man millions who suffer from this debilitating condition every year.” You can read the article here.
In spite of this research, it will take time for clinical guidelines recommending NSAIDs to change. Currently guidelines recommend paracetamol, followed by NSAIDs, followed by opioids.
Given the risks associated with NSAID ingestion, such as stomach ulcers and bleeding, it is important to note that back pain sufferers have choices besides pills to help with back pain.
If you, or someone you know, is suffering from back pain and have been taking NSAIDs and you want to try a safer, non medicinal approach to back pain relief, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We will discuss what options are available for neck and back pain relief without the side effects. We would be happy to help!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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I-83 Pepsi Sign Continues to Contribute to Baltimore Auto Accident Injuries
I-83 Pepsi Sign Continues to Contribute to Baltimore Auto Accident Injuries
As a Baltimore Chiropractor, I spend the majority of my clinic time treating patients with headaches, neck pain, and back pain. About half of the patients that we treat have been injured in Baltimore auto accidents. Typically these patients were running errands or commuting to and from work on seemingly normal days when their lives were changed forever as a result of an auto accident.
As part of our intake process we try to determine what it is that brings a patient into the office (i.e. Baltimore auto accident, Baltimore worker’s compensation injury, sports related injury, over-exertion, etc). When we evaluate a new Baltimore auto accident injury patient, we ask more questions and we typically try to determine where the patient was driving prior to their crash. For nearly 4.5 years now I have been seeing an alarming trend where many of our patients are being injured on I-83 “near the Pepsi sign” in Hamden. Many daily commuters know that stretch of the elevated highway, where the road bends ever so slightly and speed limits are only 50 mph. Now that we are a few weeks away from opening our second clinic location in Baltimore (6810 Park Heights Avenue Suite C4, Baltimore, MD 21215) I routinely take I-83 to drive between the two clinics. Nearly each day I see either near miss crashes on this stretch of the highway, or I see an actual crash with paramedics racing to the scene to help injured parties.
I read an article in the Baltimore Sun this past week that addressed the topic of auto accidents on I-83 near the Pepsi Sign. It is estimated that there are between 250-300 crashes on I-83 each year. Over the course of the year it averages out to nearly one per day. The JFX is thought to accommodate over 100,000 driver’s daily. State officials have become increasingly concerned with the number of Baltimore auto accidents that occur on this stretch of highway. As a result they have commissioned a $65,000 study to determine problem areas over the highway and to develop some solutions to these problems.
While it is thought that less than favorable geometry, tight curves and high traffic volume are thought to be the major contributors to the sheer number of crashes on the highway, no formal study has yet been conducted to conclude if these are the reasons for the crash. Further, state officials suspect that most people driving on I-83 are traveling faster than the posted speed limit of 50 mph because they are used to traveling faster on the 695 Beltway. Additionally, as I noted in previous blog posts, elevated roadways can freeze before surface roads, which leads to more icy crashes in temperatures at or near 32 degrees.
City officials are trying to have Maryland State Police extend their jurisdiction to I-83, whereas right now it falls under Baltimore City Police jurisdiction. City officials want the Baltimore city police to focus on more pressing issues such as crime and drugs and feel that the Baltimore city police are spread to thin having to responds to I-83 Baltimore auto accidents. However Maryland State Troopers reportedly oversee over 200 miles of highway and are strained as it is.
Whether you are a city resident and use I-83 for your daily commute or just someone who comes to the city on weekends for the great entertainment and night life, we all need to do our part to obey the posted speed limit of 50 mph on the JFX. The old infrastructure and winding roads lead to an abundance of Baltimore auto accidents and we all need to do our part to slow down and help our commutes move along smoothly.
If you, or someone you know, has been injured as a result of a Baltimore auto accident injury, please call Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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Meet China’s TEB-1, is it a cure for road congestion and will it help to decrease auto accident injuries?
Meet China’s TEB-1, is it a cure for road congestion and will it help to decrease auto accident injuries?
As all of my avid blog readers are aware, I am a Baltimore Chiropractor that spends the majority of my clinic time diagnosing and treating ailments of the head, neck, and back primarily. Although I am not limited to diagnosing and treating injuries just within the spine, these are the types of injuries that we typically see, especially given the high number of Baltimore auto accident injury patients that come through the doors every day. Since I focus my clinical practice on injuries associated with Baltimore car accidents, I try and stay up on news both locally and globally about how we can cut down on road congestion and how we can decrease or eliminate injuries resulting from auto accidents.
A few months ago I came across an idea out of China that I found interesting. A Chinese company created a “flying bus” in what is being called TEB-1, or Transit Elevated Bus-1. In many ways it is more like a tram than a bus, since it is affixed to a track below. The TEB-1 stands at about 16 feet tall and can straddle two entire lanes of traffic, while still clearing the roadway below by approximately seven feet. The passenger compartment is said to be roomy as it is approximately 72 feet long and 26 feet wide and capable of holding in excess of 300 passengers at a time. It has been stated that as many as 4 of these TEB-1s can be combined together almost like a train and they can hold over 1000 passengers at a time in that configuration.
While it is certainly something to behold visually, the question remains whether or not it can work in very congested cities in China. And furthermore, the question is whether or not major metropolitan areas in the U.S. would accept it as a means to decreasing road congestion and resulting injuries.
There are just a few problems remaining with the TEB-1 that need to be overcome before we can expect to see it in our neck of the woods
1. Clearance – At just over seven feet of street clearance, this device is just too short to traverse our roads with so many trucks and SUVs. It seems like an easy fix to raise it up another few feet, though.
2. Designated lanes – It would potentially be very costly to rework the framework of most major American cities to install the tram that the TEB needs to roll on. And how to we designate which lanes the TEB will operate in and where motorists can drive in or out of the lanes? That, in addition to the fact that it allegedly can not make 90 degree turns makes this bus seem more like a distant possibility than a short term reality.
3. Power – The TEB is an electric vehicle. While great for the world given its small hydrocarbon footprint, there will be some problems surrounding how to keep it charged enough to make its rounds each day. There has been some discussion about whether or not outfitting the TEB with solar panels will help ease its electricity demand, but some engineers suspect that it will have to be recharged at each stop in order to make all of its rounds on a given day. Who knows, maybe Elon Musk can engineer its batteries?
4. Cost – The estimated cost to construct at TEB is approximately 4.5 million dollars. That’s considered pretty expensive given that its approaching the cost of 11 emissions free buses that can ride around off of a designated track. That is, it may be a solution that is not currently better than what we are already accustomed to using.
I, for one, enjoy engineering marvels and I hope that we can see improvements in mass transit in major cities such as Baltimore. I would support any technological development that decreases road congestion and the likelihood of Baltimore auto accident injuries.
If you want to see some videos of the TEB in action click here or here.
In the meanwhile, if you, or someone you know, has been injured in a Baltimore auto accident and have headaches, neck pain or back pain, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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Rolling Barrier System Sets Out to Reduce Car Accident Injuries
Rolling Barrier System Sets Out to Reduce Car Accident Injuries
As my avid blog followers are already aware, I am a Baltimore Chiropractor and I spend the majority of my clinic time treating patients injured in Baltimore auto accidents. Typically I see patients that were rear-ended and are experiencing post-traumatic headaches, neck pain, and back pain related to their Baltimore car accidents. I enjoy following news trends around vehicle safety as it impacts my practice on a daily basis. In the last blog post I discussed the deadly crash in Baltimore that started with a gas truck falling from I-95 after striking the retaining wall after hitting a patch of ice. I found myself wondering if higher retaining walls would have done more to protect the driver and payload from plummeting to their deaths onto the train tracks below.
While I don’t have an answer for that question, a Korean company has unveiled a product that I believe might have helped that driver and the other 67 drivers that were involved in subsequent crashes last saturday. The company called ETI (Evolution in Traffic Innovation) created a “rolling barrier system” that they hope will help to cut down on the approximate 1.25 million people who die as a result of an automobile accident injury each year on the roads.
The idea behind the new product is simple – it is set to replace all of the hard metal guard rails that exist across every major roadway. The hard metal guard rails that can be seen anywhere attempt to stop a car or truck from crossing a median and slow them down instantly. What that means for the passenger is that the deceleration forces on the body get transferred to the occupants (the passengers), often resulting in more severe injuries, and in some cases, death to the occupants. It also helps to guide the crashing car forward and out of the way of the damage behind it, thus preventing fewer rebound crashes.
The rolling barrier system would replace the existing hard metal guard rails. They would help the occupants to “ride down” the crash by continuing to roll the vehicle forward and decelerate over a longer period of time, thus decreasing the forces on the body, and hopefully, decreasing the likelihood for injury or death as a result of these crashes. Its an idea that’s so simple I find myself wondering why I never thought about it first!
The rotating cylinders of the rolling barrier system are made out EVA, which is said to have better flexibility and elasticity compared to other polyethylene resins and has many features similar to rubber. These characteristics make it extremely durable and hard to damage even with a crash. Further, each individual roller is relatively simple to replace following a crash.
So far the Korean company has crashed small cars, large cars, and buses into the rolling barrier and they have been able to do so successfully without the vehicles ripping the rolling barrier system out of the ground and without going through or over the rolling barriers.
I suspect a lot more work needs to be done to test these rolling barriers, but the idea is novel and it appears to work. Given their ability to reduce injury due to automobile accidents and their ability to reflect headlights at night, I would welcome them onto the roads that I routinely travel. Check out some cool crash videos demonstrating the rolling barrier system here.
If you, or someone you know, has been involved in a Baltimore auto accident injury and require help to recover from your injuries, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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Winter Storm Causes Deadly 67-Vehicle Car Accident In Baltimore
Winter Storm Causes Deadly 67-Vehicle Car Accident In Baltimore
As all of my avid blog followers already are aware, I am a Baltimore Chiropractor that spends the majoirty of my clinic time treating acutely injured Baltimore car accident patients. Typically these patients present with axial spine pain (headaches, neck pain, and back pain) from acute whiplash injuries as a result of Baltimore car accidents. This week was fairly normal for us in the clinic, as we saw about another dozen new Baltimore auto accident injury patients. The weatherman was calling for snow and freezing rain Friday night into Saturday, and I predicted that the adverse road conditions would likely cause there to be more crashes. Unfortunately for the citizens of Baltimore (where I also reside) I was correct, as we saw the first major storm of the season cause a 67 vehicle pile up on I-95 Northbound near Washington Boulevard in Southwest Baltimore. Several people even lost their lives due to the horrific conditions.
By now we have all seen the cell phone video capturing the moment the gas tankard hit the retaining wall on I-95 and fell below the elevated highway to the train tracks below, exploding into a fireball almost instantaneously. While it looked like the action out of a Hollywood blockbuster, it was unfortunately real.
What happened after that was a domino effect as other vehicles, traveling too quickly under icy road conditions continued to crash around that turn. By the time the dust settled nearly 67 vehicles were involved in a chain-reaction crash that unfortunately took at least two lives. Even for hours after the event it became clear just how difficult it would be for emergency vehicles and police to get to the scene to help the injured and the stranded.
As a result of these horrible Baltimore auto accident collisions I thought it would be a good idea to explain what causes roads to be icy and how best to drive on those conditions in order to maximize safety.
Firstly, icing on roads is a condition that occurs when we have ambient temperatures at or near freezing. If you have a phone or car that alerts you to the outside temperature, always be cautious when the temperature is approaching freezing, since it is possible for ice to appear on bridges and elevated roadways without ice being visible on your car. In order for ice to form and stay on roads, the roads need to be at or below freezing temperature. So while there may not be frozen ice on your driveway or on your city commute on surface streets, it is still possible for bridges and elevated roadways (such as I-95) to get icy before the main roads do. This is because cold air impacts both surfaces (above and below) elevated bridges and roadways and as a result they freeze much faster than do roadways on the ground. I strongly suspect that drivers on I-95 had a false sense of security while driving on the road since they did not realize there would be ice on the highway. I have driven that stretch of I-95 hundreds of times and I am not sure if there are any signs indicating that it is an elevated highway. I will have to look the next time I’m over there.
Here are some tips on how to drive on icy roads if it can not be avoided:
1. Avoid it all costs – I know this is not much of a tip, but when the meteorologists tell you to stay home unless it is absolutely necessary, you should heed the warning. We want to be able to give city crews time to ice the roads and we also want to give emergency crews plenty of space to work to help those who have become injured or stranded.
2. Slow down! – Most people I know travel faster than the speed limit. But remember, the speed limit is for optimal driving conditions. If it is raining, sleeting, or icy, it is imperative that we slow down to below the speed limit to help prevent us from carrying too much speed from which we can not slow down or stop.
3. Get your vehicle checked out – Prior to impending snow storms, make sure your vehicle is in the best shape possible. Make sure your traction control is functioning properly, your antilock braking mechanism is in working order, and that you have snow tires available if you really must travel.
4. Wear your seat belt – Even if you are obeying these rules of the roads, that does not mean that all drivers are. As a result you should be wearing your safety belt at all times to help restrain you in case of an impending Baltimore auto accident. Besides, its the law and you should be wearing it under all driving circumstances.
5. Don’t stop to help those that are stranded – This one seems counterintuitive. We all want to be good neighbors and help those in need. The problem with stopping to help someone stranded due to icy or snowy conditions is that you may inadvertently cause a rubbernecking issue which can then lead to more vehicles crashing. It is best to simply call 911 and have emergency crews block the road and help the stranded motorist themselves, as they are trained in how to do so safely.
6. Avoid hills when possible – Despite your best efforts, when gravity takes over no amount of braking can stop “what goes up” from “coming down.” This is why it is best to avoid the roads altogether if you know or suspect that it may be very icy or snowy.
This 67 car crash is a terrible event and unfortunately many people were injured and some were even killed. My condolences go out to the friends and families of those who were killed. We all must do our part to obey the rules of the road in order to help lessen or eliminate unnecessary risk while driving.
With that being said, if you or someone you know, has been injured as a result of the 67-car pile up in Baltimore on Saturday, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help you on the road to recovery.
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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Mobile Apps Can Help Cut Down on Distracted Driving and Baltimore Auto Accident Injuries
Mobile Apps Can Help Cut Down on Distracted Driving and Baltimore Auto Accident Injuries
As a Baltimore Chiropractor that spends the majority of my clinic time treating patients injured in Baltimore auto accidents I treat many patients with headaches, neck pain, and back pain. Largely these injuries can be avoided if motorists are more responsible on the road. That is, if they focused on what they learned in driver’s education classes and obeyed “the rules of the road” we would see fewer Baltimore auto accidents due to human error. One of the leading causes of auto accidents in Baltimore and in other cities is human error due to distracted driving. We’ve all been at a red light and seen drivers alongside us glance down at their laps with a faint glow of cell phone shining into their faces. Sure, they are only looking at their phones at a light. But maybe they’ve been texting back and forth as they drive? It’s been noted that the average back and forth text message communication takes about five seconds of focus. A driver with their eyes off the road for five seconds can travel several hundred feet – certainly a long enough distance to injure or kill another vehicle operator and/or their respective passengers.
Fortunately for those of us that want to keep our distractions to a minimum on the road, several companies have begun to develop mobile apps that limit, or in some cases, completely eliminate distracted driving by either rewarding distraction-free driving or by completely disabling mobile communication while a car is in motion. While I think its a pretty sad state of affairs that we NEED these apps to be created, I think that these are good solutions to the growing problem of distracted driving. Personally, I choose to turn my phone off while I’m driving or to pass it to a passenger who can communicate for me when I drive, but having mobile apps is a step in the right direction.
In order to choose the best mobile app for your needs there are a few questions you may want to ask yourself. Is the app compatible with your mobile phone (i.e. android or iOS)? Does the application have the ability to block messages or phone calls from coming in or going out while driving? Does the app have the ability to track the number of safe miles you’ve driven? Can you set the app up to notify parents of the driving pattern of teenagers? Depending on what you are looking for there are apps that can do all of these things. In no particular order here are a few available apps that can be downloaded to help limit the amount of distracted driving that you do in Baltimore:
1) Drive Beehive – This app is geared towards young drivers. It can track the number of safe miles driven and can send parents notifications about driving patterns of teens. It also rewards safe driving behavior. It connects the driver with sponsors such as friends and family that can pledge rewards for reaching milestones of safe miles driven.
2) Drive Alive – Similar to Drive beehive it can track safe miles driven and it can send parents notifications about teen driving habits. The Drive Alive app helps to log the number of safe driving hours that you can accumulate and it enters these hours into a lottery where drivers can win cash and other prizes.
3) AT&T DriveMode – This app effectively blocks all incoming and outgoing phone calls and texts while driving. The app can set to “turn on” these features when the car drives above 15 mph. This app can also alert parents when the teenage user has disabled or tampered with the app.
Personally, I don’t use any of these applications on my phone because I am diligent about making sure that my eyes and focus are on the road in front of me. With that being said, it seems like these apps, either individually or collectively can help us keep our eyes on the road, and can help us each do our part to cut down on car accident related injuries in Baltimore. So if you can not delegate communication to another passenger while you are driving, please consider downloading one of these apps in order to help cut down on the number of unnecessary Baltimore auto accident injuries.
If you, or someone you know, has been injured in a Baltimore auto accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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Financial Considerations Following Baltimore Auto Accident Injuries
Financial Considerations Following Baltimore Auto Accident Injuries
As my avid blog followers are already aware, I am a Baltimore Chiropractor that spends the majority of my clinic time treating patients who have suffered injuries as a result of Baltimore auto accidents. Typically these injured patients suffer from acute post-traumatic headaches, neck pain, back pain, and in some instances radiating arm and/or leg pain. I focus most of my blog posts on how we diagnose and treat injured patients. In this post I thought I would shift the discussion to the financial end of Baltimore auto accidents. That is, if you are unfortunately injured, who pays for your treatment? What options are available for people with and without health insurance? We are asked these questions everyday in our office so I thought it would be appropriate to address financial options in my latest blog post. So, in no particular order, here are the options available to any patient injured in a Baltimore car accident that they can choose to pay for services rendered while they are receiving treatment:
- Cash (self pay) – Injured parties can pay for services rendered out of pocket. A bill of services provided can be produced weekly and the injured party can pay out of pocket. The advantage of this system of payment is that medical bills will not “pile up” as they are being paid as they are accrued. The disadvantage is that based on the extent of an injury several weeks of therapy can become very expensive very quickly. Few patients have the financial resources to pay for services out of pocket. Some patients find this method unappealing, especially if they did not cause the crash, but instead, were injured as a result of another parties negligence. In the eight or so years that I’ve been a licensed Chiropractor I can only remember a hand full of patients that chose to pay cash for their treatment following an injury.
- Health Insurance – Injured parties can pay for services rendered using their health insurance coverage following a Baltimore auto accident injury. This office is in network with many leading health insurance companies. Just like what happens when you visit your family doctor, our staff can verify your health insurance benefits and let you know what copay, deductible, or other financial responsibilities that you may have. The advantage of this system of payment is that medical bills do not “pile up” as they are being paid as they are accrued. The disadvantage of this system of payment is that our office may not be in network with your particular health insurance. Further, a copay will be due on each visit and several weeks of copays can add up very quickly. Depending on whether or not you have met your deductible in your plan, you may owe additional money out of pocket before your insurance “kicks in.” Finally, any monies paid to your healthcare providers following an auto accident injury will need to be paid back to the health insurance company in the case of an at-fault third party driver.
- PIP (Personal Injury Protection) – Injured parties can pay for services rendered using PIP coverage available on their automobile insurance policy. Unlike health insurance that requires providers to be “in network” PIP coverage is available to help pay for any treatment that is related to an automobile accident injury. This includes but is not limited to hospital visits, ambulance rides, x-rays, CT scans, chiropractic care and physical therapy. Our office staff is well trained in how to help you open a PIP claim and how to obtain a claim number to help facilitate payment on your behalf. The advantage of this system of payment is that there are no copays and no deductibles. The injured party does not have to pay any money out of pocket to open the claim. Furthermore, non-faulted auto accident injury patients can open PIP claims and can use their benefits without their insurance rates rising. The disadvantages of using PIP to pay for care is that some people in an effort to save money when they purchase automobile insurance neglect to pay for this coverage and as such do not have this benefit available to them. Often times it is not until after someone has been injured in a Baltimore auto accident that they realize that they neglected to pay for PIP coverage. This is why reviewing your auto insurance declarations every year is very important.
- Third Party Lien – Injured parties can pay for their treatment under an agreement called a third party lien. This form of payment arrangement is only available to non-faulted auto accident injury patients. In essence these injured patients can choose to represent themselves and their own self-interest in securing a settlement/judgement from the faulted third-party insurance company. This means that it is their responsibility to receive all necessary treatment, collect all medical bills, and to present these bills and records on their own behalf to an insurance company once they are done treating for their injuries. The advantage of this form of payment arrangement is that injured parties can receive treatment without any payment up front. This allows them to return to their normal lives as quickly as possible without any financial disturbances due to an unforeseen crash. The disadvantage of this arrangement is the headaches that it typically produces for those that choose to go this route. Injured parties have to continue to live their normal lives, work, and carve out time for treatment all the while they are receiving countless phone calls, messages, and demands from claims adjustors. While it is possible to successfully navigate a third party lien, most patients ultimately decide that it is too stressful to live their normal lives and to play the role of “representative” and ultimately many decide to hire a professional personal injury attorney instead.
- Personal Injury Attorney – Injured parties can pay for their treatment by hiring a personal injury attorney to represent their interests. The attorney’s job is to handle all aspects of an injury claim on behalf of a patient so that they can focus on physical and emotional recovery and not have to deal with the paperwork and phone calls that it takes to successfully navigate a personal injury claim. In essence, compared to the example of a third party lien, the attorney and their staff will handle everything on behalf of an injured client, including paying the providers involved in the care of the injured party. All the client needs to do is receive their necessary treatment and to let the attorney know once they are completely healed. The advantage of hiring a personal injury attorney is in their expertise and their financial value. As dedicated professionals that spend in excess of 40 hours a week fighting insurance companies, they know the “tricks of the trade” and which pitfalls to avoid to help you settle your claim quickly and fairly. Furthermore, they have years of experience that help them to determine what a fair value is for your injury claim. They typically bring to the case way more value than they charge a client in fees. Typically, consultations with attorneys are at no cost and with no obligation. If an attorney decides that he wants to represent you and to take your case, his or her fee is contingent. This means that until or unless you win your case, you will not owe the law office any money. Given the many advantages associated with hiring a personal injury attorney, it is no surprise that the majority of injured clients decide to go this route. The disadvantage of hiring an attorney is that in some instances, cases may take longer to settle than some patients would like. That is, since they know case values and the law, personal injury attorneys sometimes have to take time to help bring about the best resolution of a complaint for their clients.
Paying for care following an auto accident injury does not need to be confusing or scary. While our primary obligation to an injured patient is to get them well quickly, it is important to better understand the best financial choice in your particular case so that there are no surprises. If you would like to discuss a particular option available for your care, please do not hesitate to speak to one of our staff members. If you, or someone you know, has been injured as a result of a Baltimore auto accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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Predicting Chronic Pain In Whiplash Injuries
Predicting Chronic Pain In Whiplash Injuries
As many of my avid blog followers are already aware, I am a Baltimore Chiropractor and I spend the majority of my clinic time treating whiplash injuries resulting from Baltimore auto accidents. As I’ve mentioned previously these injuries typically present with acute post-traumatic headaches, neck pain and back pain. Of course, no two patients are the same, and these are not hard and fast rules.
I find this work very rewarding because there is usually a predictable outcome for the majority of our acutely injured Baltimore whiplash patients. That is, they present with intense symptoms quickly after whiplash injury, they respond favorably over the first 3-4 weeks of care, and they continue to improve as we ween them off care and progress them onto home care. For the majority of our Baltimore whiplash patients, there is a complete resolution of their symptoms and complete return to normal activities of daily living.
Unfortunately, not all Baltimore whiplash patients respond well to treatment. And this seems to be true regardless of age, gender, vehicular damage or prior injuries. I have been treating these types of patients for about eight years and I’ve often wondered why, despite my best effort, some patients make a complete recovery while others do not. And while I still don’t think we have a “perfect answer”, I think I have a bit more understanding of why that may be.
Research from the journal SPINE attempted to look at chronicity of pain in whiplash patients and they found that there was a link between early muscle fatty infiltrates (MFI) in the neck multifidi muscles and the chronicity of pain in whiplash patients.
They studied 36 whiplash subjects that were enrolled in the study less than a week after sustaining whiplash injuries. They studied these subjects at 1 week, 2 week, and three months post injury, measuring self-reported pain-related disability questionnaires, self-reported post-traumatic stress disorder questionnaires, and fat/water MRIs of their necks. They found that those subjects with higher levels of reported pain throughout the study had higher levels of MFIs in the cervical (neck) multifidus muscles.
The authors of the study suggest that we can use specialized MRIs to make predictive outcomes early on in care to determine who, despite rehab, chiropractic care, and physical therapy, are likely to have chronic pain following whiplash injuries. We can look at the MFIs in their neck muscles and based on that make predictions about who will be left suffering with chronic neck pain.
I find this result particularly fascinating for its implication in my practice. Often if patients are not having favorable outcomes to treatment and continue to report high levels of neck pain, we refer them for MRIs. The MRIs will typically focus on ligaments, intervertebral discs, and neurological tissues (nerve roots and the patency of neural foramina) while looking for evidence of pathophysiology. When these MRIs come back “negative” for disc injuries and nerve root compression, certain whiplash patients are considered to be “malingerers”, “liars”, or “crazy.” But maybe they aren’t. Maybe we need to run a different type of MRI and look for evidence of MFI as a cause of their reported chronic pain. Its something I will spend more time thinking about and discussing with radiologists who I refer MRI work to.
In the meantime, if you, or someone you know, has neck pain due to a Baltimore whiplash injury, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
BY: Mid-Atlantic Spinal Rehab
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Thanksgiving – The Deadliest Day on the Road
Thanksgiving – The Deadliest Day On The Road
As a Baltimore Chiropractor that spends the majority of my time in my clinic treating Baltimore auto accident patients with headaches, neck pain, and back pain, I spend more than a fair amount of time keeping up to date on all things Baltimore auto accidents. I am intrigued by what causes crashes, how people become injured in these crashes, and how to best help these injured individuals recover from their auto accident injuries.
If you are like me, you plan to hit the road Wednesday night to head home and stay with family before Thanksgiving on Thursday. While the holiday is one of my favorite, the grid lock and increased auto accidents that it causes are not my favorite. Did you know that Thanksgiving Day in the U.S. is the number one day for auto accidents and deaths from auto accidents each year?
As you might imagine there are a number of reasons why Thanksgiving is considered to be the deadliest day on the road. Here are some of the reasons:
1. A general increase in alcohol consumption on the evening before Thanksgiving. Since very few people have to work the next day, many people have “a few extra” adult beverages in an effort to socialize and relax. If they get behind the wheel they increase the odds of harming themselves or someone else.
2. The number of cars on the roads increases. I will personally be traveling about 250 miles to go to New York to see my family. There is about a 50 percent increase in the number of cars traveling more than 50 miles throughout Thanksgiving weekend compared to “normal” weekends. These long drives can be tiresome for drivers, so both a combination of increased cars on the roads and increased drowsiness is responsible for more crashes.
3. Increase darkness. As mentioned in a previous blog post, it is darker now when most people finish work and start driving home due to the end of daylight savings time. The decreased visibility makes it hard for us to see as we do in daylight, causing an increase in the likelihood of crashing.
Despite the numerous reasons why it is more likely that any of us will be injured or killed in a Baltimore auto accident on Thanksgiving and the days following, there are several straightforward and practical tips in order to have a safer ride and higher likelihood of surviving the weekend without being killed or injured in a Baltimore auto accident:
1. Check your tires – Even healthy tires lose air over time. Take 15 minutes to check tread and air pressure before departure. And remember to always check the air pressure of your tires when they are “cold”, generally before driving more than 2-3 miles on them.
2. Tune up – If you have been putting off that oil change, or topping off your fluids, now is the time to do it. There’s no worse time to be pulled over on a highway with a broken down vehicle then on a major holiday when support will become more sparse.
3. Follow the speed limit – Since there will be more cars on the road, it is imperative to travel at the speed limit.
4. Wear your seat belts – Don’t forget to buckle up. Engaging the proper restraints in your vehicle will make the ride safer for you and all of your occupants. Plus, its the law.
5. Minimize distracted driving – Make sure your cell phone is connected by blue tooth (if your car has it enabled) If not, designate a passenger to be a caller/texter/snapchatter on your behalf. The only job the driver should have is keeping their hands and 10 and 2 and obeying the rules of the road.
6. Get a good night’s sleep the night before. We all get anxious before the holidays given the long drives and the hustle and bustle of the holiday season. If you can get a nap in before you drive to help you stay more alert, or if you can get more sleep the night before, or better yet, if you can leave really early the day of Thanksgiving just after waking up you will be more able to focus on the ever changing road conditions and thus decrease your likelihood of a crash.
We all have to do our part to make the roads safe on Thanksgiving so that we can enjoy our time with our family without injuring ourselves and each other. If you, or someone you know, is unfortunately injured in a Baltimore auto accident on Thanksgiving, please contact Mid-Atlantic Spinal Rehab & Chiropractic. We would be happy to help you recover from your injuries!
Happy Thanksgiving from Dr. Gulitz and the entire team at Mid-Atlantic Spinal Rehab & Chiropractic!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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MVA Attempts to Save Lives with “5 to Drive” Rules
MVA Attempts to Save Lives with “5 to Drive” Rules
As my avid blog followers are already aware I am a Baltimore Chiropractor that spends the majority of my clinic time treating patients in Baltimore with headaches, neck pain, and back pain. We have been seeing an increase in the number of injured teen drivers as of late. I just figured that the end of daylight savings time which results in more dark driving hours was to blame. As it turns out, that’s only part of the reason for an increase in teen crashes and injuries as a result of Baltimore auto accidents.
As we all know young drivers are inexperienced. The inexperience they bring to driving, combined with distractions, can lead to a deadly combination for many Maryland teenagers. In 2015 Maryland saw 21 deaths in teenagers between ages 16-20, which was up from 12 in 2014.
The MVA is hoping to curb teen death by releasing what it calls the “5 to drive” rules. It is hoping that parents of teenagers go over these safety recommendations with their teenagers before they get behind the wheel.
1. No cell phones (no texting). It is said that glancing away from the road for even 5 seconds at 55 mph can have a car travel the entire length of a football field. With all of the social media apps out there, it can be hard not to glance at every beep on the phone or every snapchat message. The MVA wants teenagers to turn their phones off while they are driving.
2. No extra passengers. Driving alone allows a teen driver to focus on the road and not to be distracted by music or conversation. It has been determined that driving with even one extra friend in the car doubles the risk of a fatal crash for a teenager.
3. No speeding. Not surprisingly, it was found that the majority of teen deaths behind the wheel were directly attributed to speeding. It is important that young drivers learn how to follow posted speed limits.
4. No alcohol or drugs. Alcohol and drugs impair brain function and reaction time. This is a good recommendation for adults as well as teenagers. But as the saying goes, good habits start early.
5. Always buckle up. It has been determined that nearly 1 in 4 Maryland teenagers killed by a driving accident did not have their seat belts on. It is important to buckle your seat belt from the moment you get behind the wheel until you car is safely parked.
Obviously these “5 to drive” rules are pretty basic. It is important that parents discuss these rules with their teenagers and hold them accountable to these actions so that we can cut down the risk for teenage death and injury due to motor vehicle collision in Baltimore and Maryland.
If you, or someone you know, has been injured as a results of a Baltimore auto accident injury, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
Dr. Gulitz
BY: Mid-Atlantic Spinal Rehab
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