Roll-Over Baltimore Car Accident Patient Presents with Neck Pain

Roll-Over Baltimore Car Accident Patient Presents with Neck Pain

As my avid blog readers are aware, I am a Baltimore Chiropractor that spends the majority of my time in the office treating patients with whiplash symptoms following Baltimore auto accidents. As a Baltimore auto accident chiropractor, most of my patients typically present with some constellation of symptoms that include headaches, neck pain, radiating arm pain, mid back pain, lower back pain, and occasionally numbness and tingling into the leg. Typically these symptoms manifest from some form a car accident – typically a rear-end impact, but occasionally side swipes, t-bone impacts, and even the occasional front-end (head-on) collision.

Just this past week I saw a new patient that had suffered from a different type of car accident that I do not come across that often. I found it interesting enough to be shared in this forum. This patient had been involved in a car crash that initial included a rear-end impact but then concluded with the car flipping several times over before landing on its roof upside down. The patient had to be extricated with the jaws of life before being taken to the hospital for emergency precautions.

The patient (whose name I can not use) presented to me approximately six weeks after his injury. That is, at the request of his medical doctor, he went to a physical therapy place close by to his house. The PT place took good care of him and helped him overcome some mid and lower back pain. What remained by the time he got to me was neck pain along with radiating and burning left sided interscapular pain, and some numbness and tingling pain down his left arm.

The patient asked me if I could “just crack” his neck on his first visit. I explain to him that due to the complex nature of roll-over injuries, and due to his size, that I felt safer first ordering an MRI of his neck, as I suspect that he had one or several disc herniations in his neck based upon the mechanism of injury and his size.

He seemed surprised that I suggested that he obtained further advanced imaging, since he read our many positive reviews online from people who said that we were able to help them quickly, many times on the same day. I expressed to him that part of owning and running one of the leading Baltimore auto accident rehab clinics in Baltimore was knowing when to proceed with treatment and when to hold back. I told him that due to his large frame (he was approximately six feet four inches tall) it was not only possible but probable that during the roll-over portion of his injury that he compressed his neck on the roof of his truck. As such, we discussed that I did not feel safe manually adjusting his spine until I ordered an MRI to make sure that it was safe for me to do so.

The patient understood, but he was angry at my suggestion. I had my staff go through the process of referring him for an MRI to a local facility. This facility saw him within about a week. The problem was that he was too big for the machine and he was claustrophobic, so my office had to refer him elsewhere. Another week went by and at this point the patient was able to obtain his MRI imaging.

I scheduled for the patient to come back in the following week to review his findings. I hoped I was wrong about him needing an MRI. Unfortunately for him, I was not.

The patient’s MRI revealed three levels of disc protrustions/extrustions pressing upon his cervical spinal cord. There was some question about whether or not there was some ligamentous instability in his neck as a result of the trauma. I told him that as a result of the findings of his examination that I would be unable to offer him any spinal manipulative therapy. Instead, we put together a plan of action that included a referral to Dr. Sarah Merritt M.D. for pain management, and a neurosurgical consultation to consider surgery if he does not respond well to pain management.

After the results of the MRI were clear, the patient did eventually come around and thank me for using precaution with his clinical presentation. He admits that he wanted me to adjust his neck that visit and that he had even called a few other chiropractors that he was planning to see just to have someone do it for him. Fortunately, those other offices were too busy to see him and at this point, no manipulation has been performed on his neck.

Not all patients are the same following a Baltimore auto accident injury. Nor are all accident mechanisms the same. My staff and I are trained to ask specific detailed questions to determine if it is safe for us to treat you, or if you require further diagnostic analysis prior to treatment.

If you, or someone you know, has been a victim of a Baltimore auto accident injury and require treatment, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Now Offering Pain Management For Baltimore Auto Accident Patients

As many of my blog readers are well aware, I am a Baltimore chiropractor that spends the majority of my time treating Baltimore auto accident injuries though chiropractic care. I routinely treat headaches, neck pain, and back pain. For the most part my patients improve with treatment over a short course of therapy and are able to reach maximum medical improvement with my therapy.

Other patients are not as fortunate. Some patients are so severely injured that no matter how much treatment they receive they may never reach pre-injury status. That is, for those patients, maximum medical improvement following their Baltimore auto accident injury, is some level of chronic pain. It is unfortunate when that happens, but that is the way it goes sometimes.

In an effort to help with the more complex cases that we are seeing in the office, I have recruited another provider to work alongside me. Dr. Sarah Merritt M.D. has joined the team and is available on Tuesdays from 3-7 pm to co-treat Baltimore auto accident injury patients. Dr. Merritt is is a pain management physician that owns her own practice in Bowie, MD and she moonlights in our clinic one day per week. Her role is simple – she is here to help to provide medications as needed and pain management interventions to help with acute and chronic pain.

She has been with us for several months and so far the results have been stellar. She has helped patients with acute knee pain, hip pain and shoulder pain, in addition to the “run of the mill” headaches, neck pain, and back pain patients that we usually see in my clinic. Besides prescribing medications, Dr. Merritt is able to perform some pain management injections which helps with localized swelling and inflammation. Dr. Merritt is also able to help me determine sooner which patients are responding well to treatment and which ones may require referrals to other specialists such as orthopedic surgeons, neurosurgeons, neurologists, etc.

As the saying goes, two heads are better than one. We are happy to have Dr. Merritt on-board one day per week. We look forward to her contributions to the clinic and we look forward to helping patients get well quickly. We are discussing the possibility of extending her to a second day per week in the near future.

If you, or someone you know, requires pain management following a Baltimore auto accident injury, contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Do I Need an MRI after a Baltimore Auto Accident Injury?

As you no doubt are already aware, as a Baltimore Chiropractor that spends the majority of my time treating auto accident injuries and other personal injuries in Baltimore, I spend my fair share of time treating post-traumatic headaches, neck pain, back pain, and the occasional radiating arm or leg pain. I also treat patients that have not been involved in auto accident injuries but I find that the diagnosis and treatment of auto accident injuries is more interesting since it requires a deeper understanding of anatomy and physiology as well as more hands on “case management”. By that I mean I am often not just treating these Baltimore auto accident injury clients alone, I am part of a bigger team that usually involves a medical doctor, and perhaps even a pain specialist or orthopedic surgeon.

One of the questions that I often get asked by some patients is “Do I need an MRI?”. So let’s talk about that. First off, MRI is an acronym that stands for Magnetic Resonance Imaging. It is a sophisticated medical device that uses our bodies own atoms in a magnetic field to produce a truly amazing three dimensional rendering of the body in real time. We are truly looking inside a living being at a moment in time and assessing the structure of not only their bones, but also their intervertebral discs, ligaments, tendons, and blood vessels.

Typically following even low speed rear-end injuries I like to take x-rays of my patients. This allows me to assess their bony anatomy and draw inferences upon their intervertebral disc heights. This can help me better understand what is going on before I lay my hands on them in an effort to begin treatment. X-rays are, however, limited in the information that they convey. For the most part we can only discern fractures, dislocations, and hypermobile joints by way of xray. And on top of that we can only see bone. Don’t get me wrong- that information is incredibly useful if a patient is guarding or if there has been direct blunt force trauma to a window or if there has been airbag deployment. But after a few weeks of treatment there is little to no clinical benefit in performing repeat x-ray analysis.

After I evaluate a new patient following a Baltimore auto accident injury, I try and explain the courses of healing and how long a patient might expect to feel pain and remain under my care. I almost always suggest that within 10-12 visits (usually one calendar month) I will perform a similar re-evaluation and make future treatment recommendations. My goal by this second phase of care is to have determined whether or not I suspect the patient needs an MRI. I am typically looking for a return to pre-injury level of ranges of motion, and at least a 50 percent improvement in returns to activities of daily living and pain levels from the initial visit. That is, let’s say a patient presents day 1 with neck pain that is 9/10 and severely restricted ROM. By the 12th visit if all is going according to plan, they should be at or below a 4/5 out of 10 on the pain scale, should have nearly restored their neck ranges of motion in all planes, and should be working at full duty capacity. If those things (or more) are occurring by this stage, I am happy with their progress. I simply reduce their reliance on my therapy and see them only 1-2x/week for another 6-8 visits where I again monitor their progress.

But let’s say these patients are not that fortunate. Maybe the same example from above only sees an improvement to pain levels at an 8/10. Maybe they still can’t work because their neck is too stiff, and maybe they’ve developed some radiating numbness, tingling, and/or weakness into an arm. This is a completely different story in my eyes and one that requires further evaluation.

It is at this point that I will typically make sure that the patient is evaluated by either an orthopedic surgeron or a pain management specialist. I want to know if these other providers are “on board’ with my analysis that these clients are not improving and I want their “second opinion” as to whether or not any further diagnostic testing, such as MRI, may be helpful in the diagnosis and case management of our fictitious patient.

So to answer the question that I posed in the title “Do I need an MRI?” – the answer is, it depends on a case by case basis. We almost always try and utilize the least invasive modalities and procedures before taking the next step and coordinating for an off-site MRI. I tell most patients when they begin treatment that I hope that they do not need an MRI or to see a specialist, but if they fail to improve as expected then I will have my staff take care of a referral on their behalf. I always hope that MRIs are not necessary, but when they are, we are happy to coordinate care.

If you, or someone you know, has been injured as a result of a Baltimore auto accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic. We would be happy to help, whether your care requires an MRI or not!

Dr. Gulitz

Statute of Limitations for a Baltimore Auto Accident Injury Claim

As avid followers of my blog, yelp page, and google plus page already know, I am a Baltimore Chiropractor that dedicates that majority of my professional time treating headaches, neck pain, and back pain in Baltimore, MD. About half of the patients that I treat have suffered from Baltimore auto accident injuries that have resulted in whiplash-type injuries to the neck.

I often tell these patients when they come in for an initial evaluation that time is of the essence. First and foremost, it is important for their physical recovery that we stage their injuries and begin treatment right away. Early intervention will help them deal with physical pain as quickly as possible and will help to make sure that scar tissue does not develop that would otherwise cause a long term problem in terms of range of motion or chronic pain.

Time is also of the essence for my Baltimore auto accident injury patients, from a legal perspective. Maryland law allows for two important statutes of limitations when it comes to Baltimore auto accident injury patients. The first deals with opening a PIP claim. In order to access personal injury protection benefits under an auto insurance policy, patients have one year from the date of injury to contact their insurance company and open a claim. You would be surprised how short a year is when you are busy working, providing for your family, getting treatment, and trying to put your life back together. I referenced in a recent blog post how a patient who had been hit while riding a light rail vehicle in Baltimore was able to open a PIP claim and get all of her injury treatment paid for just 2 weeks prior to her one year statute of limitations. She was so relieved to find out that she did not have to pay any copays or any money out of pocket to receive treatment in my office. She was so relieved, in fact, that she gave me a hug when she learned that her insurance would cover her bills!

The second instance where time is of the essence is with regards to the statue of limitations for filing a lawsuit for personal injuries. This is not my area of expertise since I am a treating Chiropractor and health care provider, not a Baltimore auto accident injury attorney. However, the law states that injured clients have up to three years (and not exceeding three years) to file a lawsuit if they intend to following a Baltimore auto accident injury claim.

Notice, that does not mean that a case needs to be settled, or that a lawsuit needs to have been resolved by three years time. Rather, it just needs to have been filed. Personal injury attorneys all the time explain to me how important it is for injured clients to begin their physical recovery right away. For the majority of clients in my office that resolve their complaints with treatment in a matter of weeks to months, this is not a major timeline that they should be worried about. But for the more catastrophic injury patients that have suffered brain damage, spinal cord injuries, etc, this time line may sneak up on them quickly.

I am not necessarily advocating that every patient involved in a Baltimore auto accident injury should hire an attorney when they are injured. Many of my patients do hire one, but that is completely their choice. What I am suggesting is that there are legal time limits that Baltimore auto accident injury patients need to be aware of in order to protect their rights once injured.

If you, or someone you know, has been injured in a Baltimore auto accident, do not waste time in getting the treatment you need to recover from your injuries. Contact Mid-Atlantic Spinal Rehab & Chiropractic today at (443) 842-5500. We would be happy to help!

Dr. Gulitz

How Can I Receive Treatment Following a Hit And Run Accident In Baltimore?

As a Baltimore Chiropractor that spends the majority of my time treating whiplash patients in Baltimore, I have seen just about every type of scenario unfold when it comes to crashes. Typically speaking, if you are stopped at a red light, struck by another vehicle, and injured, it is ultimately the responsibility of the insurance company of the car that struck you to pay to fix your car, fix your body (medical expenses), pay for future medical needs if any, and to pay for pain and suffering (if any).

But what happens in the cases of hit and run accidents? We’ve all seen them on television. Maybe a drunk driver who has had a few too many drinks hits the bumper of a vehicle on the way home from the bar. Nervous that they may get a ticket or arrested for DUI they leave the scene of the crime without calling the police, and they leave the passengers of the car injured and alone. Obviously hit and run accidents in Baltimore do not always occur with intoxicated individuals. Sometimes drivers simply have not been carrying insurance and are too afraid to stop to report the collision, for fear of not having the money to pay to repair the vehicle.

In these instances where there is a hit and run (that is, one vehicle hits another and then does not exchange insurance information) there is auto insurance coverage available to injured parties in Baltimore. The type of coverage is referred to as uninsured motorist coverage, or UM coverage for short. This insurance is carried by every driver that has insurance and is mandatory under Maryland law. Vehicle drivers can purchase auto insurance limits up to, but not exceeding, the limits that they carry for liability.

For example, lets say I am driving a vehicle. I may be carrying 100k/300k limits of liability. I have to carry some uninsured motorist coverage (UM) by law. I may elect to carry limits that are 50k/100k, or, I can choose to purchase limits equal to, but not exceeding, my liability coverage, of 100k/300k.

In this example, if I am struck by a hit and run driver, If I elected to pruchase UM of 100k/300k, I would have access of up to 100k limits for my personal injuries, and up to 300k for the crash if there were other occupants in the vehicle with me.

I am not an auto insurance salesman in the state of Maryland. I can not give advice on how much insurance to buy. But most prudent people will maximize the amount of UM that they purchase in order to protect themselves in cases of hit and run accidents in Baltimore.

In addition to making a claim against your own insurance company for UM coverage, you can also make a PIP claim to pay for bodily injury and wage loss while treating.

Just like PIP, filing a UM claim in a non-fault accident can not raise your auto insurance rates.

Many people mistakenly believe that if they have been vicitimized and injured in cases of a hit and run in Baltimore that they do not have coverage available for them to receive treatment for their injuries. This is not the case, as I have described that both PIP and UM coverage will cover hit and run victims.

If you, or someone you know, has been injured as a result of a hit and run Baltimore auto accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz