Which Type of Mattress is Best For Me?

Which Type of Mattress is Best For Me?

As a Baltimore Chiropractor that spends the majority of my time treating headaches, neck pain, and back pain in Baltimore, I often get asked questions about mattress types and which option is the best for a particular patient. I wanted to use this blog post to talk about the most common types of mattresses so that I can shed some light on the subject. The three most common types of mattresses (in no particular order) are traditional innerspring, air mattress/bladder system, and memory foam.

The first type of mattress is the traditional innerspring mattress. These are the mattresses that we grew up sleeping on. They differ based on size and spring coil count. Originally these mattresses were made to be flipped and/or rotated every few months to help balance the pressure on the springs. Newer innerspring mattresses are meant not to have to be rotated. Most people (I would estimate 75% of my Baltimore auto accident and Baltimore chiropractic patients) sleep on a traditional innerspring mattress. When new these mattresses are great and provide plenty of support. Overtime as the springs compress these mattresses become less supportive. Many patients have a combination traditional innerspring mattress with some form of pillow topper. The pillow topper helps the sleeper not “feel” the springs in the mattress and can make for a more comfortable mattress. Personally, I have never really liked innerspring mattresses as I find that they produce too many pressure points and that they deform over time.

The second type of mattress is the air mattress/bladder system. I am not talking about the $20 air mattress that we all have in our basement for an unexpected guest to crash on for a weekend. These are the “sleep comfort adjustable beds” that we see commecials for. Typically they demonstrate a couple where the husband tosses and turns all night and the wife next to him sleeps comfortably undisturbed. The idea is that with two different bladder systems that can be filled or emptied of air both partners can sleep comfortably regardless of their individual preferences for mattress firmness. I have no experience sleeping on this type of mattress, but my parents sleep on it and from what I can tell they seem to enjoy it.

The final type of mattress is the memory foam mattress. This is the latest type of mattress to hit the market. Memory foam is a formulated material that is meant to compress and absorb pressure. Two common manufacturers of these type of mattresses are Tempurpedic and Casper. People with a lot of acute neck and back pain as well as people who are heavier tend to prefer these mattresses since there are no springs to compress or to cause pressure points. As someone who grew up sleeping on traditional innerspring mattresses, once I made the switch to a memory foam mattress, I became a fan for life. I get a better nights sleep, fall asleep faster, and stay asleep longer on these mattresses than I ever did on a traditional innerspring mattress. But that’s just me.

Many Baltimore auto accident patients ask me if they should change out their mattress once they have been involved in a Baltimore auto accident or Baltimore work related injury. I generally urge them not to switch out their mattress. Most mattresses are meant to last 10-15 years with an average use of 8 hours per day. Unless your mattress is approaching the end of its lifestyle it is probably not worth it to switch. Rather, try purchasing a pillow topper or a memory foam topper to place on top to give it a few more years of use.

Further, mattresses are very expensive. I have seen them cost in excess of $3,000-$5,000. Over the lifetime of the purchase, a mattress is a worthwhile investment. However, I don’t think you need to spend that much. I recently purchased a Casper mattress (King size) that was shipped to my house for under $1,000. They come with a 100 day love it or lose it guarantee, in which if you do not like it they will take it back and give you a complete refund. I am personally very happy with mine.

Research shows that neither a firm nor a soft mattress is best. That is, it all depends on the individual. Whichever mattress you can get to sleep on quickly and stay asleep for 7-9 hours a day is the best one for you.

If you have any questions about mattress types please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500.

Dr. Gulitz

Contrast Enhanced MRI Following Baltimore Auto Accidents

As a Baltimore Chiropractor that spends the majority of my time treating auto accident injuries, such as headaches, neck pain, and back pain, it is not unusual for me to treat patients that have extremity injuries as well. Often times a patient’s knee can bash against a dash board or center console, or a shoulder or hip can be injured due to shear forces resulting from a seat or lap belt. Just like with neck and back injuries following Baltimore auto accidents, these injuries are treated conservatively with passive modalities, stretching, and strengthening activities over the course of several weeks to months. If a patient does not improve as quickly as expected, it is not uncommon for me to refer these patients for advanced imaging such as MRI.

As most people are aware, MRI stands for magnetic resonance imaging. It is a form of electromagnetism that helps to three-dimensionally render a patient’s body from the inside. We can look at live anatomy and determine if there is altered morphology or injury. MRIs are considered the gold standard of advanced imaging. There is no radiation to the subject and the images are usually crystal clear.

However, MRIs are not perfect. Some structures do not appear well on standard MRI imaging. In these instances contrast-enhanced MRI may be used to better image a structure. In my daily life as a Baltimore Chiropractor that treats Baltimore auto accident patients, contrast-enhanced MRIs are most commonly used when imaging shoulders and hips.

I recently had a patient that had hip pain following a Baltimore auto accident injury. We had been treating her for a few weeks. Her headaches, neck pain, and lower back pain had been improving with therapy, but her hip remained a daily, constant complaint. I referred the young lady for a hip MRI, with the results being a negative MRI! Clinically it did not make sense. Based on her lack of significant improvement with therapy and her strangely negative MRI, we decided to try a contrast-enhanced MRI study.

Sure enough, we found some injury that we suspected all along. She had a labral tear in her hip that was causing a partial dislocation of her hip joint whenever she squatted or jogged. While most of the time a normal MRI is appropriate, if clinical indication suspects an injury that MRI may have missed, a repeat contrast enhanced MRI may find “hidden pathology.” That was the case for this young lady.

History, physical exam, and clinical intuition based on experience all lead providers to decision making. This particular young lady would have been stuck with years of hip pain had we not gone further and investigated her hip with a contrast enhanced MRI. Now she is scheduled for surgery which will hopefully fix the problem moving forward.

If you, or someone you know, would benefit from a second-opinion regarding injuries sustained in a Baltimore auto accident, please contact Mid-Atlantic Spinal Rehab & Chiropractic. We would be happy to help!

Dr. Gulitz

The Application of PIP in Pedestrian Accidents and Bicycle Accidents In Baltimore, MD

As avid readers of my blog are already aware, I am a chiropractor that spends the majority of my time treating Baltimore auto accident injury patients. Typically these patients are occupants in a vehicle that either hits or gets hit by another vehicle. In these injury cases, the occupants of the vehicle have access to PIP under Maryland law. If you’ve read my other blog posts, you know that PIP (Personal Injury Protection) is a Maryland first party benefit for injured claimants involved in Baltimore auto accidents. The injured claimant has to open a PIP claim with their auto insurance carrier and then they qualify for PIP benefits. For those who may not have read my previous blog post, PIP is used both for economic/wage loss (up to 85% of wages) and to pay for medical and chiropractic care following an auto accident injury, regardless of fault. PIP is typically written in the amounts of $2,500, $5,000, and $10,000 but can be waived in writing at the time of underwriting.

During the summer as the weather gets better we typically see other injured patients/claimants that have access to PIP although they are not technically seated within a motor vehicle during the time of their injuries. Specifically, pedestrians and bicyclists fall under this category. Provided that they are following the rules at the moment of their injuries (i.e. pedestrians are walking within a cross-walk or on a side walk) and are not in any ways contributing towards their injuries, then both pedestrians and bicyclists have access to PIP under Maryland law.

Whether one of my patients in an injured bicyclist or an injured pedestrian, if they were struck by another motor vehicle, they have four sources of benefits to pay for their injuries. The order is as follows:

1) PIP of the faulted vehicle
2) PIP of their own auto insurance policy (provided they also have a car and elected to purchase PIP)
3) PIP of a family member over age 16 that they live with (provided that family member has PIP)
4) The bicyclist’s and/or pedestrian’s health insurance

I find this rule in Maryland to be particularly interesting. Obviously no one who is riding a bicycle or walking as a pedestrian wants to be injured in a bicycle vs. motor vehicle collision or a pedestrian vs. auto collision, but the state law makers have made it very easy for these injured patients to have access to medical care in these instances. I find it peculiar that although pedestrians and bicyclists are not required to apply for a license to ride a bicycle or walk (and therefore are not required to by insurance to do so) they can claim PIP benefits from the automobile that injured them. That is a benefit that is not the same in cases of Baltimore auto accidents between two motor vehicle collisions. It’s as if the pedestrian or bicyclist is “inside” the car that struck them at the moment of impact.

While many pedestrians and bicyclists choose to engage in these activities for exercise and socialization, some who are injured do not have their own automobile insurance with PIP, and as such, without this rule would have no way to pay for their lost wages had it not been for this law.

As with Baltimore auto accident injury claims, if an injured party did not cause or contribute to his injuries as a pedestrian or bicyclists and they choose to open a PIP claim, their auto premium rates will not go up as a result.

The message is clear: speak to your auto insurance salesman. Ask them to review your auto declarations page. Make sure that you have PIP and make sure that you are purchasing as much as they will sell you. It costs pennies and is worth thousands. Hopefully you’ll never need to use it, but if you do, it is worth it.

If you, or someone you know, has been injured in a Baltimore bicycle or Baltimore pedestrian accident and have questions about how you will pay for your injuries, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Chiropractic Care for Pregnant Patients

As a Baltimore Chiropractor that spends the majority of my time treating, blogging, and thinking about Baltimore auto accident injuries, I have noticed a trend in my practice. More and more patients, particularly women, are asking about whether or not I provide chiropractic care for pregnant mother’s or for their children. Truth be told, although Chiropractic as a profession has been treating pregnant women and young children since inception, I honestly have not had many of these patients. As I enter my fourth year in practice in Baltimore some of my original patients have started to get engaged, get married, become pregnant, and have children of their own. I suppose I should not be surprised by this but it is amazing to see how their lives change around me. It made me realize that in order to be of better service to my community that I need to expand my offerings to be able to better help those in need.

For many current patients this will come as no surprise, but if you have not been in the office in some time this may be news to you. Dr. Gulitz expanded his professional staff in August to include another Chiropractor. Dr. Erica Wise D.C. joined Mid-Atlantic Spinal Rehab & Chiropractic in August of 2015. She brings a very complimentary set of skills to the practice. She previously worked at Living Wellness Chiropractic in Baltimore, where she treated more pregnant and wellness type patients. She has over three years experience in this arena and she is able to bring this skill set to the table (pun intended).

Dr. Wise enjoys treating pregnant mothers through all phases of their pregnancy. She feels that throughout the nine month process she can help expecting mother’s to naturally and safely deal with aches and pains that are expected as they gain weight during their pregnancy. In fact, she recently helped the office aquire a new “pregnancy pillow” that allows for expectant mothers to lay face down comfortably and to not put undue pressure on their abdomens as they enlarge.  While she primarily focuses on treating pain in pregnant women, some women who do not have pain also present for care, with the hope and expectation that proper biomechanics and spinal motion can lead to an easier delivery.

So if you are pregnant and have developed neck and back pain as a result of your pregnancy and require chiropractic care for pregnancy in Baltimore, please do not hesitate to contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

Do I Need an MRI After My Baltimore Auto Accident Injury?

As a Baltimore chiropractor that treats many patients involved in Baltimore auto accident injuries I am often asked whether a patient’s injuries from a Baltimore auto accident requires an MRI. It occurred to me that in my previous blog posts I have not spent much time discussing MRIs so I figured it was time to do so.

MRI stands for magnetic resonance imaging. It is a diagnostic test that involves having a Baltimore auto accident injury patient to lay down in a large tube in order to have a region of their body scanned. Typically following a Baltimore auto accident injury the regions of the body that I would typically refer for MRI include the neck, lower back, shoulder or hip. MRIs are fantastic tools to better help a practitioner appreciate the living anatomy of an injured patient. The school of thought is that if a patient is having pain in a region of his body and the MRI shows altered anatomy in that region, that the altered anatomy is usually responsible for the pain in that region.

Let’s take an example. I am treating a patient for a Baltimore auto accident injury. I start their therapy off at 3x/week for the first four weeks. At the end of the first month (12 visits) I perform a re-evaluation where I re-perform orthopedic and neurological evaluations and I ask questions about the frequency and severity of their pain. Provided that the patient has been making an acceptable level of progress towards resolution of his chief complaints (>50% improvement per region both subjectively and objectively) we decide to move on with care on a reduced treatment frequency (say, 2x/week). If, on the other hand, the patient continues to mention daily pain, or radiating pain from the neck into the arms, or radiating pain from the lower back into the legs, that may be a different story. In those instances, I will typically refer out for an MRI of the region involved, in order to rule out a “worst case scenario.” These worst case scenarios are disc herniations, ligament tears, muscular avulsions, etc. Basically, these are conditions that exist that I can not treat as a chiropractor and that require specialist referrals.

So the question as to whether or not a patient requires an MRI following their Baltimore auto accident injury is not always straight forward. It depends on the patient, and it depends on their response to treatment. If they are not improving as expected, then I have my staff refer them for an MRI and we will take whatever steps we need to to resolve their injuries moving forward. Typically following a positive MRI my staff and I will make referrals to orthopedic, neurological, or pain management specialists for second opinions and future treatment recommendations.

MRIs are wonderful tools because they do not expose the subject to any radiation. A patient can undergo as many MRIs as often as they need to without any harm to their body. The pictures produced by MRI are considered the “gold standard” for advanced imaging, with resolution and clarity that greatly exceeds CT scan and x-ray.

If you are involved in a Baltimore auto accident injury give your injury time to heal. Commit to the process of treating for your injuries and give your body time to heal. If you feel that something isn’t right and after enough time the pain is still present, an MRI may be a good idea. It is truly a case by case scenario. Please contact Mid-Atlantic Spinal Rehab & Chiropractic if you have questions about whether or not your Baltimore auto accident injury requires an MRI.

Dr. Gulitz