Dr.Zoe's Blog

DO You HURT ALL OVER, feel exhausted, even after a night’s sleep?

Do you hurt all over, frequently feel exhausted, can’t seem to ever feel “rested” after a night’s sleep, don’t respond to any of the recommended medications from your family physician and no test seems to uncover anything specific?  If this sounds like you, it is possible that you are suffering from fibromyalgia (FM).  FM is a chronic/long term condition including generalized pain in the muscles and joints, usually on both sides of the body above and below the waist, with associated “tender points” where moderate to firm pressure causes pain classically in the following locations (but anywhere is possible):        

Back of the head     -  Between shoulder blades    -     Top of shoulders    -    Sides of neck

Upper chest    -    Outer elbows    -    Upper hips    -    Sides of hips    -    Inner knees                                                    

                                                        In fact, a generalized hypersensitivity is common and it seems like you just can’t turn off your brain.  It can begin with a physical or an emotional event but doesn’t have to, as it can seem to come out of nowhere, as well.  In the US, about 2% of the population, mostly women and especially with increasing age are affected by FM.  One common underlying clinical finding is non-restoring sleep with frequent interruptions during the night.  Sleep disorders that are associated with FM include restless leg syndrome and sleep apnea.

In one study, disturbance in the central nervous system (CNS) has been implicated with FM.  In a group of 168 FM patients, various tests were performed including an auditory brainstem response (ABR) which tests the cranial nerve that is responsible for our hearing and balance; a test that measures for eye movements primarily when sleeping; and, a third test that measures balance functions.  The following is a list of the results from the 168 patient study:

• 78% of the FM patients complained of dizziness or vertigo. Most of these cases were   mild, but 4% complained of constant, severe dizziness.
• Sensorineural hearing loss was found in 15% of the FM patients.
• 51 of the subjects (30%) had abnormal ABR test findings.
• 58% had abnormal eye movement tests, and 45% had abnormal findings on the balance test.

Some studies also report that similar symptoms associated with whiplash associated disorders (WAD).  Chiropractic is a very important player in the management of the FM patient.  We help the patient set realistic goals and offer strategies that help to achieve those goals.  Because many doctors do not support the diagnosis of FM, patients with FM need a “quarterback” to them in the management process, and chiropractic is a logical choice. We are committed to help you or a loved one that is suffering with FM, and sharing this information may be one of most evident acts of kindness you can give.

After My Car Accident, Why Do I Hurt So Much?

There are many different reasons why injuries sustained in car crashes result in chronic or long term pain.  First, there are several types of tissues in the neck that can give rise to pain.  The most intense pain comes from the tissues with the greatest density of nerve fibers, such as the joint capsules and the ligaments holding the bones of the neck together.  There are many ligaments in the neck that are vulnerable to being over-stretched and injured in a motor vehicle collision.  The mechanism of a “whiplash” injury in a rear-end collision is unique.  Upon impact, the vehicle rapidly accelerates forward while the head momentarily remains in its original position, resulting in an initial straightening of the neck followed by extension. At the extreme end-range of backward extension motion, the ligaments in the front of the neck are over stretched and can tear.  Within milliseconds, the head is then propelled forwards into flexion which can then injure the ligaments in the back of the neck placing a significant amount of force on the joint capsules and ligaments holding the bones in close proximity.  Another reason the neck is injured is the speed at which the head and neck “whip” in the backwards and forwards directions after the impact. This occurs faster than what we can voluntarily contract our neck muscles to resist–within 600 milliseconds!  Therefore, even if we brace ourselves in preparation for an impact, we can’t avoid injury to the ligaments and joint capsules. Damage to the ligaments is difficult to “prove” by conventional x-ray, which is why bending views or, flexion/extension x-ray methods are needed.  When there is damage to the ligaments, the vertebra will shift forwards or backwards excessively compared to neighboring vertebra.  This can be measured to determine the extent of ligament laxity or damage and can help explain why neck pain can be so intense and/or chronic.  Not all car accidents occur from behind. In fact, only about 1/3 occur from this direction.  One study investigating which direction created greater degrees of injury reported 57% of chronic pain patient group occurred from rear-end collisions.  It also found that woman sustained more ligamentous injury compared to men and that frontal and rear end collisions resulting in significantly higher levels of ligament injury compared to side impacts
 
Another well published reason why neck pain can “hurt so much” after a car crash is that the sensory input from the injured area to the brain can be so extreme that it leaves an “imprint” in the sensory portion of the nervous system and it becomes hypersensitive or sensitized, resulting in a lower pain threshold or being more sensitive to pain. This is similar to the “phantom limb” phenomenon that often occurs after a leg is amputated where the brain still “feels” leg pain after the limb has been removed.  This has also been reported to be a reason for the significant constellation of symptoms often accompanying “whiplash” injuries.  A partial list of associated symptoms with whiplash injuries includes neck pain, headache, TMJ / jaw pain, dizziness, coordination loss, memory loss, cognitive difficulty in formulating thought, communicating, losing your place during conversation, and more.
 
Understanding whiplash and all of its nuances regarding signs and symptoms, x-ray requirements and measurement techniques, and treatment / management strategies are well understood at this office.  Chiropractors have a unique advantage over other health care providers as manual therapies, including spinal manipulation, have been shown to yield higher levels of satisfaction and faster recovery rates compared to other forms of health care.  We pride ourselves in performing thorough history and physical examinations, offering high quality evidence-based therapeutic approaches and teaching necessary home-based, self-management procedures.  If you, a loved one, or a friend are struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving a multi-dimensional assessment and therapeutic approach at this office.

For a FREE CONSULTATION With Dr. Zoe Segree, please call us at (850) 670-5494 

"I Almost Fell Over Dead When One of My Patients Who Had Been In An Automobile Accident Asked me The 'Forbidden Question'..."

What is the "Forbidden Questin"? I'll tell you in just a moment.  But first let me say that if you've been injured in an automobile accident (or know someone who has), this may be the most important letter you'll ever read.

           Now...to the "forbidden question."

I was recently speaking to one of my patients, whom I've had the privilege of treating her for quite some time now, and she is the picture of health.  She oftens comments about how chiropractic care has helped her optimize her health... to improve her energy level...to improve her physical performance...to eliminate the effects of stress in her life.  She loves to come in about once a month to fine tune her body so she can always be at her best.

          Anyway, when I saw her in last week, I thought she was in for a "wellness" visit.  But the visit quickly turned into something else, when she asked me the "Forbidden question"...

"I was in an accident the other day, and I have some neck pain.  Can you refer me to a chiropractor who specializes in helping auto accident victims?"

"What do you mean refer you to a doctor who specializes in auto accident care?" I asked.  "How could you not know that I SPECIALIZE in that?! I mean, I have treated more than thousands of accident victims over the past 20 years.  I caught myself bragging a little about how many patients I have treated sucessfully after an automobile accident and saying how could you not know that? (The "Forbidden Question" was to ask me to refer someone else to do what I do so well" 

         I felt bad when my patient...my long time, wonderful patient... could say was "Sorry.  I didn't know!"  Actually, she didn't need to apologize... I DID!  I quickly said, "Hey... you have no need to apologize! I'm the one who should say I'm sorry!"  You see, I had failed to communicate to her (and I suspect I perhaps haven't communicated the same to you... that's why I'm writing you this letter) that I not only help optimize health in my "regular" patients' lives through chiropractic care (and oh, how they benefit with an improving quality of life)... I alwo help accident victims get back to where they need to be physically with my trade-marked "Auto Accident Health & Recovery Treatment Program."

     This begins with a complete examination of neck, back and extremities to see where any bodily damage has been done as a result of the accident, this may include x-rays if needed.  You get a report of findings.  I then outline a treatment plan, and my office contacts the insurance company to let them know where you are in terms of physical damage... and what the treatment plan is.

We accept all Auto Accident Insurance, we bill the insurance company directly.  The last thing we want you to have to think about is "How much is it going to cost me to be treated by Dr. Zoe."  You let my office take care of that... and any hassles the insurance company may want to try to give you over your efforts to restore your health through my treatment.  We deal with auto accident cases and insurance companies all the time...our office is good at that, what I'm good at is caring for you in the unfortunate situation of having been in an accident, and helping you gain optimal health (sometimes even better than they had prior to the accident).

          I want you to know that I offer a free consultation for anyone injured in an accident.  And I'd be happy to tell you more about my "Auto Accident Health & Recovery Treatment Program." and how it may apply to you.

      You can comment on this letter with any questions or you can call us at (850)670-5494 and let Dana know you would like to make an appointment.

     P.S. If you know anyone who has been injured in an accident, please let them know about this letter and also, there is this thing called a statute of limitations just means, your time can run out if you do not report your injuries in time.