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Chronic-Pain-Management-2.png
29/Mar/2020

What is a diagnosis? Diagnosis is the identification of the nature of an illness or other problem by examination of the symptoms. The word nature here means a “phenomenon” of the physical world. Some this that is physically abnormal is now causing the symptom(s).

The nature of the condition or cause is what you always physically see with it. With Hepatitis C for example, there are things that always accompany it physically, such as Hepatitis C antibodies in your blood. These antibodies are the physical thing that is found to make the diagnosis. These antibodies in other words are the physical Biomarkers ( a physical, measurable, body phenomenon) that leads to the correct diagnosis. With moderate to severe spinal ligament injuries the one thing that you always see is physically is excessive joint motion. The joint moves to much and can be unstable and cause pain and the problems, or symptoms listed above. This is so easy to diagnose with a simple set of x-rays which I will explain more of in just a bit—but for now what happens to any condition that is not diagnosed properly?

An important study in the Agency for Healthcare Research and Quality finds that nearly 10% to 30% of all diagnoses in America are wrong. Although misdiagnosis is quoted to occur around 40% of the time – which is a huge number – I find that in my 25-plus years of experience, that it is at least twice that high when it comes to spinal ligament injuries.

So what happens with misdiagnosis…

Trisha Torrey, Patient Empowerment Specialist at AboutHealth.com, explains the following about misdiagnosis:

When a healthcare provider considers a patient’s symptoms of illness or injury, reviews the evidence, but arrives at the wrong conclusion about the name or source of that illness or injury, a misdiagnosis results…the wrong name is given to an illness or injury… the treatment recommendation could also be wrong, resulting in further illness or debilitation. The treatment the patient really needs, which would result from a correct diagnosis, is delayed, or never takes place.

So, what do you think? Isn’t is obvious that when a condition goes undiagnosed the patient suffers, in some cases permanently?

This is the biggest problem with spinal ligament injuries themselves and is the main reason they are the number one cause of pain and disability in the world today; too few doctors know how to properly diagnose them! This is VERY BAD for the patient as time as I mentioned earlier is critical here. The longer the ligament injury goes undiagnosed and untreated the higher the risk that the symptoms will never fully go away!

This is important to get as it is the biggest reason all those people around you that have chronic neck or back pain—have this pain in the first place. They did not get to the right doctor quickly enough! Here is chronic pain briefly. Most of you have been to a rock concert at some point in your life; wow what a pleasure moment! Now after this incredible event many of you had ringing in your ears. Why? Simple you were submitting your ears to noxious stimuli, in this case sound that can cause damage to the fine hair like nerves in your ears. The ringing was a sign that abnormal pressure was on those nerves. Now the key is you quickly got the problem relieved (left the concert after a short time – hours), and the abnormal pressure came off those nerves. What would happen if you were in that same rock concert for say 9 months? Now the damage may be permanent, or very difficult to get rid of. In other words, you may have ringing in your ears for the rest of your life—that is chronic pain in a nutshell.

Spinal ligament injuries are no different! The ligament is injured, swells, the swelling causes pressure on the nerve and the fight is now time. Can you find a doctor quickly that knows how to diagnose this accurately and then knows how to treat it (gets the pressure off quickly so that it has far less opportunity to become permanent)?

So, the question remains, how do you diagnose the spinal ligament injury?

Remember, spinal ligaments do two things: they hold the bones in perfect alignment through any activity so it can be performed without injury; and they coordinate all muscle activity via their mechanoreceptors’ communication. When mechanoreceptors get, damaged and go offline they provide the spinal muscles with corrupted communication, causing inappropriate muscle support, instability, and pain.

Knowing what a body part does means you can test to make sure it is doing it right. If spinal ligaments keep your spinal bones aligned during use, then you can x-ray those parts while you are using them to see if alignment is being maintained. From these images (x-rays) we can accurately measure your spinal alignment patterns and look for the excessive motion, which is the nature of this type of injury.

Remember what I said earlier, when a force suddenly overwhelms the spinal joints and forces them out of alignment, the ligaments are over-stretched or torn, leaving the joints looser or lax. The mechanical receptors (mechanoreceptors) that communicate with the muscles for support turn off and the pain receptors can be turned on. This injury is most commonly called a sprain.

So, when a force from an auto collision does damage to your spinal ligaments they are no longer able to hold the spine in alignment. This is what they look like:

See how in the image marked “Normal” the ligament keeps the spine aligned, but when it is damaged it allows it to slip? Remember spinal ligaments hold vertebra (spinal bones) together and keep the joints aligned; when they are damaged, they cannot maintain alignment and the joint will show excessive motion in one of two forms: a “back and forth” motion called excessive translation motion or bending motion that causes excessive joint angulation. This is generally not diagnosable on an MRI; it is diagnosed with a simple set of special x-rays called stress x-rays, along with a sophisticated measurement analysis called a Computerized Radiographic (X-ray) Measurement Analysis, or CRMA for short. This specialized technology will allow any radiologist to accurately measure the intersegmental motion patterns of your cervical and lumbar spine and tell your doctor where the most damaged units are based on their excessive motion patterns.

As a consumer, you need to understand that translation patterns are how much the vertebra is moving or slipping front to back. There is a normal range, an abnormal range, and a severely damaged range. Look at the example translation charts below, which are from actual studies.

Where there is more than 1 millimeter of excessive translation it is abnormal. Anywhere there is more than 3.5 mm of aggregate motion we have a severe ligament problem. In this case, there is 2.15 mm plus 2.03 mm, adding up to 4.18 mm at Cervical Vertebra number 6 (C6). If I ask you to look at the chart and identify where the problem is, I think you will agree it is very apparent that the problem is at C6. Any doctor now could make this diagnosis.

Take a look at a very common injury pattern with those that suffer from headaches.

At C2 or Cervical Vertebrae 2 right? C2 = 3.81 mm which is severe.

How about this one?

At C5 and C6 right? This isn’t difficult to understand.

How about this one?

It is indicated here that all the spinal ligaments are severely damaged. Again, the location and determination of a spinal sprain injury is ascertained by the amount of abnormal or excessive motion in the individual vertebral motion units.

What I have shown here are the basics, and unfortunately in some cases you will now know more than many doctors do about this condition. Spinal sprains (ligament injuries) are accurately measured and determined with this simple test. Your doctor really cannot accurately determine this without a decent set of stress x-rays and a CRMA test.

This test and its findings are so important that the test should be performed independent of the treating provider! That way there is no bias entered to the study.

Remember, excessive spinal motion is not found on an MRI. An MRI is a test to determine if you have a disc injury, independent of an excessive motion study like an x-ray and CRMA. The disc is a spinal ligament and is one of the ten total ligaments that hold your vertebrae together. The image of the spinal ligaments below illustrates that the disc is between the vertebra and acts as a cushion pad between them.

In the spine, it is reported that the total number of specialized ligaments is about 220. These ligaments hold the spine in perfect alignment and directly communicate information to 120 specialized muscles that allow you to use your spine without pain. Of these 220 ligaments, 23 are called discs, which means that the discs represent less than 10% of the ligaments in the human spine! An MRI in general is a study of the discs and therefore has some extreme limitations in a spinal ligament injury analysis. In fact, too many doctors today think that if you have a negative MRI you do not have a spinal ligament injury… but nothing could be further from the truth. Ligament injuries cause excessive motion and excessive motion is not tested for with an MRI!

Today’s spinal ligament injury specialist is a provider that knows how to use the special spinal x-rays and the CRMA Procedure to determine the severity and location of the spinal ligament injury, through an excessive motion study of your spine as well as an MRI to appropriately study the ligaments called discs IF needed.

Getting any spinal ligament injury accurately and fully diagnosed is the first step to recovery and it is the most important step when you have this type of injury. Do not take this lightly, never work with a doctor that does not understand and apply the basics explained here. The risk of long term chronic pain or other chronic problems combined with the long-term expenses are far too great!

If a doctor or their office staff cannot answer these three basic questions you are probably not in the right office. The questions are:

  1. Doctor, could I have an injury to my spinal ligaments? If the answer is yes, then ask:
  2. Can spinal ligament injuries cause a patient significant, long-term problems if they go undiagnosed? If the answer is yes let them explain all about it (remember the symptoms above that are associated with this condition) and then ask the following most important follow up question.
  3. How do you, or your clinic, accurately diagnose this condition? They should answer that they do an intersegmental motion study with special x-rays and a CRMA procedure, followed by an MRI if they feel it is necessary. If they cannot quickly tell you this, then you are probably not in the right place.

Your health is too important to turn over to a doctor that is unfamiliar with the condition that you have. If you had cancer would you try to train your treating doctor or would you expect them to be an expert already? The spinal sprain is no different. I would never let any of my loved one’s work with a doctor that does not fully understand the condition that they are treating. This is rampant, and in my experience, it is why this relatively simple condition is now causing so many people to suffer. Choose your doctor wisely!

AMERICANSIIC.COM • COPYRIGHT © 2015


Chronic-Pain-Management.png
29/Mar/2020

The spinal ligament injury is the number one cause of pain, disability, and expense in the market today. To seriously reduce your risks, you will want to work with a doctor that fully understands this condition.

Therefore, you must take this condition very seriously. I am so serious about this part. You see that patient that comes out of this type of injury with chronic pain is often going to spend a LOT of money on future medical services should they seek the help of medical professionals. The WHY here is easy to understand as spinal ligament injuries are notorious for causing chronic pain and chronic pain in America is EXPENSIVE to medically manage – as medicine is not great at managing this particular problem (chronic musculoskeletal problems), unless of course the idea of expensive addictive drugs it what you are looking for.

Look at this research that shows just how many people come out with chronic pain from a most common injury mechanism, the auto collision.

In one of the longest studies ever performed on whiplash-injured patients looked at the health status of those same patients 17 years after their injury. 55% of the patients still suffered from pain caused by the original trauma.

This research implies that no matter what doctors did that treated these patients, 55% of the them had the same problem 17 years later! Do not become a statistic by working with a doctor that does not specialize in the rehabilitation of these spinal ligament injuries! Don let anyone you know or care about become a statistic as well.

When a doctor does not understand, or cannot find the physical cause (diagnosis) of a patient’s condition, or the symptoms don’t add up to what they are used to seeing then the doctor may begin to believe that the condition is just in the patient’s head.

I will give you an example from the list of common symptoms that are associated with a spinal ligament injury as listed above and tell me if you cannot see this happening with a doctor that does not know how to diagnose this condition. Remember these same doctors could not tell you the common symptoms of this condition which makes it hard to get an accurate diagnosis, as diagnosis is just working backwards from the patients presented symptoms to finding the physical cause.

So, Mary goes to her regular doctor after being in an auto accident last week. When she sits down with her doctor she reports that her left ear has some pain in it, it seems that she has some ringing in her ears that is more pronounced at night, and she seems to be forgetting things, has some difficulty concentrating and she seems to have some neck pain that comes and goes and she has noticed that she is getting some headaches, when she used to never have them before.

Trust me when I tell you – in my experience the first thing the doctor is thinking is Mary is just too sensitive and this may all be in her head. Check out the symptom list and you find that all of Mary’s symptoms in this example are associated with a normal everyday spinal ligament injury, which is usually easy to treat if caught early. Instead Mary’s doctor again thinking this is a bit of a head case, may ask Mary such questions as, “has there been and recent major changes in your life or any stresses that are new”? Where do you think that line of questions is going? Some of you may have experienced this in the past and know exactly what I mean. Some of you know friends or family that have walked out of a medical visit like this one described above and are now on some form of Psychotropic drug!

Talk about the wrong diagnosis, and this happens all the time. Moira Dolan, MD writes to inform patients about these drugs, in here book the No-Nonsense Guide to Psychiatric Drugs found on Amazon: https://goo.gl/rSED14

If you or someone that you know has had this experience, this book is a great start to understanding how these drugs are used.

Now here is the good news, or bad I guess depending on how you look at it. Research tells us it is not in your head, but more likely in your doctor’s inability to diagnose a simple ligament injury.

Here is some research that addresses the myth that your pain is created “from your mind.”

A study found that essentially 100% of those who are suffering from chronic pain caused by a whiplash injury will have an abnormal psychological profile with standard assessments. The only way to resolve the abnormal psychological profile was to successfully treat the chronic spinal pain; psychotherapy was not able to improve the abnormal psychological profile nor was it able to improve the patient’s chronic pain complaint.

Thus, your pain is not being caused by the abnormal psychological profile; rather the pain is causing the abnormal psychological profile. If your doctor seems to be indicating that it is “all in your head,” then perhaps it is time to get a second opinion or change doctors.

The physical issues of spinal ligament injury are most heavily documented in cases of whiplash, although a ligament injury can occur from many mechanisms in many different environments: work, home, sports, etc. The mechanism of injury from an auto accident is very well studied because we carry insurance to cover our injuries and the injuries that we may cause others. It has been so heavily studied because there is a lot of money at stake!

In May of 2015, the National Highway Traffic Safety Administration put out a report that looks at trends in highway accidents. It then provides the American taxpayers a report of their findings.

In 2010, there were 32,999 people killed, 3.9 million were injured, and 24 million vehicles were damaged in motor vehicle crashes in the United States. The economic costs of these crashes totaled $242 billion… In Appendix A… The results indicate a feasible range of societal harm from motor vehicle crashes from $546 billion to $1.12 trillion in 2010, with lost quality-of-life accounting for between roughly half and three-quarters of all societal harm respectively.

That’s a lot of money at stake, which is why this is such a heavily studied injury.

As listed in the study, nearly 4 million people a year are injured in automobile accidents. From our research above if you take this condition lightly, over 2 million of you are going to be chronically suffering with the same problems 17 years later! This means that that the pain is now classified as chronic, which is defined by any condition that persists for more than three months.

To be clear, this means that over 2 million people develop chronic conditions from this one mechanism—EVERY YEAR! Injury is the primary cause of chronic pain, and chronic pain is a serious problem today. Per the National Institute of Health Report, in 2014 over 100 million American Adults suffered from chronic pain , and according to the Mayday Fund over 20% of Adolescents suffer from it. There is no bigger health problem in the world today than chronic pain. At American Spinal Injury & Impairment Consultants, we believe the world deserves better solutions… starting with your doctor.

It is important to understand this. To get out from the 55% you must find a doctor that can help you as quickly as possible.

Remember this: “Injury is the most common initiating event to the disease called chronic pain.” – Dr Jeffrey A. Cronk, DC, JD

So, if you want to look further at studies that show just how poor doctors’ results are with patients that have been treated for these injuries, please watch Whiplash Statistics Don’t Lie on YouTube (https://www.youtube.com/watch?v=st5bwC411VU). This is published by one of the top Spinal Ligament Injury Testing Companies in the United States called Spinal Kinetics (www.TheSpinalKinetics.com) Spinal Kinetics in the leader in the testing procedure that allows doctors to accurately determine the severity and location of spinal ligament damage.

Now let’s talk about costs – your costs – and why it is so necessary to stay out of the money pit caused by chronic pain. Chronic pain and its caustic expenses can leave you quite poor!

The American Pain Society, one of America’s most prestigious medical groups, explains the following in their 2007 publication of lower back guidelines:

Medical treatment for chronic low back pain is estimated to cost $9,000 to $19,000 per patient annually, and interventional treatments cost a minimum of $13 billion in 1990. Additional costs are associated with days lost from work due to low back pain. Low back pain is the most common cause for chronic or permanent impairment in U.S. adults under the age of 65, and the most common cause of activity limitations in persons under the age of 45.

In another recent study on chronic pain published in the Journal of Pain, the average American can spend more than $12,000.00 per year in additional medical expenses treating their chronic pain. After 10 years that is $120,000.00, which is a lot of deductible and copay expenses. This is BIG, BIG business and we want to keep you out of this expensive money pit!

Therefore, it is so important to choose your doctor wisely. Your health and your future finances can severely depend on it!

AMERICANSIIC.COM • COPYRIGHT © 2015


P: 512-835-6077

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