Whiplash Injury Case Study Summary
The article I am summarizing looked at the outcomes associated with utilizing Chiropractic BioPhysics technique (CBP) when traditional treatment options for whiplash associated disorders have not yielded maximum medical improvement. Traditional treatment options in this article consisted of multiple physical therapy and chiropractic treatments. In this patient, they had little or no lasting results.
The patient being treated was a 40-year-old male who was involved in a rear end collision. After the accident began his onset of whip-associated disorders. His symptoms included cervical spine pain, thoracic spine pain, cervicogenic headaches, TMJ dysfunction and left ulnar neuropathy. When he presented for care to a CBP practitioners office, he rated his pain on VAS as 5/10 and was still dealing pain for the past 8 months. His radiographic findings included a kyphotic cervical spinal configuration and anterior head carriage.
The patient was treated initially with spinal manipulation for 10 visits to temporarily reduce pain. After the initial ten visits were complete the patient only received spinal manipulation for pain management. He proceeded to receive CBP rehab protocol consisting of mirror image drop table adjustments, instrument adjusting, mirror image isometric exercises and mirror image compression-extension traction. The patient was being seen at a frequency of 4 to 5 times per week for a total of 40 visits. At this point a re evaluation was done and the patient elected to continue with care. After evaluating the new alignment of the spine on x-ray, the traction was changed slightly for the following 24 visits of care.
The patient experienced improvement in anterior head translation and cervical alignment towards normal. The patient also experienced no more cervicogenic headaches and reported having an 80% improvement in his pain levels since his initial re evaluation. After continuing his care an additional 24 visits he reported complete resolution in his pain in all areas except right shoulder pain (3/10). His neck disability index score went from a 46% at the beginning of care to a 0% at the end.
Looking at this example we can conclude that restoration of the normal cervical lordosis is associated with improved patient outcomes and long term results. The patient was not at maximum medical improvement when he stopped his initial chiropractic care and physical therapy. The standard of improvement is based on the standard of care that is available for patients. We need to raise our own standards of care and create better patient outcomes to make sure people don’t needlessly deal with pain and suffering. CBP technique succeeded with this patient where other interventions had failed. The normal cervical lordosis, or lack thereof, must be looked at and analyzed when assessing the health of the cervical spine.
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Ferrantelli, J. R., DC, Harrison, D. E., DC, Harrison, D. D., DC, PhD, & Stewart, D., MD. (march/april 2005). Conservative Treatment of a Patient with Previously Unresponsive Whiplash-Associated Disorders using Clinical Biomechanics of Posture Rehabilitation Methods. Journal of Manipulative and Physiological Therapeutics, 28(3), 205.e1-205.e8.