Stiff Joints and Degeneration


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Historically the manipulable joint lesion has, from the beginning of the chiropractic profession, been described as a painful stiff joint.  Joint stiffness, commonly called hypomobility (also known in the chiropractic profession as “fixation”) has become by consensus one of the most important aspects of the manipulable joint lesion in the professions of chiropractic, osteopathy, and manual medicine.  Nearly 100 years of clinical agreement between three separate professions supports the existence of such a lesion although research now supports its existence.

Loss of full, or global, range of motion in the lumbar or cervical spines is an indirect proof that the segmental hypomobile manipulable vertebral joint lesion exists, because it is a fact that loss of full global range of motion occurs and such stiffness is considered an objective factor in chronic back pain. Therefore, even if this decreased range of motion is a mixture of hypermobile and hypomobile joints (i.e., a mixture of loose and stiff joints) there must be intervertebral hypomobility for global hypomobility to exist. Randomized controlled trials of manipulation documenting decreased global range of motion, and post-treatment global range of motion are growing.

A meta-analysis of clinical trials of spinal manipulation performed by Anderson et al., clearly and strongly demonstrated that spinal manipulation is effective in restoring or increasing global, and therefore segmental lumbar mobility. Mead et al., documented post-manipulation treatment restored or increased lumbar mobility: data proving that the hypomobile manipulable joint lesion must have existed prior to treatment, and that manipulation restored to these hypomobile joints fuller mobility.  Other studies have documented similar results. Nansel and his associates have demonstrated in three, multiply blinded, controlled studies, in which goniometer measurements confirmed cervical range of motion or global end range asymmetries or hypomobility, that after chiropractic high velocity low amplitude manipulation, statistically significant increased mobility was restored to the global and therefore segmental hypomobility areas: proof that global and therefore segmental hypomobility was returned to more normal mobility by manipulation.

For this and other reasons, you should visit Dr. Elaine McNally, DC for all your stiff, achy joint problems. Call 334-514-7600 today for an appointment.

Love my Chiropractor

As a Chiropractor, I have found many patients tell me that they love me. It is a wonderful thing to have happen when you are taking care of them and they really appreciate it. Millions of patients love their chiropractor and appreciate our unique and safe approach to recovery from pain. Significant research suggests that chiropractic is the safest approach available for relief from neck pain, back pain, headaches and other “musculo–skeletal” complaints.

Canada has a government-run national health care system. As occurred with Medicare in this country, there had been such pressure on the Canadian government to include chiropractic as a covered benefit, that the Ontario Ministry of Health hired a renowned heath care economist to make a recommendation. The first “Manga Report” was published in 1993.

This comprehensive study reviewed all the published literature on low back pain and made some astounding suggestions. In a nutshell, it concluded that: chiropractic should be the treatment of choice for low back pain – excluding traditional medical care altogether!

The specific Findings of the report were:

  • There is an overwhelming body of evidence indicating that chiropractic management of low-back pain is more cost-effective than medical management

  • Many medical therapies are of questionable validity or are clearly inadequate

  • There is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low-back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic complications for LBP patients.

  • Chiropractic is more cost-effective. There would be highly significant cost savings if more management of LBP was transferred from medical physicians to chiropractors.

  • There is good empirical evidence that patients are very satisfied with chiropractic management of LBP and considerably less satisfied with physician management

The specific Recommendations were:

  • Chiropractic services should be fully insured under the Ontario Health Insurance Plan

  • Chiropractic services should be fully integrated into the health care system. Because of the high incidence and cost of LBP, hospitals, managed health care groups, community health centers, comprehensive health organizations, and health service organizations and long-term care facilities should employ chiropractors on a full-time and/or part-time basis

  • A good case could be made for placing chiropractic as the gatekeepers for all musculoskeletal complaints that presented to hospitals.


All the sign and symptoms of Whiplash

What are the symptoms of whiplash?

  • Headache, due to neck problems, are called cervicogenic (neck-related) headache. It may be due to injury to an upper cervical disc, facet joint, or the upper 2 vertebral joints (atlanto-occipital or atlanto-axial). Cervicogenic headache can also make migraines worse.

  • Arm pain and heaviness may be due to nerve compression caused by a herniated disc. More commonly, arm pain is “referred” from other tissues of the neck. “Referred pain” is pain that is felt at an area remote from the injury, and may not due to pressure on a nerve.

  • Pain between the shoulder blades is usually a type of referred pain.

  • Low back pain is occasionally seen and is quite common after whiplash and may be due to injury to the discs, facet joints of the low back or sacroiliac joints.

  • Difficulties with concentration or memory can be due to pain itself, medications you are taking for the pain, depression or mild brain injury. You might also experience irritability and depression.

  • Sleep disturbance can be due to pain or depression.

  • Other symptoms might include blurry vision, ringing in the ears, tingling in the face or arms, and fatigue.

    If you have any or all of the above it is imperative that you seek help. Chiropractic care is outstanding in its field for helping their patients with these type of symptoms. Call 334-514-7600 for an appointment today.

Ohh the Neck Pain


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It is usually not possible to know the exact cause of neck pain in the days or weeks after a car accident. We know the muscles and ligaments get strained and are probably inflamed, but they usually heal within six to ten weeks. Pain that lasts longer (than 6-10 weeks) is usually due to deeper problems such as injury to the disc or facet joint, or both.

  • Facet Joint Pain is the most common cause of chronic neck pain after a car accident.. It may occur alone or along with disc pain. Facet joint pain is usually located to the right or left of the center back of the neck. The area might be tender to the touch, and facet pain may be mistaken for muscle pain. We cannot tell if a facet joint hurts by how it looks on an X-ray or MRI scan. The only (MEDICAL) way to tell if the joint is a cause of pain is to perform an injection called “medial branch block (MBB)”.

  • Disc Injury can also cause chronic neck pain. The disc allows motion of the neck, but at the same time keeps the neck from moving too much. The outer wall of the disc (called the anulus) can be torn by a whiplash injury. This usually heals, but in some people, the disc does not heal. In that case, it might get weaker and hurts when stressed during normal activities. The pain comes from the nerve endings in the anulus. The disc is the major cause of chronic neck pain in about 25% of patients, and there can be both disc pain and facet pain in some people. Less often, a disc can herniate and push on a nerve. This usually causes more arm pain than neck pain.

  • Muscle Strain of the neck and upper back can cause acute pain. However, there is no evidence that neck muscles are a primary cause of chronic neck pain, although muscles can hurt if they are working too hard to protect injured discs, joints, or the nerves of the neck or there is something else wrong that sustains the muscle pain, such as poor posture and work habits.

  • Spinal nerves and the spinal cord can be compressed by a herniated disc or bone spur. This usually causes arm pain, but there can also be neck pain.

  • So if you are suffering from this type of neck pain, it might be time to have it checked out to see what is going on and get it fixed. Chiropractic do it best. Call 334-514-7600 today for an appointment

Why take pain medication when Chiropractic can often eliminate the pain?


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FDA Consumer magazine

January-February 2003

Acetaminophen is a safe and effective pain reliever that benefits millions of consumers. However, taking too much could lead to serious liver damage. The drug is sold under brand names such as Tylenol and Datril, but it is also available in many cough and cold products and sleep aids, and is an ingredient in many prescription pain relievers.

In September 2002, the FDA Non-Prescription Drugs Advisory Committee discussed safety issues related to the use of pain relievers sold over-the-counter (OTC), including acetaminophen, aspirin, ibuprofen and naproxen.

Acetaminophen can cause liver injury through the production of a toxic metabolite. The body eliminates acetaminophen by changing it into substances (metabolites) that the body can easily eliminate in the stool or urine. Under certain circumstances, particularly when more acetaminophen is ingested than is recommended on the label, more of the harmful metabolite is produced than the body can easily eliminate. This harmful metabolite can seriously damage the liver.

The signs of liver disease include abnormally yellow skin and eyes (jaundice), dark urine, light-colored stools, nausea, vomiting, and loss of appetite. The signs can be similar to flu symptoms and may go unnoticed for several days if consumers believe their symptoms are related to their initial illness. Serious cases of liver disease may lead to mental confusion, coma, and death.

To avoid accidental overdosing, it’s very important not to take more than the recommended dose on the label. Also, you should not take acetaminophen for more days than recommended, or take more than one drug product that contains acetaminophen at the same time. Consumers should be aware that taking more than the recommended dose will not provide more relief.

If you’re taking a prescription pain medicine, check with your doctor first before taking OTC acetaminophen. The prescription pain medicine may also contain acetaminophen. Acetaminophen is also available in combination with other OTC drug ingredients. So, you need to check the labels of other OTC drug products for the ingredient. In some cases of accidental acetaminophen overdose, it appears that consumers used two or more acetaminophen-containing products at the same time.

Some individuals appear to be more susceptible to acetaminophen-induced liver toxicity than others. People who use alcohol regularly may be at increased risk for toxicity, particularly if they use more than the recommended dose. Further research needs to be conducted in alcohol users to determine what factors make some alcohol users more susceptible to liver injury than others.

Parents should be cautious when giving acetaminophen to children. For example, the infant drop formula is three times more concentrated than the children’s suspension. It’s important to read drug labels every time you use a drug and to know what dosage strength you are using.

Improvements to labeling and consumer information for acetaminophen are among the recommendations made by the FDA’s Nonprescription Drugs Advisory Committee. The committee recommended including the word “acetaminophen” in bold type on the labels for all drug products containing the ingredient and a warning about acetaminophen’s potential to cause liver damage.

The committee also recommended that labeling for aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen include warnings about the potential for gastrointestinal bleeding that may be associated with use of these products. Aspirin is sold under brand names such as Bayer and St. Joseph’s. Ibuprofen is sold under names such as Advil and Motrin. Naproxen is sold under the name Aleve. There are generic versions available for all of these products, as well.

The risk for bleeding is low for those who take these products intermittently. For those who take the products on a daily or regular basis, the risk is increased, particularly for those over 65 years of age or those who take corticosteriods (such as prednisone). Those who use hormone therapy (estrogens and progestins) for post-menopausal symptoms or birth control do not have an increased risk for bleeding.

In addition, the committee recommended adding labeling language that urges consumers to ask health care providers about NSAID use if they have kidney disease or are taking diuretics (fluid pills).

The FDA is evaluating the committee’s advice and working to complete rulemaking for these OTC pain relievers/fever reducers.

Overall Improvement, Pain Reduction for people with disc herniations


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The purpose of this study was to compare the outcomes of overall improvement, pain reduction, and treatment costs in matched patients with symptomatic, magnetic resonance imaging-confirmed cervical disk herniations treated with either spinal manipulative therapy (SMT) or imaging-guided cervical nerve root injection blocks (CNRI).

RESULTS:   “Improvement” was reported in 86.5% of SMT patients and 49.0% of CNRI patients (P = .0001). Significantly more CNRI patients were in the subacute/chronic category (77%) compared with SMT patients (46%). A significant difference between the proportion of subacute/chronic CNRI patients (37.5%) and SMT patients (78.3%) reporting “improvement” was noted (P = .002).

CONCLUSION:   Subacute/chronic patients treated with SMT were significantly more likely to report relevant “improvement” compared with CNRI patients. There was no difference in outcomes when comparing acute patients only.

Athletic injury during a Taekwondo competition


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During the tournament, an athlete had a sudden, non-traumatic, ballistic movement of the cervical spine. This resulted in the patient having a locked cervical spine with limited active motion in all directions. The attending chiropractor assessed the athlete, and deemed manipulation was appropriate. After the manipulation, the athlete’s range of motion was returned and was able to finish the match. Spinal manipulation has multiple positive outcomes for an athlete with an acute injury including the increase of range of motion, decrease in pain and the relaxation of hypertonic muscles.

It is getting quite common for athletic events to have Chiropractors on staff to take care of injuries. Olympians, NFL, Rodeos, and many other sports have incorporated Chiropractic not only because it works, but because it often works so well that the athletes are back up and in the game.

You do not need to be an athlete to need Chiropractic care for your injuries.  You should be aware that manipulation may be an effective tool to treat an acute injury of all types. So if you have hurt yourself being a weekend warrior, then Chiropractic care might be what you need to get back up and running. Call 334-452-9140 for an evaluation today.

Personal Injuries from accidents are covered by insurance.


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Personal injury protection benefits applicable to basic and standard policies

(a) Personal injury protection coverage shall provide reimbursement for all medically necessary expenses for the diagnosis and treatment of injuries sustained from a covered automobile accident up to the limits set forth in the policy and in accordance with .

(b) Personal injury protection coverage shall only provide reimbursement for clinically supported necessary non-medical expenses that are prescribed by a treating medical provider for a permanent or significant brain, spinal cord or disfiguring injuries.

Chiropractic has been one of the leading professions in helping spinal injuries which the medical profession only offer pain medication and muscle relaxers.

Understanding how insurance companies work.


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Whenever a doctor is dealing with insurance companies, their reports must be consistent with the guidelines set for by the insurance companies in order to be paid. The doctor’s fees must be consistent within the insurance’s parameters for the “usual, customary, and reasonable” fees, or the insurance company will not pay for all the doctor’s bills.

This also holds true for insurance companies’ parameters for length of treatment, kinds of treatment, and who will be the treating doctor all depending on the various traumatic injuries. If the doctor’s treatment exceeds the normal parameters for a stated diagnosis, the insurance company will claim over utilization for that diagnosis and will not approve the claim, and will ultimately refuse to be responsible for the claim and that has nothing to do with the patient’s actual condition..

Many doctors object to the insurance company parameters as being too conservative and often wonder how the insurance company even arrived at this policy guideline. The answer is simple. In the US we have a clearing house of insurance statistics which monitors every claim from its diagnosis coding, treatment coding, treatment time periods, and then arrived at the average parameters and then compare it with the patient’s care.

These treatment guidelines are also influenced by politics, money available, insurance coverage purchased, With Obamacare, there will be added features that are not fully recognized until it goes into effect and the whole health industry from patients compliance to Obamacare, insurance compliance to Obamacare, Doctors and their complaince to Obamacare, and all the other companies involved in providing health care products and services.

The future of Health care is going to be undergoing changes that will soon be all too evident as to its effectiveness, efficiency, and its over all improvement to patient’s health.

The Effectiveness of Chiropractic Care


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What can be said on effectiveness about chiropractic practice for acute and chronic back and neck pain, and cervicogenic headaches including migraine, is:

a)   Chiropractic manipulation is at least as effective as any other treatment, with better results than any treatment with which it has been compared.

b)   With chronic pain it provides patients with a period of relief from pain and disability that represents a window of opportunity for long-term relief.

c)   If chiropractic management is multimodal, including patient education and motivation, prescription and monitoring of exercises, and the use of supportive modalities and therapies such as massage and acupuncture as may be needed in individual cases, and other psychosocial interventions, this can bring long-term relief.