Treatments & Diagnostics
Treatments & Diagnostics
Atlantic Coast Medical Care we treat
Anyone injured in a motor vehicle crash must be evaluated by a doctor within 14 days of the crash.
Facts to consider regarding motor vehicle crashes (mvc) Insurance companies their defense attorneys want you to believe that crash damage is directly proportional to severity of injury. In other words, minimal damage results in minimal injury. They claim most mvc result in minor imapact soft tissue injuries they call them MIST. Typically minor impact low speed crashes are defined as crashes occurring at closing velocities of 10 mph or less. However closing velocities without definition of the relative size of the involved vehicles is not quantitative or measurable. For example a Mustang struck by a Neon at 10 at a closing velocity at 10mph will experience far less velocity change than that same Mustang being struck at the same speed by a UPS sized commercial truck. Important vehicle factors include relative size of the partners, contact points, impact vectors, property damage, head restraints, seat geometry, seat type and seat damage, use of restraint system & air bag deployment.
Often times we hear from insurance company adjusters and insurance company attorneys that these type of low speed rear impact collisions crashes do not cause injuries more than mild in nature. When in fact these crashes not only cause injuries but the cause permanent Injuries which can be proven by auto accident reconstructionist. At the heart of auto crash reconstruction calculations lies the science of vehicle dynamics. The measureable variables used is vehicle dynamics include distance, time, velocity, accelaeration, friction, drag and mass. We may calculate unknowns from these factors by knowing the values of these variables. Distance is the change of body position relative to some fixed point. Distance in general is calculated from the vehicle’s center of mass and is measured in feet. Time really requires no definitive description for our purpose. Units of time are given in seconds or milliseconds. Velocity describes a body’s rate of change of position with respect to time and usually expressed as feet per second squared. Velocity is a vector quantity because it has both magnitude and direction. Acceleration is the second derivative of position with respect to time it is also a vector. Changes in velocity above 12-15 mph has been proven to cause spinal cord injuries. Let it be known that crashes with changes in velocity above 12-15 mph are frequently categorized by the insurance company and their high priced defense attorneys as minor impact soft tissue injuries or Low Speed Rear Impact Collisions (LOSRIC). Research reveals that a stopped vehicle struck from the rear and accelerated to 5mph in a span of 120 milliseconds or .12 seconds is exposed to an average acceleration force of greater than 1.9 g’s. Crash testing research reveals that it’s not the speed of the crash that’s most important but it’s the peak acceleration of the occupants head.
Typically the head will accelerate 2 to 3 times the average of the acceleration. Damage threshold for many domestic vehicles in the US is 8-12 mph. Whiplash is a true modern epidemic. The incidents of whiplash have increased over the years. The increase incidence of whiplash is related to the manufacturers building vehicles using materials with increased stiffness to improve crash testing ratings has contributed to the increased incidents of Whiplash. Seatbacks are manufactured stiffer to prevent damages to the seats and chairs backs which lowers repair costs so that consumers will believe the vehicle is safer and less expensive to repair, when in fact it is more dangerous to the occupants inside the vehicle. Vehicle manufactures have very little concern to protect occupants from injuries in low speed crashes (12mph or less). Furthermore no injury criteria for low impact crashes are implemented. Another reason for the increased incidence of whiplash is the shoulder restraint system and shoulder harness lap belts. One study revealed that neck injuries were three times more likely for belted drivers than non-belted drivers. This statement does not imply that you should not wear shoulder lap seat belts. Seatbelts save lives and may reduce major catastrophes; however, seatbelts contribute to a high incidence of injuries in motor vehicle crashes at low speeds.
We know whiplash injuries occur at 6-12 mph. The primary mechanisms of injuries are due to the forces that whip the spine back and forth and/or side to side. In a rear end fashion crash the neck is accelerated and rapidly forced into a hyper extended position, followed by the neck forcefully hyperflexing forward and then hyper extended backwards again. The forcefull whipping of the head and neck results in injuries to the spine and extremities. Primarily ripping and tearing of connective tissue or soft tissue of the body will occur. Injuries may include fractures, dislocations, disc bulging and herniation, muscle and tendon tears, ligament tears, instabilities, spinal cord contusions, joint capsule tears, nerve root injuries, traumatic brain injuries, contusions and lacerations. Frequently, whiplash injuries lead to permanent injuries and long term degenerative arthritic changes that occur after most whiplash injuries may result in permanent injuries, impairment that adversely effects the ability to maintain normal activities of daily living, recreational activities and work related limitations or disability. Whiplash is a true epidemic in the US there are 3 million low speed impact crashes each year.
In low speed rear impact crashes the risk injury is approximately 50 percent. Of those injured up to 50 percent never fully recover. Up to 15 percent will become disabled. The number of whiplash, cervical acceleration/deceleration or CAD injuries is rising. Whiplash injuries present unique challenges to some due to the myths association with Whiplash related injuries. A common myth is that property damage is most related to the risk or severity of injury. Another myth is that injury risk and severity is directly proportional to property damage. Low speed rear impact collisions occur in the following sequence of events. The bumpers collide, the seat forcefully strikes the occupants, forcefully straightening and flattening of the spine along with forceful axial compression and ramping of the spine. These forces are responsible for the injuries to the bones, muscles, ligaments, spinal disc, spinal cord, joint capsules, cartilage, blood vessels and nerves.
Important vehicle factors include relative size of the partners, contact points, impact vectors, property damage, head restraints, seat geometry, type and damage, use of restraint system and air bag deployment.
Neurologists approach patients from anatomical perspective first physiology later. The neurologist first step is to locate the lesion in the specific part of the neuro system causing the problem. The brain is unique among organ specialization. Through comprehensive history and physical examination neurologists look for symptoms such as headaches, dizziness, pain, arm weakness, asymmetric weakness, sensory changes such as pain numbness tingling pins and needles. Inability to feel vibration or distinguish between hot and cold or more serious signs and symptoms such as loss of bowel and bladder control commonly accompanying spinal cord lesions most often treated in emergency settings.
Signs and symptoms such as visual difficulties, sensations of the face, double vision, deafness, dizziness, pain with movement, difficulty swallowing, weakness of the neck and shoulders, all these symptoms may be associated with brain stem disease and each must be carefully evaluated to rule out brain stem disease. Dizziness and balance disorders are another common problem we see in our offices. Neurologically patients with dizziness or a balance disorder must be carefully evaluated and screened for future fall & prevention. Many patients who have dizziness or an undiagnosed balance disorder will frequently fall, breaking a hip resulting in permanent disability and even death.
Our Neurologist not only treats painful accident and sports injuries as well as painful conditions effecting the brain, spine and extremities, but he also diagnoses and treats progressive disorders effecting the brain, spine and extremities. Neurologists frequently use diagnostic testing to accurately diagnose most neurological disorders and conditions.
NCV/EMG Testing: Nerve conduction velocity testing (NCV) is ordered when medically necessary to determine the presence or absence of abnormality of peripheral motor and sensory nerve. An EMG electromyography is used in conjunction with NCV testing. Electromyography is an electric recording of resting and voluntary muscle activities transmitted through needle electrode to allow oscilloscopic visual display. These tests are used to determine location and severity of neurological disorders and different myogenic and neurogenic disorders.
Magnetic Resonance Imaging (MRI) and digital x-ray
Magnetic Resonance Imaging (MRI) and digital x-ray are used to evaluate spinal disorders, nerve root compressions and space occupying lesions and demyelinating conditions. Digital x-rays are used to rule out fractures, tumors, fractures, dislocations and congenital abnormalities. Digital x-rays are used to asses and measure the spinal segments, curves of the spine, and alignment of bones of the spine and extremities.
Connective Tissue & Soft Tissue
Are viscoelastic, the have the ability to stretch (elongate) and contract (shorten) under the right conditions. Viscoelasticity of connective tissue and soft tissues such as muscles, ligaments, tendons, fascia all have viscoelastic properties. However, the physical properties of connective soft tissue varies depending on whether the muscle, tendon, ligament disc are active or passive. All soft tissues and connective tissues are viscoelastic. Understanding viscoelasticity is crucial for understanding the nature of low speed impact crashes LOSRIC and MIST. The soft connective tissue is usually the source of injury and pain associated with Whiplash & automobile crashes. Injuries to the spinal structures include bone, joint disc, ligament, facet joints, end plates of the vertebrae, muscle and nerves.
The Doctors at Atlantic Coast Medical Care & Rehab are highly trained in examination, diagnosis and treatment of Whiplash and motor vehicle crash related injuries and are experienced testifying as an expert witnesses in accident injury cases. Considering most motor vehicle crashes result in injuries to the soft connective tissue and therefore is usually the source of injury and pain the best treatment for these type of injuries are therapy and rehab. Make sure to be evaluated by a doctor trained in the examination, diagnosis and treatment of motor vehicle crash and watercraft crash injuries. Remember you must see a doctor within 14 days in order for bills to be paid thru the auto insurance carrier.
The board certified Chiropractors at Atlantic Coast Medical Rehab have performed well over ten thousand safe and effective adjustments for people suffering from injuries or pain from a car accident, recent or prior sports injury, recreational injury, overuse as well as unexplained injury or pain. By incorporating basic elements of scientific research, utilizing biochemistry labs, radiology, digital xray, MRI’s, Orthopedics, Neurological testing along with over twenty years of clinical experience we may accurately diagnose your injuries and painful conditions.
Our Chiropractors are able to treat most injuries, and painful conditions using a gentle approach. Not all patients are candidates for chiropractic care. Our staff includes Chiropractors and Medical Doctors specializing in Emergency Medicine, Physical Medicine & Rehabilitation & Interventional Pain Management. Chiropractic care, therapy & rehab are often indicated and preferred after car and boating accidents, work related overuse injuries, sports related injuries, slip or trip and falls, work accidents, recreational injuries and unexplained painful conditions. Most Injuries are to the soft connective tissues and do not require surgery or even medications. Therapy and rehab treatments are usually most effective treating injuries and reducing pain, inflammations, muscle spasms, headaches, numbness & tingling sensations. Fifty percent of Americans use chiropractic for treatment of back pain.
Spine manipulation has been proven affective for treatment of lower back pain. Doctors of chiropractic use spinal manipulation adjustments as their specialty. Chiropractors are sensitive and compassionate to your pain and condition. Non operative spinal care is indicated far greater than surgery. In fact surgery is necessary in less than 2 percent of low back pain cases. In fact most good surgeons will recommend patients undergo at least six to eight weeks of therapy, treatment and limited activity. Patients should consider conservative treatments before surgery is considered unless bowel or bladder disorders.
Difficult spine & joint cases such as painful frozen joint of the spine or extremities, pre or post surgical conditions, may be candidates for manipulation under anesthesia (MUA). Dr Scott Rosenstein, MS, DC is trained and certified in performing manipulations under anesthesia for difficult spine and joint cases. Manipulation under Anesthesia (MUA) treatments are performed in an accredited surgical center with the patient under light anesthesia so that limited joint resistance exists and a gentle flow movement manipulation can occur to a painful frozen joint or restricted joint or spine segment. MUA is considered when all other options have been failed or exhausted and surgical intervention is being considered. MUA’s are performed with an anesthesiologist and a board cert specialist in physical medicine rehab orthopedic or neurosurgeon.
Sciatica is leg pain. Sciatica is frequently the result of the nucleus of a disc bulging or herniating causing irritation or compression of the Sciatic Nerve. Often amount of pain related coincided with severity of disc displacement or rupture. Severe muscle spasms associated with the back and hip my lead to Sciatic leg pain.
Facet syndrome is a type of back pain and leg pain that affects 26 percent of people with low back pain. Facet syndrome is a common condition diagnosed as sciatica or a disc related injury. Facet syndrome is when one or more of the vertebrae loses its alignment with the adjacent facet joint resulting in pain, stiffness, and weaknesses at the very least. Frequently facet joint dysfunction is secondary to intervertebral disc narrowing and thinning.
Regenerative Medicine & Stem Cells
Regenerative Medicine & Stem Cells cryopreserved regenerative cells are injected barrier can into the injured
sites of the spine and joints to promote the regeneration of spine and joint tissues.
Lab testing are offices are contracted with multiple labs throughout Duval & Clay counties enabling our patients to be seen without wait in our Jacksonville and Orange Park locations for lab testing. Comprehensive lab testing is used to analyze blood chemistry, measure & monitor blood glucose levels, measure lipid panels, testosterone levels, estrogen levels as well as other male and female hormones.
Interventional pain management is the branch of medical treatment that consists of physical medicine, diagnostics and specific pain management interventional procedures for the treatment spine and extremity pain. This includes pharmacology, the use of medications to treat symptoms. Trigger point injections are injections into painful muscle at the muscle belly, specific origins and insertions of the muscles affected by accident and injuries. The injections are primarily lidocaine with sarrapin injected into the painful points throughout the muscles defined as trigger points.
Nerve block specific injections are employed to anesthetize various nerves that produce pain along the spine and extremity joints. Included are median nerve blocks for wrist for pain at carpal tunnel. Sacroiliac joint injections are specific injections performed on the scaroilliac joints to relieve lower back, hip and pelvic pain.
Sciatic nerve block injections are performed on the sciatic nerve to relieve pain and reduce inflammation on sciatic resulting in resolution of buttock pain.
Scapular Nerve block injections for shoulder pain or reduction of peri-scapular and inter-scapuler shoulder area pain. Peroneal nerve blocks are injections using ultrasound guidance to identify the peroneal nerve and and reduce the neuropathic pain.
Occipital nerve blocks are indicated for reducing headaches and pain around the head and occipital regions. cell injections, and amniotic/umbillicus injections. Regenerative medicine procedures to are used to regenerate and restore muscles, tendons ligaments, arthritic joints of spine and extremities, intervertebral disc disorders, neuropathies, progressive disorders, osteoarthritic disorders affecting knee and shoulders & wrists.