Brain Injury Law Blog : Head Injury : Coma : Personal Injury : Las Vegas Nevada Lawyer & Attorney Tim Titolo

 A common legal defense in cases of traumatic injury is that pain complaints, like low back pain, are the source of brain injury symptoms and reported cognitive impairments.  For instance, depression.  And while it is true that chronic or lasting pain can have symptoms that mimic those found with cognitive impairments, those symptoms are often not caused by pain or are at least exacerbated by pain components.

The Journal of Neuroscience recently published a study that supports relief of chronic pain as a precursor to the relief of brain injury symptoms and cognitive impairments.   Those with chronic pain also experience cognitive impairments and reduced gray matter in parts of the brain associated with pain processing and the emotional components of pain, like depression and anxiety.

Traumatic Brain Injury Attorneys must be able to distinguish cognitive impairments caused by organic brain injury from those associated with chronic pain.  A competent Traumatic Brain Injury Attorney works closely with neuropsychologists, neurodiagnosticians, and neurologists.

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link

Dealing with Brain Injury symptoms and consequences quite frequently, I am exposed to the contention that Depression is the culprit when it comes to the subjectivity of pain.  Subjective pain is that which is rated according to the one complaining, not the observer.  Objective pain is that which can be observed independent of the one complaining.

Brain Injured Victims are often accused of malingering pain symptoms as a result of being depressed.  And the depression is dismissed as a personality flaw or pre-existing a brain injury.

Well this is the what came first argument: the chicken or the egg.  Certainly there is medical support for the statistics of depressed patients being more likely to report subjective pain symptoms.  Also there are statistics supporting the evidence that pain leads to depression.

It is difficult to weed out the two but that difficulty is not justification to dismiss complaints of pain due to depression or depression being the true source of pain.

 When it comes to pain, the two competing schools of thought are that it's either "all in your head" or "all in your body". A new study led by University of Oxford researchers indicates that, instead, pain is an amalgam of the two.  Dr. Chantal Berna and colleagues used brain imaging to see how healthy volunteers responded to pain while feeling low.

 The article is "Induction of Depressed Mood Disrupts Emotion Regulation Neurocircuitry and Enhances Pain Unpleasantness" by Chantal Berna, et al. Berna, is affiliated with The Centre for Functional Magnetic Resonance Imaging of the Brain, Department of Clinical Neurology and Nuffield Department of Anaesthetics, University of Oxford, Oxford, United Kingdom.

The article appeared in Biological Psychiatry, Volume 67, Issue 11 (June 1, 2010), published by Elsevier.  The authors' disclosures of financial and conflicts of interests are available in the article.
 

• Email This
• Print
• Comments (3)
• Trackbacks
• Share Link

The American Association of Neurological Surgeons (AANS) spokesperson reports that there are some ways to help prevent low back pain and protect your spine. Prevention tips from the AANS:

- Maintain a healthy body weight.

-  If you smoke, quit. Smoking and extra weight can not only damage the spine, but are factors that can negatively impact spine surgery.

- Maintain proper posture while sitting, standing and walking.

- Use proper lifting techniques to avoid injury. Bend your knees when picking up and lowering the object, keep a straight back, and do not twist. Do not lift heavy objects that are beyond your strength ability.

- Make sure your mattress and bed pillow support your neck and back.

- Do exercises that stretch and strengthen the muscles of your abdomen and spine. Strong back and abdominal muscles can help you maintain good posture and keep your spine in its correct position.

- If you suffer from persistent, chronic, or recurring back pain, consult your doctor. In most cases there is a conservative, nonsurgical treatment that can resolve the pain. However, if left untreated or allowed to progress, back pain may lead to serious and severe disability. 

The Journal of the American College of Sports Medicine recommends an excercise machine designed specifically for back muscles as a solution.  Such exercises can only help reduce pain and disabilities caused by back pain. He recommends those who suffer severe hurt begin with stretches on the ground with low to medium effort.
 

• Email This
• Print
• Comments
• Trackbacks
• Share Link

Over the years, Chiropractors have taken a lot of heat about their brand of healing.  Insurance companies discredit their treatment everyday.  But Chiropractic care, in this emerging age of preventable care as a way to reduce health care costs, may be ready to make a grand re-entrance.

I previously blogged about a Seven Year Study that revealed Chiropriactic was an excellent care technique.

I work with Chiropractors in appropriate cases where client care can be managed by such a physician.  These doctors often refer patients on to other specialists if the needs arise.

Low-back pain sufferers can seek relief from any number of health professionals, orthopedists, physical therapists and osteopaths among them.

Many choose chiropractors, which typically combine spinal manipulation with such treatments as exercise, massage, heat or electrical stimulation. This approach is modestly  successful in reducing pain of recent onset and improving disability, at least for a few weeks, according to a new Cochrane review. However, the review found no evidence that chiropractic works significantly better than care provided by other clinicians.

Cochrane Reviews investigate the effects of interventions for prevention, treatment and rehabilitation in a healthcare setting. They also assess the accuracy of a diagnostic test for a given condition in a specific patient group and setting.

Low-back pain is one of the most common and costly musculoskeletal problems in modern society. About 80% of the population will experience low-back pain at some time in their lives. Many people with low-back pain seek the care of a chiropractor.  

For Cochrane's review, chiropractic was defined as encompassing a combination of therapies such as spinal manipulation, massage, heat and cold therapies, electrotherapies, the use of mechanical devices, exercise programs, nutritional advice, orthotics, lifestyle modification and patient education. The review did not look at studies where chiropractic was defined as spinal manipulation alone as this has been reviewed elsewhere and is not necessarily reflective of actual clinical practice. Non-specific low-back pain indicates that no specific cause is detectable, such as infection, cancer, osteoporosis, rheumatoid arthritis, fracture, inflammatory process or radicular syndrome (pain, tingling or numbness spreading down the leg).

Twelve randomised trials (including 2887 participants) assessing various combinations of chiropractic care for low-back pain were included in this review, but only three of these studies were considered to have a low risk of bias.

This tells me that chiropractic care is a useful protocol in the effort of reducing pain and healing in many circumstances.

• Email This
• Print
• Comments (1)
• Trackbacks
• Share Link

Whiplash, or WAD (whiplash-associated disorders) refers to a series of neck injuries caused by or related to a sudden distortion of the neck - hyperextension (over-extension) injury to the neck. In many cases whiplash is the result of being struck from behind, for example, by a fast moving vehicle in an automobile accident.
 

Most people associate whiplash with one vehicle being hit in the rear by another vehicle - the driver in front sustains the whiplash. However, the impact can come from any direction and the head may move backwards or sideways, not only forwards initially. Whiplash injury may also be sustained in various ways, such as from falling off a bicycle or a horse.

 What are the symptoms of a whiplash injury?

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

A whiplash injury typically takes from 12 to 24 hours after the accident or blow to develop. At the time of the incident any swelling or bruising to the neck muscles will not be apparent straight away. In most cases the discomfort, pain and stiffness is much worse on the following day, and may continue to worsen as each day goes by. A person with a whiplash injury may experience:

• A loss (or reduction) of movement in the neck
• Headaches
• Neck pain
• Neck stiffness
• The back of the neck feels tender
   
• The following signs and symptoms are also possible: 
   
• Lower back pain
• Pain in the arms and hands
• Numbness or pins and needles in the arms and hands
• Muscle spasms
• Dizziness
• Fatigue
• Swallowing difficulties
• Vision problems (vision may be blurred)
• A feeling that you are moving or spinning (vertigo)
• Ringing in the ears (tinnitus)
• Sleep disturbances
   
• The following less common signs and symptoms are also possible: 
   
• Irritability
• Memory loss
• Poor concentration

Headaches, dizziness, problems swallowing and vision problems should not last long. If they do, tell your doctor.  These could be signs, symtoms and consequences of other injury.

Be aware that certain symptoms of whiplash are also symptoms of Brain injury. A severe whiplash injury, think of shaken baby syndrome, can result in damage to the brain.  Shaken baby syndrome  is a form of child abuse. It refers to brain injury that happens to the child. It occurs when someone shakes a baby or slams or throws a baby against an object. A child could be shaken by the arms, legs, chest, or shoulders.

A coup-contrecoup injury, for example, is common in the hyperflexion/hyperextension process. 

• Email This
• Print
• Comments
• Trackbacks
• Share Link