Brain and Spine Injury Lawyer & Attorney : Titolo Law Firm : Las Vegas, Nevada

Spine published an article of a seven-year, international study on February 15, 2008 and finds that some alternative therapies such as acupuncture, neck manipulation and massage are better choices for managing most common neck pain than many current practices. Also included in the short-list of best options for relief are exercises, education, neck mobilization, low level laser therapy and pain relievers.

Therapies such as neck collars and ultrasound are not recommended. The study found that corticosteroid injections and surgery should only be considered if there is associated pain, weakness or numbness in the arm, fracture or serious disease.

The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders 236 page review of the current research on neck pain is published in the journal Spine. The multi-national and inter-disciplinary study team included Canadian, American, South American, Australasian and European researchers. The Task Force was created to help neck pain sufferers and health professionals use the best research evidence to prevent, diagnose and manage neck pain.

Neck pain is not a trivial condition for many people, says Task Force president Dr. Scott Haldeman, clinical professor, department of neurology at the University of California, Irvine; and adjunct professor, department of epidemiology University of California Los Angeles. It can be associated with headaches, arm and upper back pain and depression. Whether it arises from sports injuries, car collisions, workplace issues or stress, it can be incapacitating. Understanding the best way to diagnose and manage this problem is of high importance for those who are suffering and for those who manage and pay for its care.

The study found that neck pain is a widespread experience that is a persistent and recurrent condition for the majority of sufferers. It is disabling for approximately two out of every 20 people who experience neck pain and affects their ability to carry on with daily activities says the Task Force.

A key recommendation of the Task Force is that neck pain, including whiplash-related pain, be classified and treated in a common system of 4 grades:

Grade 1: neck pain with little or no interference with daily activities

Grade 2: neck pain that limits daily activities

Grade 3: neck pain accompanied by radiculopathy (pinched nerve - pain weakness and/or numbness in the arm)

Grade 4: neck pain with serious pathology, such as tumor, fracture, infection, or systemic disease.

The majority of neck pain falls into Grades 1 or 2, says Task Force member, Dr. Linda Carroll, Associate Professor, School of Public Health at the University of Alberta, and Associated Scientist, Alberta Centre for Injury Control and Research (ACICR). Many sufferers manage to carry on with their daily activities. Others find their pain interferes with their ability to carry out daily chores, participate in favorite activities or be effective at work. For these people, the evidence shows there are a relatively small number of therapies that provide some relief for a while, but there is no one best option for everyone.

In addition to its comprehensive review of the existing body of research on neck pain, the Task Force also initiated a new study into the association between chiropractic care of the neck and stroke. This innovative piece of research found that patients who visit a chiropractor are no more likely to experience a stroke than are patients who visit their family physician. The study concludes that this type of stroke commonly begins with neck pain and/or headache which causes the patient to seek care from their chiropractor or family physician before the stroke fully develops.

This type of stroke is extremely rare and has been known to occur spontaneously or after ordinary neck movements such as looking up at the sky or shoulder-checking when backing up a car, noted the studys lead author, Dr. David Cassidy, professor of epidemiology at the University of Toronto and senior scientist at the University Health Network at Toronto Western Hospital.

For the minority of neck pain sufferers who experience Grade 3 neck pain -- that is neck pain accompanied by pain, weakness and/or numbness in the arm, also referred to as a pinched nerve, corticosteroid injections may provide temporary relief says the study. Surgery is a last resort according to the findings and should only be considered if accompanying arm pain is persistent or if the person is experiencing Grade 4 pain due to serious injury or systemic disease.

Top findings for neck pain suffers:

-- Stay as active as you can, exercise and reduce mental stress.

-- Dont expect to find a single cause for your neck pain.

-- Be cautious of treatments that make big claims for relief of neck pain.

-- Trying a variety of therapies or combinations of therapies may be needed to find relief - see the therapies for which the Task Force found evidence of benefits.

-- Once you have experienced neck pain, it may come back or remain persistent.

-- Lengthy treatment is not associated with greater improvements; you should see improvement after 2-4 weeks, if the treatment is the right one for you.

-- There is relatively little research on what does or does not prevent neck pain; ergonomics, cervical pillows, postural improvements etc. may or may not help.

This is an important body of research that will help to improve the quality of patient care by incorporating the best evidence into practice and patient education, says Dr. Carroll. Neck pain can be a stubborn problem -- we hope this comprehensive analysis of the evidence will help both sufferers and health care providers better manage this widespread complaint. 

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I ran across breaking and optimistic news this morning.  As reported in Washington's Reuters: 

The research, published on Sunday in the journal Nature Medicine, showed that the brain and spinal cord are able to reorganize functions after a spinal cord injury to restore communication at the cellular level needed for walking.

Spinal cord damage obstructs the pathways the brain uses to transit messages to the nerve cells that control walking. Experts had thought the only way someone with such an injury could walk again was to somehow regrow the long nerve highways linking the brain and base of the spinal cord.

But what they found in this study was that when spinal cord damage blocked direct signals from the brain, the messages were able to make detours around the injury. Rather than using the long nerve highways, the message would be transmitted over a series of shorter connections to deliver the brain's command to move the legs, the researchers said.

I will keep apprised of new advances and pass them on.

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Floyd Reed thinks so.

Floyd had spine surgery in 2006 stemming for a fall out of tree when he was 7.  At 33 he finally rid himself of the pain associated with the injury.

So what happened? He was driving with his family when a tractor-trailer hit them. Everybody else in the car was all right. But for Reed, the pain ignited all over again.

A ruptured disc occurs when the relatively soft tissue that provides cushioning between the vertebrae blows out, causing the kind of pain and numbness that Reed experienced.

The standard operation, which Reed received last year, was to "fuse" two discs. That involves removing the ruptured disc tissue between two vertebrae, inserting the bone tissue of a cadaver in the space, and bolting the whole thing together.

That stabilizes the disc and makes the pain go away temporarily. But it takes away flexibility and places greater stress on the discs immediately above and below the fused vertebrae. There's a 25 percent chance the patient will need more spinal surgery within a decade.

The loss of flexibility also leaves the patient more susceptible to injury - say, in an accident involving a tractor-trailer.

A new procedure involves a device called a Prestige Cervical Disc. That replacement disc actually consists of two metal parts, which are screwed into the upper and lower vertebrae. And in the middle, where the disc material had previously been located, the two metal pieces fit together with a small, convex bulge inserted into a dimple on the other metal plate.

This allows for far more flexibility than fusing the vertebrae, taking pressure off the surrounding discs.  Reed said the recovery from surgery was a lot easier with the new procedure than with the previous one.

"I'd recommend it to anybody," he said. 

Read the full story here.

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Dr. James Nabzdyk is with ABC Wellness & Rehab in Joliet.   He offers tips for awareness of back an spine injury.  October is Spinal Awareness Month.

The central nervous system originates in the brain and channels down through the spinal column, extending to every part of the body. A misalignment of the vertebrae of the spine may result in nerve interference, resulting in headaches, low-back pain and neck pain, among other problems.

Listen to your body. Use preventive measures at work and at home. Nabzdyk offers the following tips to help reduce the risk of spinal injury:

• While at the office, remember to take frequent stretch breaks while working on your computer. The more hours per day you use your computer, the greater the risk of discomfort or injury.

• While working on your computer, sit with your knees at approximately a 90- to 120-degree angle. Using an angled foot rest to support your feet may help you sit more comfortably.

• Make sure your chair fits correctly. Allow for two inches between the front edge of the seat and the back of your knees. Make sure your back is completely supported by the back of the chair.

• Always bend from the knees, not your waist, when lifting anything heavier than 10 percent of your body weight, such as a child or a heavy box.

• Warm up and stretch before any physical activity (including all sports), raking, gardening and shoveling snow. Be aware of your body form and technique: stand as erect as possible and let your legs and arms do the work, not your back.

• It is important to get a good night's rest. Choose a comfortable, supportive mattress as well as a pillow that supports your neck, reducing the risk of back or neck pain.

The key to spinal health is prevention: listen to your body's warning signals and adjust your lifestyle. If you do experience pain for more than one or two days despite using these preventive measures, consult your local chiropractor. Chiropractors are trained to identify the cause of the problem and to manipulate (adjust) the spine to encourage the body's natural healing process. More than 20 million Americans sought chiropractic care last year for spinal injuries and pain.

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Before x-rays there were broken bones. We just could not see them on films. Today many orthopedic injuries are visible on films and other diagnostic technology. Many times proving that someone broke a bone or injured the spinal column involves much more then simply reading an x-ray, MRI or CT Scan. Many other Syndromes and Nerve Injuries originate from, and are secondary to, the trauma and orthopedic injury. And as transportation, technology and speed increase, so do the mechanisms of injury.

When disability results - partial, whole, temporary or permanent - the issue becomes expressing it to a jury and receiving appropriate compensation. This can be done by having substantial knowledge in the areas of vocational rehabilitation, life care planning, reduction in value of life analysis, as well as anatomy and medical issues associated with the injury.

Here are some things to consider when deciding on a lawyer to represent you:

How many cases have you been involved with over the past three years?

What percentage of your practice of law is devoted to handling cases and injuries similar to mine?

 
What were the results in terms of settlements or verdicts of the last 5 cases you handled that were similar to mine?

What associations do you participate in that deal with injuries like mine?

List three textbooks that you own and refer to when discussing injuries similar to mine?

Show me a text you have read regarding my injury within the last 6 months.

Name the seminars dealing with my injury you have attended in the last two years.

How many articles have you written over the past three years that deal with any aspect of injury similar to mine?

Would your law firm be able and willing to spend in advance as much as $50,000 in the investigation, preparation, and presentation of my case, if necessary?

Hiring an attorney with the best qualifications is your right. Exercise it wisely because it may be one of the most important decisions you will ever make.

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