Sep 30, 2009

what is Chronic Pain?

 Chronic pain is defined as pain that persists longer than 90 days beyond the course of the natural expected healing time.  As a chiropractor in San Diego, I get calls from both new and established patients on a regular basis who complain of back pain, neck pain, etc. 

One of the factors that comes into play when planning a chiropractic treatment program is the duration of the patients pain.  In genereral, the longer that a patient suffers with a painful condition, the longer / more intense the treatment is needed in order to fix it.  Acute or recent episodes of pain respond much quicker than do chronic conditions.

Pain is very difficult to quantify by any practitioner.  Pain is subjective in nature and completely defined by the person experiencing the symptoms, the fact that chronic pain can exist without an obvious cause makes it much more difficult to treat. 

I see the difficulties that my chronic pain patients have with their conditions on a daily basis.  Aside from the actual pain that they experience, those who suffer with chronic pain often limit their activities for fear of exacerbating their conditions.  They also have a much harder time focussing on mental tasks as the pain is a constant source of distraction.  The more severe the pain, the more difficulties these people have with attention demanding tasks.

While we strive to avoid pain, pain is a wonderful tool of the nervous system.  Pain lets us know of actual or potential tissue damage with an unpleasant sensation that directs our attention to the affected area so that we can either immediately take action to stop the process or focus on healing the injured body parts.  Chronic pain sensations are a bit more insideous.

Chronic pain often involves a decrease in the sensativity of the nerve fibers that send messages of pain from the damaged area.  With a decreased sensativity (threshold), the nerve is much more likely to transmit painful sensations to the brain then a healthy nerve / tissue combination.  This activity within the nervous system is know as a wind up phenomenon and it is very difficult to stop once it has been established.  In some other cases, nerve fibers that normally don’t carry painful sensations not only begin to transmit pain signals but it is thought that they may actually generate the signals themselves.

In my office, chronic pain is often the result of untreated sprain / strain type injuries of the joints.  In untreated or under-treated sprain / strain injuries, the joint or the muscles that move the joint are laden with scar tisuue that acts to either limit or alter motion of that joint.  With time, the awkward, unnatural biomechanics of the scar tissue laden joint results in irritation, inflammation and finally pain and spasm. 

While chiropractic care is often successful at re-establishing “clean” biomechanics of a joint, it is always better to get the care in the beginning of an injury versus waiting for that injury to become chronic, with a requiring more care with a decreasing chance of complete recovery.

Because of the possibility of an acute painful condition becoming a chronic one, I always encourage my patients to take care of themselves immediately when they first start to experience pain.  I have practiced chiropractic care for almost two decades now and I can say that chronic painful conditions of the spine are devastating. 

Not only do they make you expereince pain, but in most instances they limit your physical activities creating a situation that can easily degrade from inactivity secondary to pain, to deconditioning and eventually to obesity and ill health in general leading to a dissatisying lifestyle.

The bottom line on chronic pain is this – avoid it if you can.  Don’t ignore your pain.  Painful acute conditions that are left untreated can easily spiral into a chronic condition that has the potential to alter your lifestyle in a negative way.



Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Sep 22, 2009

Pain Relief Doctor Mission Valley San Diego

Cold Laser therapy, also known as Low Level Laser therapy, has been used around the world for over 30 years, and is just now becoming popular in the U.S.  One of the biggest benefits of cold laser therapy is that it can be used to treat areas and conditions that all previous therapy modalities could not.  This is a truly revolutionary form of treatment.
http://www.mairschiropractic.com/cold_laser/Laser_Treatment.html


Car accidents are a fact of life; even the best of drivers will eventually be involved in one.  Injuries from car accidents can lead to a lifetime of chronic pain.  This is why it is so important to see a doctor who has the highest amount of training and knowledge specifically in the area of car accident injuries.
http://www.mairschiropractic.com/accident_injuries/Car_Accidents.html

Chiropractic treatment of Pain in Extremities

Sound Assisted Soft Tissue Mobilization (SASTM) is an extremely effective way to treat soft tissue injuries, be it acute or chronic.  It works so well that many professional sports franchises have incorporated it into the care for their injured athletes.

San Diego Soft Tissue Injury Doctor

Mairs Chiropractic

(619) 261-6590

http://www.mairschiropractic.com/

Sep 20, 2009

Chiropractic Treatment for Low Back Pain

 Chiropractic Treatment for Low Back Pain

Why do I have back pain?

Being a chiropractor in San Diego, I hear this question all the time.  Back pain and neck pain are the two most common complaints that my patients have.  The fact that my practice is in San Diego probably decreases the frequency of these complaints.  People in San Diego tend to be more active which actually lowers the incidence of low back and neck pain.

Over fifteen years ago when I first started practicing chiropractic care in San Diego, most of my low back pain patients and neck pain patients for that matter were not related to office work.  Most of the cases that I had when I first started practicing were do to injuries like car accidents and falls or heavy work.

In the mid to late nineteen nineties, I started to see a trend in injury mechanisms among my patients.  They were starting to attribute their pain to long hours of sitting at the computer.

Sitting all day at the computer not only causes back pain but it also causes neck pain, headaches, carpal tunnel syndrome and various arm problems.

Lower back pain is primarily due to poor sitting posture.  When we are standing up with good posture, our lower backs have a sweeping forward bowing curve that resembles a stretched out letter “c”.  This shape distributes our bodies weight evenly throughout the spine.  When we sit, this curve reverses, greatly increasing the stress on the joints and discs in the spine.

With time, this postural stress results in irritation and inflammation resulting in pain and muscle spasms.

Once the low back has reached a point of pain and spasms, chiropractic care is necessary to relieve the pain, improve the bio-mechanics of the spine and relax the muscles.

In addition to chiropractic care for back pain, the patient must seek out an ergonomic chair and have it adjusted properly for their body.  In many cases, I suggest a complete workstation analysis to help prevent future problems with other computer related stresses.    


Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

Ergonomically Correct Mouse Platform Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Exercise and Chiropractic to Build a Healthy Spine

 Using Chiropractic and Exercise to Build a Healthy Spine

In my San Diego Chiropractic clinic, I provide treatment for many types of injuries.   Typical injuries that result in neck pain, back pain, chronic headaches, sciatica etc., include auto accidents, work related injuries, injuries caused by domestic chores and sometimes things as simple as sleeping in an awkward position.

Of these patients suffering from neck pain, back pain and other injuries, I would say that at least 50% of them ask, “what can I do for myself to make sure that this doesn’t happen again?”  This question served as the inspiration for this article and I will address in this post.

To begin with, neck pain and back pain are great motivators.

When people are in pain they take a proactive approach to their health.  People often inquire about what kind of stretch or exercising that they can start right away.  Unfortunately, the best thing that you can do while your injury is new is to apply ice packs to the injured area and rest.

Over my 15 plus years in practice I have seen a large percentage of enthusiastic patients ignore this advice and end up giving their conditions a major set back.  The time to start exercising and stretching your back for most of us is when it is out of its acute stage of pain.

My biggest struggles in practice have been dealing with my patients exercise and diet habits.  Exercise is one of the few things that a patient can do at home, outside of chiropractic care, to help prevent or diminish the chances of developing back pain.

After an injury, you should approach exercise cautiously – almost to a point where the exercise that you are performing feels like it is doing nothing.  If you can get through a few low intensity exercise sessions like this without aggravating your condition, you should slowly add resistance, allowing you to build confidence and strength at the same time.

You have to remember to incorporate a sensible approach to exercising after a back injury.  Be sure to exercise and stretch under the advise of a health care professional.  Strong and flexible muscles add strength and support to your spine and will provide much needed stability.

I have always tried to help the patients of my San Diego Chiropractic office with their neck pain and back with stretches and exercises.  The combination of chiropractic care with stretches and exercise allows for quicker, more complete healing. 


Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Sep 16, 2009

Hip Pain & the Sacroiliac Joint

Sacroiliac Joint and Hip Pain

The patients in my San Diego Chiropractic clinic often complain of “hip pain”.  When I ask them to point to the pain they almost always point to the area right next to the spine just below their beltline. 

That is the difference between a medical definition of the hip and that of a patient.  From a medical standpoint, the “hip” is the joint where the femur articulates with the acetabulum.  While I do see and provide care for those with pain in this joint, it is much less common to see pain in this “hip” joint versus the “hip” joints that most often trouble my patients.

The joint that my patients point to when they complain of hip pain is usually the sacroiliac joint.  The sacroiliac joint is formed from the ileum aka, hip bone and the sacrum which is a triangular shaped fusion of the bottom five vertebra in the spine.  The spine (and the weight of your upper body) sit directly on top of the sacroiliac joints making the stability of these joints extremely important. 

There is a network of ligaments and muscles that act to stabilize and move the sacroiliac joints.  Since the sacroiliac joints have to support some of the greatest forces that our bodies are subjected to, the muscles that act on these joints are some of the strongest in the body.  Because of the sacroiliac joints close approximation to the spine and the hip proper, the larger muscles that act on the sacroiliac joint are also movers of the hip and the lower lumbar spine.   

Since the sacroiliac joints are large joints that are supported by big muscles and strong ligaments, they are able to withstand much of the stresses that we ask of them.  However, they do break down with the constant postural stresses (sitting), poor lifting habits, falls and other injuries leading to pain and stiffness in the lower back.

Because of its size, once the sacroiliac joint is irritated, it can be difficult to treat.  Treatment always involves reducing inflammation, mobilizing the joint (restoring normal motion) then stabilizing the joint with stretches and exercises.  This is the course of care that I have followed with great results in my chiropractic office in San Diego.

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Building a Healthy Spine

The Role of Exercise in Building a Healthy Spine

I see many types of injuries as a Chiropractor in San Diego.  Some of the common injuries can result in neck pain, back pain, chronic headaches, sciatica etc. 

Causes of these injuries range from auto accidents and work related injuries to injuries caused by domestic chores, house work and sometimes things as simple as sleeping in an awkward position.

Of these injured patients, I would say that at least 50% of them, for the moment, while they are in pain they ask “what can I do for myself to make sure that this doesn’t happen again?”  This question served as the inspiration for this article and I will address in this post.

To begin with, pain is a great motivator. 

When people are in pain they take a proactive approach to their health.  People often inquire about what kind of stretch or exercising that they can start right away.  Unfortunately, the best thing that you can do while your injury is new is to apply ice packs to the injured area and rest. 

Over my 15 plus years in practice I have seen a large percentage of enthusiastic patients ignore this advice and end up giving their conditions a major set back.  The time to start exercising and stretching your back for most of us is when it is out of its acute stage of pain.

My biggest struggles in practice have been dealing with my patients exercise and diet habits.  Exercise is one of the few things that a patient can do at home, outside of chiropractic care, to help prevent or diminish the chances of developing back pain.

After an injury, you should approach exercise cautiously – almost to a point where the exercise that you are performing feels like it is doing nothing.  If you can get through a few low intensity exercise sessions like this without aggravating your condition, you should slowly add resistance which allows you to build confidence and strength at the same time. 

Remember to follow a sensible approach to exercising after a back injury.  Be sure to exercise and stretch under the advise of a health care professional.  Strong and flexible muscles add strength and support to your spine and will provide much needed stability.

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Sep 15, 2009

Personal Injury Outcome Assessment(Part 3)

An Introduction to Outcome Assessment(Part 3)
________________________________________
Mark van Hemert, DC, DACS

In 1992, David Chapman Smith, commission counsel to the Mercy guidelines, stated: "There must be a better method of judging whether a patient's condition or health status has changed, one that has scientific credibility, can withstand scrutiny by others, and provides strong evidence of good outcomes appropriateness and quality of care."

The use of outcome assessments is imperative for the practicing clinician. Only by objective documentation of improvement can the attending physician prove that his care was therapeutically necessary; thereby staving off the onslaught of critical opinions by claims adjudicators of third party payers, insurance medical examinations, retroactive governmental utilization reviews and defense attorneys.

The Mercy Conference guidelines defines "outcome assessment" as a procedure or method of measuring a change in patient status over time, primarily to evaluate the effect of the treatment.

The Mercy guidelines go on to list the benefits of implementing outcome assessment into one's practice procedures for they can:
•    document improvement to the patient, doctor, and third parties;
•    consistently evaluate the effect of care over time;
•    suggest modifications of the goals of treatment if necessary;
•    help indicate the point of maximum therapeutic improvement;
•    justify the type, dose, and duration of care.

(Mercy, chapter 10, page 8.)
This list closely mirrors the points the IME focuses on in delivering his professional opinion. The accumulation of the patient's objective outcome assessment data during the course of care, will provide the information necessary to make these critical clinical determinations in the medical legal case.

This will individualize you opinion concerning the course of care and the length of care. Treating every patient plan as a continual living, analyzing and ongoing evaluation process.

The RAND study, "Appropriateness of Spinal Manipulation for Low-Back Pain," makes this statement on treatment duration: "No scientific evidence in the literature supports any of the treatment durations for different indications that have been proposed."

Using objective outcome assessment data that Mercy rates as established and necessary in your clinical examinations, will result in clinical decisions that are defensible against review professional opinion will determine the therapeutic necessity of care rendered.

My vision is to give the practicing chiropractor the knowledge and expertise to provide to every patient the care they deserve, and to provide objective evidence for every patient and their third-party carrier for reasonable and necessary care; thereby creating an analysis system that is fair to all concerned parties.

In future articles, we will discuss how to use the latest technology to gather objective data. It is important to use the guidelines as an authority not only to guide your practice, but to insist that the IME also follow the same standard.

Mark van Hemert, DC, DACS


Read More of this article
  1. Well Managed Chiropractic Soft Tissue Injury
  2. Managing Soft Tissue Injury with Chiropractic  
  3. Soft Tissue Treatments Personal Injury Case   
  4. Frequency of Care for a Soft Tissue Injury   
  5. Treatment Times for a Soft Tissue Injury
  6. Orthopedic Supports for Soft Tissue injuries
  7. Special Tests for Soft Tissue Injuries
  8. Narrative Reports for Soft Tissue Injuries personal Injury Cases
  9. End Points of Care Personal Injury Case
  10. Prognosis &  Fees Personal Injuries Personal Injury Case
  11. An Introduction to Outcome Assessment Personal Injury(Part 1)
  12. Outcome Assessment personal Injury(Part 2)
  13. Personal Injury Outcome Assessment(Part 3)

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Outcome Assessment personal Injury(Part 2)

An Introduction to Outcome Assessment(Part 2)
________________________________________
Mark van Hemert, DC, DACS

IME was originally an acronym for independent medical examination, but the IME doctor is now chosen by and paid by the insurance industry. The acronym now stands for insurance medical examination.

The most recent development in the insurance medical examination has been the multidisciplinary examination, where a chiropractor and a medical doctor, both with higher credentials than the average clinician, examine the patient simultaneously.

This creates an appearance of a high level of specialization and expertise. The opinion in a majority of these reviews is that care beyond two months is not needed. The rational is that the laying down of scar tissue is completed by the eighth week and therefore further treatment in not medically necessary or therapeutic.

They state that the patient is at maximum improvement and no further treatment is necessary. This rational does not consider the remodeling and strengthening of scar tissue, nor the need to restore maximum joint function.

However, without an attending physician who is knowledgeable about the guidelines and who has accumulated objective data of improvement, the professional response to this rational will be based solely on opinion and not fact.

Mercy specifically does not give a limit for reasonable care, but observations, assessments and the definitions of care based on scientific evidence.

It states that these guidelines are not designed to be a cookbook. The listed time for acute stage of care ranges from 8-16 weeks, depending on which of three cited references you go by.

In reviewing those references, I believe that the eight weeks refer to the acute healing cycle of the injury, and the 16 weeks to the acute physiology or rehabilitative healing time.

The healing and rehabilitative acute stages are followed by the subacute stage, before the unresponsive chronic phase of function and pain begin. Rebuttals of IME opinions using the Mercy guidelines increase your credibility when justifying your clinical rational to claims adjudicators.

The insurance industry recognizes the Mercy document as the authority in the chiropractic profession. The parameter of clinical practice that Mercy most fully addresses is the trauma induced patient.

Perhaps if "Acute Traumatic Cases" had been added to the title of the guidelines the criticism of the document would have been muted. Mercy creates a solid, well thought out guideline for the traumatic personal injury and workers' compensation case.

Mercy very effectively deals with narrow minded, nonflexible professional rational and makes the third-party payers conform to a set of standards which is fair to the patient and respectful of.

Read More of this article
  1. Well Managed Chiropractic Soft Tissue Injury
  2. Managing Soft Tissue Injury with Chiropractic  
  3. Soft Tissue Treatments Personal Injury Case  
  4. Frequency of Care for a Soft Tissue Injury  
  5. Treatment Times for a Soft Tissue Injury
  6. Orthopedic Supports for Soft Tissue injuries
  7. Special Tests for Soft Tissue Injuries
  8. Narrative Reports for Soft Tissue Injuries personal Injury Cases
  9. End Points of Care Personal Injury Case
  10. Prognosis & Fees Personal Injuries Personal Injury Case
  11. An Introduction to Outcome Assessment Personal Injury(Part 1)
  12. Outcome Assessment personal Injury(Part 2)
  13. Personal Injury Outcome Assessment(Part 3)

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

An Introduction to Outcome Assessment Personal Injury(Part 1)

An Introduction to Outcome Assessment(Part 1)
________________________________________
Mark van Hemert, DC, DACS

The design of this article is to give the chiropractic profession an introduction into the value and usefulness of clinical outcome assessment procedures. Using outcome assessment methods of case management gives the chiropractic profession an effective way to document the need for care.

This results in receiving the compensation for services they rendered.
In today's environment of manage care, the attending clinician's care is constantly being reviewed and challenged.

The chief areas of concern for the third-party payers is over-utilization and costs. Over-utilization is a problem in chiropractic, whether it be real or only perceived by outside reviewers.

This perception can only be overcome on a case by case basis by objectively proving that care provided was reasonable and necessary. Á Due to the acceptance of the Mercy guidelines

(Guidelines for Chiropractic Quality Assurance and Practice Parameters) by the insurance industry, the document is the authoritative reference to counter the insurance industry's attempt to limit quality and the quantity of care.

The primary reason the Mercy guidelines carry a high level of acceptance and credibility by the insurance industry, is because its ratings are based on scientific evidence.

A synopsis of today's situation reveals that the care rendered by the attending clinician is constantly being challenged by the third-party carriers. IME opinions of excessive care or no permanent impairment are detrimental to the patient's medical/legal case.

Cases that involve acute injury with associated liability frequently require the intervention of the court system or workers' compensation system to resolve the case.

This inherent intervention leaves the door wide open for the probing eyes and opinions of the IME. Due to a lack of knowledge and documentation by the attending physician, patients receive inadequate medical care and inferior documentation of their injury, rational for therapeutic care, determination of maximum improvement, and final impairment.

Third-party carriers are aggressive in their review of care to determine the point of maximum improvement. Many clinicians feel that if patient care is within the guideline numbers, their fees will be paid.

However, the therapeutic necessity of care is frequently being challenged. A lack of knowledge of the practice guidelines does not substantiate the patient's contractual right to receive care to the maximum ability of the injury to respond to active care and improved function.

power... the 1980s witnessed a shift in power from the providers of health care to the payers of it ... and those practitioners whose services are labeled worthless could face financial ruin ... chiropractors are especially vulnerable."

Read More of this article
  1. Well Managed Chiropractic Soft Tissue Injury
  2. Managing Soft Tissue Injury with Chiropractic  
  3. Soft Tissue Treatments Personal Injury Case  
  4. Frequency of Care for a Soft Tissue Injury  
  5. Treatment Times for a Soft Tissue Injury
  6. Orthopedic Supports for Soft Tissue injuries
  7. Special Tests for Soft Tissue Injuries
  8. Narrative Reports for Soft Tissue Injuries personal Injury Cases
  9. End Points of Care Personal Injury Case
  10. Prognosis & Fees Personal Injuries Personal Injury Case
  11. An Introduction to Outcome Assessment Personal Injury(Part 1)
  12. Outcome Assessment personal Injury(Part 2)
  13. Personal Injury Outcome Assessment(Part 3)
Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Liability & Labor Disability Personal Injury Cases

 Liability - Personal Injury Cases

Even when all aspects of case are well managed, problems for reimbursement can ensue. If the liability for the automobile accident is disputed, the settlement will often be different when compared to an undisputed case.

For example, if the treated patient is found to be 20 percent comparatively negligent for not wearing his seat belt, the final award of $10,000 would now total $8,000.

This final award now reflects the 20 percent comparative negligence. In our opinion, it is not fair for the doctor to reduce his bill by any amount to compensate the patient for his negligence.

Labor Disability

There are times, most often in severe traumas, when a labor disabling status will be afforded to the patient.

To justify this status and the accompanying reimbursement for lost wages, the doctor must document what specific occupational activities are prohibited by the injury. Failure to document the need for temporary disability will cause the patient to lose financial compensation for his loss of earning.

Documentation

This is a broad classification which encompasses all written words concerning this accident. We are of the opinion that "travel cards" and "fill in the blank exam forms" are no longer sufficient in the current medical/legal system.

They tell what was done but not the reason. The literature is very clear as to how to properly document each of the patient's office visits. The SOAP acronym is most often used:
"S" refers to the patient's subjective complaints,
"O" refers to the objective evidence for care seen on each office visit,
"A" stands for the doctor's assessment of the patient's condition, and the
"P" pertains to the treatment plan of that visit.

This type of documentation is not only taught in the chiropractic schools, but is also recommended by most malpractice insurance carriers as the proper way to document each of the dates of service.

It should be mentioned that even the best attorneys can not adequately represent their clients interests without proper documentation from the doctor.

We hope this discussion has enlightened and provided a reasonable source of reference for both sides of these issues.

The doctor has a heavy burden. He must not only adequately treat the patient, but also assume the responsibility placed upon him by the legal system. The financial and personal rewards for his efforts will be more than adequate for the effort expended.

Read More of this article
  1. Well Managed Chiropractic Soft Tissue Injury
  2. Managing Soft Tissue Injury with Chiropractic  
  3. Soft Tissue Treatments Personal Injury Case  
  4. Frequency of Care for a Soft Tissue Injury  
  5. Treatment Times for a Soft Tissue Injury
  6. Orthopedic Supports for Soft Tissue injuries
  7. Special Tests for Soft Tissue Injuries
  8. Narrative Reports for Soft Tissue Injuries personal Injury Cases
  9. End Points of Care Personal Injury Case
  10. Prognosis & Fees Personal Injuries Personal Injury Case
  11. Liability & Labor Disability Personal Injury Cases
  12. An Introduction to Outcome Assessment Personal Injury(Part 1)
  13. Outcome Assessment personal Injury(Part 2)
  14. Personal Injury Outcome Assessment(Part 3)

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Sep 14, 2009

Treatment for Sports Injuries San Diego

Sound Assisted Soft Tissue Mobilization (SASTM) is an extremely effective way to treat soft tissue injuries, be it acute or chronic.  It works so well that many professional sports franchises have incorporated it into the care for their injured athletes.

Read More

Sports Injury Treatment

Exercise for a Building a Healthy Spine

 The Role of Exercise in Building a Healthy Spine

I see many types of injuries as a Chiropractor in San Diego.  Some of the common injuries can result in neck pain, back pain, chronic headaches, sciatica etc.

Causes of these injuries range from auto accidents and work related injuries to injuries caused by domestic chores, house work and sometimes things as simple as sleeping in an awkward position.

Of these injured patients, I would say that at least 50% of them, for the moment, while they are in pain they ask “what can I do for myself to make sure that this doesn’t happen again?”  This question served as the inspiration for this article and I will address in this post.

To begin with, pain is a great motivator.

When people are in pain they take a proactive approach to their health.  People often inquire about what kind of stretch or exercising that they can start right away.  Unfortunately, the best thing that you can do while your injury is new is to apply ice packs to the injured area and rest.

Over my 15 plus years in practice I have seen a large percentage of enthusiastic patients ignore this advice and end up giving their conditions a major set back.  The time to start exercising and stretching your back for most of us is when it is out of its acute stage of pain.

My biggest struggles in practice have been dealing with my patients exercise and diet habits.  Exercise is one of the few things that a patient can do at home, outside of chiropractic care, to help prevent or diminish the chances of developing back pain.

After an injury, you should approach exercise cautiously – almost to a point where the exercise that you are performing feels like it is doing nothing.  If you can get through a few low intensity exercise sessions like this without aggravating your condition, you should slowly add resistance which allows you to build confidence and strength at the same time.

Remember to follow a sensible approach to exercising after a back injury.  Be sure to exercise and stretch under the advise of a health care professional.  Strong and flexible muscles add strength and support to your spine and will provide much needed stability.

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones

Work Injury & Workplace Safety Advice

Work Injury & Workplace Safety Advice

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(619) 280 0554

http://jonespainrelief.com
Visit our Ergonomical Device Website to learn more about or Buy Ergo Nav

Visit my San Diego Chiropractic Website to make an appointment

Sep 13, 2009

Drinking Soda Pop can Ruin Your Bone and Joint Health

 Drinking Soda Pop can Ruin Your Bone and Joint Health
In my San Diego Chiropractic office we see many people for neck pain, back pain, headaches and various other types of pain.  In the summer time it is not uncommon to see many of those people walk into my office with a Big Gulp from the 7 Eleven across the street.

Sometimes I like to depart from the obvious when discussing the health of your spine.  There are probably many of you who are reading this article while enjoying a tall glass of soda over ice.
 
This article should make you second guess EVER reaching for soda again.
Did you know that the average American drinks an estimated 56 gallons of soft drinks each year?  Next time you are craving a soda, consider this: one can of soda has 10 teaspoons of sugar, 150 calories, 30 to 55 mg of caffeine, and is loaded with artificial food colors and sulphites.

Soda has absolutely no nutritional value.  Studies have linked soda to osteoporosis, obesity, tooth decay and heart disease.  Despite the long list of negative health effects, soda accounts for more than one-quarter of all drinks consumed in the United States, and its consumption is becoming more prevalent.  In the last 10 years, soft drink consumption among children has almost doubled in the United States. It is estimated that teenage boys drink three or more cans of soda per day, and 10 percent drink seven or more cans a day. The average soda consumption for teenage girls is two cans per day, and 10 percent drink more than five cans a day.
Let’s take a look at the major ingredients in a can of soda:

•    Phosphoric Acid: May interfere with the body's ability to absorb calcium, which leads to osteoporosis of the teeth and bones. Phosphoric acid neutralizes hydrochloric acid in your stomach, which interferes with digestion, making it difficult to utilize the nutrients from the healthy foods that we eat.
•    Sugar:  Soda manufacturers are the largest single user of refined sugar in the United States.  Sugar consumption increases insulin levels, which lead to high blood pressure, high cholesterol, heart disease, diabetes, weight gain, premature aging and many other undesirable side effects. Most sodas include over 100 percent of the RDA for sugar.  Think of the average teenage boy who has 3 cans per day!

•    Aspartame: This chemical is used as a sugar substitute in diet soda. There are over 92 different health side effects associated with aspartame consumption including brain tumors, digestive problems, birth defects, diabetes, emotional disorders and epilepsy/seizures.  When aspartame is stored for long periods of time or kept in warm areas it changes to methanol that converts to formaldehyde and formic acid. Both are known carcinogens.  Formaldehyde is the stuff they preserve the dead with!
•    Caffeine: Caffeinated drinks cause anxiety, insomnia, high blood pressure, irregular heartbeat, elevated blood cholesterol levels, vitamin and mineral depletion, breast lumps, birth defects, and perhaps some forms of cancer.
If you are still drinking soda, stopping the habit is an easy way to improve your health. Pure, filtered water is a much better choice. If you must drink a carbonated beverage, try sparkling mineral water.
From a chiropractors stand point, bone weakening is a major concern.  As a chiropractor, I spend my days helping my patients improve the biomechanics of their joints.  If the patients are consuming soda and engaging in other detrimental practices, our efforts become less likely to have desirable results.
Animal studies demonstrate that phosphorus depletes bones of calcium and two recent human studies found that girls who drink more soda are more prone to broken bones. Phosphorus appears to weaken bones by promoting the loss of calcium. With less calcium available, the bones become more porous and more brittle.
As long ago as a 1994 Harvard study of bone fractures in teenage athletes found a strong association between cola beverage consumption and bone fractures in 14-year-old girls. The girls who drank cola were about five times more likely to suffer bone fractures than girls who didn't consume soda.  All of this is due to phosphorus consumption.

The potential damage of bone loss is compounded by the growing numbers of obese people in the United States.  The combination of weakened bones with increasing body weight can certainly undermine our future health.
Trying to stop drinking soda is difficult.  Both sugar and caffeine make soda an addicting substance.  It is best to stop drinking soda by going “cold turkey”.  Remember if you slip up to keep trying to quit.
Stop drinking soda today.  Your body will be much healthier without it.


Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs. www.JonesPainRelief.com or www.ErgoNav.com

Call Steve Jones at his San Diego Chiropractic Clinic

(619) 280 0554

Posture and Back Pain and Neck Pain

Back Pain, Neck Pain and Posture

Back pain and neck pain can strike anyone at any time. In my chiropractic clinic in San
Diego, California, we see patients that have injured their backs or necks from lifting
boxes, operating heavy machinery, sports injuries, auto accidents and falls. Many nonchiropractic.

Patients or new chiropractic patients would be surprised to find that the most
common type of injury that we see in our office is not from lifting 90 pound sacks of
concrete but from postural stress.

Postural stress is the “silent killer” when it comes to our spinal health. Postural stress
occurs during both seated and standing positions. Postural stress occurs any time that
your spine looses its’ natural curves and / or moves forward beyond its neutral balance
point.

An example of a posturally stressful position for your neck would be when you are sitting at the computer leaning your neck and head forward while either keyboarding or reading the screen. Assuming a posture in which your head and neck are extended out in front of your body reverses the normal curve of your neck and shifts your head forward of its balance point.

When we assume postures that cause stress on our spines, the stability that is inherent in our structure when postural boundaries are respected is lost. Postural stress exposes our aligaments and muscles to prolonged periods of stretching which results in fatigue,
irritation, inflammation, back pain and neck pain.

Treating postural stresses resulting neck pain and back pain requires a multifaceted
approach. Chiropractic care will relieve the pain and stiffness. This may take several
treatments based on the length of time that you have been in pain and the severity of your symptoms. Concurrent to chiropractic care, you must do everything possible to remove the causes of the postural stress. A thorough workstation analysis can reveal hidden sources of postural stress. Applying ice packs to the specific areas of neck pain and back pain in twenty minute sessions is also helpful.

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs. www.JonesPainRelief.com or www.ErgoNav.com

Why Do I Have Back Pain?

Why Do I Have Back Pain?  A Chiropractic Overview

The other day I had a new patient walk into my San Diego, California office asking for chiropractic treatment.  He was bent over 45 degrees at the waist, complaining of lower back pain and saying “Doc, Why do I have back pain?  I have no idea how I got this way but I am having trouble standing up and sitting down, can you help me?”  This is a common new patient presentation in our office.  More often than not, the typical back pain patient can’t recall a specific cause of their back pain.  Sometimes the pain has advanced enough to affect the nervous system resulting in sciatica nerve pain.

Patient’s like this always want an explanation as to how they got the way they are.  Most of my patients have followed a typical course on their way to experiencing back pain.

The joints, muscles and ligaments that allow movement, move the body and provide stability in the low back are among the biggest and strongest in the body.  This being the case, it usually takes a significant single injury to damage these structures.  A hard fall, car accident or a long day of strenuous lifting are examples of single events that can cause back pain all by themselves.

However, most cases of back pain are caused by cumulative stress.  Cumulative stress comes from postural stress (excessive sitting), poor lifting habits, awkward sleeping habits, etc.  Cumulative stress also known as repetitive stress takes place over months or sometimes years.

The bottom line is that most back injuries arise from events that seem small and insignificant by themselves but after months or years of exposure to these stresses lead to irritation of the joints and muscles resulting in back pain. 

Once the joints, muscles and ligaments of the lower back have been exposed to extended periods of stress, they become very vulnerable to injury.  This process follows a predictable path.  The joint is stressed by some activity, the stress irritates the soft tissues of the joint, the irritation causes inflammation and the inflammation causes pain and scar tissue formation.  Scar tissue limits joint motion, causes pain in the joint and is often sensitive to changes in weather. We all know someone that knows better than the weather man as to when it is going to rain.  It is scar tissue build up and arthritis that causes joint pain when it is going to rain.

Once this process has begun, a severe case of back pain can arise from something as simple as picking a sock up off the floor or reaching for a cup of coffee.

Unfortunately for the patient, the little things that they do on a regular basis that stress their backs don’t become apparent until after they are in pain.  I always advise my patients to pay special attention to the specific activities or movements that aggravate their backs while they are in pain.  These are the activities that are often responsible for the cumulative stress that I discussed at the beginning of this article.  

Joints are complex structures that in most cases are very durable and work without pain.  However, the process described above can happen silently, over time, resulting in severe back pain and / or sciatica for the person who has ignored proper back care through the course of their lives.  Chiropractic care from a licensed chiropractor can be very effective in relieving your back pain.  Chiropractic care is a safe, effective and affordable form of treatment that has a history of success with relieving low back pain.

Key: chiropractic, back pain, chiropractor, sciatica, low back pain, chiropractic treatment, nerve pain

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs. www.JonesPainRelief.com or www.ErgoNav.com

Sep 12, 2009

Chiropractor Blogs for SEO Clients

Chiropractor Blogs for SEO Clients, take a look.

http://work-injury-workplace-safety.blogspot.com/
http://car-accident-whiplash-injuries.blogspot.com/
http://back-pain-relief-treatment.blogspot.com/

Lynn & Kym Brown

SEO & Website Accessibility Consultant & Services
Hillcrest
San Diego

Home: 619 269-5372

www.seobycanz.com

www.canzdesign.blogspot.com
www.canzdesign.com
www.linkedin.com/in/seobycanz

Back Pain and Arthritis

Back Pain and Arthritis


Arthritis is a scary word to most people.

In my San Diego Chiropractic clinic, I see people each day who suffer from the effects of arthritis.  Besides the fact the in general arthritis slows you down and limits your physical abilities, it also causes pain.  Neck pain, back pain, knee pain, shoulder pain and even headaches (secondary to the neck pain) are common complaints from people with arthritis.

Most of the patients that we provide chiropractic treatment for are suffering from a type of arthritis know as osteoarthritis.  Osteoarthritis is also known as degenerative joint disease, degenerative arthritis and wear & tear arthritis.  The term osteoarthritis does describe a type of arthritis that occurs because of a wearing down of the joint.
In some cases, osteoarthritis is the result of some injury to the joint that resulted in unnatural or awkward movements of that joint.  In the medical community we refer to these abnormal movements as “biomechanical abnormalities”  In many cases, a joint has to be exposed to biomechanical abnormalities for years before the joint becomes laden with arthritis. 

In my chiropractic office, we treat many patients for automobile accidents.  I always tell these patients that while I am not trying to minimize the pain that they are currently suffering from, the most important aspect of their entire treatment program is to help restore normal biomechanics of the spine.  This is because eliminating the pain associated with car accident injuries is important but the initial pain that comes with a car accident is only a fraction of the long-term discomfort that comes with biomechanical abnormalities. 

Of course I am referring to a process that involves whiplash of a joint leading to scar tissue formation causing abnormal biomechanics that results in arthritic joints.  
We do provide effective treatment for the PAIN of arthritis but there is no treatment that CURES it.

The bottom line is this:  If you have neck pain or back pain now, get treatment for it becomes an incurable disorder like arthritis.

Article Writers Bio


Dr. Steve Jones is a licensed Chiropractor in San Diego.  Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.   Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.  Click the following links to find out how we can help you start feeling better today! www.JonesPainRelief.com, www.ErgoNav.com
How Does Your Posture Affect Back Pain and Neck Pain?

Chiropractor, neck pain ,posture ,chiropractic ,back pain ,ergonomic

Have you ever wondered how it can be that you can sit around all day doing nothing strenuous and develop back pain or neck pain?  When you start to examine the structure of our bodies and apply some simple rules of physics, the fact that we don’t suffer from more frequent or intense back pain and neck pain is a wonder.  In my chiropractic office in San Diego, California, I see office workers on a regular basis that have significant back and neck complaints related to simple ergonomic issues.

Back pain or neck pain can affect anyone at any time.  I see patients that have injured their backs and necks from lifting, operating machinery, sports injuries, auto accidents and falls on a daily basis.  I would classify these injuries as typical or expected types of injuries.  Many non-chiropractic patients or new chiropractic patients would be surprised to find that the most common type of injury that I see in my office is not from lifting heavy sacks of concrete but from the long term consequences of postural stress.

Postural stress is the “silent killer” when it comes to our spinal health.  Postural stress occurs during both seated and standing positions.  Postural stress occurs any time that your spine looses its’ natural curves and / or moves forward beyond its neutral balance point. 

An example of a posturally stressful position for your neck would be when you are sitting at the computer leaning your neck and head forward while keyboarding, mousing or viewing the screen.  Assuming a posture in which your head and neck are extended out in front of your body reverses the normal curve of your neck and shifts your head forward of its balance point.  

When we assume postures that cause stress on our spines, the stability that is inherent in our structure when postural boundaries are respected is lost.  Postural stress exposes our ligaments and muscles to prolonged periods of stretching which results in fatigue, irritation, inflammation, back pain and neck pain and eventually arthritis.

Treating neck pain and back pain that has resulted from postural stress requires a multifaceted approach.  Chiropractic care combined with stretching and nutritional support will relieve the pain and stiffness and restore normal, full joint motion.  This part of your recovery may take several treatments or a lengthy treatment program based on the length of time that you have been in pain and the severity of your symptoms. 

In addition to chiropractic care, you must eliminate or modify the causes of the postural stress.  A workstation analysis can reveal ergonomic issues that are instigators of postural stress.  Ice pack applications to the specific areas of neck pain and back pain in twenty minute sessions are also helpful.

The best way to begin your care is discuss your issues with your chiropractor.  Chiropractors are well trained in dealing with postural stress issues and the neck pain and back pain that result from it.  At my San Diego based chiropractic clinic we use a complete approach that utilizes chiropractic care supported by specific stretches and exercises.  We also encourage the proper nutritional support to facilitate the healing process.  Whatever approach that you take to relieve the pain of postural stress, please be aware of the importance of eliminating the source of the postural stress in addition to seeking treatment. 

Bio for Article city


Dr. Steve Jones is a licensed Chiropractor in San Diego.  Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.   Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.  Click the following links to find out how we can help you start feeling better today! www.JonesPainRelief.com, www.ErgoNav.com