How Car Wrecks Contribute To Future Neck and Back Pain

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CF 196: How Car Wrecks Contribute To Future Neck and Back Pain

Today we’re going to talk about How Car Wrecks Contribute To Future Neck and Back Pain. I have two different papers with what I thought were surprising conclusions in one way or another. Not only did I find themm a bit surprising but I don’t think the defense attorneys in PI cases will like either paper much. Just an assumption on my part. All of that coming up in this episode. But first, here’s that sweet sweet bumper music

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OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around. We’re the fun kind of research. Not the stuffy, high-brow kind of research. We’re research talk over a couple of beers. I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast. If you haven’t yet I have a few things you should do.

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s an invaluable resource for your patient education and for you. It can save you time in putting talks together or just staying current on research. It’s categorized into sections so that the information is easy to find and it’s written in a way that is easy to understand for practitioner as well as patient. You have to check it out. Just search for it on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
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You have found yourself smack dab in the middle of Episode #196 Now if you missed last week’s episode , we talked about Spinal Manipulative Therapy vs. Opioids and Young Elite Pitchers, Hips, and Elbow Pain. Make sure you don’t miss that info. Keep up with the class.

On the personal end of things…..

We just ended our fourth week as an integrated practice and starting our fifth. It’s a struggle. I’m not going to lie. You see the money going out but you don’t see it coming in. That’s why, to pull this off, you need to be a busy Chiro and you need to have reserves in place.

Otherwise, it could be doomed. Unless you’re a hype machine. A marketing mastermind that fills the schedule before the integration even takes place. Let’s be honest, most of us just aren’t. I know the value of marketing. I know how to market on a fundamental level. But it’s hard. It’s hard to get your message out there and it’s hard to break through.

So, week one, maybe 4-5 appointments. Week two, maybe 18 appointments. Week 2 was about the same. Then last week was maybe only 8-9. So it’s up and down. We aren’t covering the salary but, we have reserves set back AND I’m fortunate enough to be busy. The trick is just getting the message out and I feel like we’re doing that both externally as well as internally.

We have in-office brochures, flyers, and posters. Email marketing, social media, and all that good hoopla. It’s happening. We’re making it happen.

In other news, I recovered from my five days in Washington DC. Geez. What a go-cation. It’s not the cost of taking a trip. It’s the cost of being gone. How much money you lose by not being in the office. That’s the real number and it just kills me!! So, I don’t think about it because I truly believe we need to be taking a trip once per quarter. You have to so you don’t lose your damn mind. It’s just a must.

Speaking of, I have a trip in just about three weeks to Chicago for business to finish off my Fellowship in Forensics. I’m looking forward to that and to networking with everyone involved with that whole side of the profession. Multiple streams of income folks. I do it inside the office as well as outside. Speaking, mentoring, authoring, medico-legal, Ortho fellowship, personal injury, family, triwest, acupuncture, massage, laser, esthetician, Texas Chiropractic Association, Texas Council of Chiropractic Orthopedists, Nurse Prac, and everything that falls under that.

That’s inside.

Outside is music, voice-over, art, real estate investing, and all kinds of other things I’m looking at. What would it be like to just do a couple Of things? Who knows? That’s just not me. I make myself crazy but I honestly don’t know any other way.

If you were thinking you could get into business for yourself and sit on the computer half the day fiddle assing on the computer, I got news. Your competition is out there getting Diplomates, certifications, and expertise to run circles around you.

Get busy.

Or wonder where all of those new patients are going since they don’t seem to be coming to see you.

Item #1

Alright, let’s hop in with our first one today called “Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis” by Nolet et. al. (Nolet PS 2019) and published in PM&R in November of 2019. In case you didn’t know, PM&R stands for physical medicine and rehabilitation.

Why They Did It

They say in the abstract that neck injury resulting from a crash is associated with a high rate of chronicity. Prognosis studies indicate 50% of injured people continue to experience NP a year after the collision. This is difficult to interpret due to the high prevalence of NP in the general population. In other words, those that have not been in a car wreck still have neck pain, right? The stated goal of the authors here was to summarize the literature that has examined the association between a motor vehicle collision (MVC) related neck injury and future neck pain (NP) when compared to the population that has not been exposed to neck injury from a crash.

How They Did It

  • They performed a systematic review of the literature using five electronic databases, searching for risk studies on exposure to a car crash and future neck pain published from 1998 to 2018.
  • The outcome of interest was future neck pain.
  • Eligible risk studies were critically appraised using the modified Quality in Prognosis Studies (QUIPS) instrument.
  • Eight articles were identified of which seven were of lower risk of bias. Six studies reported a positive association between a neck injury in an MVC and future NP compared to those without a neck injury in an MVC

What They Found

  • Pooled analysis of the six studies indicated an unadjusted relative risk of future neck pain in the car crash-exposed population with neck injury of 2.3, which equates to a 57% attributable risk to those having been in a car wreck.
  • In two studies where exposed participants were either not injured or injury status was unknown, there was no increased risk of future neck pain

Wrap It Up

They wrap it up by saying, “There was a consistent positive association among studies that have examined the association between MVC-related neck injury and future neck pain. These findings are of potential interest to clinicians, insurers, patients, governmental agencies, and the courts.” I see personal injury patients. This is good info for their reports, their file, and their attorneys if they’re represented.

Item #2 This one is called, “Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis” by Nolet, et. al. (Paul S. Nolet 2020)and this one was published in Accident Analysis and Prevention in 2020. It’s not that hot but I’m using it anyway just because I like it and cuz I say so….

Why They Did It The purpose of this study is to summarize the evidence for the association between exposure to a motor vehicle collision (MVC) and future low back pain (LBP).

How They Did It

  • A systematic search of five electronic databases from 1998 to 2019 was performed.
  • Eligible studies describing exposure to a MVC and risk of future non-specific LBP were critically appraised using the Quality in Prognosis Studies (QUIPS) instrument.
  • The search strategy yielded 1136 articles, three of which were found to be at low to medium risk of bias after critical appraisal.

What They Found

  • All three studies reported a positive association between an acute injury in a MVC and future LBP.
  • Pooled analysis of the results resulted in an unadjusted relative risk of future LBP in the MVC-exposed and injured population versus the non-exposed population of 2.7, which equates to a 63 % attributable risk under the exposed.

Wrap It Up

There was a consistent positive association in the critically reviewed literature that investigated the risk of future LBP following an acute MVC-related injury. For the patient with chronic low back pain who was initially injured in a MVC, more often than not (63 % of the time) the condition was caused by the MVC. Thats a lot right, folks? Look, it’s obvious to say an injury was caused by a car wreck. It’s common as a chiropractor to hear patients tell you that their neck pain started with a car wreck they had 20 years before. We hear it all of the time. But for reals, 57% for the neck and 63% of the back?

That’s solid and flies directly in the face of the other side of the courtroom when they try to tell jurors that the forces experienced in a low-speed impact are about the same as stepping off of a curb on the street. This is, by the way, one of the most ridiculous things I’ve ever heard in my entire life but an argument that they most certainly use periodically. Fools!!!! The fools we must suffer in life!! I’m sure plenty of folks refer to me in the same manner. It is what it is. Let’s all just try to be the least of the fools…., if that makes any sense at all.

Alright, that’s it.

Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus so get active, get involved, and make it happen. Let’s get to the message. Same as it is every week.

Store Remember the evidence-informed brochures and posters at chiropracticforward.com.

Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

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The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots. When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few. It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient. And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!

Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints…. That’s Chiropractic!

Contact

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.

Connect

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.

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About the Author & Host Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

Bibliography

Nolet PS, E. P., Kristman VL, Murnaghan K, Zeegers MP, Freeman MD (2019). “Exposure to a Motor Vehicle Collision and the Risk of Future Neck Pain: A Systematic Review and Meta-Analysis.” PM R. 11(11): 1228-1239.

Paul S. Nolet, P. C. E., Vicki L. Kristman, Kent Murnaghan, Maurice P. Zeegers, Michael D. Freeman (2020). “Exposure to a motor vehicle collision and the risk of future back pain: A systematic review and meta-analysis.” Accid Anal and Prev 142.

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