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  • Frequently Asked Questions
    • What Do Chiropractors Do?
    • Should I Use Heat or Ice?
    • Should I Take Anti-Inflammatory Over the Counter Medications?
    • Should I Wear a Brace?
    • Should I Stop My Prescription Pain Medications?
    • Can I Continue to Play Sports?
    • Can I Continue to Exercise?
    • Should I Take Off Work?
    • Can You Treat Me If I'm Pregnant?
    • Are X-Rays Needed Before You Can Treat Me?
    • Can You Use X-Rays Taken At Another Facility?
    • Will You Take X-Rays If I'm Pregnant?​
    • Do You Take X-Rays For Small Children?
    • What Chiropractic Does Not Treat
    • Hickory North Carolina Business Affiliates
  • Home
  • Conditions
    • Back Pain Treatment >
      • Back Pain >
        • What is the Best Type of Doctor for Low Back Pain?
        • Is a Waterbed Good For Your Back?
        • Can Low Back Pain Cause Bowel Problems?
        • Ways to Relieve Back Pain When Sleeping
        • Why Do I Have Low Back Pain With Coughing or Sneezing?
        • What Causes Low Back Pain or Leg Pain With Bowel Movement?
        • What Causes Low Back Pain When Sitting Versus Standing?
        • Can Epidural Shot Cause Low Back Pain?
      • Neck Pain >
        • Can Exercise Help Neck Pain?
        • Can Stretching Help Neck Pain?
        • What is a Good Pillow For My Neck Pain?
        • Can Neck Pain Cause My Arm to Go Numb?
        • Tips to Relieve Neck Pain at Home
        • Is it Better to Sleep on Your Back or Side With Neck Pain?
      • Disc Hernation >
        • Does a Disc Herniation Heal On its Own?
        • Can a Disc Bulge Cause Leg Pain?
        • Can Heavy Lifting Cause a Disc Bulge?
        • What Is a Slipped Disc?
        • What Is the Difference Between a Disc Bulge and a Disc Herniation?
        • When Is Back Surgery Necessary For a Disc Herniation?
        • How Can You Tell if Back Pain is From a Disc Herniation?
        • Can Being Overweight Cause a Disc Herniation?
        • What Exercises Help a Disc Herniation?
        • Can Using a Whirlpool Help a Disc Bulge?
        • Can Chiropractic Help a Disc Herniation?
      • Sciatica >
        • Home Remedies For Sciatica
        • Therapies to Relieve Sciatica
        • Can Sciatica Cause Leg Weakness?
        • How to Relieve Sciatic Pain
        • Exercises to Help Sciatica
        • Will Epidural Steroids Work For Sciatica?
        • How Chiropractic Helps Sciatica Pain
        • Can Sciatica Be Caused By Sitting Too Much
        • What is Sciatica?
        • What Causes Sciatica?
      • Pinched Nerve >
        • What Are Symptoms of a Pinched Nerve?
        • What is a Pinched Nerve?
        • What Doctor to See For a Pinched Nerve?
        • Can a Chiropractor Help a Pinched Nerve?
        • How Can a Pinched Nerve in the Neck Affect the Hands?
        • Do You Put Ice or Heat on a Pinched Nerve?
        • Can Stretching Help a Pinched Nerve?
        • How Long Can You Have a Pinched Nerve?
        • Will an X-Ray Show a Pinched Nerve?
        • How To Treat a Pinched Nerve
    • Other Conditions >
      • Joint Pain >
        • How NSAIDS Affect Joint Pain
        • How Diet and Nutrition Affect Joint Pain
        • Home Therapy for Joint Pain
        • Joint Pain Therapies
        • How Chiropractic Helps Relieve Joint Pain
        • Common Causes of Joint Pain
      • Carpal Tunnel >
        • What is Carpal Tunnel Syndrome
        • What is the Best Treatment For Carpal Tunnel?
        • What are the Symptoms of Carpal Tunnel ?
        • How to Relieve Carpal Tunnel
        • Home Tips to Relieve Carpal Tunnel
      • Scoliosis >
        • Seven Signs of Scoliosis
        • What is Scoliosis?
        • The Bracing System for Scoliosis Recommended by Dr. Shook
        • Therapy for Scoliosis
        • Can a Sports Injury Cause Scoliosis?
        • Can Pregnancy Cause Scoliosis?
        • How to Check for Scoliosis
        • How to Treat Scoliosis
        • What are the Complications of Scoliosis?
        • How can a Chiropractor Help Scoliosis?+
        • How Does a Person Get Scoliosis?
      • Headaches >
        • Cause of Stress Headaches
        • How Chiropractic Relieves Headaches
        • Therapies to Relieve Headaches
        • What Causes Headaches When You Stand Up?
        • What is the Difference Between Migraine and Sinus Headaches?
        • Home Remedies For Headaches
        • Can Headaches Be Related to My Diet?
      • Arthritis >
        • Common Cause of Arthritis
        • How NSAIDS Affect Arthritis
        • Diet or Nutrition Helps Joint Pain
        • Arthritis Therapies
        • Home Therapy For Arthritis
        • How Chiropractic Helps Arthritis
  • Car Accident Treatment
    • Auto Injury Insurance Coverage >
      • Nationwide
      • Geico
      • GMAC
      • Allstate
      • Progressive
      • Integon
      • Reliance
      • Farmers
      • Esurance
      • Liberty Mutual
      • Safeco
      • 21st Century
      • Travelers
    • Attorneys & Insurers >
      • Spinal Ligament Injuires
      • Top 5 Car Accident Injuries
      • Auto Accident Treatment Therapies
      • Chiropractic Research
    • Auto Injuries >
      • Who Pays for Auto Injury Therapy?
      • Auto Injury Therapy?
      • How is an Auto Injury Compensated?
      • How can Chiropractic Help an Auto Injury?
    • Car Injuries
    • Whiplash Injuries >
      • How Chiropractic Can Help Whiplash Injuries
      • Compensation For Whiplash
      • Can a Whiplash Injury Come Back Years Later?
      • How Chiropractic Can Help car Injuries
      • How Chiropractic Can Help Auto Injuries
      • Whiplash and Double Vision?
      • Whiplash and Concussion
      • How Chiropractic Can Help Motorcycle Injuries
      • How Chiropractic Can Help Van Injuries
      • Whiplash and Disc Bulges
      • How Chiropractic Can Help Truck Injuries
      • How to Diagnose Whiplash
      • At What Speed Does a Whiplash Injury Occur?
      • How Chiroprctic Can Help Bicycle Injuries
      • How Long Does it Take Whiplash to Heal?
      • Treating Whiplash
      • How Many Treatments For Whiplash?
      • Tips to Relieve a Whiplash Injury at Home
    • Truck Injuries
    • Van Injuries
    • Motorcycle Injuries
    • Therapy For Injuries >
      • Electric Muscle Stimulation
      • Interferential Current
      • Intersegmental Traction
      • Spinal Decompression
      • Super Pulsed Laser Therapy
      • Infrared
      • ATM 2
  • New Patients
    • Treatment Cost
    • Time Related Questions >
      • What are your office hours?
      • How long is the first visit?
      • What happens on the first visit?
    • Auto Injury Therapy Payment
  • Massage
  • Employers
  • About
    • Physicians >
      • Dr. Shook's Credentials
      • Why Dr. Shook Became a Chiropractor
      • Education
      • Family
    • Office Tour
    • Testimonials
    • Blog
    • Services >
      • Decompression >
        • Non-Surgical Back Pain Treamtent Hickory, NC
      • ATM2
      • Laser
  • Frequently Asked Questions
    • What Do Chiropractors Do?
    • Should I Use Heat or Ice?
    • Should I Take Anti-Inflammatory Over the Counter Medications?
    • Should I Wear a Brace?
    • Should I Stop My Prescription Pain Medications?
    • Can I Continue to Play Sports?
    • Can I Continue to Exercise?
    • Should I Take Off Work?
    • Can You Treat Me If I'm Pregnant?
    • Are X-Rays Needed Before You Can Treat Me?
    • Can You Use X-Rays Taken At Another Facility?
    • Will You Take X-Rays If I'm Pregnant?​
    • Do You Take X-Rays For Small Children?
    • What Chiropractic Does Not Treat
    • Hickory North Carolina Business Affiliates
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Spinal Ligament Injuries - The Missing Link

Back pain is the leading cause of disability world wide, with many people missing a diagnosis of a pathoanotomic lesion, or cause.  

How many people go to their physician with back pain, and  leave with a diagnosis of "back pain"?  

People are commonly diagnosed with "lumbago" and "cervicalgia", which is nothing more than a description of their symptoms.  

Unfortunately, without a better diagnosis of the cause of a patient's back pain, such as disc herniation, facet syndrome, circumferential or radial tear, spinal stenosis, or alteration of motion segment integrity (spinal ligament instability) patient outcomes are poor and the cost of treatment is higher.  

When a person does not have an accurate diagnosis, how can they be prescribed treatment?  

Obviously, they can't be prescribed the most appropriate treatment for their particular condition, and here lies the heart of our problem and world wide back pain and opiate addiction/abuse epidemic.

The most common diagnosis for back pain in medicine, is the sprain/strain diagnosis.  A sprain/strain is a diagnosis of a torn ligament (sprain) and a torn muscle (strain).  

Sprains and strains can be graded based on how much of the muscle or ligament is torn.  According to the current ICD-10 (international classification of diseases) codes, which physicians use to describe the patient's condition, the physician cannot grade your sprain/strain!  

This is a significant problem, considering that a grade one sprain has no change in ligament length (thus no instability), but a grade three sprain is torn from 2/3 to a complete tear, and causes laxity in the joint resulting in increased pain, arthritic degeneration and possible nerve and spinal cord compression.

Grade 2 and 3 spinal ligament sprains are serious medical conditions and can cause spinal ligament instability, or "Alteration of Motion Segment Integrity", that carries up to a 25% whole person impairment according to the AMA Guides to Impairment.

The definition of spinal instability is well established in the medical peer reviewed literature, and has been defined by White and Panjabi, who are considered world leading spinal biomechanists.  

You would think there would be a standard way to "work up" and diagnosis these injuries, which are the most common cause for back pain in the world wouldn't you?  

Until Computerized Radiographic Mensuration Analysis (CRMA), there has not been an efficient way to grade and diagnosis the degree of a spinal ligament sprain.  

CRMA, or Computerized Radiographic Mensuration Analysis is not complicated or difficult to understand, rather it is exactly the opposite, a simple and uncomplicated process of measuring excessive movement of the bones of the spine on an x-ray.

A CRMA analysis of an x-ray, is nothing more than using computer software to speed up the process of what we used to do by hand to check for ligament damage to the spine, which is mark anatomical points on the x-ray image and measure slippage in millimeters, or excessive rotation of one of the vertebra on one-another in degrees.  

Now we simply mark anatomical points, and the computer does all the measuring for us.  We can now uphold a higher standard of care by checking an entire spinal region with high accuracy for ligament sprain and potential instability that could result in chronic pain, life long loss of enjoyment, create stress and difficulty with work, school and household duties, and even result in spinal fusion surgery to stabilize the spine.  

CRMA is an incredibly important test that allows us to diagnose torn spinal ligaments, which are considered one of the worst soft tissue injuries you can have. If you are interested in having CRMA performed for yourself, one of your clients, or if you want to begin using it in your practice contact my office or Spinal Kinetics.  Spinal Kinetics is leading the way in spinal ligament testing in the United States.

Healthcare providers have a duty to uphold a high standard of care, and with these injuries causing such a high degree of impairment and potential disability in the long-term, I believe that every patient should have CRMA testing as the "Standard of Care". 

​With accurate spinal ligament sprain testing, we can better diagnose, prognose and treat the most common cause of back pain in the world, the spinal ligament sprain. 
Picture
Translation Instability
Picture
Angular/Rotational Instability
Harvard’s Augustas White, MD, and Yale’s Manohar Panjabi, PhD, established the standard for the assessment of clinical instability. Their initial article was published in the journal Clinical Orthopaedics and Related Research in June, 1975, and titled (7):
Biomechanical analysis of clinical stability in the cervical spine


The following information is courtesy of Chaney Law Firm, PA:
  • Would you like to see how one of the leading law firms in the country has used CRMA? Visit their website here.
  • Click here to see the court order where a trial judge in Texarkana ruled that CRMA was "a mere technological advancement of established, reliable mensuration procedures such as the one utilized by the AMA Guides."
  • This is an excerpt from the American Medical Association's Guidelines to the Evaluation of Permanent Impairment ("AMA Guides"), which treating physicians usually follow in quantifying the extent of a connective tissue injury. The physician draws lines on x-rays and compares adjacent levels of the spine in a process known as radiographic mensuration analysis. Where the angles between adjacent levels exceed 11º, the AMA Guides state that the patient has a 25% permanent whole body impairment. Physicians have been performing these types of measurements and diagnoses for around a century, and the AMA Guides have required them since 1993.
Picture
Trial Judge Court Order on CRMA

Learn about Spinal Sprains and CRMA
Videos Courtesy of Spinal Kinetics

Hickory Spine Chiropractic
Office Hours:
Appointments available outside office hours by request, all by appointment only.

Monday:
12:00 PM–6:00 PM
Tuesday:  12:00 PM–5:30 PM
Wednesday: 12:00 PM–6:00 PM
Thursday: 12:00 PM–5:30 PM
Friday: 12:00 PM–6:00 PM
Saturday 10:00AM - 12:00 PM
​Sunday: by appointment

​Our office is by appointment only.

Office Location: 
​Hickory Spine Chiropractic

901 Hwy 321 NW, Ste 120 
Hickory, NC 28601
Phone: 
‪​(828) 655-7980​‬

Our chiropractic center is located on highway 321 in the same building with the tag office.
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