Disability vs Impairment

Clear Lake City Chiropractor Comments: One aspect of my practice is to perform independent medical examinations (IME’s). These examinations can be for workers compensation or for personal injury cases. Usually, as a part of my examination report, I will be asked several questions. One the questions that is frequently asked usually involves determining if the person has an impairment or a disability. For most people these seem like the same thing, but they are different. 

difference between medical and chiropractic doctor

The most commonly used definitions for disability and impairment in Texas come from the AMA’s “Guides to the Evaluation of Permanent Impairment” 4th Ed. In that guide, impairment is defined as “an alteration of an individual’s health status. The impairment becomes permanent when it has “become static or stabilized during a period of time sufficient to allow optimal tissue repair, and one that is unlikely to change in spite of further medical or surgical therapy”. An impairment will interfere with a person’s activities of daily living (ADL’s). A specific numerical value will be given to show what percent of the person has been permanently impaired.

A disability is defined by the same guide as being “an alteration of an individual’s capacity to meet personal, social, occupational demands or statutory or regulatory requirements, because of an impairment.” The disability is the relationship between a person’s impairment and their life requirements, especially their occupation. In short, a disability is the difference between what a person can do and what they want or need to.

Using these as definitions, a person can be impaired, but not disabled. If a concert pianist loses his hand, he is impaired and disabled since he can no longer play the piano. If a business manager loses her hand, she has an impairment, but she is not disabled since she can still perform her job.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!

Helping To Stop The Opioid Epidemic

Clear Lake City Chiropractor Comments: When I was in Chiropractic College 30 years ago, I remember my professors stating that for the treatment of back pain it should be; chiropractic first, medication second and surgery last. The intent was to see if a drugless surgery free solution could be found to get the patient out of pain and back to enjoying their life. If chiropractic did not resolve the problem then we would look at co-managing the patient’s problem with their medical doctor with the appropriate medication. Finally, if chiropractic and medication did not help, then we would look for a surgical solution.

Opiods

As people started having less time to fix and maintain their problem with proper exercises and stretches they started looking for the “quick fix” of taking drugs for pain relief. They have surgeries for problems that could have been resolved without surgery. They don’t do the follow-up exercises and stretches after their rehabilitation. Unfortunately this does nothing to fix the cause of the pain and eventually they need more and stronger drugs. 

Opioids are some of the strongest drugs available to reduce pain, but unfortunately they carry serious risks and side effects. Overdoses on these drugs were 5 times higher in 2017 than in 1999, with 70,000 drug overdoses in 2017 of which 68% involved opioids. Currently 130 people die every day in America from an opioid overdose.

Take the time to fix the problem first instead of masking the symptoms with drugs. Remember to do chiropractic first, drugs second and surgery last. If you have to have surgery, remember to continue with your exercises and stretches.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!   

Does Chiropractic Treatment Require A Referral From My MD?

Does Chiropractic Treatment Require A Referral From My MD?

Houston Chiropractor Comments: This question does not get asked much now as it did 30 years ago when I started my chiropractic career. As chiropractic care has become more mainstream people now know that a doctor of chiropractic does not require a medical referral, unlike going to a physical therapist who needs a referral from a medical or chiropractic doctor to be treated in Texas. We are portal of entry doctors for most musculoskeletal complaints and can be seen by anyone. The only time that a patient requires a referral from their medical doctor to a chiropractor is for certain insurance HMO’s to be reimbursed. 

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!  

 

Why Should I Not Crack My Own Neck?

Neck Cracking

Clear Lake Chiropractor Comments: This is a fairly frequent question that I get from patients. I will also have parents ask me to tell their kids the danger of “cracking” their own neck, especially after the parents have witnessing them doing it. 

While chiropractic adjusting is a safe procedure when performed by a trained professional, it can have risks when performed by the untrained. Before a chiropractor adjusts a neck, they take a history and perform an examination. During the examination they palpate the spine to see where the joint is subluxated, or partially out of alignment. This tells them what direction the joint needs to be adjusted, or “cracked”. This is different than when you grab your own head and twist it hoping to hear the “cracking” noise. You don’t know which way to properly adjust it and that is why 20 – 30 minutes later you feel the urge to do it again. Usually you are actually manipulating the joint above or below the one that is actually causing the problem. 

Sometimes there can be a vascular problem and the “cracking” can cause some tingling or numbness. The chiropractor can check to see if any underlying vascular issues are present before causing a problem.

The tightness or discomfort might also be due to tight muscles and not a joint problem. In this case, there is no need to adjust your own spine. The problem can be resolved by doing the correct stretches and exercises. 

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!     

Vertigo…Cuando el mundo sigue girando.

Quiropractico en Houston Comenta: 

dizzyness caused by vertigoUn par de veces al año atendere un paciente que ha desarrollado recientemente sintomas de vertigo que por lo general causa un resultado que puede ser debilitante .En ocasiones el paciente describe como si el mundo girara a su alrededor y otras veces como si fuera el,quien gira alrededor del mundo. Los mareos pueden ser leves o lo suficientemente severo como para no permitirme conducir un auto o simplemente llevar a cabo nuestras funciones diarias.Estos episodios de mareos pueden durar unos pocos minutos,varias horas o ser intermitentes.

Lo primero que necesitamos hacer, es entender que el vertigo es simplemente un sintoma y no una enfermedad por si sola. A causa de esto debemos encontrar la causa del vertigo. Si la causa es mas central (viene del sistema nervioso central) o si es periferal (inicia en lo profundo del oido.). Una examinacion nos revelara la causa.

Posibles causas del vertigo es el vértigo postural benigno,que  también se denomina vértigo postural paroxístico benigno,(VPPB). La causa de este occure cuando pequeñas particulas de calcio (canaliths) se acumulan en el oido interior del canal y se movilizan cuando hay movimientos repentinos.

Otra posible causa es la Enfermedad de Meinere. Esta enfermedad incrementa la presion y los liquidos en el oido que da como resultado el vertigo y una especie de zumbido dentro del oido (tinnitus).

Vertigo tambien puede ser causado por la neuritis vestibular. A causa de una infeccion viral que causa inflamacion en los nervios dentro del oido podemos experimentar  vertigo.Otras causas que pueden causar vertigo son ciertos medicamentos,un derrame,un tumor,deshidratacion o un golpe en la cabeza/cuello.

El tratamiento que utilizaremos sera determinado de acuerdo a la causa. Para VPPB lo mejor es la maniobra del reposicionamiento canalicular mejor conocida como la Maniobra de Epley o seguir los lineamiento estipulado por la Academia Americana de Neurologia.

Subire la proxima semana un video demostrando las diferentes series de movimientos designados para lograr un reposicionamiento correcto canalicular que he encontrado da un resultado positivo en la gran mayoria de casos y asi aprender como hacer estos ejercicios en casa.

 Algunos pacientes requieren rehabilitacion vestibular que consiste en una terapia designada en mejorar el sistema vestibular que se logra cuando se mejora el balance y la estabilidad logrando asi la disminuicion de los mareos y la estabilidad en la mirada. La manipulacion en la columna ayudara si ha existido una historia de traumas/golpes en la cabeza o cuello. Medicamentos o suplementos son de benficio para minimizar el acumulamiento de liquido en el oido interno o para aliviar las nauseas. Si la causa es un tumor o derrame en ese caso se referira al medico mas apropriado para su caso.

Dr. Ward Beecher ejerce en Beecher Chiropractic Clinic localizada en 1001 Pineloch, Ste 700 Houston, TX 77062. Haga su cita ya con el mejor quiropractico en Houston llamando al (281) 286-1300. Si tiene alguna pregunta escribala en el area  de comentarios.

What is an Impairment Rating?

What is an Impairment Rating?

Bay Area Chiropractor Comments: I waWhat Is An Impairment Rating?s in Austin last week doing a worker’s compensation examination on a lady when she asked me, “What is an impairment rating?” This was one of the questions that I was being asked to determine by the state in addition to; could she return to work (RTW) and was she at maximum medical improvement (MMI). The question reminded me that a lot of the terminology that doctors take for granted can be confusing to patients. 

Impairment is an alteration of an individual’s health status. To determine a permanent impairment rating, the impairment must be static and stable, sufficient time must be allowed for optimal tissue repair and it must be unlikely to change in spite of medical or surgical therapy. 

In Texas, there are approximately 450 doctors (medical, osteopathic and chiropractic) certified to be a designated doctor for worker’s comp patients to determine questions such as “What is the impairment rating?” To do this, the state of Texas mandates that we utilize the American Medical Association’s “Guides to the Evaluation of Permanent Impairment” 4th edition. The guides evaluate if any surgeries were performed, is there a decrease in the range of motion (ROM) of a joint, is there a decrease in strength or sensation, has there been an amputation or fusion. The doctor then takes these values and places them in several tables, charts and figures to determine what the patient’s impairment is. Usually this number is less than what the patient thinks it should be. This is because in most cases pain is not rated. Since it cannot be measured, it cannot be rated.

Impairment ratings can be used for other examinations as well such as following any type of accident where an impairment value needs to be given to determine the effect of an injury.

Now to answer the lady’s original question of “What is an impairment rating?” it is a number value to show what percentage of your entire body (whole person) was permanently impaired as a result of the accident or injury.

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!

Beware of The Summer Heat!

Summer Heat Tips

Clear Lake Chiropractor Comments: As we enter the summer, it is important that we pay attention to the heat and humidity. Whether we are working in the yard, playing sports with our friends or just lounging by the pool, we need to stay aware of the weather conditions. More importantly, we need to pay attention to how our body is reacting to the heat and humidity.

Heat emergencies have three stages: heat cramps, heat exhaustion, and heatstroke. All three stages of heat emergency are serious. It is important to treat these emergencies quickly so that they don’t progress to heatstroke, which can have lifelong consequences.

Heat cramps is the first stage. During heat cramps Heat cramps are the first stage of heat emergency. They usually happen when you’ve been physically active in the heat, but they can also occur if you haven’t been active. Heat cramps are especially likely in the elderly or small children, overweight people, and people who have been drinking alcohol. Muscle pain and tightness are symptoms of heat cramps. It is typically treated by moving out of direct sunlight and into a shaded area. You should drink cool non-alcoholic beverages without caffeine and gently massage and stretch the muscles.

Heat exhaustion has many symptoms. Some of these symptoms include muscle cramps, dizziness, mild confusion, increased heart rate or breathing, a headache, irritability, extreme thirst, nausea or vomiting, pale skin, heavy sweating or fainting. Treatment is everything listed in heat cramps plus loosening your clothes and having someone gently fan your body.

Heatstroke will have all of the symptoms of heat exhaustion plus a body temperature of 104°. The person can also have confusion, dry skin, seizures, hallucinations, rapid shallow breathing and rapid weak pulse. Heatstroke can be fatal or cause lifelong complications. Call 911 or go to the emergency room if heat illness is causing vomiting, seizures, or unconsciousness. For heat stroke you should remove any sweaty clothes and place ice under the arm pits, wrist and groin if available. If not, place cool wet towels on the chest and face.

To help prevent these problems remember to take periodic rests, drink plenty of water, wear loose fitting light colored clothes and avoid alcohol or caffeinated drinks.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!  

Do Chiropractic Adjustments Hurt?

Chiropractor Adjustment Houston TXClear Lake Chiropractor Comments: For patients that have never been to a chiropractor, this is surprisingly a common question. If your chiropractic adjustment is performed correctly, you should only feel a little stiff or sore after your initial chiropractic adjustment. This would be similar to the soreness that one feels when they first start going to a gym or do too much yard work. After the 1st couple adjustments you do not feel any soreness, just relief with increased mobility.

Chiropractic adjustments take pressure off of the joints and help to relieve any pressure or adhesions in the joint. Sometimes as the doctor of chiropractic corrects your spinal complaints you may also note some muscles being sore in different areas. This is not uncommon. You will start to use muscles differently as your body adapts to your correct posture. Your chiropractor will typically advise you to use ice for 20 minutes to help relieve any soreness. He or she will also suggest some stretches and later some exercises to allow the joints to retain their flexibility and to give the proper muscle support so that the problem does not reoccur.

If you have any questions or concerns about chiropractic adjustments, feel free to ask your chiropractor. They can explain the safety of spinal manipulation and why chiropractors have the lowest malpractice rates of any doctors. They can also modify their treatment to make sure that there is no discomfort.

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!   

How To Choose A Chiropractor

How To Choose A ChiropractorHouston Chiropractor Comments: We live in a mobile society. People change jobs. Kids go off to college. When this happens, I get asked if I can recommend a chiropractor in their new area. Some towns are easy, because I know a doctor who I can trust. Sometimes I don’t have any idea.

When I first open up my clinic in 1990 my patients all came in either because they knew me or were referred by a friend or co-worker. In the early 1990’s managed care began to change healthcare with provider networks. Things changed again in the early 2000’s with the rise of the internet with searches and reviews. Now you can find out anything that you want to know about your doctor and some things that you don’t want to know about them. 😉

When choosing a chiropractor now, a personal recommendation from someone that you know and trust is still the best way. They can answer specific questions that you might not find with an online review. When we get referrals from orthopedic surgeons, podiatrists and physical therapists, the patients are very comfortable knowing that their healthcare provider has vouched for us and our treatment.

Another way to choose a chiropractor is thru your provider network if you are on an insurance plan. Every major insurance plan will have a list of doctors with their certifications and reviews. Doctors who do not meet the accepted standards of care are removed from the list. Those doctors will require you to pay more out of pocket expenses than in network providers.

A third way to choose a doctor is thru online reviews. Review sites such as Google and Yelp allow you to hear from patients talking about what they like and don’t like about the office, treatment, staff and the doctor. These sites allow you to see positive and negative comments. Yelp has a section of reviews call “not currently recommended” that lists reviews from people who haven’t registered with Yelp as users.

A final way to choose a doctor is to check with their state board to find out if they are properly registered and if the doctor has any restrictions or complaints against them. Some doctors appear friendly and ethical, but you might find out that they have a history of fraudulent billing or specific restrictions on their license.

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!    

Are Neck & Back Injuries Permanent?

Is My Back Pain Permanent?Clear Lake Chiropractor Comments: One of the most common questions I get from patients after an injury is “Will I always have pain in the future”? Another common statement is to relate all current complaints to a previous accident or injury. This can be back pain from jumping off a roof when they were 15 or an auto accident that they had when they were in college. People are surprised when they are shown to have no degeneration from prior injuries or signs of prior trauma.

Most accidents or prior injuries do not cause permanent pain or impairments. The World Health Organization (WHO) states that impairment is “any loss or abnormality of psychological, physiological or anatomical structure or function”. Another way of saying it would be “a condition that interferes with an individual’s activities of daily living. The impairment becomes permanent when it has become static and stable and unlikely to change with further care.

Most accidents and injuries cause a mild to moderate sprain / strain injury or a soft tissue contusion (bruise). These injuries typically resolve in 8 weeks or less. With the proper treatment and therapy there is no permanent impairment or pain. The key to getting the problem resolved is to understand what happened to the body and providing the correct chiropractic adjustments to the joints, doing the proper therapy to minimize tissue inflammation and getting the patient to begin the necessary stretches and exercises as soon as possible. After the injury is resolved, the patient should be given a home based exercise and stretching program. These typically only take a few minutes to perform so it is easy to include in your daily routine, similar to brushing and flossing your teeth.

There are times when these injuries take longer, such as when a bone has been broken, ligaments or tendons ruptured or when surgery has been required. This is typically where permanent pain or discomfort can occur. Luckily that does not happen often.

Unfortunately some patients are told that they will always be in pain or that they can never do a particular activity again because of the injury. With a mild to moderate sprain / strain injury (this includes a small disc herniation) or contusion, you will not be limited with what you do if you are regularly doing the correct exercises and stretches. If you have not been given a home based exercise and stretching program by your previous doctor or therapist, ask your current chiropractor for a program that you can do on your own. He or she should be able to formulate a plan to get you out of pain and back to enjoying your activities of daily living. If they don’t give you a home care program, feel free to contact us for information.

Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at www.BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!