Raleigh, NC

Chiropractic adjustments work by restoring the spine’s natural mobility in the vertebral column in the neck mid lower back sacrum and pelvis.

What is the cracking and popping sound during a chiropractic adjustment?

The cracking and popping heard during a chiropractic adjustment is caused by the capsules around the vertebral facet joints when they being reset. The vertebral capsules contain synovial joint fluid and gases. Adjusting the spinal vertebrae restores the synovial fluid pressure and releases a build up in gases that may cause pressure, pain, inflammation and tightness in and around the spine and muscles.

As the synovial joint pressure decreases during a chiropractic adjustment gas is released. This causes a cavitation.  The cavitation is what you hear when there is a cracking or popping in the neck or back during a chiropractic adjustment.

Why do chiropractic adjustments treat pain?

Joint capsules around the facets can also become entrapped causing sharp sometimes severe pain in the neck, mid and lower back. Joint capsules fibers are very sensitive to pain and when entrapped in the spinal facet joints can become a very bothersome condition that can be addressed with chiropractic adjustments successfully.  

The re-setting of the vertebral facet joints can take irritation and inflammation off of compressed nerves that are pressed on around the spine and relieve pain generated in ligaments and muscles which are irritated by vertebral joints not functioning with full mobility.

 The chiropractic adjusting of the vertebral segments may also take irritation off surrounding nerves, The picture below shows an example of this:

 

This picture was published in a public journal in 2002 from the journal Spine:27. 2459-2466. The Effects of Side Posture Positioning and Spinal Adjusting on the Lumbar Z Joints.  Figure copied from Cramer, et. al (2002)

You can see the example on the left above the R which symbolizes the right side of the body. These are two axial slices of a lumbar MRI looking down on the spinal cord, discs, nerves and vertebrae before and after a chiropractic adjustment on the same patients.  

The white areas circled represent the spinal nerve roots which exit the vertebrae in between the facet joints and the lumbar discs. When this area becomes compressed and irritated as it is in the photo on the right side it can cause significant low back pain, sciatica, nerve pain, leg pain and even lead to weakness in the legs and chronic numbness and pain in the lower back, thighs, and feet.

The figure on the below is an MRI taken right after a spinal adjustment was administered to the lower back on the same patient. As you can see there is a significant opening in the area in which the spinal nerve root comes out on the right side.

When vertebral joints experience dysfunction and inflammation it also affects of the spinal discs which can become irritated and inflamed. The cracking, popping and realigning of the spinal vertebral column can take unnecessary weight distributions off of the spinal discs and lead to a decrease in pain and increase in function and mobility.

In summary, Chiropractic adjustments have been used for over 100 years and an effective ways to manage musculoskeletal pain with minimal side effects in comparison to many medications such as NSAIDS and Opiates.

Chiropractic adjustments are covered by most insurances, Medicare and Medicaid.

Here is an example of a recent chiropractic adjustment and physical therapy performed in my office on a patient experiencing neck and back pain from her job….Enjoy the cracks and pops!

If you live in the Raleigh, NC area and would like to book an appointment, book online here .

In health,

 

Dr. Jeffrey Gerdes, D.C.

Raleigh, NC

You just finished a long day of work or a great workout at the gym, and then it strikes you again: a deep achy pain in the front of the arm or in the back around your shoulder blade and spine.

Shoulder pain can be a big problem and shoulder pain affects millions of people every year in the United States alone.

In this blog posts I will discuss seven treatments you can do at home to help relieve shoulder pain.

Home remedy for shoulder pain #1: Refrain from activities that are causing the shoulder pain….Rest your shoulder

Oftentimes, shoulder pain is caused by tendonitis from repetitive movements of the arm and back. If you are able to stop and rest from the movements or activities that are causing the underlying shoulder pain it will give your shoulder a chance to heal and decrease the pain and discomfort that you are experiencing.

Home remedy for shoulder pain #2: Use ice

Again, one of the main causes of shoulder pain is tendonitis and inflammation in the ligaments and muscles in the shoulder. Ice is a natural remedy for tendonitis and inflammation. Ice acts by restricting blood circulation, dulling pain signals in the body, and decreasing inflammatory chemicals that get released when the body is experiencing inflammation and injury.

Try to combine number one above (i.e., rest) with number two (ice) for optimal results. Picture the baseball pitcher after a long game wrapping his his shoulder in an ice compression to minimize shoulder pain and repetitive injuries.

Home remedy for shoulder pain #3 Take care of your neck

Problems in the neck are often the underlying cause of shoulder pain. A pinched nerve in the neck can cause pain in the shoulder.

Tight muscles in the neck run down and attach close to the shoulder and around the shoulder blade. Try some neck stretches at home to keep your neck and shoulder muscles loose and limber.

Consider a massage to work the kinks out in the muscles in around the shoulder and neck. If your neck pain is coming from your pillow or mattress at home consider switching out your pillow and mattress until your neck pain and shoulder pains are resolved.

Home remedy for shoulder pain #4: Strengthen the muscles between your shoulder blades, and stretch your chest muscles

Often times, shoulder pain is caused by poor posture. A condition called kyphosis where are your upper back and shoulders are rounded too far forward (picture the Hunchback of Notre Dame) can cause biomechanical stressors on the shoulders and lead to shoulder pain.

If you like to focus on chest and biceps at the gym, take some time to learn how to work your back muscles. Consider taking up yoga or pilates which strengthens the muscles around the shoulder blades and spine. Develop a plan to combat the 8 to 10 hours most of us are in flexion at the computers and all the other activities of daily life.

On the other hand, as we sit in flexion for 8 to 10 hours a day, our chest muscles become chronically shortened and tightened. This pulls on the shoulders forward rounding them excessively causing shoulder pain.

Stretching your contracted pectoral muscles, which may be pulling your shoulders forward, will release your shoulder tension and may decrease your shoulder pain.

Home remedy for shoulder pain #5: Come up with a home exercise strengthening plan for your rotator cuff

You don’t need fancy equipment or a gym membership to strengthen your rotator cuff and shoulder muscles at home. In fact, most research suggests that low tech equipment, such as Therabands, and using your own body’s weight are superior to heavy weights when strengthening your rotator cuff.

If you need any help with a home strengthening plan schedule an appointment, and I will take you through it.

It’s important to note that, oftentimes, there may be a more serious underlying pathology, dysfunction, in the neck or back joints causing your shoulder pain. These conditions require the attention of a licensed medical profession. So, if you have tried treating your shoulder pain at home with no success make sure to seek out an appointment to get an evaluation by a licensed medical professional.

If home remedies are not enough – or if you are looking to add in a layer of professional help to combat and treat your shoulder pain, book an appointment with us today .

In health,

 

Dr. Jeffrey Gerdes, D.C.

Raleigh, N

The shoulder is a ball and socket joint which moves in all ranges of motions and planes making it a very dynamic joint. It is one of the most functional joints in the body used for lifting, pulling and other movements.

What causes shoulder pain?

Tendonitis causes shoulder pain

This occurs when the tendons of the shoulder become inflamed or irritated usually from repetitive use or acute injuries. The biceps tendon and rotator cuff tendons are the tendons typically involved and tendinitis. The symptoms feel like a deep ache or soreness in the shoulder which is exacerbated by repetitive activities or use of the arm and shoulder.

Sprains and strains cause shoulder pain

Sprains and strains occurs after an acute injury from an accident such as a car accident. Injuring the shoulder muscles and ligaments during a fall or sports related injury.

There may be swelling in the shoulder joints and surrounding muscles. Overhead reach and raising the arm typically causes shoulder pain.

There is typically a pain in the shoulder at night causing trouble sleeping on the affected shoulder pain and restriction with full range of motion in the shoulder and trouble putting on clothing are reaching behind the back.

Tearing of the rotator cuff causes shoulder pain

A tear in the rotator cuff is when one or more than one of the ligaments in the rotator cuff tear. There are four muscles and ligaments that make up the rotator cuff in the shoulder. The rotator cuff helps you raise and rotate your arm and provides stability to the shoulder joint.

 The tear can be a partial tear where the ligament tear but is still intact or a larger, full thickness tear where the ligament tear completely.

Tearing of the shoulder labrum causes shoulder pain

 The shoulder labrum is a round cartilage which hold together the shoulder ball and socket joint humerus and glenoid.  The labrum is a major stabilizing structure in the shoulder. The should labrum tears from a traumatic force. Symptoms include pain, instability in toe shoulder, clicking or popping with certain movements of the arm.

Dislocation causes shoulder pain

 This will occur after a traumatic event. Any movement of the arm and shoulder will be severely painful and limited. It’s important to seek immediate attention if one has dislocated their shoulder. It’s very common to have shoulder pain many years after a prior dislocated shoulder.

Fractures cause shoulder pain

A fracture is a break in the bone.  There are several bones that make up the shoulder that may fracture during a traumatic event including the clavicle, scapula, and humerus. A fracture may be closed or open.

 

Myalgia causes shoulder pain

 Myalgia is muscle pain from chronic or acute inflammation of the muscles around the shoulder. This may include the deltoid muscles pectoral muscles upper back muscles and muscles around the scapular region of the shoulder.

Pinched nerves in the neck cause shoulder pain

When nerves are pinched or pressed on in the neck this irritation radiates down the shoulder and arm. This condition is called radiculopathy and may be the cause of shoulder pain when the underlying condition is a dysfunction in the neck. Symptoms include shooting pain, numbness and tingling and a chronic ache or intermittent radiating pain into the shoulder, arm and hand.

Poor posture can cause shoulder pain

Chronic poor posture in the upper back and neck causes excessive strain and imbalances in the shoulders causing shoulder pain. This is a referred to as condition called upper crossed syndrome where the extensor muscles in the body are not properly strengthened and used lead into a rounding of the shoulders and contraction of the pectoral muscles.

Arthritis causes shoulder pain

Like any other joints in our bodies shoulder joints can get arthritis. This happens when the joint spaces and cartilage deteriorate in the body. This can happen with chronic use or naturally as we age.

Cancer can cause shoulder pain 

Some form of cancers cause shoulder pain. This may come from metastasis or other bone tumors which occur and longer bones of the skeleton such as the humerus. Red flags for shoulder pain from cancer would include lethargy, shoulder pain at night. sudden unexplained weight loss or weight gain.

How is shoulder pain diagnosed?

X-Ray: The typical first step is obtaining plain film x-rays which can show the joint spacing, bony structures and some general soft tissue findings.

MRI: This is the superior gold standard choice for diagnosing shoulder problems. MRIs are highly sensitive for soft tissue pathology is in the ligaments muscles and labrum surrounding the shoulder.

What are common treatments for shoulder pain?

Common treatments include:

• Resting the shoulder from activities that may be causing shoulder pain and dysfunction

 

• Nonsteroidal anti-inflammatory medications such as ibuprofen and naproxen

 

• Heat and ice to reduce chronic pain or acute inflammation and swelling

 

• Cortisone injections into the shoulder

 

• Physical therapies which include: strengthening and improving the ranges of motion in the shoulder, therapeutic ultrasound to promote healing and decrease inflammation and pain

 

• Electrical muscle stimulation to modulate pain and increase normal ranges of motion

 

• Spinal chiropractic adjustments to address pinched nerves in the neck or dysfunctions and the upper thoracic spine and shoulder blades

 

• Corrective spinal exercises to address underlying postural issues causing shoulder pain

 

• Shoulder surgery to repair torn ligaments or labrums

 

If you suffer from shoulder pain and are looking for relief treatment in the Raleigh, NC area, book an appointment today .

 

In health,

 

Dr. Jeffrey Gerdes, D.C.

Raleigh, NC

In 2012 there was over 30,000 fatal injuries from car accident injuries in the United States from 5.6 million auto crashes.

Of these 5.6 million car accidents there were 1.6 million car accident injuries reported. This resulted in an economic burden of nearly $300 billion each year in the United States.

Disability, hospitalizations, missed work can all contribute to the economic burden of car accident injuries.

Here are some of the most common injuries suffered in car accidents.

Back, Neck and Head Injuries

Whiplash of the neck is one of the most common car accident injuries. This is when an external force causes a hyperflexion and hyperextension mechanism of the neck and head causing muscle and ligament injuries in the cervical spine or neck.

Some common symptoms of whiplash include neck pain, headaches , dizziness, numbness and tingling into the arms and hands, stiffness when turning the head and looking up and down. In some instances, the discs in the neck may herniate.

Some common treatments for whiplash include chiropractic and physical therapy, ice, heat, nonsteroidal anti-inflammatory medications (NSAIDS), pain medications, muscle relaxers, ultrasound therapy, electrical muscle stimulation therapy , and therapeutic stretching and exercises.

Back injuries Are Also Very Common Car Accident Injuries

The muscles and ligaments of the back can be sprained and strained. In some instances, the lumbar discs can herniate during a car accident.

Lumbar disc herniations can cause injuries to the nerves and spinal cord of the spine. Symptoms of nerve or spinal cord  injuries include sharp severe pain, numbness, tingling and pain in the legs or feet.

If a lumbar herniated disc is suspected it’s important to obtain an MRI as soon as possible. An MRI will show the extent of the disc herniation and its effect on surrounding nerves and spinal cord.

Head Injuries After a Car Accident

Head injuries can be the most significant car accident injuries one can suffer. Occupants of the vehicle involved in a car accident often strike their heads against the dashboard, steering wheel,window, head arrest and side doors.

These forceful impacts to the head a car can cause a concussion or a more severe traumatic brain injury. Symptoms of a concussion include dizziness, headaches, feeling forgetful, loss of balance and coordination long-term memory problems.

Traumatic  brain injuries can result in memory loss, loss of speech function, and loss of permanent cognitive function.

The long term effects of head injuries can be permanent and it is critical after a car accident injury to be evaluated by a neurologist or neuropsychologist as soon as possible if you have experienced a concussion or head injury.

Shoulder Injuries

Shoulder injuries are very common injuries experienced after a car accident. Shoulder  injuries can be a sprain/ strain of the muscles and ligaments in the shoulder and shoulder girdle. In more serious cases there can be tearing of the rotator cuff, labrum and biceps tendon in the shoulder.

These injuries typically occur from the seatbelt going over the shoulder and the grasping on forcefully to the steering wheel during the impact of the collision. Many times one will  brace the arms out against seats, doors or dashboards during the crash causing an injury to the shoulders.

Symptoms of an injury or tear in the shoulder after an accident include pain raising the arm, pain and restriction flexing the arm, pain sleeping on the shoulder, pain and restricted ranges of motion putting on shirts or clothes.

If a tear in the rotator cuff, labrum or biceps tendon is suspected it’s important to obtain an MRI of the shoulder and include orthopedic shoulder specialist co-management in the care plan for adequate recovery.

Chest Injuries

It is not uncommon for one to have a chest injury during a car accident. This usually happens from hitting the chest against the steering wheel or side doors during a car accident.

It is important to be evaluated for fractured ribs if you have experienced a chest injury after an accident. Fractured ribs can puncture the lungs. The most common tests to see if a rib was fractured in a car accident are a CT scan or plain film x-rays..

 Abdominal and Pelvic Injuries

Hip fractures pelvic fractures and abdominal injuries can be significant and are common injuries experienced in a car accident. Spleen, liver and kidney injuries should be evaluated at the emergency room as quickly as possible to avoid any long-term consequences. CAT scans are the most commonly used diagnostics to evaluate abdominal and pelvic injuries.

Knee Ankle and Foot Injuries

These are common injuries after a car accident. They usually occur from having the foot planted hard down on the brake, or floorboard during a car accident. These injuries can also occur when the knee strikes the steering wheel or dashboard during an accident.

 There may be swelling In the ankle or knee is after the initial injury has occurred. It’s important to obtain an x-ray Initially to rule out a fracture or disloation in the knee ankle or foot.If the symptoms continue or improve with chiropractic care, physical therapy rets and time or a torn ligament is suspected an MRI should be obtained to rule out torn ligaments.

 I often find patients are surprised to learn that chiropractors are also licensed to perform physical therapy. We are able to provide chiropractic care with physical therapy in our office to treat car accident injuries.

If you have been in a car accident in the Raleigh, NC area – recently or in your past – please book an appointment with us today. Begin the journey to healing here. Insurances accepted.

WE ACCEPT AUTO INSURANCE & THIRD PARTY BILLING OR ATTORNEY REPRESENTATION: THERE IS TYPICALLY NO UPFRONT COST FOR CARE  

-We will file your insurance claims for you to the car insurance at fault per your request

-We will submit your office charges and records to the car insurances for you and our friendly staff will contact any adjusters assigned to your claim

– If you were the at fault driver we will verify any medpay benefits you may have to use on your own auto insurance policy to pay for your treatment

–  If you are represented by an attorney handling your case we will submit your records when your treatment has finished at no cost to you

WE TAKE THE STRESS OUT OF CAR ACCIDENT INJURIES!

Schedule an appointment now.

 

In health,

 

Dr. Jeffrey Gerdes, D.C.

Raleigh, NC

My name is Dr. Jeffrey Gerdes, I’m a Chiropractor at Carolina ChiroCare and Rehab who treats car accident injuries in Raleigh, NC .

 

 

 So, what’s the big deal with car accident injuries?

Good question. Well, it’s estimated that around 25% of people after a car accident injury will end up experiencing chronic pain. That’s one in four people.

Other research studies show that 75% of people who go to the emergency room after a car accident are still having pain six weeks later.

Somestudies suggest that 43% of patients who were injured in a car accident suffer chronic symptoms years later after the car accident.

Car Accident Injuries in Raleigh, NC: Where to Seek Treatment

This is why it’s so important to seek treatment by a chiropractor in Raleigh,NC for car accident injuries or other healthcare professionals if you have been injured in an auto accident.

The most common symptoms that become chronic are neck pain, headaches , whiplash, shoulder pain, back pain and muscle pain. Often times, there is chronic radiating pain, tingling and numbness in the shoulders or legs.

I often see my patients develop a chronic stiffness in the neck, back shoulders after an auto accident. Car accident injuries trigger the body to start developing arthritis in the vertebral joints of the spine.

Car Accident Injuries in Raleigh, NC: Why Seek a Chiropractors HelpThis traumatic insult to the vertebrae of the back and neck can lead to the development of chronic arthritis which in turn leads to chronic pain and stiffness.

Car accident injuries begin with initial soft tissue swelling in the muscles, tendons and fascia. This is typically referred to as a sprain/strain or whiplash when we are referring to the neck.

After the initial swelling, the injured and damaged soft tissues begin thickening and hardening. Scar tissue then starts to develop. This is the beginning of arthritis. This process develops over the years but is begins and accelerates with the initial injury to the soft tissues in the spine.

One study: Central Hypersensitivity in Chronic Pain After Whiplash

Injury Clin J Pain, Volume 17(4).December 2001.306-315.

This study indicates  injuries from car accidents cause a condition called central hypersensitivity.  This is when the injury causes the muscles around the spine and spinal cord neurons to become overly sensitive to pain. This process causes a chronic pain syndrome in some patients.In most cases diagnostic imaging such as x-rays, MRIs and CT scans do not show this inflammatory process in the soft tissues.

Car Accident Injuries in Raleigh, NC: Why Seek Treatment

This is why it’s critical to seek immediate treatment after a car accident injury. The sooner a trained professional can begin treating you the less likely you are to develop chronic pain from your accident.

Treatments that have a direct impact on the injured soft tissues such as mobilizing your vertebral joints with chiropractic adjustments and physical therapies such as ultrasound therapy , electrical muscle stimulation, therapeutic stretches and exercises , myofascial release, manual therapy, tens therapy and traction therapy begin the remodeling and healing process in the injured muscles, ligaments and nerves.

I often find patients are surprised to learn that chiropractors are also licensed to perform physical therapy. We are able to provide chiropractic care with physical therapy in our office to treat car accident injuries. If you have been in a car accident in the Raleigh, NC area – recently or in your past – please book an appointment with us today. Begin the journey to healing here. Insurances accepted.

WE ACCEPT AUTO INSURANCE & THIRD PARTY BILLING OR ATTORNEY REPRESENTATION: THERE IS TYPICALY NO UP FRONT COST FOR CARE  

-We will file your insurance claims for you to the car insurance at fault per your request

-We will submitt your office charges and records to the car insurances for you and our friendly staff will contact any adjusters assigned to your claim

– If you were the at fault driver we will verify any medpay bennefits you may have to use on your own auto insurance policy to pay for your treatment

–  If you are represented by an attorney handling your case we will submitt your records when your treatment has finished at no cost to you

WE TAKE THE STRESS OUT OF CAR ACCIDENT INJURIES!

 

Schedule an appointment now.

 

In health,

 

Dr. Jeffrey Gerdes, D.C.

 

Other usefull resources:

https://accidentdoctor.org/north-carolina-car-accident-doctor/raleigh

http://www.srisd.com/graduates_results.php?s=15&lname=&city=&state=North%20Carolina&zip=#

http://www.srisd.com/research.htm