Chiropractic Treatment for Lower Back Pain

Chiropractic for the low back has been repeatedly shown to be the most effective treatment for lower back pain. Chiropractic treatment for low back pain is usually pretty straightforward.

Chiropractic for Lower Back PainEighty percent of people suffer from back pain at some point in their lives. Back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. In fact, it is estimated that low back pain affects more than half of the adult population each year and more than 10% of all people experience frequent bouts of low back pain.

The susceptibility of the low back to injury and pain is due to the fact that the low back, like the neck, is a very unstable part of the spine. Unlike the thoracic spine, which is supported and stabilized by the rib cage. This instability allows us to have a great deal of mobility to touch our toes, tie our shoes or pick something up from the ground, but at the cost of increased risk of injury.

As long as it is healthy and functioning correctly, the low back can withstand tremendous forces without injury. Professional powerlifters can pick up several hundred pounds off the floor without injuring their low back. However, if the low back is out of adjustment or has weakened supporting muscles, something as simple as taking a bag of groceries out of the trunk of their car, picking something up off the floor, or even simply bending down to pet the cat can cause a low back injury.

Until recently, researchers believed that back pain would heal on its own. We have learned, however, that this is not true. Recent studies showed that when back pain is not treated, it may go away temporarily, but will most likely return. It is important to take low back pain seriously and seek professional chiropractic care. This is especially true with pain that recurs over and over again. Contact us . . . we can help!

The Causes of Low Back Pain

There are many different conditions that can result in low back pain, including: sprained ligaments, strained muscles, ruptured disks, trigger points and inflamed joints. While sports injuries or accidents can lead to injury and pain, sometimes even the simplest movements, like picking up a pencil from the floor, can have painful results. In addition, conditions such as arthritis, poor posture, obesity, psychological stress and even kidney stones, kidney infections, blood clots, or bone loss can lead to pain.

Due to the fact that there are a whole lot of things that can cause low back pain, and some of those things can be quite serious if left untreated, it is important to seek professional help. Chiropractors are the experts at diagnosing the cause and determining the proper treatment for low back pain.

Treating Low Back Pain With Chiropractic

Chiropractic treatment for low back pain is usually pretty straightforward. Most commonly, it’s simply a matter of adjusting the lower lumbar vertebrae and pelvis to re-establish normal motion and position of your bones and joints.

Chiropractic for the low back has been repeatedly shown to be the most effective treatment for low back pain. In fact, major studies have shown that chiropractic care is more effective, cheaper and has better long-term outcomes than any other treatment. This makes sense because chiropractic care is the only method of treatment that serves to re-establish normal vertebral motion and position in the spine. All other treatments, such as muscle relaxants, pain killers and bed rest, only serve to decrease the symptoms of the problem and do not correct the problem itself.

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!

Chiropractic for Upper Back Pain

ImageMost neck and upper back pain is caused by a combination of factors, including injury, poor posture, chiropractic subluxations, stress, and in some instances, disc problems. Chiropractic treatment can help.

Most people do not realize how much they move their neck during the day until they are unable to do so. The degree of flexibility of the neck, coupled with the fact that it has the least amount of muscular stabilization and it has to support and move your 14 – 16 pound head, means that the neck is very susceptible to injury. You can picture your neck and head much like a bowling ball being held on top of a stick by small, thin, elastic bands. It doesn’t take much force to disrupt that delicate balance.

The spinal cord runs through a space in the vertebrae to send nerve impulses to every part of the body. Between each pair of cervical vertebrae, the spinal cord sends off large bundles of nerves that run down the arms and to some degree, the upper back. This means that if your arm is hurting, it may actually be a problem in the neck! Symptoms in the arms can include numbness, tingling, cold, aching, and “pins and needles”.

These symptoms can be confused with carpal tunnel syndrome, a painful condition in the hands that is often found in people who work at computer keyboards or perform other repetitive motion tasks for extended periods. Problems in the neck can also contribute to headaches, muscle spasms in the shoulders and upper back, ringing in the ears, otitis media (inflammation in the middle ear, often mistaken for an ear infection in children), temporomandibular joint dysfunction (TMJ), restricted range of motion and chronic tightness in the neck and upper back.

Chiropractors associate the neck and upper back together, because most of the muscles that are associated with the neck either attach to, or are located in, the upper back. These muscles include the trapezius, the levator scapulae, the cervical paraspinal muscles and the scalenes, as well as others.

The Causes of Neck and Upper Back Pain

Most neck and upper back pain is caused by a combination of factors, including injury, poor posture, subluxations, stress, and in some instances, disc problems.


By far, the most common injury to the neck is a whiplash injury. Whiplash is caused by a sudden movement of the head, either backward, forward, or sideways, that results in the damage to the supporting muscles, ligaments and other connective tissues in the neck and upper back. Whether from a car accident, sports, or an accident at work, whiplash injuries need to be taken very seriously. Because symptoms of a whiplash injury can take weeks or months to manifest, it is easy to be fooled into thinking that you are not as injured as you really are. Too often people don’t seek treatment following a car accident or sports injury because they don’t feel hurt. Unfortunately, by the time more serious complications develop, some of the damage from the injury may have become permanent.

Poor Posture

One of the most common causes of neck pain, and sometimes headaches, is poor posture. It’s easy to get into bad posture habits without even realizing it – even an activity as “innocent” as reading in bed can ultimately lead to pain, headaches, and more serious problems. The basic rule is simple: keep your neck in a “neutral” position whenever possible. Don’t bend or hunch your neck forward for long periods. Also, try not to sit in one position for a long time. If you must sit for an extended period, make sure your posture is good: Keep your head in a neutral position, make sure your back is supported, keep your knees slightly lower than your hips, and rest your arms if possible.


Subluxations in the neck and upper back area are extremely common due to the high degree of stress associated with holding up your head, coupled with the high degree of instability in the cervical spine. Most subluxations tend to be centered around four areas: the top of the cervical spine where it meets the skull; in the middle of the cervical spine where the mechanical stress from the head is the greatest; in the transition where the cervical and thoracic areas of the spine meet; and in the middle of the thoracic spine where the mechanical stress from the weight of the upper body is greatest.

Signs of subluxation include looking in the mirror and seeing your head tilted or one shoulder higher than the other. Often women will notice that their sleeve length is different or that a necklace is hanging off center. If someone looks at you from the side they may notice that your head sits forward from your shoulders. This is known as FHP – forward head posture – and is very common for people who are stooped over their computers all day long. Subluxations are a debt to the body. If they are not taken care of soon after they occur, then they can get much worse over time due to the accumulation of compounding interest.


When most people become stressed, they unconsciously contract their muscles. In particular, the muscles in their back. This ‘muscle guarding’ is a survival response designed to guard against injury. In today’s world where we are not exposed to physical danger most of the time, muscle guarding still occurs whenever we become emotionally stressed. The areas most affected are the muscles of the neck, upper back and low back. For most of us, the particular muscle affected by stress is the trapezius muscle, where daily stress usually leads to chronic tightness and the development of trigger points.

The most effective ways you can reduce the physical effects of stress on your own are through increased exercise.

Disc Herniations

The discs in your cervical spine can herniate or bulge and put pressure on the nerves that exit from the spine through that area. Although cervical discs do not herniate nearly as often as lumbar discs do, they occasionally can herniate, especially when the discs sustain damage from a whiplash injury.

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!

Chiropractic for a Slipped Disc

Mild to moderate disc herniations (commonly referred to as slipped discs) can usually be treated conservatively with stretching, exercise therapy and chiropractic care.Image

You may have heard the term “slipped disc” used to describe a low back injury.  Discs do not actually “slip”.  Rather, they may herniate or bulge out from between the bones.  A herniation is a displaced fragment of the center part or nucleus of the disc that is pushed through a tear in the outer layer or annulus of the disc.  Pain results when irritating substances are released from this tear and also if the fragment touches or compresses a nearby nerve.  Disc herniation has some similarities to degenerative disc disease and discs that herniate are often in an early stage of degeneration. Herniated discs are common in the low back or lumbar spine.

What causes discs to herniate?

Many factors decrease the strength and resiliency of the disc and increase the risk of disc herniation. Life style choices such as smoking, lack of regular exercise, and inadequate nutrition contribute to poor disc health. Poor posture, daily wear and tear, injury or trauma, and incorrect lifting or twisting further stress the disc. If the disc is already weakened, it may herniate with a single movement or strain such as coughing or bending to pick up a pencil.

How do I know if I have a disc herniation?

Herniated discs are most likely to affect people between the ages of 30 and 40.  Disc herniations may be present without causing pain. The most common symptom will be pain in the area of the herniation that may radiate across the hips or into the buttocks. You may also experience numbness or pain radiating down your leg to the ankle or foot. If the herniation is large enough, you may notice weakness with extension of your big toe and you may be unable to walk on your toes or heels.  In severe cases of lumbar disc herniation, you may experience changes in your bowel or bladder function and may have difficulty with sexual function.

How is a disc herniation treated?

Mild to moderate disc herniations can usually be treated conservatively with stretching, exercise therapy and chiropractic care.  More advanced cases will often require some form of spinal decompression, such as traction or mechanical decompression, in conjuction with chiropractic care. 

Occasionally, a herniation may be severe enough to warrant surgical intervention.  These cases are usually reserved as a last resort when other forms of therapy have failed to relieve pain, or if there is significant compression of the spinal cord or nerves.

Chiropractic is not addictive!

The facts are scary! We all know the harm that prescription drugs can have, but when I read the report from the American Association of Poison Control I was shocked.  “Drug overdose death rates in the US have more than tripled since 1990.” As of May 2012 statistics show that the leading cause of death of females living in the U.S. between the ages of 25-34 is traffic accidents. A close second is poisoning and if you are a female between the ages of 35-44, poisonings are the leading cause of death-the #1 cause!  Men, statistics show that the leading cause of death in a U.S. male between the ages of 35-44 juggles between #1 and #2 top cause of death mentioned above. Men accounted for 71% of total deaths between the ages 35-44 caused by accidental prescription drug poisoning.

“An ounce of prevention is worth a pound of cure”.  How can we prevent us or our family members from being a statistic of Pharmaceutical addiction or worse, death?  We have already addressed who is at risk now let’s move on to why.

-Why do we have pain?  Pain is our bodies way of telling us that something is wrong and when you do a certain activity it makes it worse. This is an indication of major or minor injury.

-Where do we go to seek treatment?  If I am hurting I want to get out of pain fast- I get that.  But let’s face it, if you get hurt such as an auto accident not resulting in stitches or broken bones and go to your medical doctor the way they best know how to treat the pain is through prescription drugs. While there are times that do call for careful monitoring of these prescribed drugs many can be treated through non addictive alternatives with no side effects.

-What types of medicine do we choose to take?  Just because the doctor gave you a prescription for the medicine doesn’t mean that you need it.  Request something else that you can take that is less or non addictive.  Ask that you receive a smaller quantity with 0 refills.  Talk to your pharmacist about other medicines you are already taking to avoid drug interaction.

-When are you in pain and when are you need to take pain medication above and beyond the normal Ibuprofen?  When is it time to try another approach?

-How can you feel better without using prescription drugs?  In our office we want to get you out of pain quickly without the long lasting side effects.  First ICE, ICE, ICE any new injury or after surgery.  It is honestly the best form of pain management.  Ten minutes ON, 30 minutes OFF. Second correct the problem through chiropractic treatments to any painful joint wither it’s a knee, neck or any other joint.  Joints are built for the purpose of moving freely.  Chiropractic allows the joint to move properly.

In our office we want to get you out of pain quickly and then correct the problem, to prevent future problems.  I feel very passionate helping people live their life “pain free” or for some people it is more realistic to say less, more “manageable pain”.  I believe that through non addictive treatments with an ounce of prevention you and your family can stay clear of becoming a tragic statistic


American Association of Poison Control;

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!

Women’s Health


ImageOsteoporosis is the thinning of bone tissue and loss of bone density over time. There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include:

  • Bone pain or tenderness
  • Fractures with little or no trauma
  • Loss of height (as much as 6 inches) over time
  • Low back pain due to fractures of the spinal bones
  • Neck pain due to fractures of the spinal bones
  • Stooped posture or kyphosis, also called a “dowager’s hump”



Regular exercise can reduce the likelihood of bone fractures in people with osteoporosis. Some of the recommended exercises include:

  • Weight-bearing exercises — walking, jogging, playing tennis, dancing
  • Resistance exercises — free weights, weight machines, stretch bands
  • Balance exercises — tai chi, yoga
  • Riding a stationary bicycle
  • Using rowing machines

Avoid any exercise that presents a risk of falling, or high-impact exercises that may cause fractures.


Get at least 1,200 milligrams per day of calcium, and 800 – 1,000 international units of vitamin D3. Vitamin D helps your body absorb calcium.

dietFollow a diet that provides the proper amount of calcium, vitamin D, and protein. While this will not completely stop bone loss, it will guarantee that a supply of the materials the body uses to form and maintain bones is available.

High-calcium foods include:

  • Cheese
  • Ice cream
  • Leafy green vegetables, such as spinach and collard greens
  • Low-fat milk
  • Salmon
  • Sardines (with the bones)
  • Tofu
  • Yogurt

Quit smoking, if you smoke. Also limit alcohol intake and carbonated drinks. Too much alcohol or carbonated drinks can damage your bones, as well as put you at risk for falling and breaking a bone.

Osteoporosis is the most common type of bone disease.

Osteoporosis occurs when the body fails to form enough new bone, when too much old bone is reabsorbed by the body, or both.

Calcium and phosphate are two minerals that are essential for normal bone formation. Throughout youth, your body uses these minerals to produce bones. If you do not get enough calcium, or if your body does not absorb enough calcium from the diet, bone production and bone tissues may suffer.

As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes the bone tissue weaker. This can result in brittle, fragile bones that are more prone to fractures, even without injury.

Usually, the loss occurs gradually over years. Many times, a person will have a fracture before becoming aware that the disease is present. By the time a fracture occurs, the disease is in its advanced stages and damage is severe.

The leading causes of osteoporosis are a drop in estrogen in women at the time of menopause and a drop in testosterone in men. Women over age 50 and men over age 70 have a higher risk for osteoporosis.

Other causes include:

  • Being confined to a bed
  • Chronic rheumatoid arthritis, chronic kidney disease, eating disorders
  • Taking corticosteroid medications (prednisone, methylprednisolone) every day for more than 3 months, or taking some anti-seizure drugs
  • Hyperparathyroidism

White women, especially those with a family history of osteoporosis, have a greater-than-average risk of developing osteoporosis. Other risk factors include:

  • sodaAbsence of menstrual periods (amenorrhea) for long periods of time
  • Drinking a large amount of alcohol
  • Drinking a large amount of carbonated drinks (pop)
  • Family history of osteoporosis
  • History of hormone treatment for prostate cancer or breast cancer
  • Low body weight
  • Smoking
  • Too little calcium in the diet

If you feel that you are at risk or are interested in learning more on how to prevent osteoporosis happening to you give Dr. Collard a call 801-569-1141. Dr Collard is also available for free lectures on how to prevent osteoporosis.

Menstrual Problems/Irregularities

Many patients have found protection from unnecessary surgery, useless medication and needless suffering when they started to read drug product inserts; books on their condition; got second and third opinions; and, whenever possible, explored alternatives to hysterectomy and drug therapy. Remember, a healthy spinal column is essential for the health of the female reproductive system and it is vital for women with gynecological problems to have routine spinal checkups by a doctor of chiropractic. A chiropractic spinal examination could make all the difference between sickness and health.

Your Spine, Nerves & Hormones
The female sexual organs-the ovaries, oviducts (tubes), uterus, cervix, vagina, glands and related structures-all need a healthy nerve supply from the spine to function properly. Doctors of chiropractic help see that the sexual organ/spinal column relationship is a healthy one.

The Chiropractic Approach
Though not a treatment for gynecological troubles, the chiropractic approach has been a blessing to countless women with such problems. Chiropractors correct the vertebral subluxation complex (a dangerous condition in your spine that interferes with the nervous system and causes a state of “dis-ease” or reduced health and wholeness) that can lead to disease.

Spinal Care
It is no coincidence that many who suffer from menstrual cramps also suffer from neck or back pain. In one study of 122 dysmenorrhea sufferers, most had lower back problems and spinal displacements. Perhaps that is why many women who initially visited a chiropractor for neck or back problems experienced beneficial effects on menstrual cramps, pain and other gynecological problems. There are, however, many women who suffer from menstrual problems and other health conditions who will not go to the chiropractor because: “If I don’t have a backache, why go to the chiropractor?” Because of this misconception that chiropractors are “backache doctors” many never receive the true benefits of chiropractic care.

Many organs other than the sexual ones are responsible for reproductive health. For example, chemicals produced by the ovaries and adrenal glands that are essential for reproduction are broken down by the liver. If the liver isn’t working properly, these chemicals can build up to unhealthy levels and cause fibroid tumors in the uterus (leiomyomas), which, although benign, account for at least one-third of all gynecological admissions to hospitals.

The Spine/Pelvis Relationship
For over a hundred years, many women who have suffered from a wide variety of pelvic and gynecological conditions-from pain to PMS-have discovered the natural benefits of chiropractic care. Patients have also observed that menopausal symptoms including depression, hot flashes, back or joint pain, irritability, headaches or fatigue have been reduced from chiropractic spinal care. Dr. J. E. Browning is a doctor of chiropractic who has written extensively on the chiropractic management of patients with pelvic problems. His clinical observations have led him to state that, “Various disturbances in pelvic organ function have been successfully managed by chiropractic … symptoms [include] bladder, bowel, gynecologic, and sexual dysfunction …”

If you have any questions please give us a call 302.408.0000. Dr. Broskoskie will be happy to discuss with you how chiropractic, and therapeutic massage may help you.

Can Chiropractic Care Help During Pregnancy?

Chiropractic care and spinal adjustments help to ensure a healthier pregnancy, and alleviate some of the discomfort, as well as prevent future problems that may arise as a result of pregnancy.

Chiropractic care during pregnancy can be helpful in the following ways:

• Help to maintain daily activities during and after pregnancy
• Promotion of spinal stability
• Increased endurance
• Pain relief
• Improved physical fitness
• Promotes self care
• Aides a speedier recovery following childbirth

pregnancyChiropractors can evaluate and treat pain in the body, especially in the spine, joints, and muscles.  One of the most common complaints in pregnancy is muscle soreness and spinal discomfort.  Chiropractors perform safe treatments that will help maintain motion in the spine as well as soft tissue work and massage to relax muscles that have been strained due to the changes in the woman’s body.  Your chiropractor may also advise you on proper ergonomic positions for lifting, getting up from seated, and getting in and out of the car, to keep yourself from unnecessary strains on your body and decrease some of the common pregnancy discomforts.

Is Chiropractic Care Safe During Pregnancy?
Because chiropractors use a drug-free approach, chiropractic care is absolutely safe during pregnancy for both you and your unborn baby.  Chiropractors use special tables and treatments that are safe for the baby and equally as effective for you.  Because your body is going through a great deal of changes in a short time, it is recommended that you get regular chiropractic care, as this will keep your body limber and moving easily, thus aiding in a healthy delivery and faster recovery.

What Causes Back Pain In Pregnancy?
Back pain is a very common complaint during pregnancy.  This can be caused by a number of things.  It is most often the result of your center of gravity shifting with your growing abdomen, causing strain and stress on the muscles and ligaments surrounding your spine.  As you get further along in your pregnancy, a hormone called relaxin is produced to help your body loosen the ligaments in preparation for the birthing process.  Unfortunately, this can also be a cause of back pain, as well as pain in other areas of the body, as they are more easily strained and your body misaligned.  This hormone can remain in your system for some time after pregnancy also, causing instability in the joints.  Your chiropractor can give you some mild exercises to help re-strengthen the muscles of your back and abdomen, aiding in support of your spine.

How Can Chiropractic Care Help After Pregnancy?
One of the more common complaints following childbirth is lower back pain.  Due to the stress of carrying the baby, the relatively rapid weight gain, and hormonal changes within your body, the spine and the muscles surrounding it are strained and stretched.  Chiropractic treatments can help to restore your body structure to its pre-pregnancy state.

Can Chiropractic Care Be Helpful For My Partner And Baby?
Although mainly the mother experiences the majority of the changes during pregnancy, parenting a new baby can be physically and mentally demanding on the whole family, including the infant.  Parents often complain of beck and neck aches from holding and feeding their new baby.  The baby also goes through a demanding birth process, and a chiropractor can help your baby recover and adjust to their new environment.

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!

Chiropractic for Pregnancy

Chiropractic care can help the spine and pelvis cope with the effects of pregnancy by restoring a state of balance.Image

During pregnancy, a woman’s center of gravity shifts forward to the front of her pelvis. This additional weight in front, causes stress to the joints of the pelvis and low back. As the baby grows in size, the added weight causes the curvature of her lower back to increase, placing extra stress on the fragile facet joints on the back side of the spine. Any pre-existing problems in a woman’s spine tend to be exacerbated as the spine and pelvis become overtaxed, often leading to pain and difficulty performing normal daily activities.

Studies have found that about half of all expectant mothers develop low-back pain at some point during their pregnancies. This is especially true during the third trimester when the baby’s body gains the most weight. Chiropractic care throughout pregnancy can relieve and even prevent the pain and discomfort frequently experienced in pregnancy, and creates an environment for an easier, safer delivery. It is one safe and effective way to help the spine and pelvis cope with the rapid increase in physical stress by restoring a state of balance. In fact, most women have found that chiropractic care helped them avoid the use of pain medications during their pregnancy, and studies have shown that chiropractic adjustments help to reduce time in labor.

We should be your partner for a healthy pregnancy. We can provide adjustments, as well as offer nutritional, ergonomic and exercise advice to help address your special needs.

Chiropractic Tips for Pregnant Women

Be sure to get adjusted regularly. Chiropractic care is important to help maintain a healthy skeletal structure and nervous system function throughout a pregnancy and childbirth.

Do some gentle exercise each day. Walking, swimming, or stationary cycling are relatively safe cardiovascular exercises for pregnant women. Avoid any activities that involve jerking or bouncing movements. Stop exercise immediately if you notice any unusual symptom, such as nausea, dizziness or weakness.

Wear flat shoes with arch supports. Your feet become more susceptible to injury during pregnancy, partially due to a rapidly increasing body weight, but also because the ligaments that support the feet become more lax.

When picking up children, bend from the knees, not the waist. Your low back is much more prone to injury during pregnancy.

When sleeping, lay on your side with a pillow between your knees to take pressure off your lower back. Full-length “body pillows” or “pregnancy wedges” are very popular and can be helpful.

Eat several small meals or snacks every few hours, rather than three large meals per day. This will help alleviate nausea, stabilize blood sugar and allow your body to extract the maximum amount of nutrients from the foods that you eat.

Take a prenatal vitamin with at least 400 micrograms of folic acid every day; 800 micrograms is even better. Folic acid has been shown to dramatically reduce the risk of neural tube defects in a developing fetus. Be sure to check with your doctor before taking any vitamin or herbal supplement to make sure it’s safe for you and the baby.

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!

Chiropractic to Treat Whiplash

The most effective treatment for whiplash injuries is a combination of chiropractic care, rehabilitation of the soft tissues and taking care of yourself at home. Image

The term “whiplash” was first used in 1928 to define an injury mechanism of sudden hyperextension followed by an immediate hyperflexion of the neck that results in damage to the muscles, ligaments and tendons – especially those that support the head.  Today, we know that whiplash injuries frequently do not result from hyperextension or hyperflexion (extension and flexion beyond normal physiological limits), but rather an extremely rapid extension and flexion that causes injuries.

Due to their complicated nature and profound impact on peoples lives, few topics in health care generate as much controversy as whiplash injuries.  Unlike a broken bone where a simple x-ray can validate the presence of the fracture and standards of care can direct a health care professional as to the best way in which to handle the injury, whiplash injuries involve an unpredictable combination of nervous system, muscles joints and connective tissue disruption that is not simple to diagnose and can be even more of a challenge to treat.  In order to help you understand the nature of whiplash injuries and how they should be treated, it is necessary to spend a bit of time discussing the mechanics of how whiplash injuries occur.

The Four Phases of a Whiplash Injury

During a rear-end automobile collision, your body goes through an extremely rapid and intense acceleration and deceleration.  In fact, all four phases of a whiplash injury occur in less than one-half of a second!  At each phase, there is a different force acting on the body that contributes to the overall injury, and with such a sudden and forceful movement, damage to the vertebrae, nerves, discs, muscles, and ligaments of your neck and spine can be substantial. 

Phase 1

During this first phase, your car begins to be pushed out from under you, causing your mid-back to be flattened against the back of your seat.  This results in an upward force in your cervical spine, compressing your discs and joints.  As your seat back begins to accelerate your torso forward, your head moves backward, creating a shearing force in your neck.  If your head restraint is properly adjusted, the distance your head travels backward is limited.  However, most of the damage to the spine will occur before your head reaches your head restraint.  Studies have shown that head restraints only reduce the risk of injury by 11-20%.

Phase 2

During phase two, your torso has reached peak acceleration – 1.5 to 2 times that of your vehicle itself – but your head has not yet begun to accelerate forward and continues to move rearward.  An abnormal S-curve develops in your cervical spine as your seat back recoils forward, much like a springboard, adding to the forward acceleration of the torso. Unfortunately, this forward seat back recoil occurs while your head is still moving backward, resulting in a shearing force in the neck that is one of the more damaging aspects of a whiplash injury.  Many of the bone, joint, nerve, disc and TMJ injuries that I see clinically occur during this phase.

Phase 3

During the third phase, your torso is now descending back down in your seat and your head and neck are at their peak forward acceleration.  At the same time, your car is slowing down.  If you released the pressure on your brake pedal during the first phases of the collision, it will likely be reapplied during this phase. Reapplication of the brake causes your car to slow down even quicker and increases the severity of the flexion injury of your neck.  As you move forward in your seat, any slack in your seat belt and shoulder harness is taken up.   

Phase 4

This is probably the most damaging phase of the whiplash phenomenon.  In this fourth phase, your torso is stopped by your seat belt and shoulder restraint and your head is free to move forward unimpeded.  This results in a violent forward-bending motion of your neck, straining the muscles and ligaments, tearing fibers in the spinal discs, and forcing vertebrae out of their normal position.  Your spinal cord and nerve roots get stretched and irritated, and your brain can strike the inside of your skull causing a mild to moderate brain injury.  If you are not properly restrained by your seat harness, you may suffer a concussion, or more severe brain injury, from striking the steering wheel or windshield.

Injuries Resulting from Whiplash Trauma

Whiplash injuries can manifest in a wide variety of ways, including neck pain, headaches, fatigue, upper back and shoulder pain, cognitive changes and low back pain.  Due to the fact that numerous factors play into the overall whiplash trauma, such as direction of impact, speed of the vehicles involved, as well as sex, age and physical condition, it is impossible to predict the pattern of symptoms that each individual will suffer.  Additionally, whiplash symptoms commonly have a delayed onset, often taking weeks or months to present.  There are, however, a number of conditions that are very common among those who have suffered from whiplash trauma.

Neck Pain

It is the single most common complaint in whiplash trauma, being reported by over 90% of patients.  Often this pain radiates across the shoulders, up into the head, and down between the shoulder blades.  Whiplash injuries tend to affect all of the tissues in the neck, including the facet joints and discs between the vertebrae, as well as all of the muscles, ligaments and nerves.

Facet joint pain is the most common cause of neck pain following a car accident.  Facet joint pain is usually felt on the back of the neck, just to the right or left of center, and is usually tender to the touch.  Facet joint pain cannot be visualized on x-rays or MRIs.  It can only be diagnosed by physical palpation of the area.

Disc injury is also a common cause of neck pain; especially chronic pain.  The outer wall of the disc (called the anulus) is made up of bundles of fibers that can be torn during a whiplash trauma.  These tears, then, can lead to disc degeneration or herniation, resulting in irritation or compression of the nerves running through the area.  This compression or irritation commonly leads to radiating pain into the arms, shoulders and upper back, and may result in muscle weakness.

Damage to the muscles and ligaments in the neck and upper back are the major cause of the pain experienced in the first few weeks following a whiplash injury, and is the main reason why you experience stiffness and restricted range of motion.  But as the muscles have a chance to heal, they typically don’t cause as much actual pain as they contribute to abnormal movement.  Damage to the ligaments often results in abnormal movement and instability.


After neck pain, headaches are the most prevalent complaint among those suffering from whiplash injury, affecting more than 80% of all people.  While some headaches are actually the result of direct brain injury, most are related to injury of the muscles, ligaments and facet joints of the cervical spine, which refer pain to the head.  Because of this, it is important to treat the supporting structures of your neck in order to help alleviate your headaches.

Temporomandibular Joint (TMJ) Problems

A less common, but very debilitating disorder that results from whiplash is temporomandibular joint dysfunction (TMJ).  TMJ usually begins as pain, clicking and popping noises in the jaw during movement.  If not properly evaluated and treated, TMJ problems can continue to worsen and lead to headaches, facial pain, ear pain and difficulty eating.  Many chiropractors are specially trained to treat TMJ problems, or can refer you to a TMJ specialist.

Brain Injury

Mild to moderate brain injury is common following a whiplash injury, due to the forces on the brain during the four phases mentioned earlier.  The human brain is a very soft structure, suspended in a watery fluid called cerebrospinal fluid.  When the brain is forced forward and backward in the skull, the brain bounces off the inside of the skull, leading to bruising or bleeding in the brain itself.  In some cases, patients temporarily lose consciousness and have symptoms of a mild concussion. More often, there is no loss of consciousness, but patients complain of mild confusion or disorientation just after the crash.  The long-term consequences of a mild brain injury can include mild confusion, difficulty concentrating, sleep disturbances, irritability, forgetfulness, loss of sex drive, depression and emotional instability.  Although less common, the nerves responsible for your sense of smell, taste and even your vision may be affected as well, resulting in a muted sense of taste, changes in your sensation of smell and visual disturbances.


Dizziness following a whiplash injury usually results from injury to the facet joints of the cervical spine, although in some cases injury to the brain or brain stem may be a factor as well.  Typically, this dizziness is very temporary improves significantly with chiropractic treatment.

Low Back Pain

Although most people consider whiplash to be an injury of the neck, the low back is also commonly injured as well.  In fact, low back pain is found in more than half of rear impact-collisions in which injury was reported, and almost three-quarters of all side-impact crashes.  This is mostly due to the fact that the low back still experiences a tremendous compression during the first two phases of a whiplash injury, even though it does not have the degree of flexion-extension injury experienced in the neck.

Recovery from Whiplash

With proper care, many mild whiplash injuries heal within six to nine months.  However, more than 20% of those who suffer from whiplash injuries continue to suffer from pain, weakness or restricted movement two years after their accident.  Unfortunately, the vast majority of these people will continue to suffer from some level of disability or pain for many years after that, if not for the rest of their lives.

Whiplash is a unique condition that requires the expertise of a skilled health professional specially trained to work with these types of injuries. The most effective treatment for whiplash injuries is a combination of chiropractic care, rehabilitation of the soft tissues and taking care of yourself at home. 


Chiropractic care utilizes manual treatments of the spine to restore the normal movement and position of the spinal vertebrae.  It is by far the single-most effective treatment for minimizing the long-term impact of whiplash injuries, especially when coupled with massage therapy, trigger point therapy, exercise rehabilitation and other soft tissue rehabilitation modalities.

Soft Tissue Rehabilitation

The term ‘soft tissue’ simply refers to anything that is not bone, such as your muscles, ligaments, tendons, nervous system, spinal discs and internal organs.  During a whiplash injury, the tissues that are affected most are the soft tissues, the muscles, ligaments and discs in particular.  In order to minimize permanent impairment and disability, it is important to use therapies that stimulate the soft tissues to heal correctly.  These include massage therapy, electro-stimulation, trigger point therapy, stretching and specific strength and range of motion exercises.

Home Care

The most effective chiropractic care and soft tissue rehabilitation will be limited in its benefit if what you do at home or at work stresses or re-injures you on a daily basis.  For this reason, it is important that your plan of care extend into the hours and days between your clinic visits to help speed your recovery.  Some of the more common home care therapies are the application of ice packs, limitations on work or daily activities, specific stretches and exercises, taking nutritional supplements and getting plenty of rest.

Medical Intervention

In some severe cases of whiplash, it may be necessary to have some medical care as part of your overall treatment plan.  The most common medical treatments include the use of anti-inflammatory medications, muscle relaxants, trigger point injections and, in some cases, epidural spinal injections.  These therapies should be used for short-term relief of pain, if necessary, and not be the focus of treatment.  After all, a drug cannot restore normal joint movement and stimulate healthy muscle repair.  Fortunately, surgery is only needed in some cases of herniated discs, when the disc is pressing on the spinal cord, and in some cases of spine fractures.

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!

Neck Pain

ImageChances are, you’ve experienced a stiff or sore neck at one time or another. Given the complex mechanics and function of the neck, it’s no wonder that neck pain is so common. The neck supports your head, which may weigh 10 pounds or more, and needs to bend up and down and turn side to side. According to Renee Calliet, M.D. if the head weighs 10 lbs. and the center of the ear sits directly over the center of the shoulder, the load on the spine and its tissue is only 10 lbs. However, if the head is translated forward, its weight will increase by 10lbs. for every inch forward it is. In effect, if the center of the ear is 3 inches forward for the center of the shoulders, the weight of the head on the spine and its discs, joints and nerves is 30 lbs.(1)

Major neck pain or recurring pain is a definite sign that something serious is wrong. Even minor neck stiffness can be a signal that something is wrong inside your spine and you should seek a professional evaluation from a specialist, such as a chiropractic physician.

The Cervical Spine

The spine in the neck area is made up of seven bones called vertebrae. These vertebrae protect the spinal cord and nerve roots that exit from the spinal cord. Between the vertebrae are pads of tissue called discs that help cusion the vertebrae as the spine flexes and bends. A sudden injury such as a fall or a car accident may cause damage and pain in the neck. Often though, damage occurs slowly and silently over time from poor posture, wear and tear, lack of normal spinal position and movement even constant emotional stress from work or relationships.

Injuries and imbalances can cause cervical vertebrae to move out of their normal position or become restricted. Soft tissues (such as tendons, ligaments and muscles) can become inflamed, worn out and fatigued. The discs separating and cushioning the cervical vertebrae can begin to decay and lead to disc bulges or ruptures (herniation). Nerves can become pinched or irritated, with as little pressure as the weight of a dime, from misaligned spinal areas or bulging discs. Finally, the neck changes as we age. Arthritic changes in the spinal bones such as spurs (abnormal bony growths), disc degeneration, and muscle or ligament deterioration may change the normal, healthy curve of the neck and cause irritation to the nerves in the spine.

Symptoms of neck problems

Problems with the neck can lead to symptoms of pain and reduced range of motion (normal rotation should allow the chin to be nearly parallel with your shoulder). Neck problems can also lead to pain in the shoulder, arm, wrist, hands, or fingers. And even seemingly unrelated conditions can be due to neck problems: headaches, sinus congestion and pain, ringing in the ears(tinnitus), and vision disturbances have all been associated with neck dysfunction.

Care for your Neck

Many people seek the standard medical treatments for neck pain such as muscle relaxants, pain killers or tranquilizers. These medications only “cover up” the pain; they do nothing for the underlying cause which is why when you stop taking the pills the pain returns or increases. More drastic medical interventions include cortisone injections or surgery. Long term use of medications can lead to unwanted side effects and damage internal organs such as your liver and kidneys. There are over 400,000 deaths each year from inproperly prescribed medications. The chiropractic approach to treating neck pain doesn’t just treat the symptoms. The goal is to find what the underlying cause is and eliminate it. Your doctor of chiropractic will perform a complete history and thorough examination with special attention to the spine and its effect on the nervous system. Doctors of chiropractic are experts in the care of the bones, nerves, muscles and connective tissues that make up about 60% of your body. The conservative chiropractic approach is to find the source of the pain which most often is dysfunction (subluxation) in the vertebrae and correct it allowing the body to heal naturally. Once the dysfunction is corrected the spine moves normally and most importantly the spinal nerves are no longer irritated or pinched allowing proper nerve flow to the different body areas. Many research studies have proven chiropractic medicine to be more effective and safer the other forms of traditional care. One study, published in the Journal of Manipulative and Physiological Therapeutics found that patients who received chiropractic care reported significant improvement in their neck function and a reduction in their neck pain whereas those taking pain-killers did not.

1. Calliet R. Soft tissue pain and disability. Philadelphia: FA Davis Co., 1977

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!

Ergonomics and Back Pain

ImageSince contemporary society is becoming increasingly technologized, it’s no wonder that more and more so-called ‘white collar’ workers are seeing health issues, both physical and psychological — all because they are simply sitting down in a chair for too long. Not only do we spend the vast majority of our work days sitting in front of a computer screen, but most of our leisure time is spent in just about the same stance, as we play video games, watch TV, or browse the web.

People with poor posture will unconsciously perpetuate this fault while driving and even during their resting hours. This will dramatically increase several health risks, such as damage to the spine and back pain. Such issues start out as mere nuisances, but can soon develop into more serious problems.

Luckily, however, the science of ergonomics can go a long way in helping combat these issues. By becoming aware of your posture issues and working toward a more ergonomically-friendly environment at home and at work, you, too, can correct these problems before it becomes too late. Here are a few things you can do, in order to make sure that your poor posture doesn’t turn into a severe health threat.

  • Know your back pain

Bad posture is one of the leading causes of back pain, but it’s not the only one. You can tell if your sitting habits are the source of your sore back and neck, if you mostly experience such pains after long days spent working in a chair, yet not after more leisurely and active days, such as at the weekend. Posture-inflicted back pain will start in your neck area and travel down into your upper back, lower back, and limbs. It will also go away in the bat of an eye, if you stand up or shift positions – and, similarly, it can appear suddenly, when you get a new office chair, a new office, or a new car.

  • Take time to move

There is a vicious cycle at work, when it comes to back pain and poor posture: to a certain extent, they determine each other. After sitting for a long time, your muscular mass will grow tired, causing you to slouch or slump. In turn, this will shift your body weight to the sensitive areas of the neck and back. In order to prevent such mistakes, stand up, stretch, or take a brief, two-minute walk every other half an hour.

  • Buy ergonomically

Ergonomics is not some exotic, new-fangled thing-a-ma-jig. It’s been around as part-science, part-design for ages, and has led to the appearance of all sorts of back and posture-friendly objects and devices: from chairs for your office, to footrests, lumbar back support systems which you can carry along with you, lumbar pillows for intensive drivers, ergonomic bags and backpacks, as well as chairs with adjustable backrests, seats, armrest, etc.

Aside from this, it’s important to make sure your eyes aren’t unnecessarily straining your back. Adjust your PC screen to the position that comes most naturally to you and wear the correct prescription eyeglass lenses, to avoid tilting forward or straining your neck in other ways.

  • Use your chair wisely

It’s not like modern chair designers are completely unaware of the link between good ergonomics and a healthy back and neck. That’s why they’re designing office chairs to help users prevent such issues. The right way to use such seating is to keep the body aligned, with your body mass evenly distributed throughout your frame. Have your frontal, dorsal, and lateral body weight aligned as much as possible, and work on maintaining a vertical axis that goes down from your ears, through your shoulders and into your hips at all times – both when sitting, as well as while standing.

Remember that maintaining the same stance for hours on end will take its toll on your body, no matter how healthy the position may be. Rest your back in the chair every now and again, to avoid sitting up straight for too long a time. Also, avoid lack of balance, which is encouraged by such positions as crossed legs, hunching your back, tilting your head, or leaning to the side.

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!


Proper water intake is essential to health and healing.  The attached graphic shows just how important water is to our body systems.  If you happen to substitute coffee and soft drinks for water throughout the day then I suggest you start small.  I recommend my patients drink a glass of water with breakfast, lunch, and dinner to start.  Often, its difficult to cut out coffee/soft drinks/juice if you have been drinking them daily for years.  However, by starting with just 3 simple glasses of water per day, you will be well on your way to proper hydration.  Image

About the author:
Dr. Brian Broskoskie is a chiropractor at Results Chiropractic Center in Rehoboth Beach, Delaware. He is a graduate of Sherman College. Follow him on Twitter and be sure to LIKE his Facebook Fan page for daily health, exercise, nutrition, wellness, chiropractic tips and much much more!