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Archive for July, 2010

Prognosis Personal Injury Case:
The need for future care and the amount of settlement for that care is based on an accurate prognosis. Due to overuse, the term “guarded” has lost most of it’s meaning in the medical/legal world.

We contend a more accurate system will benefit the patient, insurance carrier, representing attorney, treating doctor, and most important, the profession as a whole.

The prognosis should encompass facts from the history of the accident, physical examination, and the radiographic studies.

Personal Injuries Lawsuit Fees:

As one might imagine, this is also a hotly debated subject. We fully believe the doctor has the prerogative to charge any fee he chooses for the level of service rendered.

For example, a charge of $5,000/visit can be made and reimbursement can be sought. However, it should be realized an uphill battle for total reimbursement will ensue. In other words, the fees charged may only be paid at the end of expensive litigation and in all likelihood will not be the amount billed.

We strongly suggest the doctors use fees which are both usual and customary to their geographic location.

Relative value studies can be a key to determine these fees. Use of these accepted relative value guides is a powerful weapon for the attorney when he argues the reasonableness of the charges as they are able to show the fees fell within an accepted range and do not represent an unreasonable amount on the doctor’s part.

The treating practitioner should realize both the legal and insurance communities consider all aspects of the personal injury case to be negotiable. This would certainly include the fees charged by the doctor.

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs. www.JonesPainRelief.com

Call Steve Jones at his San Diego Chiropractic Clinic

(619) 280 0554

www.jonespainrelief.com

Visit our Adjustable Economical Mouse Platform website to learn more about or Buy Ergo Nav

Visit my San Diego Chiropractic Website to make an appointment

Read More Articles on Chiropractic, Nutrition, Preventative Health, Back pain, Neck Pain and more

How Does Your Posture Affect Back Pain and Neck Pain?

Chiropractor, neck pain ,posture ,chiropractic ,back pain ,ergonomic

Have you ever wondered how it can be that you can sit around all day doing nothing strenuous and develop back pain or neck pain?  When you start to examine the structure of our bodies and apply some simple rules of physics, the fact that we don’t suffer from more frequent or intense back pain and neck pain is a wonder.  In my chiropractic office in San Diego, California, I see office workers on a regular basis that have significant back and neck complaints related to simple ergonomic issues.

Back pain or neck pain can affect anyone at any time.  I see patients that have injured their backs and necks from lifting, operating machinery, sports injuries, auto accidents and falls on a daily basis.  I would classify these injuries as typical or expected types of injuries.  Many non-chiropractic patients or new chiropractic patients would be surprised to find that the most common type of injury that I see in my office is not from lifting heavy sacks of concrete but from the long term consequences of postural stress.

Postural stress is the “silent killer” when it comes to our spinal health.  Postural stress occurs during both seated and standing positions.  Postural stress occurs any time that your spine looses its’ natural curves and / or moves forward beyond its neutral balance point.

An example of a posturally stressful position for your neck would be when you are sitting at the computer leaning your neck and head forward while keyboarding, mousing or viewing the screen.  Assuming a posture in which your head and neck are extended out in front of your body reverses the normal curve of your neck and shifts your head forward of its balance point.

When we assume postures that cause stress on our spines, the stability that is inherent in our structure when postural boundaries are respected is lost.  Postural stress exposes our ligaments and muscles to prolonged periods of stretching which results in fatigue, irritation, inflammation, back pain and neck pain and eventually arthritis.

Treating neck pain and back pain that has resulted from postural stress requires a multifaceted approach.  Chiropractic care combined with stretching and nutritional support will relieve the pain and stiffness and restore normal, full joint motion.  This part of your recovery may take several treatments or a lengthy treatment program based on the length of time that you have been in pain and the severity of your symptoms.

In addition to chiropractic care, you must eliminate or modify the causes of the postural stress.  A workstation analysis can reveal ergonomic issues that are instigators of postural stress.  Ice pack applications to the specific areas of neck pain and back pain in twenty minute sessions are also helpful.

The best way to begin your care is discuss your issues with your chiropractor.  Chiropractors are well trained in dealing with postural stress issues and the neck pain and back pain that result from it.  At my San Diego based chiropractic clinic we use a complete approach that utilizes chiropractic care supported by specific stretches and exercises.  We also encourage the proper nutritional support to facilitate the healing process.  Whatever approach that you take to relieve the pain of postural stress, please be aware of the importance of eliminating the source of the postural stress in addition to seeking treatment.

Bio for Article city

Dr. Steve Jones is a licensed Chiropractor in San Diego.  Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.   Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.  Click the following links to find out how we can help you start feeling better today! www.JonesPainRelief.com, www.ErgoNav.com

Repetitive Stress, Treatment and One Specific Ergonomic Improvement

Dr. Steve Jones practices in San Diego, California.  This article will relate his struggles to find appropriate and effective treatment for repetitive stress injuries (such as carpal tunnel syndrome, tendonitis, and symptoms including hand pain, wrist pain, neck pain, shoulder pain and elbow pain that were not extensive enough to warrant a specific diagnosis) and why his efforts eventually led prevention vs. treatment.
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Back in the middle part of the 1990’s, his practice started undergoing an unexpected  transformation.  He started seeing a tremendous number of people complaining of upper extremity pain that was obviously related to long hours of computer work. 

While he had studied carpal tunnel syndrome in school and had seen these patients in the past, the overwhelming numbers of these patients that were presenting to his office inspired a desire to learn more about these injuries.    

Standard conservative treatment for most types of repetitive stress injuries of the upper extremity involved some combination of wrist splints, elbow straps, massage, joint manipulations, ultrasound therapy, electrical muscle stimulation, trigger point therapy and icing.  Treatment for more advanced or debilitating cases could include cortisone injections and various types of nerve decompression surgeries. 

These treatments worked some of the time.  Most of the time treatment would provide temporary relief for short periods.  Many of those who would obtain relief from treatment would have periods of relief that would be punctuated by seemingly unprovoked exacerbations that would cause anger, frustration and depression in both the patient and Dr. Jones (I am sure that he was not the only doctor who was frustrated by treating these conditions). 
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For many of those patients who suffered with repetitive stress injuries, the end result of treatment was some level of disability followed by the loss of their employment. 

Carpal tunnel surgery is questionable, statistics that show that approximately 95% of all carpal tunnel surgeries are reauthorized one year after the initial surgery date.  How hopeless does that sound?

Dr. Jones had always been a compassionate, attentive doctor who listened to his patients.  He would pay careful attention to their complaints and as a result he started to notice certain common threads that linked his repetitive stress patients. 

Most of these complaints involved ergonomic issues that were easily fixed.  Some of these things included: having the computer monitor off to one side instead of placed in front of the patient, using the key board at the wrong height, and having a chair without armrests or postural correct supports.  Most of these issues were easy enough to fix.  The most common source of irritation that he was told of, however, was the neck, shoulder, elbow and wrist pain associated with mousing.

Continued……

Repetitive Stress, Treatment and One Specific Ergonomic Improvement 2

Call Steve Jones at his San Diego Chiropractic Clinic

(619) 280 0554

http://jonespainrelief.com
Visit our Ergonomical Device Website to learn more or Buy Ergo Nav

Visit my San Diego Chiropractic Website to make an appointment

 Repetitive Stress, Treatment and One Specific Ergonomic Improvement 1

First Read http://work-injury-workplace-safety.blogspot.com/2009/09/repetitive-stress-treatment-and-one.html

Continued…..

There are several benefits to this type of design.  First of all, a mouse platform that attaches to the armrest of the chair is natural and provides a constant distance between the mouse and the user.  With this design, the mouse is at your finger tips while your forearm comfortably rests on the armrest.  The other important feature of this design is that it allows the operator to sit back in his / her chair which allows for much needed low back and neck support. 

He purchased many of the mouse platforms that attach to the chair and started his evaluations of the available products.  This seemed like such a reasonable solution to such a common problem yet these products were not readily available.  He soon realized why.  Many were expensive and had complex attachment procedures.  Furthermore, they were big.  It was difficult to get close to your desk because they protruded off the end of your armrest by 8 to 10 inches.  Lastly, they were not adjustable.  How could these platforms be considered ergonomic without the ability to rotate or tilt the platform itself?
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After two years of development design and many different prototypes, he felt as though he had a solution.  Dr. Jones had developed a mouse platform that had a flexible attachment to the armrest of the chair, a smaller platform that didn’t intrude on the operator’s workspace and a platform that would not only laterally shift side to side, tilt side to side and tilt forward, but it would also tilt down and out of the way when having an attached product at the end of your armrest was not convenient.  

While he recognizes that this product is not a solution for all ergonomic issues for everybody, it is a valuable component of an ergonomically friendly work environment. 

When combined with a keyboard tray and a supportive chair with armrests that adjust up and down, this product makes for a very comfortable computer posture.

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Visit our Ergonomical Device Website to learn more or Buy Ergo Nav
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Call Steve Jones at his San Diego Chiropractic Clinic

(619) 280 0554

http://jonespainrelief.com
Visit our Ergonomical Device Website to learn more or Buy Ergo Nav

Visit my San Diego Chiropractic Website to make an appointment

The Causes of Back and Neck Pain and Chiropractic Treatment

My Chiropractic Office in San Diego California is like many across the United States.  While chiropractic care helps many different conditions, it is often viewed as treatment for back pain and neck pain.  Determining the specific causes of neck pain and back pain for each chiropractic patient is vital prior to the onset of any treatment.

When dealing with back and neck pain, it is important to have your pain evaluated by a professional.  Simply dismissing back or neck pain as typical and unimportant can be a very bad mistake.

Many conditions can cause back and neck pain, ranging from injury to infection to simply twisting the wrong way.   Traumatic injuries such as those sustained in an automobile or other type of accident can damage muscles, joints, ligaments, and vertebrae.
Overuse or under use of the back muscles is by far the most common cause of back pain that manifests as tightening or spasm of the muscles that connect to the spine.   Inflammation and swelling often occur in the joints and ligaments, especially in the cervical and lumbar regions, as people age.

A herniated disc occurs when the nuclear pulposus, the inner material of the disc, pushes through a tear in the annulus fibrosis, the outer material of the disc causing nerve root compression.   The cervical and lumbar regions of the spine have the most mobility and the discs there are more likely to wear down or be injured.  Ninety percent of disc herniations occur in the lower two lumbar vertebrae.

Spinal stenosis, the narrowing of the spinal canal, can cause spinal cord irritation and injury. Conditions that cause spinal stenosis include infection, tumors, trauma, herniated disc, arthritis, thickening of ligaments, growth of bone spurs, and disc degeneration.  Spinal stenosis most commonly occurs in older individuals as a result of vertebral degeneration.

A pinched nerve, or radiculopathy, occurs when something rubs or presses against a nerve, creating irritation or inflammation.  Radiculopathy can result from a herniated disc, bone spur, tumor growing into the nerves, and vertebral fracture, and many other conditions.

Sciatica is a certain type of radiculopathy that involves inflammation of the sciatic nerve. Pain is experienced along the large sciatic nerve, from the lower back down through the buttocks and along the back of the leg.

A spinal tumor that originates in the spine (primary tumor) or spreads to the spine from another part of the body (metastatic tumor) can compress the spine or nerve roots and cause significant pain.

Infections of the vertebrae (e.g., vertebral osteomyelitis), the discs, the meninges (e.g., spinal meningitis), or the cerebrospinal fluid can compress the spinal cord and result in serious neurological deterioration,  if it is not diagnosed and treated immediately.

Facet joints allow movement of the spine.  The facet joints are formed by two adjacent vertebra and direct or guide movement of the spine.   As facet joints degenerate, they may not align correctly, and the cartilage and fluid that lubricates the joints may deteriorate.  Bone then rubs against bone, which can be very painful.

These are just a few of the conditions that can cause back pain and neck pain.  Thankfully, most cases of back pain and neck pains are related to mechanical causes and can be readily addressed by a trained chiropractor.  The point is, however, pain is a warning signal that should not be ignored.  The best place to have your back and neck pain evaluated is with a chiropractor.

Bio Dr. Steven R. Jones is a licensed Chiropractor in the state of California.  He recieved his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California.  Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.  Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.  Click the following links to find out how we can help you start feeling better today! 

http://jonespainrelief.com

Chiropractic, neck pain, San Diego, back pain, chiropractor, treatment

Stretching and Chiropractic – Try to be More Flexible in 09-10

The headline of this article could be interpreted in a variety of different ways.  For the purposes of this blog post it will address our physical flexibility.  Flexibility is an important measure of our physical fitness.  Flexibility is just as important to our overall health as is strength, endurance, aerobic capacity and body composition. 

One of the big problems that I encounter with my patients in my San Diego Chiropractic office is a lack of flexibility in the joints.  Strong muscles that span flexible joints are ideal for everything from mundane household chores to weekend athletic adventures.  A lack of stretching catches up to us when we perform movements beyond the normal for our lifestyles or activities.  In some cases, an extreme movement can be something as simple as reaching to the table behind you for your cup of coffee.  Neck pain, back pain, arm pain and leg pain can all occur as a result of injuries due to inflexibility.

As a general rule, as our bodies age, our physical fitness degrades.  Regarding flexibility, we tend to loose it.  That is why it is very important to develop flexibility when we are younger and maintain it as we get older.  Even those of us in our forties or older must try to regain some and maintain most of our flexibility even though we are not 20 something anymore.

I always tell people to think about how much strength, endurance or in this case flexibility that they have lost in the last 10 or 20 years.  I know that I am not as physically fit as I was when I was 20 or even 30 years old.  There is no way that I want that same trend to continue over the next 20 years.  In order to prevent the atrophy of our bodies we have to maintain them through stretching and exercise.

In addition to perhaps regaining the ability to touch your toes, becoming more flexible will also help in the following ways.

1)    Helps Relieve Stress:  Flexible muscles are loose and relaxed muscles.  Loose, flexible muscles are less likely to tighten up during stressful, tense situations.
2)    Helps Improve Posture:  Loose muscles help your body maintain better posture.  Avoiding unnecessary postural stress will help you feel better.
3)    Helps Increase Circulation:  Increased circulation comes as a result of consistent stretching.  Improved circulation helps bring nourishment to your muscles while removing toxic build-up of lactic acid and other waste products.
4)    Helps Improve Coordination:  Stretching will improve your joints range of motion providing for better balance, mobility and coordination.  Improved coordination will help us with all athletic activities and help prevent falls as we age.

I always recommend stretching in the form of Yoga.  Stores like Target have many instructional DVDs on Yoga.  Linda and I have always found that Rodney Yee produces better than average DVD courses on Yoga.  If you are not experienced in Yoga you will need to start with a beginners course, many people look at Yoga and assume that it is easy.  THIS IS NOT THE CASE.  Yoga is not only a great stretch but an excellent work out and you can hurt yourself if you over-do it.

Some guidelines for safe stretching include:
1)    Warm up Before You Begin
2)    Don’t Bounce While Stretching
3)    Avoid Pain While Stretching – It Should Feel Like A Good Stretch – Not A Painful One
4)    Stretch Both Sides
5)    Stretch Both Before and After Exercise    

Writers Bio

Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Better Health Steve Jones

Call Steve Jones at his San Diego Chiropractic Clinic

(619) 280 0554

http://jonespainrelief.com

Visit our Ergonomical Device Website to learn more or Buy Ergo Nav

Visit my San Diego Chiropractic Website to make an appointment

Chiropractic and Nutrition – Why Not?

So you’ve had a Birthday and you’re thinking about your youth that’s slipping away.  I would like to go back to 30 myself.  Of course there are some things we can do to help feel more youthful and have more energy.

Some San Diego Chiropractic offices include nutrition in their practices.  Nutrition is a logical component of helping patients regain and maintain their health.  That being said, I do have a good grasp of some of the concepts employed by chiropractors and other doctors regarding testing for nutritional deficiencies.

I have always liked measured outcomes.  Granted, in health care, many times “improvement” in a patients’ condition is driven by the patients’ symptoms. 

In other words, when the patient is out of pain, they are done with care!

This is seldom a good call, most of the time it isn’t.  Even doctors are advised against making judgments regarding delivery of care for their own illnesses.  After all, many patients are riddled with cancer or have major blockage in their hearts’ arteries yet the patient has no symptoms.  Like any of these conditions, treatment for even seemingly minor symptoms is best when delivered until the illness is completely resolved.

Our state of wellness is fleeting and worsened when we ignore signals that we are losing our health. 

We can develop mild symptoms like insomnia or anxiety or fatigue for example and attribute them to something other than some internal issue.  Often our symptoms are attributed to things such as work stress or relationship problems.  While those stresses are contributors to our symptoms, diet and ultimately nutrition take the lead role in producing symptoms of ill health.

I recently made the decision to have a hair analysis performed for mineral content.  The lab that we are now using for hair analysis uses state of the art equipment to analyze the hair sample then they generate a report containing specifics regarding their findings.  They also include recommended supplements and gobs of information regarding the consequences of their findings.

Having considered myself above the average as far as my health goes, I was shocked by the reports findings. 

This report is exactly what I need to drive my nutritional supplement schedule.  It provides a measure of where I am and what I should take to get where I need to be.

For those of you who have dismissed the findings of a hair analysis as inaccurate, advances in this procedure over the last ten years have made the results as accurate as blood tests.

So get serious about getting healthy, do yourself a favor and get a hair analysis.  It will do wonders with guiding your nutritional plan and it will keep you on track toward better health!

Writer

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment

Better Health Steve Jones

Get Better Sleep With Nutrition

Some time ago I did an article on my nutritional state. I am doing this for several reasons.

I want to get healthier. I had a fantastic educational experience in nutrition 18 years ago while in Chiropractic College; to my dismay implementation of my nutritional education has been absent from my San Diego chiropractic office. I take responsibility for this; as my focus has been on helping patients with specific complaints of neck pain, low back pain, headaches and the like.

Secondly, before I implement anything into my patients’ care I like to be on board with it so I can have first hand experience with its benefits. Nutrition is no different. I have been hit and miss with my diet and supplements for years – it is time for a change.

To recap my first post on this topic, I had a hair mineral analysis performed approximately one month ago. The results revealed deficiencies in many nutrient minerals. Some of the minerals that I was deficient in have the ability to cause anxiety and may affect my ability to sleep soundly. Both anxiety and insomnia are conditions that I have struggled with for years.

The lab that I used for my hair analysis not only provided a report regarding my deficiencies, but they also gave me a supplement recommendation list that I could use to restore proper mineral balance in my system.

As of the date of this post, I have been taking my supplements as advised by the lab for about ten days. At this point I feel a bit clearer headed and I have slept soundly for over 7 hours per night over the last three nights. I know that three nights good sleep is not a fix, but it is unusual. In a typical month I usually only get two or three good nights sleep.

Three good nights sleep in a row is a record for me and enough evidence to justify continuing with my nutritional supplements.

In a few weeks I will post again on this topic to let you all know how I am progressing.

Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.

Call Steve Jones at
(619) 280 0554
San Diego Chiropractic

ADJUSTABLE MOUSE PLATFORM Website to learn more about or Buy Ergo Nav

Chiropractic San Diego Website to make an appointment
Better Health Steve Jones