Why an MRI Is Not the Best Ligament Injury Imaging Test

Why an MRI Is Not the Best Ligament Injury Imaging Test

Warning: American Family Doctors Publication Shows 90% of Back Injuries Are Improperly Diagnosed

In this article we want to discuss an article that was published in the American Family Physicians Journal. This article brings up a topic that I’ve been talking about for years. And it’s only gotten worse. This article claims that 90% of today’s injured patients who’ve suffered a back or neck injury are working with doctors who do not have a clear understanding of their injuries. Wait, it gets even worse.

There’s A Familiar Lack of Understanding Present in This Article

These same doctors are unable to find the underlying physical conditions of these injuries at a time when these back and neck injuries have never been easier to diagnose. We’ve gone over this before and I am not going to go into depth in this article abut the role that an MRI and stress radiological studies play in picking up the two key bio imaging markers for these injured patients. These injuries account for:
  • #1 Cause of disability and chronic pain: Lumbar Spine Injury
  • #4 Cause of disability and chronic pain: Neck Injuries
  • #6 Cause of disability and chronic pain: Headaches associated with an injury to the ligament of the cranio-cervical junction or the cervical spine itself
I want to go over this with you in detail. I’ll put a link to the article here which appears on the American Family Physician website. The article we’re going to break down is the one called “Non-Specific Low Back Pain in Returning to Work” You can open it up and follow along with me.

I’m going to point out some things that are very prevalent in the market today and this is exactly what needs to change.

It says that as many as 90% of persons with occupational non-specific low back pain are able to return to work in a relatively short period of time. Now, I’m going to contest this point and quite a few other things in this article. You see, this position paper is a telltale sign of today’s market and it’s pushing the agenda that if there are no red flags with a patient, we as doctors can get them back to work quickly.

What are these red flags, you ask?

  • Infections
  • Fractures
  • Cauda Equina Syndrome
If one of these isn’t present a patient should be encouraged to remain as active as possible. We should minimize bed rest. It states that we should advocate the use of hot and cold compresses to minimize swelling and tell patients to take anti-inflammatory medications as desired.

What this article is telling doctors to do…

These patients need to take part in home exercises and be returned to work as soon as possible. Medical and surgical interventions should be minimized when abnormalities are not found in physical examinations. Patients who are having difficulty returning to work after four to six weeks should be examined and studied for possible personal and occupational psychosocial factors. A multidisciplinary program should be strongly considered to prevent a delayed recovery in those patients struggling to return to normal baseline activities and pain levels. One of the biggest problems I see with delayed recovery is that it is often the result of a delay of an accurate diagnosis of what the problem is in the first place. This article rightly points out that these medical doctors openly admit that they do not know what the underlying pathology is as you’ll see here. So, it goes on to say that patient advocacy should include unnecessary and ineffective medical and surgical interventions, work loss, joblessness, and chronic disabilities. The next thing the article states is that the management of low back pain and determining a patient’s safe return to work are common issues encountered by family physicians today.

Challenges include unfamiliarity with:

  • A patient’s individual job demands and requirements
  • Complex Workers’ Compensation systems
  • The vast array of diagnostic and therapeutic interventions of questionable effectiveness and value
The medical doctors in this article are actually openly admitting that most of the diagnostic and therapeutic interventions they order have questionable effectiveness and value when it comes to treating and diagnosing these injured patients.

Clearly, the object of this article is to encourage a plan of conservative care.

What is conservative care?
  • Physical Therapy
  • Chiropractic
  • Massage
  • Acupuncture
This is what most family doctors follow when they talk about following a conservative care path for their injured patients with occupational low back pain. This article throws around a lot of terms, so let’s take a moment and define one of them. Occupational nonspecific low back pain is pain that occurs predominantly in the lower back without neurological involvement or serious pathology. Let’s be real here, okay?

What they are basically promoting in this article is an early return to work for injured patients. And that right there is a huge part of the problem.

It says that according to the United States Bureau of Labor Statistics that there were 4.2 million non-fatal occupational injuries or illnesses reported by private industry. Sprains and strains accounted for approximately 42% of the injuries. So, as doctors they need to understand that when we look at the number of injuries, those involving the back is number one. It’s the number one cause of chronic pain and disability in the world today. And if you remember as I stated earlier the next is number four. That’s a huge number of our injured workers. So, sprains and to the back and neck are going to require doctors in the market who understand what a bio imaging marker looks like in an injured patient with neck or back complaints. Meaning, you will no longer have patients walking around with an incorrect diagnosis of nonspecific mechanical low back pain.

The Role of Risk Factors in Diagnosing These Injuries

This article goes on to attribute the cause of this nonspecific low back pain to certain risk factors. That’s because these doctors will openly tell you that they have no way of accurately diagnosing these patients. In general, medical doctors cannot clearly identify the cause of this pain in 90% of the patients they see. Now, when I say medical doctor, I’m talking about general practitioners. Now, it goes on to say that some physical demands including manual lifting, bending, twisting, and whole-body vibration are associated with an increased likelihood of low back pain. Please note: Association is not equivalent to causation. It should also be noted that personal and occupational psychosocial variables play a more important role in spinal pathology than just the physical demands of the job.

And that’s where it can get kind of tricky…

They openly admit they don’t know the cause of this low back pain, yet in a sentence or two later they are saying there’s strong evidence that personal or occupational psychosocial variables play a more important role in these injuries than the spinal pathology itself. Now, that my fellow doctors… Could not be further from the truth.

Let’s look at what they list as psychosocial risk factors:

  • Depression: Well I would argue that anybody who suffers from chronic pain and cannot get help from the medical community might exhibit signs of depression. Especially in an active person who cannot find relief or understanding from a doctor who understands their condition.
  • Education Level: This is an understanding and belief that those with lower education levels are more prone to chronic disabilities. Again, what does someone’s education level have to do with an injury. Isn’t more likely the case that a doctor who cannot solve a problem with an accurate diagnosis is likely to blame a patient’s lack of education as the basis for the patient himself not understanding their own injury?
  • Excessive Pain: Well, if you are in constant pain and the medical community is not offering relief, over time this can build up. Is there anyone who wouldn’t say that this amount of chronic pain would be classified as excessive?
  • Fear Avoidance: If you are suffering and unable to find anyone to help you, it’s fair to say that you would fear returning to the same position that caused you pain. That’s a totally legitimate concern. That’s not something I would classify as fear avoidance or job dissatisfaction.
  • Somatization disorder: That is when you are putting too much attention on a condition. Si, again if the doctor cannot figure out what the problem is, if they cannot get to the underlying problem that is going to cause you some obvious distress. It would be hard to imagine a condition like this not dominating your life. So, this talk of “putting too much attention” on this condition seems to be unfair from the patient’s point of view.
  • Unemployment Compensation: What does this have to do with a medical condition? If you’re unemployed and trying to get money to live on from an employer whose job caused your injury, I do not see how that causes pain. I would say it’s the same thing with workers’ compensation claims. It’s not fair to say that legitimately injured patients are trying to distort their injuries just to receive some compensation.
All these issues are problematic when you consider what is really going on.

There is no standardized method of diagnosing these injuries.

Even my own profession of chiropractic is problematic. They have not and are unlikely to standardize the workup of these injuries. The major chiropractic schools don’t even teach bio imaging markers that are consistent with soft-tissue injury to the spine. So then, this becomes the problem that all professions have: physical therapy, chiropractic, Medical doctors, medical specialists. They all have the same problem. No knowledge of what is going on with these types of injuries and no way to consistently diagnose them. This is why SmartInjuryDoctors are so important in the market today. I hope that what I just laid out for you is something that you enjoyed because 90% of the patients suffering from back and neck injury should not be working with any doctor who is incapable of diagnosing the underlying condition. Most of these doctors, no matter what their specialty are just making the same mistakes over and over. They end up relying on articles like this one to justify their rush to return patients to the work force. Patients who are still injured and still in pain.

That is what I am trying so hard to change.

With these articles, my podcasts, my videos…I’m trying to reach doctors wherever they are and show them a better way of doing things. That’s what the SmartInjuryDoctors Program is all about. We need the injury market to change because the patients deserve to work with doctors who not only care, but doctors who can get real results. For more information on Spinal Ligament Injuries please check us out at www.smartinjurydoctor.com or check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher. For information on spinal ligament testing by board certified medical radiologists go to www.thespinalkinetics.com

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The Spinal Ligament Injury Niche is a RICH UNTAPPED Market for the Leaders of Every Profession!

The Spinal Ligament Injury Niche is a RICH UNTAPPED Market for the Leaders of Every Profession!

The Spinal Ligament Injury Niche is a RICH UNTAPPED Market for the Leaders of Every Profession!

Why do I say the Spinal Ligament Injury Market is a RICH UNTAPPED market for the LEADERS of every profession? Simple, today by statistics the majority of providers are awful at treating this condition (Spinal Ligament Injuries)! What I mean by that, is that the current researched statistical outcomes of these patients are really bad! No one can deny that! If the patient’s outcomes are bad, what does that say for the professionals that treat them? Must be bad right?

This of course provides an unprecedented opportunity for the Leaders of the various professions (Chiropractic, Medical Regeneration, Medical Specialists, Physical Rehabilitation Specialists) to clean up in this market. Why or how you may ask? The why is because there has never been a higher market need for doctors who are focused on, and can deliver great treatment results. The how, of course is establishing your Unique Selling Proposition (what make you unique in the market) through consistent market messaging that is easy and really cheap to do today! Most doctors in this market are not even sure how to accurately diagnose spinal ligament conditions let alone how to get great results with them. But this does not have to be true for the leaders.

As the Director of Education Spinal Kinetics (www.thespinalkinetics.com) I put out a YouTube Video a number of years back called the “Whiplash Statistics Don’t Lie” ( https://www.youtube.com/watch?v=st5bwC411VU ), and in that video I listed 41 studies that show the dismal outcomes of the patients with this type of Spinal Trauma. Car collisions are not the only mechanism that delivers this type of spinal ligament injury, there can be work related mechanisms, sports related, slip and fall, violence related, war related etc. As a matter of fact, Spinal Ligament Injuries are the number one cause of Pain & Disability in the world today, as explained to the world by the 2010 Bone & Joint Decade Report called, “The Burden of Musculoskeletal Diseases in the US.”

“Whiplash” from car collisions of course gets a lot of play because it routinely causes these types of injuries, and it can be an incredibly lucrative source of income for the doctors that treat them. Herein lies the problem for the gifted providers, the LEADERS mentioned above, that get great results with these injuries and should be the doctors that are treating everyone in their local community. If this is you listen up!

In the past and even in some cases today, many very average Doctors teamed up with very average Personal Injury Attorneys that MARKETED LIKE MAD to bring these injury patients into the attorney’s office, and then these same patients were sent out to the clinics that were “on the team” so to speak. Most of the time these offices were Doctors of Chiropractic, and their known purpose was to treat these patients quickly and keep that treatment bills very low. Treatment was one size fits all (everyone got the same treatment). These as you may suspect in many cases, were and are not the clinics that were setting records for stellar patient results, far from it. In my experience these clinics were often under-diagnosing the patient’s condition as well and under-treating, which is why their patient outcomes were so bad! These clinics were more interested in caring for the referring attorney needs as opposed to the needs of the treating patients! They seemed to be more interested on how they could make more money for their referring attorneys, so that they would continue to refer! Patient benefits, and patient results were far down the list.

As a doctor, making plaintiff attorneys money is very easy to do, as it is accomplished by getting really bad results with your patients. The worse results that you as a doctor can get with your patients, the more benefits that they (the patients) are going to need in the future, and the larger the patient settlements are in general. Bad patient results in treatment will increase the settlement and make the referring attorney more money! Patients in these clinics are at excessively high risk to come out of their treatment experience with a chronic problem. The treatment was short and the cost was low, they quickly had their claim settled and now however they still have chronic low back pain from their injuries. What is their financial exposure?

The American Pain Society in their 2007 Low Back Pain Guidelines (1) state the following on page one: “Medical treatment for chronic low back pain is estimated to cost $9,000 to $19,000 per patient annually…” So if patients come out of their injury treatment with chronic lower back pain as an example, their personal financial risks could be substantial! This should be very clear to see.

What is even more unpalatable is that these so called “team clinics” that are controlled by their referrals sources (attorneys), have to ask their referral sources it they can do diagnostic procedures that will show the severity and location of their patient’s actual injuries. Many say no, so often these patients go with serious ligament injuries that are missed. Again in my experience these clinics were more interested in the attorneys need for low bills over the patients’ needs for complete and accurate diagnosis of their injuries and effective care! You see low treatment bills make it very easy and extremely profitable for the attorneys to “turn the settlement out”, regardless of the patient’s actual results in injury recovery.

These “Team Clinics” have also seriously contributed to the profession of Chiropractic’s public image problem. In a Gallop Poll, Americans polled had a very low opinion of Chiropractic’s Ethics and Honesty. (2) As a matter of fact the profession of Chiropractic was the lowest of all of the Primary Healthcare Providers tested.

All the above being said let’s find out what the true professional leaders in the fields can do to establish and take more market share in their local markets!

These are the doctors that should be treating these Spinal Ligament Injury Patients! These are the providers that excel at great patient results and they also know that these are not just “soft tissue” injuries! These are the doctors that are not owned by anyone! Their allegiance is geared toward anything that can improve the patient outcomes. They excel in the ability to accurately diagnose the patient condition as well as treat it. They are very good in Chiropractic, Medical Regeneration (PRP, Prolo, Stem Cells), Physical Rehabilitation, Pain Management or other Medical Specialties. These providers often have a network of referral providers in each of the above categories, as they are not too proud to know they may need help!

If this is you, you may have the question of what can I do to get above the noise in my local area? What can I do to publicly market to my community why they should be coming to our treatment facility for help, especially for Spinal Ligament Injuries?

This is done by knowing what makes you unique as well as very consistent messaging that is being posted everywhere about your clinic. With today’s social media outlets, it is very easy to get known in your communities. The key factor though is being first to the market in this new approach, in this patient results approach!

For Healthcare Providers that want to do more in this niche, I have set up an online Clinical Training & Marketing Portal. You can reach it at www.smartinjuryeducation.com In this portal I have a whole clinical course on spinal ligament injuries. This is what one provider said about it today in an email, “THANK YOU, the program is absolutely great, I cannot believe how much I am learning and who would have thought that after 28 years being a Chiropractor that I still have the time, energy and passion to keep learning and improving what we can do for our patients. THANK YOU THANK YOU” So we educate on the clinical side and then provide the marketing side!

Every month now we deliver new marketing materials (like the piece above) for you to flood your local market with—all done for you! We also have a monthly implementation call for you or your clinics marketer. This is a Webinar/Conference call where we explain what that months marketing message is and how to get it out! This service is comprehensive, very inexpensive and can be located at www.smartinjuryeducation.com

For more information on Spinal Ligament Injuries please check us out at www.smartinjurydoctor.com or check out our SmartInjuryDoctors® Podcasts on Apple Podcasts, Spotify, Google Play or Stitcher.

For information on spinal ligament testing by board certified medical radiologists go to www.thespinalkinetics.com

Thank You

Dr. Cronk

  1. http://americanpainsociety.org/uploads/education/guidelines/evaluation-management-lowback-pain.pdf
  2. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=52038

Want to learn more about Smartinjurydoctor's Program?

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The Question Doctors Can’t Answer Regarding Spinal Ligament Injuries?

The Question Doctors Can’t Answer Regarding Spinal Ligament Injuries?

The Question Doctors Can’t Answer Regarding Spinal Ligament Injuries?

Spinal ligament injuries are the number one cause of pain and disability in the world today. Patients can become involved in many different kinds of mechanisms capable of causing a spinal ligament injury, such as work related injuries, car collisions, sports collisions, slip and fall, domestic violence, war, to name a few. The video below takes one mechanism (Whiplash from Car Collisions) and shows the dismal statistics that result from patients being treated for these injuries. These unfortunately are the statistics of our doctors today.

Why would these statistics be so bad when we are supposed to have the worlds best healthcare system? Perhaps the answer to this question is so simple that it has been overlooked. What is perhaps the most important question that most doctors that treat these spinal ligament injuries cannot answer? The answer when I share it will make it self evident why we today have such poor patient outcomes from such a simple injury.

The most important question that the majority of doctors that treat these spinal injury patients simply cannot answer is: “where exactly is the spinal ligament injury and how bad is it”? If a doctor does not know the exact location and severity of a injury, how in the world can we expect the patient to have a optimal outcome with their treatment? This then becomes a very important question that any treating provider had ought to be able to answer right away!

It is not enough today to simply say that the patient has injured their neck (#4 Cause of Disability Worldwide) or their lower back (#1 Cause of Disability Worldwide), or to simply say that they have sprained these areas. This tells us nothing as it is not specific enough. Todays doctors need to be able to tell us what spinal motion units are involved, and how bad is it?

Today there are specialized radiologists that can help doctors to determine the severity and location of these spinal ligament injuries through the use of Computerized Radiographic Mensuration Analysis. I recently wrote an article on it called: Today’s Radiologists Can Help Doctors Accurately Determine the Severity of Spinal Ligament Injuries.

Today no doctor should be treating these conditions without this type of information, as it puts the patient at risk for less than optimal recoveries and I believe it can put the doctor at risk for malpractice if the patient experiences an adverse response to their treatment. This is precisely why I developed a online education program that any doctor can take in order to become more competent with these kinds of injuries.

This educational program can be found at www.smartinjuryeducation.com Patients deserve the best and that’s what we as their doctors need to bring to them.

 

Want to learn more about Smartinjurydoctor's Program?

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246 Tierney Drive, Suite 1,
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Smart Injury Doctors
701 Richards Ave
Clearwater Florida 33755

labell@biocyberneticsinc.com
Call Lee Ann at 1-800-940-6513, ext 700

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© 2019 Biocybernetics Inc.

Today’s Radiologists Can Help Doctors Accurately Diagnose Spinal Ligament Injuries

Today’s Radiologists Can Help Doctors Accurately Diagnose Spinal Ligament Injuries

Today’s Radiologists Can Help Doctors Accurately Diagnose Spinal Ligament Injuries

Spinal ligament injuries are the number one cause of pain and disability in both the US and the World today. In the past doctors have absolutely struggled to determine the severity and location of these injuries. This fact alone has probably been the biggest reason why this relatively simple injury has caused so much trouble for so many people.

Patients have been walking into their Chiropractor, Osteopath or Medical Specialist with spinal ligament injuries from car accidents, slip and falls, work related incidents, sports related incidents and all manor of other incidents that can cause the spinal ligaments to over stretch and tear. These same patients for far too long now have had these doctors construct a treatment program without knowing the severity and location of the actual ligament injury of the spine. The result of which all too often is a patient that treats for months on end, sometimes years on end and comes out of that process with a chronic problem that does not seem to have any solution. These patients have often been manipulated, massaged, exercised, worked out, drugged, had their nerves burned, and still the condition does not fully resolve.

When conditions do not resolve the cause has not been fully understood. Jeffrey A. Cronk DC, JD

Not an ideal result and is perhaps the biggest reason why over 100 Million people in the US suffer from sort of chronic pain—with neck and back pain being the most common.

Today this no longer needs to happen, and today any doctor can get assistance in determining the location and severity of these injuries with the help of specialized radiologists utilizing sophisticated technology that can allow them to accurately measure “joint laxity” of the individual spinal motion units. Obviously the more laxity the joint has the more damaged the restraints (ligaments) are that are designed to keep it in alignment. Todays modern specialist can now take the inter-segmental motion report, understand where the problem is and set up a much more targeted treatment program to stabilize the now known area of instability. This of course will lead to better results with less care in many cases.

Now doctors can understand exactly where these spinal injuries and their treatment programs can be much more targeted and effective as a result.

For more information on the this national radiology service, doctors can go to www.spinal-kinetics.com

For more information on how to become more of your areas spinal ligament injury specialist, providers can go to www.smartinjuryeducation.com

Want to learn more about Smartinjurydoctor's Program?

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Smart Injury Doctors
701 Richards Ave
Clearwater Florida 33755

labell@biocyberneticsinc.com
Call Lee Ann at 1-800-940-6513, ext 700

SEARCH THIS SITE

© 2019 Biocybernetics Inc.

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