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Dear Dr. Caraotta,
I was at a traffic signal last month, and was rear ended by another vehicle. My car was forced into the intersection. I swerved to the right, went over a curb and hit a pole. My head whipped back and forth, and I hit the head rest quite hard. I went to the emergency room after the accident. The doctor examined me, took x-rays and told me that I had a neck strain. He gave me pain medication, but the pain is gradually getting worse and I am having pain, tingling and numbness down my right arm. I was told to see an Orthopedic doctor, but I can't get in for another month. I noticed that your office does Orthopedics as well as Chiropractic. What do you think is going on and can you help?
Dr. Caraotta's Response
It is important to rule out several conditions in patients who sustain head and neck injuries. Some possible injuries from what you are describing can include an internal or external nerve impingement, a reactive degenerative disc syndrome, a thoracic outlet syndrome, a disc herniation, and / or a whiplash syndrome. Without examining you, we cannot render a specific diagnosis, however from clinical experience in Chiropractic and Orthopedics,it is likely that your arm pain is related to a nerve complex originating from the middle of your neck.
All the nerves that go into the arm come from the neck. When a person has an impingement in the neck, this often produces pain, tingling and numbness in an extremity.
Where x-rays evaluate bone structure, an MRI evaluates the soft tissue and could visualize discs, nerve roots and the spinal cord.
We routinely address conditions such as what you are describing. The treatment will vary depending on the diagnosis. The more expedient we determine the status of a condition and begin treatment, the quicker and better the outcome is. Generally speaking we will often recommend some kind of therapy which may include ultrasound, interferential current, joint mobilization, traction, along with stretching and strengthening exercises. It is important to not only reduce swelling in the tissues, but to rehabilitate supportive structures to prevent recurring pain syndromes when performing normal daily activities in the months to come.