If you qualify for worker’s compensation then you will have worker’s compensation benefits. Worker’s compensation normally pays your reasonable medical expenses. This generally includes payments for doctors, psychiatrists, chiropractors, medications, and medical supplies that are used to treat you. Your right to have your bills paid should not end until you are cured.
What Kinds of Work Injuries are Covered?

The word “injury” is very broad. It includes everything from sudden injuries like broken limbs or pulled muscles to injuries that take a long time to surface, like asbestosis (from repeated exposure to asbestos) or repetitive stress conditions (from typing too much).

What are the Causes?
Numbness and tingling have many different possible causes, including:

• Remaining in the same seated or standing position for a long time
• Injuring the particular nerve supplying the body part where you feel the sensation
• Lack of blood supply to the area. For example, plaque buildup from atherosclerosis in the legs can cause pain, numbness, and tingling while walking
• Pressure on the spinal nerves, like that from a herniated disc or fibrotic tissue
• Carpal tunnel syndrome can cause numbness or tingling in your wrist, fingers, hand, or forearm
• Certain medical conditions, including diabetes, an under active thyroid, multiple sclerosis, seizures, or migraine headaches
• Changes in electrolytes, like abnormal levels of calcium, potassium, or sodium in your body
• Vitamin B12 deficiency
• Transient ischemic attack (TIA) or stroke
• Certain medications, including chemotherapy for cancer, chloroquine for malaria, D-penicillamine, isoniazid for tuberculosis, nitrofurantoin, gold therapy for rheumatoid arthritis, or phenytoin for seizures
• Toxic action on nerves, such as that from lead, alcohol, or tobacco

Where will it Occur?
The injury often times is in the neck, back, wrist, elbow, and leg but can occur anywhere in your body. If you have a neck injury, for example, you may feel the sensation anywhere along your arm or hand. Similarly, a low back injury can cause sciatica — a sensation of numbness or tingling down the back of your leg.

A headache happens when pain-sensitive nerve fibers (called nociceptors) are triggered in the network of nerves that extends over the scalp, face, and along the surface and the base of the brain.

What are the Causes?

Headaches have many causes including foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.), although 90% of all headaches are triggered by stress or tension. About 5 percent of all headaches are warning signals caused by physical problems.

What are the Treatments?

If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea. There are many different classifications of headaches and a thorough examination should rule out serious health problems before beginning treatment.

The type of treatment you receive should be highly dependent on the type of headache you have, to ensure the utmost success in relieving the headache without prolonging the pain and extra cost of erroneous treatment.

What does the Research Show?

Among the many treatment alternatives supported by evidence, chiropractic is buoyed by substantial evidence to its efficacy in the management of both tension-type and cervicogenic headaches:

• Compared to various soft tissue procedures, a course of manipulation treatments is shown to produce sustained improvement in headache frequency and severity in the treatment of cervicogenic headache.
• A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.
• A 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.
• A study in the Journal of Manipulative and Physiological Therapeutics found that Chiropractic adjustments were as effective as the pharmaceutical Amitriptyline , but without the troublesome side effects. It was also found that the positive effects of spinal manipulation continued longer after cessation of treatment that was true of Amitriptyline.

FMS (fibromyalgia syndrome) is a widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments, and tendons – the soft fibrous tissues in the body.

How will it make Someone Feel?

Most patients with FMS say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch and at other times they burn. More women than men are afflicted with FMS, and it shows up in people of all ages.

To help your family and friends relate to your condition, have them think back to the last time they had a bad flu. Every muscle in their body shouted out in pain. In addition, they felt devoid of energy as though someone had unplugged their power supply. While the severity of symptoms fluctuate from person to person, FMS may resemble a post-viral state. This similarity is the reason experts in the field of FMS and chronic fatigue syndrome ( CFS) believe that these two syndromes may be one and the same. Gulf War syndrome also overlaps with FMS/ CFS.

Symptoms and Associated Syndromes:

Pain – The pain of FMS has no boundaries. People describe the pain as deep muscular aching, throbbing, shooting, and stabbing. Intense burning may also be present. Quite often, the pain and stiffness are worse in the morning and you may hurt more in muscle groups that are used repetitively.

Fatigue – This symptom can be mild in some patients and yet incapacitating in others. The fatigue has been described as “brain fatigue” in which patients feel totally drained of energy. Many patients depict this situation by saying that they feel as though their arms and legs are tied to concrete blocks, and they have difficulty concentrating, e.g., brain fog.

Sleep Disorder – Most FMS patients have an associated sleep disorder called the alpha-EEG anomaly. This condition was uncovered in a sleep lab with the aid of a machine which recorded the brain waves of patients during sleep. Researchers found that most FMS patients could fall asleep without much trouble, but their deep level (or stage 4) sleep was constantly interrupted by bursts of awake-like brain activity. Patients appeared to spend the night with one foot in sleep and the other one out of it.

Sleep lab tests may not be necessary to determine if you have disturbed sleep. If you wake up feeling as though you’ve just been run over by a Mack truck – what doctors refer to as unrefreshing sleep – it is reasonable for your physician to assume that you have a sleep disorder. Many FMS patients have been found to have other sleep disorders in addition to the alpha-EEG, such as sleep apnea, sleep myoclonus (nighttime jerking of the arms and legs), and restless legs syndrome. A newly discovered sleep disorder, upper-airway resistance syndrome, is also being evaluated for its association with FMS.

Irritable Bowel Syndrome – Constipation, diarrhea, frequent abdominal pain, abdominal gas, and nausea represent symptoms frequently found in roughly 40 to 70% of FMS patients.

Chronic Headaches – Recurrent migraine or tension-type headaches are seen in about 50% of FMS patients and can pose a major problem in coping for this patient group.

Temporomandibular Joint Dysfunction Syndrome – This syndrome, sometimes referred to as TMJ or TMD, causes tremendous jaw-related face and head pain in one quarter of FMS patients. However, a 1997 published report indicated that close to 75% of FMS patients have a varying degree of jaw discomfort. Typically, the problems are related to the muscles and ligaments surrounding the jaw joint and not necessarily the joint itself.

Other Common Symptoms – Premenstrual syndrome and painful periods, chest pain, morning stiffness, cognitive or memory impairment, numbness and tingling sensations, muscle twitching, irritable bladder, the feeling of swollen extremities, skin sensitivities, dry eyes and mouth, dizziness, and impaired coordination can occur. Patients are often sensitive to odors, loud noises, bright lights, and sometimes even the medications that they are prescribed.

Aggravating Factors – Changes in weather, cold or drafty environments, infections, allergies, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety and over-exertion may all contribute to symptom flare-ups.

What is the Treatment?

Traditional treatments are geared toward improving the quality of sleep and reducing pain. Deep level (stage 4) sleep is crucial for many body functions (such as tissue repair, antibody production, and the regulation of various neurotransmitters, hormones and immune system chemicals). Therefore, the sleep disorders that frequently occur in FMS patients are treated first because they may be a strong contributing factor to the symptoms of this condition.

In addition, most patients will need to use other treatment methods as well, such as chiropractic care, physical therapy, acupuncture, acupressure, relaxation/biofeedback techniques, therapeutic massage, or a gentle exercise program.

What is the Prognosis?
Long term follow-up studies on FMS have shown that it is chronic, but the symptoms may wax and wane. The impact that FMS has on daily living activities, including the ability to work a full-time job, differs among patients. Overall, studies show that FMS may be equally as disabling as rheumatoid arthritis.

With chronic pain, however the pain persists and the alarm continues to shriek uselessly long after the physical danger has passed, usually for weeks, months, even years. Somewhere along the line-maybe near the initial injury, maybe in the spinal cord or brain-the alarm system has broken down. What researchers have recently discovered is that prolonged exposure to this screaming siren actually does its own damage. Research has found that pain causes a fundamental rewiring of the nervous system. Each time we feel pain, there are changes that occur that tend to amplify our experiences of pain. That is why it is a mistake, despite our grin-and-bare it traditional attitude, to ignore or under treat chronic pain.

What are the Treatments?
Medications, acupuncture, chiropractic care, local electrical stimulation, brain stimulation, psychotherapy, biofeedback, as well as surgery, are some treatments for chronic pain.

What is the Prognosis?
Many people with chronic pain can be helped if they understand all the causes of pain and the many and varied steps that can be taken to undo what chronic pain has done. Scientists believe that advances in neuroscience will lead to more and better treatments for chronic pain in the years to come.

What Research is Being Done?
Clinical investigators have tested chronic pain patients and found that they often have lower-than-normal levels of endorphins in their spinal fluid. Investigations of acupuncture include wiring the needles to stimulate nerve endings electrically (electroacupuncture), which some researchers believe activates endorphin systems. Other experiments with acupuncture have shown that there are higher levels of endorphins in cerebrospinal fluid following acupuncture. Investigators are studying the effect of stress on the experience of chronic pain. Chemists are synthesizing new analgesics and discovering painkilling virtues in drugs not normally prescribed for pain.

What are the Treatments?
Carpal tunnel syndrome is effectively treated by two different soft tissue mobilization techniques Active Release Techniques and Graston Technique. Sometimes the wrist is immobilized in a splint to minimize or prevent pressure on the nerves. If that fails, patients are sometimes given anti-inflammatory drugs or injections of cortisone in the wrist to reduce the swelling. There is also a surgical procedure in which doctors can open the wrist and cut the ligament at the bottom of the wrist to relieve the pressure. However, only a small percentage of patients require surgery.

What is the Prognosis?
Approximately 1 percent of individuals with carpal tunnel syndrome develop permanent injury. The majority recover completely and can avoid reinjury by changing the way they do repetitive movements, the frequency with which they do the movements, and the amount of time they rest between periods when they perform the movements.

Supporting muscles and ligaments for the spine and head can be torn or overstretched. Spinal discs between the vertebrae can bulge, tear or rupture. The spinal cord and nerve roots can be irritated, creating toxins around them. The instability and pain can be intense. Some symptoms of an accident are headaches, nausea, dizziness, blurred vision, pain in the shoulders (from pressure against a seat belt), pain in the arms and hands, weakness and fatigue, reduced ability to turn and bend the neck, and low back pain. Some symptoms may not appear for weeks or months as the body adapts from the shock of the trauma.

Immediate medical treatment is important after an injury. What may seem a minor discomfort following an accident could delay into a serious injury leaving you with a lifelong disability affecting your work leisure and relationships in the future.

In OA degeneration, changes describe a slow and progressive loss of the cartilage (a rubbery material between two bones) that acts as a barrier and a shock absorber between two bones, while helping to keep the joints flexible. Once the cartilage is thinned or lost, the constant grinding of bones against each other causes pain and stiffness around the joint. Abnormal and excess bone formations called spurs grow from the damaged bone, causing further pain and stiffness.

What are the Symptoms?

• Subtle development of morning stiffness is often an early symptom.
• As OA progresses, there is pain with movement of the involved joint.
• Pain and stiffness become more severe with activity (less than 15 minutes in duration), and improve with a proper amount of rest.
• Decreased range of motion of the joints
• The patient may have difficulty with brushing teeth, combing hair, or opening a jar
• The joints, such as the fingers or knees, may become unstable, causing them to buckle or lock.
• The fingers, spine, hips, knees, or ankles can all be affected, and may be tender to the touch.
• Neck or back stiffness may be present
• There may be swollen or painful joints around the fingers or knees
• Hip or knee pain may cause a limp when walking
• Popping sound or crepitations (cracking sounds) may be heard when moving the joint

What causes Osteoarthritis?
Primary OA is caused by the cumulative effects from years of use that damages the protective coating of the joint known as collagen. As one ages, the ability to restore and repair the collagen matrix decreases.

How is the Diagnosis made?

• Examination by a doctor includes a medical history and a general physical exam.
• The joint involved is then examined for degree and range of motion, stiffness, strength, and presence of fluids or crepitations.
• There may be bony knobs at the end of the fingers
• There may be swollen and tender knee joints.

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• If there is swelling and fluid in the joint, the doctor will numb the area with an injection of a local anesthetic such as Xylocaine, then use a second needle to remove the fluid so it can be examined under a microscope. This is helpful in reducing pain and ruling out other causes of arthritis.
• Radiographs (X-rays) may be normal early in the disease, but later they may show narrowed joint spaces, erosions, small cysts (tiny enclosed sacs), and spurs.

If the doctor needs a detailed view of the joint, or if there is radiculopathy (pressure on nerve roots), a MRI or CAT scan can provide better pictures of the involved joint.

What is the Treatment?

• Protect the joints from overuse by limiting unnecessary and repetitive activities such as driving or lifting heavy pots and pans.
• Be sure to keep good posture with the chin up and a straight back (shoulders pulled back).
• Exercise of all forms has proven beneficial
• A good diet and moderate weight loss is extremely important.
• Chiropractic care and rehabilitation is very helpful in decreasing joint stiffness, pain, and improving mobility and strength.
• Massage of surrounding muscles, acupuncture, or acupressure may help with pain.

A bad knee or hip can also be replaced with an artificial one.

What Causes this Pain?
Any condition that causes irritation or impingement on the sciatic nerve can cause the pain associated with sciatica. The most common cause is a lumbar herniated disc (also referred to as a ruptured disc, pinched nerve, slipped disc, etc.). Other common causes of sciatica include lumbar spinal stenosis, degenerative disc disease, or isthmic spondylolisthesis.

While sciatica can be very painful, it is rare that permanent nerve damage (tissue damage) will result. Most sciatica pain syndromes result from inflammation and will get better within a couple weeks to a few months.

Can it get Worse?
For some people, the pain from sciatica can be severe and debilitating. For others, the pain from sciatica might be infrequent and irritating, but has the potential to get worse. Usually, sciatica only affects one side of the lower body and the pain often radiates from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also radiate to the foot or toes.

Symptoms that may constitute a medical emergency include progressive weakness in the legs or bladder/bowel incontinence. Patients with these symptoms may have cauda equina syndrome and should seek immediate medical attention.

Is there any other symptoms I might experience?

• Pain in the rear or leg that is worse when sitting
• Burning or tingling down the leg
• Weakness, numbness or difficulty moving the leg or foot
• A constant pain on one side of the rear
• A shooting pain that makes it difficult to stand up

What are the Treatments?
Sciatica is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these factors. Typical sciatica treatments include:

Manual treatments for sciatica (chiropractic treatments including physical therapy) to help relieve the pressure.
Medical treatments for sciatica (such as NSAID’s, oral steroids, or epidural steroid injections) to help relieve the inflammation.

Surgery for sciatica (such as microdiscectomy or lumbar laminectomy) to help relieve both the pressure and inflammation may be warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.

What is the Treatment?
Treatment for individuals with whiplash may include chiropractic care, nonsteroidal anti-inflammatory medications, muscle relaxants, and a cervical collar (usually worn for 2 to 3 weeks). Range of motion exercises, rehabilitation, and cervical traction may also be prescribed. Supplemental heat application may relieve muscle tension.

What is the Prognosis?
Generally, prognosis for individuals with whiplash is good. The neck and head pain clears within a few days or weeks. Most patients recover within 3 months after the injury, however, some may continue to have residual neck pain and headaches.