2 Reasons Your Chiropractor May Refer You to a Medical Doctor After Trauma
Many people seek help from a chiropractor after they suffer a trauma which causes them to have neck or back pain. However, sometimes, an appointment with a medical doctor is still necessary. There may be injuries or conditions that can actually worsen with the wrong chiropractic treatment. For this reason, chiropractors need to assess the medical history and know all the symptoms a patient is experiencing prior to developing a treatment plan.
Before your first appointment begins with a chiropractor, expect to fill out a long questionnaire about your medical history and symptoms you may be experiencing. It's extremely important to be completely accurate when you fill out this paperwork. Your chiropractor will review it before and during your initial consultation.
Here are two of the medical conditions chiropractors look for after a trauma to the head or neck region.
Vertebral artery dissection
What it is: This is a small tear in the lining of the vertebral artery, which is an artery in the neck that supplies blood to the brain. A tear is typically caused by trauma or minor neck or head injuries. Vertebral artery dissection is the leading cause of stroke in young adults and children.
Symptoms: You may have neck and back pain due to the initial trauma, which leads you to seek chiropractic care. However, the chiropractor will be interested in the following symptoms if you've recently had trauma to your head or neck: hiccups, vertigo, nausea, difficulty swallowing, hearing loss, and hoarseness.
Medical tests & referrals: An MRI will be necessary to show the tear in the vertebral artery. Your chiropractor will refer you to a neurosurgeon, neurologist, or your primary care physician.
Chiropractic treatment: If your chiropractor suspects you may have a vertebral artery dissection, he or she may want to postpone chiropractic treatments until after you've been assessed by a specialist. Any chiropractic manipulation in the neck region may cause the tear in the artery to rip further, which could result in a stroke.
Chiari 1 malformation
What it is: In simple terms, the base of the brain is too large and there's no room for it. This causes the base of the brain to grow into the funnel-like opening to the spinal canal. This malformation can block the flow of spinal fluid, which can lead to paralysis and, sometimes, death. Often, people don't know they have a malformation until they seek medical care following a trauma to the head or neck.
Symptoms: The main symptom of Chiari is a pressure headache that starts in the back of the head and neck area. Depending on the flow of the spinal fluid and the severity of the malformation, additional symptoms may include excessive slobber, slurring speech, tingling in extremities, clumsiness, dizziness, difficulty breathing, sleep apnea, muscle weakness, abdominal distress, and bladder incontinence.
Medical tests & referrals: A Chiari malformation can be seen on a brain CT scan. The spinal fluid can be seen on a cine MRI. Your chiropractor will refer you to your primary care physician or a neurosurgeon for a diagnosis.
Chiropractic treatment: Patients with Chiari should not receive high velocity chiropractic manipulation. Sudden jerking movements of the neck can cause the malformation to move, which could cause the spinal fluid to be blocked. Low velocity and heat therapy may be recommended.
If your medical history and symptoms have red flags that there is something more going on with your health, your chiropractor may delay treatment until after you've had the appropriate medical testing done by a back pain specialist. If you think you have either of these conditions, consider meeting with either profession to get a second opinion before making your back feel potentially worse.