Injured worker awarded 12 million punitive damages due to denial of her work comp case

From http://www.zwire.com/site/news.cfm?BRD=1300&dept_id=156931&newsid=10853181&PAG=461&rfi=9
we find the following story.

"RAPID CITY, S.D. (AP) - A former nursing home worker has been awarded more than $12 million in a judgment against three insurance companies that denied her workers' compensation claim. The Rapid City jury returned its verdict - $60,000 in compensatory damages and $12 million in punitive damages - last week after a a four-day trial in federal court.
In 1999, Alice Torres, a cook at Meadowbrook Manor nursing home in Rapid City, filed a workers' compensation claim for carpal tunnel syndrome. She had sought about $8,000 for medical bills, lost time and physical impairment. But insurance adjusters denied the claim.
The defendants in the case were Travelers Insurance Co., Insurance Company of the State of Pennsylvania, and Constitution State Services, a subsidiary of Travelers. All were involved as claims administrators or insurers for Beverly Enterprises, parent company of Meadowbrook Manor.
Initially, Beverly Enterprises was also a defendant, but the company reached an out-of-court settlement and was dismissed from the suit on Jan. 8.
Torres, 57, now lives in Colorado.''I feel great. There is such thing as justice after all,'' she said. ''I work very hard, and I don't think nobody should go through what I went through. I was within my right to get my treatment, and they just denied me.''
The suit was originally filed in U.S. District Court in Rapid City in July 2001. Torres' attorneys, Michael Abourezk and Glen Johnson of Rapid City, accused the companies of bad-faith dealing with Torres, barratry, abuse of process, and interference with business and contract relations.For Abourezk, the case centered around a Travelers Insurance incentive program that offered bonuses to claims workers who lowered payouts on claims. Called the Claim Professional Incentive Program, it offered workers end-of-year bonuses of as much as 20 percent of their pay if they reduced overall payouts from one year to the next.
Abourezk argued that the program created an improper conflict of interest for claims adjusters, who are supposed to be motivated by fairness to claimants, not cost control for insurance companies.''An insurance adjuster is supposed to be like a judge, fair and impartial. ... If you bribe a judge, you get thrown in jail. But they bribe these claims adjusters with bounties that are tied directly to their performance in paying claims.'
'In court papers, the insurance companies said Torres' workers' compensation claim was properly denied because there was a lack of proof that her hand problems were caused by her work. According to court papers, Torres reported to Meadowbrook Manor administrators in March 1998 that she was having pain, numbness and other symptoms in her hand. She underwent a series of medical treatments. At one point, she took three weeks off from work.
In April of 1999, Torres underwent surgery for carpal tunnel syndrome. Her doctor sent a workers' compensation report to Meadowbrook Manor, asserting that her work ''aggravates and makes her carpal tunnel syndrome clinically significant so that it interferes with her activity and function.''But defense attorneys noted that there were a number of inconsistencies in Torres' accounts of what caused her pain, how long it had been bothering her or whether it was caused by repetitive stress or a specific injury from lifting a pot of soup.
The insurance companies also said her hand problems were likely the result of a 1998 home injury, not her work in the kitchen of the nursing home. Torres sought medical treatment for that injury but, at that time, did not mention numbness or tingling in her fingers, the attorneys noted. And tests in December of that year, the defense contended, did not show carpal tunnel syndrome.
Torres now works in a private home caring for a 97-year-old woman.''I told her family that no matter what happened, I will stay with her until she don't need me no more. I love this old lady,'' Torres said.
However, her lawsuit is far from over. Federal courts must review jury verdicts involving punitive damages, and judges may reduce or eliminate the awards. The legal wrangling likely will continue.
And no matter what happens, Torres will not keep the entire $12.06 million. Attorney fees in this case equal 45 percent of the award, Abourezk said."

SOFT TISSUE INJURIES - SOME OF THE MOST SERIOUS INJURIES THAT CAN BE SUSTAINED

SOFT TISSUE INJURIES
Soft tissue injuries are often treated as not serious by some people. The fact is, soft tissue injuries are some of the most serious and disabling injuries one can sustain.

"Hard tissue" injuries, such as bone fractures, in general, in a healthy adult, with proper treatment / "management", will heal in around sex weeks, and again, in a relatively healthy
adult, with few sequelae or residual problems.

Soft tissues include muscles, tendons, ligaments, the BRAIN, the SPINAL CORD, and the NERVES.

Soft tissue injuries can take far, far longer than fractures to heal. They often can leave permanent damage, or at the very least, leave the injured person more susceptible to re-injury or exacerbations in the future.

Dr. Baker also, for the same number of years, has treated many, many motor vehicle accident injury patients, and injured work comp patients, and understands quite well the basic dynamics of injuries such as whiplash, also called a hyperextension/ hyperflexion, acceleration / deceleration injury, RSI injuries affecting soft tissues such as the median nerve, crushing injuries that can result in RSD / CRPS, etc. .

Dr. Baker understands the kind of psychological effect that serious motor vehicle accidents can have on patients.

Patients often become afraid to ride in cars after the accident, or if they do, sit in traffic, fearful of a repeat of what happened in their accident.
He knows, for example. that damage to soft tissues ("soft tissue injuries") not only take FAR longer to health than broken bones, but they rank among the most serious of injuries.

The "hard tissues" are usually thought of as bone, such as the axial (vertebrae for example) skeleton and the appendicular (extremity bones such as arm and leg bones) skeleton.

Traditionally, lawyers usually think of "soft tissue injuries" as hard to document and that juries respond to soft tissue injuries as not as serious as broken bones, but the truth is, the nervous system is "soft tissue", in point of fact, being some of the softest tissue in the body. The brain , spinal cord, and nerves are soft tissues for example.

And, the real truth is that the dangers that are brought about from fractures, are usually the result of bone fragments tearing soft tissues, or impinging on soft tissues, for example, a fractured bone fragment penetrating the cord, rupturing a major blood vessel, etc..http://www.farrin.com/car-accident/soft-tissue-injury-information-center/other-brain-injuries.php "Soft Tissue Injuries - More Than Meets the EyeThe impact of a car crash can cause severe damage to the body. Hard braking, involuntarily bracing for impact, and the crash itself can jolt the body around inside the car. According to a 2002 study by the Insurance Research Council tears, sprains and strains, referred to as soft tissue injuries, are the most common type of injury reported by car accident claimants. 8 out of 10 persons injured in a car accident suffer this type of injury (Insurance Research Council, 2002).
Brain InjuryCar accidents can cause injuries to the head and brain of varying physical and psychological significance.

This type of injury can involve a substantial risk of death, unconsciousness, extreme physical pain or trauma, or the impairment or loss of mental faculty. Such suffering can have long-term or even permanent consequences for the injured person.

While only one family member may have sustained a brain injury, the entire family can suffer from its effects.
After brain injury, things that once were easy and familiar become strange and difficult. Intensive mental effort is usually required to do things that required little or no effort before the brain injury.

Work, school, personal and family life often suffer. Rehabilitation from a serious head or brain injury can take months or even years and involve long-term physical therapy, courses of medication, permanent prescription drug therapy, in-home medical care, and much more. The medical expenses alone can cripple anyone's financial future.
Traumatic Brain InjuryCar accidents are among the leading causes of traumatic brain injury. A brain injury can disrupt some or all of the normal activities of a person's body. Depending on the severity of the injury, the effects can be devastating. Severe surface wounds and fractures often accompany traumatic brain injuries."
http://www.immunesupport.com/library/showarticle.cfm/id/6090/searchtext/heal%20ing/" Soft Tissue Injuries What exactly are soft tissue injuries? “Soft tissue” is an expression commonly used to refer to the “softer” aspects of the outer body, not including bones and joints. Muscles, tendons, and fascia are examples. Soft tissue injuries are commonplace and range from minor to very serious, depending on the nature of the injury.
Muscles Muscles are the tissues that enable us to move and stay warm. Muscles are arranged in pairs to enable pulling and pushing types of movement. Whenever one muscle in the pair contracts the other is relaxed, and vice versa. This is the basic premise of movement throughout the body. Millions of muscle cells (also known as fibers) operate together to form muscles. The health of the muscles depends on the quality of nourishment they receive. Well-nourished muscle cells are less likely to develop spasms or cramps that lead to pain.
If you’ve sustained muscle injuries, it is important to be aware of the tendency many people have to adjust posture into a position that alleviates the pain, but which may weaken the structure and create muscular stress.
Tendons Tendons connect muscles to the bones they move. Injuries to tendons involve either a tear of some of the fibers or a complete rupture, where the tendon is torn in two. Because tendons require less blood supply than muscles to function, they take more time to heal. If a tendon tears near the surface of the body, bleeding from it may produce bruising. Chronically weakened tendons can occur anywhere, but especially around joints such as the shoulder, knee, elbow, etc.
Tendonitis is the inflammation of the tendons, which are tough bands of tissue that attach muscle to bone. Because tendons are not elastic, they’re more susceptible than muscles to inflammation, even from overuse. The most common areas affected are the hips, knees, shoulders, heels, and elbows.
Activities that require a different range of motion than your usual activities are beneficial to increase the resilience of tendons.
Fascia The tissue that links all the components of the body together is known as “fascia.” It carries nerves, blood, and lymphatic vessels through it. Fascia also helps to distribute the weight of the body during movement.
Nerves Nerves carry information from the brain to the body and vice versa. They allow you to move because the brain can co-ordinate all movements based on signals from the nerves. Nerves also send the brain information about the muscles and joints. Nerves transmit pain signals so the brain knows there is something wrong in the body and can co-ordinate a healing response. "

Soft tissue injuries, without ANY doubt, are some of the MOST serious, MOST painful, and potentially, have the MOST long lasting effects of any trauma induced injury.

Subclavian Steal Syndrome

Ever been working on something with your hands and arms over your head, and then suddenly passed out for seemingly no reason?

If so, you may have syptoms of subclavian steal syndrome, a syndrome that I feel is often underdiagnosed in the United States.

What is it? Here is a bit on it from the eMEDICINE site.
http://www.emedicine.com/radio/topic663.htm
"
Author: David P Brophy, MD, Assistant Professor of Radiology, Trinity College Dublin; Consulting Staff, Department of Radiology, St. James' Hospital
David P Brophy, MD, is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Massachusetts Medical Society, and Radiological Society of North America
Editor(s): Moni Stein, MD, Associate Professor II, Departments of Radiology and Surgery, University of California at Davis School of Medicine; Bernard D Coombs, MBChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand; Douglas M Coldwell, MD, PhD, Professor of Interventional Radiology, Professor of Interventional Radiology, Department of Radiology, University of Texas Southwestern Medical Center; Robert M Krasny, MD, Visiting Assistant Professor of Radiology, University of California at Los Angeles Medical Center; Consulting Staff, Healthcare Management Partners; and Ziv J Haskal, MD, Director, Division (& Fellowship Program), Professor of Radiology and Surgery, Division of Vascular and Interventional Radiology, Department of Radiology, New York Presbyterian Hospital/Columbia Disclosure


INTRODUCTION
Section 2 of 11
Author Information Introduction Differentials X-ray Cat Scan MRI Ultrasound Angiography Intervention Pictures Bibliography
Background: Subclavian steal phenomenon (SSP) refers to subclavian artery steno-occlusive disease proximal to the origin of the vertebral artery and is associated with flow reversal in the vertebral artery. While Contorni first described retrograde flow in the vertebral artery in 1960, Reivich in 1961 first recognized the association between this phenomenon and neurologic symptoms. Fisher dubbed this combination of retrograde vertebral flow and neurologic symptoms subclavian steal syndrome (SSS), suggesting that blood is stolen by the ipsilateral vertebral artery from the contralateral vertebral artery. It was later suggested that such "steal" may cause brainstem ischemia and stroke, either continuously or secondary to arm exercise.
The term SSS should be reserved for retrograde vertebral artery flow associated with transient neurologic symptoms related to cerebral ischemia. SSP refers to retrograde flow in the vertebral artery only. First diagnosed angiographically in the early 1960s, SSS is now most commonly diagnosed during Doppler ultrasound (US) examination of the neck arteries.
Pathophysiology: The primary lesion causing vertebral artery flow reversal is proximal subclavian artery stenosis or occlusion, resulting in decreased blood pressure in the arm distal to the steno-occlusive disease. This pressure reduction initially causes ipsilateral vertebral artery blood flow alteration provided the subclavian disease is proximal to the origin of the vertebral artery.
Ultimately, a flow reversal occurs in the ipsilateral vertebral artery as compensatory collateral to the compromised vascular territory beyond the subclavian steno-occlusive lesion. Other potential collateral pathways are those between the external carotid artery (ECA) and the subclavian artery, from the occipital branch of the ECA to the deep cervical branch of the costocervical trunk, and from the superior thyroid artery of the ECA to the inferior thyroid artery branch of the thyrocervical trunk.
Classification of subclavian steal can be defined by territory from which blood is stolen, as described by Vollmar et al. Vollmar recognized 4 types of subclavian steal: vertebro-vertebral, carotid-basilar, external carotid-vertebral, and carotid-subclavian (can only occur with occlusion of brachiocephalic artery). Another classification is based on vertebral artery hemodynamics as described by Branchereau and colleagues. Hemodynamic abnormalities ranged from reduced antegrade vertebral flow (stage I), reversal of flow during reactive hyperemia testing of the arm (stage II), and permanent retrograde vertebral flow (stage III). The 3 stages correlate with disease severity with stage III, usually indicating subclavian artery occlusion.
Arm symptoms may be provoked by an increased blood flow requirement to the compromised upper extremity (eg, during arm exercise or after producing peripheral reactive hyperemia by arm cuff inflation), or, alternatively, by limiting vertebral compensatory flow to the subclavian artery (eg, during neck movements).
Subclavian steno-occlusive disease produces neurologic symptoms when compensatory flow to the subclavian artery from the vertebral artery diverts too much flow toward the arm and away from intracranial structures. The quality of collateral blood supply and the capacity to increase collateral flow to the intracranial circulation (brainstem in particular) may be the principle determinant as to which patient develops neurologic symptomatology.
In times of reversed flow in the vertebral arteries, the most important collateral circulation to the posterior fossa is through the circle of Willis, principally through the posterior communicating artery. In situations where this communication is absent or inadequate, possibly from concurrent extracranial carotid stenoses, increased demand in the ipsilateral upper extremity may cause neurologic symptoms. This is the foundation for the belief that hemodynamically important disease in the cerebral arterial circulation (or vessels supplying that circulation) is a prerequisite of SSS.
Spontaneous resolution of vertebrobasilar symptoms may be related to the establishment of extracranial collaterals to the subclavian circulation.
Frequency:
In the US: The Joint Study of Extracranial Arterial Occlusion reported a 17% incidence of subclavian or innominate artery stenosis but angiographic steal occurred in only 2.5% (168/6534) of cases; of those with angiographic steal, 80% had associated extracranial obstructions and 5.3% (9/168) had neurologic symptoms.
A 6.4% incidence of SSP was observed in 500 asymptomatic patients with neck bruits undergoing Doppler US and subclavian steal test (to provoke vertebral artery flow reversal).
In 680 symptomatic patients examined with angiography, 23% had severe proximal subclavian disease or occlusion with 6% showing reversed vertebral artery flow.
Internationally: Incidence of SSP is 1.3% (324/25,000) in European patients referred for carotid and vertebral artery Doppler US; of these patients, 5% have nonhemispheric neurologic symptoms.
In the Far East, up to 36% (9/25) of patients undergoing surgical management of SSS have an etiology of Takayasu, with atherosclerosis accounting for the remaining patients. Nonatherosclerotic etiologies are rare in Caucasians.
Mortality/Morbidity: In SSS patients, risk of stroke is poorly documented but seems low. Bornstein and Norris prospectively followed 500 patients for 2-4 years, having documented SSP in 9% (45/500). None of their SSP patients had a stroke during the follow-up period while symptoms developed in 5 patients: 3 had dizzy spells and 2 had numbness of the affected arm at rest. Field et al noted that of 168 patients with vertebral flow reversal, only 5.35% (9/168) had vertebrobasilar symptoms and all of these 9 patients had other lesions that might explain their symptoms.
Despite apparent low stroke risk, patients with SSS may be severely debilitated by episodes of arm and related intracranial ischemia symptoms. Given the differences in survival between medically and surgically treated patients, surgical "prophylaxis" of stroke should be reserved for patients with disabling vertebrobasilar symptoms.
The presence of other extracranial arterial disease is a prerequisite to the development of symptoms. The reported incidence of associated extracranial stenotic disease is 24-80%.
Neurologic symptoms, when they occur, more likely are related to other extracranial arterial disease than to vertebral artery flow reversal.
Ackerman et al described a spontaneous remittence of vertebrobasilar symptoms that occurs in 50% of patients who were initially symptomatic. Only 15% of the initially asymptomatic patients experienced vertebrobasilar transient ischemic attacks during the follow-up period of at least 2 years.
Race: SSS is most frequently described in Caucasians because of increased incidence of atherosclerosis in this population.
In the Far East, as many as 36% (9/25) of patients undergoing surgical management of subclavian steal syndrome have Takayasu arteritis as the etiology, with atherosclerosis accounting for the remaining patients. Nonatherosclerotic etiologies are rare in Caucasians.
Sex: Incidence is greater in males than in females (1.5-2:1). However, when Takayasu arteritis is causative rather than atherosclerosis, there is a female predilection.
Age: SSS usually affects people older than 50 years when the disease is secondary to atherosclerosis while SSS presents far earlier (<30 y in 90%) when Takayasu arteritis is implicated.
Anatomy: The ratio of left-sided to right-sided SSP is 3-4:1; most likely, this relates to turbulence-related atherosclerosis in the proximally more acutely angled left subclavian artery.
In 2% of the population, the left vertebral artery arises directly from the aortic arch; in these patients, severe stenosis or occlusion of the proximal left subclavian artery would not reverse flow in the left vertebral artery (ie, it lacks communication with the subclavian artery).
Classify SSS by the territory from which blood is stolen as follows:

Vertebro-vertebral

Carotid-basilar

External carotid-vertebral
Carotid-subclavian (occurs only on the right side with right brachiocephalic occlusion)
Coronary-subclavian steal syndrome refers to decreased or reversed internal mammary artery flow, which causes angina related to severe subclavian steno-occlusive disease in patients with in situ internal mammary-to-coronary artery graft.

Clinical Details:
History
Commonly asymptomatic, subclavian artery steno-occlusive disease associated with flow reversal in the ipsilateral vertebral artery is diagnosed as an incidental finding during Doppler

US examination of the carotid and vertebral arteries.
Symptoms that occur (eg, dizziness, unsteadiness, vertigo, visual changes) most typically are related to vertebrobasilar and posterior cerebral circulation ischemia.
Arm ischemia occurs, causing arm claudication and rest pain.
SSS can be associated with hemispheric or global cerebral symptoms such as focal sensory or motor loss, dysphasia, and unilateral visual disturbances.

Concomitant carotid or cerebral artery disease is a factor.

Vertebrobasilar symptoms provoked by ipsilateral arm exercise are considered a characteristic, though rare, feature.

Neck movement may provoke symptoms.

In most patients, there is a clear provoking or reproducible event.

Hand ischemia is uncommon in SSS; therefore, consider a different etiology (eg, atheroembolic disease).
The physician often elicits a history of smoking, hypertension, hyperlipidemia, diabetes, and coronary and/or peripheral vascular disease.

Physical
Weak or absent radial and ulnar pulse in the presence of ipsilateral reduced blood pressure (change is >20 mm Hg) when compared to the contralateral arm suggests SSS.

A bruit may be localized to the proximal subclavian artery.

Reactive hyperemia testing (temporary arm cuff inflation above systolic pressure on the side of subclavian disease) can provoke vertebrobasilar symptoms by causing peripheral vasodilation and decreasing peripheral resistance with a resulting sump effect favoring increased flow from the vertebral circulation to the involved upper extremity.

Preferred Examination: Color Doppler US is the preferred examination.

Limitations of Techniques: Color Doppler US is operator-dependent; direct examination of the proximal subclavian is compromised by overlying clavicle, ribs, and sternum."
--SNIP---------
The danger of sustaining a cerebrovascular accident ( stroke), secondary to this syndrome should not be ignored by anyone who has the symptoms.

Another article on this syndrome is found at
http://www.5mcc.com/Assets/SUMMARY/TP0883.html
"DESCRIPTION: Origin of the subclavian artery becomes compromised causing a reversal of flow in the branches of the first portion of the subclavian artery as a means of supplying blood to the upper extremity, especially during exercise. This may result in symptoms of vertebral-basilar insufficiency. System(s) affected: Cardiovascular, Musculoskeletal, Nervous Genetics: N/A Incidence/Prevalence in USA: Unknown, not common; 70% of the time, the left subclavian artery is involved Predominant age: > 55 years Predominant sex: Male > Female (2:1) CAUSES:
Arteriosclerosis obliterans of the proximal subclavian artery in 95% of cases
Less common causes of obstruction: dissecting aneurysm of aortic arch, embolus and Takayasu's arteritisICD-9-CM: 435.2 Subclavian steal syndrome"

=========SNIP==============
Another source
http://www.gpnotebook.co.uk/cache/953155595.htm
"The subclavian steal syndrome is cerebral or brain stem ischaemia that results from diversion of blood flow from the basilar artery to the subclavian artery. This is due to occlusive disease of either the subclavian artery or the innominate artery before they branch off at the vertebral artery. It is very rare.
In the patient with subclavian steal syndrome the subclavian artery is fed by retrograde flow from the vertebral artery via the carotids and the circle of Willis.
Haemodynamic stability is possible until there is excessive demand in the upper limb. In this situation blood is 'stolen' - diverted - from the cerebral circulation resulting in transient cerebral ischaemia. This may be suspected clinically by the absence of a pulse or by a difference in blood pressure (> 20 mm Hg) between the two arms. Vertigo and syncope may result.
The condition is often demonstrated incidentally by Doppler or angiography.
Treatment is by surgical reconstruction or bypass of the subclavian artery."

Popping, clicking, locking, ringing in the ears...TMJ symptoms

The jaw muscles on the human being are, for the size of the human, some of the most powerful in the body, particularly, the masseter muscles.

They have to be.

When you are chewing your food, whether it is chicken or jawbreaker candies, your jaws are exerting tremendous amounts of force to grind and tear your food apart.Now, the proper functioning of the jaw joints require a delicate and symmetrical balance be maintained in the muscles surrounding the joints.

Many things can result in a misalignment of the jaw joint and/or spasm of the jaw muscles.

Car accidents, dental work that requires the mouth to remain open for long periods of time,trauma to the jaw such as a boxer might sustain, all of these and more can result in damage and/or malfunction of the Temporomandibular joint, so named because it marks the place where the temple and the mandible, or jaw bone, come together.

Malfunction or disease of the TMJ can cause clicking , popping, or pain on chewing, but also, it can cause or contribute to the person developing a ringing in the ears, dizziness, terrible headaches, difficulty chewing, actual locking of the jaw, difficulty swallowing, difficulty hearing or muffled hearing , or all of the above.Dentists sometimes use appliances, or plastic devices to hold in the mouth to address this problem. Often, this doesn't work.One way of checking for a TMJ misalignment is to slowly open your mouth as far as you can while looking at yourself in the mirror.

Close your mouth moderately slowly and watch to see if the point of the chin deviates to one side while you are in the closing phase. If it deviates to one side or wobbles, this is often an indication of a TMJ malfunction, especially if you are experiencing several of the previously mentioned symptoms.

At Baker Chiropractic, we have ways of addressing TMJ problems.For more background information, here are a few links :
http://www.school-for-champions.com/health/dental_tmj_symptoms.htm

http://www.clearpassage.com/TMJ.htm

http://www.michigan-headache-tmj-doctor.com/tinnitus_tmj.html

http://www.headaches.com/tinnitus.htm

Does out of Pain mean you are WELL?

I was talking with a patient the other day and she said she thought she was well, because she was out of pain. This was a patient who just a short time ago was saddled with disabling headaches, backaches, and neck pain.

During the re-exam, I was testing her grip strength and noted on her left hand, she had to let go with almost no grip at all. I asked her if this was the best effort she could give, and she said it was because she had arthritis in the hands (since she doesn't have rheumatoid arthritis, I assumed she was talking about osteoarthritis). I asked her if there were times she didn't have pain in the hand. She said, that now, she had pain in the hands all the time. I asked her if there was a time earlier, when she would have pain in the hands one day and not the next.

She said yes, that there were days she would have pain one day and not the next, but now, it was all the time.( I should add that this patient was not one of the best at coming in for care).

The obvious question that I asked then was , on those days , earlier on in the arthritis in her hands, when she would have a day free from pain, if that meant that on that day, she was well, and had no arthritis? She had to just look at me without an answer for a bit, and had to admit no, that even though she had a day without pain, she still had arthritis in the hands.

The point of all this is that, usually, pain is the last symptom to arrive, and during the treatment, the first symptom to leave.

Asymptomatic, does not mean well or problem free.

Of course, one desired goal is to get patients out of pain as soon as possible, but that is only the beginning phase in proper management of their problems. When you have a bone that has been fractured, there is a point that you are painfree, but you certainly do not have a fully healed fracture, and overuse at that time can reinjure that area.

The same is true with your spine and soft tissues.

Pain free does not mean problem free!

If we were all about just palliation, i.e. decreasing symptoms, then we would be no better than the allopathic doctor who gives you vicodin, to try to numb you out and not feel the warning signs your body is giving you.

We strive to correct the underlying problems that are causing the pain, and ultimately, wouldn't you rather have real correction and resolution to the problem rather than a temporary reprieve from the pain, only to have it to return at double the intensity?

I would!

Welcome to Baker Chiropractic ,PA of Longview

BAKER CHIROPRACTIC OF LONGVIEW TEXAS

BAKER CHIROPRACTIC OF AUSTIN TEXAS IS NO LONGER LOCATED IN AUSTIN TEXAS, IN TRAVIS COUNTY, DR. JOHN RAYMOND BAKER (John Raymond Baker ,D.C.) is now located in Longview Texas, at Baker Chiropractic, ,PA.

We are located at 1420 McCann, Longview Texas, in the Brookwood Shopping Village.Our phone is 903-753-5400 and our fax is 903-757-5604.

Dr. John Raymond Baker has been a Chiropractic Doctor, licensed in Texas since 1989,and is an ADL level two treating doctor for Texas Workers Compensation.

We serve the Northeast corner of Texas, and welcome patients from Longview,Tyler, Gladewater, Kilgore, Marshall, and all other surrounding towns, cities, and communities.

We treat a wide variety of problems including not only manipulation and treatment of theneck, mid-back, and low back (i.e. cervical, thoracic, and lumbar regions), but also extremityproblems such as ankles, shoulders, legs, feet, hands, wrists, etc.

Our office hours are 9 am til 1 pm and 3 pm until 630 pm, M -F, and by appointment occasionallyon Saturdays/. We have capabilities to take x-rays, and have various physical therapeutic modalities.Baker

Chiropractic strives to put the CARE back in healthcare, and to put patients first.

Below you will find more sites associated with Baker Chiropracctic of Austin and BakerChiropractic of Longview, as well as more articles and information by Dr. John Raymond Baker,D.C.
http://bakerchiropractic.blogspot.com/
http://www.bakerchiropractic.net/
http://www.baker-chiropractic.com/
http://drjohnbaker.3dup.net/
http://members.fortunecity.com/bakerchiropractic/
http://members.fortunecity.com/bakerchiro/
http://bakerchiropractic.atspace.com/
http://bakerchiropractic.freeservers.com/chiropractic_in_texas_means_baker.htm
http://enewsblog.com/bakerchiropractic
http://bakerchiropractic.freewebspace.com/
http://www.geocities.com/bakerchiropractic
http://members.lycos.co.uk/bakerchiropractic
http://bakerchiro.siteburg.com/
http://bakerchiropractic.6te.net/
http://johbak5.freeserverhost.com/
http://health.20mbweb.com/bakerchiropractic/
http://bakerchiropractic.freewebsites.com/
http://health.20mbweb.com/bakerchiropractic