Our team of doctors are highly trained in the evaluation, diagnosis, and proper treatment of musculoskeletal injuries that often result after an accident. They are consistently successful treating patients that have accident-related injuries.  Additionally, our doctors only treat patients that can benefit from their care. They will design a specific care plan that will allow for the maximum results in the least amount of time.  Your injuries will be accurately documented to ensure that you have everything you, your adjuster or your attorney will need to settlement your case.

To determine appropriate levels of frequency and duration of care, we can look at several documents: 1) The Guidelines for the Chiropractic Quality Assurance and Practice Parameters (Mercy), 2) the Council on Chiropractic Practice (CCP) document and 3) Foreman and Croft’s Whiplash Treatment Guidelines.

Remember, "A good diagnosis is the first step to a GREAT treatment plan".

What Other Guidelines Have Been Developed for Whiplash Trauma?

ACOEM Guidelines with regard to whiplash, the American College of Occupational and Environmental Medicine (ACOEM) guidelines mention the condition only to convey the advice made by the Quebec Task Force in 1995, which was for patients to remain active as opposed to having prolonged rest or immobilization. These guidelines, which have recently been adopted by the state of California, are aimed primarily at workers compensation claims, but do provide general algorithms of management which chiefly follow a medical paradigm. And, although the authors do provide statistical data on disability periods, they do not make specific recommendations regarding treatment or treatment durations. Some diagnostic and treatment approaches are not recommended on the basis of evidence-based medicine. Spinal manipulation is among the treatment methods acknowledged as effective for both neck, upper back, and lower back pain.

Acute Low Back Problems in Adults, Clinical Practice Guideline Number 14, U.S. Department of Heath and Human Services Public Health Service. These guidelines, which are occasionally and somewhat erroneously referred to as the “federal guidelines,” were promulgated by the Agency for Health Care Policy and Research (AHCPR) in 1994. The authors point out that they do not consider children or adults with chronic low back pain. Needless to say, they are also not intended to be used as guidelines for the treatment of whiplash injuries.

Guidelines for Chiropractic Quality Assurance and Practice Parameters (Proceedings of the Mercy Center Consensus Conference) The Mercy guidelines, as they are most often referred to, provide general guidelines to chiropractic practitioners across a broad range of clinical subjects. However, there is no specific provision for the treatment of whiplash injuries in this document.

Procedural/Utilization Facts: Chiropractic/Physical Therapy Treatment Standards-A Reference Guide, 5th edition. Also known commonly as the Olsen Guidelines, this 159-page document, authored by Richard E. Olson, DC, published by Data Management Ventures, Inc. Dr. Olson is also the author of Fee Facts, Prevailing Fees For Rehabilitative Medicine, A Reference Guide, and author of the Chiropractic Services Program, Managed Care Treatment Plans, A Reference Guide. The Olson Guidelines mention “whiplash” three times: twice in reference to PT modalities, and once in a somewhat vague reference to manipulation. In no case does he discuss treatment frequency or duration in reference to whiplash injuries.

QTF Guidelines In 1995 the Quebec Task Force on Whiplash-Associated Disorders published the results of their best-evidence synthesis (Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S, Zeiss E: Scientific monograph of the Quebec task force on whiplash-associated disorders: redefining “whiplash” and its management. Spine (Supplement) 20(8S):1S-73S, 1995). The study has been widely acknowledged in the international scientific community, but it has also received widespread criticism for violating the very promise of best-evidence synthesis because the authors ultimately resorted to consensus-based-rather than evidence-based-methods (Freeman MD, Croft AC, Rossignol AM: “Whiplash Associated disorders: redefining whiplash and its management” by the Quebec Task Force: a critical evaluation. Spine 23(9):1043-1049, 1998). The authors developed a guideline for whiplash management based largely on the combination of a small number of papers and a consensus of their own opinions. Spinal manipulation was considered one appropriate means of treatment. If a patient remains out of work for more than three weeks, specialist advice should be sought, they said. If out of work for six weeks, a multidisciplinary team evaluation is recommended. For persons not out of work, however, these guidelines do not apply.

Reed Group, Ltd. The Medical Disability Adviser: Workplace Guidelines for Disability Duration, 4th edition (2001) is edited by Presely Reed, MD. In total, there are 2685 pages of text covering everything from abdominal aneurism to herpes zoster. In the preface he writes, “The Medical Disability Advisor is intended to be used as a tool against which the user should weigh the totality of his or her available knowledge and the specific information [of the individual case]. [And] Please use this tool judiciously, tempering your decisions with thoughtfulness and compassion.” There are no recommendations for either medical or chiropractic care in the treatment of whiplash patients.

Whiplash: A Practitioner’s Guide to Understanding Whiplash Associated Disorders (WAD) This was the result of a collaborative effort of numerous authorities at the behest of the Canadian Chiropractic Association. The 210-page guide was published in 2000 and distributed to all Canadian chiropractors by the CCA. The guide explores the topics of WAD physiology, symptomatology, grading issues, management, legal and road safety issues, third party payers, and the practitioner’s role in reporting and note-taking. In chapter 4.2, “Standardized WAD Grading Systems,” the Croft treatment guidelines are introduced.