Recommendations on imaging
 

Hi,

Looking more likely that my husband will be getting some imaging done. He is doing pretty well but certain things cause some setbacks. I had an earlier post about the effects of taking a train. Anyway, his neck pain has gotten work and I feel like if he is going to get imaging for that that only and mri will really show what is going on. He had an x-ray post accident. But, for the concussion and mri seems useless. His concussion doctor agrees with this and says that maybe a functional mri or spect scan would show something.

I don't want to use up the limited funds in the personal injury insurance of the person who caused the accident on testing that is of no use. I also am concerned that they will not agree to do tests that are a little bit outside the norm.

What imaging tests do you think are useful? And, for anyone in a MVA, any thoughts on the insurance paying for them.

I think the question is: Will imaging lead to improved healing ?
Specialized imaging will be no better than the radiologist reading the images and the doctor who prescribes the treatment.

So, I suggest you search for a doctor who has a treatment plan based on findings from imaging. It sounds like the concussion doctor is taking shots in the dark.

What symptoms are you hoping to treat ?

Is he getting any treatment for his neck ?

I'm not sure how long ago the MVA happened, or if they did a neck MRI at the time?
If not I would get the cervical spine MRI if his neck is hurting more.
If nothing else it will rule it/out if there is a obvious cervical spine issue. Could still be something small that won't show up..but things have been missed , it depends on the techs reading the images and if the dr actually look s at the images or just reads the report..

If nothing shows as a cause, then it most likely is soft tissue and you can proceed with PT and chiropractic or other therapies.
( oh I see whiplash was dx also?)
https://www.google.com/search?q=Whip...lash+treatment
If it is mostly soft issue pain around the neck and upper back, if you can find a treatment provider that has a low level laser (also called soft laser/cold laser) that might be very helpful.
IF stim is nice too ( just don't let then turn it up too high).

Whoever was at fault , their ins should be covering medical bills, I don't know the process of how to do that but their Ins carrier or the website should explain how to do it.

Many auto insurance policies have a limited 'no fault' medical payments provision of $5000 or so. Anything above that amount often needs to be pursued in court. This might be what she is referring to.

If I understand correctly, he was injured about 10 to 11 weeks ago. Other than an unresolved neck injury, he still has plenty of time for normal healing. Finding the right treatment for his neck will be more important than any imaging. Not much good at spending big money to find out xxx is wrong but there is nobody who can treat xxx. Finding somebody to help with his neck should be a top priority.

Yikes - what was I thinking about when I typed that post. Oh the numerous typos. I must have typed it on my phone. My auto correct hates me. Thanks for the responses.

I am happy with the doctor. She does concussion protocol with college athletes and seems well researched. If she was stumped she would send him out to another specialist. Right now she is just doing the protocol. We talked imaging at his last appointment about a month ago because she was out of town when my husband had a setback and ended up at the er and there was talk from the other doctors in her office of him getting some imaging done. She feels, and I agree from what I have read here, that mri's and ct scans aren't really useful for recovery. We did discuss spect scans and functional mri's as possibilities if his symptoms keep coming back.

He does have whiplash and he was doing well but, after the train ride, he has had more localized continuous pain in his neck to the point where he is interested in finding out what is going on in there. He does have soft tissue pain and he has exercises and gets ultrasound for that.

For the neck, I think he would be hoping to just know that going to the chiropractor is the right thing and whether or not there is some injury to his neck that he needs to be addressing some other way. He has been at the chiropractor regularly since the accident. I have permanent issues from an accident so I got him there right away. It is also part of the reason I have just been so careful and proactive about researching and asking questions about everything. I didn't know what I needed after my accident and will live with the orthopedic issues for the the rest of my life because of it.

As for the head imaging, I just didn't know if there is any reason, if he gets a neck mri, that he should also get a head mri at the same time. I'm not one for unnecessary imaging. If the doctor starts talking imaging, I didn't know if anyone here had any experience or thoughts on if there is any reason to have it done and if anyone has had a spect scan or functional mri. Is there a theraputic reason to have one done?

We would likely have to go out of town to get those done. I wouldn't mind, if there is anyone here with a positive experience, a suggestion on a location for a scan. We live in central Illinois so we could easily go to Chicago, St. Louis, Indianapolis, Madison or anywhere in between. We also have family in DC and Portland.

Thanks again for the input. So glad I found this forum, reading through it has answered a lot of questions a long the way.

Oh, and today, I did what I should have done before.....realized that there is a good search function on this forum. I was able to find posts as old at 3 and 4 years ago that sort of answered my initial question. The only thing would be if there is research or advances in that time that would effect a decision about a scan or type of scan.

If he is being treated by a chiro and is not improving, I suggest you look into other treatments. As I have said many times, the 'twist the head and pop the neck' chiro treatment is too aggressive for many. Plus, most of his neck healing will be due to his own disciplined behavior/posture.

btw, Did he fall asleep on the train ?

Due to the pain - he did ask for no twist and pop this week. He did see a lot of improvement in the neck and back until the train ride but, I think we will look into some other things when we meet with his doctor at the next appointment.

He did fall asleep on the train. Not in the best position either.

Just the mild constant vibrations might have made his neck muscle work harder than usual too.

Doe the chiro you go to have IF stim and or Low level laser? they are really nice for soft tissue , and the laser was great for my wrist , shoulder, foot, elbow specific pain areas.. 20 sec tx and pain was gone..

If he or you have ongoing pain in soft tissue yo might consider an IF stim (like a TENS only better - IMO) of your own , I got mine from Amazon for under 80.00 - had it about 5 yrs now - digital is nicer than analog dials..analog dials are often touchy and you get zapped.

This is the one I have. battery & plug in & very easy to use. but there are many other brands too.
http://www.amazon.com/Roscoe-Medical...interferential

I'm not surprised he fell asleep on the train. I fell asleep riding in a cushy ride car and my neck was messed up for weeks. I had so much inflammation in the upper neck that I could not get my heart rate or blood pressure up for those two weeks. I could hardly get up out of a chair. The head slumped forward or two the side is killer on an injured neck.

I wonder if your chiro knows a gentle neck technique that is worthwhile. If he did, I would think he would have tried it long ago. Many chiros think they need to hear that pop. Some gentle traction with mobilization and gentle manipulation may be best. If he is not gifted at such a technique, you should consider finding someone who is. My PT was helpful for me.