Monthly Archives: March 2012

Afghan tragedy sharpens focus on brain injuries in the military

The recent Afghan tragedy involving Sgt. Robert Bales has renewed attention on the signature wounds of war­­­­–brain injuries. While the public struggles to make sense of the massacre that left sixteen dead, many are wondering if a brain injury Bales obtained while deployed in Iraq in 2010 is linked to the event.

Although Bales suffered a concussion when his vehicle rolled over, auto collisions are not the only source of brain injuries for US soldiers. Perhaps the most common culprit of the signature wound of war is the signature weapon of war, the improvised explosive device (IED).

IED explosions create high-velocity shock waves that can produce bleeding in the lungs and injury of internal organs. IED explosions can cause damage to the brain in a number of ways that are still controversial and not fully understood. What is clear is that medical advancements means that soldiers that may have died of explosions in previous wars are now able to survive with lifesaving technologies. But they often survive suffering with two life-changing, serious conditions –traumatic brain injuries and post-traumatic stress disorder (PTSD).

An estimated 16-18% of US troops have suffered from  mild traumatic brain injuries while deployed in Iraq or Afghanistan. As we’ve discussed in other posts, the military has made efforts to address the issue but recent events confirm that more is needed to adequately support and treat soldiers affected by traumatic brain injuries.

 

Walsh, Nancy. Afghan Tragedy Renews Focus on Head Trauma in Soldiers. Medpage Today. http://www.medpagetoday.com/CriticalCare/HeadTrauma/31744. March 20, 2012. Accessed March 29, 2012.

Wendle, John. Traumatic Brain Injury: Hidden Peril of U.S. Soldiers in Combat.  Time. March 19, 2012. http://www.time.com/time/world/article/

0,8599,2109277,00.html#ixzz1qYKv8ux8. Accessed March 29, 2012.

How to treat jaw pain naturally

 A new study confirms that chiropractic can provide non-invasive treatment for jaw pain and dysfunction after auto collisions.

In the study,  93 patients with temporomandibular disorders (TMDs) had been suffering from jaw pain for three months or more.1 The researchers divided the patients into three groups: one group received chiropractic treatment, one received chiropractic treatment plus patient education and self-care exercises, and the other group was put on a wait-list for treatment. The chiropractic treatment consisted of gentle adjustments to strengthen and stretch jaw muscles.

Patients under chiropractic care experienced significant relief, unlike wait-listed patients. At the six week and six month follow-up, chiropractic patients had decreased pain levels and improved range of motion. Normal movements like clenching, opening, and closing their jaws became easier again.

Surprisingly, the group practicing self-care exercises did not advance more quickly than the group only receiving treatment. After one year though, the treatment-only group regressed slightly but the self-care group maintained their improvements.  Researchers suggested that while manual therapy improved patient symptoms, self-care exercises sustained the results. Even without the self-care though, patients in the treatment-only group were significantly better-off than wait-listed patients.

Since there were no adverse effects of the chiropractic therapy, researchers concluded that it was a safe, tolerable treatment for patients with jaw dysfunction and pain.

1. Temporomandibular disorders (TMDs) refer to a complex of disorders in which dysfunction and injury to jaw joints and muscles causes pain. These disorders can occur as a result of a jaw injury or dislocation, whiplash, damage to the cervical spine (neck), grinding of teeth, or arthritis. TMDs are frequently referred to as TMJ after the temporomandibular joint which connects the lower jaw bone to the skull. Learn more about TMJ here.

Kalamir A, Bonello R, Graham P, Vitiello AL, Pollard H. Intraoral myofascial therapy for chronic myogenous temporomandibular disorder: a randomized controlled trial. Journal Manipulative Physiology Therapy 2012; 35(1):26-37.

 

Lingering effects of concussions on children

For years, doctors believed children recover quickly from mild traumatic brain injuries, but a growing body of research suggests that may not be true for every child.

A new study shows that 20% of children can have symptoms that last for at least a year after their initial injury. In the study, children with mTBIs were significantly more likely to suffer from long-lasting symptoms than children who had other orthopedic injuries.

Children who lost consciousness or had abnormal imaging suffered more lingering symptoms than children who had normal imaging test results directly after injury. Those in the former group were more likely to have headaches, fatigue, attention deficits, and memory problems.

The study compared 186 children who had suffered brain injuries with 99 children with orthopedic injuries receiving treatment in Ohio. Researchers asked parents to answer a questions on their child’s health directly after injury as well as one, three, and twelve months later.

Most parents just want to know their child is okay after a concussion or other brain injury. While many children do recover quickly from mTBIs, this study suggests that it’s crucial to watch for signs of lasting symptoms and receive help from a health professional when appropriate.

For more on this issue, see our recent post, “Brain injuries have lasting implications for children”.

Reference

Yeates, Keith Owen,et al. Reliable Change in Postconcussive Symptoms and Its Functional Consequences Among Children With Mild Traumatic Brain Injury. Archives of Pediatrics and Adolescent Medicine. Published online March 5, 2012. doi:10.1001/archpediatrics.2011.1082.