Brief Answer:
I believe MRI is potentially helpful

Detailed Answer:
Good evening to you young lady. I hope you guys are on the road to recovery....sounds like in some respects you are....but here are a few thoughts.

In direct response to your question on the MRI. I'm always of the opinion that adding as much information to a situation such as this where there is pain following an injury can be POTENTIALLY HELPFUL....on the other hand, it may not really push the ball farther down the court as well....so one must always be cautious when doing lots of diagnostic tests for things such as whiplash, back injuries, and headaches. Often, clinical assessments are as accurate as diagnostic testing results since things such as CT's, MRI's, and bloodwork for these sorts of problems are infrequently/inconsistently revealing of anything that striking or important so as materially change the therapy approach.

However, the test can't hurt and in the event it demonstrates a disk herniation or other evidence of nerve root impingement or something similar then, it could help add some aspect to the therapy or intervention that otherwise, may not have been considered so bottom line....I think you're on the right track in getting the MRI but to know the ultimate benefit you'll have to wait for the test to be scheduled and results to be known and interpreted by his doctor.

I may not have mentioned this before but I and most neurologists (as well the XXXXXXX Academy of Neurology) have strong reservations and in fact, argue against the use of NECK MANIPULATIONS under any circumstance by chiropractors or anybody else in the way they are typically done. The procedure is potentially hazardous and has been known to cause great disability and even death in some individuals. Therefore, I do not recommend such interventions by chiropractors. If you are comfortable with the rest of the treatments such as BACK ADJUSTMENTS, etc. then, by all means continue by I would leave the neck well enough alone. The potential for harm from the procedure is clearly more than the ongoing pain.

The same holds for acupuncture. I believe that such intervention has all sorts of benefits and a number of my patients have gotten long lasting relief from acupuncture so I have nothing against that as a form of pain intervention and management.

Medication management on a chronic basis is complex and must take a number of factors into consideration such as current medications that a patient is taking, what their history and response have been in the past to certain agents as well as the side effects they've experienced, and how disabling and interfering their pain is now with respect to work and social activities. You can appreciate therefore, when I say that I am not in a good position to make valid determinations for XXXXXXX based on not having all the necessary information nor am I able to examine him myself.

I can say that most frequently and typically my patients will receive pharmacological pain management using NON-NARCOTIC and NON-OPIATE types of drugs at first intention such as gabapentin and pregabalin as well as standard courses or NSAID's such as ibuprofen and naproxen. However, there are devices that can be purchased such as heating/ice pads, TENS units, SOOTHEAWAY devices, BIONESS, and other types of hardware that offer relief.

Rehabilitation therapy I believe is probably one of the most important long term solutions to the management of acute pain syndromes in order to have the best chance to avoid chronic transformations. Unfortunately, many individuals cross that threshold of transformation and then, it becomes a real challenge to find exactly the right combination of devices, drugs, and interventions that will give 100% relief on a longlasting basis.

I hope this answer satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with written feedback?

Also, if there are no other questions or comments, I'd appreciate it greatly if you would CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary.

Please direct more comments and questions to me in the future at:

bit.ly/drdariushsaghafi and I would be honored to answer you and continue this discussion.

All the best.


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