Wednesday, June 27, 2018

Guest Post- DLE Lawyers Personal Injury Firm

Guest Post- DLE Lawyers Personal Injury Firm

 Who are DLE Lawyers?

 DLE Lawyers are a Personal Injury Lawyers In Florida. They have over 15 years of experience handling personal injury cases for their clients and their home office is in Miami Florida.

What Type of cases do they help with?


DLE Lawyers take on cases regarding personal injury such as car accidents, motorcycle accidents, truck accidents, wrongful death claims and slip and falls.

What connections does DLE Lawyers have with Miami Beach Family and Sports Chiropractic Centre?


Personal Injury Lawyers and chiropractors can sometimes go hand in hand. When someone gets hurt from an accident, the first thing they should do is get help from a medical or chiropractic physician. Once they have been treated, one of the next things they should think about is contacting a personal injury lawyer.

Why should you use a personal injury lawyer?


The easy answer is to recover any of the damages that the accident caused. Some of the more common losses are wages, property damage, and medical bills. If the accident you where in was caused by a form of negligence from another party, then it will usually be a good idea to hire a personal injury lawyer.

Why should you use Miami Beach Family and Sports Chiropractic Centre?


Miami Beach Family and Sports Chiropractic Center will work to help you feel better after your accident and help to relieve the pain where it hurts you the most using physiotherapy, chiropractic and rehabilitation techniques.  Dr. Narson uses his experience and education with athletes and sports injuries to treat all patients, not just athletes.  Moreover, Dr. Narson feels everyone deserves the knowledge of a sports medicine physician, because everyone, in his or her own way is an athlete as some level. 


Do DLE Personal Injury Lawyers recommend Miami Beach Family and Sports Chiropractic Centre?


Absolutely! Miami Beach Family and Sports Chiropractic Centre provides a quality service that does more than your average chiropractor in Miami. Unlike conventional medicine, which focuses on attempting to treat disease once it occurs, Miami Beach Family & Sports Chiropractic Center emphasizes improving your health in an effort to reduce the risk of pain and illness in the first place. Most people would rather be healthy and avoid illness, if they could.

Who will I be dealing with if I speak to DLE Lawyers?


The head attorney at DLE Lawyers is Jimmy De La Espriella. Jimmy will always answer your phone call to hear about your accident case. Unlike some other law firms, your call will always be connected to a lawyer and not a receptionist or any other intermediary. 

What else should I know about Personal Injury Lawyers?


Many people are scared to talk to a lawyer because they think it will be expensive. Personal Injury lawyers are different because they chart a contingency fee. Contingency fees mean that the lawyer will only get paid based on what you win from the case. Most Personal Lawyers will charge anywhere between 30%-45% of what you made from the lawsuit. This is great because if you lose the case you wont owe the lawyer any money.  In addition, the personal injury lawyer you choose is incentivized to get you the highest amount because it means he or she will make more money with you.

What are the most common cases for DLE Lawyers?


Most of the cases that come through the DLE Lawyers door are car accidents. There are thousand of car accidents per day and it is the most common cause of injuries in the Nation.

What should I do next?


If you believe you have a personal injury case and the accident happened in Florida, make sure to call DLE Lawyers. You can find their contact info here. If you where injured or hurt from the accident, make sure to use Miami Beach Family and Sports Chiropractic Centre to heal faster.

DLE Lawyers Address:



Wednesday, September 6, 2017

Hurricane Irma Back Pain Survival Guide

Dr Narson's "Back Pain Survival Guide For Hurricane Prep & Cleanup"

In both preparing for and cleaning up after tropical storms and hurricanes, many people injure themselves. I would like to offer you a few back safety tips during your preparation/cleanup for hurricane Ike and any other storms throughout the rest of the 2017 season.

Cleaning up around your house or condo requires a lot of bending, lifting, twisting and reaching.

1) Bend & Lift Properly

When bending, even for the smallest and lightest of objects, bend with your knees. Do not bend from your waist as this is the easiest and most popular way to herniated a disc in your back. It doesn’t matter how heavy the object is, bend properly and you reduce the chance of injury. Remember, not all objects are evenly balanced. That’s why your trainer has you do those unbalanced squats!! Be careful.

2) Pack & Move Smaller Objects

Don’t be tempted to lift larger objects, even if they are light in weight. In order to move a larger awkward object yourself, you have to compromise proper lifting technique and make your back vulnerable to injury. Pack small boxes that are easy to lift. When packing a box, keep in mind the weight of it as you add items. If you have a heavy or large object, put it on a dolly, hand-truck or get another person to help.

3) Twisting & Reaching

In order to store your stuff, you may have to lift it above your head, twist and reach as you put it away. Use a step stool and put objects away that are above the level of your shoulders. Try to keep the object at the level of your shoulder when you are on the stool or ladder and hold objects close to your torso. The further you hold an object away from you, the more pressure you place on your back. When twisting to the left, be sure that your left foot, left hip and left shoulder is pointing in the same direction as you turn. Obviously the same goes for turning to the right. This method keeps your spine in line when turning. Turning this way is okay, twisting your spine is not.

4) Apply Ice, Ask Questions Later

If you do feel that you have hurt yourself and are not sure what to do, I always tell people to apply ice compresses 1st and ask questions later. Obviously, you must stop any lifting and take care of yourself. When applying ice, never put it directly on your skin; always lay a handkerchief or other cloth on the skin and then apply the ice pack on top of that. 15-20 on, the rest of the hour off, repeat as needed. (and yes, I know of some of those new ice recommendations, but after 27 years of practice, I've seen the results and I'm sticking with ice per the original recommendations) for acute injuries. Not everyone has full time professional trainers to help them with joint and soft tissue mobilization, eccentric lengthening, manual lymphatic drainage or other active techniques and until you get to a competent, physician with knowledge of muculoskeletal medicine (DO, DC or MD) , certified athletic trainer or PT, Ice First-Ask Questions Later.

5) Moist Heat To Relax

There is no question you will be somewhat sore after preparing for the hurricane. If you feel a little stiff, sore or achy, apply a moist hot compress for 15-20 minutes to the affected areas to help relive soreness. Repeat as needed 15-20 minutes per hour. Do not apply heat for longer than 20 minutes per application. And DO NOT Sleep on a heating pad! Unless you want to slow cook your muscles!!!  A hot bath is a nice way to sooth sore, stiff achy muscles- just as long as you don’t need your bathtub to store extra water.

6) Don't Sit Too Long!

Please remember that sitting in one place while you are evacuated for a prolonged period of time can flair up back pain just like an acute injury (even if you have no back problems at all). So make sure you get up and move around every 25 minutes throughout the day & stretch too!

7) We Are Here For You

Remember, when the hurricane is over, these tips apply for the clean-up as well. If you do hurt yourself or you feel sore, stiff, achy and are not sure what to do, remember, we are always here to help. If you have questions or have an issue while prepping or cleaning up, text or call me personally 305.984.6336

If you do suffer some sort of back or neck pain or other strain of your body and it doesn't do away by itself in 48-72 hours, come see us for help.


Good luck weathering the storm should it hit. I hope these tips are helpful for you and your family

Yours truly,
  

Drs. Todd & Corey Narson
Miami Beach’s Chiropractors!




“El Movemiento Es Vida!” -  Movement Is Life!  So Keep It Moving!



Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He is sports chiropractor to the University of Miami Hurricanes. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #ToddNarson #Narson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #SportsChiropractor #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic #GrastonTechnique #IASTM #FAKTR #USATriathlon #USAT #TeamUSA #CorporateWellness #HappyEmployeedProfitableBusiness #HeadacheRelief #MigraineHeadacheRelief #Migraine #SportsSpecificExam #SportSpecificTreatment #WorkCompDoc #WorkersCompensation #ankleSprain

Sunday, February 12, 2017

Dr. Narson's Paleo Shephard's Pie Recipe

I first encountered Shephard's pie during lunch at Coral Springs Middle School. Surprisingly, I loved it. That was probably a first for a school lunch anywhere. Since being an adult and a doctor, eating healthy is a part of my life and based on much research, paleo is how I eat.

I've seen and tried several recipes for paleo Shephard's pie and have tweaked them to the point I call this one my own. I make it with either grass-fed ground beef or free range ground turkey (not ground turkey breast because it comes out too dry). 

Shephard's pie has two layers, the "meat mixture" and the topping. Instead of mashed potatoes, this recipe uses a cauliflower mash. The recipe uses carrots, onions, celery and cauliflower, so there is quite a bit of 'veg' in there.

Also, you can use the cauliflower mash as a side dish for steak, chicken, fish or use it by itself as a snack. try it as you make it, you'll see. 

If you like a hearty, savory meal, this is it. I make a tray of it and use it for lunch and dinner for about 3-4 days. I hope you enjoy it as much as I do. 

Dr. Narson's Paleo Shephard's Pie:


For the top layer
  1. 2 large heads cauliflower, cut into florets
  2. 2 tbsp ghee, melted
  3. Salt and freshly ground black pepper, to taste
  4. Fresh parsley, to garnish
  5. Paprika to garnish
  6. 4 heaping Tbsp of nutritional yeast
  7. 1 tsp garlic powder
  8. 1 tbsp onion powder
For the bottom layer
  1. 2 lb. grass-fed ground beef (or free range turkey)
  2. 1 Tbsp coconut oil & 1 Tbsp of Ghee
  3. 1 large onion, diced
  4. 3 carrots, diced
  5. 2 celery stalks, diced
  6. 1 can of tomato paste
  7. 1 cup chicken broth
  8. 1 tsp dry mustard
  9. 1/4 tsp cinnamon
  10. 1/8 tsp ground clove
  11. 1 tsp of smoked paprika
  12. Salt and freshly ground black pepper, to taste
  13. 2 heaping Tbsp of the ‘cauliflower mash’
  14. 1 Tbsp of coconut flour (optional)
Instructions

  1. Place a couple inches of water in a large pot. Once the water is boiling, place steamer insert and then cauliflower florets into the pot and cover. Steam for 15-20 minutes, until fork tender. Drain and place in large mixing bowl.
  2. Add the ghee, nutritional yeast, garlic powder, onion powder, salt, and pepper to the cauliflower. Using an immersion blender (aka: stick blender) to combine the ingredients until smooth. Taste test for flavor, make any adjustments then set aside.
  3. Meanwhile, heat the coconut oil & ghee in a large skillet over medium heat. Add the onion, celery, and carrots and sauté for 5 minutes until carrots and celery get soft and onions become clear and just start to brown.
  4. Add the salt, pepper, ground clove, cinnamon and smoked paprika to the ground beef, combine well until the spices are well incorporated into the ground beef. Flatten into a large patty and place on top of the carrot/onion/celery mixture and press the ground beef into the pan. Cook until it browns (once one side is brown, cut it into 4 piece, flip each piece so the other side can brown. Once the second side browns, chop into small pieces with a chopper. Cook for another 3-4 minutes and mix as you go.
  5. Stir the tomato paste and chicken broth into the meat mixture. Season to taste with salt and pepper. Simmer for 3-4 minutes, stirring occasionally.
  6. Add 2 tbsp of cauliflower mash to the meat mixture and mix it in
  7. Sprinkle coconut flour on top of meat mixture, then, mix it into the meat mixture to thicken the sauce. Let simmer another 2-3 minutes.
  8. Distribute the meat mixture evenly in a rectangular glass pan to about ½ the height of the pan wall. Distribute cauliflower mash evenly over the meat mixture until the meat mixture is completely covered. Sprinkle (non-smoked) paprika lightly over the top.
  9. Place in oven on 325 for 15 minutes. Then broil until top later starts to brown.
  10. Enjoy!








Let me just say.... Wow, this was good!

Enjoy!

Dr. T


_____________________________________________________________
Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#MiamiBeachChiropractor
#chiropractormiamibeach  #SportsInjuriesFixedHere #DrNarson #ToddNarson #Narson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #SportsChiropractor #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic #GrastonTechnique #IASTM #FAKTR #USATriathlon #USAT #TeamUSA #CorporateWellness #HappyEmployeedProfitableBusiness #HeadacheRelief #MigraineHeadacheRelief #Migraine #SportsSpecificExam #SportSpecificTreatment #WorkCompDoc #WorkersCompensation #ankleSprain #concussion #LawrenceTaylor #LisaDwoskin #DrStevePerman

Friday, June 3, 2016

Monday, January 9, 2017

Top 20 Reasons Why You Need A Sports Chiropractor!

From my colleagues at Sports Care Performance Place... 

Top 20 Reasons Why You Need A Chiropractor

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He is an active triathlete, USA Triathlon Certified Coach and Ironman Miami 70.3 finisher.  He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine. #chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #ToddNarson #Narson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #SportsChiropractor #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic #GrastonTechnique #IASTM #FAKTR #USATriathlon #USAT #TeamUSA #CorporateWellness #HappyEmployeedProfitableBusiness #HeadacheRelief #MigraineHeadacheRelief #Migraine #SportsSpecificExam #SportSpecificTreatment #WorkCompDoc #WorkersCompensation #ankleSprain

Friday, August 19, 2016

How Do You Act When The World Is Watching?

In June 2014 I had the privilege of doing a 2 week medical rotation at the US Olympic Training Center in Colorado Springs.  Being a chiropractic physician specializing in sports medicine, this was a big deal for me.  It’s something I set goals for, worked hard to develop my skill-set, thought about and dreamed about for a very long time.  While I was there treating America’s current and future Olympians and treating athletes alongside the Olympic training center’s staff trainers, therapists and physicians, I kept one thing in mind…Whatever I do could affect my profession. I knew it was about 
more than just myself.


I knew that if If I screwed up or goofed off or played a prank, it could have a negative impact on other sports chiropractors everywhere. If I wasn’t thorough in my consults and exam, if I wasn’t effective in my treatment, if I was disrespectful in any manor it could have a negative impact on my profession.  While at the Olympic Training Center I considered myself an ambassador for my profession. What I did there could reflect positively or negatively on my profession.


As such I have to say to swimmers Ryan Lochte, Gunnar Bentz, Jack Conger and Jimmy Feigen of Team USA (and to all athletes everywhere representing your family, town, county, school, state or country) - you are all ambassadors. We watch you with high hopes and hold you in high regard. We cheer for you when you compete, we ache with you when you lose or get hurt and we feel such pride when you win. You are an extension of us.  You carry the spirit of our country with you wherever you go and what you do on the world stage reflects on the USA and each and everyone one of us here at home.

_________________

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.



# ryanlochte #chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #ToddNarson #Narson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #SportsChiropractor #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic #GrastonTechnique #IASTM #FAKTR #USATriathlon #USAT #TeamUSA #CorporateWellness #HappyEmployeedProfitableBusiness #HeadacheRelief #MigraineHeadacheRelief #Migraine #SportsSpecificExam #SportSpecificTreatment #WorkCompDoc #WorkersCompensation #ankleSprain #Olympics #TeamUSA

Monday, June 6, 2016

Concussion In Sports: An Internet TV Show Panel Discussion with Lawrence Taylor & Lisa Dwoskin

Recently I was asked to be part of a panel discussion on the topic of concussion in sports and of course I did it. It was Co-Hosted by exercise physiologist and health coach Lisa Dwoskin & New York Giants Hall of Famer Lawrence Taylor. I was happy to share the spotlight with my esteemed colleague Dr. Steve Perman of West Boca Raton, FL.

Concussion in sports is a deep topic. Think of the mad hatter going down the rabbit hole. You don't know how deep it will go or where it will lead you. Just expect the unexpected. Enjoy the video and post your thoughts and comments below.

The take home message from all this is (1) treat all concussion, even mild ones-seriously. (2) parents with children on a sports team where concussions and other sports injuries are probable, pool some money together and hire an athletic trainer or a certified sports chiropractor to evaluate and manage any injuries. (3) When it comes to concussion, all those bumps on the head add up. Addressing them early by a competent functional neurologist can make all the difference.


_________________________________________________________________________
Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He is an active triathlete, USA Triathlon Certified Coach and Ironman Miami 70.3 finisher.  He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #ToddNarson #Narson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #SportsChiropractor #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #Chirooractor #Chiropractic #ChiropracticPhysician #DoctorOfChiropractic #GrastonTechnique #IASTM #FAKTR #USATriathlon #USAT #TeamUSA #CorporateWellness #HappyEmployeedProfitableBusiness #HeadacheRelief #MigraineHeadacheRelief #Migraine #SportsSpecificExam #SportSpecificTreatment #WorkCompDoc #WorkersCompensation #ankleSprain #concussion #LawrenceTaylor #LisaDwoskin #DrStevePerman

Friday, June 3, 2016

Let’s Dispel The Myth: Trauma Can Cause Schmorl's Nodes

It’s not that Schmorl’s nodes are mythical, they actually do occur. The problem is doctors and scientists like to give conditions they discover cute (and sometimes not so cute) names that are really not very descriptive of the physiology of the actual condition. Such is the case with Schmorl’s nodes.  

First described by Schmorl in 1927, a Schmorl’s node has classically been known to be due to any process which weakens the cartilaginous endplate or the subchondral cancellous bone. Schmorl’s nodes have been most commonly associated with Scheurman’s disease, Paget’s disease, degenerative joint disease, sickle cell anemia and malignant tumors. Essentially they occur because some physicologic process has gone awry, weakened the bony end-plate of the vertebral body and as the bone weakens, pressure from the disc pushes and deforms upward into the vertebral body.

When physicians see Schmorl’s nodes on x-ray, CT-scan or MRI it is typically brushed off as an incidental finding-regardless if the area is symptomatic or not. Although radiology text books always mention trauma is a possible cause, it’s always at the very bottom of the list potential diagnosis and usually never given a second thought.  I think this needs to change.
Multi-level Schmorl's Nodes (fracture-herniation)
 

2 studies published in Spine V. Fahey et. al.) 1998 and the American Journal of Neuroradiology (Wagner, et. al. 2000) seem to bring the Schmorl’s node phenomenon to the top of the list when there is spinal pain caused by a trauma in an area where a Schmorl’s node is present. These papers show that not only can trauma cause a Schmorl’s node but most (57%) of the Schmorl’s nodes in 2000 AJNR study  were traced to episodes of “significant, sudden-onset, localized, non-radiating back pain and tenderness for which the MRI images showed Schmorl’s nodes surrounded by vertebral body marrow edema”.

Now that we know Schmorl’s nodes are occurring from trauma more often than originally thought, what exactly is a traumatically caused Schmorl’s node?  That’s a very simple answer. With a strong annulus and enough pressure placed on the intervertebral disc seen in car accidents, falls and other trauma;  the force takes the path of least resistance  fracturing and herniating up through the inferior and/or superior end plate of the vertebra - fracturing its way into the spongy bone. 

Bottom line, if you find yourself having pain after a trauma and your x-rays, CT scan or MRI shows a Schmorl's node(s) in the area of your injury, then you can bet that the Schmorl's node was caused by the trauma. Just rule out the other Schmorl's node associated conditions first.  Now you just have to find a physician open minded enough to read the research and work with you to resolve your symptoms.

Todd M. Narson, DC, DACBSP®



 References: 
1) Yochum & Rowe; Essentials of Skeletal Radiology; p. 114 
2) Paul & Juhl; The Essentials of Roentgen Interpretation 
3) V. Fahey MBBS; et al.; The Pathogenisis of Schmorl’s Nodes in Relation to Acute Trauma. Spine 1998;23:2272-2275 
4) Wagner AL, Murtagh FR, Arrington JA, Stallworth D, American Journal of Neuroradiology 2000 Feb;21(2):276-81; Relationship of Schmorl's nodes to vertebral body endplate fractures and acute endplate disk extrusions.
_____________
Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.


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