How Long Should Chiropractic Treatment Be for Whiplash Injuries?
Chiropractic Treatment Duration for Whiplash Injuries
After a car accident, one of the most common questions that arise is how long treatment should go on. As a patient you may be concerned because treatment takes up a lot of your time. Your attorney will want to know because it affects the outcome of your case. Insurance companies want to know and often cite too much treatment was an argument to minimize your case.
Professional Practice Guidelines
You first need to understand that a doctor specializing in car accident treatment does not just treat you “willy-nilly.” Whiplash specialist doctors use “guidelines” to tell them an expected range of treatments that are appropriate based on your individual injury. Professional practice guidelines are a set of parameters derived through studying the medical and scientific literature. Guidelines are then submitted to other researchers, institutes or licensing boards for comments and approval. If the guidelines are considered useful and well documented, they may be officially adopted by the profession.
When it comes to chiropractic treatment of whiplash and other injuries from car accidents, there are a few guides to consider. The most well received, best documented and universally accepted guidelines are the “Croft Guidelines.”
In 1993, Arthur Croft, D.C., M.S., M.P.H., F.A.C.O., F.A.C.F.E., published a set of management guidelines in the ACA Journal. These guidelines have also been published in Whiplash Injuries: the Cervical Acceleration/Deceleration Syndrome, second edition, in 1995 and in a recent Canadian practitioner's guide to whiplash injuries, sanctioned by the Canadian Chiropractic Association.
The Croft Guidelines have been a part of our literature now for over 2 decades. No competing guidelines relative to whiplash treatment have been published during that time. Several American state chiropractic organizations and associations, as well as in at least one Canadian province, have adopted the Croft Guidelines.
The vast majority of true car accident injury experts rely on the Croft Guidelines to determine the severity of their patient’s injuries and an estimate on how long treatment may take.
Using the Croft Guides for Duration of Treatment
The first step is to determine the “severity” or “how bad” an injury is. In a previous post, I outlined how the Croft Guides gives specific factors to use to determine severity of injury. See “How Bad is My Car Accident Injury?” for details.
Once your doctor has established the severity as either a Grade I, II, II, IV or V, the doctor consults the guidelines to see the predicted range of treatment numbers and duration. For example looking at the table below, a Grade II injury may require daily treatment (7 times in 1 week) for 1 week, then may require treatment at 3 times each week for 4 weeks or less, then 2 times each week for 4 weeks or less, then 1 treatment per week for 4 weeks or less and finally 1 time per month for 4 months or less. The total duration (TD) of treatment may be upwards of 29 weeks and the total number (TN) of visits may be up to 33 visits.
You will note that I have said “may” and “up to” many times; that is because these are practice guidelines and not rigid rules. Patients may need slightly more or less treatments depending on their individual injuries. The point is, there are professionally recognized practice guidelines that have been published by medical researchers and experts that assist the doctor, the patient, attorneys and insurance adjusters in understanding the anticipated duration of treatment.
When an automobile insurance adjuster claims that chiropractic treatment has gone on too long, the question is, “based on what?” What guidelines have they used to substantiate their assertion? Most insurers will not cite any guides. Others may try to cite disability guides or other references, but these guides are for work injuries or general non-traumatic neck or back complaints. They are not generally accepted guides specifically for chiropractic treatment of a whiplash injury. Car accident injuries have been shown in the literature to be unlike any other type of injury or cause of neck and back pain.
As the victim of a car crash injury, understanding these guides will help set you at ease knowing that your treatment is being provided in the most scientific and professional manner possible.