Episode Transcript Excerpt

HOST (Dr. Bagwell): Welcome to Episode 26 of True Health Solutions. I'm joined today by Dr. Justin Dick, a chiropractic physician specializing in structural spinal rehabilitation. Today we're talking about trauma - something most people underestimate in terms of its lasting impact.

DR. DICK: Most people don't realize the impact an old injury can have on their current aches and pains. When someone comes in with chronic neck pain or back pain, the first question I ask is - have you ever been in an accident? Because what seems like an old, resolved injury is often still active structurally. The ligaments healed in a compromised position, the joints moved differently, and now years later the body is compensating.

HOST: So what's the window - when does an injury go from treatable to permanent?

DR. DICK: The window is smaller than most people think. In the acute phase - the first weeks after injury - the tissue is still healing and we have the opportunity to guide it toward a functional outcome. As time goes on, the tissue matures. Scar tissue forms. Motion is restricted. What starts as a soft tissue injury can become a structural problem that's much harder to correct. This is why I tell patients: if you're in an accident, don't wait for the pain to go away. Pain going away is not the same as the injury healing.

HOST: What does trauma do to the spine structurally?

DR. DICK: Trauma - particularly whiplash-type acceleration-deceleration injuries - can damage the ligamentous system that holds the vertebrae in position. Those ligaments don't regenerate the way muscle does. Once they're stretched or torn, they lose their restraining function. That's what we call ligamentous instability, and it can be detected on stress radiographs. It's objective, measurable, and it explains why patients continue to have pain long after the initial injury.

HOST: What does your treatment approach look like for trauma patients?

DR. DICK: We start with objective documentation - radiographic analysis, range-of-motion measurement, neurological assessment. I need to know exactly what we're dealing with before I put hands on someone. Then the treatment is specific to those findings. We're not treating pain. We're treating the structural injury that's causing the pain. That distinction matters enormously for outcomes.

Frequently Asked Questions

Why is it important to see a chiropractor quickly after an injury?

The treatment window after injury is smaller than most people think. In the acute phase, tissue is still healing and clinicians have the opportunity to guide recovery toward a functional outcome. As time passes, scar tissue forms, motion is restricted, and what begins as a soft tissue injury becomes a structural problem that is much harder to correct.

What is dynamic ligamentous instability?

Dynamic ligamentous instability refers to abnormal intersegmental motion detected under stress loading, indicating damage to the passive stabilizing ligament system. It is measured on flexion-extension stress radiographs and correlates with ongoing pain, functional limitations, and long-term prognosis.

How does structural chiropractic care differ from pain management after a car accident?

Structural chiropractic care targets the biomechanical injury - ligamentous instability, cervical hypolordosis, segmental dysfunction - not the pain itself. When the structural injury is treated, the pain resolves as a consequence. Treating pain alone without addressing the structural cause leaves the underlying injury unresolved.