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North Florida Spine and Injury Center Blog

  • Health savings account and flexible spending account Jacksonville FL
    26/02/2021 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    Health Savings Accounts / Flexible Spending Accounts and High Deductible Health Plans

    This will be a continuation of the general overview post concerning the basics of health insurance.

    The vast majority of our patients do not have or know what Health Savings Accounts (HSA), or Flexible Spending Accounts (FSA) are. So, in this post I will do my best to help clarify what these accounts are, why you need one and you do need one, like now. No, really, you need one, now… And how easy they are to set up and maintain year after year.

    Let’s start by talking about taxes, yes taxes. You know there are only 2 things in life that are definite, death and taxes. Yes, those taxes. Those of us that are blessed enough to have gainful employment have an income. An earned income if you will. This is subject to United States tax law. I will not get into international tax laws as that is just ridiculous ;) So, as a law-abiding citizen you file a tax return at the end of the fiscal year and the government removes money from your possession. This removal process can be on a check by check / payday by payday basis or quarterly or yearly depending on your situation. Either way you will be parting with your hard-earned cash. After the removal process you will have post-tax dollars, before the removal process those dollars are referred to as pre-tax dollars. If you are smart, which you are. Come on, give yourself some credit. I mean I’m sure your mother always told you how smart you are. Well, she meant it. So, since you are smart you need to limit, or reduce your taxable income. Another way of putting it is reducing your pre-tax dollars. There are thousands of ways to accomplish this and a good CPA will gladly do it for you. Please get a CPA, they will only save you money.

    Ok, now back to the HSA / FSA subject. These accounts are funded by pre-tax dollars and effectively lessen / reduce your taxable income. This is why you need one now!

    The basic gist of an HSA / FSA account is that you are using pre-tax dollars to pay for out-of-pocket health related or doctor approved costs. A few examples are

    • co-pays
    • co-insurances
    • deductibles
    • prescriptions
    • procedures
    • durable medical equipment (DME)
    • certain vitamins / supplements and so on

    Let’s start with the FSA as these are not as common these days (2021) and have fallen out of favor a bit compared to the HSA.

    The FSA is usually an arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars. Allowed expenses include insurance copayments and deductibles, qualified prescription drugs, insulin, and medical devices to name a few.

    You decide how much to put in an FSA, up to a limit set by your employer. You are not taxed on this money as you would be funding this account with pre-tax dollars.

    If money is left at the end of the year, the employer can offer one of two options (not both):

    • You get 2.5 more months to spend the left-over money.
    • You can carry over up to $500 to spend the next plan year.

    To my knowledge FSA accounts do not bear interest / cannot be invested.

    So basically, you can lose what you do not spend, or most people just go on a spending spree at the end of each year because they do not want to lose money. But this is just wasteful. And the money you have funded the account with does not earn interest nor can it be invested. These are the downsides of the FSA and why they have fallen out of favor in general.

    Now, HSA accounts have much more flexibility and are favored by most people.

    HSA accounts and high deductible health plans (HDHPs) go hand in hand. You can take advantage of lower premium costs associated with a higher deductible plan but then use the HSA account to pay for out-of-pocket health related costs that are with pre-tax dollars. The left-over money in the account can roll over year after year. Depending on who you set the account up with / through the account will bear interest or can be an investment vehicle.

    You will need to find out if your health plan qualifies for you to open an HSA account and then search for providers to be able to open the account. Some are through banks, maybe the bank you already use. Some are stand-alone companies that provide this service.

    Here is where it gets tricky. Good HSA accounts are free. Most have fees associated with them. So be careful. Please make sure you read everything before you sign up. That being said, mistakes do happen, and you can always close an account and open a new one. I had to actually do this for myself before I found a good company. Give me a break, no one is perfect… just ask my wife, she will tell you.

    You will want to have the account include features like a debit / credit type card that you would use. This way money would come directly out of the HSA account and you would not have to keep track of every penny as the year goes on.

    There will be limitations on how much you can fund these accounts each year, but most financial planning experts agree that funding the maximum amount each year is advantageous to the average person.

    This may sound overwhelming at first, but it really is not. Basically, call your bank and see what they offer. Do a thorough internet search for companies that offer these types of accounts or speak with your employer. Find a good CPA and have them help you with your taxes each year. Involve your financial planning professional if you have one, and once you pick out an account have your CPA tell you the optimal amount you should be funding each year and you are off on your savings adventure.

    If you have any questions or need further clarification, please give the clinic a call. We at North Florida Spine and Injury Center would be glad to help you out.

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    P: 904 541-6144
    F: 904 541-6154

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  • In-Network Providers for back pain and neck pain
    27/01/2021 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    A General Overview of Health Insurance

    Most, but not all of my patients have health insurance, whether self-funded or employer sponsored. Yet, the vast majority of these people do not understand the basics of their own plan or any of the basic terminology of insurance what-so-ever.

    Well, all that changes now.

    We are going to go over the true basics of health insurance here, think of it as an insurance 101 course at the University of Dr. Zeccardi. That being said, this article is by no means a comprehensive resource. Just the basics for now. If I receive a strong response and readership, I may dive deeper.

    So, just because you have a health insurance plan it does not mean all of the services you want are free. Say it ain’t so doc? Well, it is so people. I cannot express to you how many individuals call the clinic or come in with the assumption just because they have a nice, new, crisp health insurance card that everything is free. You have to read the policy language to truly find out what is and is not covered, what is paid for in full, in part or not all by the insurance company you purchased the policy from / through. Every plan is a little different and can generally be tailored to your particular situation. For example, a single college student without dependents does not require the same plan as a family of 5. So, we purchase the plans according to our needs. Dental services and vision services are usually separate or add-ons to the policy. I said usually, so there are exceptions to every rule here.

    Ok, so let’s go over some general vocabulary as it relates to insurance.

    Policy / plan – This is what you are buying… The policy outlines what is and is not covered and the rate or percentage of the coverages the insurance carrier provides. Please read the policy language. Yes, it is in legalese and difficult to understand by design. If you need to have a professional read it to you / for you, please do so. Just do not go without reading the policy language, I like surprises in general but not these kinds of surprises. A good and honest insurance agent can be of great help here.

    Premium – This is the per month, per quarter, per semi-annual or annual fee you pay for the policy. As you can see the premium payments can be broken down by timeframe to make things affordable. Premiums can also vary in price as you would expect.

    Deductible – This is the amount you have to pay out of your pocket BEFORE your insurance kicks in and starts paying for services rendered. Deductible amounts vary wildly. They can be $500 or they can be $25,000. It all depends on the policy / plan you have chosen. As a general rule the higher the deductible, usually the lower the premium cost will be.

    Co-pay or co-payment – This is a flat fee you are responsible for at the time of receiving a service. You may even have different co-pay amounts based on who you see or what you get. Your primary care physician and a specialist tend to have different co-pay amounts. Prescription drugs and or durable medical equipment tend to have different co-pay amounts. Every plan will have a different co-pay amount, some have none and some are quite high. $0-$75 is what we see with a $35 co-pay being the average at the time of this writing (January 2021).

    Co-insurance – Once your deductible has been met your insurance will start processing claims for the services you have received. Usually there is a shared cost. What I mean by this is there may be an 80/20 or 70/30 or whatever amount split. So, as an example of an 80/20 plan, your insurance company will cover 80% and you are responsible for the remaining 20%. That remaining % is the co-insurance. Your doctor or whomever provided the service tends to send the patient a bill for the co-insurance owed after the insurance company has processed the claim. The amount of time it takes for an insurance company to process a claim also varies so be on the lookout for bills in the mail that can be many months after you received the service. 

    Then there are treatment caps, out of pocket maximums, lifetime coverage limitations, per date of service limitations, specialist limitations and much more. Honestly, there is too much for me to get into and even if I chose to do so, you would be asleep in 5 minutes.

    Now, here is the thing. Each year the deductibles reset. So, each year it all starts all over again…

    There are many different choices as to what company to purchase a health insurance policy / plan through. Maybe your employer chooses the company for you and this may also change each year as your employer or yourself for that matter shop around for the best deal. You also have the “marketplace” which is a governmental virtual storefront to buy subsidized plans that qualify under the Affordable Care Act or the ACA or sometimes referred to as Obamacare. You can purchase direct from the insurance company or go through an agent as well. Then you have numerous plans that the insurance company sells. Each plan will be a little different and here is where you need to take your time and choose wisely. Basically, you have many options for the purchasing of insurance and this article is by no means all inclusive. But it’s a good start.

    I hope this helps to clear up the basic vocabulary and definitions for you as it relates to health insurance. Please remember, its confusing by design. When in doubt please give us a call and we can help clarify any misunderstands you may have.

    We at North Florida Spine and Injury Center look forward to helping you in the future

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    P: 904 541-6144
    F: 904 541-6154

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  • Car accident injury treatment in Jacksonville Florida
    31/08/2020 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    The Fallacy Of “Full-Coverage” Auto Insurance Policies In The State Of Florida

    I cannot count how many times patients have presented to the office stating that they have been injured in a motor vehicle accident and have a “Full-Coverage” policy. These individuals are under the impression that all of their out of pocket expenses will be covered by the various insurance companies involved in the accident scenario. The scenario goes like this; they were stopped in traffic and were rear ended by another vehicle. So, lets label the vehicle that was rear ended vehicle 1 and the vehicle that caused the accident vehicle 2. The person in vehicle 1 is under the impression that vehicle’s 2’s insurance policy will cover all of the expenses, both property and medical, that are incurred being that they are not at fault in this incident. Man, there is a lot to talk about here.

    Let us back up a bit and dive into some of the intricacies of the Florida No-Fault auto insurance laws. The State of Florida is a “no-fault” state which I believe is mislabeled. It should be a “regardless of fault” state. So, no-fault means to the average person that no fault is assumed when an accident occurs and / or the person who caused the accident is responsible for paying all costs involved. Both of these assumptions are inaccurate. Now, I say regardless of fault because fault is assessed when an accident occurs and regardless of who is at fault the costs will be covered if you have a valid policy at the time of the incident, given the proper coverages are in place. Ok, what do I mean by this? Well, in the above scenario vehicle 1’s policy will cover the medical portion of the claims and vehicle 2’s policy will be covering the property portion. This is a contentious point, being the not at fault party’s insurance will be paying bills for an accident caused by an at fault party in a no-fault state. Wow, I am even confusing myself with this mess. Basically, regardless of fault means that regardless of who is at fault you are covered. And I believe this is a good thing. It’s nice to be in control of your situation and not rely on others to have the proper coverages in place to pay for their mistakes. Unfortunately in this day and age people are becoming increasingly less responsible for themselves and forget about them being responsible for others. This is why it is important to understand insurance matters and make certain you have the coverages in place to take care of yourself and your family. I will not even get into more complex scenarios involving hit and run incidents, drivers with no license, drivers with no insurance, DUI’s / matters of criminal behavior, or any on-the-clock potential worker’s compensation cases.

    Ok, let’s get back to the main topic here, the fallacy of “Full-Coverage” plans. Full coverage means that the policy meets minimum state requirements for policy limits. Again, I said minimum coverage limits. In the State of Florida that is $10,000 personal injury protection or PIP coverage. And this is covered at a 80/20 ratio. Meaning, the insurance company will reimburse 80% of the allowable fee schedule that are reasonable and necessary claims. The policy holder is responsible for the remaining 20% along with any deductibles and any balances above and beyond the $10,000 in PIP coverage. This does not sound “Full” to me. So back to the present scenario. The person in vehicle 1 went to the ER via ambulance, was seen in the ER, had x-rays and 2 CT scans. Their bill for this alone could be over the $10,000 in PIP coverage limits. For sake of argument let’s say they had a $1,000 deductible with a $10,000 allowable bill. Person 1 would be responsible for the $1,000 deductible and 20% of the remaining balance. This represents a rather large out of pocket responsibility for an accident they did not cause.

    So, how do we add coverages to approach the “Full-Coverage” utopian dream? There are 3 additional items that can be added to an auto policy in Florida that can really help and do not add that much to the premium costs.

    Bodily injury (BI): BI coverage can be purchased from a reasonable extra $10,000 in coverage to astronomical-in-limits if the person who is purchasing the policy warrants this increased coverage. There are numerous reasons and rationale for wanting and needing large policy limits. This is a topic for another day. BI coverage comes into play in the above scenario to extend coverage to additional costs beyond basic PIP coverage, and additionally will cover person 2, that is if they have BI coverage, if person 1 decides to involve legal assistance and this becomes a medico-legal matter. Once again, this is a topic for another day. But if person 1 retains an attorney person 2 better have coverage.

    Uninsured or underinsured motorist (UM): This seems to go hand in hand with the BI coverage as most are sold together with similar if not the same coverage limits. UM helps if you are hit by another driver who only has basic PIP coverage. Even though having a PIP only policy is considered “Full-Coverage” UM coverage is offered because they are considered under insured, go figure. At first they sold you on a “Full Coverage” plan now they want to up-sell you on UM coverage because people may be underinsured, I just got a few more gray hairs. UM coverage can also work for both the at fault and the not at fault parties being it can cover both parties if once again this becomes a medico-legal matter. In a nutshell UM can cover medical expenses, lost wages, and injury-related expenses for you, any permissive drivers, and your passengers. It can also provide coverage for injuries sustained in hit-and-run accidents

    Medical Bill Pay (MED-Pay): MED-Pay will cover your out of pocket costs. Some of these can be the deductible, 20% remaining and anything above and beyond the $10,000 PIP coverage. So if person 1 has say $10,000 in MED-Pay in the above scenario it is assumed that they will not have a dime in true out of pocket costs being that PIP would cover the majority of the ambulance and ER bills and then MED-Pay will kick in and cover the deductible, 20% remaining and the outlying balance beyond the $10,000 PIP. Adding MED-Pay to your policy is a very smart move for these reasons. MED-Pay also seems to be the most affordable option as well.

    Stacked vs. non-stacked coverages: Basically, if you have multiple insurance policies or multiple vehicles under the same policy you can stack the UM coverages or stack the UM and the BI coverages to multiply the benefits. So let’s say you have 3 cars each with $25,000 in UM coverage. If you were to stack the UM then each car would be eligible for $75,000 or the total of the UM coverages for all vehicles under the policy or policies. This can be confusing but this is the general gist and stacking coverages is a great and cost effective strategy to amplify coverages across the policy(ies)

    -  Then we have loan, gap, rental car, and road side assistance to name a few more coverages. I could go on in feature length with these coverages if you would like, but I’ll spare you.

    I do not want to comment on what coverage limits are reasonable or necessary, as this is a very personal thing that is different for everyone. My recommendation is to print out your policy’s declaration page and truly understand what your coverages are, or are not. Then depending on what you determine is necessary for your situation get in contact with an independent insurance agent who can work with you in designing an affordable and effective insurance policy for you and your family.

    I hope this helps dispel the fallacy of “Full-Coverage” in the State of Florida. If further clarification is needed please do not hesitate to get in contact with me or anyone at the office, we are here to help.

    This article is purely for educational purposes and should be treated as such. If you have questions concerning insurance policies, you need to call a Florida Licensed insurance agent or go to The Office of Insurance Regulation at for the proper advice as they will have the final word as it relates to insurance matters.

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    P: 904 541-6144
    F: 904 541-6154

    Read More
  • Drug-Free Pain Management
    30/08/2018 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    September is Drug-Free Pain Management Month

    North Florida Spine and Injury Center Celebrates September as National Drug-Free Pain Management Awareness Month

    September is designated as National Drug-Free Pain Management Awareness Month: an opportunity to raise public awareness about the dangers of prescription and over the counter (OTC) pain medications. It is also an opportunity to educate consumers about drug-free options, such as chiropractic care, to safely and effectively relieve chronic pain.

    In 2016, the Centers for Disease Control and Prevention (CDC) documented over 42,000 individuals in the U.S. died from an opioid-related overdose, totaling more than 115 fatalities per day. Last year alone, the number of deaths associated with opiate painkillers increased by 27.7 percent.

    Likewise, OTC pain relievers increase the risk of health complications when misused or taken in higher doses than what is recommended. Risks include ulcers, gastrointestinal bleeding, liver and kidney damage and increased risk of cardiovascular events. Nearly 200,000 Americans who misuse OTCs land in the hospital each year.

    Did you know?

    Today 100 million people in the U.S. battle chronic pain and are searching for instant relief. They often turn to prescription pain medications for treatment of headaches, including migraines, low back pain and/or general aches and pains.

    As documented by the Gallup-Palmer Annual Report, 78 percent of Americans prefer to try other ways to address their physical pain before they take pain medication.

    A recent study published in The Journal of Alternative and Complementary Medicine concludes that for adults receiving treatment for low back pain, the likelihood of filling a prescription for an opioid was 55 percent lower for those receiving chiropractic care than for adults not receiving chiropractic care.

    According to the Foundation for Chiropractic Progress (F4CP), a not-for-profit organization dedicated to raising awareness about the value of chiropractic care, results show that pain management services provided by doctors of chiropractic (DCs) may allow patients to use lower or less frequent doses of OTC medications and/or opioids, leading to lower costs and reduced risk of adverse effects.

    “Chiropractic care is proven to yield improved clinical outcomes, reduced costs and high levels of patient satisfaction,” said Dr. Adam Zeccardi DC, FIAMA. “Given the increased interest in providing Americans with
    drug-free pain management options, doctors of chiropractic are front-line providers for spinal health and well-being, specifically as it relates to the management of back, neck and headache pain.”

    DCs receive a minimum of seven years of higher education and are specifically trained to diagnose, evaluate and provide drug-free care and rehabilitation to individuals suffering from pain in the neck and back.

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905

    Jacksonville FL, 32244

    Phone: 904 541-6144

    Fax: 904 541-6154

    Read More
  • 08/08/2018 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    What to do if you are involved in a car / truck motor vehicle accident aka MVA

    What to do if you are involved in a car / truck motor vehicle accident aka MVA

    Over the years there has been a re-occurring theme in the clinic when a new accident victim enters the office for the first time. The statement we hear goes something like this; “I just did not know what to do after the accident”. After some continued conversation the individuals do not know if they should exit the vehicle, move the vehicle, exchange information, call / report the accident to the authorities, wait for a police officer / state trooper to arrive on the scene, go to the ER or even seek treatment, report the claim to their insurance company, file a claim for property / medical or both, and so on…

    If you have ever been involved in an injury event you know that the whole experience is a bit overwhelming as your brain seems to stop functioning as it did a few moments before impact. Adrenaline is a funny thing. I remember when my oldest child got hurt and required a trip to the ER. I had her in my arms at the check-in counter and the lady asked for my phone number, but I could not remember it in its entirety. I was shocked and to be honest a bit embarrassed. In my defense, we recently moved and had a new number, but regardless of my excuses, stress can wreak havoc on your brain’s function. So basically, you need to be prepared and have the steps you need to take in writing, on you or in your car. I keep a list of what to do with my registration and insurance cards in the glovebox of my vehicle because apparently I cannot be trusted with even the slightest information recall responsibilities while under stress.

    There are many resources to draw from when it comes to what you need to do when you get involved in a motor vehicle accident, motor vehicle collision, car accident, car wreck, trucking accident and so on. I will try my best to keep this simple and offer you a check list you can print out and keep in your car along with a blank crash report sheet that is specific to the state of Florida. Other states have their own specific paperwork.

    So, you just got banged up in an accident. What next?

    1.  Safely bring the vehicle to a stop and position the vehicle in a way that is not obstructing the flow of traffic or affecting the safety of others. If this cannot happen then ask for help and / or call a tow truck.

    2.  Check yourself and passengers for injury.

    3.  Call 911. Report the accident, injuries, and request police. You will most likely have to wait for an officer to arrive on-scene, this is worth the wait. Please do not leave the scene before an officer is able to make an official report. You also want to be provided with a copy of the initial report the officer produces and then when the official report is made available order / buy it asap .

    4.  Check for traffic before stepping out of your vehicle.

    5.  Exchange information (no personal information as the age of identity theft is upon us) with other drivers using the form attached here.

    6.  Document the accident. Photograph damages not only to your vehicle but any and all other vehicles that have been involved. Photograph visible injuries, where vehicles have stopped, skid marks and road conditions. Speak to any witnesses and get their contact information. This may become quite valuable if liability comes into question.

    7.  Provide police officers at the scene with an official statement, make sure this is 100% accurate and truthful, this is not the time for embellishment or untruths.

    8.  Call your  insurance company and report the accident. In Florida we have Personal Injury Protection or PIP coverage that becomes your primary insurance payor for accident related medical treatment. The claim number your insurance carrier generates will need to be provided to any healthcare facility that provides services to you as it relates to injuries incurred in the accident.

    9.  When presenting to a healthcare facility you will need a valid driver’s license, your auto-insurance card, medical claim number and the crash report / information exchange sheet. This way the facility has all the information needed to be able to verify insurance benefits and start the claims submission process as this is a time-sensitive process as per Florida statutes.

    If you feel that you or anyone else in your vehicle has been injured, please seek medical attention immediately. Deferring treatment is a big mistake and can have long term negative impact on your health. If you feel this is an emergency, please go to the nearest hospital / urgent care facility without delay. If the physicians on-staff at the hospital / urgent care discharge you, please make sure you follow up for rehabilitative care as this will ensure proper healing as you age. If this is not an emergency, facilities like ours tend to be specifically equipped to handle most non-emergent injury / pain needs. Give us a call we are here to help.

    Untreated or mistreated injuries are now known to cause changes to the muscles deep to the spine that can have long-term negative effects on health and promote arthritis as we age. So make sure you are diligent with treatment after an injury. Please do not just ignore the problem or think self-medication strategies are enough to get you by. We are here to help and make the process as fast and easy as possible.

    If you have been injured in a motor vehicle accident, please do not hesitate to give us a call. We would love to help you in your time of need

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    Phone: 904 541-6144
    Fax: 904 541-6154

    Read More
  • Low back pain, neck pain, spine pain
    23/08/2017 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    The Multifidus Muscle, So Small Yet So Very Important

    Marbling may be good for a juicy steak or hamburger but not so much for your back muscles!!!
    So, if you have been keeping up with my blog posts you know I try my best to be a bit tongue-and-cheek and at least attempt to inject some humor in what can be considered some dry topics of conversation. So, this post will be no  different in that regard.

    We will be discussing the importance of having fully functioning spinal stability musculature and the consequences of dysfunction and also how to help fix this dysfunction.

    We humans are vertebrates, if you remember back to elementary school biology class that means that we have a skeleton or more specifically a backbone / spinal column supporting our bodies on the inside. This skeleton is inherently unstable without the proper structures in place to provide not only static but dynamic stability as we go about our busy lives. Unfortunately, these supporting structures do not get much attention from us or the press… and when they do not function properly we can have all sorts of downstream negative effects as a result. Pain, injury, soft tissue damage, arthritis, weak posture, and so on can be a result of our stabilizing muscles not functioning properly or can be the cause of the dysfunction in the first place.

    The group of muscles we will be talking about today are the multifidus muscles or the multifidi. They reside deep to our spine at the posterior aspect or on the back side of the vertebrae. These muscles subconsciously stabilize our spine helping to aid in normal motion without pain or tissue damage. Picture the vertebral column being a stack of marbles. This stack will not be vertically oriented for very long without a stabilizing force acting upon it and as such will crumble and fall over rather quickly without the proper structures in place for stability purposes. The multifidi act to stabilize the spinal column by not allowing it to fall into individual pieces as the marbles would. So, their importance and value to our well-being cannot be understated.

    Now when we have an injury event take place, are sedentary, undergo a spine surgical operation etc… we can have the multifidi become inactivated. If these muscles remain “off-line” they can atrophy and undergo a process called fatty infiltration or fatty replacement. This is where the muscle is literally replaced by fatty tissue just like the marbling you see in a nice juicy steak – think ribeye. Once this fatty infiltration process has commenced it can be very difficult to undo as there is limited evidence if this can be undone. As a result of our main spinal stabilizing structure which was once strong muscle tissue now being weak fatty tissue we can experience all types of pain syndromes. Chronic low back pain sufferers will see this fatty replacement on MRI scans. Unfortunately, people involved in injury events: motor vehicle accidents, truck accidents, slip and fall events, sports injuries, work injuries and so forth can see this fatty infiltration on imaging studies if the proper rehabilitation has not taken place in a timely manner.

    Here are a few MRI images outlining the fatty infiltration process

    Grade 0 (None)         Grade 1 (Slight)       Grade 2 (Severe)

    So, the current thought on how to prevent / treat this fatty infiltration of our own “steaks” besides avoiding any and all potential injury activities is to seek the proper care of a medical provider who is specifically trained in the treatment of spinal injuries. Do not delay treatment as the “clock” is ticking from the time of injury until the fatty infiltration takes place. The generally accepted treatment protocol for spinal injuries includes an anti-inflammatory / healing phase followed closely by an active stability / strengthening phase. This will ensure the proper healing of the injured tissues and then the subsequent rehabilitation / reactivation of the muscles. Both of which will help to minimize and / or
    eliminate any fatty infiltration of the spinal stabilizing musculature. These treatment protocols tend to be quick and rather low-tech compared to a lot of the gym activities we may be used to.

    We at North Florida Spine and Injury Center are trained in how to detect these bio-mechanical faults and aid in the healing / rehabilitation of your injury. You may be a chronic pain sufferer who has been to numerous physicians and been given oral medications as the sole “treatment”. You may have had a failed surgical operation and just feel like you have nowhere else to turn. If you have been recently involved in an injury event, please do not delay treatment. We are here for you. If you have any further questions on this subject or anything related please do not hesitate to give us a call as we would be privileged in being a part of the healing process.

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    P: 904 541-6144

    F: 904 541-6154

    Read More
  • Car insuracne coverage, Car accident injury treatment, Motor vehicle accident injury, Truck accident injury treatment
    18/04/2017 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    Insurance Coverage and the Ever-Present Risk vs. Reward Formula

    So, the main question at hand; Is the reward of not having the proper coverage / any coverage worth the risk?

    A case came into the office that was a real eye opener for me and the patient. I learned something that day and I would like to use this situation and the suffering it produced to be used as, dare I say, a teachable moment. Ms. Jones walked into the clinic stating that she was involved in an automobile accident and sustained injuries. She also let us know that the primary holder of the insurance policy canceled her as a driver on the policy 3 days prior to the accident without her knowledge. She called her insurance company and they said that there is nothing they could do for her being she was not covered under the policy at the time of the accident. Ms. Jones then retained legal counsel and wanted to move forward with medical care related to the injuries sustained in the accident. Unfortunately, this is not an uncommon scenario and we will revisit the different paths this could take depending on driver fault.

    Ok, Ms. Jones has had a few visits to the clinic by now and we received a call from her attorney’s office who brought us up-to-speed concerning the recent plaintiff-harming case law developments that pertain directly to her situation. In a nutshell if you are a driver in the State of Florida, as of this writing (2017), you are required to have $10,000 personal injury protection (PIP) coverage as part of the policy. If you are a driver without insurance and therefore without the PIP coverage, attempt to receive medical treatment along with an insurance settlement, the first $10,000 of the settlement will be withheld (set off) due to the PIP requirement not being adhered to. In other words, as an uninsured driver in the State of Florida that requires, by law, each driver to have coverage will be penalized if their situation becomes a medico legal case with settlement. For example, Ms. Jones files a demand with the insurance company and has a favorable settlement of $15,000. Due to her not having a valid policy at the time of injury there will be a $10,000 penalty assessed and her settlement amount is now $5,000. Big difference here people…

    Here are a few excerpts from case law that is used as the standard which opinions are based:

    “We will pay benefits under this coverage only over and above any personal injury protection benefits that are paid or payable for the bodily injury under this or any policy, or would be payable except for a deductible.”

    “An owner of a motor vehicle with respect to which security is required by this section who fails to have such security in effect at the time of an accident .. shall be personally liable for the payment of PIP benefits under section 627.736. With respect to such benefits, such an owner shall have all the rights and obligations of an insurer in sections 627.730-627.741.”

    I’m not an attorney but this is not favorable to the uninsured individual!

    The basic math that results from not wanting to pay the monthly insurance premium for most uninsured drivers will never add up. Of course, there are outlying situations, as in Ms. Jones’s case. But by and large these drivers are breaking the law and now this is a way for the courts, and insurance companies to penalize the injured parties when in the past this was never the case. An uninsured driver that was hit by another person and therefore was not at fault was not penalized in anyway. Those days are over for the most part. The savings of not paying the monthly premium does not add up favorably in Ms. Jones’s case as there are numerous plans available that are under $100 / month. Premium cost of $100/month and a penalty of $10,000 equates to 8.33 years of premiums… This makes zero sense from a basic financial standpoint, forget about the legal and general responsibility issues that accompany such behavior.

    What can we learn from the suffering of Ms. Jones?

    • That this can happen to anyone and it is preferable to arrange with the insurance company that you are looked at as a primary driver and absolutely no modifications to the policy can be made without your express notice and/or blessing.

    • If you are an uninsured driver you are a ticking financial time bomb as this behavior is not worth it in the long run. Please call an independent insurance agent now and get the proper coverages.

    Now, let’s flip the script so to speak.

    Ms. Jones is now the at fault party and she was injured by the motor vehicle accident. She has no recourse for affordable medical treatment being she does not have the necessary pip coverage. She may have a commercially available insurance policy (Aetna, Blue Cross and Blue Shield, United Healthcare, Humana, Cigna etc…) but her deductible, co-payments, co-insurance and any potential treatment limitations / caps will apply. This makes the average medically-necessary rehabilitation treatment protocol prohibitively unaffordable for most people. Also in this scenario with Ms. Jones being the at-fault party, what if the occupants of the vehicle she impacted sustained injury and they retained legal counsel? Her personal assets are now in-play. This can be even more costly than her mounting medical bills by a large margin. Never mind the sense of guilt that will inevitably be felt by injuring others in a negligent way and then not being able to offer payment for the mess you have caused. This is wrong on numerous levels.

    As you can see it’s not just your civic duty to operate a motor vehicle in a legal way but it’s just the responsible, right-thing-to-do.

    I hope this helps inform you of the potential pit falls of being an uninsured motorist and the pitfalls of being injured by an uninsured motorist. They are out there, unfortunately.

    This article is purely for educational purposes and should be treated as such. If you have questions concerning insurance policies, you need to call a Florida Licensed insurance agent or go to The Office of Insurance Regulation at for the proper advice as they will have the final word as it relates to insurance matters.

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905

    Jacksonville FL, 32244

    P: 904 541-6144

    F: 904 541-6154

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  • Back pain causes and treatment in Jacksonville FL
    01/04/2017 - Dr. Adam Zeccardi DC, FIAMA 0 Comments
    Back Pain: How and Why Is This Happening to Me

    Walking upright on two feet has advantages, but it also puts intense pressure on the spine, as well as on other muscles and bones. Add to this improper sitting, lifting, or reaching—and the normal wear and tear of working and playing—and you have the perfect recipe for back pain. That’s why back pain is the 2nd most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. In fact, some experts say, as many as 80% of us will experience a back problem at some time in our lives.1 Back injuries are a part of everyday life. They can cause a sharp pain or a dull ache and can be accompanied by a tingling, numbness, or burning sensation. . . .

    You may also feel weakness, pain, or tingling in your pelvis and upper leg—a condition known as sciatica.

    The spine is quite good at dealing with back injuries. Minor injuries usually heal within a day or 2. Some pain, however, continues. What makes it last longer is not entirely understood, but researchers suspect that stress, mood changes, and the fear of further injury may prevent patients from being active and exacerbate the pain.

    Tips for Back Pain Prevention:

    • Maintain a healthy diet and weight.
    • Remain active—under the supervision of your doctor of chiropractic.
    • Avoid prolonged inactivity or bed rest.
    • Warm up or stretch before exercising or other physical activities, such as gardening.
    • Maintain proper posture.
    • Wear comfortable, low-heeled shoes.
    • Sleep on a mattress of medium firmness to minimize any curve in your spine.
    • Lift with your knees, keep the object close to your body, and do not twist when lifting.
    • Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
    • Work with your doctor of chiropractic to ensure that your workstation is ergonomically correct.

    Chiropractic Treatment for Back Pain

    If you experience back pain, consult your doctor of chiropractic. More than 30 million Americans sought chiropractic care last year alone. Past studies have indicated that consumers are very happy with the chiropractic care they receive.

    With a thorough knowledge of the structure and functioning of the human body, doctors of chiropractic make diagnoses and take steps to correct problems using spinal adjustments, dietary and lifestyle advice, and other natural tools.

    Spinal manipulation—the primary form of treatment performed by doctors of chiropractic—is a recommended option for back pain treatment, rated as such by many state and workers’ compensation guidelines.

    Research has shown that manipulative therapy and spinal manipulation are not only safe and effective, but can cut costs and get workers back on the job faster than other treatments. A recent medical study has also pointed out that manual manipulation offers better short-term relief of chronic back pain than medication.

    Top 10 Most “Back Breaking” Jobs

    In a recent informal survey, the following occupations were found to cause the most stress and strains on the muscles of the back.

    10. Auto mechanics work in physically awkward positions all day long—bending over cars, sliding under cars, etc.

    9. Nursing home workers have to lift elderly people into and out of bed. The workers’ bodies can become twisted and off-center.

    8. Delivery drivers are always running, often carrying heavy and awkward packages. Packages shipped via UPS, FedEx, etc., have increased in weight over the years. The job also involves a lot of driving.

    7. Firefighters/EMTs deal with fire, water pressure from hoses and have to chop obstacles with an axe. They often carry people to safety, which is particularly difficult if the victim is obese or incapacitated.

    6. Shingle roofers are always twisting their bodies.

    5. Farmers lift heavy equipment and bags of feed and grain. When doing fieldwork, they have to constantly turn backward to watch equipment that is pulled behind a tractor.

    4. Police officers sit in their cars for long periods of time, which is rough on the lower back. When called into action, they have to make sudden movements and often face resistance from those they are arresting. Police officers also wear belts that can weigh up to 40 pounds, which can cause chronic back pain.

    3. Landscapers lift heavier objects than any other profession. Wheelbarrows can twist and turn, wrenching the workers’ backs.

    2. Construction workers’ jobs can involve hammering, lifting, steelwork, or ironwork—all in very awkward positions. Moving steel beams can wreak havoc on the entire body.

    1. Heavy truck and tractor-trailer drivers endure constant compression and vibration from trucks. This can damage the back. Prolonged sitting puts pressure on the spine, which can result in disc degeneration. Liquid-carrying trucks are particularly bad. When this type of truck comes to a sudden stop, the fluid in the truck’s tank slams back and forth, and the driver feels the impact. Also, because professional truck drivers are always on the road, their diets are seldom what they should be, which can contribute to back problems.

    When choosing a doctor of chiropractic:

    • Be sure the chiropractor has attended an accredited chiropractic college.
    • Make sure the chiropractor is licensed to practice in your state. After graduating from an accredited chiropractic college, doctors of chiropractic must pass rigorous state and national board exams before they can practice.
    • Talk to your friends, family, and co-workers. The best referrals often come from satisfied patients.
    • Talk to the doctor. The chiropractor should be willing to answer your questions and should talk freely with you about your concerns and course of treatment.

    We at North Florida Spine and Injury Center would love the opportunity to help you out in your time of need. Please give us a call or come on by the clinic.

    Thank you

    Dr. Adam Zeccardi DC, FIAMA
    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    P: 904 541-6144
    F: 904 541-6154

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  • Whiplash injury treatment Jacksonville FL
    30/03/2017 - Dr. Adam Zeccardi DC FIAMA 0 Comments
    Whiplash Symptoms and Treatment Options in Jacksonville, FL

    Whiplash Treatment Options in Jacksonville, FL

    Whiplash is a generic term applied to injuries of the neck caused when the neck is suddenly and/or violently jolted in one direction and then another, creating a “whip-like” movement. This is essentially an acceleration/deceleration event. Whiplash is most commonly seen in people involved in motor vehicle accidents, but it can also occur from falls, sports injuries, work injuries, and other incidents that involve the acceleration and resultant deceleration of the body.

    Most whiplash injuries are classically associated with forward and backward movement of the head and neck. Side-impact crashes result in side-to-side or even oblique angled whiplash-style injuries, in which a person’s head is turned may induce injuries to the neck. Although severe whiplash injuries can result in paralysis and even death, most such injuries are relatively mild/moderate.

    What structures are injured in a whiplash?

    Whiplash injuries most often result in sprain-strain of the neck. The ligaments that help stabilize, support, protect, and restrict excessive movement of the vertebrae are torn, which is called a sprain. The joints in the back of the spine, called the facet joints, are covered by ligaments called facet capsules, which seem to be particularly susceptible to whiplash injury. In addition, the muscles and tendons are strained— stretched beyond their normal limits. The discs between the vertebrae, which are essentially ligaments, can be torn, potentially causing a disc herniation. The nerve roots between the vertebrae may also be stretched and become inflamed. Even though it is very rare, vertebrae can be fractured and/or dislocated in a whiplash injury.

    What are the common signs and symptoms of whiplash?

    Approximately two thirds of people involved in motor vehicle accidents develop symptoms of whiplash. Interestingly, the violence of the crash is not a definitive indicator of pain or even the amount of pain. Generally speaking, however, those involved in more severe accidents have more signs and symptoms.

    Another important and interesting aspect of whiplash is that the signs and symptoms often do not develop until 2 to 48 hours after the injury. This scenario is relatively common but not completely understood. Some speculate that it may be due to delayed muscle soreness, a condition seen in other circumstances.

    The most common symptoms of whiplash are pain and stiffness in the neck. These symptoms are generally found in the areas that are “whiplashed.” For example, during a whiplash, first the head is lifted up from the upper-cervical spine. This creates a sprain/strain in the region just below the skull, where symptoms usually occur. Symptoms may also commonly be seen in the front and back of the neck. Turning the head often makes the pain and discomfort worse.

    Headache, especially at the base of the skull, is also a common symptom, seen in more than two thirds of patients. These headaches may be one-sided (unilateral) or experienced on both sides (bilateral). In addition, the pain and stiffness may extend down into the shoulders and arms, upper back, and even the upper chest.

    The signs and symptoms of whiplash often do not develop until 2 to 48 hours after the injury.

    In addition to the musculoskeletal symptoms, some patients also experience dizziness, difficulty swallowing, nausea, and even blurred vision after a whiplash injury. While these symptoms are disconcerting, in most cases, they disappear within a relatively short time. If they persist, it is very important to inform your doctor that they are not resolving. Vertigo (the sensation of the room spinning) and ringing in the ears may also be seen. In addition, some patients may feel pain in the jaw. Others will even complain of irritability, fatigue, and difficulty concentrating. These symptoms also resolve quickly in most cases. In rare cases, symptoms can persist for weeks, months, or even years.

    How is whiplash diagnosed?

    To make a diagnosis, a thorough history of the injury and the patient’s previous medical history are taken. Preexisting conditions, such as arthritis and/or previous injury, may increase the severity of the signs and symptoms of whiplash. Following history-taking, an in-depth physical examination, with concentration on the neuro-musculoskeletal system, is performed. When appropriate, X-rays of the neck may be taken. If the doctor suspects that the soft tissues (for example, discs or ligaments) in the neck are injured, more advanced imaging studies, such as magnetic resonance imaging (MRI), may be ordered.

    How is whiplash treated?

    Staying active

    One of the most important aspects of whiplash management is for the patient to stay active, unless there is some serious injury that requires immobilization. Patients should not be afraid to move and be active, within reason. In addition, your doctor will often prescribe an exercise or stretching program. It is particularly important to follow this program as prescribed, so that you can achieve the best long-term benefits.

    Soft-cervical collar

    The use of a soft-cervical collar remains controversial. Some suggest that such devices are inappropriate, as they act as a “crutch” and encourage a patient to avoid activity. Others suggest that, with proper counseling, a collar can help a patient slowly return to normal activities. There is no controversy, however, when discussing the length of time that a soft collar should be worn—no more than one week.

    Chiropractic manipulation and physical therapy

    Ice and/or heat are often used to help control pain and reduce the muscle spasm that results from whiplash injuries. Other physical therapy modalities, such as electrical stimulation and/or ultrasound, may provide some short-term relief. They should not, however, replace an active-care program of exercise and stretching. Spinal manipulation and/or mobilization provided by a chiropractor can also give relief in many cases of neck pain.

    Surgery and injections

    Surgery, injections, and other invasive options are rarely necessary but are available, when appropriate. They are generally reserved for patients with more severe injuries to the discs, vertebrae, and nerves in the neck region.

    Can whiplash be prevented?

    Generally speaking, whiplash cannot be “prevented,” but there are some things that you can do while in a motor vehicle that may reduce the chances of a more severe injury. Always wear restraints (lap or shoulder belt), and ensure that the headrest in your vehicle is adjusted to the appropriate height.

    Thank you.

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    P: 904 541-6144

    F: 904 541-6154

    Read More
  • Neck pain causes and treament in Jacksonville FL
    30/03/2017 - Dr. Adam Zeccardi DC FIAMA 0 Comments
    Neck Pain and How a Conservative Approach Can Help

    Conservative Care of Neck Pain

    Your neck, also called the cervical spine, begins at the base of the skull and contains seven small vertebrae. Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury.

    The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear. Neck pain can be very bothersome, and it can have a variety of causes . . .

    Here are some of the most typical causes of neck pain:

    Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting “rebound” in the opposite direction is known as whiplash. The sudden “whipping” motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most common cause of whiplash.

    • Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.
    • Osteoarthritis, a common joint disorder, causes progressive deterioration of cartilage. The body reacts by forming bone spurs that affect joint motion.
    • Spinal stenosis causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally.
    • Degenerative disc disease can cause reduction in the elasticity and height of intervertebral discs. Over time, a disc may bulge or herniate, causing tingling, numbness, and pain that runs into the arm.
    • Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms.

    Chiropractic Care of Neck Pain

    During your visit, your doctor of chiropractic will perform exams to locate the source of your pain and will ask you questions about your current symptoms and remedies you may have already tried.

    For example:

    • When did the pain start?
    • What have you done for your neck pain?
    • Does the pain radiate or travel to other parts of your body?
    • Does anything reduce the pain or make it worse?

    Your doctor of chiropractic will also do physical and neurological exams. In the physical exam, your doctor will observe your posture, range of motion, and physical condition, noting movement that causes pain. Your doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm. A check of your shoulder area is also in order. During the neurological exam, your doctor will test your reflexes, muscle strength, other nerve changes, and pain spread.

    In some instances, your chiropractor might order tests to help diagnose your condition. An x-ray can show narrowed disc space, fractures, bone spurs, or arthritis. A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) can show bulging discs and herniations. If nerve damage is suspected, your doctor may order a special test called electromyography (an EMG) to measure how quickly your nerves respond.

    Chiropractors are conservative care doctors; their scope of practice does not include the use of drugs or surgery. If your chiropractor diagnoses a condition outside of this conservative scope, such as a neck fracture or an indication of an organic disease, he or she will refer you to the appropriate medical physician or specialist.
    He or she may also ask for permission to inform your family physician of the care you are receiving to ensure that your chiropractic care and medical care are properly coordinated.

    Neck Adjustments

    A neck adjustment (also known as a cervical manipulation) is a precise procedure applied to the joints of the neck, usually by hand. A neck adjustment works to improve the mobility of the spine and to restore range of motion; it can also increase movement of the adjoining muscles. Patients typically notice an improved ability to turn and tilt the head, and a reduction of pain, soreness,
    and stiffness.

    Of course, your chiropractor will develop a program of care that may combine more than one type of treatment, depending on your personal needs. In addition to manipulation, the treatment plan may include mobilization, massage or rehabilitative exercises, or something else.

    Research Supporting Chiropractic Care

    One of the most recent reviews of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation. As part of the literature review, published in the March/April 2007 issue of the Journal of Manipulative and Physiological Therapeutics, the researchers reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported as having remained unchanged, and all groups showed positive changes up to 12 weeks post-treatment.

    Thank you

    Dr. Adam Zeccardi DC, FIAMA
    North Florida Spine and Injury Center

    7855Argyle Forest Blvd., Suite 905
    Jacksonville FL, 32244

    P: 904 541-6144

    F: 904 541-6154

    Read More
  • ssoft tissue inuries, causes and treatments in Jacksonville FL
    27/03/2017 - Dr. Adam Zeccardi DC FIAMA 0 Comments
    Soft-Tissue Injuries: Better, Faster Healing

    Interest in instruments to extend the “reach” of chiropractors, massage therapists, and others got a boost in the ’80s when David Graston suffered a debilitating sports injury. Graston’s disappointment with the rehabilitation methods of the day caused him to create several stainless steel instruments with various shapes and angled surfaces. These instruments were designed to augment hands-only approaches to healing.

    Doctors of chiropractic have always worked their fingers into injured soft tissue to increase blood flow and break up restrictions. But fingers alone cannot detect restrictions at deeper levels, nor can they match the ability of the right instruments to treat the full range of restrictions. Today, several companies produce handheld devices used to perform what’s known as instrument- assisted soft-tissue mobilization (IASTM).

    Which parts of the body can develop soft-tissue injuries?

    Soft-tissue injuries, such as strains and sprains, often affect the extremities—the legs or arms. A soft-tissue injury can occur anywhere that ligaments, tendons, muscles, or myofascia are found. Ligaments connect two or more bones and help stabilize the joints. Tendons attach muscles to bones. Ligaments, tendons, and muscles provide a natural brace to protect the bony skeleton from injury. A ligament can be injured, for example, by making a movement that would take a joint outside of its normal range.

    How do the injuries heal?

    When the body is injured, it works to repair itself through a three-phase “healing cascade” process of inflammation, proliferation, and maturation. In the inflammatory (“acute”) phase, the body releases chemicals that start the healing process. This process continues through the proliferative phase, during which the body migrates materials it needs to create scar tissue at the site of injury. During the maturation phase of healing, scar tissue forms in the soft-tissue injury site. In this phase, the injury becomes chronic. Scar tissue helps the body form a “patch” at the site of an open wound or internal injury. Scar tissue, however, is much less flexible than normal tissue. It restricts movement, leading to pain when, for example, an athlete with a sprained ankle tries to return to running.

    Why is a second healing cascade important?

    Most patients with soft-tissue injuries come to a doctor of chiropractic after injuries have become chronic (months post-injury). By that point, the body has completed most if not all of the healing tasks of the original healing cascade. A second healing cascade is needed to restart the healing process, bringing to the site, among other things, oxygen and nutrients.

    How is a second healing cascade created?

    Although healthy soft tissue is laid out all in the same direction and flexible, the body lays out scar tissue in a haphazard fashion. Scar tissue is fairly rigid. Pain results when movement stresses scar tissue. The doctor of chiropractic presses his instruments into damaged tissue to help release restrictions created by scar tissue and get a chemical healing cascade started. The goal is the normalization of the tissue. Normalization refers to the release of restrictions. Treatment, which includes stretching out muscles, helps patients build flexibility and strength in the area.

    What is treatment like?

    When doctors of chiropractic trained in IASTM use the instruments, they first spread a light gel film over the patient’s skin. Then, they press into and move the instrument around the site to locate restrictions. Treatment breaks down scar tissue and encourages the body to remodel the underlying tissue. During treatment, smaller capillaries in the area are broken. Bruising is a normal response, signifying that a healing cascade is underway.

    How does treatment feel?

    IASTM can cause minor discomfort. Treatments are typically short—often just three to five minutes. The level of discomfort typically is reduced with repeated treatments. Chronic soft-tissue injuries are not healed overnight, but your willingness to perform home stretches and exercises as prescribed by your doctor of chiropractic will hasten the process.

    What side effects can I expect?

    Redness of the skin, followed by bruising, is common. These side effects show that your practitioner has been working to get at troublesome areas and help start the healing process. You may also be

    asked to apply ice as part of your at-home treatment. Doctors of chiropractic are trained to effectively address your musculoskeletal complaints. If you have further questions about soft-tissue injuries, your doctor can help.

    How do soft tissues become injured?

    Athletes who suffer a traumatic injury will often need soft-tissue-specific rehabilitation to get back full-range of pain-free motion. Many soft-tissue injuries, however, result from repetitive motion.

    People who may suffer from such injuries include:

    • Assembly-line workers
    • Golfers and other athletes
    • People who spend long hours at a computer without regular stretch breaks
    • Mothers who hold their babies only on one hip
    • Students who overfill backpacks or who hang heavy backpacks over one shoulder
    • Sedentary people who allow their muscles to atrophy.

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905

    Jacksonville FL, 32244

    P: 904 541-6144

    F: 904 541-6154

    Read More
  • Headaches, Migraines, Tension headaches, Cervicogenic headaches
    27/03/2017 - Dr. Adam Zeccardi DC FIAMA 0 Comments
    Headaches and Chiropractic

    If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea.

    What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

    New research shows that spinal manipulation – the primary form of care provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck.

    A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

    Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.
    If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea. What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

    New research shows that spinal manipulation – the primary form of care provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck.

    A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

    Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

    Headache Triggers

    Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems.

    Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern. “The greatest majority of primary headaches are associated with muscle tension in the neck,” says Dr. George B. McClelland, a doctor of chiropractic from Christiansburg, VA. “Today, Americans engage in more sedentary activities than they used to, and more hours are spent in one fixed position or posture. This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.”

    What Can You Do?

    The ACA suggests the following:

    • If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
    • Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
    • Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.
    • Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

    Avoid the Following Food “Triggers”

    • Avoid caffeine. Foods such as chocolate, coffee, sodas and cocoa contain high levels of the stimulant.
    • Avoid foods with a high salt or sugar content. These foods may cause migraines, resulting in sensitivity to light, noise or abrupt movements.
    • Avoid drinking alcoholic beverages. These drinks can dehydrate you and cause headache pain.
    • Other headache sufferers may want to avoid not only caffeine, but also high-protein foods, dairy products, red meat and salty foods.

    What Can a Doctor of Chiropractic Do?

    Dr. McClelland says your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:

    • Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
    • Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
    • Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

    “Doctors of chiropractic undergo extensive training to help their patients in many ways – not just back pain,” says Dr. McClelland. “They know how tension in the spine relates to problems in other parts of the body, and they can take steps to relieve those problems.”

    Chiropractic Care Can Help

    Talk to your doctor of chiropractic about other ways to improve your lifestyle. Doctors of chiropractic are trained and licensed to examine and treat the entire body with specific emphasis on the nervous and musculoskeletal systems. They can also help people lead healthier lives by focusing on wellness and prevention.

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905

    Jacksonville FL, 32244

    P: 904 541-6144

    F: 904 541-6154

    Read More
  • herniated discs, bulging discs and extruded disc injuries
    27/03/2017 - Dr. Adam Zeccardi DC FIAMA 1 Comment
    Herniated Discs, Bulging Discs, Extruded Discs Oh My!!!

    Spinal Disk Problems

    Eighty percent of people experinece back pain, and at any one point in time, approximately 20% of the poulation has back pain. For many decades, doctors and scientists believed that most back pain was caused by “slipped” or “torn” discs. We now know this not to be true. Disc problems constitute only a small portion of the causes of back pain and rarely require surgery for pain relief.

    What are spinal discs?

    Spinal discs are a critically important part of your spinal column. Along with the vertebrae, also called the spinal bones, they perform many functions. The discs provide shock absorption, protecting the spinal cord and ensuring flexibility of the spine. They also perform other functions. The spinal discs are essentially ligaments (structures connecting bones) that attach to the top and bottom of each vertebra. They are thick, ligament-like outer rings, also known as annuli fibrosis. Because they are arranged in an alternating pattern with the vertebrae, annuli fibrosis allow flexibility while preventing the vertebrae from moving too much and causing injury. Inside a single annulus fibrosis is a jelly-like substance called the nucleus pulposis. It contains some proteins, but is primarily made up of water. The nucleus provides more shock absorption than does the annulus, and it also acts as a fulcrum to direct the type of movement through which each vertebra travels.

    What are the most common disc problems?

    • A disc “bulge” results from slight tears in the outermost fibers of an annulus fibrosis. These small tears can be painful for a short time.
    • A disc protrusion/extrusion, also called “herniation”, is a more significant injury. It results from a complete or significant tear of the fibers of an annulus-when some of the nucleus leaks through. A herniation can also be painful and may even cause nerve compression. In the most severe cases, the spinal cord can become compressed.
    • The most common disc problem suffered by adults is degenerative disc disease. This occurs when the nucleus loses water and small tears develop in it. The body then forms osteophytes (bone spurs), along the edges of the vertebra and the disc space narrows. We used to believe that this was a function of “wear and tear” as we aged. The most recent evidence shows that, most often, there is a hereditary link to the development of degenerative disc disease. Degenerative disc disease can also be caused by trauma/injury.
    What are the common signs and symptoms of disc problems?

    Common signs of disc problems include, but are not limited to:

    Disc problems are most often diagnosed with the use of a thorough history and physical examination, including examination of your nervous and musculoskeletal systems. Your doctor will most likely move your back and arms and legs into various positions while applying pressure to your joints. Plain film x-rays are helpful in only some forms of disc problems. Magnetic resonance imaging (MRI) has become the mainstay for the diagnosis of disc problems, as it images the discs quite nicely. Your doctor may order an MRI if he or she feels it would be helpful in diagnosing a disc problem and determining the proper course of care for you. Most often, however, this is not necessary.

    How are disc problems treated?

    Luckily, in most circumstances, disc problems are easily treated with conservative interventions. Early in the course of an acute injury, your doctor of chiropractic will very likely set a goal of pain control, using several different physical modalities to reach it. Both ice and heat have shown effectiveness in managing the pain of acute low-back injury. Your doctor of chiropractic will help you determine which is most effective for you. In addition, getting you back on your feet and moving as quickly as is safely possible is critical. Typically, the less time you spend in bed, the better off you are in terms of long-term results. You’ll also need to learn not to be afraid to move. If you “baby” your back, in most cases, the long-term results will be worse.

    Chiropractic spinal manipulation has also been demonstrated to be a safe and effective tool in the management of disc problems. Manipulation is especially effective when combined with therapeutic exercise. In most circumstances, spine surgery and injections are not necessary in the management of disc problems- and they often cause more problems than they’re worth. Your doctor of chiropractic will discuss all available treatment options with you and help you decide on the best course of action.

    Can disc problems be prevented?

    While regular exercise will help strengthen your back, research has demonstrated that staying fit and using proper body mechanics alone will not prevent injury. The National Institute for Occupational Safety and Health (NIOSH) recommends that individuals do not lift more than 50 lbs. Further, activities that require awkward or prolonged postures and repetitive activities place individuals at high risk for musculoskeletal disorders and disc problems regardless of body mechanics and fitness level. Your doctor of chiropractic can conduct an ergonomic assessment of your work and home activities to help you prevent injury.

    It is also critically important to have “spinal awareness.” Make a conscious effort, for example, to be aware of what posture you are maintaining when you sit, stand, lie down, work, and exercise. Lift objects with proper posture, including bending your knees, keeping the object close to your body, keeping your back straight and lifting with your legs. Never lift an object by bending over and twisting. You’ll only invite a back injury.

    If you experience any of the following, seek immediate medical care for a spine problem:

    • Loss of bowel or bladder control
    • Inability to urinate and/or defecate
    • Acute loss of feeling in both buttocks and/or both arms
    • Inability to walk or use your arms (often from severe acute weakness)
    • Fever along with your back pain

    Thank you

    Dr. Adam Zeccardi DC, FIAMA

    North Florida Spine and Injury Center

    7855 Argyle Forest Blvd., Suite 905

    Jacksonville FL, 32244

    P: 904 541-6144

    F: 904 541-6154
    Read More