Whiplash Type Injury / Whiplash Associated Disorder.
Chiropractic treatment has been a great source of relief for many people who have suffered from whiplash. What exactly is whiplash and how does chiropractic help?
What is Whiplash?
Whiplash is a description of how the injury has been sustained. It isn’t a disease and it’s not a diagnosis. In other words, it is a description of the mechanism of injury. Anytime the spine is unexpectedly moved in one direction and then rebounds in the opposite direction there whiplash can occur. It can happen in either a backwards and forwards direction or in a side to side motion. Whiplash is not limited to motor vehicle accidents. Sports injuries, knocks, falls and slips can all result in whiplash. These injuries result in damage to muscles, ligaments and tendons. In conclusion, Whiplash type injuries can result from anything that causes extremely rapid extension and flexion that causes the damage.
What part of the spine is damaged in whiplash?
Most people who suffer from whiplash have misaligned vertebrae in their spine. These type of injuries typically involve a combination of nervous system, muscles, and joint damage.
How does this type of injury occur?
There are many different potential causes of whiplash. However, one of the most common causes is the result of a motor vehicle accident. The body goes through rapid and intense acceleration and deceleration. As a result, all four phases of a whiplash type injury occur very quickly. During each phase there are different forces acting which can cause injury. As a result, violent and forceful movement causes significant damage to the vertebrae, nerves, discs, muscles, and ligaments.
“Chiropractic Management of Spine Related Disorders” by Meridel Gatterman tells us the phases.
Phase 1
“In rear end collisions, even with a high seat back or head restraint, the neck is thrown into extension in proportion to the distance between the occupants head and the supporting structure. As the victims torso is forced backwards into the seat back, the head and neck initially remained fixed while the vehicle moves forward.”
Phase 2
“This initial inertia of the head, followed by extension of the cervical spine at the end of this rearward translation.” In other words, the seat is moving forward while the head is still moving backwards. This force in the neck is what causes most of the damage. Many of the bone, joint, nerve, disc and TMJ injuries occur during this phase.
Phase 3
After deflecting off the seat back or head restraint, the head rebounds forward. As a result the neck is forced into flexion. In addition, cars without head restraints or with low head rests more room is created. Therefore hyperextension occurs. If the headrest is not high enough then it acts as a fulcrum. As you move forward in your seat, any slack in your seat belt is removed and the restraint becomes tight.
Phase 4
As the neck recoils forward hyperflexion is stopped by the chin hitting the chest. This is when much of the sustained injuries happen. It causes a severe flexion in the neck. As a result, tremendous strain is put on muscles, ligaments, and misaligning vertebra. If your head hits the windshield or steering wheel then you may suffer a concussion, or more severe brain injury.
Symptoms
There are a number of common symptoms associated with whiplash. These symptoms include some or all of the following:
Neck pain
Most patients suffering from whiplash complain of some form of neck pain. This is a very common symptom and it may be localized. It may also defer into the head, down the arm or into the mid back region.
Headaches
It is quite common for patients suffering a whiplash type injury to suffer from headaches. These often originate in the neck and refer into the head. These are termed a cervicogenic headache. Usually, they are of a dull aching nature but can also be sharp. They may be localized in the back of the neck or refer into the front of the head.
Low Back Pain
This is a common complication of a whiplash injury. It is usually the result of twisting in the restraint/ seatbelt and from rapid bending or twisting of the spine.
Whiplash type injuries can manifest in a wide variety of ways.
The exact nature of the symptoms will vary. Symptoms depend on the direction of impact, speed of the vehicles involved. In addition a person’s sex, age and physical condition all play a role. Each case will be different. It is not uncommon for signs and symptoms to have a delay of days or even weeks. This is often because inflammation can take 24 to 72 hours to develop. Some injuries can go unnoticed for weeks or months.
The assumption is that very little damage to the car means lack of injury to the person. However, even small accidents can cause whiplash. For instance, whiplash can easily happen when you are not aware there is impending impact and are unprepared. A Lack of visible damage to the car might mean that more of the impact force has been transferred to the occupant. Therefore, always be sure to be checked by your chiropractor as soon as possible after an accident.
Diagnosis of whiplash type injuries:
A thorough history will be conducted to determine what exactly has caused the whiplash. This will include questions on :
- The nature of the accident
- The exact location of the pain
- Exacerbating and relieving factors
- Causes
- Types of pain
- Referral of pain
- Family history.
In addition, an in depth physical examination will evaluate the following factors:
- General posture and flexibility
- Palpation evaluating tenderness and tightness in the neck muscles.
- Evaluation for decreased range of motion
- Orthopedic tests may be performed
- Muscle tests to determine the extent of weakness
- Neurological assessment if required
- X-rays of the spine may be conducted depending on the extent of injury and examination findings
Finally, once a diagnosis has been confirmed, specific treatment options can be discussed.
Chiropractic Management and Treatment Whiplash Type Injuries:
Chiropractic care is a useful way of treating whiplash. There are a number of different treatment options.
Gentle spinal adjustments.
This would be the main form of treatment. Spinal manipulations are required to reduce inflammation and irritation to the nervous system.
Massage and/or stretching and strengthening exercises
These would be specifically geared for neck muscles and are based on the specific muscles that are involved.
Relative Rest
It is important in the initial phase of treatment to reduce exercise and movements. Movements that aggravate the problem should be minimal in order to reduce inflammation. However, it is important to continue with activities that do not affect the condition. For example, swimming and other low impact aerobic activities. This is a concept often described as relative rest.
Ice
Ice can be applied to the neck to reduce the inflammation. The ice pack can be a frozen gel pack or simply a home made ice pack. It is recommended to use the ice for no longer than 10 minutes. Additionally, it should be wrapped in a towel so it is not directly in contact with the skin.
If you have suffered a whiplash injury, visit our new patient center and come in for a consult.