Whiplash

Whiplash is a general term that is used to describe injuries of the neck, caused when the neck is suddenly and/or violently moved in one direction and then another, creating a whip-like movement. Whiplash is most commonly seen in individuals involved in motor vehicle accidents, but it can also occur from sports injuries, work injuries, falls, and other incidents. Whiplash injuries most often result in a sprain or strain of the neck. The ligaments that help support, protect, and restrict excessive movement of the vertebrae are torn, which is called a sprain. Ligaments called facet capsules, which are particularly susceptible to whiplash injury, cover the joints in the back of the spine, called facet joints. In addition, the muscles and tendons are stretched beyond their normal limit, which is called a strain. 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 and although rare, vertebrae can be fractured and/or dislocated in a whiplash injury.

The most common symptom of whiplash when no bones are broken and the head does not strike the windshield is neck pain and stiffness (62-98%), which typically starts 2-48 hours after the accident. The delay in pain is often a result of tightened muscles that react to either muscle tears or excessive movement of joints from ligament damage. The muscles tighten in an effort to splint and support the head, limiting the excessive movement. Headache, especially at the base of the skull, is also a common symptom, seen in more than two thirds of patients with whiplash injuries. These headaches may be one-sided or experienced on both sides of the head/face. In addition, the pain and stiffness may extend down into the shoulders, arms, upper back, and even the upper chest. In addition to the musculoskeletal symptoms, some patients also experience dizziness, jaw pain, difficulty swallowing, nausea, vertigo (the sensation of the room spinning) and ringing in the ears.

Some factors that play a role in the seriousness of the injuries include. 1) Vehicle size. When both are equal, even an 8 mph collision produces two times the force of gravity or a 2-G acceleration of the car, and a 5-G acceleration of the head. This magnification of the force gives rise to the name, Whiplash. 2) Headrest position. This can make an injury much worse if too low, and even at the right height, it must be close enough to catch the head in time (about 2 inches). A seat that is reclined too far will increase this distance, as will poor posture and driving habits if leaning forward. 3) The position of the head is important. When turned to the side, for instance, it can only move about half as far as a straightforward position. Hence, all the G forces are localized to one side of the spine, substantially increasing the severity of injuries. 4) Age – plays an important role because as the body becomes older, ligaments become less pliable, muscles weaker and less flexible, and decreases in range of motion. 5) Women and children– seem to be injured more seriously than men. This is most notable due to the fact that they tend to be shorter. Because of this, they are either too close to the steering wheel/airbag and or have improper fitting shoulder harness/seatbelts. 6) And pre-existing health problems – such as arthritis, lend to the severity of the injuries

How is whiplash treated? 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. Chiropractic care utilizes adjustments, muscle relaxation and/or stimulation, various exercises and ergonomic/lifestyle changes. 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. Ice and/or heat are often used to help control pain and reduce the muscle spasm that results from whiplash injuries. Other 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.