Whiplash is a 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. 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.
What structures are injured in a whiplash?
Whiplash injuries most often result in sprain-strain of the neck. The ligaments that help 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?
The most common symptoms of whiplash are pain and stiffness in 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. 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. 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.
According to the Spine Research Institute of San Diego, 45% of persons with chronic neck pain attribute the pain to a past motor vehicle collision injury.
How is whiplash treated?
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 traction and electrical stimulation, may provide some short-term relief. They should not, however, replace an active-care program of exercise and stretching. Spinal adjustments and/or mobilization provided by a chiropractor can also give relief in many cases of neck pain and is vital to help restore normal alignment and mechanics to the spine. This will help prevent long term adhesions and scar tissue from settling in.
Why are spinal adjustments so important?
In a 1996 study by Woodward et. al., published in the journal “Injury,” Chiropractic treatment was able to help relieve the pain for 93% of patients with chronic whiplash injuries. Chronic whiplash injuries are notoriously resistant to any form of treatment, making their conclusions particularly significant in the field of whiplash treatment. Guidelines published by the Federal Agency for Health Care Policy and Research (AHCPR) concluded that spinal manipulation was one of only three treatments for acute back pain for which there was at least moderate research-based evidence of effectiveness.
During your visit to our office, the doctor of chiropractic will perform a detailed consultation and examination to locate the source of your pain. This will involve a series of questions about your current condition, followed by 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. The doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm. A check of your upper extremity may also be in order. During the neurological exam, the doctor may test your reflexes, muscle strength and sensory testing. If warranted the Doctor may order x-rays and computerized muscle tests. Once all of the information is collected to develop a specific diagnosis, a report of findings will be delivered to you. If you qualify for conservative chiropractic care, recommendations for the appropriate adjustments and therapies will be provided.