Whiplash Injuries

Whiplash is a pandemic which is often overlooked.  It has a high rate of disability and chronicity and for these reasons, it should not be ignored after a car accident. There are over 5.5 million car accidents in the United States every year and over half result in a whiplash injury.  

Rear-impact car accidents, especially ones in which an unsuspecting driver/passenger is struck from behind by another vehicle, are considered to be the most likely car accident types to result in whiplash injuries.  The vulnerability for whiplash in these accidents is primarily related to the forces, spine position, and biomechanics involved in this type of car accident.   However, whiplash is common in all types of car accidents and even occurs in contact sports like football.  It is so prevalent that over 80% of those involved in a car accident experience whiplash.  

Of those who experience whiplash after a car accident about half continue to experience whiplash symptoms 1 year after the accident.  

Yet, whiplash continues to be overlooked and misunderstood by many.  

Some common misconceptions are:

• If there’s no pain immediately after the accident you’re in the clear.
  • This is far from the truth.  Many begin to experience the symptoms of whiplash 48-72 hours after the accident and in some cases even weeks or months after.  
• If it was a low velocity crash you won’t get whiplash.  
  • Velocity is only one risk factor for developing whiplash.  Age, body position, existing spinal conditions are often more important determinants as to who does or who doesn’t develop whiplash.
• Taking medication and relative rest is enough to recover from whiplash.
  • In whiplash cases where pain is very severe, drug therapy can certainly play a role.  However, the evidence does not support drug therapy and relative rest alone, as an effective form of treatment for whiplash injuries.  
  • As with most musculoskeletal injuries, a physical solution through hands-on care and corrective exercise is the best course of action.
  • The joints of your body heal and take in nutrients when they can move correctly in a cyclical fashion.  After a whiplash injury, the joint and soft-tissue motion is disturbed.  Just like professional athletes are taught to do when they suffer an injury, starting hands-on treatment and rehabilitative exercises should be initiated as quickly as possible in order to correct the altered motion, especially of the neck after whiplash.  

Whiplash has many common presenting symptoms mostly in the form of pain, numbness, tingling, and a sense of heaviness especially around the neck, head, shoulders, and upper and mid back.  However, many more symptoms may be present including:

• Headaches
• Dizziness/Vertigo/Balance disturbances
• Ringing in the ears
• Jaw pain
• Upper back, Mid back, and Lower back pain
• Shoulder pain
  • Rotator cuff
  • Thoracic outlet syndrome
• Hand and wrist pain
  • Carpal tunnel
• Nerve pain (sharp shooting pain)
• Difficulty sleeping
• Irritability
• Sensitivity to light and sound
• Concussion and brain injury symptoms
  • Visual disturbances
  • Nausea/vomiting
  • Difficulty concentrating
  • Cognitive, emotional, and behavioral disturbances  

Of the above symptoms the 3 most common are:

1. Neck pain along with some or all of the following referral pain patterns below (Bogduk):
2. Headaches
   1. The most common whiplash headaches are cervicogenic headaches which are headaches that originate in the neck and refer up to the head.  
   2. Whiplash can exacerbate pre-existing headache conditions.
3. Shoulder Pain – forces caused from a car accident can cause injury to the:
   1. Rotator cuff
   2. Labrum and other ligaments
   3. Impingement syndrome

Here at CMF we are experienced at providing a diagnosis and treatment plan associated with whiplash injuries after a car accident.  Our evidence-based approach of combining hands-on treatment with corrective exercises is supported by the research for best patient outcomes.  

References

1. “Road Crash Statistics.” ASIRT. N.p., n.d. Web. 17 May 2017.
2. Bogduk, Nikolai. “Cervicogenic headache: Anatomic basis and pathophysiologic mechanisms.” Current Pain and Headache Reports 5.4 (2001): 382-86. Web.
3. Bogduk, Nikolai. “The Anatomy and Pathophysiology of Neck Pain.” Physical Medicine and Rehabilitation Clinics of North America 22.3 (2011): 367-82. Web.
4. Carroll, Linda J., Lena W. Holm, Sheilah Hogg-Johnson, Pierre Côté, J. David Cassidy, Scott Haldeman, Margareta Nordin, Eric L. Hurwitz, Eugene J. Carragee, Gabrielle Van Der Velde, Paul M. Peloso, and Jaime Guzman. “Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD).” Spine 33.Supplement (2008): n. pag. Web.
5. Croft, Arthur C. Whiplash and mild traumatic brain injuries: a guide for patients and practitioners. Coronado, CA: Spine Research Institute of San Diego, 2009. Print.
6. Radanov, Bogdan P., Matthias Sturzenegger, and Giuseppe Di Stefano. “Long-Term Outcome after Whiplash Injury: A 2-Year Follow-Up Considering Features of Injury Mechanism and Somatic, Radiologic, and Psychosocial Findings.” Medicine 74.5 (1995): 281-97. Web.
7. “Spinal Injury and Whiplash Articles:.” Whiplash Information – Spine Research Institute of San Diego – Specializing in Whiplash Injury Research. N.p., n.d. Web. 17 May 2017.
8. Sterling, Michele, Gwendolen Jull, and Justin Kenardy. “Physical and psychological factors maintain long-term predictive capacity post-whiplash injury.” Pain 122.1 (2006): 102-08. Web.
9. “The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study. Nolet PS, Côté P, Cassidy JD, Carroll LJ. Eur Spine J 2010;19(6):972–81. Epub 2010 Mar 7.” The Spine Journal 10.10 (2010): 941. Web.

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