Whiplash
accidents are not limited to car accidents alone, roller coasters can
cause whiplash accidents too.
The term "whiplash" was first used in 1928 to define an injury mechanism of sudden hyperextension followed by an immediate hyperflexion of the neck that results in damage to the muscles, ligaments and tendons – especially those that support the head.
Today, we know that
whiplash injuries frequently do not result from hyperextension or
hyperflexion (extension and flexion beyond normal physiological
limits), but rather an extremely rapid extension and flexion that
causes injuries.
Due to their complicated nature and profound
impact on people's lives, few topics in health care generate as much
controversy as whiplash injuries.
Unlike a broken bone where a simple x-ray can validate the presence of the fracture and standards of care can direct a health care professional as to the best way in which to handle the injury, whiplash injuries involve an unpredictable combination of nervous system, muscles joints and connective tissue disruption that is not simple to diagnose and can be even more of a challenge to treat.
In order to help you
understand the nature of whiplash injuries and how they should be
treated, it is necessary to spend a bit of time discussing the
mechanics of how whiplash injuries occur.
The Four Phases of a
Whiplash Injury
During a rear-end automobile collision, your
body goes through an extremely rapid and intense acceleration and
deceleration. In fact, all four phases of a whiplash injury occur in
less than one-half of a second! At each phase, there is a different
force acting on the body that contributes to the overall injury, and
with such a sudden and forceful movement, damage to the vertebrae,
nerves, discs, muscles, and ligaments of your neck and spine can be
substantial.
Phase 1
During this first phase, your car
begins to be pushed out from under you, causing your mid-back to be
flattened against the back of your seat. This results in an upward
force in your cervical spine, compressing your discs and joints. As
your seat back begins to accelerate your torso forward, your head
moves backward, creating a shearing force in your neck. If your head
restraint is properly adjusted, the distance your head travels
backward is limited. However, most of the damage to the spine will
occur before your head reaches your head restraint. Studies have
shown that head restraints only reduce the risk of injury by
11-20%.
Phase 2
During phase two, your torso has
reached peak acceleration – 1.5 to 2 times that of your vehicle
itself – but your head has not yet begun to accelerate forward and
continues to move rearward. An abnormal S-curve develops in your
cervical spine as your seat back recoils forward, much like a
springboard, adding to the forward acceleration of the torso.
Unfortunately, this forward seat back recoil occurs while your head
is still moving backward, resulting in a shearing force in the neck
that is one of the more damaging aspects of a whiplash injury. Many
of the bone, joint, nerve, disc and TMJ injuries that I see
clinically occur during this phase.
Phase 3
During the
third phase, your torso is now descending back down in your seat and
your head and neck are at their peak forward acceleration. At the
same time, your car is slowing down. If you released the pressure on
your brake pedal during the first phases of the collision, it will
likely be reapplied during this phase. Reapplication of the brake
causes your car to slow down even quicker and increases the severity
of the flexion injury of your neck. As you move forward in your seat,
any slack in your seat belt and shoulder harness is taken up.
Phase
4
This is probably the most damaging phase of the whiplash
phenomenon. In this fourth phase, your torso is stopped by your seat
belt and shoulder restraint and your head is free to move forward
unimpeded. This results in a violent forward-bending motion of your
neck, straining the muscles and ligaments, tearing fibers in the
spinal discs, and forcing vertebrae out of their normal position.
Your spinal cord and nerve roots get stretched and irritated, and
your brain can strike the inside of your skull causing a mild to
moderate brain injury. If you are not properly restrained by your
seat harness, you may suffer a concussion, or more severe brain
injury, from striking the steering wheel or windshield.
Injuries
Resulting from Whiplash Trauma
As we discussed briefly in the
introduction, whiplash injuries can manifest in a wide variety of
ways, including neck pain, headaches, fatigue, upper back and
shoulder pain, cognitive changes and low back pain. Due to the fact
that numerous factors play into the overall whiplash trauma, such as
direction of impact, speed of the vehicles involved, as well as sex,
age and physical condition, it is impossible to predict the pattern
of symptoms that each individual will suffer. Additionally, whiplash
symptoms commonly have a delayed onset, often taking weeks or months
to present. There are, however, a number of conditions that are very
common among those who have suffered from whiplash trauma.
Neck
pain
It is the single most common complaint in whiplash
trauma, being reported by over 90% of patients. Often this pain
radiates across the shoulders, up into the head, and down between the
shoulder blades. Whiplash injuries tend to affect all of the tissues
in the neck, including the facet joints and discs between the
vertebrae, as well as all of the muscles, ligaments and
nerves.
Facet joint pain is the most common cause of neck pain
following a car accident. Facet joint pain is usually felt on the
back of the neck, just to the right or left of center, and is usually
tender to the touch. Facet joint pain cannot be visualized on x-rays
or MRIs. It can only be diagnosed by physical palpation of the
area.
Disc injury is also a common cause of neck pain;
especially chronic pain. The outer wall of the disc (called the
anulus) is made up of bundles of fibers that can be torn during a
whiplash trauma. These tears, then, can lead to disc degeneration or
herniation, resulting in irritation or compression of the nerves
running through the area. This compression or irritation commonly
leads to radiating pain into the arms, shoulders and upper back, and
may result in muscle weakness.
Damage to the muscles and
ligaments in the neck and upper back are the major cause of the pain
experienced in the first few weeks following a whiplash injury, and
is the main reason why you experience stiffness and restricted range
of motion. But as the muscles have a chance to heal, they typically
don't cause as much actual pain as they contribute to abnormal
movement. Damage to the ligaments often results in abnormal movement
and instability.
Headaches
After neck pain, headaches
are the most prevalent complaint among those suffering from whiplash
injury, affecting more than 80% of all people. While some headaches
are actually the result of direct brain injury, most are related to
injury of the muscles, ligaments and facet joints of the cervical
spine, which refer pain to the head. Because of this, it is important
to treat the supporting structures of your neck in order to help
alleviate your headaches.
TMJ problems
A less common,
but very debilitating disorder that results from whiplash is
temporomandibular joint dysfunction (TMJ). TMJ usually begins as
pain, clicking and popping noises in the jaw during movement. If not
properly evaluated and treated, TMJ problems can continue to worsen
and lead to headaches, facial pain, ear pain and difficulty
eating.
Dizziness
Dizziness following a whiplash injury
usually results from injury to the facet joints of the cervical
spine, although in some cases injury to the brain or brain stem may
be a factor as well. Typically, this dizziness is very temporary
improves significantly with chiropractic treatment.
Low back
pain
Although most people consider whiplash to be an injury of
the neck, the low back is also commonly injured as well. In fact, low
back pain is found in more than half of rear impact-collisions in
which injury was reported, and almost three-quarters of all
side-impact crashes. This is mostly due to the fact that the low back
still experiences a tremendous compression during the first two
phases of a whiplash injury, even though it does not have the degree
of flexion-extension injury experienced in the neck.
Recovery
from Whiplash
With proper care, many mild whiplash injuries
heal within six to nine months. However, more than 20% of those who
suffer from whiplash injuries continue to suffer from pain, weakness
or restricted movement two years after their accident. Unfortunately,
the vast majority of these people will continue to suffer from some
level of disability or pain for many years after that, if not for the
rest of their lives.
Whiplash is a unique condition that
requires the expertise of a skilled health professional specially
trained to work with these types of injuries. The most effective
treatment for whiplash injuries is a combination of chiropractic
care, rehabilitation of the soft tissues and taking care of yourself
at home.
Chiropractic Care
Chiropractic care utilizes
adjustments to the spine to restore the normal movement and position
of the spinal vertebrae. It is by far the single-most effective
treatment for minimizing the long-term impact of whiplash injuries,
especially when coupled with massage therapy, trigger point therapy,
exercise rehabilitation and other soft tissue rehabilitation
modalities.
Soft Tissue Rehabilitation
The term soft
tissue' simply refers to anything that is not bone, such as your
muscles, ligaments, tendons, nervous system, spinal discs and
internal organs. During a whiplash injury, the tissues that are
affected most are the soft tissues, the muscles, ligaments and discs
in particular. In order to minimize permanent impairment and
disability, it is important to use therapies that stimulate the soft
tissues to heal correctly. These include cold laser, massage therapy,
trigger point therapy, stretching and specific strength and range of
motion exercises.
Home Care
The most effective
chiropractic care and soft tissue rehabilitation will be limited in
its benefit if what you do at home or at work stresses or re-injures
you on a daily basis. For this reason, it is important that your plan
of care extend into the hours and days between your clinic visits to
help speed your recovery. Some of the more common home care therapies
are the application of ice packs, limitations on work or daily
activities, specific stretches and exercises, taking nutritional
supplements and getting plenty of rest.
To Request An Appointment Click Below
https://www.drgitto.com/appointment
Dr Joseph Gitto, BA, DC, FDN, CFMP, CWC
Advanced Chiropractic & Nutrition
Feel Better – Live Better – Perform Better
331 Tilton Road, Northfield, NJ 08225
609-484-9300