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Whiplash Injuries: Causes, Symptoms, And Treatment

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Whiplash, mostly caused by rear-end collisions, injures soft tissues in the neck and limits neck motion. Optimism and proactivity toward improving the cervical range of motion play a crucial role in recovery. Exercise and chiropractic restore motor control in stiff joints and muscles. Avoid cervical collars and opioid meds. Consume anti-inflammatory ginger and turmeric.

Whiplash, or WAD (whiplash associated disorders), refers to a neck injury where the normal range of motion is exceeded, resulting in injury to the soft tissues (one hopes with no fractures) in the cervical region. There are a lot of factors involved that enter into the degree of injury and length of healing time. Let’s take a closer look!

Whiplash Due To A Rear-End Collision

Picture the classic rear-end collision. The incident itself may be over within 300 milliseconds (msec), which is why it’s virtually impossible to brace yourself effectively for the crash as a typical voluntary muscle contraction takes two to three times longer (800–1000 msec) to accomplish.

In the first 50 msec, the force of the rear-end collision pushes the vehicle (and the torso of the body) forward, leaving the head behind so the cervical spine straightens out from its normal “C-shape” (or lordosis). By 75–100 msec, the lower part of the neck extends or becomes more C-shaped while the upper half flexes or moves in an opposite direction creating an “S” shape to the neck. Between 150–200 msec, the whole neck hyper-extends, and the head may hit the head rest if  the headrest is positioned properly. In the last 200–300 msec, the head is propelled forward into flexion in a “crack the whip” type of motion.

Injury to the neck may occur at various stages of this very fast process, and many factors determine the degree of injury, such as:

  • A smaller car being hit by a larger car
  • The impact direction
  • The position of the head upon impact (worse if turned)
  • If the neck is tall and slender rather than short and muscular
  • The angle and “springiness” of the seat back and relative position of the headrest
  • Dry versus wet/slippery pavement
  • Airbag deployment

Effects Of WAD

Symptoms include:

  • Limited neck motion
  • Neurological loss (nerve-specific muscle weakness and/or numbness or tingling)
  • High initial pain levels (>5/10 on a 0-10 scale)
  • High disability scores on questionnaires
  • Excessive fear of harming oneself with usual activity and/or work
  • Depressive symptoms
  • Post-traumatic stress
  • Poor coping skills
  • Headaches
  • Back pain
  • Widespread or whole body pain
  • Dizziness

Factors That Prohibit Recovery

  • Negative expectation of recovery
  • Pending litigation
  • Catastrophizing
  • Age (older is worse)
  • Poor pre-collision health (both mental and physical)

Research shows the best outcomes occur when patients are assured that most people fully recover and when patients stay active and work as much as possible. Studies have shown it’s best to avoid prolonged inactivity and cervical collars unless under a doctor’s orders.

Treatment

It’s also a good idea to gradually introduce exercises aimed at improving range of motion, postural endurance, and motor control, provided doing so keeps the patient within reasonable pain boundaries.

Chiropractic manipulation restores movement in fixed or stuck joints in the back and neck and has been found to help significantly with neck pain and headaches, particularly for patients involved in motor vehicle collisions. A doctor of chiropractic may also recommend using a cervical pillow, home traction, massage, and other therapies as part of the recovery process.

It is important to be aware that fear of normal activity and not engaging in usual activities and work can delay healing and promote chronic problems and long-term disability. It’s suggested patients avoid opioid medication use due to the addictive problems with such drugs. Ice and anti-inflammatory herbs or nutrients (like ginger, turmeric, and bioflavonoids) are safer options. Your doctor of chiropractic can guide you in this process!

Dr. Blake Kalkstein DC, MS, CCSP, TPI, ART

While earning his D.C. degree, Dr. Blake worked as a chiropractic intern at the Walter Reed National Military Medical Hospital in Bethesda, MD where he had the privilege to work in the amputee rehabilitation center. Dr. Blake’s post graduate sports medicine internship with John’s Hopkins Sports Medicine orthopedic surgeons allowed him to observe all types of injuries. Guidance from Dr. John Wilckens, team orthopedist for the Baltimore Orioles and his internship supervisor, led Dr. Blake to better understand advanced orthopedic and sports injuries and ways to appropriately manage each condition.

Dr. Blake Kalkstein DC, MS, CCSP, TPI, ART

While earning his D.C. degree, Dr. Blake worked as a chiropractic intern at the Walter Reed National Military Medical Hospital in Bethesda, MD where he had the privilege to work in the amputee rehabilitation center. Dr. Blake’s post graduate sports medicine internship with John’s Hopkins Sports Medicine orthopedic surgeons allowed him to observe all types of injuries. Guidance from Dr. John Wilckens, team orthopedist for the Baltimore Orioles and his internship supervisor, led Dr. Blake to better understand advanced orthopedic and sports injuries and ways to appropriately manage each condition.

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