Whiplash - A Source of Chronic Neck and Back Pain

You're in stop and go traffic on the freeway. You'reseveral hours, eventually peaking at 72 hours
doing 40 mph, then see the brake lights ahead. Youpost-accident. This is why your neck feels very stiff
slow down. Just as you come to a complete stop,about 2-3 days after the accident. Victims also
you glance in your rear-view mirror. The persontypically report fuzziness/ cloudiness in thinking, and
behind you is going too fast to stop in time. You hearfatigue. This is probably due to the stress to the
the screech of brakes, and brace for the impact: Younervous system-- brain, nerves-- from the forces of
hear a loud crash of metal, and feel a surge ofthe accident.
power push your stopped car forward. You feel yourSome victims of low speed car collisions will go the
neck arc backwards and your torso sink into youremergency room to rule out serious injury. The
seat. A second later, the car stops, but the built- upon-duty physician will check for brain and spinal cord
energy in your neck causes it to flex forward, thendamage by checking the pupillary reflex and asking
back again like a whip, and finally, silence. You havethe victim to perform some dexterity tests. He/she
just experienced a cervical acceleration-decelerationwill examine the internal ear for bleeding. X-rays may
injury, or whiplash.be taken to rule out vertebral fracture. If all check
The amount of damage to the spine from a whiplashout, the physician will prescribe pain medications,
accident is determined by several variables. First of all,muscle relaxants, and instructions to ice the painful
the mechanics of the crash: the velocity of theareas.
vehicles involved; their relative masses, the angle ofDespite emergency room treatment, victims often
impact, the position of the seat headrest, whether orfind persistent symptoms of neck and back pain,
not the seatbelt was worn, and the type of bumper.headaches, and sometimes numbness and tingling in
Secondly, the physical factors of the person injured:the upper extremities weeks after the accident. This
his or her height, the position of his neck at impactis most likely due to altered spinal function due to the
(turned, looking down?), the position of his arms;forces of the accident. This can affect nerve
whether or not he was aware of the impendingfunction and delay soft tissue healing. It is at this
collision (did he brace before impact, or was hepoint that the victim will seek more intervention care,
relaxed?), and obviously, his state of health at themost often at a chiropractic office. A chiropractor will
time of the accident (history of neck problems?).typically have the whiplash victim fill out a
A surprising finding in whiplash research is thatquestionnaire that will extract the fine details of the
oftentimes, the speed of the colliding car is notaccident-- speeds, forces, angle of collision, body
always directly proportional to the amount of injurypositioning at the time of collision, and so-on. This can
sustained. One would think that, the faster the carprovide useful information of the nature of the injury.
was going, the stronger the whiplash forceMotion x-rays of the neck may be taken (flexion,
generated, and thus, the more injury. But that is notextension) not only to rule out fracture, but to
the case. One possible explanation has to do withidentify vertebral dyskinesia, or abnormal joint
energy absorption. You see, a car body will deformcoupling (movement). An orthopedic and neurological
(dent) at a certain pounds per square inch force.exam will be done to assess soft tissue structures,
When a car deforms from a collision, it absorbs somejoint function, and nerve function (cranial nerves,
of the kinetic energy. If a car is subject to a forcenerve roots, and peripheral nerves). Of course, the
that is not sufficient to cause a deformation butpatient's medical history will be taken. Of particular
strong enough to generate significant g-forces to theinterest will be history of previous major trauma,
neck, then it's possible for a lower speed collision tosurgical implants, bone disease, soft tissue disease,
cause more injury than a higher speed collision. Thinkhistory of cancer, diabetes, and heart disease. Then,
about race cars: they are designed around thisassuming there are no contraindications to
concept: upon colliding with another car or thechiropractic care, a treatment plan will be prescribed.
racetrack wall, a race car will disintegrate (sections willThis will typically consist of spinal manipulation to
fly off, rather than stay with the frame). If race carsrestore vertebral alignment and movement; modalities
were not designed to disintegrate upon collision, theto address acute symptoms, and perhaps massage
drivers would sustain very serious injury as theytherapy to reduce scar tissue formation and move
would absorb most of the kinetic energy of theout swelling and stagnant lymph. Treatment may be
crash.done over several weeks to months, depending on
Whiplash injuries result in soft tissue damage (sprainsthe extent of the injuries. The last phase will focus
and strains of ligament, fascia, tendons, and muscles)on rehabilitation, or strengthening and coordination
and vertebral misalignments. The more serious varietyexercises to retrain weakened muscles and nerves.
can result in ligament rupture, nerve damage,The bottom line: if you were injured in a car accident
vertebral fractures, ruptured discs, spinal cord injury,and have persistent or residual symptoms such as
hematomas (blood pooling at the surface of theheadaches, neck pain, extremity numbness, or back
brain), concussion, and temporomandibular joint (TMJ)pain, consult with a chiropractor. Chiropractic
injury. Shortly after a typical low speed rear-endertreatment can be very effective in treating and
car collision, the victim will first feel a sense of shock.rehabilitating whiplash injuries.
The neck will typically not hurt immediately. As theFor a concise synopsis of chiropractic treatment, visit
injured soft tissues slowly release inflammatorythe Squidoo page, Chiropractic Treatment: What You
products (swelling), the internal pressure in the neckShould Know.
joints and muscles increases. This will continue for