Our practice is in the suburbs of Chicago. Today, Monday November 11th, 2019 we had a major snowfall. Surprisingly not the first snowfall we’ve had this fall/winter but probably the most significant snowfall thus far. This got me thinking that I have not had a post on whiplash injuries in a while. Treatment for whiplash injuries are important to undertake if you have been involved in a motor vehicle crash. Notice I didn’t say you should be treated if you were injured but if you are involved in a crash, well examined at least. This is because even though we know that around 65% of the time symptoms are present immediately after a crash symptoms may be delayed and start 72 hours after a crash or more. This occurs in around 23% of the time a person is injured in a crash. We also know that about 45% of people which chronic neck pain can attribute the initial cause of their pain to a motor vehicle crash. (Freeman MD, Croft AC et.al. “Chronic neck pain and whiplash: a case-control study of the relationship between acute whiplash injuries and chronic neck pain.” Pain Management Summer 2006.)
So what is a whiplash injury anyway? This is more of a description of the mechanism of trauma than it is a diagnosis. When we are involved in a motor vehicle crash where we are hit from behind. That impact accelerates our body rearward into the seatback and headrest. Our head moves rearward than hyper-extends until it reaches it’s end point of movement and then our head/body bounces off of the headrest/seatback traveling forward and our head into hyper-flexion. What it does to the soft tissue which supports our spine and skull is complicated but this can tear, or partially tear tissue. It can also injure the joint surfaces as well. It is not hard to tell that if you tear a ligament not only is this going to cause pain but it can become a chronic condition cause pain on and off for your lifetime. This is if you don’t get this taken care of properly at the time of the crash.
It is not uncommon to not have symptoms immediately after a crash. An event such as a car crash is going to stimulate a rush of adrenaline which can suppress nociception (pain.) If you have symptoms immediately after a crash this is your body screaming at you that you are injured, don’t ignore that. If you are involved in a crash get an evaluation as soon as possible even if you don’t have symptoms because you still could be injured. We see this with patients who where involved in a crash when they were younger. When we are younger we typically bounce back after trauma faster. These cases are almost the most troublesome because an untreated injury will likely become a chronic condition years down the road as the research indicates. A properly treated injury might still become a chronic condition depending on the severity of the injure. The competency of your doctor matters as well.
We suggest a proper evaluation to measure range of motion, posture, and structure of the spine. Maybe an MRI to determine if there is a tear of any spinal ligaments or muscles if the crash and symptoms are severe enough. Treatment should first involve reducing pain and restoring motion then migrate to include strengthening the supporting muscles. Working on mobility is important, even early in an injury, because it will help lessen the buildup of scar tissue formation during tissue healing. Our care includes looking at and measuring the structure of the cervical spine because the curve of your neck matters in terms of symptoms and long term relief, according to the research.
Two recent case studies have been published illustrating the importance of curve correction based care in the treatment of patients following a motor vehicle crash. The first study involved a 46 year old man who had neck pain and dizziness following a motor vehicle crash. Included in his findings were forward head posture and a loss of the cervical spine curve. This patient was treated for 16 weeks and had a complete resolution of his daily dizziness and neck pain which lasted for one year after his care ceased. His care involved what I mentioned previously but included correction of his neck curve and forward head posture.
The second case study involved a 31 year old woman with neck pain for 12 years following a motor vehicle crash. In this case the patient was treated by a chiropractor and her symptoms improved only to return after she completed her care. In this case the woman was found to have a loss of the normal neck curve and was treated to restore her curve towards normal. She underwent 30 visits over 5 months, her neck curve improved to almost normal and her symptoms improved to a level she had done experienced under previous chiropractic care. These cases highlight the importance posture and curve correction have in the treatment of spine and spine related disorders due to a motor vehicle crash.
Treatment for whiplash injuries are important for your long term health and function. That treatment should at least include an evaluation by a chiropractor whether you had any symptoms immediately after the crash or not. If you require treatment that treatment should include a correction of your head posture and cervical curve, if needed, to ensure you the best long-term option. Chiropractic adjustments by themselves have been found to help treat injuries to the spine from a whiplash event. What I described here is what we do for whiplash cases. We do a thorough evaluation to include a referral for advanced imaging or consult if needed. If we find a loss of the normal posture or structure of your spine is part of your injury we treat it to give you the best long term outcome. That is what we want to see from our patients, not that their pain is gone for the next few months but that it is gone for good when that is possible.