Some older stats report that 3.8 people per 1000 suffer a whiplash injury each year. A whiplash injury is something that does not have to follow a motor vehicle crash (MVC) but can occur with a number of similar mechanisms of trauma. In fact what we call whiplash was once called railroad spine as the mechanism of trauma occurred often with railroad car crashes. Today, though, what we commonly call whiplash has also been refereed to as cervical acceleration-deceleration (CAD) injury and whiplash associated disorders (WAD). Whiplash associated disorders is probably a better term to use because with a whiplash injury there can be injury to more than just the cervical spine and symptoms more than just the typical neck pain. CAD is a term that does describe the motion the best but leaves the impression that the cervical spine is the only structured injured.
In today’s vernacular a whiplash injury most commonly occurs when we are struck by a car from behind while driving. After impact our body moves reward into the seat back followed by our cervical spine and head. While due to this motion we can experience low and mid back pain it is most common for us to have neck pain and headaches. The neck injury occurs during the middle of the motion of our head and heck. In the middle of the rearward movement the lower cervical spine is bent backward while the upper is bent forward forming a “S” shaped curve. The lower part of the cervical spine moves far beyond it’s normal range of motion causing the potential injury to the ligaments, discs, and facet joint in the lower neck. While the upper spine moves beyond it’s normal range of motion it is usually to a lesser degree than the lower. Injuries can occur at changes in velocity at or even lower than 5mph. A change in velocity can include being struck while stopped by a car moving at 5mph or even struck while moving at 15mph by a car moving at 20mph. Studies have shown that head posture or a cervical spine curve less than ideal and preexisting spinal arthritis can result in a more severe injury than a spine that is near normal. Damage to the bumper will reduce the force transmitted to the cars occupant, so if your bumper has little to no damage it is more likely for you to be injured than less likely because the car did not absorb any of the force of the impact. If your head is turned to a side it is likely you will have greater symptoms towards one side of the spine or the other.
Common symptoms are neck and back pain but can also include headache, shoulder pain, upper extremity pain, pins/needle sensation in the upper extremity, lower extremity pain, and vertigo. Rare but possible in high speed crashes is a mild traumatic brain injury or even more rare but possible is a stroke. Symptoms can start immediately after a crash or take hours to months to begin. There are studies that show 6.2% of the US population suffer from late whiplash syndrome which are symptoms that start months to years after the crash. There are other studies that show over 75% of chronic neck pain patients attributing a MVC or whiplash injury as the initial cause of their pain.
The best way to reduce the severity of a whiplash injury is to not have one by being an alert driver and avoiding a crash if possible. If avoiding a crash is not possible the best thing to do to reduce the severity of injury include sitting with proper headrest and setback geometry, see this post for details. If you see the crash coming brace by placing your head and back against the seat and seat back, keep or place your foot on the brake but do not aggressively press it, align your wheels straight ahead to avoid being pushed into oncoming traffic, do not aggressively press against the steering wheel but keep a hold of it.
We recommend getting seen by your PCP or better yet a chiropractor soon after being involved in a MVC even if you do not have any immediate symptoms. As I mentioned symptoms can take a few days to come on and if not treated properly a whiplash injury may result in chronic neck pain. Management of a whiplash injury resolves around reducing inflammation and moving joints and tissue as soon as possible. The idea of bracing to immobilize the spine after a crash is only supported if there is a likelihood of muscle or ligament rupture which would cause instability in the spine. Only in severe cases is immobilization utilized or in the rare and most severe cases is surgical intervention required. In all other cases early mobilization or movement combined with posture correction exercises results in the best and quickest recovery from a whiplash injury.
We have over 50 years of combined experience working with patients who have suffered a whiplash injury or have chronic neck pain due to an old whiplash injury. We understand this condition and the best means to treat it. If you have had a whiplash injury, current or old, give us a call and we can talk to you about how we may be able to help.