Monday, December 10, 2012

WHIPLASH

Whiplash is the most common injury sequelae following motor vehicle accidents. Speeds of as little as 5 mph have been documented to result in whiplash injuries. And although whiplash is prevalent in today's society with hundreds of studies on the topic, it is not yet fully understood.

 What is whiplash?
The term "whiplash" was coined by Dr. Harold Crowe back in 1928. It is used to refer to:

  1. the hyperextension/hyperflexion injury of the neck, and
  2. the resulting symptoms of this injury - sustained from a motor vehicle accident.
This forwards-flexion and/or backwards-extension of the neck essentially results in a soft tissue sprain/strain injury to the structures within the cervical and upper thoracic spinal regions. When the initial impact occurs and the head is forced in either excessive flexion or excessive extension, protective reflexes cause the muscles of the neck to forcefully contract which "whips" the head back in the opposite direction. The resulting injury often leads to numerous symptoms, many of which are confusing and poorly understood.

What symptoms are associated with whiplash?
Symptoms following a "whiplash" accident include:
  • neck pain, tenderness, achiness and stiffness
  • cervical muscle spasms
  • tenderness and nodules in superficial cervical musculature
  • cervical reduced range of motion
  • post-traumatic headaches (including migraine and muscle-tension headaches)
  • shoulder and interscapular pain
  • hand and finger pain, numbness and tingling
  • blurred vision
  • difficulty swallowing/feeling of lump in throat
  • dizziness and balance problems
  • lightheadedness
  • post-traumatic depression and cognitive problems

What structures are damaged in whiplash injuries?
Whiplash injuries can damage just a few structures or many, depending on the severity of the accident and direction of the injurious forces, to name a few.
Some of the more common pain-sensitive structures that are damaged include:
  • outer layers of the intervertebral discs
  • intervertebral ligaments
  • capsule of the facet joints
  • anterior longitudinal ligament (runs down the front of the vertebral bodies-prevents excessive extension)
  • posterior longitudinal ligament (runs down the back of the vertebral bodies-prevents excessive flexion)
  • nerve root dura
  • extensor spinal musculature
  • flexor spinal musculature: the colli and scalene muscles
Damage to any of these structures results in tissue inflammation, tissue edema, microscopic hemorrhage, and the release of noxious chemicals such as histamine, prostaglandins, substance P, and kinins which further hypersensitize already painful and injured tissues.

How is whiplash treated?
The most important aspect of a successful treatment program involves active patient participation and patient compliance to the agreed upon program. When treatments focus solely on pain-relief and not tissue rehabilitation or when patients fail to comply with the prescribed treatment plan, the chronicity of problems becomes highly likely.
The chiropractic approach to treating whiplash injuries is highly successful compared with other health care professionals because chiropractors focus on rehabilitating the injured tissues and restoring optimal function. This is reflected in the high patient satisfaction scores that chiropractors have received in "patient satisfaction surveys" performed on MVA patients.
 
Chiropractic care is a safe, natural, noninvasive, and addresses the cause of the symptoms. Our treatments also include active patient participation, and in some cases, lifestyle modifications. While we do focus on eliminating pain early on, we realize that in addition to pain - optimal tissue healing, restoration of normal function, and prevention of future recurrences and reinjuries - are equally important.
Our treatments are highlighted by our use of many gentle and highly effective spinal adjustive techniques. When used properly, these techniques allow us to safely and effectively reduce pain levels, reduce muscles spasms, eliminate inflammation, restore normal joint motion and biomechanics, prevent or minimize degenerative processes, and minimize the likelihood of future recurrences.
We also incorporate many natural and safe adjunctive therapies into our treatment plan to further assist in the healing process. Some common adjunctive therapies include ice therapy, heat therapy, physical therapies like therapeutic ultrasound and muscle stimulation, spinal traction, soft tissue mobilization, spinal exercises and stretches, and nutritional supplementation.

How long do whiplash treatments take?
As with any other injury, there are a number of factors which influence the treatment length of whiplash injuries:
  • the severity of the injury
  • when treatment was initiated
  • patient compliance to the treatment plan
  • the nature of the accident
  • the size and speed of your vehicle and other vehicles involved
  • whether or not seat belts were worn
  • whether you were aware of the impending accident
  • the height of the head rest
  • the age of the individual
  • the size and strength of the cervical musculature
  • the presence of preexisting spinal conditions
The easiest and most effective way of eliminating pain and preventing residual and chronic problems is to start care immediately following the accident. As you allow time to slip by without seeking appropriate treatment, your injuries become more permanent and far more difficult to manage.

Will I have future problems from my whiplash injury?
Numerous studies show that many whiplash victims have a relatively poor outcome without immediate and appropriate treatment. One such study found that 75% of patients with whiplash still suffer from symptoms 6 months after the accident. Experts agree that individuals with any degree of neck complaints following a motor vehicle accident dramatically improve their prognosis if they seek immediate evaluation and appropriate treatment within hours of the accident.

Interesting whiplash statistics.
  • whiplash symptoms last more than 6 months in 75% of patients
  • symptoms of whiplash commonly do not appear until weeks or months after the accident
  • whiplash victims lose an average of 8 weeks of work
  • whiplash is 5 times more common in women than in men
  • whiplash occurs most commonly in those aged 30 to 50 years
  • rear-end collisions typically cause more cervical spine damage than do frontal or side collisions

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