Injuries And Treatment In Whiplash Patients
Whiplash is a non-medical term that for a condition that occurs when the neck and head move rapidly forward and then backward or, sideways. This sudden force results in the normal range of motion being exceeded and causes injury to the soft tissues (muscle, ligament and discs) of the neck. People usually associate whiplash with automobile accidents but these injuries can also occur from a slip and fall on the ice, sports injuries, as well as being assaulted, including "shaken baby syndrome."
This rapid movement of the head and neck not only injures the soft tissues of the neck but can also result in mild traumatic brain injuries. The symptoms associated with these brain injuries can be vague and non-specific. They include a sense of "fuzziness" or difficulty concentrating or remembering things. A patient may feel more fatigued, or have more difficulty processing information, be more irritable as well as having more difficulty with walking, balance and coordination. In addition, headaches are very common.
These mild brain injuries occur when the brain actually bounces off the inside of the bones of the skull as the head is forced back and forth after impact. Depending on the forces and direction of impact, different parts of the brain or brainstem can be injured.
Other common injuries involved in automobile accidents include shoulder, rib and upper back problems. This is due to the body being restrained by the shoulder belt but the rest of the body being torqued around the restraint. Obviously, depending on the severity of the accident, any part of the body could be injured and the severity of these injuries can vary from mild to severe including death.
Symptoms of whiplash vary widely. Most common symptoms include neck pain and stiffness, headache, shoulder pain/stiffness, dizziness, fatigue, jaw pain, arm pain, arm weakness, visual disturbances, ringing ear noises, and sometimes back pain. When not treated properly and these symptoms persist, depression, anger, frustration, anxiety, stress, drug dependency and sleep disturbance can occur.
Diagnosis is based on the history, physical exam, x-ray and MRI. Treatment includes rest, ice (initially) and later heat, exercise, pain management, massage and avoiding the prolonged use of a collar. Chiropractic includes all of these as well as manipulation, mobilization, muscle release methods and patient education. Prompt return to normal activity including work is important to avoid the negative spiral into long-term disability.
Fortunately, most patients can recover from these injuries when treated properly. It is not uncommon, however, that permanent residuals will remain due to scar tissue and altered biomechanics of the joints of the spine. However, proper management will help to minimize these residuals. So what is the best treatment?
This question was investigated in a study published in the Journal of Orthopaedic Medicine 1999;21(1):22-25. In this study, the authors state that conventional (medical) treatment utilized in whiplash care "is disappointing." The authors’ reference a study that demonstrated chiropractic treatment benefitted 26 of 28 patients with chronic whiplash syndrome. Hence, most patients with whiplash injuries should consider chiropractic as their first choice of health care.
Only after you are involved in an accident do you consider what kind of treatment you should seek. There are many choices when it comes to the treatment of whiplash injuries. Choices vary from traditional (medical) drug related approaches from anti-inflammatory over the counter drugs all the way to potentially addicting narcotic medications. On the other side of the fence alternative or "complimentary" forms of treatment include chiropractic, nutritional based products such as vitamins and herbs, exercise and others.
Deciding which treatment is best can be truly challenging. Studies continue to show the superiority of chiropractic management for patients with chronic whiplash injuries. A good rule of thumb is to try something conservative first and when that does not resolve the problems then and only then consider more invasive procedures. This approach will help to minimize the risk of negative side effects.