Whiplash Injuries: Part 1

With this entry into my slowly growing column database we will start to dive into an area that I see on a daily basis in my practice. It does not mean however that I or anyone has truly mastered the diagnosis, treatment and recovery of this common, yet complicated injury. Most manual therapists and chiropractors see neck (cervical spine) injuries stemming from car accidents quite regularly in practice and they should be treated diligently to prevent long term complications.

Motor vehicle accidents (MVA) are the most common cause of traumatic cervical spine fractures (which vary greatly in severity) and always require hospitalization, imaging and stabilization. A less serious, but potentially debilitation condition commonly known as whiplash can also have longstanding implications for victims. It is a type of injury that can be difficult to diagnose in terms of severity and also the road to recovery is not always smooth.

Whiplash Associated Disorders (WAD) are among the most common injuries sustained while driving a car and being involved in an accident. They are also known as Cervical Acceleration/Deceleration injuries. The forces going through the body after being hit in a rear impact collision, even at a low speed, are tremendous and can be measured in G-forces.

WAD injuries often do not present themselves until up to several days after the motor vehicle accident and because they are a primarily soft tissue type injury will usually not demonstrate any orthopaedic or neurologic impairment, or any significant findings on an initial x-ray. The “soft tissues” that we are referring to include muscle, tendons, ligaments, discs and nerve roots. It is important however, to seek care from a healthcare practitioner however to ensure that you have no serious injuries.

Whiplash injuries are classified based on their symptoms and clinical severity. This was established by what is known as the Quebec Task Force. The classification is as follows:

Grade 0: no neck pain, stiffness, or any physical signs are noticed

Grade 1: neck complaints of pain, stiffness or tenderness only but no physical signs are noted by the examining physician.

Grade 2: neck complaints and the examining physician finds decreased range of motion and point tenderness in the neck.

Grade 3: neck complaints plus neurological signs such as decreased deep tendon reflexes, weakness and sensory deficits.

Grade 4: neck complaints and fracture or dislocation, or injury to the spinal cord.

As a chiropractor, I see patients that range from Grade 1 to 3. The majority of the time I will initially see a patient anywhere from 2 days after an accident to a month to begin treatment. Because WAD injuries may not be initially symptomatic, a person may feel like they escaped injury. The soreness and reduced mobility will often make itself known and increase if left untreated. Treatment of these injuries varies on the situation but can include modalities such as ultrasound and muscle stimulation, soft tissue treatment such as Active Release Technique, spinal manipulation or adjustments and perhaps most importantly; strengthening and range of motion exercises.

Over the next several weeks, we will look deeper into Whiplash Associated Disorders including the relationship of severity of crash vs. injury, the long term consequences of whiplash and treatment options.

Feel free to submit any questions or comments to [email protected].

Thanks and have a healthy day!

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.