Whiplash and Chiropractic Care

Whiplash and Accident Post-Concussion Syndrome (PCS) and Whiplash Syndrome (WS)

A whiplash injury occurs when there is a sudden acceleration-deceleration force, that causes unrestrained forward and backward movement of the head and neck.

Long term damage to the spine and head is especially common in car accidents. Chiropractors have for years recognized the need for neuro-structural integrity in these areas and that if most victims of car accidents do not fully recover under medical care, they may continue to have problems for years after the accident. This is especially the case of those who have whiplash and concussion injuries. This of course underscores the need for chiropractic care for accident victims. New medical terms acknowledging the chronicity and incomplete healing of accident victims have arisen over the past several years. The terms used are: Post-Concussion Syndrome (PCS), Whiplash Syndrome (WS), Post Whiplash Syndrome (PWS), Mild Traumatic Brain Injuries (MTBI), and Mild Head Injury (MHI).

Studies have shown the following with whiplash:

• 62% of the people injured in a whiplash soft- tissue trauma will have continued complaints between 10 and 15 years after the date of the accident.
• About 10-15% of motor vehicle cervical injuries fail to achieve a functional recovery 2-3 years after the accident.
• Cervical sprain from whiplash not only causes pain and neuropsychological disturbances, but also the following sequelae: cervical dystonia (Spasmodic Torticollis), dizziness, hearing loss for low frequencies, dysphonia (difficulty speaking) and globus (a sensation of something stuck or of a lump or tightness in the throat).
• Cervical manipulations (adjustments) to the occiput and atlas or axis and third cervical vertebra have been found to be beneficial.
• Simulated impacts have been studied extensively and essentially confirm that a low-speed impact with minimal or no damage to the impacted vehicle can and does cause significant musculoskeletal injury to the driver’s or occupant’s head and neck.
• In many instances, a person experiences whiplash after a vehicle accident that has caused little significant damage to either vehicle.

There is an Acceleration of Degenerative Disc Disease Following Whiplash Injuries:

• Follow-up x-rays taken an average of 7 years after injury in one series of patients without prior x-ray evidence of disc disease indicated that 39% had developed degenerative disc disease at one or more disc levels since injury. There was an expected incidence of 6% degenerative change in the population over this period of time. Thus, it appeared that the injury had started the slow process of disc degeneration.

• In another follow-up study of patients with similar injuries but with pre-existing degenerative changes in the neck, it was observed that after an average of 7 years 39% had residual symptoms and x-rays revealed evidence of new degenerative change at another level of the spine occurred in 55% of those people.
• If whiplash patients are still symptomatic after 3 months then there is almost a 90% chance that they will remain so.
• Often, whiplash can lead to post-traumatic whiplash stress may cause increased sustained sympathetic tone in the nervous system, altering muscle contractibility, accelerating wasting away (atrophy) of the multifidii muscles (see pic below). This has been documented with MRI. Hence, a biosocial phenomenon causes an organic injury, increasing the risk of chronic pain.

multifidus muscle

• Similarly, fear avoidance may reduce movement, also resulting in muscle atrophy/ wasting and chronicity. Spinal soft tissue injury with subsequent articular “fibrosis of repair” will impair joint movement, also resulting in enhancing muscle atrophy, fatty infiltration, and chronicity.
• In a study looking at chiropractic care of chronic whiplash patients, using the Gargan and Bannister (1990) classification, (93%) patients improved following chiropractic treatment. The patients in this study had initially been treated with anti-inflammatories, soft collars and physiotherapy. These patients had all become chronic, and were referred for chiropractic at an average of 5 months (range was 3 – 44 months) after their initial injury. The chiropractic treatment in this study was a mean of 19.3 treatments (range 1 – 53), over a period of 4.1 months.

This suggests that in management of whiplash injury all should:

• Begin Chiropractic early – within a week of being injured.
• Include varieties of stress management.
• Encourage early and persistent movement.

Additionally, natural anti-inflammatory protocols seem logical, including nutritional support for lowered inflammation, so keep up those Omega 3’s, Vitamin D and magnesium. See our front desk team if you require these products.

References are available on request