Looking for whiplash info in Grand Rapids MI? This is part 1 of a three-part series where we're going to cover whiplash in-depth. This write-up is meant to be easy to follow and not a research article. We're going to discuss what whiplash is, what the effects are, and what can be done for treatment and recovery. If you've been in a car accident of ANY magnitude, chances are you are experiencing the effects whether you are having symptoms or not. So let's jump right in.

What is Whiplash in Grand Rapids MI?

Whiplash is a non-medical term used to describe neck pain due to injuries where the head and neck are forced into a movement beyond the normal range of motion. This can be caused by any jarring action but is most commonly associated with car accidents.

Being in the vehicle that is struck from behind is NOT the only way to suffer a whiplash injury. This can occur from striking a car in front of you as well as being hit on either side. The only difference is the tissues that are being injured.

The typical mechanism of the injury occurs when the neck is taken beyond its normal range of motion in one direction and quickly happens again in the opposite direction. In the example above, the neck is forced into hyperextension and then quickly into hyperflexion. The severity of the accident (usually determined by the difference in speed of the two objects) is the most common predictor of the severity of the injury. The hyperextension typically affects the lower portion of the neck and the hyperflexion affects the upper portion. This can cause extensive damage throughout the cervical spine, thus increasing the complexity of the injury and increasing recovery time. We'll get more into these topics in parts 2 and 3 of this series.

Whiplash injuries are more commonly associated with the soft tissue (ligaments, tendons, and muscles) but there is always a structural component as well. Partially or fully torn ligaments (sprains) or muscles (strains) will cause instability in the cervical spine, distorting the structure and posture. The weakening that occurs from the injury-even during low speed collisions-can take months or years to develop before any symptoms are experienced.

Symptoms

Now is as good a time as any to discuss the symptoms of whiplash injuries. Remember, these symptoms can occur immediately after or can take months/years to develop.

Symptoms include stiffness, loss of motion, concussion, vomiting, muscle spasm, difficulty falling and/or staying asleep, hoarseness of voice, numbness and/or pain in the arms and hands, jaw pain, depression, anxiety, and sciatica to name a few.

Why Do I Feel This Way?

Whiplash Symptom Categories

First off, there are different categories of which your symptoms can occur depending the extent of your injury.

• Short Term
  • Low Speed
  • High Speed
• Long Term
  • Low Speed
  • High Speed

Any of the symptoms can occur at any point regardless of accident/fall severity but I'm going to try and provide the most up-to-date evidence for each category. Other factors that influence the extent of injury are posture at impact, overall physical condition, awareness of the coming impact, and gender.

Short Term - Low Speed

One study states that at collisions/falls with a difference of approximately 5mph, the majority were uninjured at the time of the accident but 20% showed symptoms within the first month following the accident. Approximately 5% experience symptoms at some point between 1 and 6 months and less than 5% experienced symptoms after 6 months. Typical injuries include cervical vertebral subluxation and cervical sprain/strain resulting in headaches and neck pain. Spinal evaluation is recommended.

Short Term - High Speed

Any and/or all of the symptoms can be present immediately following a high-speed collision. Very special care should be taken to protect the cervical spine (neck) following a high-speed accident until medical imaging (X-ray, CT, MRI, etc.) can be done. Serious cases include cervical dislocation, fracture, Grade III cervical sprain/strain (complete tear), concussion, etc. MEDICAL EVALUATION IS 100% NECESSARY.

Long Term - Low Speed

The statistics were discussed briefly in the short term - low speed portion. Jarring of any degree can cause weakening of the spine, muscles, ligaments, and joints which over time, due to normal day-to-day wear and tear, can begin to lose the ability to maintain proper structure and posture. This can result in change of spine curvature and an increase in symptoms. Spinal evaluation is recommended at this point.

Long Term - High Speed

We're going to start by assuming that the proper medical evaluations were done in the short term, has been cleared of any injuries (fractures, emergency surgeries, etc) and the accident/fall victim has yet to see full, or even partial, improvement. Late whiplash symptoms following a car accident affect roughly 15.5 million Americans (6.5% of the population). Of those with chronic neck pain, 45% attribute it most to a motor vehicle accident. Spinal evaluation is highly recommended at this point.

93% of whiplash patients improve with chiropractic care.

In Parts 1 and 2 we've talked about Whiplash from different angles: what it is and what happens. Next, we're going to talk about what can be done.

In Part II we discussed the different scenarios and how that affects outcome measures. To summarize, the worse the accident and/or the longer you wait to get treated negatively impacts the prognosis in terms of recovery time. So first things first, the best thing you can do following a car accident or slip and fall injury is to have your spine evaluated immediately. An ideal situation would be to already have baselines set with a practitioner so the true outcome of the injury can be most accurately assessed. This will lead to a more accurate estimation of recovery time.

Imaging (X-ray) of the spine should be included in your spinal evaluation. In the event of fracture or dislocation, surgery may be required. The rest of the information in this post refers to situations where fracture and dislocation have NOT occurred.

Why you should see a Chiropractor for Whiplash Injuries:

In earlier posts, we talked about how soft tissue is damaged during a whiplash injury. "So why would I ever see a chiropractor? Don't they deal with bones and joints?" Muscles and ligaments cross joints. If the joints are not in proper alignment, how with the muscles and ligaments heal correctly? If the joints are not moving correctly (or at all) how will normal range of motion be restored? If the injured joints are inflamed (which they will be) how will a normal healing process occur? If there's pressure on the nervous system, how will the body heal? How will the body function? How will the pain be decreased? Essentially, a chiropractor is the only health care practitioner that can successfully impact all of these aspects of a whiplash injury to not only help you have a higher percentage of improvement but also do so more quickly.

An Overview of Treatment Options

Do nothing: Obviously, this is not a good option. The natural progression shows that over time you will eventually have some reduction in pain and mild to moderate improvement of range of motion. 43% of those with whiplash injuries experience chronic symptoms that HAVE received treatment (Woodward et al. 1996). I believe it is safe to say that with no treatment that number is bound to be much higher.

Cervical Collar/Immobilization: Research suggests that for whiplash injuries of any degree (excluding surgical situations), this is the worst course of action. In no study that was reviewed the use of a cervical collar for any amount of time was a superior option to any other option (including doing nothing). In a study comparing the use of a collar versus no intervention, no recommendation was made to choose either based on the results (Gennis et al. 1996)

Rest/Sick Days: Maintaining your normal activities of daily living showed more effectiveness than extended periods of abnormal rest (Borchgrevink et al. 1998).

Emergency Room usual care (anti-inflammatory and pain meds): 56% effective for short-term pain relief if done immediately. Joint integrity and muscular and ligamentous damage is NOT addressed (Ferrari et al. 2005).

Exercise therapy (Physical therapy): Whether supervised or unsupervised, cervical range of motion showed mild to moderate improvement in comparison to no treatment intervention but was inferior to studies comparing exercise therapy to mobilization (chiropractic adjustments). (Bonk et al. 2000, Schnabel et al. 2004, Crawford et al. 2004, Mealy et al. 1986, Fialka et al. 1989)

Physiotherapy (Ice/Heat/Electrotherapy/etc.): Showed results when done for a short course of treatment in the acute phase (starting within one week of injury) for pain relief only (Hendricks et al. 1996).

Traction: Showed no difference in effectiveness versus the use of a collar. (Think of it this way: during a whiplash injury, soft tissues are stretched and torn - why would you stretch them more?) (Pennie et al. 1990).

Chiropractic Adjustments: Proven effective for increasing range of motion, reduction of symptoms, decrease in absenteeism (missing work), and decreased apprehension in return to normal activities of daily living, studies show that whether acute, sub-acute or chronic that approximately 90% of patients see results with chiropractic care. Chiropractic adjustments are commonly coupled with exercises to strengthen and stabilize the cervical spine. Depending on the severity of the injury, return to pre-injury status occurs in an average of 6 to 16 weeks, which is the fastest versus any other intervention. (Bunketorp et al. 2006, Provinciali et al. 1996, Scholten-Peters et al. 2006, Rosenfeld et al. 2003, Mealy et al. 1986, McKinney et al. 1989, McKinney 1989, Bonk et al. 2000, Woodward et al. 1996, Russell et al. 2001, Lehman et al.)