Whiplash – What is It?

            Whiplash -- or “whiplash associated disorders” (WAD) -- is a relatively common injury usually linked with a motor vehicle collision (MVC) during which the head is whipped forwards and backwards (when rear-ended) or sideways (if T-boned). Let’s look at some facts: 1) WAD is often ignored or mistreated due to a lack of understanding about the condition; 2) WAD often occurs as a result of a rear-end collision while stationary, such as stopped at a red light; 3) Early mobilization, manipulation, and exercise can lead to a more rapid, complete recovery vs. prolonged rest or immobilization or the use of a cervical collar; 4) Failure to properly educate and treat the whiplash patient (especially in the first three months) can lead to chronic pain, including psychosocial problems such as depression, anxiety, and poor coping. So, what is whiplash?

            The term “whiplash” encompasses the damage that occurs to the bony spine, and in particular, the soft tissues, while the term “WAD” encompasses ALL the associated injuries and symptoms including the psychosocial problems that can arise due to injured tissues and associated loss of activity tolerance. The good news is that WAD is usually NOT life-threatening, but it can alter the injured person's quality of life and bring economic hardship due to poor work tolerance and high medical expenses while insurance companies dispute over who is at fault. The economic burden on society in the United States is estimated to be as high as $30 billion a year due to medical expenses, disability, sick leave, lost productivity, and litigation!

            Some more facts: 5) While many WAD patients recover without chronic ongoing symptoms, some continue to have problems for years after the injury. 6) A low-speed collision can create significant injury due to the forces being transferred to the occupants rather than absorbed by crushing metal. 7) If the head is turned at the time of impact, the injuries can be worse. 8) Mild traumatic brain injury can occur without hitting the head on anything and create significant cognitive problems (like “mental fog”) and headaches. 9) High-speed cameras have shown that the lower half of the neck extends backwards while the upper half flexes forwards creating an S-shape, which injures the muscles, tendons, and ligaments that hold the cervical vertebrae together. 10) The ENTIRE whiplash process takes place within 500 milliseconds. We cannot voluntarily contract our muscles in less than 800 milliseconds. Therefore, even if we “prepare” for impact, it all happens too fast to prevent the “crack the whip” process to the head and neck.

            Common symptoms of WAD include: neck pain/stiffness, headache, shoulder pain/stiffness, dizziness, fatigue, jaw pain, arm pain/tingling/numbness/weakness, visual disturbances, ringing in the ears (tinnitis), chest/breast injury, and mid and low back pain. When not properly managed, depression, anxiety, anger, frustration, stress, drug dependency, post-traumatic stress syndrome, sleep disturbance (insomnia), restless leg syndrome, fibromyalgia, and more can occur.

            As previously stated, patient education, immediate treatment emphasizing movement (NOT immobilization), proper home/self-management (such as cervical traction), range of motion exercises, strengthening exercises (when appropriate), and positive thinking (as we covered last month) together can help to avoid long-term chronic, disabling problems. You need a “quarterback” to guide you through this process – proper chiropractic care is the answer!