Whiplash, also known as cervical acceleration-deceleration syndrome (CAD), occurs when the human body confronts the laws of physics. More specifically, when people accelerate, in a car or on foot, the parts of their body that are in motion will stay in motion unless an external force slows them down. When a sudden impact, like a car collision, brings the body to a halt, the head wants to keep traveling. It yanks on the neck, snapping backward and forward, damaging ligaments, muscles and other soft tissues, and injuring vertebrae and vertebral joints in the process. Those who have whiplash often develop neck pain and stiffness within several hours or, more commonly, a day after the accident. Other symptoms that may follow include headaches, blurry vision, shoulder pain, back pain, anxiety and dizziness.
Rear-end car collisions most commonly cause the injury, but collisions from the front and side, contact sports and convulsions can as well. Usually, someone in a stopped or slow-moving car gets hit from behind and doesn’t have time to react; the whole cervical acceleration-deceleration process takes only one-twentieth of a second. In rare and extreme cases, whiplash can cause a vertebral fracture, which can lead to severe spinal cord injuries. While the vast majority of whiplash injuries do not involve fractures that lead to instability, it’s important to have your healthcare practitioner evaluate and manage the injury. In severe cases, this may necessitate the use of an MRI or CAT scan, and possibly a cervical collar to stabilize the neck.
The cervical spine comprises seven vertebrae, which are the stacked bones of the spinal column. Ligaments attach to these vertebrae to provide stability and support the neck, and muscles attach to provide movement. There’s also a disk between every vertebra that acts like a shock absorber, and a capsule that surrounds the joints and provides stability by limiting their range of motion.
During whiplash, damage usually occurs when the neck overextends (moves too far backward), because while the chin prevents the head from moving too far forward, there’s little to stop it going back. This happens so quickly that the supporting structures can’t react. The ligaments and joint capsules usually get overstretched, the muscles get strained and the vertebrae are forced beyond their normal range of motion. When this happens, the whole spine can become stressed, causing changes in position, excessive inflammation and swelling. Sometimes, the trauma is so severe that it can even lead to visible changes in the spine’s shape. Even if you aren’t in pain and don’t see any change in the shape of your back, you should see your chiropractor after any whiplash injury.
For your chiropractor to offer proper care for your whiplash injury, it’s essential for you to remember the details of your accident. Were you wearing your seat belt? Was the car moving or stopped? What type of impact was it, rear or frontal? Did pain occur instantly? It’s challenging for chiropractors to care for whiplash injuries because of the variables they must consider. Answering your chiropractor’s questions as best you can will help with your care.
Some chiropractors categorize their diagnosis according to four stages. If you complain of some neck pain and stiffness, the injury falls into the category of grade one whiplash. If, however, you have lost motion in the neck and can’t flex, bend, extend or rotate it, your injury will fall into grade two. Grade three whiplash covers any injury that involves neurological symptoms such as numbness, weakness, tingling, or hot and cold sensations. Grade four is reserved for trauma that causes any sort of fracture in the spine.
After your chiropractor has diagnosed and classified your whiplash, he or she will get you started on a program of care. Initially, within the first 72 hours of your injury, he or she will probably recommend that you apply ice to your neck. This will prevent further swelling and reduce pain, by constricting blood vessels, numbing pain receptors and decreasing blood flow to the affected area. After the swelling has decreased, your chiropractor may gently mobilize your affected joints. He or she will perform this technique by gently moving your neck through its normal range of motion while your body is completely relaxed. This promotes circulation, stretches tight muscles, decreases the formation of scar tissue and lubricates the joints.
It may also be necessary for your chiropractor to perform an adjustment, also known as spinal manipulative therapy, to the cervical spine. This will return joints that are out of place to their correct position, increase the joints’ range of motion, relax tight muscles, increase blood flow and decrease inflammation.
In the initial stages of whiplash injury, your chiropractor may also care for you with physiotherapeutic tools like ultrasound and interferential current (IFC). Ultrasound refers to any sound wave that has a frequency above the range the human ear can perceive. Depending on the frequency, this can increase blood flow, decrease pain, reduce muscle spasm, lessen nerve root irritation, break down scar tissue and speed healing.
IFC works in a similar way, but sends electrical waves through the body instead of sound waves. These painless, mild electrical waves penetrate the skin into nerve fibers below, which causes the body to produce endorphins, its natural painkillers. By aiming the impulses at the cervical spine, your chiropractor can cause endorphins to interrupt the flow of pain signals from the affected tissues to the brain. IFC also helps decrease inflammation and speed up the healing process.
You should also avoid sports that put your neck at risk, like football, soccer and hockey, until your injury has fully healed. But that doesn’t mean you should be inactive. As soon as your pain decreases, your chiropractor will probably recommend that you perform a number of activities, including stretching, strengthening, proprioceptive, postural and aerobic exercises. These will help restore motion in your neck and strengthen muscles so that they are better able to provide support and stability.
By combining regular adjustments and therapy with an exercise program, you can overcome the symptoms of whiplash and avoid chronic symptoms that might otherwise linger for years.
