Whiplash, or what is known by medical professionals as Cervical Acceleration/Deceleration (CAD) Syndrome, is a condition that can occur when a person's neck is hyperextended past its normal range of motion. This condition is most common when there is a violent jerking motion that forces the tissues in the neck to extend past what would otherwise be considered normal.
What Can Cause Whiplash?
Whiplash is most commonly associated with incidents related to vehicle accidents, but it can also be caused by falls, and contact sustained in sports.
What Are the Mechanics of Whiplash?
One of the most important, although least often considered, aspects of whiplash is the occurrence of the injury in an extremely short period of time. Most whiplash injuries happen during an event that occurs in one-quarter of a second. As a result, occupants of a vehicle or victims of other incidents do not have time to react. It is critical to remember this time frame when considering the actions that occur.
In the case of a vehicle accident, one vehicle impacts the rear of another, which forces the second vehicle forward. The seat upon which the driver is sitting will not move any further than that which is permitted by the vehicle. The driver himself, however, will continue to move forward. The physical law of inertia dictates that "the tendency of a body is to resist acceleration" and as a result the car seat is forced forward into the driver's mid and lower back. This movement also pushes the lower part of the driver's neck (the lower cervical spine) forward, which straightens the normal curve in the driver's neck (the lordotic curve) as well as the curve in the driver's mid-back (the kypotic curve). All of this leads to an abnormal S-shaped curve in the cervical spine (neck).
Whiplash PainDespite there being only a very small amount of tissue involved, there can be a considerable amount of damage that can occur during the different phases of an impact. The most important are these:
- A neck in motion is the result of several vertebral joints, each of which only contributes a few degrees in their response to an action.
- When the abnormal S-shaped position happens as a result of an impact, these joints are forced beyond what could be their normal range of motion. This excessive motion causes damage around the spinal joints, involving bone, ligaments, nerves and more. The degree of this motion depends largely on the severity of the impact.
The Differing Grades of Whiplash
When a patient is evaluated for a whiplash injury, a physician normally uses what is called a Quebec Task Force (QFT) grading system as a basis for his diagnosis and treatment. Under the QFT system, whiplash injuries are categorized according to the presence of differing symptoms as well as the presence and severity of physical signs. These include musculoskeletal and neurologic injuries. These categories and their characteristics are as follows:
- O: Patient has no neck pain or stiffness. There are no physical signs noted upon a physician's examination
- 1: Patient reports neck pain, stiffness, and tenderness. There are no physical signs noted upon a physician's examination.
- 2: Patient complains of neck pain, stiffness and tenderness. Physical examination reveals a decreased range of motion as well as tenderness
- 3: Patient reports neck pain and stiffness as well as neurological symptoms. These might include but are not limited to a decreased deep tendon reflexes, weakness, and sensory deficits
- 4: Patients reports neck pain and a clinical exam reveals the presence of a fracture or a dislocation, and/or an injury to the spine
It is important to remember that even a minor whiplash can cause tissue and nerve damage which can have long-lasting effects, often persisting for many years after the initial injury. Use of the QFT guidelines provide a basis for medical professionals to classify patients' injuries and to determine the type and extent of care they will likely need to relieve pain and discomfort.
How is Whiplash Diagnosed?
After a physician examines a patient, he will evaluate the symptoms to decide whether or not further treatment is required. He might place the patient in a cervical collar for support. He may also have x-rays taken to determine the presence of more serious injuries. If the x-rays reveal no abnormalities, he will probably have the patient keep wearing the collar and reschedule another examination in a week's time. If at that time, the patient continues to complain of pain, another set of x-rays may be taken. Often, in these additional x-rays, "dynamic" motion will be shown, meaning that the shots will be taken with the neck in both a forward and backward position. If these are also negative, a physician might order an MRI examination to check for soft tissue injuries and treat them accordingly.
"I am a 52 year old male who was considered totally disabled on March, 2003 when I had the good fortune to be referred to Dr. Dan Schneider.
I slipped and fell on snow covered black ice on January 9, 1997. After more than six years of chronic neck pain, very limited range of motion, pain and numbness in my right hand, two different neck fusion surgeries (C-3/4 & C-4/5) (C-5/6) and a whiplash accident on July 30, 2002, I was told by every Doctor I saw, that I must learn to live with it. Time after time I was told there was nothing further that could be done. The doctors telling me this were considered to be very good and dedicated doctors.
I was at the brink of being forced to retire on March 3, 2003 when Dr. Clark, M.D:, Board Certified Sleep Specialist referred me to Dr. Schneider. The pain was so bad. I had not slept more than three hours per night since the whiplash accident on July 30, 2002. I would grind my teeth so hard in my sleep that I broke off two teeth and had to wear a tooth guard to keep from grinding my teeth down.
I had no quality of life. I was unable to work and the simplest chores were unbelievably painful and difficult. I couldn't even look down without passing out because the arteries threaded through my Cervical Spine became pinched off when looked down, cutting off the oxygen to my brain. I simply existed day to day.
Spinal Manipulation was not considered an option due to the neck fusion surgeries. The standard manipulation or massage were too dangerous around my neck surgery area and could have complicated my condition.
Dr. Clark told me about Dr. Schneider and the Activator method of instrument adjusting that he used on the spine. He went on to say that Dr. Schneider had helped some of his patients, including himself with very impressive results.
On March 3, 2003 Dr. Schneider examined my neck, and then explained the Activator method. He told me that when he tested my neck, my left leg got extremely short at my exact area of neck pain. He ordered X-rays and asked me to return the following day.
On March 4, 2003 he told me that there was nothing he could do in the area of my neck surgery but he said there are problems in my cervical spine above the surgery, but he said there are problems in the rest of my spine that he can improve with the Activator Method.
The Activator adjustments allowed Dr. Dan to make a precision adjustment without disturbing anything else. That is why he could work right next to my surgery area without impacting or harming it.
The treatments are gentle to the point you think this can not possibly make any difference. Four hours after my first treatment, I caught myself looking down for something I dropped on the floor and realized I wasn’t getting dizzy. I had gained almost full range of motion without added pain!
Dr. Dan gave me back my life and I was able to return to work. I would recommend this wonderful type of care to anyone who has neck pain or problems like mine."~Jim B.
What Are the Short and Long-Term Problems Associated With Whiplash?
Most patients who are victims of whiplash experience no long-term problems. In fact, most patients recover fully after several days to several weeks. Most patients are fully recovered within three months of the injury.
Although it is rare, some whiplash patients experience chronic pain, headaches, and other problems for years after an accident. It is possible that a physician can trace an injury to damage to neck joints, disks, ligaments and other structures. There are even some cases where the pain associated with a whiplash has no medical explanation.
How is Whiplash Treated?
Most physicians will treat whiplash with relatively simple procedures. A physician might prescribe an over-the-counter pain medication such as Tylenol or aspirin. In more severe cases, a physician might order a prescription pain killer or a muscle relaxant to relieve muscle spasms.
Physical therapy might also be recommended by a physician for those suffering from whiplash. Patients are also advised to apply ice or heat packs for relief, as well as to perform simple exercises to build both the strength and flexibility of the neck muscles. A cervical collar might be applied to help keep the neck stable and to keep your muscles from being strained, which all contribute to a faster recovery from whiplash.
A cervical collar should not be worn for more than three hours at a time or for more than three weeks. After these periods, the neck muscles might end up being weaker, which will lengthen recovery time.
Chiropractic care is also a very effective way to treat whiplash injuries. The doctor will use low impact manipulations to treat the spine and surrounding muscles. Muscle stimulation and relaxation through stem therapy could also be used. Typically the doctor will recommend exercises and slight lifestyle changes to help with whiplash recovery.
If you or someone you know has suffered a whiplash injury or has similar symptoms, schedule a consultation with Dr. Schneider today.