Automobile accidents are some of the most common accidents almost everyone will go through at one time or another during their lifetime. One form of an accident injury that is very common is whiplash or the more scientific name of WAD or Whiplash-Associated Disorder.
After being a chiropractor in practice for 30 years I have found the best way to treat whiplash is in utilizing chiropractic care for improving joint mobility and physical therapy for improved soft tissue healing This is the approach of Total Health Systems of Macomb County.
Chiropractors want to help patients in a way that will allow them the greatest chance for full recovery and normal function. It is particularly important to do a specific history and examination. Poor examination can lead to inappropriate testing and excessive and costly treatment. This is also a major reason why there is a stigma associated with whiplash cases. It is well-known that these patients, following trauma, are more susceptible to degenerative changes of the injured joints. Chiropractic and physical therapy can help prevent, or at least minimize, long-term, chronic pain and disability subsequent to these injuries.
An article in Spine in September 2006, titled “Stabilizing Effect of Pre-contracted Neck Musculature and Whiplash,” concluded that occupants aware of an impending impact with pre-contracted neck muscles reduced overall head, neck, and spinal motions and theoretically reduced whiplash injury.1 In our history, it is helpful to find out whether the patient was caught by surprise by the accident.
According to an October 2006 Spine article titled “Fatty Infiltration in the Cervical Extensor Muscles and Persistent WAD: A Magnetic Residence Imaging Analysis,” there was significantly greater fatty infiltration in the neck extensor muscles, especially in the deeper muscles of the upper cervical spine, in patients with persistent WAD, compared to healthy controls.2 This corresponds with a J.A. Hides paper that shows lumbar multifidus atrophy and fatty infiltration when associated with a joint lesion in the lumbar spine.3 The WAD patient needs us to restore normal joint function and rehabilitate their deep cervical stabilizer muscles. Adjustments can open the neurologic window for better, more appropriate rehabilitation.
In the text, Conservative Management of Cervical Spine Syndromes, Dr. Nordhoff has a table that lists variables that lead to fewer neck injuries and variables that lead to more neck injuries. Some examples follow.
- Men are injured less in rear-end crashes than women. Men typically have thicker and stronger neck musculature, while women have smaller diameter necks and proportionately longer necks.
- A properly positioned head restraint reduces neck injuries. For example, if the head restraint is low, the neck will fulcrum over the head restraint, exaggerating the injury.
- If the seat back breaks, there will tend to be more of a low back injury and less of a neck injury. With seat-back breakage, there is less whip effect on the neck, but more stress to the low back.
- If your head is rotated – for example, if you are looking in the rearview mirror just before impact – this leads to more neck injuries. This is easy to figure out on your own by simply having your head in a neutral position and going into full extension, and then comparing this to when you turn your head as far as you can to the right and then try to go into extension. Obviously, you cannot go as far into extension with the head rotated to the right, resulting in more tissue damage.
- As far as the neck injuries are concerned, wearing a seat belt actually leads to more neck injuries. The seat belt cut down on fatal accidents, but specifically, the neck tends to be injured more due to the restraint, along with the subsequent whipping on the neck.
- Older and taller occupants tend to have more injuries. The elderly tend to have more degenerative changes, which predisposes them to a more significant injury. The taller occupants tend to fulcrum over the head restraint.
- Being in a larger vehicle helps reduce your neck injuries. The reason is fairly obvious: The larger vehicle gets pushed less dramatically than a smaller vehicle.