Introduction to Whiplash

The process of rehabilitation from a whiplash injury requires a concerted effort between the chiropractor, the patient and any other professional assisting in the case. The likelihood of success of recovering from whiplash is enhanced by a continued focus on restoring normal function with the help of the chiropractor.

Chiropractors are specialists in treating non-surgical spine injuries and commonly treat whiplash injuries from car accidents. The job of the chiropractor in helping his or her patients overcome the pain and disability associated with whiplash is to:

• Diagnose the source of the pain from the whiplash injury
• Treat the most important dysfunctions
• Teach the patient to return to a more normal lifestyle
• After a whiplash injury, chiropractors take a systematic approach to establishing a diagnosis (1), including:

Read These Whiplash and Auto Injury

Frequently Asked Questions and Find Out!

• What is whiplash?
• What are the symptoms of whiplash?
• How does whiplash occur during an auto accident?
• What factors increase risk of whiplash injury during an auto accident?
• What health issues will complicate the healing of a whiplash injury?
• What effective treatments are available for whiplash?
• What important steps should I follow if I have been in an auto accident?

What is whiplash?

A Whiplash is an injury to the neck caused by a rapid movement of the head backward, forward, or side-to-side. Whether a result of a auto wreck, sport or your job, neck injuries warrant a thorough physician check-up. The hidden danger with neck injuries is that underlying problems may take years to develop. Too often people don't seek treatment until more serious issues develop, like degenerative arthritis in the injured area, to herniated disks. Even after whiplash victims settle their insurance claims, roughly 40% - 55% of previous neck injury sufferers report that they still suffer with symptoms two years later.

In the past, a typical whiplash injury where no bones were broken, were hard to prove from   legal standpoint. Soft tissue injuries (injuries to the muscles, ligaments and tendons) do not show up on x-rays, and insurance companies would deny coverage to the injured party.   Modern, sophisticated imaging devices (CAT Scans, Magnetic Resonance Imaging, and Ultra-Sound) may now show these soft tissue injuries, and therefore insurance companies cover most whiplash injury claims.  
When no bones were broken and the head did not impact the windshield, typical symptoms will follow.   92% complain of neck pain, which usually starts within two hours, or up to two days after the accident. This is often the result of neck muscle spasms that react to either muscle tears or excessive movement of joints from the damage done to the ligaments. The muscles typically tighten in an effort to support the weight of the head.

Almost 60% of those suffering from whiplash complain of headaches. The pain may be on one side or both. These headaches are often the result of tightened, tensed neck muscles working to keep the head stable. They are similar to everyday "tension headaches" as they are often felt behind the eyes.

Radicular pain is often described as pain radiating down the back of the neck into the shoulder blade or arm area. This may also be the result of tensed muscles, or even worse, a disk or nerve injury.   Muscle tears are often described as burning pain, prickling or tingling. More severe disk or nerve injury may cause sharp, shooting pain with certain movements, that may travel into the arms, hand and fingers. Disc and nerve injury symptoms are normally relieved by holding your hand over your head.

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What are the symptoms of whiplash?

Auto accidents can result in a number of complex injuries and symptoms. This is due to a variety of factors involved.  When evaluating an injured neck, physicians should take into account the beginning & end position of the victim in the car (before & after the collision), the speed of the vehicles before the accident, size of the vehicles involved, the restraints used (air bag, seat belt), preexisting health conditions of victims, age and gender of the victims.. The following list is of the most common whiplash symptoms, as well as their rate of frequency.

If you experience any of these whiplash injury symptoms, play it safe and get an auto injury check-up at our office.

	Neck pain and/or stiffness	92%
	Headache	57%
	Fatigue	56%
	Shoulder pain	49%
	Anxiety	44%
	Pain between the shoulder blades	42%
	Low back pain	39%
	Sleep disturbance	39%
	Upper limb paresthesia	30%
	Sensitivity to noise	29%
	Difficulty concentrating	26%
	Blurred vision	21%
	Irritability	21%
	Difficulty swallowing	16%
	Dizziness	15%
	Forgetfullness	15%
	Upper limb pain	12%
	Upper limb weakness	6%
	Ringing in the ears	4%
	Pain in the jaw or face	4%+

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How does whiplash occur during an auto accident?

Whiplash occurs commonly when from being struck from behind, at any speed.  When the head is suddenly jerked back and forth beyond its normal joint range of motion, the muscles and ligaments supporting the spine can be "strained" (torn muscles) or "sprained" (torn ligaments).

A typical rear-ended auto collision can result in whiplash as follows:

Phase 1
Studies show that the car is first pushed or accelerated forward, and is essentially pushed out from under you as your back forces into the seat.   Excessive "shearing forces" develop within the neck and your normal spinal curves then straighten and become compressed. High pressure develops within the brain and skull, and the brain stem is subjected to shearing forces.

Phase 2
An upward rise of your neck then occurs, as your head snaps back over the headrest (and possibly collapses it). Head rest acts as a fulcrum and jaw injury is possible with the high compression within the joint.   Here is where some of the muscles and ligaments are stretched or torn in the neck.

Phase 3
The head now suddenly begins a forward or "flexion" motion as the torso sinks into the seat. Then the seat recoils, and you are forced forward, increasing your velocity 30-70% greater than that of your car speed!   Any slack in the seatbelt over-the-shoulder harness begins to tighten and restrict motion.  Your neck muscles, in a reflex action, contract to bring the the head forward, in an attempt to prevent excessive injury.   Unfortunately, ecause the head is already traveling in a forward direction at such a high velocity, as the car decelerates, there is an "overcompensation".

Phase 4
Overcompensation now violently throws the head forward, stretching more muscles and ligaments in the back of the neck. Full deceleration of the head, neck and torso is now restricted by the shoulder harness. High pressure and sheaing- forces in the spine can cause the soft vertebral discs to bulge, tear, or rupture.   Vertebrae can be jostled out of their normal position, resulting in a "vetebral subluxation".   The brain stem, spinal cord and nerve get stretched and irritated. A neck with vetebral subluxations may quickly show arthritic joint degeneration if not properly treated within a short time after the accident.

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What factors increase risk of whiplash injury during an auto accident?

• Vehicle mass. When both vichles are equal in size, an 8 mph impact produces 2 times the force of gravity (2-G's) acceleration of the car, and a 5-G acceleration of the head
• Headrest/head restraint position. This can make an injury much worse if too low, and even at the right height, it must be close enough to catch the head in time (about 2 inches). A seat that is reclined too far will increase this distance, as will poor posture and driving habits if leaning forward. Some older vehicles (trucks, vans) do not have head restraints, adding insult to injury.
• Forward position of the head at impact. If turned to the side it can only move about half as far as a straightforward position, but leads to other types of neck injuries. Therefore, if your head was turned during the impact, all of the G forces are localized to one side of the spine, substantially increasing the severity of injury
• The use of the seatbelt and shoulder harness. Yes, the chance of whiplash is higher, but it's much better than the other option. . . death.
• A rigid, non-collapsing seatback.
• Ligamentous instability (joint loosening) after the accident.
• A rear-direction impact (being struck from behind)
• Non-awareness of the impact.
• Limited range of motion and neurological symptoms after the crash.
• Women and children seem to get injured more seriously than men in collisions. Possibly due to a smaller neck. They may also sit too close to the steering wheel & airbag, or have an improperly fitting shoulder harnesses. Children's spinal injury problems may go undetected, so it is VERY important to have them checked, even if they claim to feel okay.
• Headaches or neck injury or pain prior to the crash. Pre-existing health problems such as arthritis and degenerative disk disease add to the severity of the injuries.
• Age. As the body becomes older, muscles may become weaker and less flexible, ligaments less pliable, and the joints may have a decrese in range of motion.

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What health issues will complicate the healing of a whiplash injury?

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What effective treatments are available for whiplash?

Hillside Chiropractic specializes in whiplash and auto injury care.   We start with a thorough exam for all injured parties, and thoroughly document the injury.   A care plan is developed using multiple providers at our office.   Treatments may include:

• An orthopedic/neurological examination by Dr. Jeff, who specializes in physical medicine and rehabilitation.
• A chiropractic evaluation to check alignment and occurence of subluxations.
• Physiotherapy:   Active Release Technique treatment, TENS, neurostimulation, massage and mechanical traction.
•  Chiropractic adjustments of misaligned vetebrae that probably occured in the crash.
• Cervical curvature restoration:   gentle treatment designed to restore proper natural curvature of the spine after being traumatized in the injury.
• Rehabilitation:   therapeutic exercise, kinetic activities and neuromuscular education designed to speed healing and to strengthen the muscles.
• Cusom at-home exercise program prescriptions
• Whether you have an attorney representing your case or not, your treatment should be of no cost to you.   We can assist in finding you a good personal injury attorney, or can work with one that you have pre-selected to get you the care that you require.   Call us at 763.241.5393 for more information

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What important steps should I follow if I have been in an auto accident?

• Stop your car and turn off your engine to minimize the risk of fire.
• Get out of your vehicle, out of traffic, and out of further danger. If possible, collect information about the accident at the scene, or as soon after as is practical. Help the injured at the scene of the accident.
• Call 911 for police or medical assistance. Even if there are no apparent injuries, police may be necessary to handle traffic and clear the accident scene. They will also fill out an important accident report, so let them know if any party is injured, or has left the scene. If the police fail to arrive at the scene, go to the local police department to file a report. If the other vehicle left the scene of the accident, try to give the police whatever information you can about the vehicle (license plate number, description of vehicle and driver).
• Exchange Information no matter who is at fault. Gather the following info from the other driver(s) involved:
• Document time and place of accident, weather and road conditions, and other circumstances of the accident. Get names and contact info of witnesses and passengers, and the police officer's name, badge and department telephone number.
• Don't sign anything except a police citation, ticket or report. Signing other documents may jeopardize your rights.
• Obtain medical attention as soon as possible. Shock and trauma can mask a serious injury. If in doubt about your condition go to the emergency room (ER). The ER is only concerned about immediate danger (shock, fracture, hemmorage, concussion, etc.) , and will release you once you are stable. This does NOT mean that you are without whiplash or subluxation or other injury! After being released from the ER, or as soon as possible after the incident (if you chose to not go to the ER), call Hillside Chiropractic at 763.241.5393 for a thorough auto injury evaluation and treatment. Bring any children involved, and any passengers in your car, if available, for a check-up.
• Call your insurance company and give them all the information you have collected. If you were injured or if your car was damaged, your insurance company needs to be notified promptly in order to conduct an investigation into the claim. Your claim will probably be denied by the insurance company if there is late or no notice. You may want to follow up with a written notice.
• Don't discuss the accident at the scene. Except for giving necessary details to police, medical personnel, your insurance company, or your attorney. Especially avoid discussion about the accident with insurance companies or lawyers representing others. Refer inquiries to your insurance company, your doctor, or your attorney.
• You can print this page for future reference, to be placed in your glove box in case of an emergency. Or you can download the entire form to be printed and placed inside all of your vehicles. In an emergency - don't panic. Just simply follow the instructions.

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