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Auto Accidents and Whiplash:

Most Traumatic Cervical Syndromes result from rear-end collisions, although frontal or side impacts, as well as other types of accident, may induce similar injuries. As more people use seat belts they restrict their upper torso, causing greater whipping of the unrestrained neck and head.

Often, drivers and passengers have their head restraints too low, and this allows increased hyperextension at impact. However, even if raised to the proper height, the headrest is usually too far behind the person's head to minimize the damage. If the person's head is within 1 inch or direct contact with the headrest, it can limit excessive motion.

The neck is only area that can be injured. Many patients have also had pain in their chest due to hitting the steering wheel, knee pain from hitting a dashboard, wrist or shoulder pain from the impact while holding the wheel and even TMJ. Your pain will depend on the type of car, type of accident, seat location and speed for example.

Sometimes an accident victim will have immediate pain and other times they will get sore and stiff days later. The problem is the person may not associate this feeling with their accident because they “walked away without a scratch”. By ignoring it, the condition will get worse over months and years until one day you have no explanation for why your spine is arthritic.

Pain after an accident will vary because each person is different and many body parts can be involved. Next to neck pain, headaches are the second most common symptom. You can have any number of aches and pains after an accident. Some patients will never be able to completely rid themselves completely of their pain so drive smart and stay aware.

Appropriate treatment depends upon an accurate diagnosis. The first step in evaluating a whiplash patient is a thorough history and extensive review of symptoms. A comprehensive physical examination, including orthopedic, neurologic and sensory evaluation and films may be performed. Range of motion testing is mandatory and is most revealing when the examiner compares joint mobility and pain during active, passive and resisted movements.

Doctors of Chiropractic are well trained in detecting muscular problems as well as areas of joint dysfunction. Studies have shown movement is far superior to immobilization collars after an accident. Treatment will routinely include heat or ice, electric stim, rehabilitation exercises, home exercises and spinal adjustments as tolerated. Because many injuries involve damage to ligaments and tendons, healing takes time and can range from weeks to months.

  • Bogduk N, The Anatomy and Pathophysiology of Whiplash, Clinical Biomechanics. 1986:1:99-100. . A rear-end impact which causes the struck vehicle to accelerate instantaneously only 10 mph will produce a 5g force (gravity = 1g) on the vehicle and a 12g force of extension of the head and a 16g force of flexion of the head during recoil. Also known as "Traumatic Cervical Syndrome", the whiplash injury occurs when the body reacts to a deceleration or acceleration force by hyperflexion or hyperextension of the neck.

  • Macnab I: Acceleration extension injuries of the cervical spine. In Rothman RH, Simeone FA (eds): The Spine, ed 2. Philadelphia, WB Saunders, 1982, vol 2, p 653.. 45% of those injured in a whiplash, or hyperextension/hyperflexion trauma, continue to be symptomatic 2 years after settlement of claims. Some researchers feel the number could be as high as 3-5 years after settlement.

  • Cassidy JD, Lopes AA, Yong-Hing K: Immediate Effect of Manipulation versus Mobilization on Pain and Range of Motion in the Cervical Spine: A Randomized Controlled Trial. J Manip Physiol Ther 1992;15(9) 570-575. A chiropractor's systematic approach to treatment consisting of spinal manipulation and rehabilitative exercise can achieve better-than-average results for many patients.
  • Osterbauer PJ, Dickerson KL, Peles JD, et al.: Three-dimensional Head Kinematics and Clinical Outcome of Patients with Neck Injury Treated with Spinal Manipulative Therapy: A Pilot Study. J Manip Physiol Ther 1992;15(8)501-511. Early active mobilization and chiropractic manipulation have been shown to decrease pain and hasten return to function, marked by reduced disability and symptoms.