ARMANI CHIROPRACTIC, dedicated to the care of the injured.
ROBERT BENTELY ARMANI, D.C., Q.M.E.
Qualified Medical Evaluator
Independent Medical Evaluator
Car Accident Injury and Whiplash
Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of your neck (specifically ligaments, tendons, and muscles). It is caused by an abnormal motion or force applied to your neck that causes movement beyond the neck's normal range of motion.
•Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault.
•The term whiplash was first used in 1928, and despite its replacement by synonyms (such as acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury), it continues to be used to describe this common soft tissue neck injury. Your doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury.
The most frequent cause of whiplash is a car accident. The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, whether or not they wear seat belts.
•Other common causes of whiplash include contact sport injuries and blows to the head from a falling object or being assaulted.
•Repetitive stress injuries or chronic strain involving the neck (such as using your neck to hold the phone) are a common, non-acute causes.
These signs and symptoms may occur immediately or minutes to hours after the initial injury; the sooner after the injury that symptoms develop, the greater the chance of serious damage.
•Tenderness along the back of your neck
•Muscle spasms (in the side or back of your neck)
•Difficulty moving your neck around
When to Seek Chiropractic Care:
The best time to call your primary care provider and/or your chiropractic doctor is immediately after the injury. If the patient cannot determine whether an emergency department visit is needed for the symptoms, then contact the doctor and ask for advice. If the doctor is unavailable at the time of the injury, then call 911 for transport to the emergency department. The risks associated with a possible neck injury are far too great to attempt to diagnose and self-treat. See a doctor and have the patient's neck braced to keep the head from moving during transport.
Depending upon the severity of a car accident, emergency medical personnel may take the patient to an emergency department immediately. In this case, a cervical collar will be placed around the patient's neck, and the body will be strapped to a long, firm board to prevent any movements until a doctor sees the patient.
With less severe car accidents, sports injuries, or other accidental injuries, emergency medical services may or may not be involved in the patient's pre-hospital care. You should call 911 emergency medical services if the patient develops any of the following symptoms shortly after the injury:
•Pain in either or both arms
•Weakness, tingling, or loss of function in the arms or legs
Exams and Tests:
•If the patient is transported to the emergency department with a cervical collar strapped around the neck, the emergency physician will remove the collar when appropriate.
•In most cases, the collar will be removed without the need for x-rays if the patient meets all of the following criteria:
◦Normal level of consciousness or alertness
◦No muscle weakness or sensation problems
◦No evidence of intoxication with alcohol or drugs
◦No tenderness in the back of the neck
◦No other painful injury elsewhere on the body
•Your collar will remain in place if the doctor determines that the patient needs x-rays of the neck.
•The doctor will first examine the functioning of the spinal cord in order to determine if any damage is present. The following areas will probably be assessed:
◦Physical strength in both arms and legs
◦Ability to sense the touching of the skin in different parts of the body
◦Reflexes at the joints of the arms and legs
•The doctor will also inspect the patient's head and neck for any external signs of trauma including bruises, cuts, and abrasions. The patient's neck will be pressed in specific areas to be sure the patient does not perceive any pain or tenderness. The patient may be asked to move their neck in a controlled way to the left, right, up, and down. Tell the doctor if neck pain, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers is felt.
•X-rays may be taken of the neck bones to make sure there are no fractures or signs of other serious injury. The doctor will review these x-rays and order further imaging with a CT scan or MRI if needed. If the patient's x-rays are normal, then the cervical collar will probably be removed, and should not need any further X-rays.
Self-Care at Home
Home care is intended to relieve the pain and minimize the amount of inflammation in the soft tissues of the neck.
•Apply ice to the neck for 20 minutes at a time each hour for the first 24 hours while awake. Do not apply ice directly to the skin. Place a towel between the ice and the neck. Continue to use ice therapy until the pain stops. (After you see the doctor, follow his or her directions for ice therapy.)
The Chiropractic Doctor most likely will recommend a treatment plan including a mixture of the following:
•Electrical Muscle Stimulation
•Immobilization of the neck with a soft cervical collar (only a minimal benefit if any at all)
•Early range of motion exercises combined with heat therapy starting 72 hours after the injury to restore flexibility
•Avoidance of excessive neck strain for the next week and then increased activity as tolerated in the following weeks
If no serious injury is detected in the emergency department, then the patient will be allowed to return home and will be referred to their doctor for follow-up care.
•If you continue to have symptoms from your whiplash injury, contact the Chiropractic Doctor. Examine this list of complaints and mention any that the patient may be experiencing:
◦Shoulder or arm pain
◦Sleep disturbance or irritability in young children
•Depending on the nature and severity of any continuing symptoms, the doctor may refer the patient to another doctor who specializes in the orthoepdic surgery and or a neurologist. The Chiropractic Doctor may also encourage continuation of the physical therapy and monitor the patient for other injuries that may have been aggravated.
Some people recover completely from a whiplash injury in the first six weeks. Others' symptoms continue to improve over the course of a year. There is a 40% chance of experiencing some symptoms after three months, and an 18% chance after two years. No reliable way exists to predict the prognosis.
•A worse outcome has been reported in people with a more rotated or inclined head position at the time of impact injury.
•The amount of time that elapses between injury and the onset of neck symptoms can predict the severity of injury and prognosis. A shorter time signifies a potentially severe injury with more frequent long-term complications.