After an accident or trauma patients may wonder about chiropractic treatment and what can be done for whiplash injury.
Whiplash Symptoms and Causes
Whiplash is a type of neck strain that is caused by the head jerking back and forward. Commonly, whiplash is thought of as being something that results from car accidents, but athletes in contact sports can also experience this condition. Symptoms include reduced range of motion, tightness, and pain in the neck, pain when the head moves back and forth or side to side, tenderness, and headaches that radiate from the base of the skull to the forehead. The symptoms might be immediate or they may take hours or days to develop.1 Whiplash is named because the rapid and forceful back and forth motion of the neck is “like the cracking of a whip”. Aside from car accidents and sports, other trauma and physical abuse can cause this disorder. While some patients recover after months of medication, treatments, and exercises, others might have “chronic neck pain and other ongoing complications”. In most cases, symptoms develop within a day of the injury. The pain and stiffness worsen with movement. The tenderness could include the upper back, arms, or shoulder region, with arm numbness or tingling possible. Fatigue and dizziness are other symptoms, aside from the headaches, and some patients may experience blurred vision, tinnitus (ear ringing), irritability, sleep disturbances, memory problems, depression, and trouble concentrating. The back and forth motion of the head injures spinal bones as well as “disks between the bones, ligaments, muscles, nerves and other tissues of the neck”. The patients who end up with chronic pain and complications are generally the ones who had a “rapid onset of pain, severe neck pain, headaches and pain that radiates to the arms”. Doctors examine the range of motion, check for tenderness and reflexes, and may order X-rays, CT, or MRI scans.2
What Can Be Done for Whiplash Injury?
Care for whiplash includes medical and alternative treatment options. Whiplash could heal on its own over time, but to deal with the immediate pain, patients may wish to try some treatment options for relief. One option is icing the neck “for 20-30 minutes every 3-4 hours for 2-3 days”, while another is using NSAID medications to alleviate swelling and pain. If these medications do not provide relief, a doctor might prescribe muscle relaxants and painkillers. Some patients may opt for wearing a neck brace, but these can weaken neck muscles over time. After a couple of days of icing the neck, moist heat may be an appropriate treatment. Ultrasound, massage, and chiropractic care might also be beneficial for whiplash. It could take weeks to heal this condition, but rehabilitation is also important in recovery and preventing future neck strain. Healthcare providers typically recommend stretching exercises, as appropriate, and easing back into normal physical activity, once the patient is ready. The patient needs to be able to “look over both shoulders without pain or stiffness”, and also be able to rock the head back and forth and side to side, also without pain. If the patient is not careful and tries to resume regular activities before the strain is healed, there is a risk of “chronic neck pain and permanent injury”. While whiplash from a car accident is not preventable, patients can try to prevent other causes of whiplash by practicing “strengthening exercises to keep (the) neck muscles strong” and by taking regular stretch breaks if the patient works in an office or sits all day in the same position.3 Aside from rest, ice, heat, pain medications, and muscle relaxants, doctors may also prescribe lidocaine injections to numb the painful muscles and assist the patient in being able to participate in physical therapy. The types of exercises (suggested after moist heat) include rotating and tilting the head, rolling the shoulders, and bending the neck to the chest. Physical therapists typically help the patient with exercises and posture. If a patient wears a foam collar, it is recommended that it be used “no more than three hours at a time during the first week after injury”. It may be helpful for comfort during sleep.4
Prognosis and Alternative Treatments
Whiplash treatment options include alternative therapies, such as acupuncture, massage, TENS (transcutaneous electrical nerve stimulation), and chiropractic care. Chiropractic care appears to be most effective when “paired with exercise or physical therapy”.5 By doing exercises and working on range of motion early on, patients tend to recover more rapidly than using a cervical collar or prolonged immobilization.6 Women are usually more seriously injured, with whiplash, than men, due to the smaller bones and muscular bulk. The prognosis and risk factors for patients are influenced by symptoms lasting more than six months, significant nerve, disc, ligament or joint injury, delay in receiving treatment, being over 65 years of age, having ridden in a small car, intoxication at the time of the accident, prior whiplash, cervical spine fusion, initial radicular (tingling, pain, numbness of the arms) symptoms, or cervical collar usage for over 2 weeks.7
Chiropractors employ many different treatment methods, such manipulation, muscle stimulation and relaxation, exercises, and “ergonomic and lifestyle changes”. During manipulation, a chiropractor may either involve “a short thrust” or a “slow mobilizing movement”. For muscle stimulation or relaxation, a chiropractor would use “gentle stretches to the muscle that has excessive tension or repeated contractions of the muscle that is inhibited”. McKenzie exercises are simple movements that can be done at home to “reduce disc derangement related to a whiplash injury”. Stabilization/sensorimotor activities are exercises that are meant to “correct faulty movement patterns in routine activities”. Chiropractors often advise patients about home, work, and recreational activities, and the proper ergonomics, posture, “use of self”, and even methods of stress
reduction.8 In one study, “ 93% of the 28 patients studied…were found to have a statistically significant improvement following chiropractic care”. Those patients were treated with cryotherapy, PNF, and spinal manipulation. Prior to the chiropractic care, most of the study’s patients had been treated with physiotherapy, NSAIDs, and soft collars. It is not uncommon for whiplash patients to have cervical disc injuries. These types of injuries may respond well to chiropractic care. In another study, most in a group of whiplash patients with cervical pain responded well to chiropractic treatments. The ones who responded best had neck pain, reduced range of motion, and some neurological symptoms (tingling, numbness). The ones who didn’t respond as well “had severe neck pain with full neck ROM and bizarre pain distributions in the extremities…blackouts, nausea, vomiting, chest pain and visual dysfunction”. Patients with these types of symptoms may benefit more with multidisciplinary care.9 It is important to remember that pain is not the only symptom of whiplash. Nausea, dizziness, headaches, numbness, and blurred vision are all possible. The injury could occur even “at speeds less than 5mph”. The impact forces the neck “into an unnatural S curve”. Very often, X-rays do not show a fracture, but they generally display “a straightening of the cervical curve”. Chiropractors are trained to diagnose and treat whiplash injuries. It could take months of treatment, depending on the degree of injury, but chiropractic treatment may be covered by insurance.10
2, 4, 5 http://www.mayoclinic.org/diseases-conditions/whiplash/basics/definition/con-20033090
Learn more about chiropractic care and whiplash.