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Posted on 04-19-2012

Morning folks!

The insurance industry has long put out that whiplash, particularly from low speed rear impact collisions causing little vehicle damage, cannot cause whiplash or even damage.  The science and physics tell a different story.  This review from the the American Journal of Orthopedics in January 2005 found that cervical (neck) sprain/strain or whiplash injuries are a common cause of acute and chronic musculoskeletal impairments and are ubiquitous after rear-end automobile collisions.

They noted the diagnosis is largely subjective and the ideal treatment controversial.

Unfortunately, the majority of compensated litigation claims are associated with whiplash-type injuries secondary to motor vehicle accidents.

Fortunately, many recent advances have led to better understanding of the collision and injury biomechanics and to development of a predicting outcomes to treatment, objective diagnostic tests, an array of treatment modalities, and, most important, safer automobiles.

These advances will undoubtedly lead to decreased incidence, a more accurate

diagnosis, and a tailored management regimen resulting in improved outcomes and

ultimately fewer legal proceedings.

THESE AUTHORS ALSO NOTE:

Whiplash associated disorders (WADS) are caused by

acceleration/deceleration injuries and are most often seen after rear-end motor

vehicle accidents.

These injuries "present a significant risk for permanent disability." [IMPORTANT]

In 1995, 5.5 million Americans were injured in motor vehicle accidents.

"The majority of patients report resolution of their symptoms by 4 to

6 weeks, but up to one third may complain of chronic neck/arm symptoms."

[Important, one-third of WAD patients have not recovered by 6 weeks].

Approximately 15 million Americans currently complain of chronic whiplash symptoms.  85% of all compensated litigation claims are associated with whiplash-type injuries from motor vehicle accidents, and insurance companies pay out $29 billion a year for claims associated with these accidents. [WOW!]

"The most common complaint after a whiplash-type injury is neck pain in the

cervical and upper back region. Other symptoms include decreased range of

motion, headaches, shoulder pain, dizziness, arm paresthesias, and visual and

auditory disturbances."

During a rear-end collision, the automobile and its occupant are forced forward while the occupant's head and neck are forced backward.

"Any rotation of the head or neck at the time of impact increases the forces

imparted to the cervical facet joints and capsular structures, which are believed to

be the source of neck pain." [Very Important]

Visual and auditory disturbances may result from brain injury. [Important]

"Commonly, symptoms may be mild initially but may intensify within 48 to 72

hours." [Very Important]

"Plain radiographs [x-rays] are usually normal except for loss of physiologic lordosis [curve in neck] and/or anterior widening of the prevertebral soft-tissue space [from swelling]."

"If a ligamentous injury of herniated nucleus pulpous [disc] is suspected, MRI is performed."

"If no significant injury is identified, delayed flexion/extension lateral plain radiographs are obtained to rule out occult instability." [Important]

There is a myriad of biomechanical force vectors during a motor vehicle accident. Higher speeds at impact result in increased force imparted to the passenger and increased head acceleration/deceleration.

"Rotation of the head (such as looking in your mirror or at a passenger) and neck position at time of impact

increases the force imparted to cervical anatomical structures, especially the

cervical facet joints and capsular structures [neck joints...not muscles]." [Again, Very Important]

"Just before a rear-end collision, drivers often rotate the head to look into the rearview mirror." This increases facet capsule strain leading to injury.

Headrests decrease injury by 10%.

Headrests should be at the level of the ear, the head's center of gravity.


The more reclined the seat is at the time of a rear-end collision, the larger

the arc of motion of the head and neck is in the sagittal plane relative to the chest,

which increases neck injury.

"Although wearing seat belts at time of impact has prevented countless life threatening injuries, whiplash injuries have doubled since mandatory seat-belt laws were introduced." [Very Important] The seat belt can act as a fulcrum increasing injury to the neck.

"Patients with advanced degenerative [arthritis] changes at 2-year follow-up had poor outcomes."

Whiplash injured patients have 3 times the incidence of neck and/or shoulder pain 7 years post-accident compared to a normal population.

84% of patients who sustained a second whiplash injury reported recurrence

and/or worsening of previously resolved neck and arm symptomatology. "Of those

patients reporting a recurrence, 97% were symptom-free before the second

accident."

"A large majority of drivers and passengers suffer acute and chronic symptoms related to whiplash-type injuries."

"Many researchers believe that primary injuries to facet [neck] joint structures may be the source of chronic neck pain after whiplash injuries."

The neck joints have many pain receptors to tell the brain something is damaged.

The 2 top joints in the neck are the primary pain generators in cervicogenic headaches [headaches that start at the base of the skull and can refer to the forehead].


SUMMARY FROM AUTHORS:

"Whiplash injuries or WADs are true pathologic entities associated with

significant morbidity." [This is important because it indicates that the

complaints are not made up, they are real!].

"Often, patients with whiplash symptoms have no objective findings and negative radiographic [x-ray] studies." [Important]

"Although symptoms resolve spontaneously in most cases, one third of

patients develop chronic complaints." [Important]

Actively moving the joints early on is the best way to recover.

Surgery is rarely indicated in treating WAD patients. Surgery is reserved for

ligament instability, worsening cervical deformity with increasing neck pain, and

worsening neurologic complaints.

KEY POINTS FROM WellnessOne:

1) Rear-end motor vehicle whiplash injuries "present a significant risk for

permanent disability."

2) At least one third of rear-end motor vehicle whiplash injured patients do not

resolve in six weeks and complain of chronic neck/arm symptoms.

3) About 15 million Americans currently have chronic whiplash symptoms.

4) 85% of all compensated litigation claims are associated with whiplash-type

injuries from motor vehicle accidents, and insurance companies pay out $29 billion a year for claims associated with these accidents.

5) Visual and auditory disturbances after whiplash may result from brain injury.

6) It is common for whiplash symptoms to be mild initially but then intensify

within 48 to 72 hours.

 Folks, I've been treating whiplash victims for over 11 years.  Most times when the victim is sent to the ER they are told to rest, heat the injury, and take pain killers and muscle relaxants.  This is fine to help your comfort but will do NOTHING to rehabilitate the injured joints to reduce future problems.  The research is clear...early treatment is key and Chiropractic is best suited for this purpose.  The next time you are someone you know is in a car accident, no matter how bad and no matter who is at fault...its always BEST to give our office a call to evaluate your condition...before it becomes a life long pain in the neck!

Have a blessed day!

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