Whiplash Pain

Whiplash is a term that describes injury to the neck that occurs as a result of a motor vehicle or car accident or any significant acceleration/deceleration. The most common type of car accident is the rear impact, and most typically, the occupant in the vehicle that gets "rear-ended" (hit from behind) is at the greatest risk of injury, including whiplash.

What Is Now Known About Whiplash

Until recently, the reason for the extent of whiplash injuries was poorly understood. In addition, due to the legal and insurance issues, the veracity of complaints of neck pain and other symptoms by people who suffer from whiplash is commonly viewed as suspect.

However, recent research has helped clarify why occupants struck from behind experience more extensive whiplash injuries than those in other types of crashes. This new information is important for the physician treating whiplash pain, as it impacts the physician’s case management strategy.

Related Whiplash Symptoms/Conditions
Whiplash injuries can be quite complex and may include a variety of related problems, such as:
  • Joint dysfunction. As a result of the whiplash, one of the joints in the spine or limbs may lose its normal resiliency and shock absorption (referred to as the joint play), possibly leading to restricted range of movement and pain.
  • Disc herniation. A whiplash accident may injure the discs between the vertebrae, lead to small tears and cause the inner core of the disc to extrude through its outer core. If the disc's inner core comes in contact with and irritates a nearby spinal nerve root, a herniated disc occurs, with symptoms possibly including sharp, shooting pain down the arm and even neurological symptoms like numbness, tingling and muscle weakness.
  • Faulty movement patterns. It is believed that the nervous system may change the way in which it controls the coordinated function of muscles as a result of a barrage of intense pain signals from the whiplash injury.
  • Chronic pain. While often resulting in minor muscle sprains and strains that heal with time, more severe whiplash injuries may produce neck pain and other symptoms that are persistent and long-lasting (chronic).
  • Cognitive and higher center dysfunction. In some instances, whiplash may affect the patient's mental functioning, possibly leading to difficulties concentrating, as just one example.

A whiplash accident occurs when one motor vehicle strikes another from behind, causing certain forces to be transmitted from the striking vehicle to the struck vehicle. These forces are then transmitted to the occupant(s) of the struck vehicle, where they have the potential to cause whiplash injury.

Research Findings on Whiplash Accidents

Research both in the Biomechanics Laboratory at Yale University in New Haven and in live crash tests using human volunteers has shed relatively new light on the contortions the cervical spine (neck) undergoes as a result of impact culminating in whiplash.

Shortly after impact (about 150 milliseconds), the cervical spine undergoes what is called an S-shaped curve. In this configuration, the cervical spine, rather than simply being curved to the front in a normal C-shape, as it would normally be at rest, takes on an altered shape:
  • The lower part of the cervical spine moves into extension (bent backward)
  • The upper part of the cervical spine moves into flexion (bent forward).

When a whiplash accident occurs, the lower part of the cervical spine moves well beyond its normal range of motion, causing the potential for injury to the ligaments and discs in that area. The upper part of the cervical spine also moves beyond its normal range of motion, but to a lesser extent.

Cervical Spine Reactions to a Whiplash Accident
There is an inherent stabilization response in the cervical spine that helps protect it from potential whiplash injury:
  • The nervous system detects the presence of the impact
  • The muscles of the cervical spine, under the direction of the nervous system, contract quickly to try to minimize the affects of the impact on the ligaments and discs.

If this stabilization response is working efficiently following the whiplash accident, there is a greater likelihood of protection and less potential for whiplash injury.

But if the response is inefficient, an injury is more likely, with various types of whiplash pain possibly resulting and whiplash treatment potentially necessary.

At Restore Medical Partners, we will complete a thorough review of your history and ask patients to describe the location, severity and type of pain, in addition to the history of the pain: when the patient started to feel it, and any activities or positions that make the pain better or worse. We will review your MRI or order imaging if you do not have imaging completed on your first visit. Then, we will explain to you what is causing your pain from whiplash injury. Our goal is to prevent major surgery and use minor interventional techniques to relieve your pain and get you back to doing the things you enjoy. For pain radiating down the leg or into the buttock, we may recommend an epidural steroid injection. For axial or midline cervical, thoracic or lumbar pain we may recommend radio frequency ablation to treat the advanced arthritis of the facet joint that is commonly caused by whiplash injury. Some patients may require a combination of techniques to completely resolve your pain symptoms.

To watch a video about whiplash, please click below:

http://www.spine-health.com/video/whiplash-video

REFERENCES:

http://www.spine-health.com/conditions/neck-pain/what-whiplash

 
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