The Whiplash Syndrome

by drmccluskey

             The term “whiplash” was coined by Dr. Harold Crowe in 1928 during an interview on car collision related neck injuries but he reportedly “…regretted it later.” The term “whiplash” quickly became a household word and relates to a sudden movement of the head producing a neck sprain. It is now accepted that not only forward/backward movements during motor vehicle collisions (MCV) result in neck injury but also side to side and angular movements at the time of impact. In the past, we’ve discussed the number of milliseconds that takes place during the whiplash process after impact (~500 msec.) and the fact that voluntary muscle contraction takes longer (~800 msec.) making it next to impossible to adequately “brace” prior to impact, even when the collision is anticipated. Today, we’re going to look at the symptoms and complaints that are commonly described by whiplash patients. 

            “Early whiplash syndrome” is defined as the condition where immediate or very close to immediate symptoms are noted. One study reported symptoms commonly described after a MVC include the following: neck pain (93%), headache (72%), shoulder pain (49%) and back pain (38%) and, 87% of patients had multiple symptoms. Others reported nausea (48%) and dizziness (38%) as initial symptoms. For some, many of these symptoms resolve within days, weeks or months leaving a smaller percentage with symptoms that last beyond 6 months, which is then referred to as “late whiplash syndrome.” In one study of 52 patients, symptoms improved over a 2 week to 12 month time frame but then remained static or unchanged for the following year. Another study of 117 patients at the 2-year point, reported the following symptoms (the frequency of occurrence is in parentheses): Neck pain (17%), headache (15%), fatigue (13%), shoulder pain (13%), insomnia (12%), anxiety (11%), concentration loss (10%), and forgetfulness (10%). 

            Reasons for the continuation into a late syndrome are supported by two possible causes. 1. It is due to a high level initial symptom, including severe neck pain and headache often with radiating arm pain (radiculopathy). 2. It is caused by the stressful events that are present either at the time of the motor vehicle collision or soon thereafter. These stressors could include work loss, marital stress, financial stress, and/or depression or anxiety issues associated with being injured. It was also reported that the specific type of headache suffered in the late whiplash syndrome in a 47 patient study, 74% had tension-type headache, 15% had migraine and 11% had cervicogenic headache. Some authors have reported that the type of headaches that occur as a result of an MVC are similar to almost identical to those seen after head trauma from other causes including sports injuries such as football, hockey, and boxing. 

            Because “whiplash” results in a mechanical type of injury to the small joints of the neck, muscles and ligaments, the only logical choice for management and treatment is chiropractic.  This is because chiropractic addresses the mechanical injury with a manual, hands-on approach specifically aimed at restoring function in the injured area. Studies are clear that whiplash patients make a faster, less painful recovery, return to work and desired activities faster and are the most satisfied when utilizing chiropractic when compared to covering up the symptoms with medications that have negative side effects that interfere with being able to think and ultimately, reduce productivity.

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