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Dear Doctor:
A few weeks ago I was involved in a serious car accident and I’ve
been experiencing neck pain ever since. Could I be suffering from whiplash?
S.W. Billings.
Chances are, if you’ve ever been involved in a car accident, you’ve
experienced a whiplash injury. It is estimated that each year, almost two
million Americans are injured in whiplash related accidents. A whiplash
injury, also referred to as a sudden acceleration/deceleration injury,
refers to an injury to the soft tissues of the neck. This type of injury
characteristically involves the soft tissue structures of the neck and
upper body. A whiplash injury is typically caused by sudden hyper-extension
and hyper-flexion movements of the neck. Generally, this type of injury
occurs as a result of rear-end crashes, though side-impact collisions,
rollovers and sports injuries are all potential instigators of this
outcome. This backward and forward movement of the head can cause the soft
tissue and joints of the neck to be overstretched. Additionally, sudden
acceleration/deceleration may cause microscopic tears in the muscles in the
front and back of the neck. Our necks have a complex anatomy. The spine is
supported by strong longitudinal, transverse and interspinous ligaments, in
addition to tendons, discs, intervertebral joints
and nerve roots. This complexity, combined with the neck’s capacity to move
in various directions, makes it particularly vulnerable and susceptible to
this type of injury.
The provocation of
excessive joint movement results in involuntary contraction of the
collateral soft tissue. This contraction encourages restricted motion and
depleted blood and nutrient supply, resulting in pain and inhibition of
movement. Without nutrient supply, soft tissue becomes irritable, producing
trigger points and congestion in the adjacent tissue. The tissues of the neck attempt to
stabilize themselves by going into spasm, which leads to faulty movement
patterns, provoking additional trigger points and generating a cycle of
pain. Additionally, the facet joints of the neck (that region of bone which
articulates with the contiguous segment) become “jammed” with sudden
injury. As a result of this disturbance, the increased stress on the joints
can cause chronic pain, numbness and tingling. Our joints contain a
profusion of nerve receptors. As the nerves and vascular structures become
involved, headache pain may develop, as well as dizziness and other neurologic-related symptoms.
Symptoms of whiplash
characteristically manifest as burning pain in the neck, accompanied by
muscle ache, stiffness and loss of motion. Often tingling in the shoulders
and arms with pursuant joint pain quickly ensues. This pain can be
immediate, or develop days or even weeks after the precipitating event has
occurred. Problems arising from injury can vary according to the severity
of accident, age and health of patient, or pre-existing structural
integrity of the spine, as well as other variables which may factor into
the equation. Other associated symptoms may include headache pain, shoulder
pain, dizziness, sensation of “pins and needles”, weakness, visual disturbances, ringing in the ears, fatigue, sleep
problems, depression and even irritability.
The good news? Whiplash
is a treatable condition. The goals of treatment include relieving pain,
promoting soft tissue healing, increasing range of motion and restoring
strength and stability to the involved structures. In any serious injury,
any indication of concussion or head trauma should result in immediate
medical attention. However assuming there is no objective evidence of
fracture, head trauma or dislocation, in the initial stages of injury,
conditions can be self-limiting. Protocol for treatment includes the
application of ice in the acute phase to reduce pain and edema. A cervical
collar is often prescribed to temporarily immobilize the neck if the pain
will not subside. However these should only be worn for a brief period of
time, as immobilized tissue can atrophy. After the acute phase of injury,
passive modalities such as heat, electrical muscle stimulation, ultrasound
and massage can prove effective in addressing the swelling, muscle spasm
and loss of range of motion. It is also strongly advised to get neck
x-rays, as injury to the bony structures of the spine are not always
immediately evident.
Too often, treatment for
whiplash injuries is neglected or even ignored. It is critical to see your
health care professional immediately following any accident or injury
involving the cervical spine to help prevent the development of fibrotic or
facetal adhesions and the development of osteophytic formation.
Chiropractic treatment, physical therapy and acupuncture have long been
recognized as effective measures of managing whiplash injuries.
Additionally, nutritional advice from a licensed professional will promote
healing and ensure the health of the tissue.
Remember that the best
protection against whiplash injury is prevention. Always wear your
seatbelt, and wear it correctly. Make sure your headrest is adjusted
appropriately. If you participate in sports, remember to wear the
appropriate equipment and stretch before any activity. Though some injuries
may be impossible to avoid, being prepared physically can often enhance recovery.
Exercise, eat well, drink plenty of water, and remember to make choices
designed to contribute to a healthy and active lifestyle!
Yellowstone Naturopathic
Clinic
720 N. 30th St.
Billings, MT 59101
PHONE 406·259·5096/FAX 406·248·5655
ync@180com.net
Dispensary
406·254·9682
dispensary@yncnaturally.com
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