Suffering from whiplash?

Approximately 4.27 million Canadians are injured seriously enough to impede their daily living on a yearly basis. A very common cause of such injury is known as whiplash. Whiplash is a term that often shows up in popular movies and TV, but only because the official term of cervical acceleration-deceleration syndrome doesn’t have quite the same ring to it!

Muscle and Joint


Owen Wiseman
@AVogel_ca


29 May 2018

Cervical what now?

The spinal column is divided into four distinct regions based on the anatomy of the vertebrae. At the top, supporting the neck and head, is the cervical region. The thoracic region that follows is responsible for the ribcage. We move to the lumbar region where the vertebra begin to thicken as they gradually support more weight moving down the spinal column. Finally, we end with the fused sacral bones which connect the spine to the hips, further distributing the weight of the upper body.

The vertebrae forming the spinal column are pretty flexible, allowing a healthy individual to bend in all manner of directions…even more if you find yourself performing as a contortionist. Now THAT’S a flexible spine! However, even the most supple spine is subject to trauma and degeneration.

What causes whiplash?

As the medical term, cervical acceleration-deceleration syndrome may imply, a whiplash injury is caused by a rapid acceleration and subsequent deceleration of the cervical spine. This is most often associated with a motor vehicle accident, but it can result from a hard tackle or body check in sports, or even a fall.

The body has an inherent defense against over stretching. When we bend a body part such as the neck, we feel a certain amount of tension, the body’s way of telling us to quit while we’re ahead. This is also known as active range of motion, where we go through all of the typical motions of a body part ourselves, and passive range of motion, where our clinician, chiropractor, or physiotherapist does the motion for us. During these motions, they can gently push the body slightly past what we could ourselves to test for “end-feel”, the point where the body says enough.

In whiplash, the impact that caused the rapid acceleration-deceleration moves our neck past end-feel so quickly that the surrounding tissues don’t have time to accommodate. Like a rubber band snapping, the tension is so great that the tissues let go – resulting in tears and strains as the muscles are stretched far beyond their limit. As the head lashes around, blood vessels and nerves that are normally snug in their regular spots get jostled into new areas, and can become caught as the structures of the head attempt to fall back into place.

The body is no fragile thing. Humans evolved to withstand some bruising and trauma, but the suddenness of the motion is the cause of the injury. Studies have shown that whiplash can occur at speeds as little as 10-15km/h. Does that mean you should avoid the bumper cars at your local fairground the next time they come to town? No, but caution and awareness are key.

What signs and symptoms should I watch for?

As said, whiplash can result in nerve root impingements, muscle strains, and ligament tears amongst others. You may start to experience expected symptoms such as headaches, neck pain, difficulty moving your neck, and dizziness.

Others may be subtler, such as difficulty concentrating, fatigue, or blurred vision. These symptoms are a result of the brain getting rattled around inside the skull which can lead to mild traumatic brain injuries as it undergoes inflammation. Additionally, the vagus nerve, the one responsible for transmitting neurological signals to the gastrointestinal tract, larynx, and heart may be affected by the motion. Keep an eye on such changes following the event that caused the whiplash.

The most helpful thing to do for your clinician is to record the details of the accident and get yourself to a clinic following any accident. Many of the common signs and symptoms of whiplash may not present themselves until days or even weeks later, and knowing the details helps your primary care provider get a clearer picture.

How can I get relief?

The body tends to protect itself by preventing excessive motion on an injured area. However, a whiplash injury should be treated differently. Much like the Tin Man from Oz needed oil to keep his joints limber, the neck following a high-impact accident tends to stiffen up unless the individual works the muscles and joints.

In addition to creating an appropriate exercise plan with a professional, symptomatic relief of neck and shoulder pain can be achieved through the use of a topical product such as Absolüt Arnica Gel. The namesake of the product, arnica montana, has been shown to reduce the levels of pro-inflammatory agents circulating in the area of application as well as increase antioxidant levels. This all serves the purpose of moderating inflammation.

What should I do to prevent this from happening to me or my loved ones?

One of the most overlooked preventative measures is properly adjusting the headrest of your seat when you enter a vehicle. The Insurance Bureau of Canada determined that about 86% of head rests are improperly adjusted…and the whole purpose of the headrest is to prevent injuries such as these from occurring! It should be no more than a few centimeters from the back of your head and set to your individual height level.

In general, remain active and get into the habit of performing neck exercises regularly. With the amount of time spent looking down at computers and cell phones, looking up could literally save your neck.

References:
https://canadasafetycouncil.org/properly-adjusted-headrests-prevent-injuries/
https://www.hindawi.com/journals/aorth/2018/4765050/abs/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256773/
https://www.ncbi.nlm.nih.gov/pubmed/9455663
https://www.ncbi.nlm.nih.gov/pubmed/11470396
https://www.ncbi.nlm.nih.gov/pubmed/19333822
https://www.ncbi.nlm.nih.gov/pubmed/20357684
https://www.ncbi.nlm.nih.gov/pubmed/29377453
https://www.ncbi.nlm.nih.gov/pubmed/29392244
https://www.ncbi.nlm.nih.gov/pubmed/29470185
https://www.ncbi.nlm.nih.gov/pubmed/29472891
https://www.statcan.gc.ca/pub/82-624-x/2011001/article/11506-eng.htm