Curvesday Thursday: Is it Whiplash?

When the cervical spine (neck) is subject to whiplash, there is usually a combination of factors that contribute to whiplash pain in the neck and back, and ultimately need to be addressed individually by a chiropractor.

The doctor of chiropractic maintains a “holistic” view of the patient’s whiplash pain, specifically focusing on one or more of the following:

  • Joint dysfunction
  • Muscle dysfunction
  • Faulty movement patterns
  • Disc derangement.1

This article explains how chiropractors approach treating neck pain, back pain, and/or other whiplash symptoms, and help patients prevent chronic whiplash pain.

Whiplash Pain Management for Joint Dysfunction

Joint dysfunction from whiplash occurs when one of the joints in the spine or limbs loses its normal joint play (resiliency and shock absorption). It is detected through motion palpation, achiropractic technique in which the chiropractor gently moves the joint in different directions and assesses its joint play. When a joint develops dysfunction, its normal range of movement may be affected and it can become painful.

Additionally, joint dysfunction can lead to muscle imbalance and pain, and a vicious cycle:

  • The loss of joint play can cause abnormal signals to the nervous system (there are an abundance of nerve receptors in the joint)
  • The muscles related to that joint can subsequently become tense or, conversely, underactive
  • The resulting muscle imbalance can place increased stress on the joint, aggravating the joint dysfunction that already exists.2

Muscle Dysfunction from Whiplash Injuries

When joint dysfunction develops, muscles are affected. Some muscles respond by becoming tense and overactive, while others respond by becoming inhibited and underactive. In either case, these muscles can develop trigger points that may necessitate whiplash treatment involving muscle relaxation or stimulation.

Trigger points are areas of congestion within the muscle where toxins accumulate. These toxins can irritate the nerve endings within the muscle and produce pain. This whiplash pain can occur in the muscle itself or can be referred pain (perceived in other areas of the body).

The muscle can also send abnormal neurological signals into the nervous system, which can then cause disruption of the ability of the nervous system to properly regulate muscles in other parts of the body, leading to the development of faulty movement patterns.

Faulty Movement Patterns and Whiplash Pain

It is thought that the intense barrage of pain signals from a traumatic whiplash injury to the cervical spine can change the way the nervous system controls the coordinated function of muscles.3 The disruption of coordinated, stable movement is known as faulty movement patterns.

Faulty movement patterns cause increased strain in the muscles and joints, leading to neck pain and back pain. They can involve the neck itself or can arise from dysfunction in other areas of the body such as the foot or pelvis.

Instability is also considered part of faulty movement patterns. There are 2 types of instability that can occur in whiplash:

  • Passive instability—the ligaments of the neck are loosened, making it more susceptible to whiplash pain
  • Dynamic instability—the nervous system disruption causes a disturbance in the body’s natural muscular response to common, everyday forces.3

As a result of instability, even mild, innocuous activities can be difficult to perform as they often exacerbate the whiplash pain.

Whiplash Pain from a Herniated Disc

The force of whiplash can cause injury to the discs between the vertebrae, and small tears can develop. If the gelatinous middle of the disc seeps out, it can irritate the nerve endings in this area. This is known as disc derangement. Occasionally, the gel can seep all the way out and press on a nerve root exiting the spinal cord behind the disc, known as disc herniation. A herniated disc may involve whiplash pain in the neck as well as sharp, shooting pain down the arm and possibly neurological symptoms such as numbness, tingling and muscle weakness.

Because each individual case of whiplash is different, it is not possible to generalize about the chiropractic whiplash treatment. The appropriate chiropractic treatment is unique to each whiplash injury and is directed at the primary dysfunctions detected during the chiropractic exam. However, chiropractors commonly employ different chiropractic treatments for whiplash, often including:

  • Manipulation
  • Muscle relaxation and/or stimulation
  • Various exercises
  • Ergonomic and lifestyle changes.

This article explains when, why and how chiropractors may employ these whiplash treatments for neck pain, shoulder pain, back pain and other related symptoms.

Chiropractic Manipulation for Whiplash

The primary whiplash treatment for joint dysfunction, spinal manipulation involves the chiropractor gently moving the involved joint into the direction in which it is restricted.

Also known as a chiropractic adjustment, spinal manipulation may involve the application of a short thrust in that direction. In many cases, instead of a thrust, a slow mobilizing movement is used by the chiropractor.

Muscle Relaxation or Stimulation as Whiplash Treatments

The chiropractor’s primary whiplash treatment for related muscle dysfunction, muscle relaxation and/or stimulation consist of gentle stretches to the muscle that has excessive tension or repeated contractions of the muscle that is inhibited.

If the muscle is very tight, a more vigorous stretch may be applied by the chiropractor. Gentle finger pressure techniques may be applied to trigger points to relieve the pain associated with the tight muscles.

McKenzie Exercises and Stabilization/Sensorimotor Activities

Chiropractors may employ different types of exercises, including McKenzie exercises and/or stabilization and sensorimotor exercises, to help treat patients with whiplash injuries.

McKenzie exercises are specifically designed to reduce disc derangement related to a whiplash injury. They consist of simple movements that are initially done in the office but make for an easy transition to self-care at home. McKenzie exercises also help the patient take an active role in his or her own recovery.

Stabilization and sensorimotor exercise approaches are designed to correct faulty movement patterns in routine activities and everyday life. Such whiplash treatment trains the nervous system to better coordinate and control movement patterns, and improves the ability of the neck muscles to maintain stability of the neck.

These exercises are designed to help in a major trauma, such as a fall or whiplash during a motor vehicle accident, or in “micro trauma” from simple things such as being jostled in a crowd, playing sports or performing occupational or home jobs that require physical effort.

Chiropractic Advice on Ergonomic and Lifestyle Changes

These whiplash treatment suggestions stress improvements for performing everyday activities with minimal strain to the body. The chiropractic advice addresses factors in an individual’s work, home or recreational activities that perpetuate the dysfunctions that result from the whiplash accident.

Additionally, spine care professionals at the chiropractic clinic may teach the patient better “use of self” and, if necessary, stress reduction methods to help chiropractic problems.

Whiplash Treatment in Chiropractic Care

The whiplash treatment plan developed by the chiropractor for each specific problem may include one or more of these approaches and may involve others as well.

In addition to his or her whiplash treatment plan, the doctor of chiropractic might give a referral to another health professional, such as a medical specialist, if it is deemed appropriate.

After sustaining whiplash injuries, it is fairly common for people to suffer from chronic neck pain. A chiropractor can detect certain factors in a patient’s history and chiropractic exam to better determine patients who may be more susceptible to chronic pain from a whiplash injury.

This process will help the doctor of chiropractic identify when aggressive preventative measures should be taken for patients who may be at a greater risk of developing chronic neck pain from whiplash injuries.

Chiropractic Treatment Approach to Whiplash Injuries

The chiropractor’s general approach to managing the patient’s chiropractic care is critical to the success of preventing chronic pain from whiplash injuries.

  • In the early stages of management, it is very important for the chiropractor to rapidly reduce the patient’s neck pain, back pain and/or other symptoms.
  • Soon after, the chiropractor’s whiplash treatment must be shifted toward restoration of the patient’s function. This means helping the patient return to work, home and recreational activities as soon as possible after sustaining the whiplash injuries. This process may involve a gradual transition to these activities, even if the patient is not sure that he or she can engage in them fully.
  • Restoring confidence after a whiplash injury on the part of the patient in his or her ability to get back to normal activity levels is also important for rehabilitation.
  • Exercise, both for the purpose of correcting faulty movement patterns and instability, and for general fitness, is important in this effort to treat whiplash injuries.

Teaching the patient the nature of chronic pain (that “hurt does not necessarily mean harm”) and placing focus on those activities the patient can do, rather than those he or she cannot, are major parts of chronic pain and disability prevention after whiplash injuries. Chiropractors integrate the strategies explained above to develop the most effective approach for recovering from a whiplash injury and preventing future episodes of back pain.

Are you currently suffering from whiplash pain? Call our office today at (304) 263-4927 to schedule an appointment. Dr Terry Chambers is a Board certified chiropractor and acupuncturist licensed in WV.

 

Source: http://www.spine-health.com/treatment/chiropractic/preventing-chronic-pain-whiplash

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