Back Clinic Whiplash Chiropractic Physical Therapy Team. Whiplash is a collective term used to describe injuries to the cervical spine (neck). This condition often results from an automobile crash, which suddenly forces the neck and head to whip back and forth (hyperflexion/hyperextension). Almost 3 million Americans are hurt and suffer from whiplash annually. Most of those injuries come from auto accidents, but there are other ways to endure a whiplash injury.
The symptoms of whiplash may include neck pain, tenderness and stiffness, headache, dizziness, nausea, shoulder or arm pain, paresthesias (numbness/tingling), blurred vision, and in rare instances difficulty swallowing. Soon after it happens at the acute phase the chiropractor will focus on reducing neck inflammation utilizing various therapy modalities (eg, ultrasound).
They might also use gentle stretching and manual therapy techniques (eg, muscle energy therapy, a type of stretching). A chiropractor may also recommend you apply an ice pack in your neck and/or light neck support to use for a short time period. As your neck gets less inflamed and the pain diminishes, your chiropractor will execute spinal manipulation or other techniques to restore normal movement to your neck’s spinal joints.
Those experiencing neck pain, stiffness, headache, shoulder and back pain may suffer from a whiplash injury. Can knowing whiplash signs and symptoms help individuals recognize the injury and help healthcare providers develop an effective treatment plan?
Whiplash Signs and Symptoms
Whiplash is a neck injury that typically occurs after a motor vehicle collision or accident but can happen with any injury that rapidly whips the neck forward and backward. It is a mild to moderate injury of the neck muscles. Common whiplash signs and symptoms include:
Some individuals can develop chronic pain and headaches.
The symptoms and treatment depend on the severity of the injury. Treatment can include over-the-counter pain medicines, ice and heat therapy, chiropractic, physical therapy, and stretching exercises.
Frequent Signs and Symptoms
The sudden whipping movement of the head can affect several structures within the neck. These structures include:
Muscles
Bones
Joints
Tendons
Ligaments
Intervertebral discs
Blood vessels
Nerves.
Any or all of these can be affected by a whiplash injury. (MedlinePlus, 2017)
Statistics
Whiplash is a neck sprain that occurs from a fast neck-jerking motion. Whiplash injuries account for more than half of vehicle traffic collision injuries. (Michele Sterling, 2014) Even with a minor injury, the most frequent symptoms include: (Nobuhiro Tanaka et al., 2018)
Neck pain
Next stiffness
Neck tenderness
Limited range of motion of the neck
Individuals can develop neck discomfort and pain shortly after an injury; however, the more intense pain and stiffness typically do not occur right after the injury. Symptoms tend to worsen the next day or 24 hours later. (Nobuhiro Tanaka et al., 2018)
Beginning Symptoms
Researchers have found that approximately more than half of individuals with whiplash develop symptoms within six hours of the injury. Around 90% develop symptoms within 24 hours, and 100% develop symptoms within 72 hours. (Nobuhiro Tanaka et al., 2018)
Whiplash vs. Traumatic Cervical Spine Injury
Whiplash describes a mild to moderate neck injury without significant skeletal or neurological symptoms. Significant neck injuries can lead to fractures and dislocations of the spine that can affect the nerves and spinal cord. Once an individual develops neurological problems associated with a neck injury, the diagnosis changes from whiplash to traumatic cervical spine injury. These differences can be confusing as they are on the same spectrum. To better understand the severity of a neck sprain, the Quebec classification system divides neck injury into the following grades (Nobuhiro Tanaka et al., 2018)
Grade 0
This means there are no neck symptoms or physical examination signs.
Grade 1
There is neck pain and stiffness.
Very few findings from the physical examination.
Grade 2
Indicates neck pain and stiffness
Neck tenderness
Decreased mobility or neck range of motion on physical examination.
Grade 3
Involves muscle pain and stiffness.
Neurologic symptoms include:
Numbness
Tingling
Weakness in the arms
Decreased reflexes
Grade 4
Involves a fracture or dislocation of the bones of the spinal column.
Other Symptoms
Other whiplash signs and symptoms that can be associated with the injury but are less common or only occur with a severe injury include (Nobuhiro Tanaka et al., 2018)
Tension headache
Jaw pain
Sleep problems
Migraine headache
Difficulty concentrating
Reading difficulties
Blurred vision
Dizziness
Driving difficulties
Rare Symptoms
Individuals with severe injuries can develop rare symptoms that often indicate traumatic cervical spine injury and include: (Nobuhiro Tanaka et al., 2018)
Amnesia
Tremor
Voice changes
Torticollis – painful muscle spasms that keep the head turned to one side.
Bleeding in the brain
Complications
Most individual generally recover from their symptoms within a few weeks to a few months. (Michele Sterling, 2014) However, whiplash complications can occur, especially with severe grade 3 or grade 4 injuries. The most common complications of a whiplash injury include chronic/long-term pain and headaches. (Michele Sterling, 2014) Traumatic cervical spine injury can affect the spinal cord and be associated with chronic neurological problems, including numbness, weakness, and difficulty walking. (Luc van Den Hauwe et al., 2020)
Treatment
The pain is typically more severe the next day than after the injury. Whiplash musculoskeletal injury treatment depends on whether it is an acute injury or the individual has developed chronic neck pain and stiffness.
Acute pain can be treated with over-the-counter medicines like Tylenol and Advil, which effectively treat the pain.
Advil is a nonsteroidal anti-inflammatory that can be taken with the pain reliever Tylenol, which works in different ways.
The mainstay of treatment is encouraging regular activity with stretching and exercise. (Michele Sterling, 2014)
Physical therapy uses various range of motion exercises to strengthen the neck muscles and relieve the pain.
Chiropractic adjustments and non-surgical decompression can help realign and nourish the spine.
Acupuncture can cause the body to release natural hormones that provide pain relief, help relax the soft tissues, increase circulation, and reduce inflammation. The cervical spine can return to alignment when the soft tissues are no longer inflamed and spasming. (Tae-Woong Moon et al., 2014)
Sterling M. (2014). Physiotherapy management of whiplash-associated disorders (WAD). Journal of physiotherapy, 60(1), 5–12. doi.org/10.1016/j.jphys.2013.12.004
Tanaka, N., Atesok, K., Nakanishi, K., Kamei, N., Nakamae, T., Kotaka, S., & Adachi, N. (2018). Pathology and Treatment of Traumatic Cervical Spine Syndrome: Whiplash Injury. Advances in orthopedics, 2018, 4765050. doi.org/10.1155/2018/4765050
van Den Hauwe L, Sundgren PC, Flanders AE. (2020). Spinal Trauma and Spinal Cord Injury (SCI). In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2020. Chapter 19. Available from: www.ncbi.nlm.nih.gov/books/NBK554330/ doi: 10.1007/978-3-030-38490-6_19
Moon, T. W., Posadzki, P., Choi, T. Y., Park, T. Y., Kim, H. J., Lee, M. S., & Ernst, E. (2014). Acupuncture for treating whiplash associated disorder: a systematic review of randomised clinical trials. Evidence-based complementary and alternative medicine : eCAM, 2014, 870271. doi.org/10.1155/2014/870271
Individuals who have suffered cervical acceleration-deceleration/CAD more commonly known as whiplash, can experience headaches, and other symptoms like neck stiffness, pain, fatigue, and shoulder/neck/back discomfort. Can non-surgical and conservative treatments help alleviate the symptoms?
Cervical Acceleration – Deceleration or CAD
Cervical acceleration-deceleration is the mechanism of a neck injury caused by a forceful back-and-forth neck motion. It happens most commonly in rear-end vehicle collisions when the head and neck whip forward and backward with intense acceleration and/or deceleration causing the neck to flex and/or extend rapidly, more than normally, straining and possibly tearing muscle tissues and nerves, ligaments, dislocation of spinal discs and herniations, and cervical bone fractures.
For symptoms that do not improve or worsen after 2 to 3 weeks, see a healthcare provider or chiropractor for further evaluation and treatment.
Whiplash injuries strain or sprain the neck muscles and/or ligaments, but can also affect the vertebrae/bones, disc cushions between the vertebrae, and/or the nerves.
Whiplash symptoms can present right away, or after several hours to a few days after the incident, and tend to worsen in the days after the injury. Symptoms can last a few weeks to a few months, and can severely limit activity and range of motion. Symptoms can include: (National Institute of Neurological Disorders and Stroke. 2023)
Pain that extends into the shoulders and back.
Neck stiffness
Limited neck motion
Muscle spasms
Numbness and tingling sensations – paresthesias or pins and needles in the fingers, hands, or arms.
Headaches – A whiplash headache usually starts at the base of the skull and can vary in intensity. Most individuals experience pain on one side of the head and toward the back, though some can experience symptoms all over their head, and a small number experience headaches on the forehead or behind the eyes. (Monica Drottning. 2003)
The headaches can become aggravated by moving the neck around, especially when looking up.
Headaches are often associated with shoulder pain along with sensitive neck and shoulder muscles that when touched can increase pain levels.
Whiplash headaches can lead to chronic neck-related headaches known as cervicogenic headaches. (Phil Page. 2011)
It is also important to rest your neck area following the injury.
A cervical collar can be utilized temporarily to stabilize the neck, but for long-term recovery, it is recommended to keep the area mobile.
Physical activity reduction until the individual can look over both shoulders, and tilt their head all the way forward, all the way back, and from side to side without pain or stiffness.
Non-steroidal anti-inflammatories – NSAIDs – Ibuprofen or Naproxen.
Muscle relaxers
If symptoms do not improve, a healthcare provider may recommend physical therapy and/or stronger pain medications. For whiplash headaches that last for several months, acupuncture, or spinal injections may be recommended.
Neck Injuries
References
National Institute of Neurological Disorders and Stroke. Whiplash Information Page.
Drottning M. (2003). Cervicogenic headache after a whiplash injury. Current pain and headache reports, 7(5), 384–386. doi.org/10.1007/s11916-003-0038-9
Page P. (2011). Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy, 6(3), 254–266.
Whiplash is a neck injury where, because loads and displacements develop in the neck, they have become the main interest in the study of whiplash injury mechanisms. Human subject studies, however, have only reported the peak speed of the head relative to a fixed reference frame.
Since head acceleration is often the result of the head-restraint impact, these peak values might be conducive to whiplash injury and do not reflect loads developed in the tissues of the neck. The kinematics of the head have been computed relative to the axis between the C7-T1 vertebra to supply a better indication of the dynamics. The first peak in the acceleration trace results from the torso’s acceleration relative to the still-stationary head.
This peak is the larger and later acceleration peak, governed by the impact between the head restraint and the head. When head acceleration is measured, a result that highlights the importance of quantifying the head’s relative rather than absolute dynamics, the first negative peak isn’t observed.
Cause of Whiplash Injuries
Cadaveric, animal and human subject experiments have led investigators to propose various anatomical sites for whiplash injury, including the cervical facet joints, facet capsular ligaments, vertebral arteries, dorsal root ganglia, craniovertebral junction, and cervical muscles. Muscle injury could be responsible for some symptoms in patients; however, of the anatomical sites listed above, only the facet joints have been linked to chronic whiplash pain. The facet joints have become the focus of research directed at understanding the mechanical basis for chronic whiplash injuries.
In a study conducted by researchers and colleagues (1996), chronic whiplash pain was relieved in about 60% of whiplash patients by anesthetizing medial branches of the cervical dorsal rami. Articular branches from these nerves run through the capsular tissues and presumably originate in the capsular tissue from mechanoreceptors and nociceptors. Possible injury sites inside the facet joints include fractures of the bony elements, bruising of the rectal folds (menisci), or ruptures or tears of the capsular ligament. Skeletal fractures and aspect hemarthroses are not commonly observed in whiplash patients and are therefore related to loading. Bruising of the folds is common after fatal chest or head injury, and motions of the cervical vertebra consistent with this type of injury have been documented during the severe loading associated with whiplash injury in human subjects.
Cineradiography used to inspect the intervertebral motion of subjects exposed to simulated influences has shown that the C5 vertebra rotates about a stage than during voluntary expansion moves. This movement pattern resulted in compression of the facet joints posteriorly through impact-induced motion during activity and increased distraction of the vertebral bodies anteriorly. These researchers proposed that the posterior synovial fold might be pinched by rear compression of the facet joints though this altered motion was detected in only four of six subjects. This proposed mechanism of injury is promising. Follow-up research that quantifies the loads applied to the meniscus during whiplash exposures and the loads necessary to injure the meniscus is needed to confirm whether this proposed injury mechanism occurs at the loads generated during collisions that produce a whiplash injury.
The facet joint capsules contain fine, unmyelinated nerves that likely have a nociceptive function. Distending these ligaments by injection of contrast media has generated whiplash-like pain patterns in normal individuals. Tears or ruptures to the cervical facet joint capsular ligaments have also been observed under severe loading conditions. Excess capsular ligament strain was proposed as a mechanism for whiplash injury under minor- to moderate-loading requirements. With subsequent loading to failure, the technology strain in the capsular ligaments under both whiplash-like heaps and cadaveric motion sections has recently been quantified. Maximum strains in the facet joint capsular ligaments under loads were, on average, half. In two of the 13 specimens, the top songs observed in the ligament under whiplash-like heaps were larger than those detected in their initial failure.
This finding suggested that the neck loads developed during an automobile accident could injure some individuals’ facet capsular ligaments. Further work is needed to determine if these ruptures generate pain and whether the subcatastrophic failures identified with breaks inside the capsular ligaments in the response of the tissues correlate.
Whiplash injury has proved difficult to research because its pathoanatomy has remained poorly understood. The facet joints have been isolated as a site of chronic pain in many populations.
A better understanding of the etiology of whiplash injury will lead to improved care and injury prevention methods. Human subject testing has provided the essential kinematic and kinetic response information needed to conduct tests of those cells, and tissue evaluations have led to a possible mechanical explanation for whiplash injury. Additional research is required to complete the connection between the whiplash symptoms experienced by some people and an automobile accident.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please ask Dr. Jimenez or contact us at 915-850-0900.
By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, is frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. The sheer force of an impact can cause damage or injury to the cervical spine and the rest of the spine. Fortunately, a variety of treatments are available to treat automobile accident injuries.
Studies on the effectiveness of chiropractic care for patients afflicted with pain secondary to whiplash injury are emerging. In 1996, Woodward et al. published a study on the efficacy of chiropractic treatment of whiplash injuries.
In 1994, Gargan and Bannister published a paper on the recovery rate of patients and found that when patients were still symptomatic after three months, there was almost a 90% chance they would remain injured. The study’s authors were from the Department of Orthopedic Surgery in Bristol, England. No conventional treatment was shown to be effective in these based chronic whiplash injury patients. However, high success rates have been found by whiplash injury patients through chiropractic care in recovering these types of patients.
Whiplash Treatment Study Results
In the Woodward study, 93 percent of the 28 patients studied retrospectively were found to have a statistically significant improvement following chiropractic care. Chiropractic care in this study consisted of PNF, spinal manipulation, and cryotherapy. Most of the 28 patients had prior therapy with NSAIDs collars and physiotherapy. The average length of time before when the patients began chiropractic care was 15.5 months post-MVA (range of 3-44 months).
This study documented what most DCs experience in clinical practice: chiropractic care is effective for individuals hurt in a motor vehicle accident. Symptoms ranging from headaches to back pain, neck pain, interscapular pain, and extremity pain related to paresthesias all responded to quality chiropractic care.
Normal & Whiplash X-Rays
Whiplash MRI Findings
The literature has also suggested cervical disc injuries aren’t uncommon after a whiplash injury. In a study published on chiropractic care for disk herniations, it was demonstrated that patients improve clinically and that repeated MRI imaging often shows decreased size or resolution of the disk herniation. Of the 28 patients studied and followed, many had disc herniations that reacted well to chiropractic care.
In a recent retrospective study by Khan et al., published in the Journal of Orthopedic Medicine, on whiplash-injured patients concerning cervical pain and dysfunction, patients were stratified into groups based on levels of a good outcome to chiropractic care:
Group I: Patients with neck pain only and restricted neck ROM. Patients had a “coat hangar” distribution of pain with no neurologic deficits; 72 percent had a fantastic outcome.
Group II: Patients with neurological symptoms or signs and limited spinal ROM. Patients had numbness, tingling, and paresthesias in the extremity.
Group III: Patients had severe neck pain with full neck ROM and bizarre pain distributions from the extremities. These patients often described chest pain, nausea, vomiting, blackouts, and dysfunction.
The results of the study showed that in class I, 36/50 patients (72%) reacted well to chiropractic care: in group II, 30/32 patients (94 percent) responded well to chiropractic care; and in group III, only 3/11 instances (27%) responded well to chiropractic care. There was a significant difference in outcomes between the three groups.
This study provides new evidence that chiropractic care is effective for whiplash-injured patients. However, the study didn’t consider patients with back injuries, extremity injuries, and TMJ injuries. It did not identify which patients had disc injuries, radiculopathy, and concussive brain injury (most likely group III patients). These types of patients respond better to a model of chiropractic care in combination with multidisciplinary providers.
These studies show what most DCs have already experienced, that the doctor of chiropractic should be the principal care provider in these cases. It’s a common opinion that in cases like group III patients, care should be multidisciplinary to achieve the best possible outcome in difficult scenarios.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please ask Dr. Jimenez or contact us at 915-850-0900.By Dr. Alex Jimenez
Additional Topics: Automobile Accident Injuries
Whiplash, among other automobile accident injuries, is frequently reported by victims of an auto collision, regardless of the severity and grade of the accident. Whiplash is generally the result of an abrupt, back-and-forth jolt of the head and neck in any direction. The sheer force of an impact can cause damage or injury to the cervical spine and the rest of the spine. Fortunately, a variety of treatments are available to treat automobile accident injuries.
While bruising, soreness, and scrapes are common, whiplash and chronic whiplash injuries may not show for several days or weeks. While today’s vehicles are safer than ever, they can still only do so much when it comes to the body and musculoskeletal health. Being involved in an automobile accident, even a light tap can give a sudden jolt to the spine that although the individual might not have felt anything like discomfort or pain, it was enough to shift the disc/s out of place or set them up to shift out of place. No one wants to be involved in a car or motorcycle accident, but regardless of good driving habits, or how advanced the safety features on the vehicle might be, the average driver will be involved in three to four automobile accidents in their life.
Whiplash
Whiplash and chronic whiplash injuries are common in motor vehicle accidents. More than 3 million Americans will see a doctor and a chiropractor for automobile accidents and whiplash effects. It only takes a 2.5 mph hit to cause an injury. And whiplash doesn’t only happen when hit from behind, there are several ways an individual can be subjected to whiplash, including being T-boned, amusement park rides, and falling off a bicycle or a horse.
Symptoms
Most whiplash symptoms develop in the first twenty-four hours, but this is not always the case. Common symptoms include:
Most individuals realize they have whiplash a day or two after, but for others, it can take a few weeks or even months to present. Whiplash is classified by degree or grade:
Grade 0
The individual has no complaints and there are no symptoms/signs of physical injury.
Grade 1
There is neck pain but there are no physical signs of injury.
Grade 2
There are signs/symptoms of musculoskeletal damage and neck pain is presenting.
Grade 3
There are signs/symptoms of neurological damage and neck pain is presenting.
The average amount of time most individuals stay home from work is around 40 days. However, when whiplash pain lasts longer than a few weeks, it is deemed to be chronic whiplash.
Chronic Whiplash
Some individuals with whiplash experience painful symptoms for years. This is true of those that avoid or refuse medical attention and learn to live with it.
Treatment Options
There are very effective methods for treating whiplash and chronic whiplash injuries. Depending on the extent of the injury/s, developing the right treatment/rehabilitation plan requires individual consultation with a chiropractor to discuss options that can include:
Pain Relief
The pain can be excruciating. Over-the-counter pain relievers like ibuprofen for temporary relief. However, the individual will need extended treatment to ensure it does not become chronic pain.
Neck Brace
Neck braces help limit the pain, but should not be worn for more than three or four days. If worn for too long the neck muscles are prevented from gaining the strength needed to support the head.
Don’t Sit For Too Long
Avoid keeping the head in any one position for too long. This includes sitting in bed, watching TV, or working at a desk. This places a large amount of pressure and stress on the neck, making the pain even more severe and longer-lasting.
Sleeping Properly and Comfortably
For many, it can be difficult to get into a comfortable position when sleeping. Sleeping on the back with the head turned to one side can worsen the pain. Try a high-quality ergonomic pillow that allows the individual to sleep on their side and takes the pressure off of the neck.
Spinal Alignment
Whiplash can cause the spine to shift out of alignment. This can lead to additional problems in the back or shoulders. It�s always a good idea to see a chiropractor that specializes in motor vehicle accident injuries to realign the spine and neck, as well as for rehabilitation to strengthen the muscles and prevent further injuries. See a chiropractor for an evaluation of the injuries and develop a customized treatment plan that works for the individual’s condition.
Everyone is different
Some individuals can be stiff and sore for a few days and then are okay with not much pain. Some individuals experience severe pain immediately after the wreck, while others have no pain for days or even weeks. Both scenarios are pretty common. Soft tissue injuries can be very deceiving. Some don�t experience any pain for months after the accident. Many don�t think they need to see a doctor or chiropractor because there is no pain or symptoms. However, underneath serious problems could be getting ready to present including:
Constant headaches
Numbness or pins and needles in the hands or arms
Pain between the shoulder blades
Poor posture
Chronic muscle tension
Painful spasms
Degeneration of the discs
Painful inflamed arthritis
The quick development of arthritis
Sore, tight, or inflexible muscles
Sleep disturbances
Fatigue
Dizziness
Body Composition
A decrease in physical activity
Physical inactivity is a primary factor in the progression of sarcopenia. Resistance exercise can help maintain muscle mass and help build muscular strength. Individuals that are more sedentary can exacerbate the effects of sarcopenia.
A decrease in motor neurons
Aging is accompanied by motor neuron loss resulting from cell death. This leads to a decrease in muscle fiber. This decrease in muscle fibers leads to:
Impaired performance
A reduction in functional capacity
A decreased ability to perform everyday tasks
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The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Axial neck pain is also known as uncomplicated neck pain, whiplash, and cervical/neck strain. They refer to pain and discomfort running along the back or posterior of the neck. Axial is defined as forming or around an axis. This type of pain stays around the neck and immediate surrounding structures. It does not spread/radiate out to the arms, hands, fingers, and other areas of the body. Axial neck pain differs from two other neck conditions. They are:
Cervical radiculopathy describes irritation or compression/pinching of the nerve as it exits the spinal cord. The nerves of the cervical spine are known as the peripheral nerves. They are responsible for relaying signals to and from the brain to specific areas of the arms and hands. The signals sent from the brain are for muscle movement, while signals going to the brain are for sensation.
When one of these nerve/s gets irritated, inflamed, or injured, it can result in:
Muscle pain
Weakness
Numbness
Tingling sensation
Burning pain
Other types of abnormal sensations in the arms, hands, or fingers.
Cervical myelopathy describes compression of the spinal cord itself. The spinal cord is the information highway/pipeline to all parts of the body. There is a range of symptoms that can include:
Same symptoms as cervical radiculopathy
Balance problems
Coordination problems
Loss of fine motor skills
Bowel and bladder incontinence
Axial neck pain
Axial neck pain is a quite common type of neck pain. It affects around 10% of the population. However, the majority of these cases do not involve severe symptoms that limit daily activity.
Symptoms
Pain in the back of the neck is the primary and most common symptom. Sometimes the pain travels to the base of the skull, shoulder, or shoulder blade. Other symptoms include:
Neck stiffness
Headaches
Localized muscle pain
Warmth
Tingling
Developmental Risk factors
Poor posture, lack of ergonomics, and muscle weakness increase the chances of developing axial neck pain. Risk factors for development include:
Age
Trauma – Auto accident, sports, personal, work injury
Headaches
Depression
Chronic neck pain
Sleep problems
Diagnosis
Based on symptoms and physical exam findings are how a diagnosis is usually achieved. A doctor will typically order an x-ray, CT, or MRI of the cervical spine. This calls for an immediate visit to a hospital/clinic for evaluation. There could be severe symptoms that could indicate something more dangerous, causing pain like infection, cancer, or fracture. These symptoms include:
Prior trauma/injury from a fall, automobile accident, sports, work injury
Fever
Weight loss
Night sweats
Constant night pain
Rheumatic conditions/diseases that cause neck pain can include morning stiffness and immobility that gets better as the day progresses. If symptoms continue for more than 6 weeks, imaging of the spine could be recommended, especially for individuals that have had previous neck or spine surgery or if it could be cervical radiculopathy or myelopathy.
Treatment
There is a wide range of treatment options. Surgery is rarely required except for severe cases. Returning to normal activities almost right away is one of the most important things to prevent the pain from becoming chronic. First-line treatments typically begin with:
Physical therapy
Chiropractic
Stretching routine
Strengthening exercises
Acetaminophen
Anti-inflammatory medication/s
Muscle relaxants are sometimes prescribed
If a cervical spine fracture has been diagnosed, a neck brace could be recommended for short-term use. A soft collar could be utilized if the pain is severe, but a doctor usually discontinues use after 3 days. Other non-invasive treatment options include:
Invasive treatments like injections, nerve ablation, and surgery are rarely required. But if necessary, it can be beneficial for those cases.
Causes
A variety of the neck’s anatomical structures can contribute to the pain. Common causes include:
Poor posture
Age
Degeneration
Ergonomics
Injury to muscles or ligaments
Arthritis
All of these can affect vertebral bodies, discs, and facet joints. Shoulder arthritis or a rotator cuff tear can imitate axial neck pain. Dysfunction of the temporomandibular jaw joint or the blood vessels of the neck can cause axial pain, but it is rare.
Prognosis
Symptoms are usually alleviated within 4-6 weeks from when the pain started. Pain that continues beyond this should encourage a visit to a chiropractic physician.
Physical therapy involves both passive and active treatments and�is an effective treatment for whiplash, especially combined with other treatments, like bracing and chiropractic. Whiplash causes the soft tissues in your neck to get damaged. A physical therapist can work with you to restore proper function and movement of those tissues.
Passive treatments help to relax tension in the muscle tissues brought on during the accident in the neck and body. It is considered a passive treatment because the patient does not actively participate. Fresh from the injury acute pain sets in, therefore passive treatment is usually the first type of therapy used as your body begins to heal and adjusts to the symptoms.
The primary goal of physical therapy is to get the patient actively participating in active treatment until they can do the exercises on their own. The therapeutic exercises that physical therapists teach to a patient are for strengthening your entire body to ensure that your spine is optimally supported.
Passive Treatment
Deep Tissue Massage
This technique focuses on tight muscle tension that develops from the injury. Direct pressure is applied and massaged to release the tension in the soft tissues like the:
Ligaments
Tendons
Muscles
This will help these tissues heal quicker and keep them loose.
Hot/Cold Therapy
Heat therapy is used by physical therapists to circulate more blood to the injured area. Increased blood flow allows more oxygen, and nutrients to the area. Blood also removes the waste products created by muscle spasms.
Cold therapy slows the blood’s circulation, which helps to reduce inflammation, muscle spasms, and pain. Physical therapists alternate between hot and cold therapy depending on the patient’s condition.
Whether in a car accident or other type of trauma hot and cold therapy can be used at home. Ice should be used first to bring down the inflammation. After 24 to 48 hours, switch between ice and heat. The heat helps relax tense muscles and increases blood circulation to the injured area. Never put ice or heat directly on the skin, wrap in a towel then apply.
Ultrasound
Ultrasound helps reduce muscle:
Cramping
Pain
Spasms
Stiffness
Swelling
Sound waves are sent deep into the muscle tissues and create a gentle heat that circulates the blood that optimizes the healing process.
Active Treatment
When the active part of the therapy begins, the therapist will teach/train you a variety of exercises to work on strength and range of motion or how the joints move with ease or not. Each physical therapy program is customized to each patient’s condition, health, and medical history.
Some exercises might not be appropriate for someone else with a whiplash injury as they could worsen their symptoms and exacerbate the injury. Learning how to correct your posture and utilizing ergonomics into your regular daily activities is part of the therapy program. Once recovered this posture work will continue to help because of the training/exercising you can prevent other forms of neck pain that develop from regular life.
Physical therapy for whiplash patients helps reduce muscle spasms, increase blood circulation, and promote healing of the neck tissues.
Spinal Bracing Another Treatment Option
Whiplash is very treatable, another option is using a cervical brace or cervical collar. The brace provides support to the neck while the soft tissues heal. The soft tissue’s job is to support your neck, but when they’re injured, they can’t do their job. That’s where the brace comes in.
Cervical devices limit the neck’s movement and support your head, which takes the weight off the neck.
This allows the muscles to rest while they heal. Your doctor will inform you of how long you need to wear the brace. Generally, it is worn for two to three weeks. The doctor will explain how to wear the collar, which means how long to weary it each day, caring for the collar, handling daily activities like showering, sitting, sleeping, etc. Symptoms usually subside in two to three weeks. However, if there is still pain, soreness, or other symptoms, you may have to try other treatments.
Whiplash Massage Therapy El Paso, TX Chiropractor
�NCBI Resources
After a car accident, you may notice neck pain.�It could be a�slight soreness that you think is nothing but take care more than likely you have whiplash.�And that�little soreness can turn into a lifetime of chronic neck pain�if only treated with pain meds and not�treated at the source.
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