Whiplash Injuries

History

For many people today, the word “whiplash” is often associated with a fraudulent injury concocted by an individual seeking unjust financial enrichment at another’s’ expense. This word, “whiplash” and associated injuries, has been so demonized in today’s medico-legal system that most researchers have discontinued the use of the word altogether.

Back in the 19th century, railroad passengers sometimes complained of headaches, neck pain and other strange symptoms after seemingly minor collisions between passenger cars. As a result of the subjective nature of these claims, and the fact that many of the people were filing claims for these injuries, the term" railway spine" emerged. Not surprisingly, the term “railway spine" enjoyed the same stigma then as the term “whiplash" enjoys today.

Researchers today often use such terms as “whiplash associated disorders” (WAD), “cervical acceleration/deceleration injury” (CAD), or simply “soft tissue injuries” or “cervical strains or sprains”. Regardless of what ever word or term one chooses to use, whiplash is a serious injury which, for some, can become a lifelong ordeal to suffer.

Anatomy of a whiplash

Studies suggest that as many as 10% of whiplash injuries result in permanent disabilities. In spite of a plethora of studies suggesting otherwise, comments from those unfamiliar with the scientific literature might include," it's only a soft tissue injury." But these injuries are complex and can involve, quite literally, any and all of the tissues of the neck. These tissues might include the muscles, the discs, the ligaments, the tendons and the joint capsules. Even fractures to the vertebral bones of the neck can occur during a whiplash event.

Spinal fractures are seen in only a small number of rear end collisions. Such spinal fractures are extremely serious and require immediate medical attention. Though serious, most broken bones will usually heal within eight weeks. And unless there is an associated nerve injury or paralysis, broken bones often heal without any residual pain or dysfunction.

On the other hand, some soft tissues, once injured, are never restored to a normal state. Some injured soft tissues can generate pain for the rest of a person’s life. Damage done to a joint’s support ligaments could allow for the instability of that joint. Years later, this joint instability could contribute to the development of an arthritic joint condition.

Whiplash propaganda

Insurance companies and defense lawyers often promote the claim that if there is no damage done to the car then there could be no significant injury to the occupants. This is ludicrous. Some studies show that the likelihood of injury increases when there is little or no damage done to the car. Trying to assess the extent of a car crash occupant’s injury by examining the damage done to his car would be as silly as trying to predict the extent of a person’s injury by examining the damage done to the sidewalk he fell onto.

The potential for injury has been shown to be related to the occupants change in velocity with respect to the interval of time in which this change in velocity occurs. This means that high speeds are not necessary for occupant injuries to occur. For instance, when space shuttle astronauts blast off into space, they can be accelerated to speeds of up to 18,500 MPH – without injuries. There are no injuries because this velocity is achieved over an extended period of time (60 minutes or 3,600 seconds) and only subjects the occupants to about 0.24 g’s.

The change in velocity of a car in a rear end collision might be less than 8 MPH. And as unimpressive of a speed as 8 MPH is, this change in velocity takes place in a very short time interval of only 1/3 of a second. This equates to about 1.9 g’s of acceleration – an acceleration speed at which real world occupant injuries do occur.

Mechanics of the whiplash

Whiplash injuries often occur when a car is struck from behind by another car. The risk of injury depends on multiple factors. Factors such as the relative size of the involved vehicles, the speeds of the collision, the type of headrests in the vehicle and whether your headrest was properly adjusted, pre-existing injuries or medical conditions and degree of awareness of the impending collision are certainly at the top of this red flag list of whiplash risk factors.

Adding to the difficulty of documenting the extent of an occupant injury is that the more common features of a whiplash injury are difficult to assess. This is because many of these injuries do not easily show up on x-rays, MRI’s or CT scans.

For most, a thorough history combined with a careful physical examination is crucial. Many of those suffering whiplash injuries are taken to the emergency room. There, doctors concerned with the diagnosis and treatment of life-threatening injuries, usually fail to find any whiplash injuries which are life-threatening. Most whiplash cases are then referred on to primary care or family doctors. Aside from pain medication, anti-inflammatory drugs and muscle relaxers, there is often little else medical care can offer.

Treatment of Whiplash

If symptoms persist, some medical doctors will recommend a trial of chiropractic care or physical therapy. I believe chiropractic care of these injuries will yield the best results - especially if proper treatment is initiated within 24 hours of the crash. Some chiropractic doctors pursue advanced training in the care of auto crash related injuries. Coursework I have taken myself has included live, instrumented car crashes using human volunteers.

This additional training can be critical when accurate diagnoses stem from an in depth understanding of the mechanics of the actual car crash. In the event a claim is contested, it may be necessary for the treating doctor to provide expert testimony. Few medical doctors or physical therapists are capable of providing the range of services needed in such contested cases.

Whiplash chronicity

As mentioned previously, whiplash is a serious injury and some never fully recover. In the US, studies demonstrate that roughly 770 people will be injured for every 100,000 people that are rear-ended. Conservatively speaking, if we assume 75% of those injured will fully recover from their whiplash injuries, each year another 500,000 people will be added to the list of chronic sufferers (the actual reported recovery number is closer to 50%). Using this conservative 75% figure, almost 7% of all Americans would become chronic sufferers in only a twenty-five year period.

Chiropractic and whiplash

Many people so afflicted by these, potentially, lifelong, painful soft tissue injuries find tremendous benefit from a trial of chiropractic care. Sometimes, in spite of improper initial care, these cases can be resolved quite satisfactorily. Certainly selecting the right type of care from the start is advantageous.

Whiplash sufferers will sometimes seek what they believe to be the top tiered services of an orthopedic or neurosurgeon. But as skillful as a gifted surgeon may be when compared to a family or chiropractic doctor, whiplash injuries rarely require surgical intervention. There simply is nothing to cut out or stitch up with the majority of whiplash injuries.

And the moment that contemplated surgical intervention is ruled out, non-surgical care is ruled in. As conservative care specialists, chiropractic doctors are well suited for the care of most whiplash injuries.

Your whiplash plan

Surely if one is concerned with the possibility of an injury being life-threatening one should immediately present oneself to the nearest emergency room. But many car crash injuries are not apparent until hours, if not days, after the crash.

Often times those prescribed medications by their family physicians are made more comfortable initially. When symptoms return as the prescriptions run out many are told that their recovery will just take some time. But allowing these whiplash injuries and the related dysfunction, swelling and accumulation of scar tissue to progress over time actually increases the risk of permanent pain or disability.

Chiropractic doctors are specially trained to treat soft tissue conditions of a whiplash event. In fact, some chiropractors receive special training in the assessment and care of whiplash injuries.

Many of the conditions chiropractors treat in their offices every day are referred to as “functional conditions” as opposed to pathological conditions. The functional conditions often seen with whiplash are unlikely to show up on standard x-rays, MRI’s or CT scans. The Doctor of Chiropractic (DC) specializes in the nonsurgical care of nerve, muscular and skeletal conditions. Some chiropractors even have additonal training in auto crash trauma (Please see my training below).


Whiplash is a condition well-suited for safe, reliable chiropractic care.

If you or someone you know is suffering from a whiplash injury, please call my office for an appointment.

[1] Whiplash Trauma Certification, Los Angeles Chiropractic College - 1996

[2] Advanced Whiplash Certification Course, Spine Research Institute of San Diego - 1996

[3] Motor Vehicle Collision Injuries, Louisiana Union of Chiropractic Physicians - 1998

[4] Collision Analysis Reconstruction for the Medical Practitioner, Texas A&M University - 1999

[5] Human Crash Testing, Spine Research Institute of San Diego in cooperation with Texas A&M University and the United States Navy -1999

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