Osteopathy Journals and Research by Darren Chandler

 

Whiplash

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Contents

  • What is whiplash?
  • The symptoms of whiplash
  • Injuries caused by whiplash
  • The treatment of whiplash
  • In summary

What is whiplash?

Whiplash is an injury caused by a rapid ‘jolt’ (rapid acceleration and deceleration). The mechanisms of the injury are that of a tail end of a whip when it is rapidly shook.

The symptoms of whiplash

Typically whiplash injuries are associated with neck pain but this is not exclusively the case. Whiplash injuries can include(1):

  • Neck pain in 88-100% of cases
  • Headaches in 54-66% of cases
  • Shoulder pain in 40-42% of cases
  • Dizziness in 17-25% of cases
  • Paraesthesia (pins and needles) in 13-62% of cases
  • Visual disturbances in 8-21% of cases
  • Auditory disturbances in 4-18% of cases

This is not a complete list of all symptoms that should be referred to the doctor after a whiplash just the most common that we see in clinic:

  • Pins and needles in both arms and/or legs 
  • Any disturbance in how you walk
  • Deteriorating symptoms that include weakness or altered sensation
  • Pins and needles or numbness around the face
  • Difficulty speaking or swallowing
  • Fainting, dizziness, light headiness or fits 
  • Bladder or bowel problems
  • Memory loss
  • Poor concentration
  • Irritability

Injuries caused by whiplash

Practically any injury can be caused by a whiplash incident especially if you have an underlying condition or injury prior to any whiplash. The most common injury we see in the clinic caused by whiplash injuries is soft tissue(2,3) and joint problems in the spine. Usually this is in the neck and shoulders which can cause headaches but it can be in the low back and pelvis giving symptoms in the legs. Due to the complex nature in which the force from a whiplash injury can go through you a thorough diagnosis is essential. Often the failure to cure whiplash injuries is due to the complex nature of these forces and the injuries it produces not being fully appreciated.

The treatment of whiplash

The treatment of whiplash injuries include:

  • Moving and mobilising the joints by your osteopath as well as treatment to the tight bands of muscles(2,3) can relieve areas of tightness and tension.
  • Exercises: treatment, such as osteopathic manipulative treatment, when combined with exercises prescribed by your osteopath regains function quicker than interventions that advise more rest(4). For this reason you want to avoid excessive rest and the use of soft collars(5).

Patients who have anxiety, are excessively inactive, have low mood or low confidence in being able to perform activities should be given the appropriate advice(5).

This is because when you injure an area the brain acts as an amplifier to the pain. The more you overly worry and think about the pain the worse it can get(6). Practical advice to help with this includes(6):

  • Encourage, without aggravating your symptoms too much, normal relaxed activity and movement to help the pain settle and the body get stronger.
  • Discourage over-protecting the area and avoiding movement.
  • An injured area can be sensitised by awkward movements and postures, muscle tension, inactivity, lack of sleep, stress, worry and low mood.

In summary

Whiplash is a complicated disorder due to the nature of the forces that go through you during the incident. However a thorough diagnosis and appropriate treatment from your osteopath using osteopathic manipulative treatment can reduce areas of tightness and spasm. This when combined with keeping as active as you can without aggravating your symptoms too much encourages movement to help loosen things off.

References

(1) Fracture of the cervical thoracic and lumbar spine (2002). Vaccaro A

(2) Myofascial trigger points in patients with whiplash-associated disorders and mechanical neck pain (2014). Castaldo M, Ge HY, Chiarotto A, Villafane JH, Arendt-Nielsen L.

(3) Myofascial-entheseal dysfunction in chronic whiplash injury: an observational study (2012). QMK Bismil and MSK Bismil

(4) Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (2008). Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S;

(5) Neck pain – whiplash injury. http://cks.nice.org.uk/neck-pain-whiplash-injury. Accessed 5.11.2016

(6) Acute low back pain. Beyond drug therapies. O’Sullivan P & Lin I.  

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