Whiplash and Other Latent Car Accident Injuries

Many patients who come into Northern Nevada Chiropractic after a car accident initially refused medical treatment on the scene of the accident. Patients typically explain that they didn’t have immediate complaints, or did not want to deal with the paramedics on scene because they believed their injuries were not serious.

Unfortunately, the flight or fight response coursing through their bodies is numbing them to the true extent of their injuries. Pain and inflammation may develop later. When this happens, it’s called a “latent injury.” The best course of action is to seek medical treatment immediately, since many injuries, particularly those affecting the soft tissues of the body, may take days or even weeks to become a problem. It’s important to seek early intervention even for minor fender benders, not only to treat the immediate complaints, but more importantly the long-term chronic degenerative changes that could arise.

Auto accidents can cause various types of injuries depending on the circumstances of the collision. Here are some of the more common car accident injuries that should not be ignored:

Whiplash from a Car Accident

The most common injury following a car accident is whiplash. Whiplash, a soft tissue injury to the neck, is also called neck sprain or neck strain. It is characterized by a collection of symptoms that occur following damage to the neck, usually because of sudden extension and flexion, according to the National Institutes of Health. The cervical soft tissue is typically unable to contract quickly enough to overcome the inertia of the accident, causing the musculature to fail. According to a review in the Journal of Bone and Joint Surgery, most whiplash injuries occur as the result of a rear-end crash at speeds of less than 14 mph. This confirms that it is a misconception to directly associate the speed at impact or damage of the car with the impairment to the victims.

Approximately two-thirds of people involved in motor vehicle accidents develop symptoms of whiplash. The symptoms usually do not develop until two to 48 hours after the injury. Although typically associated with auto accidents, whiplash can also occur from falls, sports injuries, work injuries and other incidents involving a sudden acceleration followed by deceleration of the neck.

According to Marshall, 45 percent to 85 percent of people who suffer a whiplash injury have the symptoms five years after the accident, and 82 percent had a straightening or reversal of their cervical curvature.2

Most people associate whiplash with pain. There are a number of other symptoms that could also arise. Dizziness, difficulty swallowing, nausea, vertigo, lethargy, neurologic deficits, incoordination, confusion and emotional distress are just a number of symptoms associated with whiplash. These symptoms typically occur within the first 48 hours post trauma, but have been known to start one to two weeks following the car accident.

Not every whiplash-type injury warrants medical treatment, but the importance of the examination can’t be understated. If your doctor’s examination justifies an x-ray, it’s not just to see if a fracture is present. One important aspect an x-ray can determine is the presence of vertebral instability. Instability occurs when the results of the impact cause the ligaments (what connects bone to bone) to rupture enough that there is excessive motion between the vertebral levels. If this is present, the potential for spinal cord damage multiplies. Drifting motion in the vertebral levels left unchecked can also cause early onset degenerative changes, such as osteoarthritis. This is relatively easy to diagnose, but the condition does not always present with sharp pain.

Long-Term Whiplash

Whiplash that lasts for six months or more is known as chronic whiplash or late whiplash syndrome. Typically, these patients have less than optimal long-term prognosis.
There’s little in the way of scientific evidence to suggest which treatments are most effective for long-term whiplash. Many of these patients turn to pain medications and opioids to cope. A conservative approach should always be the starting point over drugs or surgery. Possible co-management between your doctors and a professional cognitive specialist/counselor has been shown to be beneficial. The brain chemistry in these patients is likely to be affected at this stage.

Chiropractic care is also very beneficial for those experiencing late whiplash. A retroactive study by Woodward et al. published in Injury demonstrated that chiropractic treatment benefited 26 of 28 patients suffering from chronic whiplash syndrome.3 Chiropractic care in this study included spinal manipulation, proprioceptive neuromuscular facilitation stretching (an advanced form of flexibility training, which involves both the stretching and contracting of the muscle group), and cryotherapy (ice-pack therapy).

Brain Injuries After a Car Accident

Concussions occur when the head strikes a hard surface and damages the brain, interfering with its function. Concussions do not always occur following a loss of consciousness. It is important to get evaluated by a trained professional. Initially a CT scan or MRI may be warranted to see if there is brain swelling or possible hemorrhaging. Many of the post-concussion patients NNC sees were unaware they were experiencing low-grade concussion symptoms. These include complaints such as increased difficulty remembering where they are driving, inability to concentrate, loss of smell, inability to focus eyesight, nausea, or a feeling generally sick or “off”. The earliest these symptoms can be diagnosed, the better the long-term results.

Many patients have altered sensation in the upper extremities following a whiplash injury. When symptoms are numbness or tingling instead of pain, the patients may attempt to ignore the complaint. This could be a serious sign of cervical radiculopathy, which is pressure on the nerves that exit the neck traveling to the arms. Think of an exposed nerve in a tooth, if left unchecked, the nerve can die, resulting in a root canal. For the nerves exiting the spinal cord through the upper extremity, this could lead to surgery or permanent impairment, which may have been prevented with a series of simple isometric cervical strengthening exercises and stretches.

Get professional help with your car accident injuries to prevent long-term issues

As previously mentioned, early detection of whiplash is vital to overall prognosis. Every case needs to be treated individually, and will need different treatment modalities and interventions. In more severe cases, advanced imaging may be required for proper diagnosis. In cases where there are mild headaches with stiffness, treatment may consist of a light mobilization routine and monitoring of neurologic symptoms. Your chiropractor will determine if your car accident injuries requires at-home only rehabilitation vs a more structured program. The doctors at Northern Nevada Chiropractic are trained to treat and prevent latent whiplash from transferring in to long-term chronic disability.

Sources:

1. www.ninds.nih.gov/disorders/whiplash/whiplash.htm
2. Marshall D. Correlation of cervical lordosis measurement with incidence of motor vehicle accidents. ACO5.3 1996:79-85.
3. Woodward MN, Cook JCH, Gargan MF, Bannister GC. Chiropractic treatment of chronic whiplash injuries.Injury 1996;27:643-645)