Back Clinic Personal Injury Chiropractic Team. Injuries from an accident can not only cause physical harm to you or a loved one, being involved in a personal injury case can often be a complicated and stressful situation to handle. These types of circumstances are unfortunately fairly common and when the individual is faced with pain and discomfort as a result of trauma from an accident or an underlying condition that has been aggravated by the injury, finding the right treatment for their specific issue can be another challenge on its own.
Dr. Alex Jimenez’s compilation of personal injury articles highlights a variety of personal injury cases, including automobile accidents resulting in whiplash, while also summarizing various effective treatments, such as chiropractic care. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
The function of the arm is to allow for movement of the wrist and hand. Various muscles initiate the arm’s actions, large muscles flex and extend, pronate and supinate, and the more sensitive muscles allow fine motor control. Lifting capacity and grip strength come from the arm muscles, making them essential for all types of activities. Because of the many functions and jobs the hands and arms do, added stress is placed on them. Arm discomfort symptoms, radiating pain, weakness, numbness, and tingling are common conditions. Chiropractic care can relieve injury symptoms and restore mobility and function.
Arm Discomfort Symptoms
The muscles of the upper arm, the biceps, and the triceps, control the movement and positioning of the elbow joint, and the muscles of the forearm control the wrist and hand. There are 30 bones from the top of the arm to the tip of the finger that include:
The humerus in the upper arm.
Ulna and radius in the forearm.
Carpal bones in the wrist.
Metacarpals and phalanges make up the hand and fingers.
The joints allow movement between the bones and are stabilized by ligaments and joint capsules.
Symptoms
Discomfort or Radiation
Symptoms vary based on the severity of the injury but commonly include.
Numbness and tingling in the elbow, forearm, or hand can develop.
Pain sensations often radiate to other areas.
Causes
Individuals that work with their hands related to work, home tasks, sports, or hobby activities, such as construction workers, hair stylists, store cashiers, graphic artists, automotive technicians, carpenters, painters, butchers, and more, have an increased risk of injury and developing chronic conditions. Work that involves manually cutting, writing, typing, gripping, operating motorized tools, hair clippers, working with animals, etc., makes the arms susceptible to injury from the constant stress on the ligaments. Common overuse injuries affecting the upper extremity include:
Carpal Tunnel Syndrome and Cubital Tunnel Syndrome
These conditions involve the nerves of the forearm.
Prolonged or repetitive bending or flexing of the wrist or elbow can generate swelling pressure that compresses the nerve/s.
Symptoms include numbness, coldness, tingling, and/or weakness in the hand and fingers.
Tennis, Golfer, and Pitcher Elbow
These conditions involve the inflammation of the tendon structures surrounding the elbow joint.
Repeating the same motion over and over causes damage.
This leads to tenderness and pain inside and surrounding the elbow.
De Quervain’s syndrome affects tendon structure in the wrist.
Swelling near the base of the thumb.
Individuals have difficulty grasping objects.
This is common for landscapers, gardeners, and sports where constant gripping is involved.
Tendonitis
Tendons attach muscles and bones
The condition causes tendon inflammation, presenting pain in the area around single or multiple joints.
Common types include wrist tendonitis, pitcher’s shoulder, and swimmer’s shoulder.
Tendon Tears
Overuse and frequent stress from continuous motion can wear tendons to the point of partial or complete tearing.
Rotator cuff tears in the shoulder are often caused by overuse wearing down.
Chiropractic Treatment
Chiropractic and massage therapy can rehabilitate arm injuries, restore function and reduce arm discomfort symptoms. Treatment includes:
Ice or heat treatment.
Manual therapy – soft tissue massage and trigger point alleviation.
Joint mobilization.
Taping or bracing support.
Rehabilitation targeted exercises.
Work and sports modification training.
Training on upper extremity overuse, practicing caution, and knowing when to seek professional medical help.
Shoulder Pain Rehabilitation
References
Bass, Evelyn. “Tendinopathy: why the difference between tendinitis and tendinosis matters.” International Journal of therapeutic massage & Bodywork vol. 5,1 (2012): 14-7. doi:10.3822/ijtmb.v5i1.153
Cutts, S et al. “Tennis elbow: A clinical review article.” Journal of Orthopaedics vol. 17 203-207. 10 Aug. 2019, doi:10.1016/j.jor.2019.08.005
Hoe, Victor C W, et al. “Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults.” The Cochrane Database of systematic reviews vol. 2012,8 CD008570. 15 Aug. 2012, doi:10.1002/14651858.CD008570.pub2
Konijnenberg, H S et al. “Conservative treatment for repetitive strain injury.” Scandinavian Journal of Work, Environment & Health vol. 27,5 (2001): 299-310. doi:10.5271/sjweh.618
Luger, Tessy, et al. “Work-break schedules for preventing musculoskeletal symptoms and disorders in healthy workers.” The Cochrane Database of systematic reviews vol. 7,7 CD012886. 23 Jul. 2019, doi:10.1002/14651858.CD012886.pub2
Pitzer, Michael E et al. “Elbow tendinopathy.” The Medical Clinics of North America vol. 98,4 (2014): 833-49, xiii. doi:10.1016/j.mcna.2014.04.002
Verhagen, Arianne P et al. “Conservative interventions for treating work-related complaints of the arm, neck or shoulder in adults.” The Cochrane Database of systematic reviews vol. 2013,12 CD008742. 12 Dec. 2013, doi:10.1002/14651858.CD008742.pub2
Zaremski, Jason L et al. “Sport Specialization and Overuse Injuries in Adolescent Throwing Athletes: A Narrative Review.” Journal of athletic training vol. 54,10 (2019): 1030-1039. doi:10.4085/1062-6050-333-18
Many individuals are constantly in their vehicles and driving from one place to another in the quickest amount of time. When auto accidents occur, numerous effects can affect many individuals, especially their bodies and mentality. The emotional impact of an auto accident can change a person’s quality of life and take a toll on the person as they become miserable. Then there is the physical side, where the body lunges forward rapidly, causing excruciating pain in the upper and lower portions. The muscles, ligaments, and tissues become overstretched beyond their capacity causing pain-like symptoms to develop and overlap other risk profiles. Today’s article discusses the effects of an auto accident occurs on the body, the symptoms associated with auto accidents, and how treatment like chiropractic care utilizes techniques like the MET technique to assess the body. We provide information about our patients to certified medical providers that offer available therapy techniques like MET (muscle energy techniques) for individuals dealing with back and neck pain associated with auto accidents. We encourage each patient appropriately by referring them to our associated medical providers based on their diagnosis results. We accept that education is a spectacular way when asking our providers the most crucial questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., assesses this information as an educational service. Disclaimer
The Effects Of An Auto Accident On The Body
Have you been dealing with excruciating pain in your neck or back after an automobile collision? Have you noticed any of your muscles feeling stiffed or strained? Or have you been dealing with unwanted pain-like symptoms affecting your daily life? When a person has been through an auto accident, the spine, neck, and back along with their associated muscle groups, are affected by pain. When it comes to the effects of an auto accident on the body, we have to look at how the body reacts when the vehicles collide. Research studies have revealed neck pain is a common complaint to many adults involved in an auto accident. When a person collides with another car, their necks are lunged forward rapidly, causing a whiplash effect on the neck and shoulder muscles. Not only the neck is being affected, but also the back. Additional studies have mentioned that low back pain associated with vehicle collisions can cause the lumbar back muscles to be overstretched and develop non-fatal physical injuries over time, either during or the day after the accident. To that point, it can lead to unwanted symptoms associated with auto accidents and correlate with overlap risk profiles.
Symptoms Associated With Auto Accidents
The symptoms associated with auto accidents affecting neck and back muscles vary depending on the collision’s severity. According to “Clinical Application of Neuromuscular Techniques,” Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., stated that when someone suffers from an auto accident, the traumatic forces affect not only the cervical or temporomandibular muscles but also the lumbar muscles. This causes the muscle tissue fibers to be torn and damaged, which causes muscle pain. The book also mentioned that a person injured in a collision could develop nociceptive modulated neck, shoulders, and back muscle dysfunction. To that point, the flexor and extensor muscles are hyperextended, shortened, and strained, which is the result of causing muscle stiffness, pain, and limited range of motion to the neck, shoulder, and back.
Unlocking Pain Relief: How We Assess Motion To Alleviate Pain-Video
Have you been experiencing a limited range of motion to your shoulders, neck, and back? What about feeling muscle stiffness when stretching? Or do you feel muscle tenderness in certain body areas after an auto accident? Many of these pain-like symptoms are associated with auto accidents affecting the neck, shoulders, and back. This causes constant body pain, and many issues develop over time in the various muscle groups. Luckily there are ways to reduce the pain and help restore the body to function. The video above explains how chiropractic care is used to assess the body through spinal manipulation. Chiropractic care uses various techniques to help with spinal subluxation and loosen up stiff, tight muscles to help relax and restore each muscle group while relieving unwanted pain from the muscle tissues and ligaments.
Chiropractic Care & The MET Technique Assessing The Body
Studies reveal that auto accidents are a major cause of spinal and muscle injuries treated by chiropractic care. When a person suffers after an auto accident, they will experience pain all over their bodies and try to find ways to relieve the pain affecting their daily lives through treatment. One of the treatments that can help reduce pain and restore the body is chiropractic care. When chiropractors are treating the body to reduce pain, they use various techniques like the MET technique (muscle energy technique) to stretch and strengthen soft tissue and use manual manipulation to realign the spine, work out the tight muscles, nerves, and ligaments to prevent further damage on the body while getting the affected individuals back to shape. Chiropractic care also has a close relationship with other treatments like physical therapy to help strengthen the muscles in the body and help many people be aware of how their bodies function.
Conclusion
Overall, when a person has experience pain in their back, neck, and shoulder muscles from an auto accident, it can affect their emotional and physical well-being. The effects of an auto accident cause unwanted pain symptoms to develop and correlate with nociceptive modulated dysfunction. To that point, it can cause issues like muscle stiffness and tenderness in the affected areas. Fortunately, treatments like chiropractic care allow the body to be restored through manual manipulation and the MET technique to gently stretch the soft tissues and muscles and realign the body back to functioning. Incorporating chiropractic care with the MET technique, the body will experience relief, and the host can be pain-free.
References
Chaitow, Leon, and Judith Walker DeLany. Clinical Application of Neuromuscular Techniques. Churchill Livingstone, 2002.
Dies, Stephen, and J Walter Strapp. “Chiropractic Treatment of Patients in Motor Vehicle Accidents: A Statistical Analysis.” The Journal of the Canadian Chiropractic Association, U.S. National Library of Medicine, Sept. 1992, www.ncbi.nlm.nih.gov/pmc/articles/PMC2484939/.
Fewster, Kayla M, et al. “Low-Velocity Motor Vehicle Collision Characteristics Associated with Claimed Low Back Pain.” Traffic Injury Prevention, U.S. National Library of Medicine, 10 May 2019, pubmed.ncbi.nlm.nih.gov/31074647/.
Vos, Cees J, et al. “Impact of Motor Vehicle Accidents on Neck Pain and Disability in General Practice.” The British Journal of General Practice : the Journal of the Royal College of General Practitioners, U.S. National Library of Medicine, Sept. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2529200/.
Automobile collisions, work, sports, and personal accidents can cause neck injuries that can affect other areas, leading to long-term health problems. Neck injuries involving soft tissue damage frequently persist after the incident. One of the injuries includes vocal cord damage caused by impact to the larynx. The larynx, or voicebox, is an organ that is behind the Adam’s apple. A neck injury impacting the larynx can affect the ability to speak and breathe and cause vocal cord paralysis. Treatment can involve surgery, voice therapy, physical therapy, and chiropractic.
Vocal Cord Injury
The vocal cords are two flexible bands of muscle tissue at the entrance of the trachea. The vocal cords are normally in a relaxed open position to allow breathing. When talking, the bands combine and vibrate to make a sound. Surgery, viral infections, certain cancers, and neck trauma can cause vocal cord paralysis. In this condition, nerve damage blocks or inhibits impulses from transmitting to the voice box. The muscles, usually one of them, become paralyzed, preventing swallowing and ingesting saliva through the windpipe/trachea. In rare cases, both muscles are unable to move.
Trauma to the neck or chest can injure the voice box nerves.
Infections
Infections like Lyme disease, Epstein-Barr virus, and herpes can cause inflammation and nerve damage.
Tumors
Tumors, cancerous and noncancerous, can grow inside or around the muscles, cartilage, and nerves.
Neurological
Neurological conditions like multiple sclerosis or Parkinson’s disease can lead to vocal cord paralysis.
Surgical Injury
Surgical procedure mistakes or complications on or near the neck or upper chest can result in damage to the voice box nerves.
Surgeries to the thyroid or parathyroid glands, esophagus, neck, and chest have an increased risk.
Stroke
A stroke chokes blood flow to the brain and can damage the region of the brain that transmits messages to the voice box.
Treatment
Treatment is determined by a doctor based on the individual medical condition and diagnostic tests. Treatment can involve:
Speech Therapy
Speech therapy is recommended as the laryngeal muscles are strengthened through various exercises, improving breathing function. A speech therapist will begin working with the individual on exercises targeting the weakened vocal folds by enhancing airflow and blood circulation.
Physical Therapy and Chiropractic
Treatment involves performing gentle exercises that work on the vocal cords gradually and progressively but does not stress them. Chiropractors work with the physical therapist performing high-velocity, low-amplitude manipulation targeted at the lower neck and upper thoracic area, the C3/T1 vertebrae. A treatment plan will also use massage, non-surgical decompression, instrument/tool-assisted soft-tissue mobilization, low laser or ultrasound, and at-home stretches and exercises.
Surgery
Surgery could be necessary for individuals experiencing no improvement despite doing the prescribed speech and physical therapy exercises. Different types of procedures are based on the degree and extent of the paralysis:
Injections – Collagen and fillers are injected into the vocal cords to reposition the affected muscles closer to the larynx.
Phonosurgery – The vocal cords are repositioned through restructuring.
Tracheotomy – If the vocal folds are closing, a surgeon may make an incision in the neck at the opening of the windpipe and insert a breathing tube. This bypasses the air blockage caused by the vocal folds and promotes proper air circulation.
Cervical Spine Instability
References
Chen, Ching-Chang, et al. “Long-term result of vocal cord paralysis after anterior cervical discectomy.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 23,3 (2014): 622-6. doi:10.1007/s00586-013-3084-y
Dankbaar JW, et al. Vocal cord paralysis: Anatomy, imaging, and pathology. Insights in Imaging. 2014; doi:10.1007/s13244-014-0364-y.
Fitzpatrick, P C, and R H Miller. “Vocal cord paralysis.” The Journal of the Louisiana State Medical Society: official organ of the Louisiana State Medical Society vol. 150,8 (1998): 340-3.
Kriskovich, M D et al. “Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury.” The Laryngoscope vol. 110,9 (2000): 1467-73. doi:10.1097/00005537-200009000-00011
Waddell, Roger K. “Chiropractic care for a patient with spasmodic dysphonia associated with cervical spine trauma.” Journal of chiropractic medicine vol. 4,1 (2005): 19-24. doi:10.1016/S0899-3467(07)60108-6
Slip and fall accidents are among the most common causes of workplace/job injuries and can happen anywhere. Work areas can have all kinds of slipping or tripping hazards, including uneven or cracked floors, equipment, furniture, cords, wet floors, and clutter from debris. Individuals involved in a slip-and-fall accident can sustain injuries that vary in severity. The key is to see a doctor or chiropractor immediately to document the slipping and falling injuries and develop a personalized treatment and rehabilitation plan. Injury Medical Chiropractic and Functional Medicine Clinic can help.
The type of injury and degree of severity depends on physical and biological factors present during the slipping and falling. These include:
Physical Condition
An individual’s age, size, gender, and health can influence the type of injury sustained.
Height and Location of the Fall
Slipping, tripping, stumbling, or tumbling injuries could be minimal to severe, depending on the force, height, and location.
Surface Impact
The acceleration during the fall and how the body impacts the surface play an important role in the severity of the injury.
Body Position
Protective reflexes, such as outstretched arms, to break the fall or whether or not the body hit the ground directly determine the injury and to what extent.
Symptoms
Muscle pain and tension are the most common symptoms after slipping and falling.
The muscle fibers overstretch, causing inflammation and swelling to develop.
The pain can often start immediately after or a few days later, known as delayed injury symptoms.
If the nerves sustain injury or irritation, they begin to swell, and the body responds to protect the damaged areas.
The contact inflammation and irritation can cause tightness and spasms.
Continuing ongoing discomfort and pain.
Stomach discomfort and pain.
Significant bruising.
Limitations in movement.
Chiropractic Treatment
Chiropractors are experts in slip-and-fall injuries and will use adjustments and various therapy protocols to realign the body and restore function. The objective is to relieve symptoms, rehabilitate the injured area/s, and regain mobility. Physical therapy and strength-building exercises under a specialist’s supervision and at home are implemented to get back the use of the injured body part.
Inflammation
References
Li, Jie, et al. “Slip and Fall Incidents at Work: A Visual Analytics Analysis of the Research Domain.” International journal of environmental research and public health vol. 16,24 4972. 6 Dec. 2019, doi:10.3390/ijerph16244972
Pant, Puspa Raj et al. “Home-related and work-related injuries in Makwanpur district, Nepal: a household survey.” Injury prevention: journal of the International Society for Child and Adolescent Injury Prevention vol. 27,5 (2021): 450-455. doi:10.1136/injuryprev-2020-043986
Shigemura, Tomonori, et al. “Characteristics of stepladder fall injuries: a retrospective study.” European journal of trauma and emergency surgery: official publication of the European Trauma Society vol. 47,6 (2021): 1867-1871. doi:10.1007/s00068-020-01339-8
Smith, Caroline K, and Jena Williams. “Work-related injuries in Washington State’s Trucking Industry, by industry sector and occupation.” Accident; analysis and prevention vol. 65 (2014): 63-71. doi:10.1016/j.aap.2013.12.012
Son, Hyung Min, et al. “Occupational fall injuries presenting to the emergency department.” Emergency medicine Australasia: EMA vol. 26,2 (2014): 188-93. doi:10.1111/1742-6723.12166
The NHTSA records show that rear-end collisions are the most common and make up 30% of all traffic accidents, crashes, and collisions. Rear-end collisions can come out of nowhere. One moment a driver is waiting at a stop or light, and suddenly they are catapulted forward by the intense force of another vehicle/s resulting in serious and sustaining injuries that can impact an individual’s physical capabilities. Rear-end collision injuries most commonly affect the neck and back. This is because of the excessive force and intense shifting and whipping the body goes through. Chiropractic care, massage, and decompression therapy can realign the body, relax the muscles, release compressed nerves, expedite recovery, and restore mobility and function.
Rear-End Collision Injuries
Rear-end collision injuries can range from mild to serious, and what seems like a minor pull can result in a severe injury. The most common injuries include:
Pre-existing conditions such as degenerative disc disease can worsen.
Collision Types
A rear-end collision can occur in several ways. The most common types include:
Tailgating
When drivers in the rear follow another motorist too closely, and the lead motorist slows down or has to stop quickly, the rear driver hits the vehicle because there was not enough adequate time and distance to stop.
Slow Speed Collisions
Slow-speed/low-impact collisions or fender benders can result in spinal injuries and concussions.
They can also lead to facial and head injuries from sudden airbag deployment.
Vehicle Pile-Ups
A single rear-end collision on a busy street or interstate highway can cause a chain reaction of multiple-vehicle collisions.
These accidents can cause devastating injuries.
Causes
Causes that can take attention away from the road include:
Speeding
Distracted driving – Talking or texting.
Tailgating
Looking at something like an accident while driving by.
Symptoms of rear-end collision injuries may not immediately present following an accident. It can take 24 to 48 hours for discomfort symptoms to come on and sometimes longer. The adrenaline rush allows the individual not to experience the physical symptoms, which is why individuals think they’re fine when they are not. Ignoring signs increases the risk of permanent injury. A herniated disc, for example, left untreated, can lead to permanent nerve damage. Chiropractic treatment for rear-end collisions is one of the most effective options available. A chiropractor manipulates the spine to realign the spinal cord, allowing the body to decrease inflammatory cytokine production, which reduces the inflammatory response. Specific techniques and various tools can realign individual vertebrae, restore joint flexibility, and break up the scar tissue so the areas can heal faster.
The Spine In A Rear-End Auto Accident
References
Chen, Feng, et al. “Investigation on the Injury Severity of Drivers in Rear-End Collisions Between Cars Using a Random Parameters Bivariate Ordered Probit Model.” International journal of environmental research and public health vol. 16,14 2632. 23 Jul. 2019, doi:10.3390/ijerph16142632
Davis, C G. “Rear-end impacts: vehicle and occupant response.” Journal of manipulative and physiological therapeutics vol. 21,9 (1998): 629-39.
Dies, Stephen, and J Walter Strapp. “Chiropractic treatment of patients in motor vehicle accidents: a statistical analysis.” The Journal of the Canadian Chiropractic Association vol. 36,3 (1992): 139–145.
Garmoe, W. “Rear-end collisions.” Archives of physical medicine and rehabilitation vol. 79,8 (1998): 1024-5. doi:10.1016/s0003-9993(98)90106-x
The ladder is one of the most utilized tools. Most individuals have a ladder or two in their homes or at work and never consider the dangers. Falling off a ladder can lead to serious injuries like muscle tears, broken bones, damage to the spinal cord, skull fractures, or traumatic brain injury. The objective is to educate homeowners and workers on being more alert, increasing awareness, and reinforcing safety protocols.
Ladder Falls and Injuries
According to the Centers for Disease Control and Prevention, ladder falls account for more than 500,000 injuries and 300 deaths annually. Even professionals with experience in safety can make simple mistakes like carrying too heavy a load or not spotting signs of wearing or a defect that leads to injury.
Causes
Causes can arise from defects or user mistakes. These include:
A Defective Ladder
Old worn-out
Damaged or broken
Loose or cracking rungs
Ladders folding during use
Using the improper type of ladder for the job or task
Incorrect Ladder Use
Carrying dangerous objects or heavy loads
Stretching or reaching too far out
Failing to secure the ladder properly
Recklessness or horseplay
Injuries
Common falls can cause injuries severe enough to require professional medical care. Around one in five falls, on average, cause serious injuries that include.
Muscle sprains and/or tears
Neck and back injuries
Herniated discs
Hip injuries and fractures
Broken bones
Spinal cord injuries
Skull fractures
Traumatic brain injuries
Any of these injuries could cause permanent disabilities or chronic conditions.
Chiropractic Care
A fall can damage joints, muscles, bones, and ligaments without realizing there is a problem or injury. The back and spine are most likely to be affected. When landing flat on your back, the joints that connect the spinal column can slip, causing inflammation and joint swelling. To prevent chronic pain and alleviate acute pain, seeking medical attention and chiropractic care as soon as possible is recommended. After confirming the spine is not fractured or broken, a chiropractor can bring relief and restore mobility and function. Injury Medical Chiropractic and Functional Medicine Clinic are committed to helping individuals rehabilitate and recover from injuries. We develop a personalized plan to maximize the potential of recovering and returning to daily activities as soon as possible.
Safer In Seconds
References
Cabilan, C J et al. “Impact of ladder-related falls on the emergency department and recommendations for ladder safety.” Emergency medicine Australasia: EMA vol. 30,1 (2018): 95-102. doi:10.1111/1742-6723.12854
Hicks, Cameron, et al. “Ladder Use in Older People: Type, Frequency, Tasks, and Predictors of Risk Behaviours.” International journal of environmental research and public health vol. 18,18 9799. 17 Sep. 2021, doi:10.3390/ijerph18189799
“Ladder falls.” Health news (Waltham, Mass.) vol. 4,2 (1998): 7.
Muir, L, and S Kanwar. “Ladder injuries.” Injury vol. 24,7 (1993): 485-7. doi:10.1016/0020-1383(93)90156-z
Partridge, R A et al. “Causes and patterns of injury from ladder falls.” Academic emergency medicine: official journal of the Society for Academic Emergency Medicine vol. 5,1 (1998): 31-4. doi:10.1111/j.1553-2712.1998.tb02571.x
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.
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