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.
Find essential information on whiplash, including signs, prevention tips, and recovery strategies for optimal health.
Introduction
An abrupt impact, whether from a vehicle accident, sports injury, or fall, may cause symptoms that start off as a small shock and progress to crippling pain and functional impairment. Whiplash is one such ailment that often lacks recognition due to its intricacy. Although it is often linked to rear-end crashes, whiplash is a complex injury that, if ignored, may have long-term consequences for the musculoskeletal system and cervical spine. Have you had shoulder and neck stiffness before? Do you have persistent, chronic headaches? Or does it seem like your neck’s range of motion is limited? We’ll talk about whiplash’s frequent origins, symptoms, effects on the cervical spine and musculoskeletal system, and evidence-based therapy options to lessen the pain-like symptoms in today’s post.
What Is Whiplash?
Whiplash is a type of neck injury associated with a rapid back-and-forth head-and-neck motion, mimicking the crack of a whip, hence the name. This causes persistent physical complaints and disability, and complaints when left untreated. (Mayou & Radanov, 1996) Medically, it is categorized under cervical acceleration-deceleration (CAD) injuries. This abrupt motion can damage muscles, ligaments, intervertebral discs, and even the neural structures of the cervical spine.
Common Causes Of Whiplash
While motor vehicle accidents are the most recognized cause, many mechanisms can precipitate a whiplash injury:
Even minor collisions at speeds as low as 5–10 mph can produce enough force to cause whiplash symptoms in vulnerable individuals.
Symptoms of Whiplash
When individuals are experiencing whiplash, the symptoms can appear immediately or may be delayed for 24–72 hours post-injury. Additionally, whiplash injuries are considered soft tissue injuries to the neck with various clinical symptoms that vary in severity and may include: (Chen et al., 2009)
Neck pain and stiffness
Reduced range of motion
Shoulder and upper back pain
Headaches, especially originating at the base of the skull
Jaw pain or temporomandibular joint (TMJ) dysfunction
Dizziness or visual disturbances
Tingling or numbness sensations in the arms (cervical radiculopathy)
Fatigue and cognitive issues (“whiplash-associated disorders” or WAD)
How Whiplash Affects the Cervical Spine and Musculoskeletal System
Whiplash is more than just a soft tissue injury, as it impacts several interconnected systems:
1. Cervical Spine
The rapid motion during a whiplash injury can lead to:
Cervical facet joint irritation
Intervertebral disc compression or herniation
Muscle strain or ligamentous sprain
Altered cervical lordosis, leading to chronic postural imbalances
This causes pain, stiffness, and tenderness in the neck area due to injuries within the bony, muscular, and ligamentous regions. (Alektoroff & Papanagiotou, 2021)
2. Musculoskeletal Dysfunction
Whiplash often initiates a cascade of biomechanical issues:
Myofascial pain syndromes, especially in the trapezius, levator scapulae, and sternocleidomastoid muscles
Compensatory thoracic or lumbar strain
Poor proprioception and neuromuscular control
Chronic trigger points and fibrotic tissue development
The longer these musculoskeletal imbalances persist, the more likely they will evolve into chronic pain syndromes and central sensitization.
Why Choose Chiropractic?-Video
Diagnosing Whiplash
Diagnosis is largely clinical, supported by a thorough history and physical exam. Imaging may be required to rule out more severe pathology:
X-rays: To rule out fractures or malalignment
MRI: For soft tissue or disc pathology
CT scans: If fracture or serious trauma is suspected
Functional assessments: Range of motion, palpation, neurologic evaluation
Evidence-Based Treatments for Whiplash
Treatment for whiplash should be multimodal and individualized, focusing on restoring function, reducing inflammation, and promoting healing. (Bussieres et al., 2016)
1. Chiropractic Care
Chiropractic adjustments can offer significant benefits in managing whiplash-associated disorders:
Myofascial release and soft tissue mobilization: Target muscle tension, trigger points, and fascial restrictions.
Postural retraining and ergonomic correction: Essential for long-term resolution.
Additionally, chiropractic patients experienced significant improvements in neck pain and function.
2. Physical Therapy
Individuals dealing with neck pain associated with whiplash can benefit from physical therapy to improve neck pain and disability. (Chrcanovic et al., 2022) Rehabilitative exercises are fundamental:
Neck range-of-motion drills
Isometric strengthening
Scapular stabilization and postural correction
Proprioceptive neuromuscular facilitation (PNF)
3. Functional Medicine Approach
From a functional medicine standpoint, addressing systemic inflammation, nutritional deficiencies, and stress response can enhance recovery:
Magnesium and B-complex supplementation for nerve healing
Sleep optimization and cortisol balance
4. Other Complementary Treatments
Acupuncture: Improves blood flow and pain modulation while alleviating pain and promoting relaxation. (Moon et al., 2014)
Gua Sha or cupping therapy: Relieves muscular tension
Dry needling: Effective for persistent trigger points
Manual lymphatic drainage: For patients experiencing edema or prolonged inflammation
Recovery and Prognosis
With consistent and proper treatment, many individuals recover within a few weeks. However, approximately 30–50% of individuals may develop chronic symptoms if not properly managed early on. Factors predicting prolonged recovery include:
High initial pain intensity
Poor coping mechanisms
History of prior neck injury
Psychosocial stressors
Early intervention using a holistic, integrative care model offers the best outcomes in preventing chronic whiplash-associated disorders.
Final Thoughts
Beyond the common “neck strain” classification, whiplash is a complicated neuromusculoskeletal injury that requires careful consideration by both patients and medical experts. Accurate diagnosis and successful treatment depend on an understanding of the complex effects on the cervical spine, neurology, and musculoskeletal function. Reducing symptoms and improving quality of life may be achieved by combining non-surgical treatments as part of a personalized treatment strategy.
Injury Medical & Personal Injury Clinic
We associate certified medical providers who understand the importance of assessing individuals with whiplash associated with their necks. When asking important questions to our associated medical providers, we advise patients to incorporate customized treatment plans for their pain associated with whiplash. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer
References
Alektoroff, K., & Papanagiotou, P. (2021). [Whiplash injury of the cervical spine]. Radiologe, 61(8), 710-713. doi.org/10.1007/s00117-021-00877-5 (Schleudertrauma der Halswirbelsaule.)
Bussieres, A. E., Stewart, G., Al-Zoubi, F., Decina, P., Descarreaux, M., Hayden, J., Hendrickson, B., Hincapie, C., Page, I., Passmore, S., Srbely, J., Stupar, M., Weisberg, J., & Ornelas, J. (2016). The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther, 39(8), 523-564 e527. doi.org/10.1016/j.jmpt.2016.08.007
Chen, H. B., Yang, K. H., & Wang, Z. G. (2009). Biomechanics of whiplash injury. Chin J Traumatol, 12(5), 305-314. www.ncbi.nlm.nih.gov/pubmed/19788851
Chrcanovic, B., Larsson, J., Malmstrom, E. M., Westergren, H., & Haggman-Henrikson, B. (2022). Exercise therapy for whiplash-associated disorders: a systematic review and meta-analysis. Scand J Pain, 22(2), 232-261. doi.org/10.1515/sjpain-2021-0064
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. Evid Based Complement Alternat Med, 2014, 870271. doi.org/10.1155/2014/870271
Dr. Alex Jimenez: Pioneering Integrative Care as a Chiropractor and Nurse Practitioner
Dr. Alex Jimenez, a licensed chiropractor and board-certified nurse practitioner based in El Paso, Texas, brings over 25 years of expertise to his Injury Medical & Chiropractic Clinic practice. His dual licensure provides unique insights into the etiologies, pathogenesis, and treatment of complex clinical conditions, enabling him to deliver patient-centered, integrative care that bridges physical medicine, functional medicine, and advanced diagnostics. Combining chiropractic expertise with nurse practitioner-driven medical management, Dr. Jimenez offers comprehensive treatment protocols tailored to acute and chronic conditions, promoting metabolic resilience, longevity, and whole-person wellness.
Dual Expertise: Chiropractic and Nurse Practitioner Roles
Dr. Jimenez’s practice stands out due to his ability to integrate the biomechanical focus of chiropractic care with a nurse practitioner’s diagnostic and therapeutic scope. As a chiropractor, he specializes in restoring musculoskeletal function, particularly after trauma, neck, back, spine, and soft tissue injuries. His chiropractic interventions emphasize non-invasive techniques, such as spinal decompression, manual adjustments, and functional rehabilitation, to alleviate pain and enhance mobility.
As a board-certified nurse practitioner, Dr. Jimenez employs evidence-based medicine to address systemic and metabolic dysfunctions. His expertise extends to managing chronic degenerative disorders, hormonal imbalances, weight loss, sexual health, and pain syndromes. This dual perspective allows him to identify underlying disease causes, from biomechanical misalignments to physiological imbalances, and design treatment regimens that address symptoms and root causes.
The synergy of these roles enables Dr. Jimenez to offer a holistic approach that is particularly effective for complex conditions such as sciatica, fibromyalgia, disc herniation, spondylolisthesis, and chronic neck or back pain. His integrative protocols combine functional medicine assessments, lifestyle interventions, and advanced diagnostics to achieve homeostasis and physiological balance.
Treatment Protocols: Evidence-Based and Patient-Centered
Drawing from integrative protocols outlined on his website, www.chiromed.com, Dr. Jimenez employs a multidisciplinary approach to patient care. His treatment plans are grounded in evidence-based medicine, functional medicine, and lifestyle wellness strategies, tailored to each patient’s unique health profile, lifestyle, and medical history. Below are key components of his integrative care model:
1. Chiropractic Care and Functional Rehabilitation
Spinal Decompression: Non-surgical decompression therapy is used to relieve pressure on spinal discs, addressing conditions like disc herniation, sciatica, and spinal stenosis. This modality promotes healing by improving blood flow and nutrient delivery to affected areas.
Manual Adjustments: Targeted adjustments correct spinal misalignments, reduce nerve compression, and restore joint mobility. These are particularly effective for whiplash, scoliosis, and poor posture.
Functional Strength Training: Dr. Jimenez designs conditioning programs to enhance recovery and prevent re-injury. These programs are tailored for athletes and individuals seeking optimal performance and incorporate mobility, flexibility, and agility training.
2. Functional Medicine Assessments
Functional medicine tools evaluate metabolic, hormonal, and nutritional status. These assessments identify the root causes of conditions such as fatigue, weight gain, or chronic pain, enabling precise interventions.
Advanced diagnostic protocols, including blood panels and imaging, provide data-driven insights into etiologies and pathogenesis. This allows Dr. Jimenez to address underlying dysfunctions rather than merely masking symptoms.
3. Lifestyle and Nutritional Interventions
Weight Loss and Metabolic Resilience: Dr. Jimenez integrates nutritional counseling and metabolic optimization strategies to support sustainable weight loss and prevent chronic diseases like diabetes or cardiovascular disorders.
Hormone and Sexual Health: Personalized regimens address hormonal imbalances and sexual dysfunction, improving quality of life and overall wellness.
Pain Management: Nutritional and lifestyle modifications complement physical therapies to manage chronic pain syndromes, reducing reliance on pharmaceuticals.
4. Specialized Care for Complex Conditions
Sciatica and Disc Injuries: Dr. Jimenez employs targeted decompression and rehabilitation protocols to alleviate nerve compression and restore function.
Chronic Degenerative Disorders: Conditions like fibromyalgia, arthritis, and spondylolisthesis are managed through integrative plans that combine physical therapy, nutritional support, and metabolic optimization.
Sports and Auto Accident Injuries: Tailored rehabilitation programs address soft tissue damage, shoulder injuries, and whiplash, ensuring rapid recovery and long-term resilience.
5. Advanced Wellness Programs
Dr. Jimenez’s clinic offers comprehensive wellness programs on longevity, skin care, and hair loss. These programs integrate nutritional supplementation, lifestyle coaching, and cutting-edge therapies to promote vitality and aesthetic health.
High-level conditioning programs optimize performance for athletes, incorporating functional strength training and recovery-focused interventions.
Integrative Team and Clinic Highlights
Injury Medical & Chiropractic Clinic is El Paso’s largest mobility, flexibility, and agility center, integrating chiropractors, nurse practitioners, registered nurses, nutritionists, and physical performance trainers. The clinic’s multidisciplinary team collaborates to deliver personalized care, ensuring patients achieve measurable health outcomes. Key services include:
Acupuncture: A Complementary therapy to reduce pain and promote relaxation.
Advanced Nutritional Programs: Evidence-based dietary plans to support metabolic health and recovery.
Physical Performance Training: Programs to enhance fitness, prevent injuries, and optimize athletic performance.
The clinic accepts major insurances, including Aetna, Blue Cross Blue Shield, Cigna, and First Health, making care accessible to a broad patient base.
Insights from Dual Licensure
Dr. Jimenez’s licensure as both a chiropractor and nurse practitioner provides him with a comprehensive understanding of disease processes and treatment modalities. His chiropractic training equips him to address biomechanical dysfunctions, while his nurse practitioner expertise allows him to manage systemic conditions with a medical lens. This dual perspective enhances his ability to:
Clarify Etiologies: By combining musculoskeletal assessments with metabolic and hormonal evaluations, Dr. Jimenez identifies multifactorial causes of conditions, ensuring targeted interventions.
Understand Pathogenesis: His knowledge of disease progression informs proactive treatment plans that halt or reverse degenerative processes.
Design Appropriate Regimens: Integrating physical, nutritional, and medical therapies, Dr. Jimenez creates synergistic treatment plans that address both symptoms and underlying dysfunctions.
This integrative approach is particularly valuable for patients with chronic or multifactorial conditions, as it addresses the interplay between physical, metabolic, and lifestyle factors.
Patient-Centered Care: In-Person and Online
Dr. Jimenez’s practice emphasizes personalized attention, whether patients visit in person at 11860 Vista Del Sol, Suite 128, El Paso, TX 79936, or engage through telehealth. His functional medicine series, accessible via www.dralexjimenez.com, educates patients on holistic health principles, covering topics from spinal health to metabolic optimization. The website features:
Informative Content: Blog posts, articles, and videos provide insights into chiropractic care, functional medicine, and injury rehabilitation.
Patient Testimonials: Success stories highlight the transformative impact of Dr. Jimenez’s care, showcasing outcomes for conditions like sciatica, sports injuries, and chronic pain.
Appointment Booking: A user-friendly interface allows patients to schedule in-person or online consultations, with clear guidance on what to expect during their first visit.
Commitment to Education and Community Health
Dr. Jimenez is dedicated to empowering patients through education. His website is comprehensive, offering evidence-based information on health conditions, treatment options, and wellness strategies. By fostering health literacy, Dr. Jimenez enables patients to make informed decisions and take charge of their well-being.
His commitment extends to the El Paso community, where he aims to expand access to integrative care. Dr. Jimenez promotes proactive health management and preventive care through workshops, online content, and community outreach.
Conclusion
Dr. Alex Jimenez’s dual expertise as a chiropractor and nurse practitioner positions him as a leader in integrative medicine. His ability to bridge physical medicine with systemic health management allows him to address complex clinical issues with precision and compassion. Dr. Jimenez delivers personalized care that promotes healing, resilience, and longevity by leveraging evidence-based protocols, advanced diagnostics, and lifestyle interventions.
For more information or to schedule an appointment, visit www.dralexjimenez.com or contact the clinic at +1-915-412-6677.
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
Dr. Alex Jimenez�s Blog Post Disclaimer
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*
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Common Causes Of Whiplash
