Treatment and Prevention of Whiplash Injuries
By Dr. John A. Papa, DC, FCCPOR(C)

The unique forces generated during a motor vehicle collision (MVC) cause more than 100,000 whiplash cases in Canada each year.  This article will specifically focus on the treatment and prevention of whiplash injuries.

The term WAD (Whiplash Associated Disorder) is used to describe a range of injuries that can be attributed to whiplash.  This may include:  neck pain, whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.

 

WAD Grades 1 and 2 represent the majority of whiplash cases and are amendable to conservative management.  Early treatment and consultation can greatly improve the recovery process and prevent future complications and chronic pain.  Effective treatment strategies may include: pain controlling modalities such as electrotherapy and acupuncture to help facilitate and promote activity and functioning; manual and soft tissue therapy to assist in the healing of injured tissues; education on how to safely re-integrate into activities of daily living; and rehabilitative exercises that may include range of motion, flexibility, strengthening, and balance/coordination training.  An independent home exercise program should also be provided.

The goal of treatment is to get the injured individual back on their feet and up to their normal level of activity.  The majority of people with WAD Grades 1 and 2 experience no significant disruption to their normal activities of daily living.  Some may experience a temporary disruption to their normal activities, but usually improve after a few days or weeks.  Occasionally, symptoms may persist over a longer period of time.  A return to normal activities of daily living may be assisted by active treatment and rehabilitative exercise prescription as described above.

Included below are some tips that may help prevent a MVC and/or whiplash injury (courtesy of the Alberta College and Association of Chiropractors):

1.    Drive defensively.  Always anticipate the actions of other drivers.

 

2.    Wear your seatbelt at all times.

 

3.    Make sure your headrest is positioned properly, that is, the top of the headrest should be no lower than the top of your ear.  If more than one driver uses the car, remind each other to always check the headrest height.

 

4.    Never operate cell phones or other electronic equipment while driving.

 

5.    When road conditions are poor (i.e. icy, wet, dark, or crowded), slow down accordingly.

6.    Be sure your car is always in good working order, particularly your brakes, tail lights, headlights, and directional signals.

 

7.    Engage in regular physical activity consisting of cardiovascular, strength, and flexibility training.  This will help keep your body strong and offer some protection in the event your are involved in a MVC. 

 

If a whiplash injury is interfering with your activities of daily living, consider chiropractic care.  A chiropractor can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for you.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Massage Therapy Questions & Answers

1. Q: What should I expect on my first visit?
   A: On your first visit, your Therapist will take a confidential health history, which will guide them in performing an assessment. This will help them understand your current physical condition, medical history, lifestyle and stress level. Once this is completed, the Therapist will prescribe a treatment plan which will be explained to you before treatment starts.
   
   
2. Q: Will I have to undress?
   A: The degree to which you undress is dependent on the treatment and your comfort level. Your Therapist will communicate your treatment plan to you and the areas of your body that will be treated. Your Therapist will briefly leave the room for you to prepare for treatment if required. Once the Therapist leaves the room, most people undrape down to their underpants and cover themselves with a sheet. Your privacy will be protected at all times. The Therapist is trained to drape towels or sheets discreetly over areas of the body not involved in the treatment.
   
   
3. Q: Is massage therapy painful?
   A: There may be some injuries or conditions that may be uncomfortable. During the course of treatment, there will be continual communication between the Therapist and client on whether the pressure is too deep or soft. The Therapist is well trained and experienced in modifying technique and pressure to ensure maximum patient comfort is attained. Most people actually find massage therapy to be very relaxing and therapeutic.
   
   
4. Q: How long do massage treatments last?
   A: Massage therapy treatments can last 30, 45, 60, or 90 minutes. The length of treatment depends on several factors including patient comfort, number of areas being treated, and the specificity of therapeutic goals. The Therapist will discuss with you what treatment time may be best for you.
   
   
5. Q: Is massage therapy covered by insurance?
   A: Yes. If you have Extended Health Care (EHC) insurance you may be eligible for all or part of your treatment to be reimbursed. In some instances, insurance plans may require a physician's referral prior to the start of treatments. Your employer, human resource representative, or union will be able to provide information as to the details of your coverage for massage therapy under your EHC plan. Massage Therapy may also be covered by your automobile insurance company in the event of a motor vehicle accident, and by Veterans Affairs Canada, in the case of war veterans.

Understanding Whiplash Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance.  The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.  The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Air Travel Comfort Tips

By:  Dr. John A. Papa, DC

 

Comfort is not usually the first word that comes to mind when someone mentions flying.  Sitting cramped in a small space for a long plane ride can also lead to muscle and joint pain.  Here are some helpful tips for a more enjoyable voyage.

Choose the Correct Seat - Some airlines fill the plane from front to back, so ask for a seat in the back row to increase your chances of having an empty seat next to you.  If the arm rests lift up, you might even be able to lie down.  Aisle and emergency exit seats maximize leg room and are less claustrophobic.  If you are susceptible to motion sickness, request a seat over the wings and try to schedule flights on larger airplanes.

Keep Moving - Moving around is good for your circulation and helps to prevent swollen feet and ankles.  Wear loose clothing and walk about the cabin periodically every 60 to 90 minutes.  Wear shoes you can slip off easily.  Every so often, draw circles with your toes and contract your calves to help prevent blood from pooling in your legs.  Tapping your feet can also help increase circulation and reduce the chance of muscle cramping.
 

Stretch it out - Try not to place anything under the seat in front of you so you can stretch your legs out.  Quick and easy stretches also include standing up and raising your arms above your head, rotating your shoulders back and forth, and moving your head side to side.

 

Keep Good Posture While Seated - Position your lower back against the back of the chair to obtain the greatest amount of support for your spine.  A rolled sweater or blanket can also be used for added support.  Make sure that your weight is evenly distributed on your seat, your shoulders are not rounding forward, and you are not slouching.  Support your neck and head with a pillow if necessary and avoid awkward positions if trying to rest or sleep.  Try not to stay in one position for a long period of time.

 

Additional Tips

·       Eat Right - Eat a light, non-fatty meal just before you leave for the airport.  Avoid caffeinated beverages and fried food.  This can make handling turbulence a little easier.

·       Handling Pressure - Chewing gum, yawning or sucking on hard candies can help to relieve the pressure that builds up in your ears as the airplane ascends and descends.  This is not recommended for toddlers.  For young children, sipping a drink may help.

·       Prevent Dehydration - The air in most airplanes can dry out your skin and cause eye and nasal dryness.  Take a moisturizer with you for your skin and wear glasses instead of contact lenses to prevent eye dryness.  Drink enough water and steer clear of caffeine and alcohol as they further dehydrate you.  Alcohol can also interfere with your ability to sleep.

In the event that you suffer from ongoing muscle and joint pain following your trip, you should contact a licensed health professional.  For more information, visit www.nhwc.ca.  The author credits the CCA in the preparation of this educational information for use by its members and the public.

 

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.