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. Join us next month when we specifically take
a closer look at the treatment and prevention of whiplash injuries. 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.
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