LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

whiplash

So What Do I Do for My Neck Pain?

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I hear this question quite often for just about every ache and pain you can imagine. Many people want miraculous answers or miracle treatments. I find that most of us don’t really want the simple answer.

Many times the simple answer requires a change on the patients part. And not just a month long change, but a lifelong change. This is a wee bit harder to accept.

For low back pain, it would seem that moving around more and exercise is intuitively a good idea. And sure enough, studies on exercise and yoga have proven to help chronic low back pain sufferers as well as patients in my office that are more active. I always say that couch potatoes are much harder to fix than athletes.

But if exercise is good for low back pain, what about neck pain? In 2008, the worldwide Neck Pain Task Force took a very hard look at the evidence surrounding neck pain (causes, prognosis, treatments) and determined that exercise was a strong recommendation for whiplash associated neck pain, but there was not enough evidence at the time to make a judgment call on exercise for other types of neck pain.

This particular study is a new look, done by the same group, at research that has been done in the past decade on exercise for other types of neck pain. Here’s what they found:

  1. Supervised qigong and Iyengar yoga were helpful for the management of persistent neck pain.
  2. In addition, therapies combining strengthening, range of motion, and flexibility are also effective for the management of persistent neck pain.

Qigong is of Chinese origin and has its roots in Chinese medicine, martial arts and philosophy. There are similarities to Tai-chi, although Tai-chi’s forms are generally considered more complex.

Iyengar yoga is a form of yoga derived from Hatha yoga.

While you may not practice either of these, keep in mind that these are the types of exercise that the joint task force found evidence for, but you can rest assured that all forms of exercise are going to be beneficial for neck pain. Movement is good. Sitting on the couch or spending hours of the computer is not.

Development in pain and neurologic complaints after whiplash – (03-18-03)

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Development in pain and neurologic complaints after whiplash.

I realize that this article is a little off the usual topic, but I am a DC after all. Basically, there has been many attempts to minimize the injuries sustained during a whiplash. Well, any physician that treats these types of injuries knows that they are real and patients do experience both short term and long term effects. 74% of whiplash patients had pain 1 year later. Personally, I think that number reflects poor care following the accident….

Neurology — Abstracts: Kasch et al. 60 (5): 743

Click here for more information.

Quick Manual Treatment in Whiplash is Best – (08-21-00)

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Quick Manual Treatment in Whiplash is Best

Ask any chiropractor and they could have saved alot of money on this research project. As with any injury, the longer treatment is delayed the less likelihood of a good outcome.

Spine 2000 Jul 15;25(14):1782-1787 – In patients with whiplash-associated disorders caused by a motor vehicle collision treatment with frequently repeated active submaximal movements combined with mechanical diagnosis and therapy is more effective in reducing pain than a standard program of initial rest, recommended use of a soft collar, and gradual self-mobilization. This therapy could be performed as home exercises initiated and supported by a physiotherapist.

Whiplash Injury Changes Everything

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As a chiropractor, I have an opinion on this one. Whiplash injuries are common & so is the patient whose chronic neck pain has been present “since that accident.”

Whiplash occurs when the head gets thrown back and forth as a result of a sudden change in momentum of the head relative to the neck, resulting in strains affecting the bones, discs, muscles, nerves, or tendons of the neck.

We used to call them hyperflexion / hyperextension injuries, but more careful evaluation showed that the neck does not always go beyond it’s normal range of motion. Rather, small regions of the cervical spine undergo too much flexion and too much extension. Consider an “S” shaped spring getting crunched down from the top–there will be areas of the spring that get scrunched and areas that get stretched. This is closer to what we understand happens during a whiplash type of injury.

Because of this type of injury, studies have identified multiple problems with patients who suffer this type of injury. Fat deposits in the muscles. Change in the muscular coordination of the neck. Jaw pain. Chronic pain. All are potential outcomes following a whiplash type injury.

This particular study continues to paint a depressing picture for those who have had this type of injury. Researchers found changes in those who are suffering from chronic whiplash pain during exercise.

Normally, exercise stimulates the release of built in pain relievers (endogenous). Everyone’s heard of the experience known as “runner’s high” when these opioid-like compounds are released by the body. However, in the chronic whiplash patients, they did not experience the pain reduction associated with exercise like the normal patients did. They were more likely to have an increase in pain after they exercise rather than improvement.

So what is the solution? I’ve already mentioned my bias. I can tell you, from personal experience over 15 years of practice, that when patients get in to our office for treatment within hours of an accident, they never seem to get to the severe levels of pain that we see when compared to patients who come in days or weeks after the injury.

Regardless of where you go for treatment, make sure that all of the potentially injured tissues (ligaments, tendons, fascia, joints, etc..) are treated. Just exercising or just adjusting or just medications will likely not fully address the nature of the tissue damage that occurs in a whiplash type of injury. Only treatments that encompass both the joints (adjusting) and the soft tissues that are injured is likely to be successful at preventing your injury from becoming chronic.

If you have had a whiplash injury in the past, what did you do to fully recover? Or do you still deal with chronic pain?

WHIPLASH-TYPE INJURIES NEED TO BE ADDRESSED TO PREVENT LONG TERM DYSFUNCTION – (09-01-08)

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Comparison of Sensorimotor Disturbance Between Subjects With Persistent Whiplash-Associated Disorder and Subjects With Vestibular Pathology Associated With Acoustic Neuroma

As a chiropractor, I find it unfathomable that a patient involved in a motor vehicle accident would not seek chiropractic care. The known involvement of the facet joints coupled with altered signals being sent up to the brain from the receptors around the joints produces a condition that ONLY manipulation will impact. Rehab exercises, medications, interferential, ultrasound, massage–these will not affect the proprioceptive input to the brain like an adjustment.

This article further supports the idea that dysfunction of the facet joints following whiplash-type injuries are real, and need to be addressed to prevent long term dysfunction.

Read entire article here

DID YOU GET THIS AFTER A WHIPLASH?

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As a chiropractor, I obviously have seen many whiplash patients.  And sooner is always better.  I’ve found that the sooner I see a patient after the trauma (even the same day of the accident) that better the outcome.  But not everyone seeks care after an accident.

There are multiple reasons why not seeing a chiropractor after trauma is a bad idea.  The obviously one is that the damage from the trauma needs to be controlled and then the healing process needs to be guided.  There are clearly long term problems that occur following improperly treated whiplash injuries.  These include:

 Even if you do not have more than some minor stiffness after the accident, it is still wise to get an evaluation.  This does not mean that you need extensive care, but a few visits can go a long way towards fixing any imbalance that occurred as a result of the trauma. 

If someone does not seek an evaluation after trauma, it is possible that problems will creep up months later, again because of an imbalance created.  This particular study lends support to this idea.

The jaw (temporomandibular joint, or TMJ) generally does not get directly injured in a car accident.  However, it is very susceptible to imbalance between the muscles in the back of the neck (injured during whiplash) and the muscles that open the jaw. 

24% of the patients in this small study developed jaw pain some time after the accident.  Even more interesting, those who experienced low-speed accidents were more likely to suffer jaw pain.  Is this because they chose NOT to get care immediately after the trauma??

I’VE HAD NECK PAIN EVER SINCE THAT ACCIDENT…

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The statistics on the persistance of neck pain following a whiplash-type injury are pretty disheartening.  Depending on the study you read, up to 90% of patients may experience some type of symptoms 10 years later.  This leads to a few comments from me.

First, I think this stresses just how important it is to address both the soft tissue AND the articular components of any type of injury.  Physical therapists stress exercises to strengthen the muscles injured.  Chiropractors generally address the movement of the joints in the neck following the injury.  Quite frankly, as someone who addresses the fascial, muscular and tendonous as well as the joint problems that occur after an injury, I feel that almost all cases are not treated with a comprehensive approach that addresses all aspects.  If all a chiropractor does is adjust, you miss the soft tissue component.  If all that is done is strengthening, you miss the articular component as well as the soft tissue pathology that occurs!!  (strengthening does NOT address the problems that develop in the fascia as a result of the injury).

The other aspect of this is that you should never, ever wait to get treatment after an injury.  The longer you wait, the more difficult that problem is going to be to fix.

This particular study confirms what anyone that deals with residual problems from a car accident.  If you do the right tests, you do indeed find problems.  Researchers found increased activity in the area of the 2nd cervical vertebrae that indicated inflammation was present.  This was years after the injury.

If you’ve had an injury recently, or have been dealing with a problem that started years ago, find a chiropractor that has a strong