Symptoms of whiplash

Symptoms of whiplash covers some aspects of the chiropractic management of this potentially serious injury.

This page was last updated by Dr Barrie Lewis on 21st May, 2019.

A great multitude of signs and unusual sensations may occur after a motor vehicle or diving accident, for example. Every trauma is unique and there is no typical patient. The common MVA crash can damage the body, literally from the toes to the skull, and everything in between.

After thirty-nine years in practice I am convinced of one thing; there are very few whiplash injuries that leave people completely unscathed. 

The human skull weighs typically just a little less than five kilograms. Set upon very small and fairly fragile cervical bones, supported by soft tissue structures designed to make the head highly mobile, the cranium, when set abruptly in motion, places very great forces on the neck and upper back, not to mention the brain.

Fracture is not uncommon, strain of muscles and sprain of ligaments is usual, and the shock to the neurological and psychological system is enormous. Every MVA is after all a brush with death. Psychological sequelae are ever present, and to make it more complex, research indicates that the presence of litigation often appears to delay healing.

Whiplash Chiropractic is a vital subject in the management of cervical trauma to prevent devastating UncoVertebral Joint Luschka arthritis and the ensuing arm pain. Read more at these arm pain case histories, for example.

Until recently, it was mystery how people emerged from an accident with almost no symptoms or signs, yet within 10 years their necks have become an arthritis mess. Now we know why: Immobilisation arthritis. Fixation of the joints causes them to degenerate, mysteriously often with little pain or discomfort. It is indeed mystery.

Symptoms of whiplash

Symptoms of whiplash describes the mechanics and symptoms after trauma.

Concussion

Brain injury in whiplash.

Did you notice how the brain moves backwards and forwards within the skull in this picture? Many of the bizarre symptoms of whiplash, like dizziness, blurry vision, hearing loss, and tinnitis (ringing in the ears) may be due to brain injury rather than neck injury as such.

What is important is to recognise the wholeness of the human being. The brain and spinal cord make up one system. Whether whiplash is a traumatic brain injury, or a spinal cord myelomalacia as it's called, or cervical joints and soft tissue sprain, the symptoms of whiplash are complex. And often are very serious.

There is a school of thought promulgated by a prominent orthopedist in the Netherlands that whiplash is no different to a sprained ankle. A prominent (and I believe highly irresponsible) newspaper article caused great stress to many victims of whiplash. Either whiplash kills you, or causes little more than sprain of ligaments and strain of muscles. There is no continuum. Oddly they even deny that a collar may be of value in whiplash, but are happy to recommend a cast or supporting bandage for a sprained ankle.


"If the only tool you have is a hammer,

you tend to see every problem as a nail."

- Abraham Maslow


Post traumatic stress disorder

Seemingly, having forgotten that the skull and cervical spine contain the most sensitive structures in the body, the central nervous system, they have plunged many victims of whiplash into despair. Are all these symptoms dreamed up? Are you going crazy? Certainly not.

As such they have certainly contributed to the Post Traumatic Stress Disorder often associated with whiplash.

This I can personally attest to. Some years ago a sports car passed us at very high speed. Fifteen minutes later we came upon the scene of the inevitable. Five dead bodies were lying on or close to the road. The sports car was lying in three completely separate parts. Just having witnessed the scene, to this day my wife may unexpectedly become extremely agitated when travelling.

We weren't physically injured, yet the psychological impact was profound as we mentally revisit the scene.

Chiropractic

Chiropractic fortunately has many of the right tools at hand for the symptoms of whiplash. We can immobilise (with a collar), stretch, massage, cross-friction, adjust the spine using both forcible and gentle techniques, use ice for the swelling, and counsel.

What is problematic for doctors who see whiplash in only one mindset, having only one implement in their toolbox, is that that tool may indeed become a hammer in his hand.

This is just as true of a medical man who has only drugs at hand, as the chiropractor who only adjusts the spine forcibly. Neither may be the treatment of choice for an acute whiplash, and may aggravate the symptoms of whiplash.

X-rays and scans

Every doctor can and should use his own discretion, but for myself I would choose to rule out fracture and serious ligamentous injury more often than not.

Whiplash of course doesn't not only occur after MVAs. A fall from a horse, a trampoline ... it's common. Few escape without some form of injury that may leave lasting symptoms of whiplash.

The so-called Joints of Luschka are, because of their proximity to the foramen from which the nerve exits on its way to the various parts of the body, particular susceptible to whiplash and likely to cause nerve-type symtoms in the future. Read more newsletter Whiplash and the Joints of Luschka …

Oblique x-ray showing foraminal encroachment after whiplash type injury.

Symptoms of whiplash

What are the symptoms of whiplash? They are divergent and complex. There are no two that are exactly the same. The position of your head in the accident, the angle at which you were struck, or collided with another impediment and then another, whether you anticipated the accident and tensed your muscles, these variables all make each injury unique.

It can affect your low back, your ribcage and, the seatbelt may save your life, but contuse the breastbone and ribs; airbags can in themselves cause injury.

You are not going crazy. But recognise that, if you are hoping for a big monetary claim, it's likely to delay healing, perhaps seriously so. Get on with life, accept that what has happened, cannot be changed; it's set in concrete and bemoaning the fact will do you not one iota of good.

A lecture series given by paramedic, turned nurse, turned chiropractor, Dr Larry Nordhoff gave me a whole new perspective on whiplash. With 13 years working in the ambulance, the emergency room, in ICU and 25 years as a chiropractor under his belt, books like his Motor Vehicle Collision Injuries are a must for every chiropractor, and even for those suffering from the symptoms of whiplash who may want to understand more.

There are other excellent texts by chiropractors.

How bad is your neck pain? Scroll down for a classification that will enable you to rate the seriousness of your injury.

Whiplash research

Because road accidents and whiplash have such huge economic and social consequences, there has been much research done in the field, including in Chiropractic.

Whiplash research ...

Pain medication

Some pain medication may well be needed after whiplash, and we Chiropractors are not in general against the limited and wise use of medicine.

Certainly cortisone and NSAIDS have been proven to reduce healing of the soft tissues and should only be used with discretion and a short period, and never more than one.

Cervical artery dissection

Cervical artery dissection is one of the most serious sequelae or symptoms of whiplash.

Should you have change of taste, ringing in the ears, dizziness, a drooping eyelid or other unusual neurological symptoms after a whiplash, be sure to tell your chiropractor. Even months and months after the accident. Whiplash Cervical Artery dissection ...

Cervical ribs

Cervical ribs are not that uncommon, though the really large ones as seen below are only rarely seen in private practice.

Cervical and first ribs and drawn by Netter.

Ribs belong properly to the Thoracic Spine, but occasionally there might be a rib in the neck, a Cervical Rib. Two persons per thousand. Mostly they are small and of minimal clinical significance - until something upsets the applecart. Like a whiplash injury.

Reduced movement at C7-T1 means even greater stress at the C5-C6 and C6-C7 joints creating more symptoms of whiplash at these levels, with a greater likelihood of shoulder and carpal tunnel syndromes.

Spinal Cord Injuries

It's sobering that South Africa has the most dangerous roads in the world with 20,000 deaths and 150,000 seriously injured persons in 2014. As of writing in 2019, the whiplash statistics continue to soar.

And the United States lies not far behind at fourth.

Spinal cord injuries are probably, after head injuries, the most serious of these traumatic injuries; fractured or dislocated vertebrae or seriously injured discs damage the spinal cord.

If these are not treated immediately permanent paralysis occurs; the rule of thumb is get them to a skilled trauma unit within the golden hour; that's sixty minutes.

Interesting links

  • Fish Soup ... an invaluable aid to reduce arthritic changes.
  • LEG LENGTH INEQUALITY - a cause of neck pain too?
  1. Chiropractic Help
  2. Whiplash chiropractic
  3. Symptoms of whiplash


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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Interesting questions from visitors

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You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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