Integrative Chiropractic Treatment for Whiplash
Whiplash is an injury to the neck muscles commonly seen after a car accident. In a car crash, the rapid whipping motion of the neck can permanently damage the spine, causing severe pain and chronic disability. In fact, almost 50% of people with chronic neck pain attribute their condition to a car crash1. Herniated discs, spinal fracture, torn ligaments, pinched nerves, and brain injuries may develop slowly over the course of weeks or months following a crash. As you continue to move and swelling increases, your whiplash can worsen, leaving you with a stiff neck and splitting headache. Your best bet at a speedy recovery is to pursue chiropractic treatment for whiplash as soon as possible.
The chiropractic physician will evaluate your whole spine from head to tail and any area of pain because other regions of the body may be affected (not just your neck). The doctor will perform a complete orthopedic and neurological evaluation, as well as look for stiff joints, muscle spasm, disc/ligament injury, brain injuries and vascular damage. The doctor will use diagnostic techniques that involve moving your neck and back to feel for tenderness, tightness, and restricted spinal joints. He or she will also analyze how you move and take note of your posture. These details will help the chiropractor understand your body’s mechanics and how your spine works, helping with the diagnosis process. In addition, the chiropractor may order an x-ray or an MRI of your spine to evaluate acute injuries as well as any degenerative changes that may have existed before your whiplash injury. The diagnostic images and results of your physical and neurological evaluation are compared to develop the best treatment plan.
There are 4 Stages of Whiplash Injury from acute to chronic.
|A. Stages of Whiplash Injury 2|
|Stage I||Acute: Inflammatory phase; Up to 72 hours|
|Stage II||Subacute: Repair phase; 72 hours to 14 weeks|
|Stage III||Remodeling phase: 14 weeks to 12 months or more|
|Stage IV||Chronic: Permanent|
There are 5 Grades of Whiplash Severity from minimal to severe.
|B. Grades of Whiplash Severity 2|
|Grade 1 – Minimal: No limitation of motion; No ligamentous injury; No neurological findings|
|Grade 2 – Slight: Limitation of motion; No ligamentous injury; No neurological findings|
|Grade 3 – Moderate: Limitation of motion; Some ligamentous injury; Neurological findings may be present|
|Grade 4 – Moderate to Severe: Limitation of motion; Ligamentous instability; Neurological findings present; Fracture or disc derangement|
|Grade 5 – Severe: Requires surgical management/stabilization|
Established treatment guidelines help direct care based upon your stage and severity of injury. Nonsurgical chiropractic treatment for whiplash typically involves a blend of many different techniques. While the doctor usually adheres to the treatment guidelines, each case is unique and some whiplash injuries require a custom tailored approach.
In acute and subacute cases, reducing cellular inflammation is key to chiropractic treatment for whiplash. Anti-inflammatory supplements, medication for muscle spasms, soft cervical collars, acupuncture and therapy modalities like muscle stim, ultrasound, cryotherapy, and gentle stretching are all beneficial during stages I through III. As you progress through the recovery process, medication and passive therapy modalities (muscle stim, ultrasound, cryotherapy, soft collars, ect.) should be replaced by more active exercise to stretch, strengthen, and stabilize the spine. Your whiplash management plan depends on the severity and stage of your whiplash injury. The most common chiropractic treatment for whiplash is the spinal adjustment. Some spinal adjustment techniques commonly used are:
- Flexion-Distraction Technique: This hands-on technique is a gentle, elongating type of spinal adjustment to help manage herniated discs and other whiplash injuries. The chiropractor uses a slow pumping action on the disc instead of direct force to the spine.
- Ultralign Instrument-Assisted Adjustment: This technique is a gentle, non-thrusting technique using a specialized hand-held instrument. Computer based algorithms developed by NASA guide the practitioner in assessing spinal mobility and identifying areas of restricted mobility. This type of adjustment is useful for acute stages or older patients who have degenerative joint disease.
- Specific Spinal Adjustment: This hands-on technique involves identifying spinal joints that are restricted and delivering gentle thrust to restore normal joint mobility. This gentle thrusting stretches soft tissue and stimulates the nervous system to restore normal motion to the spine.
In addition to spinal adjustments, the chiropractor may also use manual therapy to treat injured soft tissues (eg, ligaments and muscles). Some examples of manual therapies your chiropractor may use are:
- Instrument-Assisted Soft Tissue Therapy: Graston and Gua Sha are instrument-assisted techniques used to treat soft tissue injuries. The doctor or therapist will perform gentle repeated strokes using the instrument over the injured area.
- Manual Joint Stretching and Resistance Techniques: Muscle energy manipulation, active release technique, and PNF stretching are beneficial forms of manual therapy during the subacute and remodelling stages of recovery that involve breaking up scar tissue and directing new collagen formation in the muscle.
- Therapeutic Massage: The chiropractor may prescribe a therapeutic medical massage to ease muscle tension in your neck and relieve stubborn knots.
- Trigger Point Therapy: Your chiropractor will identify specific hypertonic (tight), painful points of a muscle by putting direct pressure (using his or her fingers) on these specific points to alleviate muscle tension.
Chiropractic treatment for whiplash may also use other therapies to help reduce neck inflammation caused by whiplash. Examples of treatment adjuncts your chiropractor may use are:
- Interferential Electrical Muscle Stimulation (EMS): EMS uses a low frequency electrical current to improve circulation, reduce inflammation, reduce pain, and ultimately improve healing times.
- Ultrasound: Ultrasound uses a soundwave to improve blood flow, decrease muscle spasms, relieve stiffness, and reduce pain in your neck.
- Class IV Laser: Infrared laser therapy treatments reduce pain/inflammation and enhance tissue healing—both in hard and soft tissues, including muscles, discs, ligaments, or even bones.
- Acupuncture: Used for thousands of years, acupuncture can stimulate your bodies rest and repair mechanism, release pain relieving endorphin’s, and reduce pain without the side effects of medication or injections.
- Vitamins/Supplements: The chiropractic physician may prescribe certain pharmaceutical grade vitamins or supplements to aid in the management of your whiplash injury. Taking these as directed can shorten your recovery and lessen your dependence on narcotic medications.
- Therapeutic Exercise/Home Traction: Stage II-IV of the recovery process involve therapeutic exercise to stretch, strengthen, and stabilize your spinal injury. The doctor will work with you and the therapist to develop an exercise prescription specific to the needs of your whiplash injury.
Chiropractic treatment for whiplash is based on established treatment guidelines with proven results. Using a blend of non-surgical techniques, your chiropractor will develop a plan to manage your whiplash injury and get you back to normal life as quickly as possible. For cases that require stronger medication or more invasive procedures like injections or surgery, your chiropractor will work as a member of the medical team to ensure the best possible outcome. Many chiropractors can also help you navigate the maze of insurance companies and attorney’s necessary in some injury cases. Integrative Chiropractic Treatment for Whiplash following a car accident can prevent years of pain and suffering. If you have neck pain caused by a car accident, consider chiropractic treatment for whiplash to get relief.
Non-surgical Spine Pain Expert, Dr. J. Adam Metzger works to help people overcome neck pain, back pain, and headaches as quickly as possible. Triple Board Certified in Chiropractic Medicine, Physiotherapy, and Acupuncture, Dr. Metzger is focused on accurate diagnosis, individualized treatment plans, and teaching patients how to best care for themselves and their family. He holds advanced post graduate certification in the biomechanics of whiplash and traumatic brain injuries from San Diego Spine Research Institute. For more information visit: https://spinewellnesscincinnati.com/
1 Chronic neck pain and whiplash: A case-control study of the relationship between acute whiplash injuries and chronic neck pain Michael D Freeman, PhD DC MPH,1 Arthur C Croft, DC MPH MS,2 Annette M Rossignol, ScD,3 Christopher J Centeno, MD,4 and Whitney L Elkins, MPH4 2 Adapted from Croft, AC: “A Proposed Classification of Cervical Acceleration/Deceleration Injuries with a Review of Prognostic Research” Palmer J Research 1994; 1(1): 10-21
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