Imagine, your driving to work on a Friday morning. Your making great time. Today you get off a few hours early for the long weekend ahead so you and the family can go camping. You reach down to take a sip of your fresh double double. The aroma filling the cabin of the car.
You approach the traffic light, and hit the red that you always seem to hit. But you don’t mind. You grab your bacon and sausage biscuit sandwich - after all it is Friday. You take a bite.
Delicious.
The next thing you know you hear a loud crashing sound, and your being pushed into the intersection! And the pain! Like someone is stabbing a knife into your neck!
Whiplash is a type of neck injury that occurs when the head is suddenly jolted backward and then forward. It is commonly associated with car accidents, especially rear-end collisions, but it can also result from sports injuries, falls, or other traumatic incidents.
Understanding the Mechanism of Whiplash
Rapid Acceleration-Deceleration:
The most common cause of whiplash is a sudden acceleration-deceleration force, typically occurring during a car accident.
This quick movement can cause sprain and strain and injuries to neck, jaw, upper back, shoulders, low back…really anywhere in the body. However, whiplash is typically thought of as an injury to the neck.
If a person doesn’t see the impending collision, they can’t brace their muscles. This is why some of the worst injuries that I’ve seen have been from a rear-end collision.
Do You Understand Whiplash Symptoms?
The hallmark symptom of whiplash is neck pain, which is often described as a dull, aching pain. It can also be sharp and stabbing, even throbbing. The pain may be localized to one area or may radiate to the shoulders, upper back, or arms.
Stiffness
Whiplash can lead to neck stiffness, making it difficult to move the head or turn from side to side. Checking your blind spot is often challenging.
Headaches and Migraines
Many people with whiplash experience headaches. They can range from mild to severe. While usually at the base of the skull, and back of the head, they can also be felt in the forehead and temples.
I have also seen whiplash injuries cause horrendous migraines, making day to day activities next to impossible.
Tenderness
The injured area, and other areas of your entire body may be tender to the touch. It isn’t uncommon to be sore and to have muscle spasms in your neck and back.
Reduced Range of Motion
Due to pain and stiffness, it is very common to have reduced range of motion in your neck and back. This makes getting dressed, checking your blind spot, and normal daily tasks like bathing or getting changed challenging.
Fatigue and Dizziness
This may be overt vertigo, or even a more vague woozy, or unbalanced sensation. Some people also have difficulty concentrating, and often become very tired with normal activities.
I had a patient earlier this week who couldn’t stand with his eyes closed without falling over! After an accident happened three years ago, he still hasn’t fully recovered.
Depending on the severity of the injury, individuals may also experience symptoms such as:
Ringing in the ears (tinnitus)
Blurred vision
Numbness and tingling
Weakness
Concussion like symptoms
You may wonder how these problems go undetected. One reason may be that often symptoms do not appear immediately after the injury. They can develop in the hours or days following.
I’ve seen patients who told me they don’t know why they are hurting so much. With further questioning they ‘remember’ that they were in a car collision a week before. They initially didn’t think much of it. However, that is the reason they woke up with a sore neck, blinding headache and ringing in their ears. Not because they ‘slept funny’.
Seeking prompt medical attention and appropriate treatment is crucial for managing whiplash and preventing long-term complications. Remember, 1 in 3 people injured in an accident end up with chronic pain. Don’t let happen to you!
This is why receiving the appropriate treatment and home care strategies is crucial!
Understanding the Grading of Whiplash Injuries
Whiplash-associated disorders (WAD) are typically classified into different grades or levels based on the severity of symptoms and the extent of injury. The grading system helps healthcare professionals assess and categorize the impact of the injury. The most commonly used classification system for whiplash-associated disorders is the Quebec Task Force Classification. It consists of four grades, ranging from Grade 0 to Grade 4:
Grade 0 Whiplahs: No Symptoms
- No neck pain, stiffness, or physical signs of injury.
- No complaints or physical findings related to the whiplash injury.
Grade 1 Whiplash: Neck Pain, Stiffness, or Tenderness
- Neck pain, stiffness, or tenderness, but no physical signs of injury.
- No objective clinical findings.
Grade 2 Whiplash: Neck Symptoms with Clinical Signs
- Neck pain along with clinical signs, such as decreased range of motion, point tenderness, or muscle stiffness.
- No neurological signs (e.g., no sensory or motor deficits).
Grade 3 Whiplash: Neck Symptoms with Neurological Signs
- Neck pain along with neurological signs, such as changes in reflexes, weakness, or sensory deficits.
- These neurological signs may indicate nerve involvement.
Grade 4 Whiplash: Neck Symptoms with Fracture or Dislocation
- Neck pain along with the presence of a fracture or dislocation, which may be confirmed through imaging studies like X-rays or other diagnostic tests.
- This grade suggests a more severe and potentially dangerous injury.
It's important to note that this classification system is used as a guideline for healthcare professionals to determine appropriate treatment and management strategies.
While there is no ‘one size fits all’ approach, grading these injuries with an accurate diagnosis by a competent healthcare professional is a useful first step.
I wish I could tell you they always get this right. But I’ve seen to many patients diagnosed as a ‘WAD 2”, who were clearly a “WAD 3”, with severe nerve injury.
People experiencing symptoms of whiplash should seek medical attention. Remember, 1 in 3 end up with chronic pain. These aren’t good odds! So make sure to get the care you need! Especially if there are persistent or worsening symptoms. The sooner someone gets help the better their chances are of making a full recovery!
What Causes Chronic Pain?
1 in 3 people injured in a vehicle collision end up with chronic pain. Those aren’t good odds! Why do so many still hurting over a year later? Some for years to come. I’ve met many in their 60’s and 70’ with a ‘bad neck ever since that “damn car accident” in [their] 20’s.””
We are going to go over some of the most common reason’s that chronic pain happens after a whiplash’s injury. There are typically a combination of physical, psychological, and neurobiological factors involved. In order to solve this problem, understanding the complexity of chronic pain requires considering all of these factors. In my experience, here are the most common factors that are missed.
Incomplete Tissue Healing
- Some individuals tissues may not fully heal. This could be due to multiple reasons. Inappropriate treatment, exercises and stretches, continued re-aggravation of the injury, too much rest leading to inadequate healing. Sometimes it may be due to other health conditions which impair healing, such as uncontrolled diabetes, and others.
Muscle Imbalances and Weakness:
- Whiplash injuries can lead to muscle imbalances and weakness. Often theses imbalances go unnoticed, unless specifically looked for. This causes altered movement patterns, de-conditioning, and excessive stress on injured tissue’s.
Joint Injuries:
- Whiplash can result injuring the joints of the spine, particularly in the neck and upper back. Undetected or untreated joint issues may contribute to ongoing pain, stiffness, and even vertigo. I’ve seen people with ongoing issues for several years. After we start treating the joint injury, their symptoms significantly improve.
Central and Local Sensitization:
- Nerves may become sensitized or hyper-excitable following a whiplash injury. This can happen in a local area of the neck. However, it can also happen more diffusely, throughout an entire region of the neck , upper back and shoulders. With this increased sensitivity, chronic pain is not far behind. This may happen even in the absence of ongoing tissue damage.
Psychological Factors:
- Trauma, and lets face it, a whiplash injury is traumatic - often causes an emotional reaction. It is very normal to experience anxiety, depression, or post-traumatic stress after this type of injury!
- Unfortunately, if these issues are not addressed, they can contribute to experiencing chronic pain..
Delayed Onset of Symptoms:
- Some symptoms, including chronic pain, may have a delayed onset after the initial whiplash injury. Failure to recognize and address these delayed symptoms can lead to chronic pain.
Inadequate Rehabilitation:
- If a person does not complete their rehabilitation program, or if the program is not comprehensive or tailored to the individual's specific needs, certain aspects of recovery, such as muscle strengthening, flexibility, and proprioception, may be overlooked. This is a big factor! This also happens with other injuries, not just whiplash. This is why people end up with a ‘Bad hip”, “Bad shoulder”, “bad [insert body part]”.
Medication Over-reliance:
- Relying solely on medications for pain management without addressing underlying issues may not lead to optimal outcomes. Remember, just because the pain is gone it doesn’t mean the causes of the pain has been resolved. This is why medication often provides fleeting pain relief, if any.
Addressing whiplash injuries requires a comprehensive approach. When all of these factors are not addressed, developing chronic pain is more likely.
1 in 3 people with injuries after a vehicle collision end up with chronic pain.
Don’t be one of them!
From “Not that bad” To “I can’t move”
Several years ago I was treating a patient for neck and back pain. After several weeks we had finally gotten to the point where he was feeling good as new. No back pain. His neck pain and headaches were gone. Everyone was happy!
Unfortunately, just a few days later he was rear ended.
He was a driving a full sized Dodge Ram, pulling a 20” trailer. While at a complete stop, someone drove into his trailer. He told me he barely felt the impact. It just caused him to lurched forward a bit.
He got out of the truck, checked on the other driver, who was shaken up, but “OK’ overall. Luckily no one was serious injured.
The next morning he was feeling some stiffness in his neck again so he thought he would come back to see me.
Other than slight reduced range of motion in his neck, and some localized tenderness he was fine.
I provided treatment that a day, and asked him to perform a few specific exercises, and to follow up at the end of the week.
I told him that he can expect to be sore and stiff over the next week, so it was important that a he work on those stretches I gave him, and that the soreness is normal and expected.
Well, the week goes by and I didn’t hear from him. Then another week passes. A month later he comes back into the office.
He was wearing dark sun glasses, being helped into the office by his wife. He could hardly walk without losing his balance. It took him about 10 minutes to walk to the treatment room, about 20 feet away from the front door.
“What the hell happened?” I asked him.
Well, it turns out that he was still stiff after his appointment with me - even though I said he would be, and that it was normal and to continue to stretch - so he decided he would see another healthcare provider in town to see if they could get it to loosen up.
Then he was recommended to see this “health care provider” EVERY. SINGLE. DAY. over the past month.
(I put healthcare provider in quotations, because no sane healthcare provider would do this.)
And because he was mismanaged, and tissues were not given time to heal between appointments like I had suggested, things got worse. A lot worse.
He was experiencing blinding migraine headaches. Excruciating neck and upper back pain. He could hardly move his neck without stabbing pains. And he could hardly walk without tripping over himself. He needed someone to help him walk everywhere he went or risk falling down - and he was not a small man!
Thankfully over the next few months we were able to stabilize everything and get him back to normal again. Suffice to say, he didn’t return back to the other ‘professional’.
This is why it is so important to find a health care provider that provides appropriate health care. AND why it is also up to the person being treated to actually take their advise.
Inappropriate treatment - either to much, or not enough, or not the correct kind- can really have life altering impact.
Don’t let what happened to this person happen to you!
If you have found this helpful, but need personalized and guided direction, consider requesting your RECOVERY BLUEPRINT Call. This is a Free, no-obligation, 15-minute call with Dr. Joseph Tanti, where you will have a clear BLUEPRINT of your options to improve your health and wellbeing.
Or if you would like an in person assessment, feel free to schedule an in office appointment. I’m looking forward to meeting you!