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Symptoms of WhiplashWhat is whiplash?What are the symptoms of whiplash ? A great multitude of indications after whiplash may occur owing to the fact that every accident is unique and there is no typical patient. The common motor vehicle crash can damage the body, literally from the toes to the skull, and everything in between.
After nearly thirty years in practice I am convinced of one thing: there are very few whiplash injuries that leave people completely untouched. 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 skull, 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 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. Until recently, it was mystery how people emerged from an accident with almost no symptoms or signs, yet within 10 years their necks are 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.
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 per se. 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 tramatic brain injury, or a spinal cord injury, or a spinal or soft tissue injury, the symptoms of whiplash are complex! And may be 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. 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 in the car. We weren't physically injured, yet the psychological impact was profound as we mentally revisit the scene.
"If the only tool you have is a hammer, you tend to see every problem as a nail." Abraham Maslow Fortunately, as Chiropractors, we have many tools at hand. 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. Their treatment may not be the treatment of choice for an acute whiplash, and may aggravate the symptoms of whiplash. X-rayEvery 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. SymptomsThe 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 struck another impediment and then another, whether you anticipated the accident and tensed your muscles, these variables all make each whiplash unique.It can affect your low back, your ribcage, 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 this: 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, has happened; 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
(there are other excellent texts by chiropractors) are a must for every chiropractor, and even for the victims of whiplash who may want to understand more.
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