Tuesday, March 22, 2011
Whiplash...Injuries of the Neck
The crunch, the crash, the whiplash. Whiplash is usually due to trauma such as a car accident. So what is whiplash ? A whiplash injury of the neck is one that involves an abrupt movement of flexion and extension( bending forward and backward). Symptoms include severe pain, spasms, loss of motion of the neck as well as headache. In my opinion, every case of trauma should be evaluated by a doctor or other qualified health professional to rule out cervical neck injury (spine). Pain can be persistent despite only little identifiable abnormalities found on xrays or even MRI scans. Often with the case of whiplash, it is the soft tissues, spinal nerves, discs, ligaments, or small joints in the spine, called facet joints, that are injured.
These injuries are very common after trauma, even more than fractures. They are; however, poorly understood. In a study involving nearly nineteen-hundred people involved in a car accident, 26% had neck pain for greater than a day. There were eight risk factors identified for whiplash injury: females, younger age, prior history of neck pain, rear injury collision, stationary vehicle at the time of the impact, the severity of the collision, not being at fault, and monotonous work( isn’t that one interesting?). In a review of some 47 studies, approximately 50% of adults with whiplash injury reported neck pain symptoms at the end of one year. If you are involved in a car wreck or have an injury to the neck either directly or indirectly, seek help sooner as opposed to later.
The cause or pathology of whiplash is unclear. Theories include micro-vascular bleeding into the ligaments as well as the release of inflammatory cells. This would explain the short term symptoms but hard to explain why many people remain with symptoms months or years later. A study using high resolution MRI of the Cervical spine in patients with a history of whiplash injury average of 6 years previously, demonstrated soft tissue damage was not detected in the MRI images of patients without symptoms( the controls).
There was a study published in the United Kingdom a number of years ago. It stated that the most important factors to predict if someone would have pain at the end of one year were pain severity (or how painful it was) at the time of the rear-end collision and the presence of a compensation claim. This is also likely to be true here in America where we have whiplash “experts” and personal injury attorneys. This is why I call this the “wild wacky world of car accidents!” In fact, Australia had a change of law where financial compensation for pain and suffering were removed from whiplash claims. This was associated with improvement in functional status as well as pain. Interesting.
So, if you have had a car accident or some injury to your neck, see your doctor for an evaluation. He is the one who will most likely look out for your best interest! =)
Dr. Frank Marinkovich and his wife Rita own and operate Eastside Family Health Center in Kirkland, WA. Serving Kirkland and the Eastside, Seattle, Bellevue, Renton and the surrounding local communities. Specializing in Primary Care, Automobile Accidents and FAA physicals. Be sure to find out more about their NEW specialized Laser Treatment. Visit them online at http://www.eastsidefamilyhealth.com or call them at (425) 899-2525.