This is the symptom
most commonly associated with whiplash type injuries. The
soft tissues of the neck take the brunt of the trauma,
and as such, this is the most painful area post accident.
The majority of
patients report the onset of neck pain within the first
six hours. Neck pain has been reported as starting 72
hours post accident.
There are three major
sources of pain which result from whiplash injuries,
including soft-tissue, neurological, and skeletal.
Soft-tissue damage is
by far the most common type of physical trauma caused by
whiplash injuries. This includes damage to the following
tissues: ligamentous, myofascial, and disc related.
Damage to the
anterior or front ligaments of the cervical spine
is common because of the stress put on them
during the backward movement of the head.
Complete disruption of ligaments are rare.
Myofascial
damage is by far the most common source of pain
in whiplash injuries. This results from strain to
cervical muscles.
Whiplash can
cause many disc related injuries and studies
reveal that those who suffer these types of
injuries have a higher than normal frequency of
positive MRI findings. Whiplash injuries can
cause changes in the cervical spine resulting in
premature degenerative disc disease.
Neurological trauma as
a result of whiplash can be broken into two types,
indirect and direct.
Disc
herniation is the most common cause of indirect
nerve damage. This condition can cause pressure
on nerve roots, which can lead to radiating
symptoms, shoulder symptoms, headaches, and
different types of sensory disturbances,
depending on which nerve root is involved.
Concussion is
a primary example of direct damage and can be
examined in more detail on the next page. Another
example is damage to the cervical sympathetic
chain, which is most susceptible to trauma during
the hyperextension phase of the whiplash injury.
This is believed to result in Horner's Syndrome
which can include nausea, dizziness, blurred
vision, and tinnitus or ringing in the ear.
Serious fractures of
the cervical spine are very rare. Smaller types of
fractures, though, can occur and be left undetected,
causing long term pain.
Treatment
Chiropractic care
offers early mobilization of damaged joints. Studies have
shown that spinal manipulation for non-specific neck and
back pain was more effective than care by a general
practitioner. Doherty Chiropractic also offers adjunctive
therapies, including cryotherapy, hydrocollator, spinal
traction, as well as muscle/myofascial work and
stretching. Advice on stretching and exercises to
strengthen damaged areas is also offered.
The best and most
widely recognized approach for neck pain is conservative
treatment.
Some practitioners
still prescribe a cervical collar. Studies have found
that early mobilization of the neck was more effective at
treating whiplash pain than was rest or a cervical
collar.
Some practitioners
prescribe cervical traction, but studies have shown that
cervical traction can aggravate symptoms in both the
acute and later stages, and that traction should not be a
substitute for a good stretching program.
Direct soft tissue
manipulation/adjustments using massage therapy can be
very effective in treating the myofascial component of
whiplash injuries.
Medical treatment of
neck pain includes bed rest, analgesics, NSAIDs, muscle
relaxants, and sleeping medication. Narcotics are
occasionally prescribed. The possible side effects of
medications is well documented, and patients should be
aware of these before they take them.