Today we are reviewing a paper that was published in 2008 titled “Whiplash: Diagnosis, treatment, and associated injuries.” in the journal Current Reviews in Musculoskeletal Medicine. This study is a review of 485 articles on Whiplash and Whiplash associated disorders. These injuries are from acceleration and deceleration in the cervical spine.
In the united states whiplash is the most common injury associated with car accidents. It affects up to 83% of the population and costs patients $3.9 billion annually in medical bills. However, if you total the litigation fees, it totals up to $29 billion.
In 1995 The Quebec Task Force met and created a grading and classification system to Whiplash injuries:
Grade 0: No complaint about the neck. No physical signs of injury.
Grade 1: Neck complaint of pain stiffness or tenderness only. No physical signs.
Grade 2: Neck complaint and Musculoskeletal signs including decreased range of motion and pain or tenderness.
Grade 3: Neck complaint and neurological signs including decreased or absent Deep Tendon Reflex’s weakness and sensory deficits.
Grade 4: Neck complaint and fracture or dislocation.
Controversies exist in how to diagnose, treat, and give a prognosis for whiplash injuries. There is a wide variety in the way patients report their injuries as well, and in many cases it can be hard to find diagnostic criteria to prove the problem. The diagnosis of whiplash associated disorders is grounded in the clinical findings of Headache, Neck pain or stiffness, arm pain and numbness or tingling, TMJ pain, Visual disturbances, memory and concentration problems and psychological distress. Patients may also experience Psychosocial symptoms like depression, fear, anger, hypochondriasis, and anxiety.
Commonly there will be radiographic findings that accompany whiplash injuries like Preexisting degenerative disc or joint disease in the cervical spine or a loss of the normal cervical curve, known as the lordotic curve. Some studies even suggest that part of the problem with whiplash is the joints in the cervical spine are actually misaligned and become hypomobile or stuck out of place and that early mobilization or correction of the alignment can improve motion and speed recovery.
Some of the studies suggest that symptoms persist in 25-40% of patients after one year. Another study showed that 7 years post injury, 40% of patients were still suffering from Whiplash Associated Disorder symptoms.
The paper described factors that may delay recovery like age, sex, and preexisting cervical spine conditions. We see that whiplash associated disorders appear more in patients that are older in age, more females than men (due to the physical size of the neck and the structures in it), and the proper curve, or lack thereof, before the accident.
Click the link below to see the paper discussed here. And feel free to watch Dr. Evans Facebook live video, too!
If you or someone you know are suffering from some of the whiplash associated disorders symptoms like: neck pain, headache, numbness or tingling, loss of range of motion in the neck and jaw pain, Upper Cervical chiropractic care may be an option to help them recover. To learn more, come and join us at our Dinner with Don on Whiplash coming up on September 27 at 6:30. Dinner is on us at the Atlantic Grill in Rye, NH. Check out the EVENT on Facebook or call 603.380.9184 to reserve your seat today!