In this article we will discuss whiplash injuries as a result of car accidents and focus on repairing the damage caused by the sudden extension and flexion – that is the whipping of the head back and forth.
Whiplash injury and chronic neck pain
Doctors are confirming what Prolotherapy doctors have known for sometime, that prolonged symptoms of whiplash – neck pain, headaches, dizziness, burning or prickling sensations (paresthesias), back or shoulder pain, and difficulties with concentration and memory are usually not problems with the cervical discs but a problem of damage to the cervical ligaments.
So a rush to fuse vertebrae may be a rush to the wrong treatment.
Here is a study from the journal Traffic Injury Prevention: What the doctors were looking for was how the placement of the head at the time of impact affected long-term symptoms. In other words – how stretched were the neck ligaments at the time of impact – and how much more did they get stretched during the impact.
The doctors then came up with a model that would predict ligament damage. Here is what they concluded:
- Higher potential for injury when the head was turned (ligaments will be stretched in head turned position). This time of impact position could lead to a higher potential for whiplash injury by as much as 50%.1
This is agreed to and embellished in a paper from Fort Lewis College and Colorado State University researchers who suggested doctors can be mislead in their diagnosis and treatment by not fully understanding the complexities of range of motion in the neck. To find the cause of cervical instability – doctors need to increase the physical examination of the neck ligaments.2
Caring Medical Published Research
This is also confirmed in our own published research spearheaded by Danielle R. Steilen-Matias, PA-C. In this research that appeared in The Open Orthopaedics Journal we showed that conventional treatments for chronic neck pain remains debatable, primarily because most treatments have had limited success because they did not address the cervical ligaments.
This section comes from the research as it pertains to whiplash injury:
Damage to cervical ligaments from whiplash trauma has been well studied, yet these injuries are still often difficult to diagnose and treat. Standard x-rays often do not reveal present injury to the cervical spine and as a consequence, these injuries go unreported and patients are left without proper treatment for their condition.3
Part of the difficulty lies in the fact that major injury to the cervical spine may only produce minor symptoms in some patients, whereas minor injury may produce more severe symptoms in others.4 These symptoms include acute and/or chronic neck pain, headache, dizziness, vertigo and paresthesia in the upper extremities.5,6
Multiple studies have implicated the cervical facet joint and its capsule as a primary anatomical site of injury during whiplash exposure to the neck. Others have shown that injury to the cervical facet joints and capsular ligaments are the most common cause of pain in post-whiplash patients. In a research update from December 2016, Swedish researchers found a substantial number of whiplash patients indeed had pain emanating from the cervical facet joints.7
In our study we were able to conclude and document Prolotherapy injections to be an effective treatment for chronic neck pain and cervical instability due to whiplash, especially when due to ligament laxity in the cervical joints.8
Discussion on Treating chronic neck pain and instability are continued in our article.
Chronic Neck Pain and Cervical Neck Instability.
1. Shateri H, Cronin DS. Out-of-Position Rear Impact Tissue-Level Investigation Using Detailed Finite Element Neck Model. Traffic Inj Prev. 2015;16(7):698-708. doi: 10.1080/15389588.2014.1003551. Epub 2015 Feb 9. [Pubmed]
2. Leahy PD, Puttlitz CM. Addition of lateral bending range of motion measurement to standard sagittal measurement to improve diagnosis sensitivity of ligamentous injury in the human lower cervical spine. Eur Spine J. 2016 Jan;25(1):122-6. [Pubmed]
3. Johansson BH. Whiplash injuries can be visible by functional magnetic resonance imaging. Pain Res Manage. 2006;11(3): 197–9. PubMed
4. Swinkels RA, Oostendorp RA. Upper cervical instability fact or fiction. J Manip Physiol Ther. 1996;19(3): 185–94. PubMed
5. Barnsley L, Lord S, Bogduk N. Whiplash injury. Pain. 1994;58: 283–307.PubMed
6. Spitzer WO, Skovron ML, Salmi LR , et al. Scientific monograph of the Quebec task force on whiplash-associated disorders redefining “whiplash” and its management. Spine (Phila Pa 1976). 1995;20(8) Suppl : 1S–73.PubMed
7. Persson M, Sörensen J, Gerdle B. Chronic Whiplash Associated Disorders (WAD): Responses to Nerve Blocks of Cervical Zygapophyseal Joints. Pain Med. 2016 Dec;17(12):2162-2175. doi: 10.1093/pm/pnw036. Epub 2016 Mar 27. Pubmed
8. Steilen D, Hauser R, Woldin B, Sawyer S. Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability. The Open Orthopaedics Journal. 2014;8:326-345. [Pubmed]