The Walking Wounded
By Dr. Benton McCone, D.C.
In his famous book, Whiplash: the Epidemic, Dr. Arthur C. Croft describes whiplash as an epidemic plaguing American culture as well as other cultures of the world. Almost 10% of our population suffers from whiplash syndrome, most often resulting from an automobile accident. Collisions, most notably rear-end collisions, of speeds as low as 4 MPH can cause whiplash, and over 3 million people per year are affected.
The medical dictionary defines whiplash as follows:
"…injury through rapid acceleration of the head, with hyperextension of muscles and ligaments supporting the cervical spine. Site of damage usually occurs at third or fourth cervical vertebrae; painful and slow to heal."
In layman’s terms, whiplash is generally used to describe what happens to the human neck in an automobile accident. Usually whiplash in the traditional sense occurs in rear-end collision accidents, but can occur in all varieties of collisions. In addition to the neck, the low back is also often injured in accidents since whiplash first throws your lower body into the back of the seat while the upper body recoils and "whips" back into the headrest, stretching the neck beyond its normal range of motion. This process often involves the hyperextension or tearing of ligaments and muscle tissues in and around the neck and back. Even if immediate pain is not felt, an injury of this type will leave the neck and back unstable and highly susceptible to future re-injury.
Even if an accident seems trivial at the time because of slow speeds or little or no damage to the vehicle, this does not indicate that passengers in the vehicle have not been injured. In a collision occurring at about 10 MPH, the body is subjected to high acceleration at a rate of 9-12 G's. For reference, the units of acceleration (G) are measurements of change in velocity (speed). The force of 10 G's is greater than a fighter pilot would experience during combat. At that force, special G-suits are required to prevent the pilot from blacking out. Studies have shown that the speed at which the body whips back and forth is anywhere from six to ten times the speed at which the vehicle was moving. This means that in a 10 MPH collision, the neck will move at a rate of up to 100 MPH.
The truth is that even slow-speed crashes can produce a violent acceleration to the neck that produces painful, progressive and often, if not diagnosed correctly and treated promptly, permanent injuries. The symptoms, in order of prevalence, are neck pain & stiffness, shoulder pain, headaches, back pain, arm pain and weakness, dizziness or light-headedness, and pain down into the legs. Whiplash can also produce facial pain, auditory symptoms with hearing loss, vertigo, blurred vision, or even hoarseness. This injury is real, and is painful because ligaments and muscles that support the neck have been stretched or torn. The injury is progressive because the neck vertebrae are now unstable and arthritis will accelerate. The injury is often permanent because the ligaments and soft tissues, without prompt attention and proper treatment, cannot be repaired to their natural state and will heal with scar tissue which is less elastic and far more susceptible to future injury. In extreme cases, surgery may be needed to stabilize the neck.
Today’s automobiles offer no relief from the whiplash epidemic. Modern bumpers are built to withstand accidents in the 10 MPH range without noticeable damage. This feeds the incorrect belief that if there is no damage to a vehicle, there is no damage to a human body. These stronger bumpers, however, actually can make the injury worse. They transmit the energy of the crash into the car and whip the occupants’ bodies back and forth. The entire process of whiplash takes place in less than 300 milliseconds at a speed of 10 MPH. It happens so fast, occupants at first may not even be aware that their body has moved. Delayed pain is quite common in whiplash injuries, sometimes taking days or weeks for symptoms to surface. It is never safe to assume that you have not been injured in an automobile accident, no matter how minor an accident it may have seemed at the time. While seatbelts save lives, they also can magnify the effects of whiplash. Women, in general, are more prone to injury than men because they have a more fragile neck structure.
Research has shown that the majority of whiplash injuries occur at speeds between 6-12 MPH. It has been further demonstrated that the threshold for injury in collisions is about 4-5 MPH. Outcome studies confirm that crash property damage does not correlate with injury severity. This is explained further by the fact that modern bumpers are designed to withstand crashes of 10-15 MPH without showing damage. Since most whiplash injuries occur at speeds of 6-12 MPH, most vehicles involved in these crashes would show little or no damage while significantly injuring the vehicle’s occupants.
Traditional diagnostic tools have not helped with whiplash injuries much over the years because standard diagnostic tools such as static x-rays are not well suited to diagnose ligament injuries. Probably the best diagnostic tool for detecting soft tissue and ligament injuries in the neck are dynamic x-rays. By taking dynamic x-rays at various levels of the cervical spine and positioning the neck specifically to show movement of soft tissue, injuries will be revealed and ligament damage becomes visible that would otherwise be overlooked in standard, static x-rays.
What should you do if you have been involved in an auto accident? First, you should follow all the correct procedures the law requires. Second, see a Chiropractor. Chiropractors have the most experience with and are best trained to diagnose and treat these specific types of injuries at the source. Drugs can only mask the pain, and surgery should be used only as a last resort and only in extreme cases. Chiropractic care, complimented by massage and physiotherapies, is proven effective at treating soft-tissue whiplash injuries. The important thing is to get checked out as soon as possible after an accident. Take charge of your health and take positive action. Be safe, and be healthy.
Benton D. McCone, D.C. can be contacted at Total Wellness Chiropractic, located at 3535 Plymouth Blvd Suite 110, Plymouth, MN 55447. For more information or an appointment, call 763-550-1006.