The injury to the spinal column resulting from a rear-end collision is generally known as an acceleration-deceleration injury. The most common injury resulting from this type of collision is diagnosed as a “cervical strain”. This is frequently called a “whiplash” injury. This injury effects over “one” million people in the U.S. each year, and is the most common type of injury resulting from car accidents.
Whiplash injury symptoms are often chronic problems that persist for years. Headaches, neck pain, low back pain, and travel anxieties are but a few of these symptoms. Between 25 and 40% of whiplash injury victims never fully recover. Of these “one” million people in the U.S. who have sustained a whiplash injury, about 25% will suffer long-term chronic disorders. This injury can be especially troublesome for women who do not have as much muscle mass in the neck as men. Accelerated/decelerated injuries can range from mild muscle strains to even death or brain injury.
The acceleration/deceleration injury caused by a rear-end collisions causes energy to be transferred to the neck and the spinal column. These forces cause injuries sufficient to permanently disabled persons. Clearly studies have shown that the severity of the trauma is not often correlated with the seriousness of the clinical problem. Even at low speed impacts (around 8 mph) the accident victim’s head moves roughly 18 inches at a force as great as 7 Gs in less than a quarter of a second by comparison. The Discovery space shuttle is only built to withstand a maximum of 3 Gs. It is a common misconception that if there is no vehicle damage then there is little or no injury. Manufacturers use rigid or stiff motor vehicle bodies at testers as well as to improve bumper systems, but they still produce an increased g-force to occupants involved in car accidents.
Recent studies at the Chalmers University of Technology in Sweden suggest that the rapid changes to the spinal column as a result of acceleration/deceleration injuries cause damage to the nerves. Studies indicate that acceleration/deceleration forces in “rear-enders” may cause tiny focal lesions in the brain. Focal lesions caused by this type of trauma can affect language as well as difficulties with attention spans, reception and reasoning. These are symptoms similar to what is known as the “shaken baby syndrome”. These injuries are often subtle and can only be diagnosed with detailed a neural-psychological testing from an experienced practitioner. A focal brain injury can occur without an external direct impact to the head but from the “whipping” motion of the head, because of the uneven, rough surfaces of the inner skull. Acceleration/deceleration head injuries are often seen in the areas of the frontal or templar lobes. The deficits in this area which may result are in the areas of learning, memory, planning, organization, attention and emotional control of the victim.
The anatomical difference of a child’s brain (compared to the adult) renders it more susceptible than the adult brain to certain types of injuries following a rear-end collision. The child’s head is larger in proportion to his/her body and stability of the head is dependent upon the ligaments rather than a bony structure. A child’s brain has a higher water content which makes the brain softer and more prone to an acceleration/deceleration injury. Thus, making these young brains more susceptible to sheer-type injuries.
A whiplash injury in its simplest form essentially occurs when the soft tissue in the spine is stretched and strained after the body is thrown in a sudden, forceful “jerk”. The most frequent accompanying complaints are headaches and stiffness in the neck and the back of the head. Clearly these symptoms will appear within the first couple of days after the accident and usually pass after a few days or weeks.
A doctor or hospital should be alerted if the person suffering whiplash experiences any memory loss or any unconsciousness after the accident. This is especially true if the patient experiences severe pain in the back of the head or has pins and needles feelings in the shoulders or arms, or a sensation of heaviness in the arms.
In the first twenty-four (24) hours after a minor whiplash injury an ice pack applied to the back of the neck will often help relieve inflammation. The patient should lie in bed with his or her head resting on an ice bag for twenty minutes at a time. If normal over-the-counter pain killers don’t work you should consult your general physician. There are a number of exercises that can be used to relieve pain and stiffness to the neck after the initial onset. There are a number of sites where you can obtain specific information on these treatments.
The “whiplash” injury cannot be seen on x-rays, CAT scans or MRIs. Most doctors recommend that despite the pain in the cervical region, patients should start neck exercises as soon as possible and get out of bed within two or three days. Few people will develop continuing symptoms after a few weeks; but some may demonstrate reduced motion of the neck, tingling in the arms, back pain, fatigue and sleep disruption. This type of “syndrome” which continues after a few weeks is often difficult to treat. Fortunately, only in a small number of people with severe whiplash injuries do symptoms persist for months or years before receding. Even then, there can be residual long term discomfort in a small percentage of cases. In any event, after a few weeks if you are not better you should see your physician.
What is known as “whiplash syndrome” refers to persistent symptoms present for more than six months after the accident. This is at times called “cervical myofascial pain syndrome” and/or “hyperextension-flex injury”. In the event that over-the-counter pain medications and self-care treatment at home are not enough, your doctor may suggest prescription painkillers, injections of corticoid steroid medicine or lidocaine into painful muscle areas and/or muscle relaxants which are drugs that ease muscle spasms but can often cause drowsiness. In addition, there are various forms of physical therapy that may include ice, heat or ultrasound, as well as exercises to stretch and strengthen neck muscles. The doctor may even prescribe a foam collar which were once used a great deal but is no longer the recommended routine. During the day the cervical neck collars should never be worn longer than three hours at a time.
Currently there are many non-traditional therapies being employed to successfully treat whiplash pain including acupuncture, (which involves inserting ultra-fine needles into specific locations on the body); and chiropractic care, (which is similar to physical therapy); massage, (which is kneading the tight muscles in your neck) and could be helpful if you continue to have muscle spasms for more than a week or two. If the pain doesn’t resolve doctors often prescribe the use of a TENS unit. A TENS unit is a device which applies mild electrical currents to the skin. This non-harmful current helps decrease some types of pain, possibly by interfering with the transmission of pain segments.