Health Society of South Africa

WHIPLASH
A chiropractic approach to treatment and self-care

Whiplash: A Forceful Neck Injury

Whiplash is a powerful force. Like the sudden, sharp snap of a whip, it hurls your head backwards (hyperextension) and forward (hyperflexion), injuring your neck. A car accident, sports injury or simply a push from behind - all can cause a whiplash injury. You can also have "hidden whiplash," since symptoms don't always appear right away. Chiropractors are spine specialists uniquely trained to diagnose and treat whiplash, relieve symptoms and help prevent more serious injuries from developing.

Your Neck Thrown out of Balance
Your head is delicately balanced on the top of your neck, held by fragile structures. The snapping motion of whiplash damages your neck, upsetting its balance. Then your neck can't easily move or support your head. A wide array of symptoms may follow in the wake of whiplash: neck and shoulder pain, headache, stiffness or dizziness. If left untreated, more serious problems may develop.

Restoring Your Neck's Balance
Under your chiropractor's care, you can bring back the balance your neck needs to work smoothly. A chiropractic evaluation helps your chiropractor diagnose a whiplash injury. While helping to heal your injured neck, chiropractic treatment can also relieve your symptoms. And early treatment helps prevent more permanent damage. You, too, can play a part with self-care, which aids healing and reduces your chances of future injury.

Your Chiropractic Evaluation

An evaluation helps your chiropractor diagnose a whiplash injury, discover the extent of damage and determine the most suitable treatment for you. A health history begins to uncover your symptoms and the cause of your injury. It may also reveal other, pre-existing problems with your spine. A physical examination helps identify the nature of your injury. You may also have x-rays, which help diagnose a whiplash injury or rule out other problems.

Health History
Your symptoms:
Do you have neck, shoulder, arm or lower back pain?
Do you have headaches, stiffness, numbness, dizziness or blurred vision?
When did your symptoms begin? Are they constant, or do they come and go?
What makes your symptoms better or worse?

Your injury:
Have you ever been in a car accident, fallen, had a sports injury or been hit forcefully?
Have you been injured more than once?
What, if any, treatment have you received since your injury? Has it helped?
What kind of work, sports or hobbies do you do?

Physical Examination
Your chiropractor uses special techniques to identify spine-related problems. Using firm finger pressure, your chiropractor checks for pain, stiffness, limited range of motion or swelling in neck or shoulder muscles. Finger pressure combined with bending your neck in different directions (motion palpation) may help your chiropractor locate restricted bones or joints (vertebral subluxation). You may also have other routine tests.

X-rays
X-rays give a detailed view of the bones (vertebrae) in your neck and back. They help spot where vertebrae have moved into an unbalanced position (called a misalignment), such as when the curve of your neck is reversed by whiplash. If your vertebrae are lined up like "stairs," rather than one on top of the other, you're likely to have soft tissue damage as well. X-rays also rule out other problems, like fractures or tumours.

Regular spinal checkups help your chiropractor diagnose and treat spinal problems - even those you aren't aware of. "Hidden" whiplash, for example, produces no symptoms; and a series of minor accidents over time may cause a "cumulative" whiplash injury.

Understanding Whiplash

Your neck does much more than simply connect your head to the rest of your body. Without your neck, you couldn't hold up your head, or turn it easily from one side to the other. Many complex parts of your neck work together to perform a delicate balancing act. But your neck is a fragile part of your body, as well. When the powerful force of whiplash strikes, your head is tossed around like the head of a flimsy rag doll. Your neck can be seriously injured. Then it is unable to move and support your head the way it normally does. If not corrected early, whiplash can lead to other problems, such as arthritic degeneration.

Your Spine Aligned
When you look at a balanced spine from the side, it is aligned in three natural curves; your neck's curve is one of them. From the front or back, a balanced spine is lined up straight down the middle of your back. When your spine is aligned, your weight is evenly distributed, making your back less likely to be injured.

Healthy Neck Anatomy
Maintaining your neck's balance requires an aligned spine and healthy neck anatomy. Your neck's anatomy has many fragile, complex parts. Some make up the spinal column itself, such as vertebrae and joints. Others - like muscles and ligaments - help support and move your head and neck, or run throughout your neck, such as spinal nerves.

Vertebrae are moveable bones that make up your spine.
Joints between vertebrae allow your neck to move freely.
Ligaments are soft tissues that connect vertebrae together.
Muscles are soft tissues that move and steady your neck and head.
Spinal nerves between vertebrae control your body's functions.
Discs are shock-absorbing pads of cartilage between vertebrae.
Blood vessels run throughout your neck's vertebrae, carrying blood.

Before Whiplash: Your Neck's Delicate Balance
Imagine balancing a 5 kilogram ball on the end of a stick. That's the delicate balancing act your neck performs throughout the day. Soft tissue is really the only thing keeping your head poised on the top of your spine. If your cervical spine is aligned and neck anatomy healthy, your head's weight is evenly balanced.

The Powerful Force of Whiplash
Whiplash turns your head's weight into a powerful force, hurling your neck past it's normal range of motion. In the typical whiplash injury, your head is shipped backward, injuring muscles, ligaments, discs and other structures. As your head whips forward, its speed greatly increases, adding to the force on your neck. If your head is turned to the side, injury is often more severe.

After Whiplash: Your Neck out of Balance
After a whiplash injury, your neck's balance is upset. Your neck's natural curve may be reversed, which unevenly distributes your head's weight and further misaligns your vertebrae. Your fragile, damaged neck must now strain to hold up your head. If not corrected, scarring - and even arthritic degeneration - may develop. You may also have recurring pain.

Your Chiropractic Treatment

Using spinal adjustments and related treatment, your chiropractor helps to restore your neck's balance and heal your injured neck. This relieves symptoms and improves your neck's ability to move and support your head. Because whiplash injuries can produce a "domino effect," one problem leading to another, early treatment helps to prevent further deterioration in your spine.

Spinal Adjustments
Spinal adjustments restore balance, helping to reduce stiffness and relieve pain and pressure in joints and nerves. Adjustments also realign vertebrae, improving your neck's strength, flexibility and range of motion. Your chiropractor can tailor treatment to your particular injury. Because soft tissue takes time to heal, you may need regular treatment over a period of time.

Your experience
You may feel light pressure on joints and hear a popping sound, the result of joints opening. Adjustments rarely hurt; instead, you may have immediate pain relief and feel more relaxed.

Related Treatment
Your chiropractor may recommend one or more other kinds of treatments to help heal your neck, relieve symptoms and restore your neck's function. These techniques work in a variety of ways - often by relaxing or strengthening muscles and by reducing swelling. You may be asked to continue some of these at home.

Trigger point therapy
Your chiropractor applies pressure to small, precise areas of pain (trigger points). This relieves "knots" in your muscles, helping to reduce pain.

Ice and heat
Your chiropractor may apply ice to your neck after an injury to help reduce swelling. Moist heat relaxes muscles when swelling is not present.

Traction
A "sling" around your chin gently releases pressure on joints and nerves. A rolled-up towel under your neck helps restore your neck's curve.

Cervical collar
A stiff collar immobilizes your neck. This technique is used only for pain relief or to support your neck when you can't hold up your head.

Electrical stimulation
Electrical impulses cause muscles to contract gently and automatically. They may relax muscles, reduce swelling and improve circulation.

Ultrasound
Painless sound waves reduce pain and swelling in joints and muscles. Ultrasound helps prevent scarring and may also improve circulation.

Self-Care

Chiropractic treatment is most effective when combined with self-care. Good posture helps keep your spine aligned, allowing your neck to heal in its proper position. Proper posture also reduces pressure on neck structures, helping to prevent future injuries. Neck exercises improve your flexibility and strength - another lifetime preventive measure against future injuries.

Good Posture
Keeping your spine balanced is a 24-hour job - whether you're sitting or sleeping. Even slightly bad posture can put pressure on your spine: tilting your head forward just 7-8 cm triples the strain on your neck. Try to keep your chin level with the ground and don't tilt your head to one side or the other. Since perfect posture isn't always possible, shift positions often.

When sitting
Sit up "tall" with a rolled-up towel or lumbar roll in the small of your back. To avoid slouching, hold reading material up vertically in front of your face. Try putting pillows on the armrests to help support your arms.

When sleeping
Sleep on your back with a pillow under your knees and a rolled-up towel under your neck. Or sleep on your side with a pillow under your head and neck to keep them level. Don't sleep on your stomach.

Neck Exercises
Neck exercises can help restore your neck's balance. They can strengthen your neck and help improve flexibility, by loosening muscles and ligaments and by increasing your joints' range of motion. Remember to do neck exercises only when your chiropractor prescribes them.

Flexion and extension
While sitting, push down on your knees with your hands. Arch your back, bending your neck backward. Then slump forward. Repeat this exercise 10 times, twice a day.

Side bend
Lace your fingers, with elbows pointing outward. Bend at the waist, moving your body to one side as far as you can; Then bend your head and neck. Repeat 10 times on both sides, twice a day.

Sit and twist
Lace your fingers, with elbows pointing outward. Twisting first at the waist, rotate your head and neck to the left side, then to the right. Repeat this exercise 10 times, twice a day.

Spinal moulding
Lie with a rolled-up towel under your neck and lower back. This "exercise" will help to remold your three natural curves. Repeat this for 15 minutes every night before you go to bed.

Don't exercise if you're in severe pain. Stop any exercise that increases you pain, and call your chiropractor.

Healing Your Injured Neck
It takes time to heal a whiplash injury. But with early diagnosis and treatment, your chiropractor can help correct your spinal problem, speed your healing and relieve your pain and stiffness. Self-care also helps to heal your neck and can act like an insurance policy for a healthier neck in the future.