Neck Pain and Injuries, Whiplash and Accidents

A person’s head is heavy and balanced on a narrow support (the neck) made up of seven bones called vertebrae. The vertebrae are separated from each other by discs, stabilised by joints and ligaments and moved by muscles.

Many people suffering from neck pain have muscle tightness. This tightness may be due to injury or poor posture. Specific stretching exercises can be very useful in reducing the pain and discomfort, and may eliminate the pain altogether (4).

Injury and postural problems are the most common causes of neck pain (1). Diseases such as arthritis or degeneration of the discs can also cause pain.

Most episodes of acute neck pain are due to a muscle strain or other soft tissue sprain (ligaments, tendons). This type of injury can be caused by a sudden force (such as from a car accident), or from straining the neck (such as a stiff neck from sleeping in the wrong position, or a strain from carrying a heavy suitcase).

Most minor injuries to the ligaments, tendons and muscles in the neck usually heal with time.  If the pain is present for more then a couple of days seek attention from your primary care provider. There are a number of treatments for neck pain and this includes spinal manipulation (2,3,5). The role of your chiropractor or osteopath is to help you via hands-on treatment and appropriate self management such as appropriate excercises (4).

Whiplash

Whiplash is a term used to describe a soft tissue injury to the neck, which occurs when the head has been forced into a sudden forward, backward or sdeways movement. The most common cause of whiplash is a motor vehicle accident, but it can also be the result of a sporting injury or other trauma such as a fall.

Even at low speeds, the amount of force generated by such an accident is very strong and can cause trauma to the ligaments, muscles, facet joints, discs and the spinal nerves. Besides neck pain and immobility, symptoms such as headaches, nausea, vertigo, arm and shoulder pain, tingling in the hands and fingers and weakness of the arm and hand are associated with whiplash injury.

When these additional symptoms are present it is called Whiplash –Associated –Disorder (WAD). The symptoms of WAD my come on immediately or be delayed by days or weeks. WAD injury is graded 1-4 (6,7).

0= No Pain or other symptoms
1= Minor pain, but no evidence of physical injury.
2= Signs of physical injury such as trouble turning neck
3=Neurological signs such as loss of reflexes or arm weakness
4= Neck fracture or dislocation.

It is very important to get immediate evaluation to rule out the possibility of fracture (WAD 4) which requires urgent medical attention (6,7). However in most cases (WAD 0- 3), the injuries are usually to the soft tissues and joints.  If the pain is present for more then a couple of days seek attention from your primary care provider. Approriate management of whiplash (0-3) is important and the role of your chiropractor or osteopath is to help you via hands-on treatment and appropriate self management (8).

Source:
https://www.coca.com.au/wp-content/uploads/2013/04/Neck-Pain.pdf

References:
1. Hoy DG, Protani M, De R, et al: The epidemiology of neck pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):783-92

2. Gorrell LM, Beath K, Engel RM, Manual and Instrument applied cervical manipulation for Mechanical Neck Pain. A Randomized Controlled Trial. J Manipulative Physiol Ther. 2016 Jun;39(5):319-29.

3. Saavedra_Hernandez M, Arroyo-Morales M, et al, Short-term effects of spinal thrust joint manipulation in patients with chronic neck pain: a randomized clinical trail. Clin Rehabil. 2013 Jun;27(6):504-12.

4. Theresa M Kay1,2,*, Anita Gross3, Charles H Goldsmith4, et al.  Exercises for mechanical neck disorders. Editorial Group: Cochrane Back Group . Published Online: 28 JAN 2015  -  Assessed as up-to-date: 29 MAY 2012 DOI: 10.1002/14651858.CD004250.pub4

5. Anita Gross, Jordan Miller, Jonathan D'Sylva, Stephen J Burnie,et al: Manipulation or Mobilisation for Neck Pain. Editorial Group: Cochrane Back Group Published Online: 23 SEPT 2015  -  Assessed as up-to-date: 7 JUL 2009 DOI: 10.1002/14651858.CD004249.pub3

6. Spitzer, W.O., Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: Redefining ‘whiplash’ and its management. Spine, 1995. 20: p. 1-73.

7. State Insurance Regulatory Authority. https://www.maa.nsw.gov.au/for-professionals/for-health-professionals/acute-whiplash/whiplash-assessment-tools?result_3871_result_page=1.

8. Wong JJ1, Shearer HM2, Mior S3, Jacobs C4, et al. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? an update of the bone and joint decade task force on neck pain and its associated disorders by the optima collaboration. Spine J. 2015 Dec 17. pii: S1529-9430(15)01234-6. doi: 10.1016/j.spinee.2015.08.024