Just a few weeks ago we had a 38-year-old female patient, Debbie, come into Chirolink complaining of neck pain. After taking a history we discovered that while Debbie was crossing the road with her two children, she had a sudden fall over the curb. Initially, she thought everything was alright but throughout the day her neck gradually started stiffening and some pain started to build. The next day Debbie could not turn her head and started noticing some pins and needles down her arm. For a few days, she was irritable, tired, and couldn’t shake a low-grade headache. This was when she decided to book her appointment with us.
This is a classic example of a low-grade whiplash injury and the best advice we could give is to get it seen as soon as possible to stop the buildup of symptoms that become much harder to get rid of with time.
We saw Debbie go from having pain, sleeping poorly, overall fatigue, and irritability to zero symptoms within just a few sessions.
Whiplash injuries occur with a sudden movement of the head forwards and then backward. This can also occasionally occur with sidewards movements. The mechanism of this injury involves rapid acceleration and then deceleration with possible hyperflexion to hyperextension of the head and neck. Ultimately, this can result in mild to severe injuries and the most common way it occurs is with motor vehicle collisions but can often occur with something as simple as a trip or fall.
The symptoms may include:
- Neck pain
- Neck stiffness and difficulty moving the head
- Headaches
- Pain and muscle spasms in the shoulders
- Dizziness or vertigo
- Difficulty focusing
- Pins and needles either locally or down one or both arms
- Difficulty sleeping
- Irritability
- Nausea
The neck is a small and complex system with many very intricate muscles, tendons, ligaments, capsules, bones, blood vessels, intervertebral discs, and nerves that all work as a specialized mechanism to solidly house, protect and facilitate the function of the very first part of the spinal cord. It is home to very important neurological centers that keep us alive, and it carries every single message that is sent from the brain to the body and every single message sent from the body to the brain. It is small, complex, and so very important.
When a whiplash injury occurs, the sudden exaggerated movement of the head forward and then backward is unguarded and ‘unprotected’ and is often beyond the neck’s normal physiological limits. The brain does not have sufficient time to process the sudden events occurring and, thus, the muscles that normally hold the neck strong to protect themselves, don’t fire fast enough. In response to this, when the body starts to go back to ‘normal’ and out of the stress response that was triggered, the muscles start to overcompensate and tighten excessively to protect the area. This is just one of the reasons why normal neck movements are so difficult to perform.
Common structures affected are:
The muscles – ranging from very mild strains and micro-tearing to major tearing or rupture. The sternocleidomastoid, anterior, middle, and posterior scalene muscles, and longus coli muscles are most commonly affected in the front and side of the neck. At the back of the neck, the most commonly affected muscles are the splenius capitis, semispinalis capitis, levator scapulae, trapezius muscles, and the tiny rectus capitis major and minor muscles.
The ligaments – the deep ligaments of the neck are in a very complex arrangement. Most are less than a centimeter long and are only a few millimeters thick. These small structures can overstretch relatively easily, resulting in micro-tearing or even rupture. The most common ligaments affected are the interspinous ligaments and the intertransverse ligaments spanning the cervical spine. There are a few larger ligaments such as the anterior longitudinal ligament or posterior longitudinal ligament that each respectively extend along the front and back of the vertebral bodies in the neck and lastly, there are the more superficial ligamentum nuchae at the back of the neck which is a thick syndesmosis in the midline spanning the cervical spine.
With a whiplash injury, when the head accelerates forward, the structures at the back of the neck are suddenly overstretched while the structures at the front are suddenly compressed. All the structures mentioned above can be affected. There can be wedging of the front of the vertebral bone and intervertebral disc damage with possible bulging which can irritate or compress the correlating spinal nerve.
When the head decelerates backward, the structures at the front of the neck are suddenly overstretched while the structures at the back are suddenly compressed. As mentioned before, all the structures above can be affected. There could even possibly be tiny pieces of the bone pulled off the front of the vertebrae by the anterior longitudinal ligament, fracture of the back piece of the vertebra by compression, intervertebral disc compression injury posteriorly, and tearing anteriorly. There could even be sympathetic chain nerve injury. This is in more severe cases which could also have associated concussions, spinal cord injuries, and even eye injuries.
Any of these structural changes will irritate the surrounding soft tissue structures and nerves either directly due to primary injury or indirectly due to the surrounding inflammation and localized swelling but in most cases – which are usually mild – there are often no visible abrasions or bruising.
It is important to remember that most of the time whiplash injuries are considered mild to moderate but no matter how mild the injury it is always crucial to get examined by your primary health provider.
In summary, this intricate yet exceptionally strong system needs to be taken care of. No one wants to be living in any pain or discomfort that builds and gets harder to get rid of as time goes by.
At Chirolink, we have helped many people with whiplash injuries and more than happy to help you if you have had similar injuries and looking to get some relief from your pains and aches.