There are several factors that affect a whiplash injury, including:
· Body position at impact
· Overall physical condition and general state of health
· Awareness of coming impact
· Gender
It should be known that some of these factors related to whiplash are within the patient’s ability to control while others are not.
In this Blog Entry:
· What is Whiplash?
· How does Whiplash Occur?
· Factors Affecting the Whiplash Injury
· What is a Stabilization Response?
· Whiplash Treatment
There is a reflexive stabilization response in the cervical spine that helps protect it from potential whiplash injury:
· The nervous system detects the presence of the impact
· The muscles of the cervical spine, under the direction of the nervous system, contract quickly to try to minimize the affects of the impact on the ligaments and discs.
If this stabilization response is working efficiently following the whiplash accident, there is a greater likelihood of protection and less potential for whiplash injury.
But if the response is inefficient, an injury is more likely, with various types of whiplash pain possibly resulting and whiplash treatment potentially necessary.
Body Position Affects Whiplash Injury
The posture in which a person is sitting at the moment of impact affects the severity of the whiplash injury.
Sitting in a correct posture promotes an efficient stabilization response.3 Sitting in a poor posture, particularly a “slumped” type posture, promotes an inefficient stabilization response possibly resulting in more severe injuries.
Overall Physical Condition and Whiplash Injuries
The better conditioned the body is in general, the more efficient the stabilization response will be. This particularly relates to the condition of the nervous system, as a well-functioning nervous system is essential to a proper stabilization response.
Awareness of Coming Impact on Whiplash Injury Severity
Perhaps the most important factor that affects the efficacy of the stabilization response in relation to whiplash injuries is awareness of the impending impact.
Scenario 1: Aware of impending impact. This person is able to automatically prepare the stabilization system to respond quickly and efficiently.
Scenario 2: Unaware of the impending impact. This person cannot prepare the stabilization system, thus slowing the response and decreasing its efficiency. This person is likely to sustain greater whiplash injury than is the person who is aware.
This may help explain the findings of some studies that have shown a passenger in a struck vehicle is likely to sustain greater whiplash injury than the driver.4, 5 The driver is more likely to see the vehicle coming in the rear view mirror.
Whiplash Injuries and Gender
Women in general are more frequently and more seriously injured by whiplash than men due to the differences in muscular bulk and the female’s smaller bony structures. These factors result in less protection of the cervical spine (neck) to the abnormal forces such as those that occur in a whiplash-type of injury.
Other Factors Affecting Whiplash Injury
Risk factors influencing prognosis of a whiplash injury include:
· Whiplash pain/symptoms persisting beyond 6 months (43% failed to recover on average)
· Significant ligament, disc, nerve, or joint capsule injury.
· Delay in initiating treatment
· Need to resume treatment for more than one flare-up of pain.
· Occupant age over 65
· Head restraint more than 2″ away from occupant’s head
· Occupant in a small car
· Alcohol intoxication at time of automobile accident
· Pre-existing x-ray evidence of degenerative changes
· Prior whiplash injury
· Prior cervical spine fusion
· Patient having initial radicular (arm pain, numbness, tingling) symptoms
· A cervical collar used for more than 2 weeks.6
Common Misconception about Whiplash Injury
A common misconception about whiplash injury is that if the vehicle does not sustain damage in a low speed impact, then whiplash injury to the occupant does not occur.
In reality, low impact collisions can produce correspondingly higher dynamic loading on the occupants because the lack of crushing metal to absorb the forces results in a greater force applied to items or occupants within the vehicle.7, 8
Treatment
Treatment of a whiplash type injury will vary depending on the type and severity of injury. Consult your Maitland Chiropractor today for a complete evaluation of your whiplash type injury. For people who don’t seek out immediate treatment for their whiplash injuries often complicating factors develop and it becomes more difficult to treat with less optimum outcomes.
References
· 3. Murphy DR. “Normal function of the cervical spine II: Neurophysiology and stability.” In: Murphy DR, ed. Conservative Management of Cervical Spine Syndromes. New York: McGraw-Hill, 1999:45-70.
· 4. Harder S; Veilleux M; Suissa S. “The effect of socio-demographic and crash-related factors on the prognosis of whiplash.” J Clin Epidemiol 1998 May;51(5):377-84.
· 5. Parmar HV, Raymakers R. “Neck injuries from rear impact road traffic accidents: prognosis in persons seeking compensation.” Injury 1993; 24:74-78.
· 6. Nordhoff L: “Motor Vehicle Collision Injury for the 1990’s Doctor/Attorney”, Automotive Injury Research Institute,1994.
· 7. Macnab I: “Acceleration Extension Injuries of the Cervical Spine.” Rothman and Simeone, The Spine. 1982.
· 8. Hirsch SA, Hirsch PJ, Hiramoto H, “Whiplash Syndrome: Fact or Fiction?” Ortho C1 N Amer,19(4):791-95;1988.
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