Tuesday, October 1, 2019

Whiplash: 12 Things you should know


1. Significant injuries occur at low-speeds.
2. Women suffer greater injuries than men because they have less strength in their neck muscles.
3. Early mobilization is critical. Use of a cervical collar actually gives worse results than no treatment at all. Immobilization following injury causes muscle wasting and loss of strength that significantly delays recovery. Corticosteroids damage articular cartilage & decrease collagen strength & repair. Early mobilization improves healing & repair of bone, cartilage, ligaments, & tendons. It also improves joint proprioception, which helps to prevent early joint degeneration. 
4. Most whiplash injuries are occult and cannot be identified on conventional imaging such as x-ray, MRI, or CT scans.
5. The peak inflammation associated with whiplash is located around the C2 vertebra and is the most common origination of headache symptoms. The C2/C3 facet joint in particular is the cause of cervicogenic headache 53% of the time.
6. The severity of vehicle damage is not predictive of injury or outcome. Stiffer vehicles actually increase the probability of long-term consequences because the forces get focused on the head & neck. A more accurate predictor of outcome is if the injured person experiences acute neck pain within the same day of injury. These people are 3x more likely to report chronic neck pain 7 years later. Also of note, younger people generally have a better prognosis & require less treatment.
7. Upper Cervical spine is most injured when head & neck are in flexed & rotated position at time of impact (e.g. looking at cell phone or child in back seat).
8. Whiplash patients are 5x more likely to suffer from chronic neck pain compared to control population.
9. Whiplash patients are at a significantly increased risk for premature disc degeneration. Most common site of disc injury is C5/C6.
10. Cervical range of motion is the most important indicator of physical impairment. It has proven to be 90% accurate in diagnosing people with whiplash symptoms. Flexion and extension are usually the most impaired movements.
11. Over 90% of whiplash patients under chiropractic care showed notable improvement over a 6 month period of care. Chiropractic treatment has been shown to be 5x more effective than Celebrex or Vioxx within 9 weeks of treatment. Chiropractic care has also been shown to have a 2x greater success rate than standard medical care, and a significantly higher success rate than Physical Therapy. Some measured markers include less work absences and less reliance on pain medications. Passive joint motion is superior to active exercise therapy.
12. In order to get the best therapeutic outcome, treatment must be initiated within the first 3 months following whiplash injury. Recommended guidelines for acute or sub-acute recovery with treatment ranges from 2 months to 2 years, with a mean of 7 months. An appropriate initial treatment frequency is 2-3 x per week for the initial 10 weeks of care.

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