Whiplash injury

Neck movements whiplash injury, "head-banging," hairdresser visit, head injury, falls Yoga... 

A 34-year-old man with a whiplash injury consulted a chiropractor for his neck pain, and 36 hours after one particularly painful treatment he experienced throbbing, positional headache, dizziness, diplopia, otorrhea, and rhinorrhea (183). After thorough neurological examination the author concluded that the patient had suffered a dural tear due to cervical manipulation. 

Cassidy JD, Carroll LJ, Cote P, et al. Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. N Engl J Med 2000 342 1179-1186. 

The cervical spine is frequently involved in trauma caused by the flexibility of the neck with a heavy head sitting atop the small vertebrae. With the rapid motion of modern vehicles, ac-celeration/deceleration injuries of the neck are quite common. As the neck is snapped forward and backward, the long muscles tend to have their fibers torn, with associated bleeding into the muscles. However, it is important to remember that "whiplash injury" is not a problem of the cervical spine alone, because the entire body has abnormal forces applied to it. Osteopathic manipulation is a major part of the treatment of the patient with whiplash injuries. 

The initial phase of whiplash injury is characterized by muscle contraction and limitation of head and neck motion. Soft tissues feel warm and boggy. These tissues require ice for the first 18 hours after the injury, to stop the microhemorrhages, and rest for 24 to 48 hours to allow healing to begin. Moist heat may be used at home after that time. A soft collar may be used to prevent unwanted motion of the neck for the first 24 to 48 hours. It should be removed after that time so that the cervical muscles do not lose strength. Areas adjacent to those most severely injured should be treated with osteopathic manipulation, particularly the cranium and the sacrum. Nonsteroidal anti-inflammatory medication may be given, if appropriate, to ease the discomfort. 

Foreman SM, Croft AC. Whiplash Injuries, The Cervical Accel-eration/Deceleration Syndrome, 2nd ed. Baltimore Williams Wilkins, 1995. 

Avery, M., and Weekes, A. 2009. Autonomous Braking Systems and their Potential Effect on Whiplash Injury Reduction. Paper Number 09-0328. Thatcham. Retrieved on the 20th April 2012 from http //www-nrd.nhtsa.dot.gov/pdf/esv/esv21/09-0328.pdf. 

The most common type of injury due to combined tension and extension of the cervical spine is the whiplash syndrome. However, a large majority of such injuries involve the soft tissues of the neck, and the pain is believed to reside in the joint capsules of the articular facets of the cervical vertebrae [Wallis et al., 1997]. In severe cases, teardrop fractures of the anterosuperior aspect of the vertebral body can occur. Alternately, separation of the anterior aspect of the disk from the vertebral endplate is known to occur. More severe injuries occur when the chin impacts the instrument panel or when the forehead impacts the windshield. In both cases, the head rotates rearward and applies a tensile and bending load on the neck. In the case of windshield impact by the forehead, hangman s fracture of C2 can occur. Garfin and Rothman [1983] suggested that it is caused by spinal extension combined with compression on the lamina of C2, causing the pars to fracture. 

The issue of whiplash is a controversial one principally because researchers in the field cannot agree on an injury mechanism. Currently, five such mechanisms have been proposed. It began with the hyperextension theory, which was discarded when the automotive headrest did not reduce the incidence of injury. The flexion theory is also considered untenable because head and neck flexion after the rear end collision is... 

The most common neck injury is caused by rearward flexion and forward extension ( whiplash ), which may result in dislocation or fracture of the cervical vertebrae, and compression of the spinal... 

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