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February 2, 2013: Whiplash


This week, Dr. Cassaro discussed Whiplash.

Whiplash is a common injury that usually heals on it's own. In the cases where it does not, however, it can lead to a lifetime of chronic pain. In this show, we discussed the causes of whiplash, the long term considerations, and treatments.

Q- What is Whiplash, and what causes it?

A- Whiplash is a neck injury. Most associate this condition with a bad car wreck, but it can occur from minor slip-and-fall accidents, shoulder impact, or head trauma.

Q- What happens inside the neck?

A- A whiplash injury can damage soft tissue, bones, and nerves. This includes tendons, lligaments, muscle fibers, nerve fibers, and vertebrae. Everything pretty much "snaps, crackles, and pops".

Q- Are there other symptoms besides neck pain?

A- Yes. In fact, many pain conditions can affect a person years (even decades) later. The neck pain may go away completely, but the injuries sustained in a whiplash may cause chronic pain conditions that are not even felt in the neck.

Here are some examples:

  • Shoulder pain
  • pain in both hands
  • Pain in both feet
  • Pain in lower back
  • Pain in upper back
  • Chronic headaches
  • Digestive complications

In many cases, a person suffering from one of these conditions as the result of a whiplash injury, may not even remember having a whiplash injury at all!

Q- What is the eventual outcome of a whiplash injury?

A- Eventually, most people who suffer from a severe whiplash injury will develop arthritis in the neck. Arthritis is the underlying cause of many future pain conditions. It can be avoided, depending on the lifestyle of the person after the injury.

Here are some factors that will accelerate the arthritis process:

  • Sedentary lifestyle
  • Sugar
  • Bad diet (very little vegetables, fruits, etc.)
  • Lack of exercise
  • Inadequate sleep

Q- What are some signs that I may have damaged ligaments during a whiplash injury?

A- Here are a few:

  • Chronic headaches
  • Dizziness
  • Arm/hand weakness (or loss of control)
  • Ringing in ears
  • Face pain
  • Limited range-of-motion in neck
  • Shoulder pain

Q. Are some ligament injuries worse than others?

A. Yes. If the alar ligament is injured, this can cause severe pain and future complications. The alar ligament is the big ligament that basically holds your head on your shoulders. If it is torn, it can give the person a "bobble-head" sensation, feeling as though there is no head/neck stability. In severe cases, this can lead to paralysis.

Q. What might cause a limited range of motion?

A. Limited range of motion can occur when blood from the initial whiplash injury leaks into the little stabilizing joints in the neck and form scar-like tissue. Just as a cut heals together, the blood attempts to bond the joints in the neck.

Q. What are some symptoms that I may have suffered a whiplash injury in my past?

Here are some daily/frequent chronic pain symptoms that may indicate you have suffered a whiplash injury in the past.

  • Neck pain upon waking in morning
  • carpal tunnel in BOTH hands
  • Shoulder pain with no sign of shoulder injury
  • Low back pain
  • Pain in face
  • Pain in shoulder blades
  • Knee pain
  • Hand pain (especially thumb pain)
  • Reduced range-of-motion in neck
  • Digestive problems

This list is not complete...there are many others. Consider these being related to a prior whiplash injury if traditional treatment for these symptoms does not work. For instance, if you have had a shoulder surgery, and your shoulder still hurts, the condition may be in your neck...referring pain to the shoulder. (You neck may not even hurt at all!)

Treatments for Whiplash

At home treatments:

  • Diet restrictions
  • Glucosamine
  • Fish oil
  • Vitamin D3
  • Vitamin B12
  • Epsom salts/magnesium
  • Topical medications
  • Exercise
  • Sleep
  • MSM
  • DMSO
  • Alpha Lipoic Acid
  • Fish oil

Professional treatments:

  • Radio frequency
  • Spinal stimulator
  • Chiropractor
  • Injections (joints/arthritis)
  • Nerve blocks
  • Prolotherapy (ligaments)
  • Physical therapy
  • Water aerobics
  • Anti-inflam. medications
  • Inversion table
  • Surgery
  • Braces/supports