Whiplash and Muscle Weakness

Whiplash, as previously discussed, occurs quicker than the speed at which we can voluntarily contract our muscles in attempt to guard ourselves against injury. Hence, it is nearly impossible to properly brace in anticipation of an impending collision. When muscles, ligament, and joint capsules become injured, there is pain, and as a result, reflex muscle spasm occurs as the body attempts to “splint” the area to protect it. This sometimes sets up a vicious cycle which can make the pain last longer, hurt more intensely and / or hurt more frequently. Because of pain, as well as direct muscle injury that sometimes occurs in whiplash associated disorders (WAD), the natural tendency is to stop doing many activities and guard against motion both because of pain and the fear of it hurting worse. In both cases, the result is the same: muscle atrophy or shrinkage and muscle weakness due to not using the muscle.

There are other reasons that muscles become weak. When an injury occurs, a herniated or “ruptured” disk can injure the spinal nerves exiting the spine. The disk is like a jelly donut where the center is liquid-like surrounded by a thick ring of fibrocartilage and functions as a “shock-absorber” as it sits between 2 vertebral bodies

Think of the spinal nerves like electrical wires that connect a fuse box to a house. The fuse box is the spinal cord and each wire represents the spinal nerves going to different parts of the house (body). In the cervical spine or neck, each wire goes to different parts like the head, shoulder, arm, and hand and innervates specific areas. Patients who have a pinched nerve from a whiplash injury describe their symptoms as numbness, tingling, pain and/or muscle weakness in a specific distribution or area.

There are 8 pairs of nerves in the neck that travel to different parts of the head (C1-3), the shoulders (C4, 5), and the arm (C6-T2). Let’s say a patient has numbness and tingling down the arm to the 4th & 5th fingers and the pinky side of the hand. That immediately tells us as chiropractors that the C8 nerve is injured (pinched) because that’s the pain pattern of the C8 nerve. Certain muscles are controlled by C8 that we can test in our office to determine if they are weak (abnormal) or strong (normal).

We grade the weakness between 0-5 (5=normal). The chiropractic treatment is aimed at un-pinching the nerve which results in a return of normal nerve function or no numbness/tingling and a strong C8 muscle (finger flexion strength). To accomplish this, we may use a combination of treatments such as spinal adjustments, mobilization, traction, exercises, and/or modalities (electric stim, light therapy, ultrasound or others).

We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

Whiplash & Chiropractic Treatment

The term ‘whiplash’ represents a collection of symptoms that occur as a result of a soft tissue injury of the neck. This includes over stretching and/or tearing of muscles, tendons, ligaments, disk tissue and/or nerve injuries due to the extreme movements that occur during a whiplash event (usually arising from a car accident). We have discussed the mechanism of injury and the symptom complex that can arise in past articles.

So the question is – how many patients who sustain a whiplash injury actually improve and recover compared to those that don’t? In one study, it was stated that 43% of patients will suffer long-term symptoms after a whiplash type of injury. More specifically, if a patient is still symptomatic after 3 months following the injury, “…then there is almost a 90% chance that they will remain so.” They go on to state that no conventional treatment has proven to be effective in helping these chronic cases. The purpose of their study was to determine the effectiveness of chiropractic treatment in a group of chronic whiplash patients. To do this, they studied 28 patients (20 women and 8 men, between ages 19-66, mean 39) over a 2-year time frame, injured in motor vehicle collisions. Their symptom severity was graded on an A to D scale (A=minimal symptoms vs. D=disabling symptoms, with B= nuisance and C=Intrusive or partially disabling). Those in Groups C & D either had to significantly modify their work or, they lost their jobs and relied on continual use of medications. The chiropractic treatment included spinal manipulation (adjustments), controlled resistance of muscles to improve stability and coordination, and the use of ice. Treatment from an emergency facility and/or their general practitioner and physical therapy had been previously utilized for on average 15.5 months, before entering this chiropractic-based study. Initially, 27 of the 28 were classified into symptom groups C or D and symptoms included neck pain (82%), neck stiffness (36%), and other complaints of headache, shoulder, arm and back pain. Following treatment 26 of the 28 (93%) improved, 16 by one symptom group and 10 by two symptom groups and this degree of improvement was assessed and agreed upon by both an orthopedic surgeon as well as by a chiropractor. Seventeen (61%) improved to a point of satisfaction where care was discontinued after the 1st assessment with 4 of the 17 considering return for treatment due to a return of symptoms. Litigation was still pending in 20 of the 28 cases at the time the study concluded.

This study is very important as over 90% of chronic whiplash cases improved from chiropractic management well beyond the point of improvement obtained through standard emergency, family practice and physical therapy. Other studies have pointed out that early intervention or treatment with chiropractic manipulation and management approaches generally results in a more favorable response compared to waiting for longer time periods. To be able to obtain this level of success after an average of 15.5 months is truly remarkable!

Chiropractic methods often utilized for patients with a “whiplash” injury include spinal manipulation (or adjustments), mobilization techniques (this includes stretching, figure 8 movements, manual traction), muscle release work (this includes trigger point therapy, myofascial release/friction massage, and others), and promoting self-help approaches (this includes exercise, home traction methods, computer station modifications and other job modifications as indicated, and others).

We realize you have a choice in where you choose for your healthcare services. If you, a friend or family member requires care for whiplash, chiropractic care is a logical first choice and we would be honored to offer our services.

The Only Proven Effective Treatment” for Chronic Whiplash?

You may have wondered, “If I get hurt in a car accident, who should I go to for treatment of my whiplash problem?” This can be quite a challenge as you have many choices available in the healthcare system ranging from drug-related approaches from anti-inflammatory over-the-counter types all the way to potentially addicting narcotic medications. On the other side of the fence, there are nutritional based products such as vitamins and herbs as well as “alternative” or “complementary” forms of treatment such as chiropractic, exercise, and meditation, with many others in between. Trying to figure out which approach or perhaps combined approaches would best serve your needs is truly challenging. To help answer this question, one study reported the superiority of chiropractic management for patients with chronic whiplash, as well as which type of chronic whiplash patients responded best to the care. The research paper begins with the comment from a leading orthopedic medical journal stating, “Conventional [meaning medical] treatment of patients with whiplash symptoms is disappointing.” In the study, 93 patients were divided into three groups consisting of:

  • Group 1: Patients with a “coat-hanger” pain distribution (neck and upper shoulders) and loss of neck range of motion (ROM), but no neurological deficits;
  • Group 2: Patients with neurological problems (arm/hand numbness and/or weakness) plus neck pain and ROM loss); and,
  • Group 3: Patients who reported severe neck pain but had normal neck ROM and no neurological losses.

The average time from injury to first treatment was 12 months and an average of 19 treatments over a 4 month time frame was utilized. The patients were graded on a 4-point scale that described their symptoms before and after treatment.

  • Grade A patients were pain free;
  • Grade B patients reported their pain as a “nuisance;”
  • Grade C patients had partial activity limitations due to pain; and
  • Grade D patients were disabled.

Here are the results:

  • Group 1: 72% reported improvement as follows: 24% were asymptomatic, 24% improved by 2 grades, 24% by 1 grade, and 28% reported no improvement.
  • Group 2: 94% reported improvement as follows: 38% were asymptomatic, 43% improved by 2 grades, 13% by 1 grade, and 6% had no improvement.
  • Group 3: 27% reported improvement as follows: 0% were asymptomatic, 9% improved by 2 grades, 18% by 1 grade, 64% showed no improvement, and 9% got worse.

This study is very important as it illustrates how effective chiropractic care is for patients who have sustained a motor vehicle crash with a resulting whiplash injury. It’s important to note the type of patient presentation that responded best to care had neurological complaints and associated abnormal neck range of motion. This differs from other non-chiropractic studies where it is reported that patients with neurological dysfunction responded poorly when compared to a group similar to the Group A patient here (neck/shoulder pain, reduced neck ROM, and with normal neurological function). We realize you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you through this potentially difficult process.

 

Whiplash: What Are The Odds of a Permanent Injury?

I’m sure you’ve heard someone claim, “…you’re not really injured – you’re just going for a big settlement!” Or, “…that person isn’t really hurt, they’re just in it for the money!” Though there are cases that may fit this scenario, the majority of people who are injured in a motor vehicle collision would gladly forfeit any settlement to have their health and sometimes their life back. So, where in this process does the truth lie? Do most people “fake” their complaints or, are they really in pain? And, is there a way to determine who is more likely to suffer with problems long after their case is settled?

To answer this question, the Quebec Task Force (QTF), published two studies to investigate what types of whiplash injuries, which they term “whiplash associated disorders” (WAD), sustained in a rear end or side impact motor vehicle collision might end up with no residual injury vs. those more likely to become permanently disabled or impaired. The first of the two studies published in 1995 introduced 3 categories of injuries:

  1. Those with neck pain, stiffness or tenderness only – no clinical (exam) findings;
  2. Neck complaints and clinical findings including decreased ranges of neck motion;
  3. Neck complaints and loss of neurological function including numbness or weakness in arm strength and/or altered reflexes.

The QTF then set out to investigate whether this approach could indeed accurately predict those more vs. less likely to end up with significant disability with ongoing problems. They published these results in 2001 and found if they broke down the 2nd category into two groups, those with vs. without neck motion loss, those patients who fell into the 2nd group (with neck motion loss) and the 3rd group (those with neurological signs) were more likely to suffer long term disability compared to those in groups 1 and 2a (without neck motion loss). However, these conclusions have been challenged by many as being too simple because they do not include the psychological problems like depression, anxiety, and poor coping abilities, all of which play an important role in predicting long term disability. Also, treatment strategies must include aspects to deal with the post-traumatic stress disorder, anxiety, depression and coping, not just the biological injury aspects. A convincing study published in 2008 looked at 226 studies on this subject and reported on 7 prognostic factors and found that 50-75% of people with current neck pain will report neck pain again 1-5 years later. Older age and psychosocial factors including psychological health, coping patterns, and the need to socialize were the strongest predictors. Three other potential predictors that require more investigation include the presence of arthritis, genetic factors, and compensation policies.

The bottom line or best advice to minimize our chances of having chronic, disabling neck pain after a car crash is, don’t stop living! That is to say, carry on with work and hobbies as much as you possibly can so that you don’t fall into the negative spiral of disability. If you feel yourself slipping, get help sooner than later! Pain relief and function restoration are strong goals and chiropractic has been found to be one of the first and most effective forms of treatment recommended by all treatment guidelines published on whiplash management. Comparing potential side effects, medications carry a significant list of negative effects while chiropractic carries very few and, a host of positive benefits.

We realize that you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you through that potentially difficult process.

 

Interesting Facts About Whiplash

We all know the most common causes of “whiplash” are injuries that typically arise from automobile accidents or, motor vehicle collisions (MVC’s) although whiplash can also occur from slip and fall and virtually, any injury where your head is whipped backwards. But there are many things about whiplash you may not be aware of, which is the reason for this month’s Heath Update on whiplash.

For example, did you know the effect whiplash has on public health (in general) is tremendous? The number of cases occurring annually is frequently quoted as 1,000,000 per year, but this is based on an outdated (1971) and incomplete dataset. A more recent figure of 3 million per year is considered to be more accurate because it’s based on several governmental databases and it accounts for the expected number of unreported cases by the NHTSA (National Highway Traffic Safety Administration). That’s a huge difference! The updated figure accounts for whiplash victims not attended to by emergency medical services. In less catastrophic accidents, the injured party may not appear to be significantly injured at the scene of the MVC and decline emergency care and hence, the MVC will to unreported to a governmental data collection center.

Another interesting study surveyed over 3500 chiropractors who were asked if they commonly applied cervical (neck) spinal manipulation to patients who had known herniated or protruded disks (in their neck). Over 90% of the chiropractors indicated they found it safe and effective to utilize cervical adjustments (manipulation) in this patient population. It is VERY important for you to know this as frequently, you may be told by your medical doctor (or next door neighbor), “…don’t let anyone crack your neck!” Now, you can rest assured that in the experience of MANY chiropractors (not just me), significant benefits can be achieved by this treatment approach. Moreover, the sooner neck adjustments are applied, the better the results – so don’t wait to get a chiropractic treatment after an MVC!

Another interesting study investigated the “proper” or “best” seated position in a car during a rear-end collision, based on an analysis of many previously published studies on this topic. Because the seated position of the person involved in a MVC is related to the degree of the injury, the factors studied included the angle of the seat back, seat-bottom angle, the density of the foam in the seatback, the height above the floor [of the knees], and the presence of armrests in cars. They found that the seat back angle of 110-130 degrees reduced disk pressure and low back muscle activity but 110 degrees – MAX. – was found to minimize the forward positioning of the head. A 5 degree downwards tilt of the seat bottom further reduced the pressure in the low back disks and muscle activity as measured by EMG (electromyography). The use of armrests and the use of a lumbar support were also found to be important to reduce injuries associated with MVCs. This combination was reported to be optimum for all of us to use in order to minimize the bodily injury in a rear-end MVC. Other important factors included firm dense foam in the seat back, an adjustable seat bottom (for angle, height, and front to back distance), horizontal & vertical lumbar support adjustments (…best if they pulsate to reduce the static load encountered in a crash), seat shock absorbers, and seat adjustments for front to back to adjust for different patient heights.

We hope this information is enjoyed! We realize you have a choice in where you go for your health care needs. We truly appreciate your consideration in allowing us to help you through this potentially difficult process.

 

Whiplash: How Do X-Rays Help?

Whiplash commonly occurs as a result of a motor vehicle collision when (typically) there is a sudden stop or slow down that occurs so fast a person cannot adequately brace himself or herself, even when aware of the impending collision. This is because the “whiplash” effect is over in about 500 msec and we cannot voluntarily contract a muscle quicker than about 800 msec. The injury effect is worsened by several other factors including: 1. Small target / large “bullet” vehicle; 2. Too much seat inclination; 3. Improper headrest position; 4. A “springy” seat back; 5. A tall slender neck (females > males); and 6. Head rotation at the time of impact. Suffice it to say, in many cases, there is little one can do to avoid injury. So, how do x-rays help?

Let’s use a classic “rear-end collision” as our example. The driver (female) is seat-belted, in a small compact car, and her car is stopped in traffic. All of a sudden, the car is struck from behind by a ¾ ton pickup truck (“bullet vehicle”). Just before impact, the driver, startled by the squeal of the tires breaking suddenly, turns her head to look behind the car via the rear view mirror. Upon impact, the car is propelled forward and she feels her head accelerate back initially (50-150msec), ride over the headrest (because it was set too low) and then accelerate forwards (150-300msec), without striking the steering wheel (the air bag does not deploy). Her head returns back to an upright position (~500msec) and the she reports being “shaken up.” She visits her chiropractor and an examination reveals neck pain at the endpoints of forward and backward bending, headaches, numbness into the left arm to the thumb side of the hand and weakness in certain arm and wrist muscles. The chiropractor orders a flexion-extension cervical spine x-ray as shown below:

The x-rays are explained to the patient as follows: “…The middle image shows a reversed cervical curve when bending forwards but notice how little the spine and head have moved forwards? It hurts because the ligaments that hold the bones together have either over stretched or tore, which is called a “sprain.” If the head and neck are forced far enough forwards, then something has got to give. Either bones will fracture or, ligaments will tear, or both. When ligaments tear, the bones separate or open up greater than the levels above and below (see the 2 arrows). This creates a rather acute angle, like someone broke a stick (see the 2 arrows). Looking closely on the x-ray, the vertebra above appears to be sliding forwards (C4 over 5), which again supports torn ligaments and loss of stability.”

We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Whiplash. Biomechanics and cost.

Whiplash or Cervical Acceleration-deceleration Disorder (CAD) is primarily associated with motor vehicle collisions (MVCs) and in particular, rear-end collisions. Last month, we discussed how CAD can be prevented and focused greatly on paying attention while driving and, the position of the headrest. Whiplash is defined as an injury to the cervical spine (neck) caused by a rapid/sudden, usually unexpected, forceful movement. (Typically, forwards and backwards, if struck from in front or behind, or, a side to side movement if struck from the side.) Even worse, when coupled with the head being rotated at the time of impact, tearing of the ligaments, muscles, and joint capsules in the neck can cause a myriad of symptoms that can remain present for years, sometimes permanently. Some of these symptoms include:

  • Neck and shoulder pain and/or stiffness
  • Middle and low back pain
  • Dizziness
  • Vertigo (balance disturbance)
  • Fatigue
  • Numbness/Tingling
  • Face/Jaw pain
  • Cognitive dysfunction or brain injury (even without hitting the head directly)
  • Sleep disorders

A report published in January 2011 discussed recent advances and a new law that goes into effect 9-1-11 regarding the design of head restraints that is aimed at significantly reducing the injury severity and consequently the costs associated with CAD. The Code of Regulations (CFR) describes the new bill, (FMVSS 202a) as a standard, “…to reduce the frequency and severity of neck injury in rear-end and other collisions.” This new law requires testing the absorbency (springiness), the locking mechanisms, and the height by making sure the restraint is above the center of gravity of the occupant’s head to reduce the “backset” (distance between the head and the restraint). This is done by testing the seat back and head restraint as a system to ensure the head restraint remains in its proper position throughout the collision. The concept is to reduce the rearward shift of the occupant’s head relative to their torso or to avoid extreme hyperextension. Companies have been manufacturing both dynamic, as well as static, head restraint systems in response to this new requirement that becomes fully effective on 9-1-11 for both front and rear seats. So, how does this equate to costs?

Between the years of 1988 and 1996 from 805,851 whiplash injuries, the National Accident Sampling System (NASS) reported the total annual cost of treatment, excluding damage to property, was $5.2 billion. This amount includes costs derived from medical, legal, insurance, productivity loss and work loss. The report estimates, by improving the seat back and head restraint position to the occupant’s head, a total reduction of 14,247 whiplash injuries is expected which will have a nearly $92 million total cost reduction through both direct injury costs and also the indirect societal costs!

We realize you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you through that potentially difficult process.

Dr. Rusty Dorn  254-690-7090

http://www.carechiropractic.net/

 

 

 

 

What really causes whiplash?

Whiplash is a non-medical term for a condition that occurs when the neck and head move rapidly forwards and backwards or, sideways, at a speed so fast our neck muscles are unable to stop the movement from happening. This sudden force results in the normal range of motion being exceeded and causes injury to the soft tissues (muscles, tendons and ligaments) of the neck. Classically, whiplash is associated with car accidents or, motor vehicle collisions (MVCs) but can also be caused by other injuries such as a fall on the ice and banging the head, sports injuries, as well as being assaulted, including “shaken baby syndrome.”The History Of Whiplash. The term “Whiplash” was first coined in 1928 when pilots were injured by landing airplanes on air craft carriers in the ocean. Their heads were snapped forwards and back as they came to a sudden stop. There are many synonyms for the term “whiplash” including, but not limited to, cervical hyperextension injury, acceleration-deceleration syndrome, cervical sprain (meaning ligament injury) and cervical strain (meaning muscle / tendon injury). In spite of this, the term “whiplash” has continued to be used usually in reference to MVCs.

Why Whiplash Occurs. As noted previously, we cannot voluntarily stop our head from moving beyond the normal range of motion as it takes only about 500 milliseconds for whiplash to occur during a MVC, and we cannot voluntarily contract our neck muscles in less than 800-1000 msec. The confusing part about whiplash is that it can occur in low speed collisions such as 5-10 mph, sometimes more often than at speeds of 20 mph or more. The reason for this has to do with the vehicle absorbing the energy of the collision. At lower speeds, there is less crushing of the metal (less damage to the vehicle) and therefore, less of the energy from the collision is absorbed. The energy from the impact is then transferred to the contents inside the vehicle (that is, you)! This is technically called elastic deformity – when there is less damage to the car, more energy is transferred to the contents inside the car. When metal crushes, energy is absorbed and less energy affects the vehicle’s contents (technically called plastic deformity). This is exemplified by race cars. When they crash, they are made to break apart so the contents (the driver) is less jostled by the force of the collision. Sometimes, all that is left after the collision is the cage surrounding the driver.

Whiplash Symptoms. Symptoms can occur immediately or within minutes to hours after the initial injury. Also, less injured areas may be overshadowed initially by more seriously injured areas and may only “surface” after the more serious injured areas improve. The most common symptoms include neck pain, headaches, and limited neck movement (stiffness). Neck pain may radiate into the middle back area and/or down an arm. If arm pain is present, a pinched nerve is a distinct possibility. Also, mild brain injury can occur even when the head is not bumped or hit. These symptoms include difficulty staying on task, losing your place in the middle of thought or sentences and tireness/fatigue. These symptoms often resolve within 6 weeks with a 40% chance of still hurting after 3 months, and 18% chance after 2 years. There is no reliable method to predict the outcome. Studies have shown that early mobilization and manipulation results in a better outcome than waiting for weeks or months to seek chiropractic treatment. The best results are found by obtaining prompt chiropractic care.

We realize that you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you through that potentially difficult process.

Dr. Rusty Dorn  254-690-7090

http://www.carechiropractic.net/

 

Whiplash and Vision. What’s the connection?

In whiplash, “post concussive syndrome” (PCS) can affect up to 20-30% of patients who have had a mild head injury with resulting left over, long-term problems. Interestingly, eye movements have a close relationship to the function of the brain and can be an accurate measure for determining the presence of PCS as well as a good barometer for tracking the recovery process. The correlation between eye movement and PCS was studied by a group of New Zealand researchers using 2 groups of 36 patients each – those with PCS who showed good recovery vs. those who did not at a 3-5 month point after their accident. The method of evaluating this included neuropsychological evaluations using various tools that assess memory, reading, recall, use of numbers, and other brain function tests. They found the worse PCS patient group had poorer brain function test results and the correspondingly worse eye movement tests. Most interesting was that the group who had a better psychological recovery, STILL HAD eye movement abnormalities. This suggested, in spite of seemingly good recovery, injury to the brain persisted. They also stressed importance of the correlation between the psychological test abnormalities now have a specific biological marker which can be used as a clinical “tool” and, that PCS is NOT merely a psychological condition.PCS symptoms include headaches, dizziness, poor concentration, memory loss, irritability, mood swings and these and other symptoms vary between patients with PCS. This makes the assessment process challenging since each patient is rather unique in how PCS portrays itself. To make this more challenging, these symptoms can last for the first few hours after a motor vehicle collision with a mild closed head injury to days, weeks, months and even years after the injury, some with complete loss work capabilities and significant life impact. The World Health Organization first clinically recognized PCS in 1992, with the American Psychiatric following in 1994. Another diagnostic challenge is that the conventional tests such as CT scans and MRI scans usually do not display abnormalities in most patients with PCS, thus doctors must rely on psychological tests to establish the diagnosis and track recovery (or lack thereof). More recently, special tests such as functional MRI, diffusion tensor imaging, MR spectroscopy and arterial spin labeling can help detect functional, structural, or perfusion changes in the brain but these tests are costly and not routinely available in most clinical settings. There are also criticisms that these less available/costly tests can’t track changes in function very well. Similarly, there exists criticism of neuropsychological test results being affected by uncontrollable factors such as age, education, state of employment, economic status, depression, malingering, and litigation.

The good news is that most patients with PCS largely resolve by 1-3 months post-injury. However, this reported rate of recovery relies on neuropsychological tests, which loses their ability to detect PCS with the passage of time. The benefits of being able to detect brain injury which include complex reflex pathways and different parts of the brain through the measurement of eye movement is very important as no other method has yet been found to be as accurate and, is completely independent of intellectual ability and neuropsychological injury. The ability for eye movements to show abnormality at 3-5 months post-injury is tremendous!

We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Dr. Rusty Dorn  254-690-7090

http://www.carechiropractic.net/

 

Car Accidents and Mild Traumatic Brain Injuries

When you woke up today, you thought this was like any other Friday. You’re on your way to work, and traffic is flowing smoother than normal. Suddenly, someone crashes into the back end of your car and you feel your head extend back over the headrest and then rebound forwards, almost hitting the steering with your forehead. It all happened so fast. After a few minutes, you notice your neck and head starting to hurt in a way you’ve not previously felt. When the police arrive and start asking questions about what had happened, you try to piece together what happened but you’re not quite sure of the sequence of events. Your memory just isn’t that clear. Within the first few days, in addition to significant neck and headache pain, you notice your memory seems fuzzy, and you easily lose your train of thought. Everything seems like an effort and you notice you’re quite irritable. When your chiropractor asks you if you’ve felt any of these symptoms, you look at them and say, “…how did you know? I just thought I was having a bad day – I didn’t know whiplash could cause these symptoms!” Because these symptoms are often subtle and non-specific, it’s quite normal for patients not to complain about them. In fact, we almost always have to describe the symptoms and ask if any of these symptoms “sound familiar” to the patient.

As pointed out above, patients with Mild Traumatic Brain Injury (MTBI) don’t mention any of the previously described symptoms and in fact, may be embarrassed to discuss these symptoms with their chiropractor or physician when they first present after a car crash. This is because the symptoms are vague and hard to describe and, many feel the symptoms are caused by simply being tired or perhaps upset about the accident. When directly asked if any of these symptoms exist, the patient is often surprised there is an actual reason for feeling this way.

The cause of MTBI is due to the brain actually bouncing or rebounding off the inner walls of the bony skull during the “whiplash” process, when the head is forced back and forth after the impact. During that process, the brain which is suspended inside our skull, is forced forwards and literally ricochets off the skull and damages some of the nerve cells most commonly of either the brain stem (the part connected to the spinal cord), the frontal lobe (the part behind the forehead) and/or the temporal lobe (the part of the brain located on the side of the head). Depending on the direction and degree of force generated by the collision (front end, side impact or rear end collision), the area of the brain that may be damaged varies as it could be the area closest to initial impact or, the area on the opposite side, due to the rebound effect. Depending on which part of the brain is injured, the physical findings may include problems with walking, balance, coordination, strength/endurance, as well as difficulties with communicating (“cognitive deficits”), processing information, memory, and altered psychological functions.

The good news is that most of these injuries will recover within 3-12 months but unfortunately, not all do and in these cases, the term, “post-concussive syndrome” is sometimes used.

We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Dr. Rusty Dorn  254-690-7090

http://www.carechiropractic.net/