[Back to Contents] [Home][1 What is Whiplash?] [2 Treatment] [3 Legal aspects]

[4 Research]  [5 Prevention] [6 Ten Tips] [7 Discussion] [8 Case histories] [9 Bone Marrow]  [10 E-Mail me]

WHAT IS WHIPLASH?

                                                                                                                   

 

Nothing to do with the group, sorry.  Whiplash or WAD is a problem affecting numerous people through out the world.  Normally a result of a traffic accident - below are links to sites giving more detailed information.

 

 

 http://www.injuryresources.com/IC_W_A2.html

What researchers originally believed occurred in a whiplash, and what they now believe.  Nice simple diagrams.

 

http://www.bodymindonline.com/whiplash.htm

The Complete Guide to Whiplash by Michael Melton can be reviewed on this page and ordered.  The book covers causes, treatments, prevention, legal issues and more.

 

http://www.icbc.com/Library/recovery/volume10/Number2/

Nikolai Bogduk in Fact vs. Fiction outlines the "Compression Loading" theory of whiplash.  Looks at the common symptoms of whiplash, and treatment studies (most notably diagnostic blocks and neurotomies of cervical z-joints for chronic pain).  Argues against the "no claim no pain" assertion.

 

http://www.injuryresources.com/IC_Whiplash.html

Looks briefly at the history of whiplash medicine, and explains how collisions can hurt your body and the possible injuries.  Looks at whiplash resulting from low speed impact.  14 other assorted articles on WAD.

 

 http://www.whiplash101.com

Very detailed site with a wealth of information (over 6000 pages): Research articles; detailed anatomy diagrams; explanations how to read x-rays and MRIs, details of those involved in whiplash research, step-by-step self diagnostic, search facility.

                                                                     

http://www.bcinjurylaw.com/whiplash.html

Canadian law firm site that gives a very basic outline on causes, symptoms, treatments of WAD. largely based on the findings of the Quebec Task Force.

 

http://www.spinecare.com/treatments/whiplash.html

Page of the Patient Education Series of the San Fransisco Spine Institute giving a broad outline of Whiplash causes, symptoms, and treatments.  Their Glossary page also provides a useful A-Z resource on all aspects of spine-care.

 

http://www.upstate.edu/neurology/haas/hpwhip.htm

Outlines the common symptoms of whiplash (concentrating on headaches), the history of whiplash medicine, shows how radiographical imaging can often be flawed, looks at a few studies into whiplash.

 

http://www.amazon.com

THE WHIPLASH HANDBOOK (ISBN 0-398-06380-X) by MONIQUE B. HARRITON
CHARLES C. THOMAS. PUBLISHER

The Whiplash Handbook is a survivorís guide intended to inform and reassure whiplash victims and their families. 
"It is an all-too common, frustrating injury. But until now, whiplash victims have had nowhere to turn for a comprehensive source of information. . . An invaluable resource." (Neshama Franklin, editor of Medical Self-Care).

 

WHIPLASH:  COMMON FALLACIES

How can whiplash injuries be controversial and even politically incorrect when, according to the National Safety Council which publishes Injury Facts every year, "angle and rear-end collisions added together cause the greatest number of nonfatal injuries"? They are now so common, they have become an accepted hazard of city driving.  Here are the latest statistics from Injury Facts for the year 1998: 

Rear-end collisions caused:   Angle collisions caused: 
All accidents: 3.700,000   All accidents: 4,550,000 
Deaths:2,300            Deaths: 9,900 
Non-fatal injuries: 695,000 Non-fatal injuries :900,000 
   

It is important to realize that these figures only represent reported injuries and accidents. Researchers estimate that true figures would be several times higher, if all the collisions were reported. Whiplash injuries are misunderstood for several reasons: first. they are not visible to the naked eye; second, as the driver responsible for the rear-end or angle collision is usually not hurt,  it is assumed that the passengers of the other car cannot have been hurt either; third, whiplash injuries are caused by a complex interaction between mechanical factors, such as size, weight and traveling speed of the cars involved  and body build of the passengers in the rear-ended car.  This means that there is great variation in whiplash injuries.  They can range from a mild strain to a more severe sprain or even result in a minor closed head injury. There are seven common whiplash fallacies. In general,  most fallacies involve a flat denial of the whiplash injury or they blame the victim.

Fallacy No. 1.  Men are more vulnerable to the injury because of their greater neck muscle mass". Nothing could be further from the truth. Health care professionals confirm that their whiplash patients are several times more likely to be women than men, that women take longer to heal and that they are more likely to suffer from chronic whiplash residuals. A bull-neck man (football player, boxer or weight lifter) is rather whiplash-proof, while a woman with a swan-like neck is at much greater risk of injury because her neck is longer and slimmer. The most common neck size in men's dress shirts is 16 to 16 112. However, women whiplash victims answering the authority's whiplash questionnaire, report having a neck size 13 inches or less In circumference. Yet, there are still cars on the road which were crash tested with a unisex dummy patterned after the average male, 165 lbs, 5'10"; the neck of the dummy was fabricated of rubber and metal, hardly reflecting most women's anatomy. Indeed, it takes a rear-end or an angle collision to show that whiplash injuries are not gender-neutral and that necks are not all created equal.

Fallacy No. 2.  Your neck could not have been injured because there was no direct impact upon your neck".  A direct blow does not need to take place for a whiplash injury to occur.  The collision can force the neck backward and forward, (or sideways in the case of an angle collision) far beyond its normal range of motion.  This occurs so fast that neck muscles and ligaments are actually over stretched twice with no time in between to recover. The neck muscles and ligaments that are injured are the very same muscles and ligaments that bend the head sideways, backward, forward or turn the head around. These muscles and ligaments must work sixteen hours a day to hold the head up. This explains why most whiplash victims complain of extreme fatigue toward the end of the day. A whiplash injury is quite different from a strain or a sprain in another part of the body, like the ankle for instance. First, it is different because it takes place so close to the cervical cord and the brain and these two form a single unit. Second, the involved anatomy creates a domino effect (neck muscles, ligaments, vertebrae, nerves, blood vessels and the cervical cord are all very close together). So, if the shock is brutal enough, it could trigger a chain reaction along the cervical spine and upward inside the skull , disturbing  the hindbrain. Cervical vertebrae will get slightly displaced, the soft brain (which has the consistency of jello) will bounce against the hard skull (which no longer acts as a protective shell)  and nerves and blood vessels will even get bruised. Why is the neck so vulnerable? First the neck is very flexible to accommodate our senses of sight, hearing and smell; second, it is very light (the 7 cervical vertebrae only weigh a few ounces); and third, it is positioned between the heavy head (weighing ten to fourteen pounds) and the trunk. Hence it bears the brunt of the impact. Occasionally people will complain of symptoms quite similar to those of whiplash victims (such as having a sore neck, being in a daze), after going on roller coaster rides. This is why amusement parks now post warnings next to their roller coasters.

Fallacy No. 3. There cannot be anything wrong with your neck: nothing shows on the X-rays". In other words, there is nothing broken! X-rays can only show bone fracture or vertebral displacement; they will not show a so called "soft tissue injury". Soft tissue includes neck muscles, ligaments, nerves and blood vessels. The new imaging technology is required for a better understanding of what is often dismissed as a soft tissue injury. The majority of "hands-on" practitioners, however, have no problem evaluating a whiplash victim's condition.

Fallacy No.4.  All those complaints are psychosomatic! In this instance, "psychosomatic" is a put-down, meaning that psychological factors are the real cause of the physical symptoms. What the word psychosomatic actually means is that there is a complex interaction between the body (soma) and the mind (psyche). This close interrelationship works both ways. It is totally arbitrary to define it as a one way interaction. Whiplash injuries are the perfect illustration of this interdependence of mind and body. When whiplash victims act anxious or irritable, or have crying spells, it may be that the vibration from the force of the impact bruised the brain, thereby interfering with neurotransmitter and nerve connections. Psychological treatment at this point would be premature. These psychological symptoms usually fade away, as the physical therapy progresses. When whiplash experiments on animals were discontinued, it was not because their suffering was considered "psychosomatic", but because the experiments were considered too cruel.

Fallacy No. 5. Rest and time plus some muscle relaxants and tranquilizers will take care of a whiplash patient's distress. It is indeed true that time and rest can help whiplash patients. However, without adequate physical therapy, whiplash patients run the risk of having a chronic problem with a sore, stiff neck. Physical therapy helps whiplash patients regain some degree of pain-free mobility and will prepare them for the exercises that they will have to do later on. The value of muscle relaxants and tranquilizers is more than offset by their side effects. Sports medicine has now refined a regimen of cold and hot packs, ultrasound, massage, traction, manipulation and guided exercise that is available from a team made up of orthopedic specialists, osteopaths, chiropractors and massage therapists. Injured athletes are not dismissed with a prescription for tranquilizers and home rest.  Whiplash patients are entitled to the same level of care.

Fallacy No. 6. Whiplash victims are guilty of malingering for monetary gain. The complaints of whiplash patients are suspected of being tainted with an ulterior motive. There are no valid statistical studies to support those suspicions. Military personnel, even though they have no legal recourse against the government and nothing to gain financially,  can also suffer from whiplash injuries. Rear-end or angle collisions are not the one and only cause of whiplash trauma. Lately, pediatricians have cautioned parents not to shake their infants. Children can be very seriously injured when shaken by an adult. This Whiplash Shake Syndrome" is now recognized by pediatricians as a form of child abuse. If a 165-pound adult can do that much harm to a child, is it any wonder that a 3,0OO-pound car can also severely injure the occupants of the car it has struck?

Fallacy No. 7.  "If people wore their seat belts,  they would not suffer whiplash injuries ". Seat belts have a great protective feature: in the event of a collision, they can prevent you from being thrown out of the car. There is no denying that seat belts have saved many lives.  Unfortunately, seat belts do not prevent whiplash injuries at all. They are even now suspected of compounding some whiplash injuries.   At the present time, the best way to minimize the injury is to have a well-designed, well-positioned head restraint and a sturdy seatback, the kind that is recommended by The Insurance Institute for Highway Safety. In order to act as a dependable head stop, a head restraint must be positioned high enough above the ears, and very close to the back of the head. It should also be made of the same material as the seat and should need no prior adjustment. The Insurance Institute for Highway Safety regularly rates head restraints of new automobiles on their web site: http://www.hwysafety.org/crash/crashgen/head.htm To dismiss whiplash injuries with buzz words like "soft tissue injury", or "psychosomatic" will not make whiplash injuries disappear. Nor will no-fault laws. There is a drive for no-fault legislation in many states (Three states already have such laws: Florida, Michigan and New York); fortunately ,  there are also Congresses on Whiplash-Associated Disorders held every year in Canada or Switzerland where world-known experts present research papers on car design, diagnosis, treatment and prevention of the injury. Copyright 2OO1: Monique Breuil Harriton Reprinted from WorldWideSpine, Fall 2001,  pp25-27

 

GLOSSARY

WAD  -  Whiplash Associated Disorders, the term more correctly used for whiplash injuries.

Neurotomy - -  (Percutaneous Radiofrequency Neurotomy/Rhizotomy; Facet neurotomy; Zygapophysial/z-joint neurotomy).  A procedure recommended by leading WAD authorities for relief of pain from the facet joints (injured it is believed in approximately 60% of whiplash cases).  A needle is inserted next to the two nerves coming off the joint and a radiofrequency is used to burn a tiny hole which disconnects the joints from the brain, eliminating the pain for an average of 12-14 months.  Diagnostic blocks are first used to test the potential results of the procedure.  In this, an anesthetic is injected to numb the two nerves near the suspected damaged facet joint - pain relief indicates that a neurotomy will be successful.  A second diagnostic block is done at a later date for confirmation.  This process is one that should only be considered for chronic pain following an injury - generally speaking it is only applicable in cases where there has been no improvement in symptoms for a period of three months or more.  Go to this site to find out more.

MRIs  - Magnetic Resonance Imaging.  An imaging technique used to produce high quality images of the inside of the body. 

"No claim no pain" - Common whiplash myth that pain is only present in whiplash sufferers who pursue an insurance claim.  Modern studies consistently deny this myth.

 

[Back to Contents] [Home]

[1 What is Whiplash?] [2 Treatment] [3 Legal aspects]

[4 Research]  [5 Prevention] [6 Ten Tips] [7 Discussion]

[8 Case histories] [9 Bone Marrow]  [10 E-Mail me]