Dr. Lipoff: Whiplash: Why Treatment May Help Avoid Years of Pain

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Dr. Lipoff: Whiplash: Why Treatment May Help Avoid Years of Pain

9/6/2012

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By Dr. Jay Lipoff


Don’t forget First Responder Appreciation Day is Tuesday 9/11. In a massive effort to improve Health and Wellness in the State of Maryland, and to pay tribute to our everyday heroes, active and retired, on Tuesday, September 11, 2012, participating Maryland Chiropractic Association (MCA) members will be honoring all 1st Responders with free services.

Both Henry Chiropractic & Wellness (301-737-0662) and Back At Your Best Chiropractic, Physical Therapy & Massage (301-863-2378) are participating in St. Mary’s County. Ask your chiropractor if they are a MCA member and will be joining in this day of appreciation and free care.

The good neighbor looks beyond the external accidents and discerns those inner qualities that make all men human and, therefore, brothers.Martin Luther king Jr.

I wanted to address this condition again because people still don’t receive the care they need after a motor vehicle accident. Recently several patients came in to my office with complaints that were related to a previous accident but they didn’t know it. I got fired up and told them I had to write another article on this subject.

All of them did seek medical care or went to the ER but were told there were no fractures, they would be sore, take some Tylenol and should be okay. This is a huge part of the problem. The ER is great for emergencies and they are usually over-burdened with the sick and injured.

However, to tell someone they are okay after a motor vehicle accident is a travesty and a crime. The ER room sees an estimated 900,000 cases like this each year. That’s a lot of people being told they will be okay. Doctors of Chiropractic are trained to diagnose and treat musculoskeletal injuries exactly like this. Some hospitals employ Chiropractors for cases just like this.

A study conducted by The George Institute (University of Sidney in Australia) found that accident victims recover rapidly during the first three months after an accident. Beyond that, recovery is slow and limited, further supporting the fact treatment should be sought immediately.

If a 3,000 pound vehicle of steel shows damage, the soft tissue driver and passengers that withstand that impact most definitely have injuries. Remember you are belted across your chest and your head flings forward and backwards.

Current studies have shown the damage to the neck and back from a blow to the head, a motor vehicle accident (MVA) or a fall may either be felt immedi­ately, not for hours, or sometimes even years.

The damage to the spine can go undetected and lead to biomechanical stress, which later results in chronic pain.That is what keeps bringing patients in for treatment two months later or two – five years later. In fact, 20 – 40 percent of accident sufferers will have symptoms that persist for years.This is called late whiplash syndrome.

Insurance companies constantly try to put a limit on the amount of time you have to file a claim after such an accident. WHY??? Because they know if you sign off and take a payment to close the case, or don’t seek treatment, their responsibility is over. Kaput.

Now when you start to have these complaints, they are not responsible and it is now on your dime. That is why legal counsel may need to be found so you can get the care you need, have your vehicle fixed and receive money for any damages related to the accident.

I’m not into suing everyone but I have seen too many auto insurances take advantage of accident victims. With a good lawyer you will be protected. And the lawyers have heard all the nonsense before.

What’s also frustrating is that the patient always fixes their vehicle before they continue to put years of abuse on it. What about your spine that protects the brain and nervous system? If you could see the damage, like your car or a chipped tooth, you would rush in for treatment.

You’ll own five more cars before you’re 90, but you’ll only have one spine to get you there. Replacement parts are expensive. I have never heard of a car hitting a person and the person being okay. It’s pretty clear the soft tissue of your body would be much worse off than the vehicle.

I have even told patients, who know someone who has been in an accident, to have the injured person go see a different chiropractor. I will give them information in hopes they will seek care, but the need to receive care somewhere is imperative. It will reduce the debilitating effects of a motor vehicle accident that could take years to show up. I see it over and over in practice.

Whiplash is a sudden forward and/or backward movement of the head after an accident or a fall. This can cause postural abnormalities and joint dysfunc­tion.

The impact to the driver is 2.5 times greater than the force to the vehicle itself.So whatever damage you see to the vehicle, realize the force to your body was 2.5 times greater.

Some patients profess that their vehicle was fine, but of course they still had it checked, just to be safe, yet they were fine. Changes of speed of only 2.5 miles an hour during crash tests caused occupants symptoms of soft tissue injuries; whereas damage to a vehicle may not be seen until 8.7 mph.

If left untreated or uncorrected, resultant adaptive changes will occur in the architecture of the spine (see pictures at beginning of article). The soft tissue and bones of the neck will cause pain, muscles will become fibrotic or less pliable, scarring will develop in the tendons and ligaments and there will be degenerative changes in the spine.

When the ligaments heal, they will develop a cross linkage or net-like mesh of their fibers that create inferior strength in the tissue. Unless these scars and adhesions are disrupted by mobilization or adjustments,the result will be the tissues involved will now fail at only 40 percent of their original strength.

Your neck has a wide range of motion, so you put greater bending, twisting and turning demands on it than you do on the rest of your spine. The seatbelt protects your torso making the neck the most vulnerable part of your spine, especially during an auto accident.

Even minor whipping of the cervical vertebrae of the neck can cause severe trauma to the neck muscles, ligaments and soft tissues. A hit during a football game or slipping and falling can have the same result.

In a rear-end collision your neck is forced to move into extension starting with the lower vertebrae first. This motion is completely different from the normal motion of the spine during extension and can be a source for understanding how the neck is injured in an accident.

Neck position at the time of the accident also plays a role in the amount of damage that occurs. Over 55 percent of people, who were complaining of per­sistent symptoms for more than two years after their whiplash injury, reported they had their head rotated at the time of impact.

Additionally, being unaware of the impending impact will lead to much worse damage than if you were braced for impact found an article in The Spine Journal 2003 about Whiplash research. They found amplitudes were 180 percent larger with forward movement and 25 percent larger with backward motion, if you were surprised when the accident occurred.

In a sudden rear-end collision of only 20 mph, a force of 12 Gs is placed upon the neck during the extension phase of whiplash (head moves backward) and 16 Gs of force on the flexion recoil of the neck(head moves forward). A patient who flies planes told me an F-15 fails at 10 G! That’s less force than what your neck just withstood. Trust me; it is not “okay” after an accident.

The normal curve of your neck is C-shaped. Whiplash produces an S-shaped curveduring the initial stages of an accident, with hy­perextension occurring at the lower cervical levels. The damaging hyperexten­sion happens in 75 milliseconds (ms) after impact, while it takes 200 ms for the body’s muscles to develop enough force to brace the spine.

Essentially there isn’t enough time for the brain to send a message to the muscles that prevent the overstretching from happening. By the time the muscles contract, it is too late. Your body has no chance to fully protect your neck from injury during an accident. When the muscles do contract, they are supporting a damaged spine.

The hyperextension of the neck is the cause of facet joint pain and demon­strates the biomechanical process of whiplash.That muscle tightness or pain you feel the next day is your body’s incredible recuperative attempt to stabilize itself during and after such a collision.

It was also found that a small woman would experience two – four times the force on the neck when compared to a large male.

Left untreated the muscles will remain tight and adapt to this new position. This will alter your Range of Motion (ROM); the spine will wear unevenly and lead to degeneration due to the atypical stress. These are the people who have symptoms years after an auto accident and don’t grasp the connection.

One study followed whiplash victims over a period of time and compared their spinal health to an age similar control group. They found the whiplash subjects to have 39 percent more disc degeneration than the control group, which had only six percent degenerative changes.

When you fail to give your neck proper attention immediately following an injury, pain and stiffness can develop and lead to limited motion, changes in your posture, headaches and muscle tension. These problems can lead to disc bulges, nerve pain, hypolordosis, arthritis and instability.

If you or a friend has been in any fall, collision or motor vehicle accident, please do not ignore your spine. It is not okay after a collision, no matter what you are told. You should get preferential treatment and receive immediate attention to correct it. Research shows it will be with you longer than your vehicle, and probably your teeth.

These topics come from my book, “Back At Your Best; Balancing the Demands of Life With the Needs of Your Body.” It is available in book and Kindle format at Amazon, www.BAYBBook.com and at my office.

If you have any personal health concerns or questions, feel free to email me at DrJay@BackAtYourBest.com. I will answer them in private or in this section in a week or two.

Dr. Jay M. Lipoff is the owner of Back At Your Best Chiropractic & Physical Therapy, LLC, which is located in the Wildewood Shopping Center. He received his Bachelor of Science degree from Syracuse University in 1990, a Doctorate of Chiropractic (D.C.) from New York Chiropractic College (NYCC) in 1994 and he became a Certified Fitness Trainer (CFT) in 2005.

Dr. Lipoff is an Executive Board Member, International Chiropractic Association Council on Fitness and Sports Health Science; has a radio segment: Back At Your Best in 5 Minutes or Less, Co-Founder, Drug Free Training USA; Member, NY Strength-promoting the importance of physical conditioning; Board Member of Public Relations Committee, Maryland Chiropractic Association; has done over 15 nationally broadcasted radio interviews, has articles in print and referenced in over 100 print papers, magazine and on websites, President, Wildewood Business Network-promoting better business relations and community outreach

For more information, go to www.BackAtYourBest.com, find us on facebook or call 301-863-BEST (2378).



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