I’ve recently seen a lot of whiplash cases and needed to write
several reports. The general
medical opinion is that most cases will self resolve within 6 months. This is only true in half the cases.
The more I researched the greater the extent of the potential problems became.
There are an estimated 250,000 new cases of
whiplash-associated disorder (WAD) in the United Kingdom each year. In a recent Canadian study of the last
10 years worth of research, they found that half the cases of whiplash were
still reporting symptoms 1 year after the accident. Between half and two thirds of WAD’s will have neck pain
between 1 and 5 years after the collision. The quicker the onset of symptoms and the more severe they
are, and the greater the risk of a prolonged problem. It is now established that a delayed
onset of the symptoms 6 to 8 weeks after the collision is normal. Neck pain is the most commonly reported
problem, but others include; headaches, jaw pain or clicking, numbness in the
face or arms, dizziness, loss of energy, back and shoulder pain. Other more complex problems include; hormonal
disorder, emotional changes, mental faculty changes and personality disorders.
The speed of the impact does have some bearing on the outcome,
but injury is expected with a combined impact speed above 10mph. There is some evidence that 2.5mph
collision speed is enough to shift the vertebrae in the neck. In severe collisions (those above 30mph
impact speed) there is usually muscle and ligament damage. Severe cases involve bone fractures and
require orthopaedic intervention.
Another study found that a third of WAD involved irritation of
the jaw joint (TMJ) that can manifest up to a year after the collision.
Many of the problems associated with WAD occur as the brain is
bruised against the skull. This is
known as mild traumatic brain injury (MTBI). Such cases, where there is often no other obvious trauma
visible by X-ray or MRI scan, have to endure accusation that ‘they are faking
it for the insurance’. The
emotional trauma of this only aggravates their symptoms further. Certainly there are bogus claims out
there, but to quote a German university neurological department that looked at
headaches from MTBI, “Investigators should refrain from
oversimplifying these complex mechanisms as hysteric exaggeration of everyday
complaints and from implying greed as motivation for this potentially very
I’m often asked ‘When it is best to be
checked out after a car accident?’
My answer is simple. Once you’ve been cleared by A&E then as soon as
possible. Early intervention
significantly reduces the risk of long term problems developing. Many of my patients who present with
unexplained symptoms will have a car crash as part of their medical history.’
Principal Chiropractor at
South Street Chiropractic