28 Finch Avenue West
Suite 212
Toronto, Ontario M2N 2G7
Dr. Katherine Marek, Hons BSc, DC, FIAMA, DWTT
Whiplash is NOT a Minor Injury and it does NOT self resolve
What Really is a Whiplash Injury?
The new term to describe a Whiplash Injury is Traumatic cervical syndrome. TCS is defined as the “biological and neurological consequences for the cervical spine and nervous system caused by neck trauma, and is a syndrome comprising various symptoms of the motor and nervous system but also mental, neurological, as well as otological and visual balance dysfunction”
The Injury
Crash Speed 8.3 mph
Look at slide 4, the neck is undergoing 6 forces almost instantaneously.
Now the Scary Part
Long Term Outcome Studies - See the List Here!
Squires 1996: 15.5 years post injury, 70% still in Pain!
Reverse S Curve
This causes damage to the ligaments that stabilize the spine. They remain structurally intact, but are functionally weak.
Consequence of loss of Spinal Function.
Problem 1. You ONLY Have 3 Weeks until this process has occurred. This means that you need to be in treatment, and receiving the correct treatment within the first several days post Whiplash Injury!
In review of Tens of Thousands of Whiplash Related Reports in my career, I have seen less then 1% obtain this required treatment at the start of care. This is why a Doctors Specific Whiplash Traumatology Training MATTERS!
Problem 2: Loss of Normally Physiological Function Globally!
Decreased Regional Cerebral Blood Flow to the Brain.
Research Link
Problem 3: Loss of Strength and Biomechanics
The cervical vertebral column is heavily dependent on the active support of muscles for physical support. In particular, the deep sleeve of muscles that envelope the cervical spine is considered to play a vital role in segmental cervical motion particularly in controlling buckling and unwanted rotary intersegmental motion associated with contraction of large multi-segmental muscles during daily tasks.
Good muscle function in the neck is necessary for good static balance and to avoid dizziness, pain and disability, as well as disturbed activity of daily life.
When we lose function due to injury and fatty infiltration resulting from a change in the spinal curvatures this can lead to Cranial Nerve Impairment, Vestibular Impairment, HPA Axis Dysfunction and a host of other injuries. That is why Whiplash is a PROGRESSIVE DISEASE!
Research Ling
Chronic Pain
The changes above set the stage for altered spinal biomechanics that progressively worsen over time, leading to changes in immune function, hormone function, continued altered biomechanics, overuse injuries, depression, anxiety, nerve entrapment and brain remodeling.
The picture to the left is from Dr. Ming Kao of Stanford Pain Medicine Lab, that shows the pain process. If pain is left untreated or improperly treated, this is the bodies Physiological Response. A primary Reason why YOU WILL NEVER GET BETER after a WHIPLASH INJURY unless you are able to obtain whiplash specific injury treatment almost directly after an accident. Don't believe me, look at the research above.
Final Consquecy
Physiological Changes to YOUR
Spinal Cord and Brain!
<-- SPINAL CORD CHANGES LEADING TO CHRONIC PAIN. Continued C-Fiber stimulation (Pain) of the spinal cord, results in continuous excitation of Wide Dynamic Range Neurons (WDRN). ] If WDRN continually receive pain information, neuronal sprouting of A-Beta Fibers can occur in which the A-Beta Fibers sprout from lamina V into lamina II of the dorsal horn. When this occurs, proprioceptive information is no longer sent along WDRN, rather pain signals are being sent. This is a maladaptive response indicating that a chronic pain process is present due to non-protective changes in the nervous system function and structure.
-
Boswell M, Cole B: Weiner’s Pain Management. A Practical Guide for Clinicians. Seventh Edition. American Academy of Pain Management Credentialing Text Book.
LOSS OF GRAY MATTER AND BRAIN VOLUME WITH CHRONIC PAIN -->
A consequence of pain-related plasticity in the amygdala is increased pain behavior. This gray matter reduction correlated with the duration of pain. A more recent study compared phantom limb patients to matched controls and noted a reduction in gray matter in the posterolateral thalamus contralateral to the side of the amputation (Draganski et al., 2006). This gray matter reduction was positively correlated with the duration of time since the amputation, but not the severity or frequency of pain.
This research that was also found by Dr. Sean Mackey at Stanford Pain Medicine and the American Pain Society shows that the duration of pain is more important than the severity of report pain.
Now you know 1% of the vast body of knowledge on whiplash.
If you are involved in claims management, legal representation, medical treatment, or have been injured in a motor vehicle accident, having the right knowledge is critical.
Proper understanding ensures swift claim resolution, fair settlements for the injured, and the best chance for a full recovery.
Conversely, delayed or inappropriate care, as well as a lack of expertise among claims adjusters, lawyers and doctors, can stall the process—ultimately increasing the risk of chronic pain and long-term disability for the injured.
Choose wisely when seeking medical and legal assistance. You recovery will most likley depend on it!
Coming Soon
