When the cervical spine (neck) is subject to whiplash (an
abrupt backward and/or forward jerking motion of the head), there is usually a
combination of factors that contribute to whiplash pain in the neck and back,
and ultimately need to be addressed individually by a chiropractor. The doctor of chiropractic maintains a
“holistic” view of the patient’s whiplash pain, specifically focusing on one or
more of the following: joint dysfunction, muscle dysfunction, faulty movement
patterns, and/or disc derangement.
This newsletter explains how chiropractors approach treating
neck pain, back pain, and/or other whiplash symptoms, and help patients
Whiplash Pain
Management For Joint Dysfunction
Joint dysfunction from whiplash occurs when one of the
joints in the spine or limbs loses its normal joint play (resiliency and shock
absorption). It is detected through
motion palpation, a chiropractic technique in which the chiropractor gently
moves the joint in different directions and assesses its joint play. When a joint develops dysfunction, its normal
range of movement may be affected and it can become painful. Additionally, joint dysfunction can lead to
muscle imbalance and pain, and a viscous cycle: The loss of joint play can
cause abnormal signals to the nervous system (there are an abundance of nerve
receptors in the joint) – The muscles related to that joint can subsequently
become tense or, conversely, underactive – The resulting muscle imbalance can
place increased stress on the joint, aggravating the joint dysfunction that
already exists.
Muscle Dysfunction
From Whiplash Injuries
When joint dysfunction develops, muscles are affected. Some
muscles respond by becoming tense and overactive, while others respond by
becoming inhibited and underactive. In
either case, these muscles can develop trigger points that may necessitate
whiplash treatment involving muscle relaxation or stimulation.
Trigger points are areas of congestion within the muscle
where toxins accumulate. These toxins
can irritate the nerve endings within the muscle and produce pain. This whiplash pain can occur in the muscle
itself or can be referred pain (perceived in other areas of the body).
The muscle can also send abnormal neurological signals into
the nervous system, which can then cause disruption of the ability of the
nervous system to properly regulate muscles in other parts of the body, leading
to the development of faulty movement patterns.
Faulty Movement
Patterns and Whiplash Pain
It is thought that the intense barrage of pain signals from
a traumatic whiplash injury to the cervical spine can change the way the
nervous system controls the coordinated function of muscles. The disruption of coordinated, stable
movement is known as faulty movement patterns.
Faulty movement patterns cause increased strain in the
muscles and joints, leading to neck pain and back pain. They can involve the neck itself or can arise
from dysfunction in other areas of the body such as the foot or pelvis.
Instability is also considered part of faulty movement
patterns. There are 2 types of
instability that can occur in whiplash: Passive instability- the ligaments of
the neck are loosened, making it more susceptible to whiplash pain – Dynamic
instability- the nervous system disruption causes a disturbance in the body’s
natural muscular response to common, everyday forces.
As a result of instability, even mild, innocuous activities
can be difficult to perform as they often exacerbate the whiplash pain.
Whiplash Pain From a
Herniated Disc
The force of whiplash can cause injury to the discs between
the vertebrae, and small tears can develop. If the gelatinous middle of the
disk seeps out, it can irritate the nerve endings in this area. This is known as disc derangement.
Occasionally, the gel can seep all the way out and press on
a nerve root exiting the spinal cord behind the disc, known as disc herniation.
A herniated disc may involve whiplash pain in the neck as
well as sharp, shooting pain down the arm and possibly neurological symptoms
such as numbness, tingling and muscle weakness.
