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The Neck Before and After Whiplash

The Neck Before and After Whiplash
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Whiplash associated disorders (WAD) is a term used to describe the cluster of symptoms that can occur following the sudden acceleration and deceleration of the head and neck, most commonly during a motor vehicle collision (MVC). Individuals who experience such an event may experience no injury at all, while others may have catastrophic outcomes. In many cases, a whiplash sufferer may develop neck pain and stiffness that can prompt them to seek out chiropractic care. Doctors of chiropractic also treat patients with non-traumatic neck pain. Is there a difference in the presentation of patients with traumatic vs. non-traumatic neck injury?

A study published in May 2024 may help give healthcare providers greater insight into how these two types of neck disorder compare and contrast. The study included 41 patients who had sought care for neck pain at one of three health clinics within two years of an MVC, where they subsequently underwent examination and treatment. This afforded researchers a unique opportunity to identify any biomechanical, activity tolerance changes, or pain intensity differences resulting from the whiplash injury.

The research team found that pain levels increased from 2.5 to 5.0 (on a 0-10 pain scale) post-whiplash. Likewise, on a 0-100% disability scale (measured by the commonly used Neck Disability Index questionnaire), activity tolerance worsened from 15.7% to 32.8%. The results from pre- and post-whiplash X-rays revealed greater flattening of the cervical curve (an average of 8 degrees) at all cervical spine levels, but greatest in the mid-cervical spine. The patients were also more likely to exhibit forward head posture in which the head rests forward of the midline of the body, as seen from the side. Four of the patients also developed segmental translation (excess motion) in the cervical spine.

Numerous studies have reported a correlation between altered neck curves and resulting biomechanical dysfunction and its effects including neck pain and accelerated joint and disk degeneration. The loss of cervical curve following a whiplash event may help to explain why up to 50% of WAD injured patients continue to report lingering pain, dysfunction, and disability one-year post injury.  Thus, restoring cervical curvature as much as possible is often a treatment goal with WAD patients.

Doctors of chiropractic are well trained in the diagnosis and management of WAD patients, including treatment to address postural faults of the cervical spine. While specifics may vary as each patient’s case is unique, chiropractic treatment for WAD will often be multimodal in nature encompassing manual therapies, various cervical traction techniques, specific exercise approaches, self-care techniques, and dietary/supplement recommendations to aid in the healing process.