Whiplash (also called cervical acceleration-deceleration, or CAD) is not just one pathology. Rather, it is a blanket term to refer to a combination of injuries including sprain, joint trauma, bone fractures, herniated discs, and concussions.
Causes of Whiplash
Whiplash occurs when a sudden impact causes an abrupt acceleration-deceleration force, jerking a person’s cervical spine into hyperextension and hyperflexion suddenly and rapidly. (Eck & Shiel, 2016). Approximately 85% of neck pain in the United States is related to neck injury, and about one million cases of whiplash in relation to motor vehicle accidents are recorded each year (Werner, 2009). Whiplash is most commonly caused by car accidents, in which the patient was in a car that was struck from behind.
Symptoms of Whiplash
When the neck is forced into the hyperextension and hyperflexion, the cervical spine is forced into an abnormal “S” shape. It is believed that this causes damage to the soft tissues in the neck (Eck & Shiel, 2016).
Symptoms of whiplash include (Werner, 2009) (Eck & Shiel, 2016):
- Ligament sprains – Damage can occur to the supraspinous and intertransverse ligaments that hold each other together. Damage to the area can refer pain into the head, chest, and arms. Ligament sprains can take a long time to heal, and are the most common cause of lasting pain.
- Damage to the facet joint capsules – These are fibrous capsules that protect the facet joints between the vertebrae (Hacking, Palipana, et al). They can become irritated in cases of whiplash at which point they can refer pain to the head. Their proprioceptors can also cause dizziness and disorientation.
- Misaligned vertebrae – The cervical vertebrae can become displaced in cases of whiplash. Left untreated, the lack of structural support may cause spondylosis.
- Damaged disc – Trauma to the neck can cause so much stress on the ligaments that the annulus (ntervertebral disc) may crack, which can lead to herniation.
- Spasm – With acute neck injuries, neck muscles may go into spasm, which can limit the range of motion of the neck and restrict blood flow to connective tissue in the area.
- Trigger points – Trigger points are common symptoms of muscle stress or injury. The sternocleidomastoid may develop trigger points, and you can read about them in last week’s blog post.
- Neurological symptoms – These include dizziness, blurred vision, tinnitus, or unusual taste, smell or loss of hearing. These are symptoms of internal bleeding or bruising of the brain, typically caused by a specific blow to the head.
- Temporal Mandibular Joint disorders – It is thought the rapid movement of the neck can cause stress on the structures that make up the jaw, thereby causing TMJ disorder.
- Headaches – These can be a complication of many of the other symptoms of whiplash.
- Stiffness, pain, or weakness in the shoulder or arm – This would be caused by soft tissue damage in the cervical muscles.
- Sleepiness and irritability.
Can Massage Be a Treatment?
Typical treatments of whiplash include neck collars to immobilize the neck while healing occurs. Treatment may also include use of pain relievers, anti-inflammatories, or muscle relaxers. Patients seeking massage therapy as a treatment should not be under the influence of any of these drugs at the time of the massage, as they may alter the quality of tissue, or the patient’s perception of pain.
Massage therapy should not be pursued as a treatment for whiplash until after the acute stage of healing. It is also important that any serious symptoms have subsided before massage is considered, as there are certain symptoms which can be exacerbated by soft-tissue manipulation.
Massage can be a very beneficial way to strengthen injured neck muscles, reduce muscle spasms, and treat trigger points (Werner, 2009). Releasing trigger points can improve the range of motion in the neck, and decrease pain caused by the referral patterns of these trigger points. Deep tissue massage should only be used if approved by a physician. Coupled with other manipulative therapies, such as physical therapy or chiropractic work, the benefits of massage therapy can be even more beneficial.
Eck, J.C. and Shiel Jr., W.C. 2016. Whiplash. [Internet]. [updated 2016 Sep 09]. Medicine Net. [Accessed 2017 Jan 20]. Available from: http://www.medicinenet.com/whiplash/article.htm
Hacking, C., Palipana, D., et al. Facet joint capsule. [Internet]. [Updated 2017 Jan 20]. Radiopaedia. [Accessed 2017 Jan 20]. Available from: https://radiopaedia.org/articles/facet-joint-capsule
Cover image by JG Moellendorf, DC, ND, LCP