Whiplash and Chronic Pain
As a Charlotte, NC Chiropractor I see a lot of patients with all kind of injuries. In my experience, the injuries that respond the quickest to treatment are of acute nature. Such injuries have happened within only a few days and have been correctly diagnosed and treated. Restoring the proper joint motion, controlling inflammation, and functional muscle movement are paramount for decreasing pain and avoiding chronic pain.
Therefore, it is important to get examined and if needed treated as soon as possible after a car accident to avoid chronic pain setting in. Lets examine the neck as a cause of chronic pain in a whiplash type of situation. The neck or the cervical spine is composed of 7 vertebrae and has the job of positioning the head in space. The information that is gathered from the neck joints allows the muscles to properly appropriate the head in the right location as it relates to space. Although, the relationship between the head placed atop the neck allows for optimal movement, the arrangement also creates for potential injuries during an event of forceful flexion, extension or lateral movement.
In addition to cervical spine, muscles, ligaments, tendons and neural structured may also be damaged in the event of hyperflexion/extension. In the occurrence of such injury a reflex spasm may occur. A reflex spasm occurs due to activation of alpha motor neurons from nociceptive impulses that are of high intensity. The nociception, or the pain impulse causes contraction of the muscle fibers, which comes from any pain generating tissue, especially the intervertebral disc. As the muscle contraction continues, ischemia causes the pain intensity to increase, providing discomfort upon movement. With treatment or even without treatment, as the painful stimuli decreases, residual tension or improper function of the muscle may remain.
This low level tension will continue to send pain signals, inhibiting the muscle, creating aberrant motion of the joints and the improper function of the muscles. This dysfunction can lead to chronic pain in the tissues involved. Therefore, it is imperative to get proper and correct treatment, that both treats the joint movement and muscle function. Another phenomenon that can occur and contribute to chronic pain, is pain inhibition by another body part that has a higher intensity of pain. For an example, a patient that is experiencing severe neck pain after a car accident, develops low back pain a couple of weeks after the initial injury as the discomfort in the neck area decreases. In this situation the pain in the low back doesn’t just magically show up, it actually occurs due to the intensity of the nociceptive stimuli being now higher than that of the neck. The usual treatment protocol for neck injury will be determined after a thorough examination.
Longus Colli and Capitus muscles will be rehabbed by doing chick tuck exercises. These muscles of the neck have an important job of stabilizing each segment of vertebrae in the cervical region allowing proper movement. These muscles are the second most common injured in a car accident. If these muscles would not be properly activated, the person can still experience pain relief, but with aberrant motion. Later on the patient may experience pain once more as the incorrect motion puts undue stress on the cervical spine.