By. Dr. John R. Mishock, PT, DPT, DC
Each year, two million Americans suffer from whiplash-associated disorders (WAD) secondary to motor vehicle accidents. Studies using high-speed cameras and sophisticated crash dummies have determined that rear-impact car accidents cause the lower cervical vertebrae (lower bones in the neck) to be forced into a position of hyperextension (movement of the vertebrae backward).
In contrast, the upper cervical vertebrae (upper bones in the neck) move rapidly into hyperflexion (movement of the vertebrae forward). This traumatic movement leads to an abnormal S-shape curve of the cervical spine during the accident. This abnormal motion causes damage to the soft tissues that hold the cervical vertebrae together (ligaments, facet capsules, muscles).
The lower back and shoulders can also be injured as the seat belt restraint causes rotational stress to the torso and spine. These insults during an auto accident can lead to symptoms of WAD.
The most common symptoms related to WAD include:
* Neck pain and stiffness
* Headaches
* Shoulder pain
* Dizziness/visual changes
* Fatigue
* Jaw pain
* Arm pain/weakness
* Low back pain
* Numbness and tingling
Recent evidence has shown that physical therapy may be the best choice to decrease pain, improve motion, and lower cost secondary to whiplash-associated disorders. In the Journal of Rheumatology, a large scale meta-analysis was performed of the existing literature on mechanical neck pain secondary to motor vehicle accidents.
There was substantial evidence supporting stretching/strengthening exercises combined with mobilization/manipulation. Standard medical care (pain medication, surgery, and injections) had limited evidence or no long-term benefit.
Furthermore, the treatments with physical therapy were less expensive and demonstrated less long-term disability versus standard medical care.
An article in the Emergency Medical Journal compared two groups. The first group received mobilization (hands-on muscle and joint work) and exercise therapy. The second group received medication and a cervical collar. The mobilization and exercise group had significantly less neck/shoulder pain, improved headaches, and lower prevalence of all other symptoms when compared to the group receiving medication and a cervical collar.
Another research article in the journal Spine demonstrated decreased medical cost and fewer days lost at work in patients who received physical therapy versus standard medical treatments (advanced tests, drugs, collar, injection, and surgery).
The scientific evidence clearly shows that using PHYSICAL THERAPY in combination with standard medical care would be the best choice to decrease pain, improve function, and prevent chronicity in individuals who have injuries associated with auto accidents.
Dr. Mishock is one of only a few clinicians with doctorate level degrees in both physical therapy and chiropractic in the state of Pennsylvania.
He has authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon.
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