Even though whiplash or whiplash associated disorders (WAD) is very common, it remains poorly understood. Recent studies report that up to 60% of people may still have pain six months after their injury. Why is that?
Investigations have shown there are changes in the muscle and muscle function in the neck and shoulder regions in chronic WAD patients. Symptoms often include balance problems as well as increased sensitivity to a variety of stimuli including pressure, light vibration, and temperature.
Interestingly, this hypersensitivity not only occurs in the injured area, but also in areas away from the neck such as the front of the lower leg or the shin bone. This can only be explained by some type of neurobiological processing of pain within the central nervous system, which includes the spinal cord and brain.
It’s not surprising that when pain continues for lengthy time frames, people with these symptoms may also experience psychological distress. The confusing thing is that not every WAD injury case has this “central sensitization” and when it’s present—its intensity is highly variable.
Current research into WAD is focused on the following: 1) developing better treatments in the early or acute whiplash injury stage with the goal to PREVENT development of these chronic symptoms; 2) determining what factors can PREDICT slower recovery following a WAD injury; 3) investigation into how the stress response associated with motor vehicle crashes influence pain, other symptoms and recovery, and how to best address and MANAGE the stress response; 4) research into the effect a WAD injury has on daily life function; and 5) developing improved assessment methods for healthcare providers so that EARLY treatments can be more targeted and effective.
A Swedish study is currently looking at the importance of reducing the acceleration of the occupant during an automobile collision by redesigning the body of the vehicle and its safety systems. In rear-end crashes, the main issue is to design a seat and head restraint that absorbs energy in a controlled way and gives support to the whole spine. In frontal crashes, the air bag, seat belt pretensioner, and load limiter must work together in a coordinated way to reduce the acceleration between the vertebrae of the spine and occupant.
What is known is that a “wait and watch” approach may NOT be appropriate in a lot of cases. It appears there is a relatively short window of time, the first three months, when treatment seems to be most effective. Doctors of chiropractic are trained to identify and treat these types of injuries, so PLEASE, don’t delay your initial visit—time is truly of the essence. Don’t waste it!
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