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Whiplash Associated Disorder (WAD) and Cervical Spine Injury,Cold/Low Level Laser Therapy (LLLT). Research,for neck pain and injuries, published by The Lancet.
An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, headache at the back of the head, thoracic back pain and/or lower back pain. Some pins and needles and pain can also be present in the arms.
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Whiplash Associated Disorder (WAD) and Cervical Spine Injury
An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, headache at the back of the head, thoracic back pain and/or lower back pain. Some pins and needles and pain can also be present in the arms.
Typical cervical over-extension injuries occur in passengers an drivers of a stationary or slow-moving vehicle that is struck from behind. Body is thrown forward but the head lags, resulting in hyper-extension of the neck. When the head and neck have reached maximum extension, the neck then snaps into flexion.
- A rapid deceleration injury throws the head forwards and flexes the neck. When the chin hits the chest it limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyperextension may occur in the subsequent recoil.
“Whiplash” injuries may occur at relatively low vehicle velocity impacts. One study showed the cervical muscle injury threshold to be about 10 km/hour. Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms:
- Grade 1: no complaints or physical signs.
- Grade 2: indicates neck complaints but no physical signs.
- Grade 3: indicates neck complaints and musculoskeletal signs.
- Grade 4: neck complaints and neurological signs.
- Grade 5: neck complaints dislocation and fracture. Most cervical spine fractures occur predominantly at two levels:
1. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7.
2. Most fatal cervical spine injuries occur in upper cervical levels, either at cranio-cervical junction C1, or at C2
Uncomplicated cases of Whiplash Associated Disorder (WAD)
“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles of the neck spasm naturally, as a protective reaction. The “Whiplash”(WAD) injury may cause stiff neck and pain that may be present down one or both arms if the nerves of neck part of spinal cord get compressed. Pain Relief for “Whiplash”(WAD) can be found with Chiropractic care or Physiotherapy including pain medication.
****** Studies have shown that 35 of 39 patients, or 91%, of patients with chronic Whiplash associated disorder (WAD) “Whiplash” benefited from chiropractic care and Physiotherapy ********
Severe cases of Whiplash Associated Disorder (WAD).
In severe cases of “Whiplash”(WAD) the symptoms may last for a month or more with persistent and in some cases constant pain. This may indicate that the “Whiplash”(WAD) injury has extensive damage and resulting in discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped” disc, also known as a prolapsed, bulging, ruptured or herniated disc in the back.
(View our Cold Low Level Laser Therapy section,a five star rating has been given to Cold/Low Level Laser Therapy, for healing & pain relief ).
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The symptoms of Whiplash Associated Disorder (WAD)
- pain or stiffness in the neck, jaw, shoulders, back, or arms
- headaches
- dizziness
- blurred vision or ringing in the ears
- tingling or numbness in the arms, hands or shoulders
- memory loss or difficulty concentrating
- nervousness or irritability
- difficulty sleeping
- fatigue
- burning or prickling or tingling, particularly around your neck
- depression
- vertigo
What if I don’t feel anything at first, but start to have symptoms later?
It is common for “Whiplash”(WAD) symptoms to occur right away but often there is a delay for several hours after the incident and then worsen over the next 36 to 72 hours.
How long do the symptoms last?
Most neck and head pain symptoms clear up within a few days or weeks. For others, the recovery can take up to three or four months. About 35 percent of people with “Whiplash”(WAD) report symptoms for up to a year. Around 15 percent of patients report permanent symptoms as a result of their injuries.
Diagnosis of Whiplash Associated Disorder
Determining the source of the pain is essential in establishing the appropriate treatment and rehabilitation. Therefore, a comprehensive examination is required to determine the cause of neck pain.
“Whiplash”(WAD) is difficult to diagnose since most injuries are to soft tissues like muscles and ligaments and will not show up on an x-ray. If an x-ray fails to reveal a problem, Chiropractor or Physiotherapists will sometimes order specialized tests such as magnetic resonance imaging (MRI). But more often they will make a diagnosis based on your symptoms.
Your Chiropractor or Physiotherapist will take a complete medical history. The Chiropractor or Physiotherapists may ask you about other illnesses, any injuries that occurred to your neck, and any complaints you have associated with neck pain. Previous treatment for your neck condition will also be noted.
X-rays often will be obtained to allow your Chiropractor or Physiotherapy to look at the Vertebrae (bones) in your neck. This entails simple diagnostic imaging study (radiography) and aids your Chiropractor and Physiotherapist to determine the cause of neck pain and to prescribe effective treatment.
Further evaluation may involve the following:
- MRI (magnetic resonance imaging). This non x-ray study allows an evaluation of the spinal cord and nerve roots.
- CT (computed tomography). This specialized x-ray study allows careful evaluation of the bone and spinal canal.
- EMG (electromyography). This test evaluates nerve and muscle function.
Treatment for Whiplash Associated Disorder (WAD).
The treatment of neck pain depends on the diagnosis. Most patients are treated successfully with Chiropractic care. Also rest, medication, immobilization, exercise, activity modifications, or a combination of these methods can be very useful.
Inflammation is a result of stretching muscles and ligaments beyond their limits. Cold/Low Level Laser Therapy is extremely effective in the treatment of inflammation. Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic care or Physiotherapy, rest, medication, will relieve neck pain.
Surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disc or bony narrowing of the spinal canal. Surgery may also be required following an injury to stabilize the neck and minimize the possibility of paralysis, such as when a fracture results in instability of the neck.
If you’ve seen your doctor about your injury and the symptoms persist for more than four weeks, it may be time for you to see a specialist. Such as a neurologist or Chiropractor who can help diagnose your condition.
What is the treatment for Whiplash Associated Disorder (WAD.
Doctors often prescribe anti-inflammatory painkillers or muscle relaxants. You can apply ice to the injured area to reduce pain and swelling for up to 15 minutes every hour. Chiropractic treatment is very effective in the management of “Whiplash”(WAD).
Cold/low level Laser Therapy (LLLT). Research,for neck pain and injuries, published by The Lancet.
Neck pain is a pain in the neck. It is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders.
1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5; 374(9705):1897-908.
Cold/ Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force (published in the journal Spine).
(View our Cold / Low Level Laser Therapy(LLLT) section. Cold/low level Laser Therapy has a five star rating for healing & pain relief for Whiplash soft tissue injuries ).
What can I do to help prevent Whiplash associated disorder (WAD)
Since the most common cause of the injury is car crashes, experts say safe driving, seatbelts, and properly adjusted headrests are your best protection against “Whiplash” (WAD). Seatbelts help keep you from being thrown forward; a low headrest in your car allows your head to pivot backwards over the top during an accident: Always raise or lower your car’s headrest until the centre of the rest meets the centre of the back of your head.
Causes and Risk Factors of Cervical disc injuries
Most cervical disc syndromes are caused by injuries that involve hyperextension, which results in compression of the anatomic structures.
Flexion injuries in the cervical area do not result in nerve compression.
Symptoms of Cervical disc injuries
Pain, loss of sensation or new sensations, and weakness are the main symptoms and signs of cervical disc injury. The most common symptom is pain and it is usually the only one. Rarely, cervical disc injury is complicated by compression of either a cervical nerve root or even more rarely by a compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report loosing strength in one arm (nerve root compression) or in both arms and legs (spinal cord compression).
1. Pain is the most common complaint and can be felt in the neck or arm.
a. Pain is usually limited to the neck and upper back between the shoulder blades. It occurs because of low-grade inflammation of the disc and the cervical vertebra joints. While the disease is chronic, inflammation can flare up after a minor added injury or for other reasons that are not yet well understood. Less commonly, neck and shoulder pain occur because the disc bulges acutely (herniates) and stretches the posterior longitudinal ligament. With conservative treatment, this pain usually goes away in a few weeks, but it is likely to happen again, especially if the affected individual does not change his/her lifestyle.
b. Rarely, the pain will be felt down the arm. This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usual.
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