I’ve recently seen a lot of whiplash cases and needed to write several reports.  The general medical opinion is that most cases will self resolve within 6 months.  This is only true in half the cases. The more I researched the greater the extent of the potential problems became.

There are an estimated 250,000 new cases of whiplash-associated disorder (WAD) in the United Kingdom each year.  In a recent Canadian study of the last 10 years worth of research, they found that half the cases of whiplash were still reporting symptoms 1 year after the accident.  Between half and two thirds of WAD’s will have neck pain between 1 and 5 years after the collision.  The quicker the onset of symptoms and the more severe they are, and the greater the risk of a prolonged problem.  It is now established that a delayed onset of the symptoms 6 to 8 weeks after the collision is normal.  Neck pain is the most commonly reported problem, but others include; headaches, jaw pain or clicking, numbness in the face or arms, dizziness, loss of energy, back and shoulder pain.  Other more complex problems include; hormonal disorder, emotional changes, mental faculty changes and personality disorders.

The speed of the impact does have some bearing on the outcome, but injury is expected with a combined impact speed above 10mph.  There is some evidence that 2.5mph collision speed is enough to shift the vertebrae in the neck.  In severe collisions (those above 30mph impact speed) there is usually muscle and ligament damage.  Severe cases involve bone fractures and require orthopaedic intervention.

Another study found that a third of WAD involved irritation of the jaw joint (TMJ) that can manifest up to a year after the collision.

Many of the problems associated with WAD occur as the brain is bruised against the skull.  This is known as mild traumatic brain injury (MTBI).  Such cases, where there is often no other obvious trauma visible by X-ray or MRI scan, have to endure accusation that ‘they are faking it for the insurance’.  The emotional trauma of this only aggravates their symptoms further.  Certainly there are bogus claims out there, but to quote a German university neurological department that looked at headaches from MTBI, “Investigators should refrain from oversimplifying these complex mechanisms as hysteric exaggeration of everyday complaints and from implying greed as motivation for this potentially very disabling disease”.

I’m often asked ‘When it is best to be checked out after a car accident?’  My answer is simple. Once you’ve been cleared by A&E then as soon as possible.  Early intervention significantly reduces the risk of long term problems developing.  Many of my patients who present with unexplained symptoms will have a car crash as part of their medical history.’

Julien Barker

Principal Chiropractor at South Street Chiropractic