Because each individual case of whiplash is different, it is not possible to generalize about chiropractic treatment. The appropriate chiropractic treatment strategy is unique to each whiplash injury and is directed at the primary dysfunctions detected during the examination. However, chiropractors commonly employ the following chiropractic treatments for whiplash:
• Chiropractic spinal manipulation to treat whiplash: the primary treatment for joint dysfunction. The chiropractor gently moves the involved joint into the direction in which it is restricted and may involve the application of a short thrust in that direction. In many cases, instead of a thrust, a slow mobilizing movement is used by the chiropractor.
• Muscle relaxation or stimulation to treat whiplash: the primary chiropractic treatments for muscle dysfunction related to a whiplash injury. They consist of gentle stretches to the muscle that has excessive tension or repeated contractions of the muscle that is inhibited. If the muscle is very tight, a more vigorous stretch may be applied by the chiropractor. Gentle finger pressure techniques may be applied to trigger points to relieve the pain associated with the tight muscles.
• McKenzie exercises to treat whiplash: exercises specifically designed to reduce disc derangement related to a whiplash injury. These exercises consist of simple movements done initially in the office which make for an easy transition to self-care at home. These exercises help the patient to take an active role in his or her own recovery.
• Stabilization or sensorimotor exercise to treat whiplash: exercise approaches designed to correct faulty movement patterns in routine activities and everyday life. They train the nervous system to better coordinate and control movement patterns, and improve the ability of the neck muscles to maintain stability of the neck. These exercises are designed to help in a major trauma, such as a fall or whiplash during a motor vehicle accident, or in "micro trauma" from simple things such as being jostled in a crowd, playing sports or performing occupational or home jobs that require physical effort.
• Ergonomic and lifestyle advice for a whiplash injury: suggested improvements for performing everyday activities with minimal strain to the body. The advice addresses factors in an individual’s work, home or recreational activities that perpetuate the dysfunctions that result from the accident. The chiropractor may teach the patient better "use of self" and, if necessary, stress reduction methods to help chiropractic problems.
The whiplash treatment plan developed by the chiropractor for each specific problem may include one or more of these approaches and may involve others as well. The chiropractor might give a referral to another health professional, such as a medical specialist, if it is deemed appropriate.
1. Chiropractic treatment for joint dysfunction from a whiplash injury
This occurs when one of the joints in the spine or limbs loses its normal joint play (resiliency and shock absorption). It is detected through motion palpation, a procedure in which the chiropractor gently moves the joint in different directions and assesses its joint play. When a joint develops dysfunction, its normal range of movement may be affected and it can become painful. In addition, joint dysfunction can lead to a muscle imbalance and muscle pain and a vicious cycle:
• The loss of joint play can cause abnormal signals to the nervous system (there are an abundance of nerve receptors in the joint)
• The muscles related to that joint can subsequently become tense or, conversely, underactive
• The resulting muscle imbalance can place increased stress on the joint, aggravating the joint dysfunction that already exists
2. Chiropractic treatment for muscle dysfunction from a whiplash injury
When joint dysfunction develops, muscles are affected. Some muscles respond by becoming tense and overactive, while others respond by becoming inhibited and underactive. In either case, these muscles can develop trigger points.
Trigger points are areas of congestion within the muscle where toxins accumulate (2). These toxins can irritate the nerve endings within the muscle and produce pain. This pain can occur in the muscle itself or can be referred pain (perceived in other areas of the body).
The muscle can also send abnormal neurological signals into the nervous system. This can then cause disruption of the ability of the nervous system to properly regulate muscles in other parts of the body, leading to the development of faulty movement patterns.
3. Chiropractic treatment for faulty movement patterns from a whiplash injury
It is thought that the intense barrage of pain signals from a traumatic whiplash injury to the cervical spine can change the way the nervous system controls the coordinated function of muscles (3). The disruption of coordinated, stable movement is known as faulty movement patterns.
Faulty movement patterns cause increased strain in the muscles and joints, leading to neck pain and back pain. They can involve the neck itself or can arise from dysfunction in other areas of the body such as the foot or pelvis.
Instability is also considered part of faulty movement patterns. There are 2 types of instability that can occur in whiplash (3):
• Passive instability—the ligaments of the neck are loosened; and
• Dynamic instability—the nervous system disruption causes a disturbance in the body’s natural muscular response to common, everyday forces.
As a result of instability, even mild, innocuous activities can become painful.
The force of whiplash can cause injury to the discs between the vertebrae and small tears can develop. If the gelatinous middle of the disc seeps out it can irritate the nerve endings in this area. This is known as disc derangement.
Dr. Stern uses Biofreeze and also recommeds Biofreeze to be used by many of his patients at home
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