Auto Injuries
One-third of all claimants injured in motor vehicle accidents seek chiropractic treatment.
This is an impressive number given that the National Safety Council (NSC) has determined there to be more than 12 million MVA's annually involving more than 20 million vehicles.
The reason individuals like yourself choose chiropractic care for treatment of injuries sustained in MVA's is simple - chiropractic care is exceptional in the treatment of soft tissue injuries, especially of the spine. Since the most common injuries associated with MVA's are sprains and strains of the spinal muscles and ligaments, it's only natural that chiropractic be the treatment of choice.
Many studies have also found individuals injured in MVA's prefer chiropractic care for the treatment of their injuries. One such study evaluated 190 whiplash injury victims and found those who received chiropractic care reported treatment satisfaction of 100%.
Common Injuries and Symptoms
Motor vehicle accidents can result in a number of very diverse and complex injuries and symptoms. This is due to the diversity of factors involved with the each MVA - i.e. vectors of the collision, size of the vehicles involved in collision, preexisting health conditions of victims, age of victims, size and strength of victims, etc.
Whiplash
Whiplash is the most common injury sequelae following motor vehicle accidents. Speeds of as little as 5 mph have been documented to result in whiplash injuries. And although whiplash is prevalent in today's society with hundreds of studies on the topic, it is not yet fully understood.
What is Whiplash?
The term "whiplash" was coined by Dr. Harold Crowe back in 1928. It is used to refer to the hyperextension or hyperflexion injury of the neck, and the resulting symptoms of an injury sustained from a motor vehicle accident.
This forwards-flexion and/or backwards-extension of the neck essentially results in a soft tissue sprain/strain injury to the structures within the cervical and upper thoracic spinal regions. When the initial impact occurs and the head is forced in either excessive flexion or excessive extension, protective reflexes cause the muscles of the neck to forcefully contract which "whips" the head back in the opposite direction. The resulting injury often leads to numerous symptoms, many of which are confusing and poorly understood.
Symptoms associated with whiplash:
- Outer layers of the intervertebral discs
- Intervertebral ligaments
- Capsule of the facet joints
- Anterior longitudinal ligament (runs down the front of the vertebral bodies-prevents excessive extension)
- Posterior longitudinal ligament (runs down the back of the vertebral bodies-prevents excessive flexion)
- Nerve root dura
- Extensor spinal musculature
- Flexor spinal musculature: the colli and scalene muscles
Whiplash injuries can damage just a few structures or many, depending on the severity of the accident and direction of the injurious forces.
Some of the more common pain-sensitive structures that are typically damaged include:
- Neck pain, tenderness, achiness and stiffness
- Cervical muscle spasms
- Tenderness and nodules in superficial cervical musculature
- Cervical reduced range of motion
- Post-traumatic headaches (including migraine and muscle-tension headaches)
- Shoulder and interscapular pain
- Hand and finger pain, numbness and tingling
- Blurred vision
- Difficulty swallowing/feeling of lump in throat
- Dizziness and balance problems
- Lightheadedness
- Post-traumatic depression and cognitive problems
Damage to any of these structures results in tissue inflammation, tissue edema, microscopic hemorrhage, and the release of noxious chemicals such as histamine, prostaglandins, substance P, and kinins which further hypersensitize already painful and injured tissues.
How is Whiplash Treated?
The most important aspect of a successful treatment program involves active patient participation and patient compliance to the agreed upon program. When treatments focus solely on pain-relief and not tissue rehabilitation or when patients fail to comply with the prescribed treatment plan, the chronicity of problems becomes highly likely.
The chiropractic approach to treating whiplash injuries is highly successful compared with other health care professionals because chiropractors focus on rehabilitating the injured tissues and restoring optimal function. This is reflected in the high patient satisfaction scores that chiropractors have received in "patient satisfaction surveys" performed on MVA patients.
Chiropractic care is a safe, natural, noninvasive, and addresses the cause of the symptoms. Our treatments also include active patient participation, and in some cases, lifestyle modifications. While we do focus on eliminating pain early on, we realize that in addition to pain - optimal tissue healing, restoration of normal function, and prevention of future recurrences and reinjuries - are equally important.
Our treatments are highlighted by our use of many gentle and highly effective spinal adjustive techniques. When used properly, these techniques allow us to safely and effectively reduce pain levels, reduce muscles spasms, eliminate inflammation, restore normal joint motion and biomechanics, prevent or minimize degenerative processes, and minimize the likelihood of future recurrences.
We also incorporate many natural and safe adjunctive therapies into our treatment plan to further assist in the healing process. Some common adjunctive therapies include ice therapy, heat therapy, physical therapies like therapeutic ultrasound and muscle stimulation, spinal traction, soft tissue mobilization, spinal exercises and stretches, and nutritional supplementation.
As with any other injury, there are a number of factors which influence the treatment length of whiplash injuries, including:
- The severity of the injury
- When treatment was initiated
- Patient compliance to the treatment plan
- The nature of the accident
- The size and speed of your vehicle and other vehicles involved
- Whether or not seat belts were worn
- Whether you were aware of the impending accident
- The height of the head rest
- The age of the individual
- The size and strength of the cervical musculature
- The presence of preexisting spinal conditions
The easiest and most effective way of eliminating pain and preventing residual and chronic problems is to start care immediately following the accident. As you allow time to slip by without seeking appropriate treatment, your injuries become more permanent and far more difficult to manage.
Will I have Future Problems from my Whiplash Injury?
Numerous studies show that many whiplash victims have a relatively poor outcome without immediate and appropriate treatment. One such study found that 75% of patients with whiplash still suffer from symptoms 6 months after the accident. Experts agree that individuals with any degree of neck complaints following a motor vehicle accident dramatically improve their prognosis if they seek immediate evaluation and appropriate treatment within hours of the accident.
Interesting whiplash statistics:
- Whiplash symptoms last more than 6 months in 75% of patients
- Symptoms of whiplash commonly do not appear until weeks or months after the accident
- Whiplash victims lose an average of 8 weeks of work
- Whiplash is 5 times more common in women than in men
- Whiplash occurs most commonly in those aged 30 to 50 years
- Rear-end collisions typically cause more cervical spine damage than do frontal or side collisions
Headaches
Headaches are the second most common complaint following motor vehicle accidents (MVA's). Like the many other MVA symptoms, headache may not be present immediately following the accident and may take several weeks and often months to eventually surface.
Most post-traumatic headaches are thought to originate from the soft tissues and facet joints of the neck as well as injury or irritation to the nerves of the upper cervical spine.
Multiple types of headaches may be experienced following a MVA, including:
- Cervicogenic Headaches
- Muscle Tension Headaches
- Migraine Headaches
- Myofascial Trigger Point Headaches
- Site-Of-Impact Headaches
- Drug-Induced Headaches (following excessive or prolonged analgesic use)
Back Pain
In addition to whiplash/neck injuries, the mid and lower back are also frequently injured in motor vehicle accidents (MVA's).
The mid back or thoracic spine is most commonly injured as a result of the asymmetry of most seat belt designs. As the torso moves forward the seat belt locks and the torso is forced to stop at the end of the shoulder strap. Because the shoulder strap crosses only one shoulder (usually the left), the side without a strap (usually right) is able to travel forward further which results in a forward flexing and twisting injury to the mid back.
The Lower Back
The lumbar spine is also frequently injured, but the mechanism differs from the above. As the torso and pelvis move forward the pelvis is stopped by the lap belt. However, the torso continues to move forward which producing a shearing force in the lumbar spine. These injuries often result in lumbar disc injuries.
Pain Sources
Spinal injuries can damage a number of pain sensitive structures located in the spinal region. Some of the more common structures that are damaged and that have innervation which allows them to transmit pain include:
- Anterior longitudinal ligament (runs down the front of the vertebral bodies-prevents excessive extension)
- Outer layers of intervertebral disc (located between adjacent vertebrae)
- Posterior longitudinal ligament (runs down the back of the vertebral bodies-prevents excessive flexion)
- Nerve root dura
- Capsule of the facet joints
- Intervertebral ligaments
- Extensor musculature
- Flexor musculature: the colli and scalenes
When these tissues are injured, pain is experienced. Damage to these structures also results in tissue inflammation, edema, microscopic hemorrhage, and the release of noxious chemicals such as histamine, prostaglandins, substance P, and kinins which further hypersensitize already painful and injured tissues. In addition, when spinal injury occurs spinal muscles often reflexively spasm to protect the area from further injury - whether or not the muscles are injured. This spasming can lead to muscle ischemia (lack of oxygen) due to increased energy demands.
Head Injuries
Half of the approximate 7 million non-major head injuries occurring annually in the US are estimated to be caused by motor vehicle accidents (MVA's). These head injuries, although mostly mild, give rise to an assortment of symptoms and events and frequently affect higher levels of cognition and personality.
Symptoms include:
- Headache
- Scalp pain and hypersensitivity
- Blurred vision
- Balance and coordination impairments
- Memory impairment
- Language and task handling difficulties
- Slowed reaction times
- Ringing of in the ears
- Reduced attention span and patience
- Earlier fatigue and mental stamina
- Sleep disturbances
Unfortunately, symptoms continue to persist in some victims leading to a condition known as "Chronic Postconcussion Syndrome." (note: a concussion is a loss of consciousness or lessening of mental processes following a direct or indirect head trauma).
Another interesting point to note is the paradoxicalness of headaches following head trauma. Recent evidence suggests that relatively minor head injuries seem to result in more severe headaches than the more severe head injuries.
Extremity Pain, Numbness, and Tingling
Extremity symptoms such as arm and hand pain, numbness and tingling are common following motor vehicle accidents (MVA's). They are caused by thoracic outlet syndrome, myofascial adhesions, muscular trigger points, and spinal disc lesions.
It's important to note that these symptoms are commonly not experienced until weeks or even months after the injury. A study, published in the Britain Journal of Rheumatology, involved 37 motor vehicle injury patients and found 35% had an onset of arm and hand symptoms (upper extremity symptoms) beyond 3 months of the accident.
This reinforces the need for proper and full treatment of MVA injuries. Failure to receive appropriate treatment (where injured tissues are fully healed and tissue functioning is adequately restored) is a major contributor to the development of these symptoms.
Factors Influencing Injury Tolerance
A number of factors influence the extent and severity of injuries experienced by victims of motor vehicle accidents, including:
- How long after the accident treatment was initiated
- The type of treatment received
- Patient compliance to the treatment plan
- The nature of the accident (frontal, rear, side impact collision or a combination)
- Severity of accident (i.e. automobile speeds)
- The size and speed of your vehicle and other vehicles involved
- Whether or not seat belts were worn
- Whether you were aware of the impending accident
- The height of the head rest
- The age of the individual (elderly and children more susceptible to the forces involved in MVA's)
- The size and strength of the individual - more specifically, their spinal musculature
- The presence of preexisting spinal conditions
Findings from a recent Canadian study, published in the Journal of Clinical Epidemiology, indicate that the following patient and crash characteristics lead to a poorer prognosis. The prognosis for recovery was poor if:
- There were additional injuries besides whiplash,
- The patient was female, elderly or had dependents,
- The crash was severe, involved a truck or bus,
- The injured party was not wearing a seat belt
Patients who lacked full-time employment, collided with a moving vehicle, or were hit head-on or perpendicularly were also at greater risk of a poor prognosis compared with other patients.
What to Do After an Accident
Schedule an Appointment
If you have been involved in a motor vehicle accident you will need to make an appointment for a brief, but thorough, examination. Often, individuals involved in motor vehicle accidents experience minimal or no symptoms for the first few weeks and even months. It's important to not only receive immediate and appropriate treatment for any injuries sustained, but also to document the extent of the injuries, if present.
Failure to obtain a timely evaluation or appropriate treatment for injuries sustained in a motor vehicle accident may negate your ability to receive monetary compensation for any future medical bills resulting from the accident, negate your ability to receive pain and suffering settlements, and negate compensation for work loss.
We will determine:
- the extent of the injury or injuries
- the number of estimated treatments required to treat your injuries
- if referral to another medical specialist is required
- if special tests are required (i.e. MRI, CT Scan, etc.)
- if you need to take "injury time off" from work (and provide you with a note to present to your employer)
Research
Minimum Accident Speed to Cause Injury
Studies involving live humans have demonstrated that a motor vehicle accident of as little as 5 mph can induce cervical (neck) injury. However, other studies have shown that cars can often withstand crashes of 10 mph or more without sustaining damage.
Time for Symptoms to Manifest
Symptoms arising from injuries sustained in motor vehicle accidents were once thought to present immediately following the accident. However, research and clinic experience now demonstrate that a delay of symptom onset seems to be the norm. Also, delay of symptom onset does not eliminate the possibility of severe injury.
Number of Disabilities from Automobile Accidents
Most experts have found that 10 percent of all motor vehicle accident victims become disabled.
Symptom Resolution Statistics
Many studies have found a significant number of individuals to be symptomatic for many months and even years after a motor vehicle accident. In one such study, 75 percent of individuals remained symptomatic 6 months after the accident.
Another study, published in the European Spine Journal, found that during the period of time between the first and second years following a motor vehicle accident over 20 percent actually had their symptoms worsen.
Number of Annual Motor Vehicle Accidents
According to the National Safety Council (NSA), there are more than 12 million motor vehicle accidents annually including more than 20 million vehicles. This results in over 5 million nonfatal accidents annually of which approximately 2 million are disabling injuries including approximately 1 million work-related auto disabling injuries.
Injury Severity in Motor Vehicle Accidents
A 1990 National Highway Traffic Safety Administration (NHTSA) study reported found that about 28 percent of occupants in motor vehicle accidents incur minor to moderate injury while 6 percent incur severe to fatal injuries.
Likelihood of being Involved in a Motor Vehicle Accident
The US Department of Transportation estimates that the typical driver will have a near automobile accident one to two times per month and all will be in a collision of some type on average of every 6 years.
Annual Costs of Motor Vehicle Accidents
According to a report released back in 1993, the total costs for motor vehicle accidents in the US was over $333 billion in 1988.
According to the Insurance Research Console:
- 63 percent of injuries are paid by the injured individuals own automobile insurance company
- 55 percent of injuries are paid by the auto insurance company of another vehicle
- 36 percent of injuries are paid by health insurance
- 20 percent of injuries are paid by government programs
- 19 percent of injuries are paid workers' compensation insurance
- Almost 60 percent of those injured reported to have used 2 or more sources of payment.
