Whiplash No Longer Just Something to Put a Collar Around

WEST ORANGE, NJ , UNITED STATES, May 11, 2022 /EINPresswire.com/ — Whiplash? Just put a collar around it, right?

Not necessarily, according to Interventional Pain Management Specialist Dr. Kaliq Chang² with Atlantic Spine Center¹. He says use of a cervical collar to keep the neck immobile for a period of time is being less and less considered a standard of care. Scientists are learning more about the mechanisms involved in whiplash injury. They are also discovering how whiplash can develop into an “evolving disease” with long-term implications, he states.

“Immediate, clinical manifestations of whiplash include neck pain and stiffness, limited range of neck motion, muscle spasms, headache, fatigue, blurred eyesight, tenderness in the shoulder or upper back, and pain, tingling, or numbness in the arms,” says Dr. Chang.

“Until recently, the patient would have automatically been given a soft foam collar to limit movement of the head and neck, minimize pain, and avoid any further damage. But an increasing amount of research indicates this type of immobilization can actually interfere with the recovery process and weaken neck muscles. Some physicians still promote collar use, but usually only for very limited periods, such as at night to help the patient sleep or immediately after the injury occurs to control pain,” Dr. Chang says.

Other common treatments for the whiplashed neck include hot or cold applications, various prescribed or over-the-counter medications to minimize pain and prevent swelling, steroid injections, physical therapy, and exercise, and even alternative therapies like mindful meditation and massage, Dr. Chang adds.

Whiplash is the term for an injury sustained when the head and neck are forcefully accelerated forward and then whipped backward, resulting in sprained neck muscles and possible trauma to the cervical discs and ligaments, the nerves, and other bones and tissues of the neck. The injury most frequently occurs in car crashes, especially those involving rear-end collisions, but also can result from sports activities and falls, Dr. Chang says. Approximately three in every 1,000 persons will sustain a whiplash injury.

But experts warn that as many as 40 percent of whiplash victims will develop chronic pain and associated disorders, which can sometimes linger for years. They are calling for newer, more effective therapies able to address the cascade of debilitating symptoms that sometimes follow a whiplash injury. These symptoms may appear well after the initial trauma and go beyond the pathology of the neck, affecting the brain, the eyes, and the lumbar region of the back and causing posture and balance problems, sleep disturbances, difficulties with memory and concentration, and even psychological disorders, including post-traumatic stress disorder (PTSD).

Dr. Chang refers to one of the most recent whiplash studies. It was published in a March 2022 issue of Frontiers in Neurology (https://doi.org/10.3389/fneur.2022.821097), In it, scientists suggest whiplash can develop into a “disease,” which evolves even after a trivial trauma and proves disruptive to the central nervous system (CNS) in at-risk patients. This disruption can lead to hyperexcitability and a lowered pain threshold, even though he neck itself may show little evidence of tissue injury or other pathophysiological alterations in standard diagnostic tests, including X-ray and MRI scans. Understanding that the CNS may underlie whiplash disease could “open a window for specific neuropharmacological interventions,” the scientists say.

Meanwhile, investigators writing in an earlier study, this one in EBioMedicine (10.1016/j.ebiom.2016.07.008), report finding changes in the brains of patients who develop long-term, whiplash-associated disorders that are not evidenced by any standard diagnostic tests. The changes involve altered blood flow in brain regions associated with pain perception and the processing of sensory information

“We continue to discover more and more about the interactions between neck and CNS. But additional study is still needed to further our knowledge of the mechanisms involved in whiplash injury. Increased understanding will enable us as physicians to enhance patient recovery and rehabilitation and potentially avoid onset of whiplash disease,” Dr. Chang states.

Of course, the best treatment for whiplash is prevention. Dr. Chang offers these tips for keeping the neck safe.

• Properly adjust the headrests in the front seats of motor vehicles where a majority of whiplash injuries occur. The seat occupant’s head should never be up and over the headrest. The headrest should be set about even with the tips of the seat rider’s ears.

• Avoid inclining front vehicle seats more than approximately 20 degrees. Too much of an incline creates an unacceptable distance between the headrest and back of the head and encourages poor posture.

• Position the steering wheel towards the chest – not the neck.

• Wear the right protective gear during sports activities.

• Always use a helmet when riding a bicycle. Whiplash injuries are not limited to rear-end accidents but can occur in sideways falls or collisions as well.

• Maintain a healthy lifestyle. That means eat nutritiously, exercise, manage stress, and get adequate sleep.

“Most importantly, if you do sustain whiplash, seek prompt treatment, no matter how minor the trauma may seem. It’s what you do not experience immediately after the injury that could later become your biggest problem,” Dr. Chang advises.

Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. http://www.atlanticspinecenter.com

Kaliq Chang, MD, is an interventional pain management specialist, dual board-certified in anesthesiology and pain management. Dr. Chang is with Atlantic Spine Center.