Let’s talk a little bit about whiplash. Why do some people get better quickly after whiplash and others take a little bit longer to feel better? It’s been estimated that about 50% of Americans live with chronic pain right now, most commonly low back pain, knee pain, headaches, and neck pain in that order. And these pains make up about 95% of the reason why people go to the chiropractor. Whether you call us Nite Lite Chiropractic, Night lite, or Night Light Chiropractic, so many people show up here at our office because of whiplash.
When people have neck pain, back pain, or headaches, they go to the chiropractor. And the reason for that is that spinal manipulation. Adjustments to the spine have been proven to be great at reducing some of that pain, and chiropractic adjustment are on the front line of helping with that spinal pain. When you boil it down, pain is just inflammation. Cells release chemicals. Those chemicals stimulate your nervous system to then tell your brain, “Ouch. We’re feeling some pain.”
TWO TYPES OF INFLAMMATION
You can’t have pain without inflammation. Some of that pain is going to be local inflammation. Some of that pain happens because of systemic inflammation. What does that exactly mean? When you have local pain that is at the tissue level. Tissues have experienced some kind of trauma, like a sprain, strain injury, a broken bone, a bruise, and that’s that local inflammation.
Systemic inflammation is your whole body. And we see this a whole lot more in practice. And the problem with this is that it’s hard to tell a patient, “You have systemic inflammation from poor lifestyle choices.” It’s easy to tell a patient, “You sprained your ankle because you stepped wrong off of a curb. And that’s why you’re hurt.” It’s harder to tell the patient, “Yes, you stepped off a curb and sprained your ankle, but you’re still in pain eight weeks later because your body was primed with too much fat tissue. You smoke a pack of cigarettes a day. You drink a fifth of alcohol a day and you eat nothing but fast food.” It takes longer to heal when your body is experiencing this systemic inflammation. Those two different types of inflammation are equally important to you feeling better after a trauma or injury. A lot of times when we’re having this inflammation, people reach for that jar of pills: Aleve, Tylenol, or Advil. Some of those might work temporarily, but they’re bad for you in the long term.
WHAT HELPS WITH A WHIPLASH INJURY?
So, if pain relievers aren’t the best thing, then what should we be doing? Number one is motion. You should be getting motion into the affected area, whether it’s a sprained ankle or a spinal injury. When you have an injury of your neck from a whiplash-type trauma, you want motion, but you want healthy, good motion.
Back in the 1980s, you saw a lot of neck collars. Everyone seemed to be wearing a neck collar after a car accident because doctors thought that immobilizing your neck after a car accident was the best thing to do. Nowadays, you hardly ever see those neck braces. When you do see those neck braces, typically it’s because somebody has had surgery, and post-surgically, you need to immobilize the spine. After an accident, you want motion. Motion disperses some of those inflammatory chemicals in the area after injury, but it also closes the pain gate.
THE PAIN GATE
Back in 1965, two researchers came together and figured out that pain works as a gate into your brain. If pain is going into your brain and you can figure out how to make something else run faster to that gate, you can close that gate, so the pain doesn’t actually turn into pain in your brain. For example, when you bump your knee and you start to rub it, it makes it feel better. And it’s because you closed that gate of pain to that area. Motion helps to disperse inflammatory chemicals, and also helps to close that pain gate just a little bit. We have millions of receptors all through our joints, and they’re loaded with nerve endings.
When we create motion, either with a spinal adjustment or massage, what we’re doing is stimulating all those nerve endings to go close that pain gate. They race the pain signals to your brain. And if they beat it, because these mechanical receptors are a little bit faster than those pain signals, you don’t feel as much pain. So motion is good to decrease swelling in the area and get rid of those inflammatory chemicals. It’s also good for closing that pain gate into your brain.
SPINAL DEGENERATION AND PAIN
Another reason that people recover more slowly from whiplash injuries is degeneration in the spine. Degeneration is when you start to see little peaks that grow out on your spine. When you have too much inflammation, these points start to grow and that’s because there’s too much inflammation for too long in the area. Once you have some of this degeneration, the rest of the area is primed for pain. You might not even have pain yet if you just have degeneration. It might not be painful yet, but all it takes is a small amount of injury to then get pain after a car accident. When we look at x-rays and MRIs of your spine, we get to see what degeneration has happened before your accident because this takes a long time to develop. And when we’re looking at that, I can tell you it’s going to take you longer to recover if you have some of that spinal degeneration.
Spinal degeneration is not about age. Patients come in and I tell them, “Yeah, you have some arthritis going on in your spine.” They’re in their 30s. They say, “That can’t be, I’m not 70. I’m not my grandfather. I don’t have spinal degeneration, doctor. Not possible.” But this happens in varying degrees throughout your lifespan. You’ll see 30-year-olds with this, you’ll see 70 year-olds without this, you’ll see people who go their whole life without much degeneration going on in their spine. So understand this is a continuum. It’s not black and white, this is something that just happens throughout life.
Another factor in healing time after a whiplash injury is radiculopathy. If you have radiating pain down your arms and hands and fingers after a car accident, it means that these nerve endings, as they exit from your spine are inflamed and they are telling your body that there’s pain down into your arm. And that’s a big red flag for the potential of having a disc herniation. After whiplash trauma, that just complicates things.
LOST RANGE OF MOTION
I also look for lost range of motion after a whiplash injury. When there’s inflammation in your joints and your muscles, you lose the ability to turn. And the more lost range of motion you have, the more inflammation in your spine and it’s going to take you longer to recover. You get a loss of the curvature of your neck. Your spine is supposed to have nice curves. When you get into a car accident, oftentimes you lose that curvature of your neck and your spine goes straight in your neck. That’s not normal and that’s not good.
There’s some disagreement a little bit on how many people actually end up with symptoms that are permanent. Some research says as many as 11% of people after a car accident have permanent whiplash-type symptoms. A lot of that has to do with stress. Stress plays into pain a lot. First of all, stress makes your head go forward like we just talked about. It pushes your head forward just a little bit. We have patients coming in all the time right now saying, “Oh, it hurts right here, doctor.” That’s because stress makes you lean forward, and so it plays a big role after a car accident for sure.
HOW TO TREAT WHIPLASH INJURY
So, what can we do right now to prevent us from ending up in that five to 10% of people who have permanent symptoms after whiplash? If you get rear-ended, if another car bumps into you, how do we avoid that? You want to make sure that you have a good range of motion. Chiropractic adjustments will help. Getting some curvature into your neck is really important. You can take a regular 16.9-ounce water bottle and put it behind your neck. You can do home stretching exercises to make sure that you keep good motion and good curvature into your neck.
The other thing is to reduce systemic inflammation. Make sure you’re eating a diet of mostly lean meats and vegetables. Avoid a lot of wheat, grains, pasta because that omega fatty acid profile and ratio plays a big role in your systemic inflammation. We want to make sure that we are avoiding all kinds of other toxins that are going to increase the amount of systemic inflammation in our bodies. You can reach me at [email protected] with any questions you might have about whiplash injuries.