• What is whiplash?

• What if I’m in an accident?

• Auto accident treatments

• Returning to work

• Low-speed collisions

• Acute Risk Factors checklist

• Chronic Risk Factors checklist

What is whiplash?

Is “whiplash” an actual injury?

It certainly is, and a very well-documented one at that. Over 50 years ago, whiplash injuries were seen in pilots launched from aircraft carriers by high-power steam catapults. The rapid acceleration pulled their bodies out from underneath their heads, injuring their necks. Research shows the same type of injury at work today in whiplash injuries.

A whiplash type of injury takes its name from the mechanism that causes it. A sudden impact on the body causes whipping trauma to the neck and head. Today they are usually seen in auto accidents when one car hits another, and the force is transmitted through the vehicle to the car seat and eventually into the person. During the impact, the moving vehicle creates thousands of pounds of force in the blink of an eye. The result is a violent whipping of the spine, or “whiplash.”

Whiplash damage presents as tearing muscles and ligaments in the neck, upper back, and sometimes lower back. But the most significant damage area is to the spine’s nerves. The rapid impact and location of the damage are reasons some symptoms do not immediately appear, or aren’t directly associated with the accident. The best research says that whiplash is a serious injury and takes great skill to evaluate and treat effectively.

What if I’m in an accident?

Appropriate treatment must begin immediately after an accident if you want to prevent long-term damage. But what constitutes the best treatment?

In general, recovery happens in three stages:

• Relief: use ice to reduce swelling and calm muscle spasms. 

• Correction: restore motion to tight spinal joints. 

• Rehabilitation: strengthening and stretching exercises to improve core stability. 

Given the stages of recovery, “appropriate” treatment includes using ice, physical therapy, spinal manipulation/adjustments by a chiropractor, and exercise. 

Complex cases may require advanced diagnostics like MRI or CT scans and a possible referral to a family practice physician or appropriate specialist. 

Our office maintains an extensive list of other medical professionals in case a referral is required.

Auto accident treatments

DiBella Chiropractic offers numerous low- and high-tech treatments, therapies, and diagnostic tests to help you recover from your injuries. Treatments are safe, gentle, and effective. 

Scientific research literature consistently demonstrates the superior effectiveness of spinal manipulation in treating soft tissue damage secondary to motor vehicle collisions. 

Diagnosis and treatments may include the following: 

• Consultation and examination
• X-rays
• Spinal manipulation/adjustments: Diversified Technique, Impulse Adjuster, etc.
• Therapeutic modalities: ice, heat, electric stimulation, mechanical traction, ultrasound, laser, decompression, etc.
• Rehabilitation using therabands, exercise balls, wobble boards, etc.
• Trigger point therapy

Returning to work

The primary goals of care include pain relief, spine correction, and rehabilitation. However, a very close secondary goal is an early return to work.

Patients who return to normal activities as soon as possible recover quicker than those who remain sedentary. As a result, our office works closely and cooperatively with you and your employer to get you back to work.

Most patients return to work without complication. Others require a work transition beginning with a few restrictions and limited hours. We will remain diligent in restoring your life to a pre-accident level.

If you follow our recommendations concerning home management, keep your appointments, and comply with your initial restrictions, you will likely return to work quickly.

Low-speed collisions

The insurance industry often reduces the value of an accident case based on the erroneous belief that low-speed collisions accompanied by minor vehicle damage cannot cause an injury. Is there a correlation between Vehicle Damage and Injury potential? 

The short answer to this question is: NO. Vehicle damage is not a reliable indicator or predictor of injury potential. 

No credible studies have suggested that one can predict injury based on vehicle damage. The legal and insurance communities should forever abandon the “No Crash, No Cash” myth as a valid injury determination standard, as this continues to mislead the public, injured patients, and the courts. The threshold of soft tissue injury is much less than the force required to damage a bumper/vehicle.

Significant Facts

• There is no relevant science that equates injury potential to vehicle damage.
• No accident reconstructionist can predict an individual’s INJURY THRESHOLD. 
• The examining physician best determines the presence of an injury and should be based on the CORRELATION between history, examination, x-ray, and other diagnostic tests.
• No MD, DC, DO, or other medical professional education includes consulting an accident reconstructionist to determine the presence or absence of injury. 
• Strong research exists correlating RISK FACTORS and injury potential. 
• Strong research exists demonstrating that chronic pain is often the result of Low-Speed Rear Impact Collisions (LOSRIC).
• The legal and insurance communities should forever abandon the “6-8 weeks natural healing time” and “No Crash, No Cash” myths as valid injury determination standards.

Acute Risk Factors Checklist

The following risk factors (based on solid scientific research) help explain why some patients involved in Low-Speed Rear Impact Collisions (LOSRIC) get injured while others do not.

These risk factors are associated with the potential to develop acute pain after a LOSRIC. Other issues to consider include change of velocity, G force, injury threshold, vehicle mass, and examination findings.

• Female gender
• Weighing less than 130 lbs.
• History of neck injury
• Head restraint below head’s center of gravity (males & females); large top set
• History of cervical acceleration/ deceleration (CAD) injury
• Poor head restraint geometry/tall occupant (e.g., _80th percentile male)
• Rear vs. other vector impacts
• Use of seat belts/shoulder harness (i.e., standard three-point restraints)
• Body mass index/head neck index (i.e., decreased risk with increasing mass and neck size)
• Out-of-position occupant (e.g., leaning forward/slumped)
• Non-failure of the seatback
• Having the head turned at impact
• Non-awareness of the impending impact
• Increasing age (i.e., middle age and beyond)
• Front vs. rear seat position
• Impact by vehicle of greater mass (i.e., ~25% greater)
• Crash speed under 10 mph
• Rear Struck Occupant, when bullet vehicle has a longitudinally mounted motor

Other factors: 

• Digital motion X-ray (DMX) findings
• Patient age and the life expectancy chart for future meds
• Range of motion (ROM) as a good predictor of pain and disability
• Muscle strength or imbalance
• Military spine / reverse curvature
• Length of time after the accident the patient was first seen
• Symptoms that come and go

Chronic Risk Factors Checklist

The following risk factors (based on solid scientific research) help explain why some patients involved in Low-Speed Rear Impact Collisions (LOSRIC) get injured while others do not.

These risk factors are associated with the potential to develop chronic pain after a LOSRIC. Other issues to consider include change of velocity, G force, injury threshold, vehicle mass, and examination findings.

• • Female gender
• Rear vector vs. other vectors
• Body mass index (females only)
• Immediate/early onset of symptoms (i.e., within 12 hours) and/or severe initial symptoms
• Ligamentous instability
• Initial back pain
• Greater subjective cognitive impairment
• A more significant number of initial symptoms
• Use of seat belt shoulder harness (for neck – not back – pain)
• Initial physical findings of a limited range of motion
• Neck Pain on palpation
• Muscle pain
• Initial neurological symptoms, such as radiating pain to the upper extremities
• History of neck pain or headache
• Headache
• Initial degenerative changes seen on radiographs
• Loss or reversal of cervical lordosis
• Increasing age (i.e., middle age and beyond)
• Front seat position
• Target vehicles manufactured from the late 1980s through the 1990s