When the cervical spine (neck) is subject to whiplash, there is usually a combination of factors that contribute to whiplash pain in the neck and back, and ultimately need to be addressed individually by a chiropractor.
The doctor of chiropractic maintains a "holistic" view of the patient's whiplash pain, specifically focusing on one or more of the following:
- Joint dysfunction
- Muscle dysfunction
- Faulty movement patterns
- Disc derangement.1
This article explains how chiropractors approach treating neck pain, back pain, and/or other whiplash symptoms, and help patients prevent chronic whiplash pain.
Whiplash Pain Management for Joint Dysfunction
Joint dysfunction from whiplash 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 chiropractic technique 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.
Additionally, joint dysfunction can lead to muscle imbalance and 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
Muscle Dysfunction from Whiplash Injuries
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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 that may necessitate whiplash treatment involving muscle relaxation or stimulation.
Trigger points are areas of congestion within the muscle where toxins accumulate. These toxins can irritate the nerve endings within the muscle and produce pain. This whiplash 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, which 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.
Faulty Movement Patterns and Whiplash Pain
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:
- Passive instability—the ligaments of the neck are loosened, making it more susceptible to whiplash pain
- Dynamic instability—the nervous system disruption causes a disturbance in the body’s natural muscular response to common, everyday forces.3
As a result of instability, even mild, innocuous activities can be difficult to perform as they often exacerbate the whiplash pain.
Whiplash Pain from a Herniated Disc
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.
Occasionally, the gel can seep all the way out and press on a nerve root exiting the spinal cord behind the disc, known as disc herniation.
A herniated disc may involve whiplash pain in the neck as well as sharp, shooting pain down the arm and possibly neurological symptoms such as numbness, tingling and muscle weakness.