Neck Problems & Whiplash

 

Your Amazing Incredible Neck

Inside your neck are your bones (cervical vertebrae), spinal and cranial nerves, spinal cord, blood vessels, glands (including the thyroid and parathyroids), voice box (larynx), esophagus, trachea, brain stem, and muscles, ligaments and other structures. With all that, it's still able to gracefully balance your head and turn, tilt and bend without damaging its vital "occupants." That's amazing because if your neck's functions are interrupted for even a few seconds you'd lose consciousness and begin to die.

 

The Cervical Spine

 

Cervix is the Latin word for neck, meaning a constricted area (the uterus and urinary bladders have a neck or cervix too). Your seven small neck bones are called cervical vertebrae, numbered C-1 to C-7.

Inside your cervical vertebrae lies your spinal cord, a continuation of the brain down your neck and back. Protection of the spinal cord is extremely important because an injury to it can result in instant paralysis or death.

Your vertebrae are connected to each other by discs, ligaments and tendons that help give the neck its shape (the cervical curve). Between the vertebrae are openings where nerves, blood vessels, lymphatic vessels, fat and connective tissues are found.

 

 

Neck Problems

With all of the neck's complexity it should come as no surprise that neck problems are common. They may develop suddenly from a trauma such as a whiplash or fall, or slowly as a result of spinal imbalance, vertebral subluxations, emotional stress or bad posture. Damaged or irritated neck nerves can cause more than neck pain. Pain in the face, shoulder, arm, wrist, hand and fingers as well as reduced neck motion may also occur. Other neck problems include headaches, vision difficulties,(1-2) dizziness, ringing in the ears, decreased attention span, learning and memory impairments,(3) nasal problems, tongue and throat problems.(4-5)

The most serious neck problems-such as fracture, dislocation or severe tissue damage-can be fatal if not given emergency medical care. Most other neck problems, however, although not life-threatening, can impair your health if not corrected.

 

Neck Pain

Pain in the neck can be caused by irritation, inflammation, injury or infection. Pain in the neck, shoulder, arm, hand or head "most frequently results from irritation of cervical nerve roots in the region of the intervertebral foramen, encroachment of the vascular supply as it courses through the vertebral canal, or invasion of the cord in the spinal canal."(6)

 

Disc Degeneration & Herniation
Disc herniation (or rupture) is relatively rare but can be the source of intense pain. Sometimes surgery is needed in this instance, especially when it's due to trauma.

However, in many cases, chiropractic techniques can re-establish the integrity of the disc and prevent the need for neck surgery. This should be explored if possible.

 
 
Disc degeneration is a more common cause of pain, nerve root and spinal cord irritation. Although many doctors tell their patients that the cause of disc degeneration is age, age alone cannot be blamed for the condition because it can be found even in young children. The most common causes of disc degeneration are years of spinal imbalance, spinal subluxations, physical trauma or emotional stress.

 

Spinal Imbalance-Cause Of Neck Stress

Let us suppose that one day you carried a bowling ball around for the entire day, but instead of carrying it closely at your side, you held it a little distance from your body. You'd get tired very fast! It's the same with your head. If it's properly balanced that's fine, but if it's held even a little off center you will start to suffer from fatigue as well as stress on your neck.

 

Arthritis

If unhealthy, your neck's normal forward curve may reduce, become straight or "military" or even reverse its curve. Over time arthritic changes in the vertebrae such as lipping or spurring (bony growths); disc thinning or degeneration; or deterioration of muscles, ligaments and other structures may occur. In spite of all these changes, however there may or may not be pain. In fact, studies show little or no correlation between the degree of pain felt in the neck and arthritic changes found on X-rays and MRI.

Lipping, spurring and other irregularities (osteoarthritis) do not in themselves constitute a disease but are rather defense mechanisms that arise to stabilize an off-balance spine.(7) Recent research has shown that chiropractic care can reverse some of the effects of osteoarthritis-something that had previously been considered impossible.(8)

 

Whiplash & Neck Injuries

Of the millions of people who visit doctors of chiropractic each year a large number have had whiplash injuries. Whiplash injuries occur when a person's spine, usually their neck, was hurt by being unexpectedly or suddenly thrown very quickly in one direction and then in the opposite direction. You might say the head is "whipped around" on the neck.

Whiplash is one of the most common consequences of auto accidents; it is estimated that 15%-30% of car occupants will suffer neck pain.(11)

In almost all whiplash-type injuries the spine is thrown first in one direction and then is pulled in the opposite direction(12) because the muscles react to the initial injury by pulling or rebounding in the opposite direction. The rebound can and often does cause injury to your soft tissues-muscles, ligaments, tendons and other tissues. Occasionally a whiplash injury can result from side-to-side motion of the neck, also called left and right lateral hyperflexion.(13)

There is more to whiplash than being thrown forward and backward. Usually the head is turned to the right or left a little when an accident occurs and this can complicate the effects of the injury.(14)

 

Whiplash Damage

Whiplash can be mild to severe and can range from rapid healing to slow healing to long-term chronic pain and impairment. It can cause serious problems because it can cause long-term damage. Studies show that a large percentage of whiplash sufferers, from 50% to as much as 88%, may continue to suffer pain and some amount of disability for years after the accident.(15-16)

 

Spinal Cord Damage

Depending on the severity of the accident, whiplash damage can range from barely noticeable stiffness to death. A worst case scenario occurs in a small minority of cases where there is actual bone fracture and spinal cord damage causing paralysis or death.

 

Whiplash Symptoms

Whiplash symptoms may start as neck soreness or stiffness, perhaps accompanied by a headache immediately or within a few hours of the accident. Along with these symptoms there may be pain and/or numbness, tingling or a pins-and-needles feeling between the shoulder blades, arm and hand.

Some people may experience ear ringing, dizziness or even hearing loss. Sometimes the eyes can be affected and there may be pain behind the eyeballs, blurred vision, sensitivity to light or other visual symptoms. Occasionally, there may be tearing or running of the nose.(17)

 

Post Concussion Syndrome

   
A concussion may accompany a whiplash. It occurs from a violent shaking of the head where the brain is thrown around against the skull-similar to scrambling an egg without damaging the shell. Concussion symptoms may include headache, restlessness, irritability, insomnia, moodiness, depression and emotional "jitters" that may last for hours or days after the accident. This grouping of symptoms is now being called Post Concussion Syndrome (PCS) ,(18-19)

 

Old Whiplash?

Anyone who has ever had a whiplash injury, no matter how long ago, should see a chiropractor. The M.D.s may have sent them home after x-rays and MRI or CT scans and found nothing broken or ruptured, yet the spine may still be structurally unsound. Without structural integrity the spine will not heal properly and may develop problems years later. Arthritis and disc problems may develop years after the accident (and the legal settlements) because chiropractors were not consulted for spinal integrity.

 

The Medical Approach

 

The standard medical approach to neck pain is painkillers, muscle relaxers and/or tranquilizers. If the pain doesn't subside, an orthopedic surgeon may be consulted and more drastic treatment-cortisone or other injections-may be administered. When should the physician resort to surgery? "As a last resort."(9) Clearly, a patient should not consent to anything as drastic as neck surgery without first consulting another healer, in particular, a chiropractor!

 

 

An individual who has been in an accident should first make sure that there is no life-threatening emergency, broken bones, bleeding or hemorrhage, internal organ damage, serious contusions or abrasions, shock and other damage. This is the specialty of emergency medicine, which does its best work when dealing with trauma or accidental injury.  After the patient is out of immediate danger, and when it is safe to do so, their spine desperately needs to be checked by a doctor of chiropractic for life threatening spinal damage, called the vertebral subluxation complex.

That is essential because many whiplash sufferers live in pain for years after the injury forced to survive on painkillers, muscle relaxants and various therapies including surgery because the spinal damage a doctor of chiropractic can correct has not been eliminated. In many cases a visit to the chiropractor may give great relief safely, quickly and without drugs or surgery.

 

The Role Of The Chiropractor

When the spinal bones are off center, the small openings through which the nerves travel may become narrower causing irritation to the cervical nerve roots(20) and may also cause pressure upon the spinal cord. Chiropractic spinal care counters the effect of stress and unnatural wear and tear by relieving your neck of the vertebral subluxation complex and restoring proper movement to the spinal column.

Any kind of accident may cause the vertebral subluxation complex where the vertebrae (spinal bones) are out of proper alignment and "impinging" or irritating spinal nerves.(10) Painkillers, muscle relaxers, sedatives or physical therapy cannot realign the vertebrae and relieve the nervous system from pressure. What is needed is chiropractic care (spinal adjustment) to realign the spinal column.

 

References

 

  1. Gorman, R.E. The treatment of presumptive optic nerve ischemia spinal manipulation. JMPT, 1995, j~, pp. 172-177.
     
  2. Zhang, C., Wang, Y, Lu, W et al. Study on cervical visual disturbance and its manipulative treatment. I Trad Chinese Medicine, 1984,4,pp 205-210.
  1. Di Stefano, C. & Radanov, BR Course of attention and memory after common whiplash: A two-years prospective study with age, education and gender pair-matched patients. Acta Neurol Scand, 1995, 91, pp. 346-352
     
  2. Barre, M. Sur un syndrome sympathetique cervicale posterieur et sa cause frequent. Larthrite CervicaleNeurological Review ~3, p. 1246.
     
  3. Vernon, H. Upper cervical syndrome. Baltimore: Williams & Wilkins, l988,p. 192.
     
  4. Cailliet, R. Neck and arm pain. Philadelphia: PA. Davis, 1979, p. 45.
     
  5. Ibid, p. 53.
     
  6. Ressel, O.J.. Disc regeneration: Reversibility is possible in spinal osteoarthritis. International Review of Chiropractic, March/April 1989, p. 39.
  7. Cailliet, R., p. 85.
  1. Jackson, R. The cervical syndrome (2nd ed.).Springfield, Il., 1958.
     
  2. McKinney, M.B. Treatment of cervical spine distortions in v injuries. Orthopade, 1994, 23(4), pp. 287-290.
  3. Cailliet, R. Neck and arm pain. Philadelphia: EA. Davis Co., 1979.p. 64.
     
  4. Smith, G.H. Headaches aren't forever: How incurable headaches can be cured. Newtown, PA: Int'l Center for Nutritional Research, 1986, p. 96.
     
  5. Chrisman, O.D. & Gervais, R. E Otologic manifestations of the syndrome. Clin. Orthop., 1962, 24, pp. 34-39.
     
  6. Nunn, P.J. Whiplash Syndrome - A Transformational Approach, Pain (supplement 5), 1990.
     
  7. Gargan, M.F Long-term prognosis of soft-tissue injuries of the Neck. J of Bone and Joint Surgery, Sept. 1990.
     
  8. Stewart, D.Y. Current concepts of the 'Barre Syndrome' or the Cervical Sympathetic Syndrome. Clin. Orthop., 1962, 24, pp. 40-48.
     
  9. Bohnen, N. et al. Late outcome of mild head injury: Results from a controlled postal survey. Brain Injury, 1994, 8(8), pp. 701-708.
     
  10. Evans, RW. The postconcussion syndrome - 130 years of controversy seminars. Neurology, 1994, 14(1), pp. 32-39.
     
  11. Seletz, E. Whiplash injuries: Neurophysiological basis for pain and methods used for rehabilitation. Journal of the American Medical Association, 168, pp. 1750-1755.
     
  12. Smith, G.H. Headaches aren't forever, how incurable headaches can be cured. Newtown, PA: Int'l Center for Nutritional Research, 1986, p. 96.