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Whiplash treatment plan: Whiplash – Diagnosis and treatment

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Whiplash – Diagnosis and treatment

Diagnosis

Your doctor will ask questions about the event and your symptoms. You also may be asked questions that help your doctor understand how severe your symptoms are and how often they occur. Your doctor will also want to know how well you can perform normal everyday tasks.

Examination

During the exam your doctor will need to touch and move your head, neck and arms. You will be asked to move and perform simple tasks so that your doctor can check the:

  • Range of motion in your neck and shoulders
  • Degree of motion that causes pain or an increase in pain
  • Tenderness in your neck, shoulders or back
  • Reflexes, strength and sensation in your limbs

Imaging tests

A whiplash injury isn’t apparent on imaging tests. But your doctor will likely order one or more imaging tests to rule out other conditions that could be making your neck pain worse. Imaging tests include:

  • X-rays. Fractures, dislocations or arthritis can be identified by X-rays of the neck taken from many angles.
  • Computerized tomography (CT). This special type of X-ray can produce cross-sectional images of bone and show possible bone damage.
  • Magnetic resonance imaging (MRI). This imaging test uses radio waves and a magnetic field to produce detailed 3D images. In addition to bone injuries, MRI scans can detect some soft tissue injuries, such as damage to the spinal cord, disks or ligaments.

Treatment

The goals of whiplash treatment are to:

  • Control pain
  • Restore normal range of motion in your neck
  • Get you back to your normal activities

Your treatment plan will depend on the extent of your whiplash injury. Some people only need over-the-counter medication and at-home care. Others may need prescription medication, specialized pain treatment or physical therapy.

Pain management

Your doctor may recommend one or more of the following treatments to lessen pain:

  • Rest. Rest may be helpful for a day or two after your injury, but too much bed rest may delay recovery.
  • Heat or cold. Either heat or cold applied to the neck for 15 minutes every three hours or so can help you feel better.
  • Over-the-counter pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), often can control mild to moderate whiplash pain.
  • Prescription medications. People with more-severe pain may be given certain antidepressant drugs that have been shown to relieve nerve pain.
  • Muscle relaxants. Short-term use of these drugs may be recommended to loosen tight muscles and soothe pain. The medicine also can make you feel sleepy. It may be used to help restore normal sleep if pain prevents you from getting a good night’s rest.
  • Injections. An injection of lidocaine (Xylocaine) — a numbing medicine — into painful muscle areas may be used to decrease pain so that you can do physical therapy.

Exercise

Your doctor will likely prescribe a series of stretching and movement exercises for you to do at home. These exercises can help restore range of motion in your neck and get you back to your normal activities. Applying moist heat to the painful area or taking a warm shower may be recommended before exercise.

Exercises may include:

  • Rotating your neck in both directions
  • Tilting your head side to side
  • Bending your neck toward your chest
  • Rolling your shoulders

Physical therapy

If you have ongoing whiplash pain or need assistance with range-of-motion exercises, your doctor may recommend that you see a physical therapist. Physical therapy can help you feel better and may prevent further injury. Your physical therapist will guide you through exercises to strengthen your muscles, improve posture and restore normal movement.

In some cases, transcutaneous electrical nerve stimulation (TENS) may be used. TENS applies a mild electric current to the skin. Limited research suggests this treatment may temporarily ease neck pain and improve muscle strength.

The number of physical therapy sessions needed will vary from person to person. Your physical therapist can also create a personalized exercise routine that you can do at home.

Foam collars

Soft foam cervical collars were once commonly used for whiplash injuries to hold the neck and head still. However, studies have shown that keeping the neck still for long periods of time can decrease muscle strength and interfere with recovery.

Still, use of a collar to limit movement may help reduce pain soon after your injury, and may help you sleep at night. Recommendations for using a collar vary though. Some experts suggest limiting use to no more than 72 hours, while others say it may be worn up to three hours a day for a few weeks. Your doctor can instruct you on how to properly use the collar, and for how long.

Alternative medicine

Nontraditional therapies have been tried to treat whiplash pain, but research about how well they work is limited. Some include:

  • Acupuncture. Acupuncture involves inserting ultrafine needles through specific areas on your skin. It may offer some relief from neck pain.
  • Chiropractic care. A chiropractor performs joint manipulation techniques. There is some evidence that chiropractic care may provide pain relief when paired with exercise or physical therapy. Manipulation of the spine may cause minor problems, such as numbness or dizziness, and rarely damage to spinal tissues.
  • Massage. Neck massage may provide short-term relief of neck pain from whiplash injury.
  • Mind-body therapies. Exercises that incorporate gentle movements and a focus on breathing and mindfulness, such as tai chi, qi gong and yoga, may help ease pain and stiffness.

Preparing for your appointment

If you’ve been in a car accident, you might receive care on the scene or in an emergency room. However, a whiplash injury may not cause symptoms immediately. If you have neck pain and other symptoms after an injury, see your doctor or an urgent care center as soon as possible.

Be prepared to describe in detail the event that may have caused your symptoms and to answer the following questions.

  • How would you rate your neck pain on a scale of 1 to 10?
  • Does movement make the pain worse?
  • What other symptoms do you have?
  • How long after the event did the symptoms appear?
  • Have you had neck pain in the past, or do you experience it regularly?
  • Have you tried any medications or other treatments to relieve the pain? If so, what was the effect?
  • What medications do you take regularly, including dietary supplements and herbal medicines?


Feb. 05, 2020

Whiplash | Sparrow

The goals of whiplash treatment are to:

  • Control pain
  • Restore normal range of motion in your neck
  • Get you back to your normal activities

Your treatment plan will depend on the extent of your whiplash injury. Some people only need over-the-counter medication and at-home care. Others may need prescription medication, specialized pain treatment or physical therapy.

Pain management

Your doctor may recommend one or more of the following treatments to lessen pain:

  • Rest. Rest may be helpful for a day or two after your injury, but too much bed rest may delay recovery.
  • Heat or cold. Either heat or cold applied to the neck for 15 minutes every three hours or so can help you feel better.
  • Over-the-counter pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), often can control mild to moderate whiplash pain.
  • Prescription medications. People with more-severe pain may be given certain antidepressant drugs that have been shown to relieve nerve pain.
  • Muscle relaxants. Short-term use of these drugs may be recommended to loosen tight muscles and soothe pain. The medicine also can make you feel sleepy. It may be used to help restore normal sleep if pain prevents you from getting a good night’s rest.
  • Injections. An injection of lidocaine (Xylocaine) — a numbing medicine — into painful muscle areas may be used to decrease pain so that you can do physical therapy.

Exercise

Your doctor will likely prescribe a series of stretching and movement exercises for you to do at home. These exercises can help restore range of motion in your neck and get you back to your normal activities. Applying moist heat to the painful area or taking a warm shower may be recommended before exercise.

Exercises may include:

  • Rotating your neck in both directions
  • Tilting your head side to side
  • Bending your neck toward your chest
  • Rolling your shoulders

Physical therapy

If you have ongoing whiplash pain or need assistance with range-of-motion exercises, your doctor may recommend that you see a physical therapist. Physical therapy can help you feel better and may prevent further injury. Your physical therapist will guide you through exercises to strengthen your muscles, improve posture and restore normal movement.

In some cases, transcutaneous electrical nerve stimulation (TENS) may be used. TENS applies a mild electric current to the skin. Limited research suggests this treatment may temporarily ease neck pain and improve muscle strength.

The number of physical therapy sessions needed will vary from person to person. Your physical therapist can also create a personalized exercise routine that you can do at home.

Foam collars

Soft foam cervical collars were once commonly used for whiplash injuries to hold the neck and head still. However, studies have shown that keeping the neck still for long periods of time can decrease muscle strength and interfere with recovery.

Still, use of a collar to limit movement may help reduce pain soon after your injury, and may help you sleep at night. Recommendations for using a collar vary though. Some experts suggest limiting use to no more than 72 hours, while others say it may be worn up to three hours a day for a few weeks. Your doctor can instruct you on how to properly use the collar, and for how long.

A review of treatment interventions in whiplash-associated disorders

Barnsley et al. [1] C 5 8 16
 Double-blind comparison of intraarticular corticosteroid (Betamethasone) injection therapy with local anesthetic (bupivacaine) injection therapy. Neither treatment provided lasting pain-relief. The median time for return to 50% preinjection level of pain was 3 days in the betamethasone group and 3.5 days in the bupivacaine group
Bonk et al. [5] A 2 3 8
 Comparison of active therapy (3 weeks of active and passive mobilization, postural exercises and advice) with collar therapy (3 weeks wearing collar). Patients receiving active therapy were significantly improved in pain intensity and cervical range of motion and comparable to a control group of unexposed individuals at 6 weeks. At 12 weeks, the collar-therapy group did not differ from the control group of unexposed individuals either. Outcome assessors were not blinded
Borchgrevink et al. [6] A 2 6 11
 Single-blind comparison. All patients received instructions for self-training of the neck beginning on the first day of treatment and a 5-day prescription of NSAIDs before being randomized to “act-as-usual” group (advice to act as usual, no sick-leave, no collar) or immobilized group (14 days sick-leave, soft neck collar). Patients in the “act-as-usual” group had greater improvements in subjective symptoms, including pain localization, pain during daily activities, neck stiffness, memory and concentration, and pain and headache intensity
Byrn et al. [9] C 1 5 11
 Double-blind comparison of subcutaneous sterile water injection therapy with saline injection therapy. Patients receiving active treatment improved in minimum and maximum pain intensity, neck mobility, and self-assessment of improvement. Therapist blinding failed because sterile water injection therapy was painful to the patient. The eligibility criteria for inclusion were not specified
Cassidy et al. [10] C 1 5 13
 Single-blind comparison of manipulation with mobilization of the neck. Patients receiving manipulation had greater improvements in pain intensity and cervical range of motion. Evaluation was conducted immediately posttreatment without long-term follow-up
Fitz-Ritson [12] C 1 3 9
 Comparison of chiropractic therapy plus either standard exercise program or “phasic” exercise program. Patients doing “phasic” exercises improved in measures of Neck Disability Index. The groups were dissimilar in age, gender distribution, and previous injuries. Blinding of the outcome assessor inadequate
Foley-Nolan et al. [13] A 4 7 15
 Placebo-controlled double-blind trial of high-frequency pulsed electromagnetic therapy. Patients receiving active treatment improved in measures of pain intensity at 2 and 4 weeks but not at 12. Cervical range of motion was initially worse in the active treatment group but became significantly better than that of the placebo treatment group at 12 weeks. Patients in the active treatment group used significantly less analgesics at 2, 4, and 12 weeks
Gennis et al. [14] A 1 3 6
 Trial of the effect of soft cervical collars. Patients were assigned to either soft cervical collar or no collar groups. Both groups were advised to rest. The groups showed no difference in pain scores at 6 months. The randomization procedure was flawed, and blinding of the outcome assessor unknown
Hendriks et al. [16] A 1 4 8
 Comparison of ice treatment, neck exercises, and advice on neck care, posture and use of collar with/without ultrareiz current therapy. Patients receiving ultrareiz current therapy significantly improved in pain intensity and cervical range of motion at 6 weeks. Blinding of outcome assessor unknown
Humphreys et al. [18] C 1 4 8
 Trial of the effect of coordination exercises. Four groups: chronic neck pain or asymptomatic individuals assigned to coordination exercises or nonexercise group. Individuals with chronic neck pain assigned to coordination exercise group experienced reduction in pain intensity. Both coordination exercise groups exhibited an increase in head-repositioning accuracy. Blinding of outcome assessor unknown
Johansson et al. [21] C 2 2 8
 Trial of the effect of a 4-week cognitive behavioral pain management program. Patients were randomized to treatment group or waiting list control group. Patients participating in the program had decreased catastrophizing and pain behaviors and greater activity level in the spare time post-treatment. At the 1-month follow-up, they still had greater activity level in the spare time and were more often in occupational training. Not reported whether the outcome assessors were blinded and whether the groups were similar at baseline
Lord et al. [28] C 5 8 17
 Placebo-controlled double-blind trial of percutaneous radiofrequency neurotomy. Patients receiving active treatment improved in measures of McGill Neck Pain Questionnaire and pain intensity
McKinney et al. [30] A 3 5 10
 Single-blind comparison of outpatient physiotherapy (treatment could include heat, cold, short-wave diathermy, hydrotherapy, traction, McKenzie assessment and treatment, Maitland mobilization, postural correction and home exercises) with standard therapy (rest and analgesia, general advice on mobilization after 10–14 days), and home mobilization (instructions on postural correction, use of analgesia and collar, use of heat sources and muscle relaxation, mobilizing exercises). Both patients receiving outpatient physiotherapy and patients receiving home mobilization improved in cervical range of motion and pain intensity more than patients with standard therapy. There was no difference in effectiveness between outpatient physiotherapy and home mobilization
Mealy et al. [32] A 2 5 8
 Single-blind comparison of standard treatment (rest, initial immobilization with soft cervical collar for 2 weeks, gradual mobilization) with early active mobilization (ice in the first 24 h, Maitland mobilization, daily neck exercises every hour). Patients in the early active mobilization group had greater improvements in pain intensity and cervical range of motion at 8 weeks
Pennie et al. [35] A 1 1 6
 Comparison of standard treatment (2 weeks of rest in soft collar, then exercise therapy) with active treatment (traction, advice on neck care and sleeping posture, neck and shoulder exercises). No differences were found between the two treatments at 6–8 weeks or 5 months in pain intensity, neck mobility, or time off work. The randomization procedure was flawed and blinding of the outcome assessor unknown
Pettersson et al. [36] A 4 8 16
 Placebo-controlled double-blind trial of high-dose methylprednisolone therapy administered within 8 h of injury. Patients receiving active treatment exhibited reduction in sick leave at the 6-month follow-up
Provinciali et al. [37] C 1 5 8
 Single-blind comparison of multimodal treatment (postural training, manual technique, psychological support) with control treatment (physical agents only, such as electrical or sonic modalities). Patients receiving multimodal treatment had greater improvement in pain levels, return to work delay, and self-rating scores of treatment efficacy. Neck mobility increased equally in both groups
Rosenfeld et al. [39] A 2 5 8
 Single-blind comparison of standard intervention (initial rest, recommended use of soft collar, gradual mobilization) with active intervention (frequent active cervical rotation, McKenzie assessment and treatment) either within 96 h or after 14 days. Patients receiving active intervention had a greater reduction in pain intensity at the 6-month follow-up. There were no differences in cervical range of motion. Active intervention gave better results when administered within 96 h. Standard intervention gave better results when administered after 14 days
Rosenfeld et al. [40] A 3 7 12
 Single-blind comparison of standard intervention (initial rest, recommended use of soft collar, gradual mobilization) with active intervention (frequent active cervical rotation, McKenzie assessment, and treatment) either within 96 h or after 14 days. Pain intensity, cervical range of motion, and sick leave were significantly lower for patients receiving active intervention at the 6-month and 3-year follow-up. Cervical range of motion at the 3-year follow-up was similar to that of a control group of unexposed individuals if active intervention was received within 96 h
Sand et al. [41] C 2 3 8
 Double-blind comparison of subcutaneous sterile water injection therapy with saline injection therapy in patients with cervicogenic headache. No benefit was observed for either treatment on either pain or neck mobility. Not all patients in the sample suffered from whiplash-associated disorders
Schreiber et al. [43] C 3 5 11
 Single-blind comparison of fluoxetine therapy with amitriptyline therapy. Both groups decreased in pain intensity. The between-group differences were not significant. Not all patients in the sample suffered from whiplash-associated disorders. No long-term follow-up
Söderlund et al. [45] A 2 5 11
 Single-blind comparison of coordination exercise therapy. Patients were randomized to regular treatment (advice on posture and being active, neck and shoulder exercises) or additional treatment group (as previous plus a coordination exercise). Patients in the additional treatment group had not improved more than patients with regular treatment at 6 months
Söderlund et al. [44] C 2 5 9
 Single-blind comparison of individualized physiotherapy management (treatment could include stabilization exercises, coordination exercises, muscle stretching, body posture training, strengthening exercises, relaxation training, TENS, acupuncture, heat) with individualized physiotherapy management integrating cognitive behavioral components (learning, application and generalization of basic skills in everyday activities). Basic skills could include muscle stabilization techniques, relaxation training, reeducation of humeroscapular rhythm, and exercises aimed to increase neck range of motion, coordination, and endurance of neck muscles. Patients whose physiotherapy included cognitive behavioral components reported less pain and better performance of daily activities at 3 months
Thuile et al. [50] C? 1 4 7
 Comparison of low-energy, low-frequency magnetic-field treatment. Patients received standard treatment (diclofenac and tizanidine therapy) with or without magnetic field treatment. Patients receiving magnetic-field treatment improved in pain intensity and neck mobility. Blinding of outcome assessor unknown. Uncertain whether the patients suffered from acute or chronic whiplash-associated disorder (WAD)
Van Wieringen et al. [53] C 5 8 14
 Placebo-controlled double-blind trial of melatonin treatment. Patients with delayed melatonin onset receiving active treatment exhibited advances in melatonin onset and sleep-wake rhythm. Other sleep parameters, pain, quality of life, cognitive processing speed, and vigilance were not influenced by 1 month of treatment
Wallis et al. [56] C 4 6 12
 Double-blind placebo-controlled trial of percutaneous radiofrequency neurotomy. Patients receiving active treatment improved in measures of pain intensity and exhibited resolution of their preoperative psychological distress. No report on whether the groups were similar at baseline

3 Exercises for Chronic Whiplash Injury Physical Therapy Seattle

The exercises noted in this blog post should not be a substitution for a quality physical therapy assessment. If you have long-standing pain or disability after an injury to the neck you should see a physical therapist. Prior to starting an exercise routine you should check in with your doctor to be sure exercise is safe for your body.

How long should neck pain last after a car accident?

There is no right answer to this question. About 50% of people who experience neck pain after a car accident improve within three months, but the other 50% can go on to experience pain that is defined as chronic.

What is chronic pain?

Chronic pain can be defined a number of ways. Some use time frame to define chronic pain.  For example, pain that has been persistent longer than 12 weeks can be considered chronic.   Usually chronic pain is pain that is no longer related to inflammation and related to and injury that has not healed correctly.

What is Whiplash?

Whiplash is a forceful forward and back movement of the head that can cause injury to the neck and cervical spine. Tissues affected can be muscles, nerves, joints, ligaments, and bone. Whiplash can also cause changes to other body systems like those that help with balance hearing, vision and cognitive processing.  This can also be associated with muscle spasms, spinal cord compression and chronic damage to soft tissues such as ligaments of the spine. If you are suffering from any of these changes, consider following up with the therapists at the Whiplash Injury Treatment Center where we specialise in treating neck injuries. We provide some of the best therapy for whiplash so you can get back to your daily activities. 

What are Three Exercises for Chronic Neck Pain? Seattle Physical Therapy

1. Chin tuck- range of motion exercises

Studies show that people who have chronic neck pain after car accident have decreased activity of the deep muscles in the neck, specifically the longus coli and longus capitus. The chin tuck exercise helps to retrain these important muscles that act like the “core” of your neck. Hold 5-10 seconds, repeat 10 times.

2. Serratus wall slide – light strengthening 

The serratus anterior muscle is a muscle that comes from the shoulder blade and wraps upward and forward to the rib cage. The serratus is a stabilizing muscle of the shoulder and studies (Helgadottir et al 2011) show that the timing of this muscle is compromised in people who have had a whiplash injury. This can lead to poor mechanics with reaching and moving the arm which can make people who have had a whiplash injury more likely to suffer a shoulder injury (Abbassain et al 2008). The serratus wall slide can be helpful for retraining this muscle. 2 sets of 10-15 reps.

3. Levator release with a ball – reduce muscle tone

People who have chronic neck pain after a whiplash injury will often complain of tightness in the area where the shoulder and the neck meet.  The levator scapulae is a common spot of tension.  Levator release with a ball is a nice way to work on relieving tension in the neck and shoulders. You may want a towel roll under your head.

The exercises highlighted in this post should feel helpful. If you are having pain with them, stop. 

Everyone’s situation is different and it can be helpful to have your body assessed by a physical therapist to be sure the proper tissues are being addressed and the appropriate exercises are being assigned. The exercises listed here should be considered a starting point in your treatment plan, but should also be expanded upon along your road to recovery. At the Whiplash Injury Treatment Center our therapists have advanced training in orthopedics, manual therapy, vestibular and dizziness treatment, TMJ (TMD) management, and concussion management. We offer some of the best physical therapy Seattle has to offer. If you are suffering from chronic neck pain or other symptoms following a whiplash injury schedule an appointment today.

Schedule Appointment Today

About the Author: Amanda Benson, PT, DPT, CMPT, OCS has been treating patients in the Seattle area since 2005. She has advanced training in manual therapy and in orthopedics. Amanda is one of the founding members of the Whiplash Injury Treatment Center.

Chiropractic Care for Whiplash

Whiplash is an injury to the neck muscles from rapid forward and backward motion of the neck caused by a trauma (eg, a car accident). It can cause acute (short-term) neck pain as well as restricted movement in your neck.

How Does a Chiropractor Diagnose a Whiplash Injury?

The chiropractor evaluates your spine as a whole—even if you go to the chiropractor complaining of neck pain following a trauma. He or she will examine the entire spine because other regions of the spine may be affected (not just your neck).

The chiropractor identifies any areas of restricted joint motion, intervertebral disc injury, muscle spasm, and ligament injury. He or she may use a technique called motion and static palpation—diagnostic techniques that involve touch. Your chiropractor will also feel for tenderness, tightness, and how well your spinal joints move.
Whiplash is an injury often affecting the soft tissues of the cervical spine. Sudden and rapid backward (hyperextension) and forward (hyperflexion) of the head and neck can cause acute pain. Photo Source: SpineUniverse.com.He or she will also analyze how you walk and take note of your posture and spinal alignment. These details will help the chiropractor understand your body’s mechanics and how your spine works, helping with the diagnosis process.

In addition to the chiropractor’s evaluation of your spine, he or she may order an x-ray or an MRI of your spine to evaluate any degenerative changes that may have existed before your whiplash injury. The diagnostic images and results of your physical and neurological evaluation are compared to develop the best treatment plan.

Stages of Whiplash Treatment

Soon after whiplash occurs—in the acute phase—the chiropractor will work on reducing neck inflammation using various therapy modalities (eg, ultrasound). He or she may also use gentle stretching and manual therapy techniques (eg, muscle energy therapy, a type of stretching).

The chiropractor may also recommend you apply an ice pack on your neck and/or a light neck support to use for a short period of time. As your neck becomes less inflamed and the pain decreases, your chiropractor will perform gentle spinal manipulation or other chiropractic techniques to restore normal motion to your neck’s facet joints.

Chiropractic Whiplash Treatments

Your treatment plan depends on the severity of your whiplash injury. The most common chiropractic technique is spinal manipulation. Some spinal manipulation techniques commonly used are:

  • Flexion-distraction technique: This hands-on technique is a gentle, non-thrusting type of spinal manipulation to help treat herniated discs with or without arm pain. Your whiplash injury may have aggravated a bulging or herniated disc. The chiropractor uses a slow pumping action on the disc instead of direct force to the spine.
  • Instrument-assisted manipulation: This technique is another non-thrusting technique chiropractors often use. Using a specialized hand-held instrument, the chiropractor applies force without thrusting into the spine. This type of manipulation is useful for older patients who have a degenerative joint syndrome.
  • Specific spinal manipulation: The chiropractor identifies spinal joints that are restricted or show abnormal motion (called subluxations). Using this technique, he or she will help restore motion to the joint with a gentle thrusting technique. This gentle thrusting stretches soft tissue and stimulates the nervous system to restore normal motion to the spine.

In addition to spinal manipulation, the chiropractor may also use manual therapy to treat injured soft tissues (eg, ligaments and muscles). Some examples of manual therapies your chiropractor may use are:

  • Instrument-assisted soft tissue therapy: Your chiropractor may use the Graston technique, which is an instrument-assisted technique used to treat injured soft tissues. He or she will perform gentle repeated strokes using the instrument over the injured area.
  • Manual joint stretching and resistance techniques: An example of a manual joint therapy is muscle energy therapy.
  • Therapeutic massage: The chiropractor may perform therapeutic massage to ease muscle tension in your neck.
  • Trigger point therapy: Your chiropractor will identify specific hypertonic (tight), painful points of a muscle by putting direct pressure (using his or her fingers) on these specific points to alleviate muscle tension.

Your chiropractor may also use other therapies to help reduce neck inflammation caused by whiplash. Examples of other therapies your chiropractor may use are:

  • Interferential electrical stimulation: This technique uses a low frequency electrical current to help stimulate muscles, which can ultimately reduce inflammation.
  • Ultrasound: By increasing blood circulation, ultrasound can help decrease muscle spasms, stiffness, and pain in your neck. Ultrasound does this by sending sound waves deep into muscle tissues. This creates a gentle heat that increases circulation.

Chiropractors look at the whole person—not just the painful problem. They view neck pain as unique to each patient, so they don’t just focus on your neck pain. They emphasize prevention as the key to good long-term health. In addition to these treatments, your chiropractor may also prescribe therapeutic exercises to help restore normal motion in your spine and reduce whiplash symptoms.

Using these chiropractic techniques, a chiropractor will help you increase your daily activities. He or she will work hard to address any mechanical (how the spine moves) or neurological (nerve-related) causes of your whiplash.

Chiropractic Treatment for Whiplash from a Car Accident

Car accidents can be a very scary, stressful, and often painful experience. These accidents often cause all types of damage, from physical to emotional to mental. The time after a car accident is truly a whirlwind, from filing police reports to insurance claims. Often, people involved in car accidents report no injuries, particularly in minor accidents.

However, many accident victims report severe neck pain in the days following a car accident. That neck pain is due to whiplash. Whiplash pain does not always surface until a day or two after a car accident. Sometimes the pain does not occur until a week or more. This is why it is very important to seek medical attention from a chiropractor, even if you do not have any visible injuries or immediate pain.

What Is Whiplash?

Whiplash is an injury caused by a sudden distortion of the neck. Whenever the neck is thrown out of its normal range, it results in ligaments, tendons, and muscles to be sore. Whiplash injuries are one of the most common injuries in nonfatal car accidents. Whiplash can occur at speeds of fifteen miles per hour or less. When a car is hit by another vehicle, it can cause the head to jolt in a direction that is not natural, causing sudden strain and muscle spasms in the neck and shoulder area. We at Mountain View Pain Center know the pain that this can cause you.

How Do I Know If I Have Whiplash?

Most often, the symptoms of whiplash are not instantaneous. Many times, the pain will not surface for several days. Those who suffer from whiplash complain of severe neck and shoulder soreness, tight muscles, and headaches. More severe cases of whiplash may cause nerve damage, ringing in the ears, and an obstruction of vision. Patients may also experience pain when attempting to rotate their neck and head in a normal fashion.

How Do I Treat Whiplash From A Car Accident?

After a car collision, patients can greatly benefit from seeking out the assistance of a chiropractor to reduce the level of pain and possible damage. We can discuss the type of accident and gather other important details so they can develop a proper treatment plan. Treatments will vary from person to person and is dependent on the type of injury. We may use a variety of therapies to treat an injury from whiplash. These therapies include spinal manipulation, electrotherapy, and cervical spine adjustments, among others. We may also want to take an x-ray of the neck to fully determine the severity of the injury.

How Do We Treat Inflammation Caused by Whiplash?

We may first want to deal with the inflammation caused by the injury. This is a gentle therapy that does not include hard thrusts or force. In order to prevent even more pain, the chiropractor may perform a series of soft tissue manipulation before moving on to cervical adjustments. Soft tissue manipulation can be done through the use of ultrasound, muscle stimulation, and soft tissue mobilization. Massage therapy is commonly used to both reduce inflammation and release endorphins, the body’s natural pain killers.
Spinal Manipulation and Electrotherapy
Once the inflammation begins to go away, we will begin utilizing very gentle spinal manipulation. These manipulations, also known as adjustments, are characterized by specific thrusts on different areas of the vertebrae in order to provide proper alignment. These adjustments can provide the patient with more neck function and restore their normal movement.

Electrotherapy is another positive method to treat whiplash. It involves the use of a very small battery unit and electrode applied to the injured areas. This electrotherapy unit is very discreet and comfortable to wear. It will send small electronic charges to the impacted areas of the neck and spine in order to reduce the pain. The electric energy bypasses and essentially blocks the pain signals to the brain.

The treatment plan for car accident victims will be different for everyone. Mountain View Pain Clinic will determine the diagnosis and treatment plan for the affected joints. There is no one-size-fits all way to treat whiplash. We will make a full assessment in order to best treat an injury. Chiropractic care offers the most non-invasive, natural way to treat this type of injury. Hopefully, with proper chiropractic care, those suffering from whiplash will resume their normal activities very quickly.

Whiplash Treatment After a Car Accident

Whiplash treatment plans will be dependent on the extent of the injury, but often involves a commitment to physical therapy.

Whiplash, a painful injury to the neck seen most commonly in low impact car accident victims, can last for just a few days or for the rest of a victim’s life.

Whiplash Diagnosis

The first hurdle with whiplash is with its diagnosis. Since X-rays are inefficient at detecting the injury, a physician must rely on the events leading up to the onset of the pain, and their physical assessment. They will employ techniques that isolate painful areas to pinpoint the source. If he suspects an injury that is severe in nature he may employ one or more of the following diagnosis methods:

X-ray imaging is only used if the doctor believes there has been a fracture to the cervical spine or if the spine appears to be unstable. This tool will not be useful for any other soft tissue diagnosis.

An MRI is used if the physician suspects a pinched nerve in the neck. Although not always effective in diagnosing whiplash, and MRI can help rule out a pinched nerve if the pain is acute and persistent.

If your neck is not responding to therapy, a physician may be considering surgery. Before committing to this treatment plan, he will use discography to determine if a damaged disc is contributing to the condition. This is the introduction of an injection into the disc to find any flaws.

These diagnosis techniques are generally only used when traditional treatments are not working. In most cases, giving the doctor the events leading up to the accident and a full physical exam will be enough for a diagnosis.

Treatment Methods Of Whiplash

The extent of treatment for whiplash varies depending on the severity of the injury. In minor cases, you may be prescribed pain medication and ice therapy to bring down the swelling and restore mobility. For more advanced cases of whiplash treatment could include:

Strength Building: Exercises designed to strengthen the region and restore muscle may be prescribed by a physician. In some cases, you may be referred to a chiropractor or physiotherapist, who can help you with common exercises.

Spinal Injections: Typically used in acute cases of whiplash that involve compression of the nerves.

Radiofrequency Neurotomy (RFN): For severe pain in the facet joint from nerve damage, heat may be applied to the nerves to help stop them from sending pain signals. This treatment can control pain for approximately a year and is only used with chronic cases of whiplash.

Spinal Manipulative Therapy (MT): This is typically administered by a physiotherapist who use the therapy in conjunction with strength building exercises to relieve pain and restore function.

Surgery: Surgery is advised when there is a significant deterioration of a disc that is causing disability for the patient.

Of utmost importance is getting diagnosed quickly to allow for treatment to begin. Patients who delay treatment increase their risk of developing further painful complications.

What to do If You Suspect You Have Whiplash?

If you are experiencing neck pain that lasts more than one day you should make an appointment with your physician immediately. After an exam, he should be able to prescribe a treatment method that is designed to minimize your pain and discomfort and facilitate healing to the neck muscles.

If it was an accident which caused your whiplash to speak to an attorney about the events leading up to it. Your treatment may be indefinite, and an attorney could help you recover any monetary damages from the individual responsible for the accident.


Conservative treatment of whiplash injuries | Cochrane

Whiplash is caused by the acceleration-deceleration mechanism of energy transfer to the neck. It can be caused by a head-on collision with a vehicle, side impact, submersion in water, and other accidents.

Whiplash disorders can be classified in severity of symptoms from grade 0 (no complaints or physical signs) to grade 4 (fracture or displacement). Whiplash disorders have been reported in 70 inhabitants per 100,000 in the Canadian province and 188-325 inhabitants per 100,000 in the Netherlands.Conservative treatment (such as physical therapy, acupuncture, or collar) is the most common treatment option for patients with whiplash, but the evidence to support their effectiveness remains conflicting.

We included 23 studies (2344 participants with grade 1 or 2 disorder), nine of which are new to this review. Overall, the methodological quality was unsatisfactory; the studies covered populations and interventions that were too different to be pooled.Two studies looked at treatments for patients with chronic pain (more than three months), two looked at subacute pain (four to six weeks), two looked at the subject unclear (probably one was chronic pain), and the rest were patients with acute symptoms lasting less than three weeks.

Eleven studies compared the active approach to treatment (a treatment strategy including exercise or “do business as usual”) with a passive strategy, no treatment, or an adjunctive intervention.Eight studies compared active versus passive (the patient received advice to rest and wear a special collar, watched a training video, received electrotherapy, manipulations, hot and cold compresses, traction or acupuncture). Eight studies compared an intervention with placebo or no treatment. Seven studies compared two active interventions with each other and one compared passive interventions with injections.

Since we were unable to combine these studies, we still cannot confirm or deny the effectiveness of conservative treatments for acute, subacute, or chronic whiplash injury using the available evidence.

Possibilities of osteopathic correction in case of whiplash

Skoromets A.A., Novoseltsev S.V.

Whiplash is a term used to describe traumatic injury to body structures as a result of abrupt extension and flexion of the cervical spine.For example, some force suddenly moves the head back and forth. As a result of a sharp displacement of the structures of the neck, damage to the intervertebral joints, discs, ligaments, cervical muscles and even nerve roots is possible. Usually the term is used in relation to the cervical spine, but damage is possible in any part of the spine.

Whiplash (CT) may be accompanied by a concussion, damage to the temporomandibular joint, impaired circulation in the vertebrobasilar basin with bulbar disorders and paresis of the extremities.The effects of chemotherapy can be short-term and long-term and can leave the neck permanently vulnerable.

HT is the most common result of car accidents, although the injury can be both industrial and domestic. American experts cite numbers over 1 million people undergoing HT annually in the United States (it is easy to guess that the situation in Russia is no better). Approximately 25% of all CT cases end in chronic pain and disability.

So, there are 2 situations for the occurrence of HT:

1) sharp (unexpected) acceleration (hitting the rear bumper of a standing car, hitting a person, sports injuries, etc.)etc.).

2) hard braking.

Various experiments were carried out to study the effect of chemotherapy. The following example can be indicative: a car was immersed in a pool, an explosion was made in a water environment at a distance, and a shock wave was formed. It turned out that even 8 hours after the explosion, structural changes took place in the metal of the car. You can draw an analogy with the human body, skull-pool, cerebrospinal fluid-water, brain-machine.

However, the reaction of a living organism is longer and can cause changes at the cellular level within 30 days.At this moment, the balance in the body is completely disturbed. Biochemical changes occur in the muscles, muscles and tendons are shortened. If the traumatic force is significant, then bone fractures and ligament ruptures occur. If the force is less, the tissues are fibrotic, deformed and fixed in this state.

Consider 3 options for the action of the traumatic force.

1 typ. Rear kick. The wave is transmitted to the driver’s seat and the body moves with the car, and the head is deflected backward.

2 typ.Frontal impact (frontal), the most severe, since the speeds of the cars moving towards them are summed up. The driver’s body is tilted backward and the head is forward.

3 typ. Side blow. The broadcasts will also be in the direction of the acting force.

Based on the three mechanisms of action of the traumatic force, it can be concluded that in the first and second cases, deformities will develop in the frontal plane, since the impact occurred in the sagittal plane (remember the balancing of the tightrope walker). In the third case, deformities will develop in the sagittal plane, since the blow fell in the frontal plane.Here, damage to the Achilles tendons, spasm of m.psoas, lumbago are possible.

Here it is necessary to attract the attention of chiropractors: if the manipulation is not correct, then it can be the very traumatic force. The result is HT. The body will react by translating and flexing structures not involved in the impact.

Of course, the nervous system will try to compensate for the imbalance by changing the tone of the deep muscles in order to maintain the balance of the postural lines (lines of the eyes, ears, feet).With closed eyes, a person loses balance, this is one of the diagnostic signs of CT.

So, when the chest is displaced forward, the neck and lower back deviate back, then there are reverse translations. When struck from the front, the ribcage is displaced posteriorly, and the neck and lower back are displaced anteriorly. Based on the difference in flexion and extension loads in the cervical spine, hyperextension is more traumatic than hyperflexia. At this moment, a traumatic traction of tissues occurs with an effect on the capsules of the joints, ligaments, muscles.At the level of the brain, traumatic cellular stress occurs with impaired metabolism and tissue function. The brain stem may be damaged with the involvement of the cranial nerves and the effect on the arteriovenous circulation. Tissues lose elasticity, the ability to deform decreases and fibrosis begins. Thus, the affected tissues become a non-physiological element in the body. Adaptation to this phenomenon is necessary and it will manifest itself clinically.

Whiplash can be mild to severe.

Mild whiplash occurs when the impact is not very strong. The pain appears in the first 6 hours after the injury and gradually increases. Clinically, various neurological symptoms are possible, disappearing after a few days.

With a strong impact, severe tissue trauma occurs. Severe whiplash is manifested by instant sharp pain, neuralgia of various localization (suboccipital, thoracic, lumbar level), a vivid picture of vascular disorders in the vertebrobasilar basin (dizziness, nausea, vomiting, visual disturbances).Later, paresthesias, numbness in the arms, muscle weakness join. Decreases memory, attention, behavioral disorders are possible. This condition lasts 2-3 months.

The consequences of a severe whiplash injury may persist after several months. Although the early signs of trauma disappear, adaptation-related symptoms come to the fore. Thus, after 6-8 months, the clinical picture no longer has a direct connection with the whiplash injury. This is why it is very important to take a thorough history.In addition to the anamnesis, neurological examination, manual (osteopathic) testing, which includes standing and sitting examination, assessment of the statics and dynamics of all parts of the spine, palpation of soft tissues, fascia and areas of dysfunction, as well as visceral testing, play an equally important role. Fasciae play a special role in the diagnosis and treatment of whiplash. Peripheral fascia and centerline fascia should be tested.

In case of severe whiplash injuries or prolonged pain, an X-ray examination of the cervical and lumbar spine should be performed, as well as modern neuroimaging techniques (MRI, CT) should be used in diagnostics.

In a whiplash injury, the body absorbs traumatic energy, which penetrates the tissues and disrupts the cell’s metabolism. The whole body is involved.

In cases of type 1 or 2 injury, the posterior ligaments of the spine, the deep and middle aponeuroses, the posterior and anterior muscles of the midline (flexors: m. SCM, m. Longus colli, m. Rectus capitis anterior, m. Omohyoideus; extensors: m. splenius capitis et cervicis, m. trapezius, m. interspinalis, m. transversospinalis, mm. rectus capitis posterior major et minor).At the level of the cranio-sacral system, the dura mater and the bones of the midline (occipital, sphenoid, ethmoid bones and vomer) suffer, which leads to a violation of the longitudinal fluctuation of the cerebrospinal fluid. At the level of the spheno-basilar symphysis, vertical displacement occurs, at the level of the sacrum, bilateral traumatic flexion or extension.

In type 3 trauma, the disorder occurs in the frontal plane. The same muscles and ligaments are damaged only on one side, as well as mm. levatores costarum, mm.intertransversarii, m. quadratus lumborum, lateral parts of the superficial and middle aponeuroses. The paired bones of the skull (temporal, parietal, etc.) suffer, which leads to a violation of the transverse fluctuation of the cerebrospinal fluid. At the level of the spheno-basilar symphysis, lateral displacements (strain), lateral inclination with rotation (side-bending rotation), and torsion are possible. Similar disorders occur on the sacrum.

If the blow fell on an oblique trajectory, then violations will be in the frontal and in the sagittal planes, while there will certainly be a predominant plane.At the level of the cranio-sacral system, there may be vertical and lateral displacements, impaired fluctuations of the cerebrospinal fluid, impaired activity of the nervous system as a whole, reticular formation, muscle tone.

Thus, the patient’s body becomes disorganized, more fragile. The blockage of the occipital bone and sacrum keeps this state.

Locking of the sacrum occurs as follows. The ischial tubercles rest against the driver’s seat and are, as it were, a continuation of it.The sacrum “floats” between the ilia and, at the moment of impact from behind, the ischial tubercles move forward with the seat, and the sacrum in the opposite direction. At the next moment, the sacrum moves forward and may remain blocked in bilateral flexion. A similar situation unfolds with an impact from the front, in which case the sacrum is blocked in bilateral extension.

At the craniosacral level, the dura mater is stretched, which helps to keep the sacrum and occipital bone in a blocked state.

The occipital bone, depending on the direction of impact, is blocked in flexion or extension between the temporal bones, which will be in internal or external rotation, respectively.

Thus, it is imperative to test the elements of the primary respiratory mechanism, the movement of the occipital and temporal bones relative to each other. Blockage of the occipital bone due to damage to the cervical spine is more common in flexion. The types of damage to the occipital bone and sacrum are diverse, but the most severe consequences of whiplash injury will be when the sacrum is fixed in extension and the occipital bone in flexion.

In the treatment of whiplash injury, primary attention should be paid to the release of blocked elements of the cranio-sacral system, since dysfunctions of the cervical and lumbar regions will be adaptive. Then you need to work on the area of ​​the most deformed tissues. First, these are fascial techniques to restore normal fluid circulation, then structural release. In the tissue area, where the primary respiratory mechanism is not carried out, work only with direct fascial techniques with very gentle effort.

It was mentioned above that the trauma can be fresh (acute) and chronic. The treatment of each of them will have its own characteristics.

So, with an injury not more than 1 month old, treatment can have the following sequence: 1) restoration of fascial balance at the level of the cervical spine, shoulder girdle, pelvis, lower extremities; 2) cranio-sacral treatment is possible only in the bone parameter: release of the level of L5-S1, S2 and the ilium; 3) balancing the abdominal, pelvic diaphragms, upper aperture.

After 2 weeks the treatment can be continued: 1) work fascial with the remaining compression zones; 2) eliminate structural dysfunction with articular techniques; 3) cranial treatment, having previously released C0-C1-C2 and the sacrum, balancing the spheno-basilar symphysis and occipito-sacral balancing.

Treatment of chronic whiplash injury begins with fascial treatment of the extremities (pelvis, lower extremities, lumbar and cervical spine). This is followed by the balancing of the sacrum and iliac bones, the occipital and temporal bones, the spheno-basilar symphysis and, in general, the skull and sacrum.The last stages of treatment will be structural and soft tissue treatment of dysfunctions.

With the right tactics and accurate execution of cranio-sacral, fascial and structural (osteopathic) techniques, the consequences of whiplash can be eliminated in 1-2 procedures.

The article was published in the scientific and practical journal Manual therapy № 3 (7) – 2002

90,000 Childhood injuries. “Restless conversations” – State budgetary institution of health care of the Republic of Karelia “Children’s Republican Hospital”

This is one of the most severe injuries, depriving the body of support, and – when involved in the traumatic process of the spinal cord – disrupting the functions of internal organs and limbs.

– How often do children experience such trauma?

L. R .: Injuries of the spine in childhood are much less common than other skeletal trauma, and, according to our and foreign authors, make up from 0.3 to 3.5% of the total number of hospitalized children with injuries. Unfortunately, the number of spinal injuries increases annually with the growth of general child injuries. It is important to note that as spinal injuries increase, so does the incidence of severe spinal cord injuries, which often lead to the child’s disability and sometimes death.Not for the first time in our conversations we have to say that today there is not a single effective program for the prevention of child injuries that would reduce the frequency and severity of any injuries, including spinal injuries.

– What determines the frequency and severity of injuries?

RK

: First, let’s talk a little about the structure of the spine. It is a complex anatomical formation and consists of 33–34 vertebrae, forming 5 sections: cervical, thoracic, lumbar, sacral and coccygeal.Each vertebra consists of a body, arches, spinous and transverse processes. The vertebrae are connected to each other by elastic discs that act as “shock absorbers”, as well as muscles and ligaments, which form a protective frame around the spinal column and allow flexion, extension and lateral bending. Situated one under the other, the vertebrae form the spinal canal through which the spinal cord passes.

Such a complex structure of the spine determines the existing variety of injuries: soft tissue bruises, sprains of muscles and ligaments, injuries of intervertebral discs, subluxations and dislocations, different in localization and nature (from compression to multi-splintered, with and without displacement of fragments) vertebral fractures, without or with the involvement of the spinal cord in the traumatic process.In turn, clinical manifestations, course, therapeutic tactics and outcome of trauma are largely determined by spinal cord injury, which are subdivided into concussion, contusion, or crush (rupture) with partial or complete conduction disturbance.

Injuries to the spine can occur both from direct forceful action on it, and from a sharp and excessive tension of the muscles in this area at the time of the so-called. reflex muscle contraction, when there is a sharp flexion and extension of the spinal column.

Injuries of the cervical spine are usually received when falling from a height on the head, at the moment of somersault over the head, with a sharp and sudden turn or tilt of the head, with a blow to the head, when pulling up on the horizontal bar “behind the head”, when diving – in the event of a blow to the head about the bottom of the reservoir. The most common injuries of the cervical spine include muscle and ligament sprains, subluxations and dislocations; cervical vertebra fractures are less common.

Trauma to the thoracic spine occurs, as a rule, when falling on the back or when the force of the impact is redistributed in such a way that most of it falls on the thoracic spine.

The causes that lead to injuries of the lumbar spine include falls from great heights when the child lands on straight legs or on the buttocks (although, in addition to the lumbar, the sacral and coccygeal spine are often affected).

It should be especially noted that in recent years the number and severity of spinal injuries sustained by children as a result of road traffic accidents have increased. Moreover, in almost half of the cases, children are passengers of vehicles.Often they have a so-called whiplash injury, when injuries occur in the cervical spine from a sharp extension as a result of an unexpected collision of cars. Extremely severe and complex injuries of the spine and spinal cord occur in children with a motorcycle injury, when several sections are damaged, and vertebral fractures, as a rule, are multi-splinter in nature.

– At what age and under what circumstances are children most often injured?

L.R .: The risk group consists of victims aged 9-15 years, who account for more than 65% of all cases of spinal injuries by children, less often (about 30%) injured 4-8-year-olds, and extremely rarely (up to 5%) – children up to 4 years.

It is important to remember that a child can get a spinal injury at any age and in different situations. This can be both at home and at school – in a physical education lesson when you carelessly perform an exercise on a projectile or during a break when you fall from a ladder with your back.This also happens during sledding or rollerblading, ski jumping from a springboard, falling from a horse or bicycle, with a direct and strong blow to the back during a fight or in a traffic accident (at the time of sudden braking and collision of cars). Falling on the back of a heavy object, jumping into the water upside down (especially diving into a shallow body of water) can also lead to injury. Damage can be obtained even during dressing with a sharp movement of the head, small children are injured both with a sharp fright, and with incorrect, rough massage, etc.d.

Extreme sports, often without proper preparation, contribute not only to an increase in the number of injured with spinal injury, but also to an increase in the proportion of victims with severe and complicated (with spinal cord injury) trauma. So, when riding a bicycle, moped, motorcycle or roller skates, teenagers do not use various protective equipment (knee pads, elbow pads, protective helmets), perform various acrobatic elements on a bicycle, roller skates, skateboard, without thinking about the consequences.

– How to distinguish a spinal injury and correctly provide a child with first aid, while not harming him?

RK

: Indeed, in order for help to be effective, it is necessary not only to know how to do it, but also to identify or at least suspect a spinal injury in a timely manner. The most common symptom is pain, which is localized at the level of the damaged vertebra and increases with palpation (feeling) or movement.

With an injury of the cervical spine, a forced (unnatural) position of the head is often noted: it is turned or tilted to the side, to reduce pain, the shoulder on the side of the injury is raised up.

In case of trauma to the thoracic spine, a short-term (up to 10-15 seconds) respiratory arrest may occur.

With simultaneous damage to the spine and spinal cord, there may be a burning sensation, a feeling of heaviness in the limbs or numbness, weakening or complete absence of movement.

When providing first aid, it is very important to stop the further action of the traumatic (damaging) factor.

If an uncomplicated spinal injury is suspected, the rules of first aid seem to be simple, but strict implementation is required to prevent possible spinal cord injuries.The victim should be correctly laid down on a solid plane (shield), with a secure fixation of the head using special products (Shants collar) or other available means (for example, cotton-gauze pillows). Place rollers under the lumbar and cervical spine.

If a child is unconscious, he must be laid on his stomach, in order to prevent suffocation with a sunken tongue or vomit, rolls must be placed under the forehead and shoulders, to ensure urgent delivery of the victim to the hospital, while constantly monitoring the pulse and breathing.

If the consciousness of the injured person is not impaired (saved) and his position does not threaten his health, then, if possible, this position should be maintained and not changed until the doctor arrives.

If the child is unconscious, needs resuscitation and must be turned over onto his back, hold his head, torso and legs along a straight line and (with the help of several people) turn him over. The same overturning technique should be used when laying on a stretcher or wooden board.

It should always be remembered that improper first aid for a spinal injury due to damage or compression of the spinal cord by bone fragments can lead to such a serious complication as paralysis of the limbs (lack of movement and sensitivity in them).

It is strictly forbidden to lift the victim (with suspicion of any injury to the spine of any localization) by the arms and legs, to plant, and even more so to put on his feet.

– Please tell us about the main directions of prevention of spinal cord injury in children.

L. R .: In the prevention of spinal injury, as we have already noted in our previous conversations, an important place should be given to teaching children a safe lifestyle.

Parents and educators need to teach a child to correctly assess, understand and prevent the development of situations that can lead to injury, especially damage to the spine. For this, it is very important to conduct situational analyzes of the most characteristic causes and circumstances of the occurrence of an injury.

In sports schools and in classes in sports clubs, in order to avoid unnecessary injuries, it is necessary to teach children to properly group when falling from a sports equipment, bicycle, horse, etc.p.

If parents decide to buy rollers or a bicycle (moped) for their child, then they must immediately purchase protective equipment (helmet, knee pads, elbow pads).

Strict and strict observance of the rules for finding children in the car (children are located only in the back seat, fasten with seat belts, there should be head restraints on the backs of the seats, special child seats are used for babies) will significantly reduce the frequency and severity of spinal injury.It is unacceptable for the child to be in the front seat. Misunderstanding and particular concern are caused by situations when parents ride in the front seat with small (nursing) children in their arms!

It is important to remember and know that observance of traffic rules, adequate and realistic assessment of unforeseen situations on the road can reduce the risk of severe spinal injury. Children’s ignorance of traffic rules is not an excuse for them; rather, this is a reproach to parents

An important stage in the prevention of post-traumatic complications in children, in particular with a spinal injury, is differentiated training in the provision of first aid to their parents and teachers, vehicle drivers and cadets of driving schools, inspectors of the road patrol service, firefighters, etc.d.

Breast open, or Spare your belly

Injuries to the chest organs account for about 12%, and the abdominal injuries – about 25% of the total number of childhood injuries requiring hospitalization. Trauma to the chest and abdomen is one of the leading causes of death in children. It refers to severe and complex injuries, the outcome of which is difficult to predict, especially with combined and multiple injuries, when more noticeable, but less life-threatening injuries can “hide” severe injuries to the internal organs of the chest and abdomen.The danger of such an injury also lies in the fact that the victims often lack its external signs (hematomas, soft tissue wounds). Therefore, every child with suspected chest and / or abdominal trauma should be hospitalized.

The severity of an injury depends on many factors, primarily on the location and nature of the injury, the amount of blood loss and the degree of traumatic shock.

Allocate open and closed injuries of the chest and abdomen, soft tissue injuries (bruises, hematomas, wounds).A chest injury can be accompanied by fractures of the ribs, sternum or clavicle, bruises and ruptures of internal organs, great vessels are possible.

Superficial injuries to the soft tissues of the chest and abdomen are minor trauma, and the child usually feels well after 4–5 days. However, attention cannot be weakened, since a seemingly mild injury can be accompanied by internal bleeding and severe damage to internal organs (bruises and ruptures of the lung, heart, liver, kidneys, ruptures of large vessels, etc.).etc.).

Closed injuries in children result from compression, from falling onto a hard object or from a height, from a direct blow to the chest or abdomen with a fist, leg, protruding parts of a machine, etc.

The main cause of open injuries is wounds caused by stabbing and cutting objects, gunshot wounds, as well as falling onto protruding sharp objects – broken glass, wire, metal pins, etc. Open injuries of the chest and abdomen are always accompanied by bleeding of varying intensity and volume – internal or external.Formidable complications of open chest trauma are pneumothorax (air entering the pleural cavity), hemothorax (similar blood ingestion), or a combination of both.

The main signs of damage to the chest and internal organs are pain, aggravated by coughing and deep breath, the characteristic position of the child. With superficial injuries of soft tissues, slight bleeding is noted. Damage to internal organs and blood vessels can be the result of mechanical injury or injury by bone fragments in the fracture of the ribs, collarbone, sternum; such cases are often accompanied by severe dysfunctions of the respiratory and cardiovascular systems (frequent and shallow breathing, restriction in breathing of the damaged half of the chest, rapid pulse, pallor or cyanosis of the skin, the release of foaming blood from the wound when the lung is damaged, whistling of sucked air in pneumothorax ).

For abdominal trauma, pain is also the most common symptom. If it is permanent or intensifies during the first 24 hours after the injury, then organ damage or internal bleeding can be suspected. But children are not always able to clearly characterize and localize pain sensations, which sometimes creates difficulties in diagnosing injuries.

In case of an injury to the abdomen, nausea, vomiting are possible; when breathing, the child spares the stomach. Pallor of the skin, cold clammy sweat, rapid pulse, dizziness, tinnitus, excruciating thirst, lack of air are signs of shock and may indicate massive internal bleeding with ruptures of the liver, spleen, kidneys or blood vessels.If the stomach or intestines rupture, when their contents are poured into the abdominal cavity, or with open and extensive wounds of the abdominal cavity, when internal organs prolapse outward, there is a high risk of infection and the development of peritonitis (inflammation of the peritoneum). With an injury to the internal organs of the abdomen, the child lies on his back or on his side, often with his knees pulled up to the stomach. When trying to get him out of this position, there is a sharp increase in pain, and he tries to take the previous posture (the symptom of “vanka-stand up”).If the abdominal injury is accompanied by bleeding into the subphrenic space, then when the position changes, the child develops shortness of breath (shortness of breath).
The most severe and life-threatening condition occurs with simultaneous damage to the chest and abdomen or other concomitant or multiple trauma. Therefore, the correct assessment of the general condition of the child and the severity of injuries, timely provision of adequate first aid and hospitalization in the first hours after the injury are important points in preventing the development of complications, aggravating the severity of the child’s condition.

The main risk group is children aged 8–11 years. They are also more likely to receive damage to the chest and abdomen. But a child can be injured in this way at any age and under various circumstances – at home, on the street, at school, during fights, outdoor and sports games, rollerblading, cycling or motorcycle (especially when a hit on the steering wheel is possible during sudden braking), as a result of traffic accidents (in a collision of cars, the child can be squeezed in the passenger compartment between the seats, squeezing his chest and stomach), when falling from trees, from windows.Infants are more likely to be injured when falling, mainly from a low height – from the couch, from the crib, from the hands of their parents. It is very rare, but still it happens that small children, through an oversight of their parents, fall out of windows or from balconies.

In case of injury, the child should first be freed from tightening clothing (open the collar of the shirt, the belt on the trousers, take off the sweater), provide him with peace and fresh air, give him a half-sitting position with legs bent at the knees. Apply cold to the injury site to relieve pain.If you suspect a fracture of the ribs or collarbone, a bandage should be applied to reduce pain and prevent further tissue trauma from fragments. In case of open injuries (external bleeding), it is recommended to apply an aseptic (clean) dressing, and if pneumothorax is suspected, an airtight dressing to prevent further air ingress into the pleural cavity and infection. If the child is unconscious, it is important to monitor the pulse, breathing, give the patient a semi-sitting position, turn his head to one side and take him to the hospital as soon as possible.

It is important to remember that a child with any trauma to the chest and abdomen must be hospitalized as soon as possible.
Teaching children a safe lifestyle, conducting explanatory conversations with parents and children are the main links in the prevention of child injuries.
Particular attention should be paid to adolescent children, since the unstable psyche of the child during this period and his desire to establish himself in life, to prove his independence sometimes lead to sad consequences.We are talking about falls from a great height (from windows or from rooftops) as a result of a suicidal attempt.

90,000 possible causes, symptoms, therapy and consequences

Many people call this neck injury “whiplash”, as the name came from the people. In fact, this is a serious injury to the cervical spine. There is a violation in the muscles during extension and flexion of the neck. Learn more about whiplash injury of the cervical spine below.

Why is it so serious?

Physicians classify this type of injury as severe.This is due to the fact that the consequences of trauma seriously disrupt the quality of human life. Often such injuries lead to disability and this is terrible for the patient’s later life. If improperly or untimely treatment, such injuries can be fatal.

If such tragic consequences did not reach without treatment, then the trauma eventually turns into a chronic form.

Unfortunately, whiplash is not always recognized in the early stages, this is due to the fact that it has no pronounced symptoms.

Causes

Whiplash injury of the cervical spine can occur only with mechanical action of external factors. We are talking about situations when a person is forced to throw his head back sharply, tilt it forward. The vast majority of cases in which whiplash is diagnosed are car accidents. In order to get such an injury, you need a serious external influence with great force. Rarely does it happen that injury occurs with natural flexion and extension.

In addition to car accidents, common causes of this injury are:

  • Falls from great heights.
  • Striking with a heavy object in the neck and head.
  • Abrupt movements and excessive loads in professional sports.

Based on the above reasons, it can be unambiguously concluded that this type of injury occurs precisely for mechanical reasons. No congenital and other pathologies can lead to this type of injury.Also, there are no cases when the physiological characteristics of a child’s development can lead to this type of injury.

Whiplash injury to the spine and neck can be recognized with a serious examination. There are two methods that are used to diagnose this pathology – X-ray and tomography. Both methods of recognizing an injury are quite informative, they provide the most complete information about the state of the cervical region of a person at the time of examination.

It should be noted that the most extended picture is provided by MRI, tomography. There is one drawback to this type of examination, it is quite expensive, so not every patient can afford it.

When it is found that the injury is of a sufficiently severe nature, additional examination is required, the nerve roots are examined for lesions and changes.

Symptoms of trauma

Over the course of the research, it became clear that if there is appropriate timely treatment, then this type of injury is not as dangerous as it seems.If the right actions are not taken in time, then there may be unpredictable consequences. It is often difficult to understand that it is taking place. Symptoms of a whiplash injury to the neck and spine may not be obvious, among them:

  • Severe painful signs in the neck.
  • Pain in the occiput and temples.
  • The appearance of a veil on the eyes, everything becomes cloudy around.
  • Excessive nervous excitability, feelings of anxiety and fear.
  • Decreased attention, constant confusion, absent-mindedness.

Agree, according to these signs, it is very difficult to say what exactly happens to a person and what his diagnosis is.

Signs

There is the very first and vivid sign that should make the patient think about this type of injury, if it is difficult to turn the head, there is such pain in the neck region that blocks movement completely. If this sensation does not let go for a long time, then an examination should be started urgently.

And here are the secondary signs that appear further can be very different.Often people do not pay attention to the fact that the neck does not turn for a while. After a certain time, he lets go and the person forgets about it. In fact, everything related to the cervical spine and spine is very serious. It may turn out that time will be lost and the progress of the injury will begin to develop quickly enough.

All the signs that were given above can appear after a different period of time. Some symptoms give themselves away immediately, already in the first hours after the injury, and some, after some time.In any case, having received even, as it seems to you, a minor injury in the neck area, it is imperative to be examined and make sure that nothing is too serious.

It should be noted that with severe trauma, many symptoms will manifest themselves immediately, but when it comes to hidden bruises of a mild degree, the symptoms may appear after a few days.

In the acute form of trauma, painful sensations arise immediately after the impact has occurred, the patient asks for help immediately.Such a situation will simply not give an opportunity to sit and not take medical action, the pain will simply lead to loss of consciousness.

Consequences of pathology

It is very insidious, since first aid can be provided, but the disease is not completely cured, then negative consequences may arise after the assistance measures are provided.

Often the consequences of a whiplash of the spine occur when the patient has already forgotten about it.

Here are some of the consequences of the pathology that arise against the background of the trauma:

  • The occurrence of an intervertebral hernia, which did not exist before, and the prerequisites for it too.
  • Constant feeling of nausea and discomfort.
  • Daily condition of migraines and headaches.
  • Back pain, discomfort when moving.
  • Neurological disorders that are accompanied by various pains in different parts of the body.
  • Difficulty turning the neck, and over time, complete loss of mobility.
  • Groundless stoop when a person wants to bend over all the time.

Do I need to be careful after being injured?

In order to avoid such consequences, care must be taken not only to ensure that the injury is fully healed, but also to provide preventive measures after the full course of treatment.What does it mean? A person must be observed by a specialist for some time after the treatment process and undergo prophylaxis, it includes:

  • Moderate physical activity in preventive measures, swimming, physiotherapy, therapeutic baths.
  • Depending on the form of the injury, courses of various massages are often prescribed, this is very useful for the body to be always in good shape.
  • The use of various herbal preparations that strengthen bone tissue and serve to support the immune system.

And, of course, you need to constantly keep your finger on the pulse in terms of examination and check the state of the body. Do not neglect the medical advice given by doctors.

It is also worth noting that after such a serious injury, any preventive measures of an independent nature are contraindicated. All actions are carried out only in agreement with the attending and observing doctor. Any self-medication can cause serious harm to masturbation, especially in such a situation when some parts of the body are weakened.

Treatment of trauma

Today there are a large number of treatments for whiplash injury, every patient has the right to choose. With traditional methods, a course of both drug treatment and physiotherapy is prescribed.

Medicine has also successfully used injections to treat this kind of injury. All procedures are prescribed by a doctor, a schedule is drawn up according to which the patient performs all the recommended manipulations.

In this case, it is important to remember that the result of the treatment will be only if you follow everything exactly on time and do not miss a single procedure.The fact is that our body gets used to a certain system and, in accordance with it, accumulates everything that is needed for recovery. If there is no consistency, then the body will not perceive correctly all the actions that the patient uses. That is why it is so important not to violate the treatment regimen.

Osteopathy

Today, there are many alternative methods of solving the problems associated with such trauma. In particular, osteopathy is one option. Medicine is often perceived with skepticism, while there are a huge number of real examples of patients who, after such procedures, recovered and did not receive negative consequences.

Of course, this is a big risk to turn to an area that is completely unfamiliar to you. But the risk is often justified.

Osteopathic therapy is aimed at healing the body using energy that is transferred from person to person. Today there is a huge number of specialists who offer such services. Before contacting a specialist in this field, you should definitely consult how competent he is and can help you. For this, there are special resources where former patients leave feedback on how a particular doctor treats.

Benefits of this treatment

This method certainly has its advantages:

  • When receiving treatment, a person does not experience pain.
  • With the correct procedures, the effect is noticeable after just a few sessions.
  • During the procedure, the whole body is relaxed.

When resorting to this method, you should understand that you will not have forecasts and guarantees. It takes time to be convinced of the effectiveness of such treatment.Not everyone takes such risks, but tries to stay with traditional methods of treatment.

Should I contact them

There is a less risky option, but still suitable for skeptics. In the acute period, you can be treated with those drugs that the doctor prescribes. And after undergoing treatment, receive preventive measures from an osteopath. Thus, the risks are reduced. If it happens that the energy of this specialist does not suit you, or you basically understand that this is not for you, you can always refuse.Indeed, most often the reception of such specialists is carried out one-time, it is absolutely not necessary to go through as many sessions as recommended.

Rare cases, but still there are, when traditional doctors advise to turn to osteopaths, in such situations, as a rule, they recommend which ones. If you trust the doctor recommending a specialist, then you can contact him in this case.

Also one of the alternative options is to receive a mixed treatment. Yes, in this case, it will not be entirely clear which method brought the results, but then the risks are much less.

Recommendations

There are general recommendations that should be followed (it doesn’t matter which method of treatment you choose):

  • Keep calm, rest more.
  • Do not overload yourself with physical activity.
  • Take fortifying infusions and herbs that are allowed for everyone.

In this case, you will save your strength and health.

KMN – Whiplash injury of the neck, contusion of the neck and back of the head, cervico-cranial syndrome.

Whiplash injury of the neck, contusion of the neck and occiput, cervico-cranial syndrome

Cervico-cranial syndrome is a painful condition of the cervico-occipital junction resulting from trauma to the head or neck (cervical spine) or their chronic overload. This causes irritation of pain receptors in the ligamentous apparatus, in the capsules of the intervertebral (facet) joints, the muscles of the cervical spine and the aponeurosis in the occipital part of the skull.

The source of pain in the neck and back of the head is an injury or chronic overload of the supporting structures of this area (injury or contusion of the cervical spine). Injury to the cervical spine in terms of the time of occurrence can be either acute (as a result of car accidents, falls, blows to the head or blows to the head, bruised neck and back of the head when falling), and chronic (sedentary work, feeding or carrying the child for a long time, etc. etc.).

Whiplash mechanism of injury to the ligaments and muscles of the neck and brain during a car accident or collision when skating, rollerblading, skiing or snowboarding, bruised neck and back of the head from a fall.

Acute injury to the neck (cervical spine) and cervico-occipital junction occurs when falling, colliding with another moving or stationary object, a person (while skiing, snowboarding, etc.). From a similar mechanism of injury or contusion of the cervical spine, a sharp movement occurs in the cervico-occipital junction and intervertebral joints.As a result of this whiplash injury of the cervical spine, the ligaments and muscles of the neck (posterior, anterior, lateral group and their combinations) are stretched.

Sometimes this movement in the neck can be greater than the physiological norm for the cervical spine. Then ruptures of ligaments and muscles with subluxation of the intervertebral joints and the odontoid process of the cervical vertebra C2 are likely.

Depending on the intensity of pain in the back of the head and neck in case of injury or bruise of the cervical spine, the patient cannot find a comfortable sleeping position.

Chronic injury to the neck (cervical spine) and cervico-occipital junction is formed by static load from monotonous efforts for a long period of time (sedentary work). At the same time, for a certain amount of time, a person experiences discomfort in the neck and back of the head. Exacerbation of pain in the cervical spine can cause hypothermia, sudden head movement (turning the head to the side or back), uncomfortable neck position during sleep.

Against the background of whiplash and pain in the cervical spine, irritation of the vertebral arteries occurs, which run in the transverse processes of the cervical vertebrae.

Localization of pain in the case of whiplash injury of the neck, radiating from the back of the head to the zone between and below the shoulder blades, to the shoulders.

It should be noted that in addition to pain in the neck and head (occiput, temples, crown, forehead), patients may experience vestibular disorders.Vestibular disorders as a result of irritation of the vertebral arteries, which are expressed by dizziness and unsteadiness when walking, nausea and vomiting. Sometimes the clinical manifestations of cervical-cranial syndrome lead to an erroneous diagnosis by some doctors of a concussion.

In case of cervical-cranial syndrome, complaints of the appearance of noise or ringing in the ears and head (cochlear manifestation), numbness of the skin of the face, occiput, in the area of ​​the ear, mucous membrane of the tongue are also possible.

Rapid fatigability occurs. In the morning after sleep, there is no feeling that you have managed to get enough sleep. Sometimes insomnia may occur against this background. General performance and attention decrease, irritability arises.

The vertebral arteries running in the transverse processes of the cervical vertebrae may react with vascular spasm with dizziness.

Effective treatment of neck injury on DocDoc.ru

Traumatologists of Moscow – latest reviews

I had doubts about the doctor, I read a lot of good things about him.But it turned out that he is really wonderful. At the first appointment, the doctor listened to all my complaints and made a plan for a phased examination for me. I went through them and came back, and the doctor himself deciphered them and suggested a treatment plan. It helps me, the effect quickly came. And post-isometric relaxation is just magic!

Helena,

02 November 2021

When making an appointment, I was told that the doctor accepts children from scratch.And in the end, the doctor said that we need a pediatric orthopedist and he is not a practitioner, not an operator. Artyom Yuryevich didn’t really tell us anything. I felt the child who was sitting on my lap, wrote out the wrong diagnosis in these recommendations. It is not clear what I paid for, and there was a desire to return the money back. There was no reception as such, but they simply said that you were not for me.

Tatiana,

01 November 2021

Viktor Mikhailovich is a qualified and attentive doctor.There was enough time at the reception. The doctor consulted, examined and gave useful advice. You can personally take them into account, you can also go through additional procedures. I was pleased with the reception.

Anatoly,

October 29, 2021

The doctor is friendly.Alexey Mikhailovich carefully examined the child, recommended which exercises to do, which insoles to buy. As a result, it became clear what we need to do next.

Inna,

October 28, 2021

I didn’t really like the reception.The doctor, of course, told me to raise my hands to the side or up, but did not perform any palpation. The doctor very often referred to the Internet. I even asked if I could come for a follow-up appointment in a month, but I said no. It seemed to me that a strange specialist. As a doctor, I sat for a very long time and thought before prescribing something to me. For this I will not apply again. Calm and polite specialist. But about my professional qualities, a doubt crept in.

Tatiana,

12 October 2021

Everything went well, I liked everything.Many thanks. We had a routine examination. Ramik Rufat oglu is polite, asks questions, is interested in health.

Natalia,

October 11, 2021

The reception went very well.I am very grateful to the doctor, he operated on me and I am already at home on sick leave. Sergey Alexandrovich is friendly, very attentive. I highly recommend this specialist.

Catherine,

October 10, 2021

There was a house call.Very professional doctor, delicate. The review is very good. I left good impressions about myself. Gave good advice. Nikolai Nikolayevich told how to be treated, what to do, at the moment, what is in the future. I stayed in touch with him, said if you call. There are few such doctors now.

Natalia,

04 October 2021

The traumatologist scared me very much that I needed to go to the hospital.I went to another surgeon, where they gave me completely different information about what to do. Therefore, I am not happy with this specialist.

Evgeniya,

August 14, 2021

I am very happy with the doctor! He shot my previous pictures, extracts, compared everything,
I did not miss any detail, I clearly, quickly made a diagnosis, determined the cause and prescribed an effective treatment that helps me.