By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

CHRONIC WHIPLASH OFTEN IMPROVES WITH OSTEOPATHIC MANIPULATION

Question: About a year ago my son was in a bad car accident but has fully recovered from his broken bones and deep cuts. He lost a lot of blood. However, he still has pain because of the whiplash he experienced. What can be done to help him?

Answer: Although it may not have been as apparent as the broken bones and lacerations that your son experienced, whiplash can cause ligament and muscle damage. This damage can extend from the neck muscles and supporting ligaments to the arteries that supply blood to the brain. Regardless of the extent of underlying damage, whiplash injuries can cause long-lasting discomfort.

Before I get to the heart of your question, let’s look at upper body anatomy and its consequences. The head -- a relatively heavy object -- is secured to the end of a flexible support that we call the neck. Unfortunately, this flexibility comes at a price. The muscles and ligaments that move and support the neck are easily injured in auto accidents.

As you drive down the highway, your neck muscles are only under sufficient tension to hold the head in a position to see the road. When your car suddenly decelerates as it strikes another object or accelerates when it’s struck from the rear by another vehicle, your neck is put under tremendous strain.

While your body -- supported by the car seat, seatbelt, shoulder harness, feet and arms -- slows nearly as fast as the car, the heavy head continues forward or backward, depending upon the forces in the wreck. The head doesn’t stop until it has reached or exceeded the normal limits of the neck’s mobility. Further, this immense strain occurs so fast that the muscles don’t have sufficient time to react. They and the ligaments of the neck get injured and become the source of pain in a whiplash injury.

The initial severe pain of whiplash typically subsides enough to allow return to normal activities in two to eight weeks. However, as your son has found out, the acute phase of whiplash is often followed by a period of several months of chronic discomfort. This may include neck ache and headache, as well as soreness and muscle tightness in the upper back.

In this chronic phase of whiplash, tests like X-rays and MRIs often are unable to find a clearly identifiable abnormality that causes pain. I find, however, that my patients with chronic whiplash complaints typically have signs of abnormal motion of the muscles and bones in the neck and back. This abnormality is subtle. Osteopathic physicians, chiropractors and physical therapists are trained to diagnose these types of muscle injuries through physical exam.

Identifying the problem is the first step to resolving it. Physical therapy and osteopathic manipulative treatment usually promote healing. Antiinflammatory medications and muscle relaxants can also help the injured tissues heal. It takes time to heal the damage that has been done, and healed tissue is not the same as “never injured” tissue. Most people are well within a year but can still tell in subtle ways that their neck isn’t the same as it was before their injury. Perhaps your son would benefit from an examination by an osteopathic physician.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.