By: Bill Haggerty, Donna Comp
Whiplash is perceived by many to be a very common and troublesome disorder. The very definition of whiplash injury remains controversial, however, the essential elements are that the injury takes place in a motor vehicle accident (MVA) and that the upper body, and more specifically, the head, is subject to acceleration forces that result in bending of the neck. Furthermore, the term “whiplash” correctly applies to the mechanism of injury, not to the injury itself. It is a known fact that these injuries can be painful and can cause long-lasting disabilities.
Although many physicians have a tendency to downplay the effects of whiplash disorder, the medical literature shows that these injuries are frequently associated with damage to
(1) muscles, including interstitial tearing, inflammation, and infarcted tisssue;
(2) ligaments, including overstretching and detachments from bones;
(3) joints, including disruption of capsules and displacement of surfaces;
(4) vertebrae, including compaction and chipping;
(5) nerves, including compression, stretching and tearing; and
(6) blood vessels, including decreased or blocked circulation.
These primary injuries may cause secondary ones to the spinal cord or brain, to cervical sympathetic nerves that interfere with balance and posture, and to nerves that control pupil dilation or eyelid droop. The primary injuries frequently aggravate preexisting arthritis, transforming a relatively benign dormant condition into a disabling one.
Disabilities also are associated with the healing process. For example, ligaments before injury are typically elastic (depending to some extent on age), but scar tissue that replaces normal fibers during healing is inelastic, reducing the range of motion and activity.
A clinical pathologist can best describe the difference between healthy and injured tissue by comparing normal muscle, fibers, ligaments and nerves with damaged ones, and explaining what happens when soft tissues are stretched, torn or otherwise injured. A radiologist can demonstrate the effects of injury by comparing films of a normal spine with films of a damaged one by documenting anatomical changes and noting changes to the normal curvature (lordosis) of the cervical spine.
Chiropractors are excellent resources for both treating and understanding whiplash disorder. Chirpractors spend more hours studying the anatomy of the spine during their training than many orthopedists or neurosurgeons. Perhaps this is why so many people seek their treatment from chiropractors after they have sustained traumatic cervical syndrome injuries.
Not all patients who suffer a whiplash injury develop chronic symptoms. Indeed, despite its reputation, whiplash disorder is a relatively benign condition in that most patients recover. In fact, three studies (Maimaris 1988, Gargan and Bannister 1990, and Olsson 1990) indicate that those patients destined to recover will do so in the first 2-3 months after injury. The rate of recovery then slows dramatically to become asymptotic, with no further change in symptoms after 2 years. To put it more simplistically, the outcome for patients is dichotomous; either the neck pain will resolve in the first few months or it will persist indefinintely.
The Quebec Task Force (Spitzer, et al., 1995) set about to redefine “whiplash” and its management. Five physical symptoms and signs, in addition to age and gender, appear to be important prognostic factors in whiplash-associated disorders. According to data collected for presentation at the World Congress on Whiplash-Associated Disorders in 1999 (Suissa et al.), neck pain on palpation, muscle pain complaint, headache, and pain and/or numbness radiating to the arm, hands or shoulders appear to have a major influence on the course of recovery following a whiplash-related injury. What follows is a table identifying the classifications identified by this task force.
|Quebec Task Force Clinical Classification of Whiplash-Associated Disorders|
|Grade I Neck complaint, stiffness, or tenderness only; no physical signs|
|Grade II Neck complaint and musculoskeletal signs|
|Grade III Neck complaint, stiffness, or tenderness and neurologic signs|
|Grade IV Neck complaint and fracture or dislocation|
In summary, there exists undeniably strong evidence that whiplash-associated disorders are often truly significant injuries that involve long-term disability and risk of future harm. _______________________________________________________________
This article was authored by Bill Haggerty and Donna Comp., June 2001. Haggerty Law Firm was founded by Board Certified Civil Trial Specialist Bill Haggerty to represent Auto Accident Victims and their families. A longstanding member of the Association of Trial Lawyers of America and the National Board of Trial Attorneys, Mr. Haggerty has practiced law for over 25 years and has earned the respect and reputation necessary to speak with insurance companies to protect your rights.
Reprinted with permission of the Haggerty Law Firm.