Whiplash and Osteopathic Manipulative Treatment

Whiplash is a term used to describe an injury most commonly occurring to the neck region. The actual mechanism behind such an injury is that of a rapid acceleration and deceleration occurring within moments of each other. This is usually a result of a rear end collision. This can also be the mechanism of injury behind some types of low back injury if a lap type seat belt is worn. It is, therefore, not really limited to the neck region at all. For the purpose of this article the neck will be used for an example.

In the neck, the inertia of the head is in direct contrast to the sudden movement of the body, causing the hyperextension of the neck with a reflex shortening of the muscles on the front of the neck and throat. This reflex shortening is one of the many ways the body attempts to protect us.

The exact mechanism of injury is variable from person to person although the hyperextension - hyperflexion feature is consistent. Often there is a side bending or a rotational component involved which tends to complicate the injury and create a cascade of symptoms that can hardly be explained by the seemingly insignificant "fender-bender."

Symptoms experienced by the injured person can be immediately experienced or they can come on gradually taking a few days, weeks or months to manifest completely. The injured party may even perceive themselves to be uninjured initially, having a few symptom-free days. A whiplash of the neck region rarely, if ever, results in symptoms exclusively at the neck, rather the entire body will experience the repercussions of the injury.

In Osteopathy it is believed that the head and upper neck dictate to the rest of the body; housing the brain and spinal cord. Rolin Becker (1997, Life in Motion, Rudra Press, Portland, Oregon) states that the total body physiology "from the soles of the feet to the top of the head is subjected to the whiplash energies and all of the body physiology is influenced by the accident."

In Osteopathy there are four axioms or philosophical concepts, and they are: 1/that the body is a functional unit - which means that an injury to the neck will be experienced and adapted to by the rest of the body in order to retain function.

2/ structure governs function and function governs structure - which suggests that a physiological change (change in function) will become a structural change and visa versa. 3/ the body is auto regulating - which describes both the self-healing ability of the body and the ability of the entire body to adapt and compensate for any injury or changes to continue to enable function. 4/ the role of circulation is absolute (this was originally stated as" the role of the artery is absolute") - this suggests that without adequate circulation we can not nourish our cells and our tissues - and without adequate circulation we are unable to carry away toxic metabolic waste products. The effects of whiplash typically begin with a shock, which in a motor vehicle accident, may be evident from the moment of the impact i.e. not having seen the car coming or a perception of slow motion and slow reaction to the accident while it was occurring. This shock is not limited to one's emotions, rather it is the response of the central nervous system to an overwhelming amount of incoming stimulus. Our organs, in this situation, are also responsive ensuring that our vital organs (heart, lungs) remain functional by rushing blood to these organs specifically. This causes congestion and further injury to the function of the organ, with all the best intention. This shock will usually wear off within a few hours or days only to be replaced by stiffness, pain, swelling and maybe a loss of function i.e. turning the head or constipation or both. Effects will also vary if the injured driver/passenger was stopped or moving.

Common complaints following whiplash are:

a.. muscle spasm and pain at the neck, shoulder or chest region

b.. laryngitis from the overstretch of the larynx, pharynx and front of the throat muscles

c.. muscle weakness and full body exhaustion

d.. a stiff neck and/or back with a loss of range of motion

e.. pain at the shoulder or chest region which may accompany bruising from the shoulder harness portion of the seatbelt

f.. blurred vision or double vision

g.. ringing in the ears

h.. headaches to varying degrees sometimes accompanying jaw pain or eye pain or nausea

i.. numbness or tingling into one or both hands and arms or even into the face

j.. dizziness or light headedness

k.. mood swings with or without depression, although depression is fairly common following an accident

l.. low back pain

m.. a change in bladder or bowel function due to the lap portion of the seatbelt

n.. constipation or diarrhea

o.. leg or knee pain if the knee hit the dashboard or if the foot was planted on the brake or accelerator in preparation of the impact

This list is representative of a sample of physical experiences following a whiplash injury. By no means is it intended to suggest that these are the only possibilities, rather just the most common complaints. In a severe injury, the symptoms could include head injury or coma, shooting pains, numbness and tingling, neurological compromises of any sort, paralysis and may accompany what appears to be a virus or flu-like symptoms.