WHIPLASH – CAUSES AND TREATMENT

Whiplash is a non-medical expression used to describe relatively common injuries caused to a human’s neck because of sudden and unrestrained forward and backward movement of neck and head after a rapid acceleration-deceleration force. This type of injury is usually a result of motor vehicle accidents. This type of neck injury affects both soft tissues and the bone structure of the neck. Whiplash associated disorders is a term used to describe a more chronic and severe condition. Typically, whiplash is not a life threatening injury but it might lead to a partial disability for a long time. Most of the people who sustain such injuries might not experience such long term pains but some might experience pains even after years of the accident.

Causes

The most common cause of a whiplash injury is a motor vehicle accident especially when a person is in a static car and is hit from behind by another vehicle in motion. After sustaining a rare impact, the lower bones of the neck (lower cervical vertebrae) go into a hyperextension position while the upper bones of the neck (upper cervical vertebrae) are hyperflexed. These movements cause the cervical spine to assume an abnormal S-Shape. It is this abnormal movement that damages the soft tissues that hold the muscles, facet capsules, and ligament of the cervical vertebrae together. Severe impact can also cause several other injuries to the nerve roots, cervical muscles, ligaments, discs, and intervertebral joints.

Symptoms

The most common symptom of whiplash is muscle stiffness and pain in neck. The symptoms largely depend on the severity of the injury but the symptoms and signs may include:

·         Swelling in neck

·         Difficulty in rotating, extending, or flexing the head

·         Difficulty in chewing due to tightness of jaw

·         Fatigue

·         Disturbance in sleep

·         Trouble concentrating

·         Headache

·         Back pain

·         Tinnitus (ringing in ear)

·         Visual disturbance

·         Weakness in arms

·         Pain in arms

·         Dizziness

The more chronic and severe case of “whiplash associated disorder” may include the following symptoms:

·         Insomnia (disturbance in sleep)

·         Post traumatic stress disorder

·         Dependency on drugs

·         Stress

·         Anxiety

·         Frustration

·         Anger

·         Depression

Treatment

The treatment of whiplash injury depends upon the symptoms present in the patient. The most important factor in managing and treating whiplash is to educate the patients about their condition. This would include knowledge of the cause, possible treatments, and their outcomes. Patients should understand that this is not something that they can simply ignore, but that almost all the patients fully recover. Patients who are not well aware of the situation might develop severe “whiplash associated disorder.”

In the past, the initial cure for whiplash was usually a soft cervical collar that the patient had to wear for several weeks. The aim was to control the range of motion of the neck in order to avoid any additional injuries. But after more recent studies, it became evident that immobilization of neck for a long time can slow the process of healing. In case there is no evidence of abnormal alignment of the spine, then early range of movement is advised.

Patients who are treated with exercises for early range of motion have exhibited rapid improvement, and more reliable improvement in all their symptoms. On the other hand, decrease in the range of motion leads to increased stiffness and pain. Immobilization may also cause decrease in the blood flow to the injured soft tissues, muscle atrophy, and healing the muscles in shortened range which makes that less flexible. 

Physical therapy can also be very useful to aid patients wean from a cervical collar and to help them strength their muscles. Occupational therapies can also be used to help patents return to their work environments. 

In case the patients start to develop psychological symptoms such as depression, anxiety, and anger after sustaining the injury then it is advised that the emotional condition should be promptly treated. This will help patients understand their chances of complete recovery and will also reduce their chances of developing chronic symptoms. 

Factors That Can Affect the Prognosis of Whiplash Injury

Following are some of the risk factors that can influence the prognosis of this injury:

·         The symptoms and pain of Whiplash persisting beyond the duration of 6 months.

·         Significant joint capsule, nerve, disc and ligament injury.

·         Patient being older than 65 years of age.

·         Need to restart treatment due to more than one bout of pain.

·         Delay in starting the treatment.

·         Injury was sustained in a small car.

·         Head restraint was more than 2” far from the head of occupant.

·         The occupant was under the influence of alcohol at the time of the accident.

·         The occupant already had a previous whiplash injury.

·         Pre-existing evidence of degenerative changes.

·         Use of cervical collar for more than 2 weeks.

·         Initial radicular (tingling, numbness, arm pain) symptoms.

·         A previous fusion cervical spine.

The symptoms of the injury may appear in 2 to 3 days of the injury or immediately after it. 

For more information on Dr. Joseph Mills, visit: www.westhillspaincenter.com or call: 631-659-2980

References

Cunha, J. P. DO, FACOEP. Whiplash. Retrieved from <http://www.emedicinehealth.com/whiplash/article_em.htm>

Eck, J. C. DO, MS. Whiplash. Retrieved from <http://www.medicinenet.com/whiplash/article.htm#whiplash_facts>

Murphy, D. DC. What is Whiplash? Retrieved from http://www.spine-health.com/conditions/neck-pain/what-whiplash

TIPS ON HOW TO TAKE BETTER CARE OF YOUR BACK

You must have heard the phrase, “To be the backbone of something” which means the part of something that makes it strong or successful. Well, your back is not metaphorically, but literally your backbone and you need it to be in perfect shape if you want to lead a happier and healthier life. 

Millions of people all around the world experience back pain daily. Apart from living with the constant pain, this condition is enough to drastically affect your quality of life and can make even daily, simple and necessary tasks entirely impossible. Taking care of your neck, spine and back today is going to help you decrease your risks of acquiring back pain in the future.

 

Better Choices, Better Health Leads To Healthy Aging

How you age depends on the choices you make today. If you wake up every morning with the thought that your back hurts then you are not the only one who complains about that. On an average every one in five people in America reported of back pain at least once during the last month. (Shaw, 2014)

Growing old does not necessarily mean that your mental and physical abilities should diminish because there is a lot you can do to keep you mind sharp and your body healthy. Simple and minor changes in your lifestyle such as, sitting with the correct posture, lifting weights correctly, losing extra pounds and choosing a healthier lifestyle can ensure healthy aging. 

Following are some simple changes that you can adopt to walk on the healthier path to aging as well as reduce the risk of back pain.

 

The Correct Way of Lifting

Following are some factors that you should take care of while lifting heavy objects:      

• You should use your legs muscles to lift heavy objects rather than your back muscles.
• You should squat, lift and then stand up, rather than bending at your waist in order to lift.
• Another risky maneuver is when you lift and twist at the same time. You should bend at your knees, lift the weight and then turn your whole body along with your feet rather than just twisting your back.

 

What NOT To Do While Exercising/ Stretching

Following are the key things that you should absolutely avoid while stretching/exercising:

• Be patient when you stretch after a workout. Know the limits of your body and never force your body to go beyond them. Stretch your limits a little each day but don’t break them. Gradually you will see the results as your body eases towards flexibility.
• Do not bounce while stretching. Use even, slow movements when you stretch. Bouncing can cause a lot of stress to your joints and muscles and will not even help you stretch any better.
• Do not overextend your joints. This can cause injury to your joints and won’t help you in any way.
• Lastly, do not do it if it hurts. If you exercise a sharp searing pain during stretching, stop! That is your body screaming that it is has had enough.

 

The Correct Sitting Position

All those who suffer from back pain are not the same. Some find relief from their pain while standing, and then there are some who feel better when they sit. (Kam, 2014)

If you are stuck in a job where you need to sit for long hours then you should try these tips:

• Stretch and stand up frequently.
• Make sure that you don’t slump while sitting.
• Keep your work close to you so that you don’t have to lean in.
• Position your desk slightly above your waist.Position your chain in a way that when your feet are flat on the floor, your knees should be as high as your hips. Sit on a chair that has a support for your lower back. In case it does not, keep a lumber cushion behind your lower back. 

 

Shed Extra Pounds

People who are obese suffer from back pain without even realizing that their weight is contributing to their back aches. While this relation has not been thoroughly studied, it is hard to say to what extent weight contributes to back ache. However, it is safe to say that people who are overweight have a high risk of experiencing back pain. This happens because having extra pounds around your waist strains your lower back by pulling the pelvis forward. According to AOA (American Obesity Association) obese women with a large waste size are particularly susceptible to this ailment.

Being overweight is just not good for your health in any way therefore, you really need to buckle up and make an effort to shed the extra pounds. Adopt healthy eating habits and a healthier lifestyle. Be more active and add physical activity in your lifestyle especially if you have a job that requires a lot of sitting. Minor changes in what you eat and how active you are can give you positive results in terms of weight loss. 

Types of Back Strengthening Exercises

Following are two exercises that will help you strengthen your back: (Teare, 2014)

Hip Bridge – lie flat on your back, hip-width apart with flat feet. Relax your arms and bend your knees. Lift your hips as you squeeze your buttocks, creating a straight posture from your shoulder to your knees. Hold the position for 2 seconds and then slowly lower your body. Do this up to 10 to 12 times. 

Bird Dog – get on all fours. Knees apart and hip-width under the hips. Keep your shoulder-width apart and your hand flat. Pull your belly towards your spine and squeeze the abs. Make sure your spine is neutral and without rotating the hips or arching your back extend your left arm straight and your right leg back. Hold this position for two seconds and repeat this exercise 5 to 6 times for each side. 

For more information on Dr. Joseph Mills, visit: www.westhillspaincenter.com or call: 631-659-2980

 

References

Shaw, G. Managing Your Back Pain at Home. Retrieved from

<http://www.webmd.com/back-pain/living-with-low-back-pain-11/back-pain-at-home>

Kam, K. How to Protect Your Back. Retrieved from < http://www.webmd.com/back-pain/living-with-low-back-pain-11/protect-your-back?page=1>

Orenstein, B.W. 7 Tips For a Healthy Spine. Retrieved from

<http://www.everydayhealth.com/back-pain/healthy-spine-tips.aspx>

Michaels, J. The Dos and Don’ts of Stretching. Retrieved from

<http://www.everydayhealth.com/fitness/team/specialist/jillian/dos-and-donts-of-stretching.aspx>

Teare, T. 4 Back-strengthening Exercises. Retrieved from

<http://www.realsimple.com/health/fitness-exercise/workouts/4-back-strengthening-exercises-10000001722657/index.html>

Frisco, D.J., MD. Weight Loss for Back Pain Relief. Retrieved from < http://www.spine-health.com/wellness/nutrition-diet-weight-loss/weight-loss-back-pain-relief>

WHY IS LOWER BACK PAIN THE MOST COMMON AILMENT IN AMERICA?

Low back pain or pain in the lower back is a very common ailment in America, effecting up to ninety percent of Americans at some point during their lives. Up to 50% of the people who experience back pain will have more than one incident. Pain in lower back is not a specific disease; rather it could be a symptom of various different processes. In about 85% of the people who experience pain in their lower backs, no specific cause of the pain could be diagnosed even after a thorough examination. America approximately spends $50 billion annually on lower back pain. 

There can be a number of underlying reasons for this ailment but more often than not, no specific reason can be found and the pain eventually stops. 

·         Pain in lower back is second only to the common cold as a reason for employee absenteeism. It is also one of the major reasons why people visit the Emergency room in extreme cases or a doctor’s office for milder ones. It is also the second most common neurological complaint in the US, seconded only by headaches. 

·         For ninety percent of the people, even those who experience irritation in their nerve roots, experience an improvement in their within two months regardless of the medical treatment used or even if no treatment is done. 

·         If back pain stays for less than a month then doctors refer to it as acute and chronic if it lasts for a longer period of time.

Causes

The back is a complex structure and it includes joints, nerves, muscles, and bones. This is one of the reasons why sometimes it is difficult to pinpoint the exact reason of the pain.

In most cases back pain does not occur due to some serious disease or damage but by irritated or pinched nerves, minor injuries, minor strains or sprains. Pain in the back can also be triggered by regular everyday activities at work and home, or it can grow overtime due to bad lifting, standing or prolonged sitting. Some other causes of back pain are:

• Excessive use of muscles, generally due to repetitive movements or sports
• Driving for a very long period without a break or keeping your back hunched while driving
• Over stretching
• Twisting
• Slouching
• Pulling incorrectly, pushing, carrying or lifting
• Bending in an awkward position for a long time 

Sometimes pain in the back can also develop suddenly for no obvious reason. Some people might just wake up one morning with it without any idea as to what caused it.

Risk Factors

Following are some of the factors that might increase chances of developing a back ache:

·         Depression – pain in the back can make people feel fairly depressed making them gain weight. This eventually leads to an increase in pain and more depression. 

·         Stress – it is believed that stress causes tension in the muscles of the back which can lead to pain.  Using medication that can weaken the bones if used for a prolonged period of time. 

·         Pregnancy – the extra weight the woman carries around can place additional strain on her back thus causing back pain. 

·         Smoking – smoking damages tissues of the back which might cause severe back pain. Moreover it can also be caused by the fact that smokers generally have an unhealthier lifestyle as compared to non-smokers which might increase the symptoms. 

·         Overweight – all the extra weight that fat people carry around their weight can put extra pressure on the back and spine. People should calculate their BMI in order to find out whether or not they should lose weight. 

In a number of cases back pain can be caused due to serious medical conditions. But more often than not it is the lifestyle of an average American that is the reason of back pain. 

 For more information on Dr. Joseph Mills, visit: www.westhillspaincenter.com or call: 631-659-2980

References

Shaw, T. Causes of back pain. Retrieved from <http://www.nhs.uk/Conditions/Back-pain/Pages/Causes.aspx>

Shiel, W. C. Jr. M.D, FACP, FACR. Low back pain. Retrieved from <http://www.onhealth.com/back_pain_health/article.htm>