Car Accidents and the Resulting Whiplash Injury
Whiplash injuries resulting from motor vehicle collisions (MVCs) are a common occurrence, and for many, they resolve successfully over time. However, an estimated 25% of whiplash patients continue to experience chronic pain and disability. To address this challenging issue, numerous studies have delved into identifying factors that distinguish those who recover from those who do not. These insights aim to pave the way for additional treatments that can minimize the risk of chronicity. This article examines the characteristics of MVCs and their potential connection to chronic whiplash pain and disability.
In a comprehensive 2019 study, researchers embarked on a mission to evaluate 37 acutely injured patients within a week of their MVC, at the two-week mark, and again three months later. Their objective was to discern any links between pain and disability and specific crash-related variables, such as head position at the time of impact, seatbelt usage, airbag deployment, whether the vehicle was struck while stationary or turning, the primary direction of force, estimated damage costs, impact speed, and more. Simultaneously, the study sought to explore the influence of patient characteristics, including gender, body mass index, signs of post-traumatic distress, and negative affect, on the outcome.
Surprisingly, the research team discovered a significant association between self-reported neck disability three months post-MVC and several patient-related factors, including post-traumatic distress, negative affect (comprising emotions like anger or sadness), and uncontrolled pain. Intriguingly, there was no direct correlation between crash characteristics, such as vehicle damage, force direction, or speed change, and chronic whiplash pain and disability. This finding, while shedding light on the complexity of whiplash recovery, underscores the importance of adopting a holistic, biopsychosocial approach to treating whiplash-associated disorders. It emphasizes that successful recovery necessitates addressing not only the biological aspects, such as tissue damage and diagnosis, but also the patient's mindset and determination to heal.
This research echoes the conclusions of a similar study that investigated the connection between post-traumatic stress disorder (PTSD) and prolonged recovery from whiplash-associated disorders. In this earlier study, researchers found that specific PTSD symptoms, particularly hyperarousal and numbing, were predictive of long-term neck pain-related disability. This demonstrates how psychological factors can play a crucial role in the recovery process.
Beyond the conventional methods of managing musculoskeletal disorders, such as manual therapies, nutritional guidance, modalities, and tailored exercise programs, doctors of chiropractic are increasingly adopting a holistic, health-oriented approach. They aim to empower patients with tools to manage stress and anxiety, thereby facilitating the healing process. These tools include techniques like deep-breathing exercises, visualization, contract-relax or tensing exercises, and more. Moreover, chiropractors are well-equipped to collaborate with primary care physicians and specialists, such as mental health counselors and clinical psychologists, when patients require additional support beyond physical rehabilitation.
In conclusion, the journey to recovery from whiplash-associated disorders is a multifaceted one. While the characteristics of the motor vehicle collision itself may not directly predict the likelihood of chronic pain and disability, the psychological and emotional factors experienced by the patient play a pivotal role. This understanding underscores the need for a comprehensive, biopsychosocial approach to whiplash treatment, where healthcare professionals address not only the physical aspects of the injury but also the mental and emotional well-being of the patient. By embracing this holistic approach, we can better support those who continue to grapple with the challenges of whiplash recovery, offering them a path towards improved quality of life and well-being.
Written By Dr Diego Caban for OrthoTrust