Monday, May 7, 2012

Whiplash and Upper Cervical Care


If you are like many others that have been in a car accident at some time in your life, but thought that “I’m not in pain anymore” or “I was fine” or “it was just a fender bender”, think again. There are 3 million new whiplash injuries per year. 35-50% of those people will never fully recover and 14% of them will become disabled. This is pretty significant. Most people that I see in my clinic have had a motor vehicle accident at one time or another in their lifetime. Some of them have had some real doozies, while others deny that they were affected by an accident that happened so long ago. Some report that they walked away without any problems or pain. Then 7-10 years passes and these folks start complaining of problems: arthritis, headaches, neck and back pain, neurological problems like vertigo, etc. The presence or absence of pain right after an accident is not indicative of damage done to the upper neck structures. Only a 10 MPH collisions is equivalent to catching a 200 lb. bag of cement from a 2nd story window! (Much of this information was taken as notes during a recent NUCCA conference address by an upper cervical doctor and whiplash specialist, Dr. Scott Rosa, DC from New York.)

If you pay attention to the following information, you might be able to save yourself from a world of hurt. Upper cervical chiropractors are the best suited, in my opinion, to helping people deal with the underlying damage done from whiplash injuries. Car crash injuries have gone up 284% since 1984 because of changes made to cars to make them “safer”, like more rigid seat backs and stiffer frames. When there’s a collision, there are forces involved that get either absorbed in the car, or you. If the car is more rigid, then it gets absorbed into you, translating into whiplash damage that tears ligaments and structures in the neck, especially the upper neck, which is not as protected. These injuries can create a whole host of problems and compensations into the rest of the spine and body that negatively affect our health.

The injury mechanism occurs when the neck is forced into an S-shaped curve during impact in just milliseconds of time. **I’m going to get a little technical here. The lower neck hyperextends, and the upper neck flexes. Whiplash is like getting hit from the front and behind by 2 football players at the same time, all within 150 milliseconds. This causes tearing damage to the upper cervical ligaments (like the posterior atlantooccipital membrane, the posterior atlanttoaxial ligament, the alar ligament, and others). This damage is usually overlooked by most radiologists looking at the MRIs because they fail to pay attention to the craniocervical junction (where the skull and the neck meet). Also, the best views to see such damage are usually not utilized (you need upright MRI and coronal and axial views of this region to see most of the damage). Another problem shown on MRI and CSF (cerebral spinal fluid) flow studies is the cerebellar tonsils that dip down in to the foramen magnum in many whiplash victims. These cerebellar tonsils can “choke” the spinal cord and impede the flow of nerve signals and cerebral spinal fluid from circulating properly. This is called Cerebellar Tonsillar Ectopia (CTE). Some of you might have heard about Arnold Chiari malformations, which, along with whiplash injuries, can be a factor in CTE. According to Dr. Scott Rosa, It is 4 times more prevalent to find CTE with someone that has had a whiplash. Dr. Rosa is in the middle of publishing a scientific study with pre and post-MRIs to show how upper cervical techniques will actually remedy the misaligned atlas, return the normal CSF flow and also how the cerebellar tonsils will get “sucked” back up after a correction, restoring normal neurological and CSF flow.

If you’re still with me to this point, then you’re serious about getting help for yourself or your loved ones. Before you go to the extremes of toxic meds or surgery, you owe it to yourself to get relief and get to the root of the problem. The best qualified individuals to assess and address the problem, in my opinion, is an upper cervical chiropractor. Whiplash patients should come and see us within 72 hours of an accident. I do the NUCCA technique, in which we take precise films before and after the correction. The films show us how the head, the atlas and the neck are misaligned before adjustment and how they realign afterwards. It’s as simple as that. The adjustment is barely felt but yet profound in its effect of restoring the body to balance. The body then does the rest in healing itself. Although I don’t need pre and post-MRIs to tell me if I have done my job, it is sure nice that we have some nice explanations for why what I do works.

Whiplash patients usually don’t care why it works, but that it simply does. Here’s an example to finish the blogpost: I recently had a young teenage girl that came in with hip and low back pain that radiated down into her thigh. Two weeks previous, she was involved in a rollover where she was in the passenger seat and was not wearing her seatbelt. Her truck flipped and rolled and she remembers waking up in the car afterwards with lacerations on her face. Consequently, she couldn’t run, jog or ride a bike because of her hip. After taking films and making the correction she reported that her back pain was gone and was giddy as a school girl. She came 2 more times over the next couple of weeks and both times she was holding and did not need an adjustment. The first follow up visit she reported that her left thigh still hurt a bit, but that her low back pain was gone. The second follow up visit, she said the thigh pain was also gone.

I never adjusted her hip or her low back but they were related to the upper neck misalignment. This is something I find often with patients, where the low back responds to getting the head back on straight due to the body being out of balance and compensating for the upper neck misalignment. If you're around Southern Utah or Nevada, come by for a free consultation to see if you are a good candidate for care (435-688-1890). If you're not in the area, look up an upper cervical chiropractor close by. You can find a good NUCCA practitioner by going to http://www.nucca.org/.