This is an excellent question, and in order to understand the answer, one has to understand what types of injuries occur to the neck in whiplash. In an earlier post on our blog, I wrote about the Croft Grading system. This grades the severity of injuries from 1 (minor muscle strain), to grade 5 (requiring surgery). We start seeing permanent injuries at about grade 3, where we have neurological symptoms and ligament damage. Normally, the ligaments of the neck are tight all the time, providing stability. One of the most common causes of chronic pain and disability is over stretching of the ligaments of the neck to the point where they will heal in a more scar tissue type formation, but now are no longer tight like they were supposed to be. This is called ligamentous instability.
With ligamentous instability, you basically have a little “sloppiness” in that area allowing the joints of the spine to move too much, causing more pain in the already overstretched ligaments and joint restriction or “lock-up”. These are the painful, reoccurring kinks people get in their neck restricting movement and often cause not only localized pain but referred pain and spasms elsewhere. This scenario is called “mechanical neck pain”, and the best-known therapy for this is the therapy we do here in our clinic which includes mobilization of the locked-up joints (Gross, et al, Conservative Management of Mechanical Neck Disorders: A Systemic Review).
We sometimes need to analyze our whiplash patients for ligamentous instability by Digital Motion X-ray (DMX). By assessing the areas of instability, we can direct our therapy to help bring about restoring proper biomechanical motion. These ligamentous instability injuries are permanent, painful, and progressive. Without identifying these most commonly overlooked causes for chronic pain the proper treatment may not be applied. This is why we tout “Research Based Diagnosis and Treatment”.
If you or someone you know is suffering from whiplash, give us a call at 907-349-4212 and we can help!