Occupants of a car that is involved in a collision may experience neck pain, no matter which direction the impact comes from; however, this is far more likely to occur when the impact comes from the rear.
An eight mile per hour rear-end collision that has a 2-g acceleration (2-g = 2 times the gravitational force of earth) of the vehicle could cause a 5-g acceleration of the head. Experiments that used volunteers showed that a ten mile per hour rear-end collision could generate a 9-g acceleration of the neck and 23-g of the frontal cortex.
It has been shown that 10-60% of people in a car accident suffer from sprains in the neck. The ones that did not wear seat belts have less sprains of the neck than those wearing them.
The incidence of whiplash caused by rear end impacts can be significantly reduced by the use of head restraints. In fact, the reduction is as much as ten percent in cars that have adjustable head restraints and seventeen percent in those with fixed head restraints.
Plain radiographs (x-ray):
They say that plain radiographs should be used first when evaluating a whiplash injury. This is in order to obtain an image for reference of the cervical spine when injured, and in addition, to evaluate possible lesions that are traumatic. Using this method, secondary symptoms like degenerative disease can be assessed objectively, even when they are noted some length of time after the trauma.
Cons of X-rays. Additionally, caution that plain radiographs may not be entirely effective in the identification of traumatic cervical spine injuries. In a large percentage of patients with cervical injuries, the combination of cross-table lateral (CTL), AP and OM-views had the following results:
Sixty-one percent of all fractures were missed. Thirty-six percent of subluxations and dislocations were also missed. Additionally, injuries in twenty-three percent of the patients were falsely identified. Half of these patients had unstable cervical injuries, and some had normal cervical spines.
For this reason, when a trauma victim has a plain film that shows cervical injury or a high clinical suspicion of injury, the patient should have an MRI (magnetic resonance imaging) or a CT (computed tomography) scan. This will give a clearer and more definitive evaluation of the condition of the cervical spine.
CT scans:
A CT scan is a good choice for all patients who have experienced acute trauma. This is especially true when the cervical spine cannot be seen well utilizing plain film. This is also true when there is focal neck pain that cannot be explained, or there is a neurological deficit that does not show up on plain film.
Additionally, if there is unexplained soft tissue swelling in the pre-vertebral region or if the plain film is abnormal for any other reason, a CT (computed tomography) or MRI (magnetic resonance imaging) is advised.
These tests can reveal soft tissue problems like herniated disks, ruptured ligaments, and soft tissue hematoma. However, CT is limited when it comes to its ability in evaluating cervical trauma.
Cons of CT Scan: It is not as easy to see dislocations, subluxations, abnormal angulations, and intervertebral distances using CT as it is using old-fashioned radiography or the newer, tomography. In one research experiment CT just detected 54% of dislocations and subluxations of trauma victims.
MRI Scan
MRI data of whiplash injuries vary greatly and differ considering the time period between the x-rays and the accident.
- During the chronic phase, the first year after the trauma, usually findings will be non-specific. They will include degenerative disk disease as well as disk protrusions and/or herniation. Very few patients show bony or ligamentous lesions.
- While experiencing the subacute phase, within four months of the whiplash incident, more characteristic results such as separations of the disk from the vertebral end plate, as well as ligamentous lesions are typically reported. When comparing the anterior longitudinal ligament (ALL) and the posterior longitudinal ligament (PLL) or interspinous ligament, the ALL is more frequently injured.
- Often no specific findings will be made during the fifteen days following the original injury. This phase is often referred to as the acute phase.
- If the patient experiences neurological deficit, myelopathy, spinal cord injury, or radiculopathy, an MRI (magnetic resonance imaging) may be indicated. This is especially true if the symptoms surpass what should be expected from findings revealed by a standard radiograph. In cases of whiplash injury, it is wise to use MRI (magnetic resonance imaging) as standard procedure. This is especially true when the patient complains of symptoms specific to whiplash injury or if other investigation reveals significant findings.



Cons of MRI Scan. Cost. Although in cases of whiplash injury this is taken care of by the insurance company.
Neck injuries or whiplash from car accidents respond very well to chiropractic treatments.
A San Diego Chiropractic who specializes in treating whiplash patients, Andrew Mairs also offers SASTM (deep tissue massage) which is particularly helpful for older injures where scar tissue has formed, and Cold Laser Treatment which is particularly helpful for new injuries.
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