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Whiplash

Whiplash” is a common term that refers to a neck injury in which the neck is forced to move beyond its normal range of motion. The first place where this type of injury usually comes to mind is in a car accident, especially one in which the car has been rear-ended. Typically when this happens, a passenger’s head will forcibly snap backwards as the body is thrown forward. Then, in a recoil motion, the head may snap back forward. This severe backward and forward motion damages the neck muscles, specifically the soft tissues (muscles and ligaments) that support the head, neck, and jaw. The medical term that usually refers to this type of damage is extension- flexion injury.
To understand why “whiplash” may occur, consider the fact that the head weighs up to 15 pounds, which is equivalent to the weight of a bowling ball. When this “bowling ball” snaps backward, it creates 500- 600 pounds of force on the neck. This causes strain to all the structures surrounding and supporting the head and neck. In addition, women are more vulnerable to whiplash injuries than men because they have a smaller neck muscle size to head weight ratio.
To understand why “whiplash” may occur, consider the fact that the head weighs up to 15 pounds, which is equivalent to the weight of a bowling ball. When this “bowling ball” snaps backward, it creates 500- 600 pounds of force on the neck. This causes strain to all the structures surrounding and supporting the head and neck. In addition, women are more vulnerable to whiplash injuries than men because they have a smaller neck muscle size to head weight ratio.
Unfortunately, soft tissue injuries do not show up on x-rays, making it difficult to determine whether these structures have been damaged. Often times, a whiplash injury is not suspected until one or more of the following symptoms arise:

  • Neck pain, stiffness and decreased range of motion
  • Headaches
  • Numbness of the head and face
  • Blurry vision and pain behind the eyes
  • Problems with balance
  • Difficulty swallowing
  • Ringing in the ears
  • Jaw Pain
  • Difficulty chewing

These symptoms may not be felt for hours, days, or even months after an accident. Once symptoms do appear, however, they can be very painful and persistent.

WHIPLASH & TMJ
The head is supported by seven small bones, or vertebrae, that are collectively called the cervical spine. In between the vertebrae are pads of cartilage called discs, which act as cushions or shock absorbers during spinal movement. In order to keep the head properly balanced on top of the spine, multiple muscles of the jaw, neck, shoulders, and back are all involved. When the neck is forced to move beyond its normal range of motion, as in a whiplash, the muscles and ligaments may stretch and tear. The muscles that control the jaw may be affected, and an accident may even trigger a condition in which these muscles go into a spasm.

Specific clues of TMJ trauma or damage to supporting jaw muscles include:

  • Pain in, or around, the jaw joints
  • Clicking or popping of the jaw joints
  • Locking or limited opening of the mouth
  • Difficulty in bringing teeth together

TREATMENT
Because both patients and health care providers rarely suspect that the TMJ or jaw muscles have been damaged, this injury is often overlooked. When it is not recognized or treated in time, it can become a severe medical problem, the treatment for which may then unfortunately be denied by insurance companies. If the treatment of whiplash begins as soon as possible after an accident, it is beneficial to the patient health wise and financially. Many insurance companies have a 90-day window within which treatment will be covered.
Necessary management of such cases may include:

  • Orthopedic treatment
  • Physical therapy
  • Chiropractic treatment
  • Pain management
  • Evaluation by a dentist specially trained in TMJ/Facial Pain who may recommend some or all of the following:
  1. Trigger point injections
  2. Orthotic appliance (as opposed to a “night-guard”)
  3. Medication
  4. Specific TMJ exercises

Since whiplash injury is easier to treat the earlier it is suspected, it is important to keep it in mind when a patient has experienced “whiplash” trauma, like in the case of a car accident. Remember that symptoms may not manifest themselves immediately after an accident– it may take hours, days, or even months. If any of the above symptoms appear, worsen, or persist, please consult a healthcare professional who can determine an appropriate treatment plan.