If you've been in a motor vehicle accident, most automobile insurance covers 100% of your chiropractic care, and you may also be entitled to compensation for your pain and suffering.

Most Americans will be involved in at least one motor vehicle accident at some time in their life. Injuries that result from a motor vehicle accident are often misunderstood. Frequently, the pain or other symptoms of the injury are not apparent at the time of the accident. In fact, some injuries are hidden so well they may be missed by emergency room technicians and can take weeks, months and even years before actual symptoms appear.

The term "whiplash" is commonly associated with rear-end auto accidents. It conjures up a variety of reactions in different people. A large percentage think that these accident victims over emphasize their condition to profit from what may seem a trivial accident.

The term "whiplash" is not a diagnosis of a condition or description of an injury; it refers to the injury's mechanism. An example of proper terminology is cervical hyperextension/hyperflexion sprain and/or strain of whiplash dynamics. Hyperextension means that the head and neck are bent backward beyond their normal range of movement; hyperflexion means that the head and neck are bent forward beyond the normal range of motion.

The amount of damage to the vehicle does not depict the amount of injury sustained by the victim. Studies indicate that injuries can occur at impact speeds of 10 mph where there is little or even no damage to the car. Today's vehicles absorb much of the impact in the bumper, but transmit this energy from the impact to the person's head and neck. This can eventually cause pain and stiffness possibly leading to arthritic changes in the spine.

If you or anyone you know has been involved in a motor vehicle accident it makes good sense to have your spine examined for possible misaligned vertebrae causing pinched or irritated nerves.

Sherman Chiropractic has been successfully treating patients who have sustained injuries in auto accidents. Please do not hesitate to contact us for a consultation at (818) 888-8058.

PATHOMECHANICS OF WHIPLASH

There is a dilemma in the mechanism of the Cervical Acceleration-Deceleration Syndrome: Why (in many cases) is the damage to the vehicle not proportional to the injury experienced by the passengers? Recent research has demonstrated that high impact forces are transmitted directly to the passengers involved in low speed impacts. Vehicles are designed not to compress until the speed of impact exceeds 15-20 miles per hour. A 10-mile per hour impact can produce a total collapse of only 2.5 inches in the case of a rear end collision. This relative non-compressive force is then transmitted to the passenger with resultant high acceleration and deceleration forces. Therefore, the important question to ask is not, "What is the damage to the vehicle?" Rather, you should ascertain, "What was the change in acceleration induced to the victim's vehicle when it was struck?"

It is well known that it is the change in acceleration of the passengers, which causes the injury due to shearing forces.

Some important information to obtain includes:

What were the road conditions?
Was the injured passenger using a shoulder-lap belt?
Was the vehicle moving or stopped upon impact?
Which seat was the injured passenger occupying?
Was the victim aware of the impending crash?
Did the victim brace before the crash?
Was the victim male or female?
What position was the headrest in?
Was the impact at an angle?

SOME COMMON AND OVERLOOKED CAUSALLY RELATED SYMPTOMS

It is not unusual for symptoms to occur which may not commonly be associated with the injuries sustained in a motor vehicle accident. If not asked about these, patients will often not associate them with the accident and consequently ignore the symptoms or not mention them to the attending physician. You may wish to ask your clients if they have experienced any of the following symptoms after their accident:

Muscle Pain
Paresthesia (Altered sensation or numbness)
Headache and Occipital Neuralgia
Pseudoangina
Eye and Vision Problems
Ear and Balance Problems
Dysphagia (Throat Problems)
Breathing Difficulties
Bad Dreams
Difficulty Concentrating
Forgetfulness
Digestive Problems.

IS PRE-EXISTING A PROBLEM?

Trauma imposed upon a spine that has pre-existing disc degenerative changes will find the soft tissue structures of the involved motor unit less capable of tolerating and dispersing the traumatic forces. Therefore, injury will be greater! However, even though there may be a pre-existing condition, if the accident causes additional medical impairment or damage, it is the accident that is responsible. Treatment should be directed toward bringing the patient as close to pre-injury status as possible.

Trauma imposed upon a normal spine is adequately managed by the elastic discs, the resilient ligaments, elastic capsule tissues, and openings for nerves and blood vessels, as there is an innate margin of safety. Trauma to a degenerated spine finds less compressibility, less resilience, and narrowing of the foramen and therefore there is less of margin of safety.

WHIPLASH NECK INJURIES

According to V. H. Frankel in his paper on the Pathomechanics of Whiplash Injuries of the Neck, a deceleration injury is a traumatic incident. Characteristics usually include a rear-end collision while the driver or passenger is waiting for a red light to change. Other very typical aspects are that most accidents occur in the morning and are less than 15 miles per hour in speed. Usually after the car is hit, there is a lag period before the neck of the victim hyper-extends and then with the recoil of the seat a second hyperextension occurs. If restraints are not used, the head may undergo direct impact of some part of the vehicle.

COGNITIVE DEFECTS

Dr. Arthur Croft describes this phenomenon of the Whiplash injury that is often ignored. This disorder may occur concurrently with the Post Concussive Syndrome. He reports that he has suspected mendacity or at least embellishment of some physical and psychological complaints.

After Dr. Croft was involved in an accident, he discovered that his complaints included headaches, fatigue, serious memory and concentration problems, insomnia, and several other of the myriad of symptoms commonly seen in Post Concussive Syndrome.

Since most physicians are reluctant to ascribe much significance to such symptoms, there is little reference to this medical issue in the literature. Three new studies have validated this aspect of whiplash injury. Radanov et al. studied 51 patients injured by cervical hyperextension and found two distinct syndromes arose: 1-The Cervicoencephalic Syndrome in which there were headaches, fatigue, poor concentration, disturbed accommodation and impaired adaptation to light. 2-The Lower Cervical Spine Syndrome that is primarily composed of neck and upper extremity pain.

In a related study, Radanov et al. found that long term cognitive function is impaired in 32% of the cases, particularly in the older patients. In related studies Bohnen et al. reported information processing problems and memory problems.

It is important to remember that symptoms of Whiplash and the Post Concussive Syndrome may be similar to those of the Chronic Pain Syndrome. A distinguishing feature of PCS is that it occurs almost immediately after trauma.

If the PCS does occur, a referral to a neuropsychologist or a psychologist who specializes in trauma may prove very beneficial to the patient. If there is a permanent psychological impairment as a result of the injury, the psychologist may render an impairment rating and prognosis for future medical/psychological treatment and needs.

WHAT TO EXPECT OF THE DOCTOR:
FIRST ATTENDING PHYSICIAN'S REPORT DONE IMMEDIATELY
ALL BILLS SENT TO THE ATTORNEY ON A REGULAR BASIS
A DETAILED MEDICAL HISTORY OF THE ACCIDENT AND HOW ACTIVITIES OF DAILY LIVING ARE AFFECTED
DAILY OFFICE NOTES SENT REGULARLY TO THE ATTORNEY
PROGRESS REPORTS SENT AT LEAST MONTHLY
FINAL NARRATIVE REPORT SENT EXPEDITIOUSLY