Whiplash is a growing problem. Cars have become safer in that fewer people are dying in car accidents. That is thanks to modern engineering and safety features of cars such as airbags, reinforced doors, better pillar designs, ABS brakes, etc. Experts point out that whiplash injuries however, are on the rise.
Incidence of whiplash injury has climbed despite fewer deaths because the design of newer cars is based on making the car able to take a larger hit without requiring body shop repairs. This means that a crash at 8 mph that used to mangle a rear bumper now doesn’t even leave a scratch! That’s good right?
Yes and no.
It’s good for the auto insurers because they do not have to pay for an $800 rear bumper. It’s bad for the motorists because an 8 mph rear end collision could result in an $8,000 whiplash injury! How can that be?
Basic physics teaches us that any energy created by two cars colliding must go somewhere. Some is given off as heat and noise, but most goes directly to the car. If a cars bumper crumples, excess energy is being dissipated and less energy is passed through to the chassis and eventually into the occupant. If no crumple occurs though, ALL of the energy is transmitted to the chassis and then to the person in the vehicle.
Therefore more whiplash injures are being caused by our “safer” cars.
So how can you prevent or at least minimize whiplash?
There are two very simple adjustments you can make right now to your car that will make your car much safer and drastically lower your potential for a whiplash injury. Read about them here: Two Simple Things to Prevent Whiplash Injury
Most people think of massive head trauma when they think of a head injury or concussion in regards to a car accident, but the fact is most head injuries do not even involve a direct blow to the head.
Head Injury Definitions
Concussion is a temporary state of altered consciousness (woozy, dizzy, seeing stars) but no loss of consciousness after a blow to the head or a rapid acceleration of the head, that usually resolves within a matter of weeks uncomplicated.
Post-Concussion Syndrome (PCS) is a concussion with symptoms lasting 3 mos or longer. (Some experts say 3 weeks, but by strict medical disability standards, 3 mos is the period of time required to consider a condition chronic)
Mild Traumatic Brain Injury (MTBI) is a loss of consciousness lasting 30 mins or less with or without amnesia due to a head trauma that has a Glasgow Coma scale score of 13-15.
Head Injuries: Direct and Indirect Trauma
Direct head trauma involves the head striking an object such as an airbag, the head restraint, door, window frame, sunroof frame, another occupant, etc. It is easy to see how a direct force to the head can create an injury to the brain.
Indirect trauma involves the brain being injured inside the skull vault by being quickly jolted front to back or side to side, but no frank direct trauma to the outer head. Three theories explain this mechanism: first, the brain is physically damaged by bouncing on the inner skull vault, second, the ligaments that tether the brain in the skull vault are overstretched by inertia and pulls on the tissue where it is affixed to the brain and third, the fluid nature of the brain causes a tidal wave like effect within the brain on impact causing damage to the brain tissue.
Real life examples of these head injuries:
You’re driving in the parking lot and a car suddenly pulls out in front of you and you cannot avoid it and hit them. Your head is jolted forward quickly. You see stars and feel a little woozy, but do not lose consciousness. You develop a headache that continues off and on for several days. Eventually, 2 weeks later you feel back to normal. This is a classic concussion.
You’re rear-ended in your car. You recall smacking your head on the head restraint and you immediately feel head pain and dizziness. Later you develop nausea and a stiff neck. Over the next few days your spouse notices you are spacing out and can’t concentrate well. You have trouble remembering things at work. You feel more emotional than usual and feel anger easily. After several months of treatment, your neck is better, but you occasionally have headaches and at stressful times you cant think as fast as usual. This is an example of post-concussion syndrome (PCS)
Mild Traumatic Brain Injury
You’re walking in the mall and slip on water spilled on the tile and strike your head. Observers say you were unconscious for a minute or so before you were revived. You are taken to the hospital and have a CT scan (which is normal) and an examination. The ER doctor completes a form called the GCS and you score a 14. This is an illustration of a MTBI.
Of all these injuries, a concussion following a rear-impact car accident is the most common. Many accident victims do not even realize they have suffered a head injury because the symptoms may be very subtle and your doctor may miss the signs. Lingering headaches and loss of mental acuity after a car accident concussion is fairly common, but may not be diagnosed as PCS because non-specialist doctors do not recognize the symptoms as brain related and instead attribute the headaches to a neck or muscle problem.
Proper Diagnosis of Head Injuries
After a car accident, your doctor should have you complete specialized questionnaires designed to uncover head injuries. If it’s an acute injury, the Glasgow Coma Scale (GCS) and/or Acute Concussion Evaluation (ACE) forms are the most common. If you were injured 1 week or longer prior to the exam, a Post-Concussion Syndrome Symptoms form is a commonly used tool.
Your doctor must then perform a specialized brain examination to uncover objective signs of brain malfunction.The exam will involve checking your reflexes, ability to sense light touch, pain and vibration stimuli, coordination of hands and feet and walking, eye movements and more.
After a comparison of the questionnaire and examination data, your doctor will then determine what type of injury you have suffered and order more tests if needed or set a plan for treatment.
If you’ve suffered a car accident, with or without actual force to the head and with or without headache, you must be evaluated properly.
The Fourth of July is a time honored celebration of the history of our great nation. It is also the busiest travel holiday of the summer season. A weekend that is looked forward to for many Americans to get away and enjoy the outdoors.
Unfortunately, much of the revelry involves alcohol and since it is a heavily traveled weekend, that means more impaired drivers than usual. The National Highway Safety Administration (NHTSA) reports that the 4th of July weekend accounts for more traffic deaths than any other holiday–more than New Years day in most years. More than half of the fatalities are alcohol related.
The NHTSA also reports that most deaths occur on 2-lane roads and at night.
For far too many Americans, this 4th of July may be their last.
Avoid becoming a tragic statistic. Take these simple steps to to stay safe on the road this 4th of July:
Be responsible, don’t drive if you’ve been drinking. Have a designated driver who has not imbibed.
Stay off the roads between midnight and 3 am; this is when the majority of drunk drivers are on the road.
Be alert; most drunk drivers cause accidents by running head on into people by crossing lanes or running red lights. Watch the road ahead for cars that are swerving, and at intersections look carefully when your light turns green for any cross traffic that might be ignoring their red light before entering the intersection.
If your car stalls or is broken down, call for assistance and get out of the car and walk as far up an embankment as possible away from the car. Impaired drivers are attracted to tail lights and blinkers and have a tendency to crash into cars on the shoulder. Police cars are often struck while stopped to assist (ticket?!) motorists.
Avoid breaking down on the road; temperatures are hot in July, especially this year, so before you leave make sure your oil and coolant are properly filled, that your tires are inflated to specs and you have plenty of gas. On a busy travel holiday, you may find yourself stuck in bumper to bumper traffic on a very hot day, so avoid problems by doing a little vehicle preventive maintenance.
On the freeway, stay in the center lane; it gives you the most options for maneuvering should an accident occur in front of you. The far left and right lanes have more trouble and less options.
Keep these tips in mind while embarking on your 4th of July holiday and have a safe celebration.
SELECTED POST-GRADUATE EDUCATION, CERTIFICATIONS AND DIPLOMATES
Assessing Medical Fitness to Return to Work, Essential fitness to work definitions such as impairment or restrictions, disability, functional capacity examinations, systematic approach to fitness to work assessments using the American Medical Association publication Guides to the Evaluation of Work Ability and Return to Work and the American College of Occupational and Environmental Medicine (ACOEM) guidelines, Harvard Medical School, Department of Continuing Education, 2013
Personal Injury, History taking, physical examination, diagnosing and proper documentation of auto accident injuries. International Chiropractic Association of California, Irvine, California, 2012
Personal Injury Update, Latest medical research and legislative changes affecting the care of personal injury patients. International Chiropractic Association of California, Irvine, California, 2011
Corrective Exercises for Common Injuries, Active and passive exercises for spine and extremity injuries after trauma. Innercalm Associates, Burbank, California, 2010
11th Annual SRISD Scientific Conference, A review of important new literature and research in whiplash and brain injury from automobile collisions from the past year. Spine Research Institute of San Diego, Coronado, California, 2009
Clinical Mastery of the Cold Laser, Understanding the fundamentals and characteristics of laser physics and the biological basis of low level laser light therapy. This course demonstrated the implementation of laser as a pain management tool and to achieve treatment goals of stabilization of the injured area, improvement of range of motion,
increase muscle strength/endurance/flexibility, and reduction of inflammation Erchonia, Inc Clinical Seminars, Newport Beach, California, 2007
Pediatric Radiology & Infant Physical Examination of the Spine & Extremities, Normal pediatric spine and extremity radiography, common pathologies of the pediatric spine and extremities. Palmer Institute for Professional Advancement, Anaheim, California, 2005
Advanced Certification of Competency Whiplash and Brain Injury Traumatology, Science-based training program designed to provide treating physicians with the critical tools they need to successfully manage victims of motor vehicle trauma in order to achieve optimal clinical outcomes. Spine Research Institute of San Diego, Coronado, California, 2004
Whiplash and Brain Injury Traumatology Program, Module 4, Foundations for successful outcome in medicolegal cases. Preparing for depositions, arbitration, and court. Use of demonstrative evidence. Learn to avoid pitfalls, take advantage of your opponent’s weaknesses, and gain total confidence in all medicolegal proceedings. Spine Research Institute of San Diego, Newport Beach, California, 2004
Whiplash and Brain Injury Traumatology Program, Module 3, Critical documentation from day 1; What every personal injury and forensic expert needs to know, the fundamental of expository, scientific writing you were never taught; common dos and don’ts, the essential craft of narrative report preparation from A-Z; style, strategy, methods, organization, and common pitfalls, incorporating outcomes assessment and disability instruments into your reports (SCL-90-R, Oswestry, Roland-Morris, Rivermead PCS, and more), the application of AMA guidelines in personal injury and forensic practice, modern guidelines and best practices (Presley Reed, Mercy, QTF, ACOEM, Croft); how they are commonly abused and how and when to use them correctly Spine Research Institute of San Diego, Newport Beach, California, 2004
Whiplash and Brain Injury Traumatology Program, Module 2, In-depth training on all aspects of management of trauma, from beginning to end; a comprehensive primer on crash reconstruction. Auto crash reconstruction in low speed crashes: critical knowledge for today’s forensic practitioners, historical documentation in personal injury and forensic medicine applications, comprehensive physical examination of whiplash and traumatic brain injury, special laboratory methods, such as the S-100 protein, the latest techniques, special diagnostic imaging modalities (SPECT, PET, MRI, MRA, VF, etc.); how and when to use, electro diagnostics (EMG, SEMG, SSEP, VEP, ETC…); how to use, rendering a diagnosis/impression in the personal injury or forensic setting; pearls and pitfalls, soft tissue healing times and implications for successful case management. The state of the injury and implications for case management: designing a treatment plan and living with guidelines, important applications of activities of daily living; optimizing outcomes, chiropractic manipulation, deep tissue massage, and PT Modalities for best outcomes. Spine Research Institute of San Diego, Newport Beach, California, 2004
Whiplash and Brain Injury Traumatology Program, Module 1, Requisite and comprehensive biomechanics knowledge for forensic experts Whiplash and brain injuries: the real reasons they are on the rise, the minimal property damage = minimal injury risk myth exposed, In-depth analysis of brain, neck, and cervical spine trauma mechanisms, soft tissue injuries: a comprehensive and cutting edge analysis, all clinical syndromes and conditions resulting from Whiplash (WAD/CAD), forensic experts need to know about the various pain syndromes risk assessment: the fundamental key to modern forensic practice.. Spine Research Institute of San Diego, Newport Beach, California, 2004
Practice Guidelines Workshop Understanding and applying the American College of Occupational & Environmental Medicine Occupational Medicine guidelines to injured workers. Palmer Institute for Professional Advancement, Irvine, California, 2004
9th Annual SRISD Scientific Conference, A review of important new literature and research in whiplash and brain injury from automobile collisions from the past year. Spine Research Institute of San Diego, Coronado, California, 2004
Physical Diagnosis Online Clinical Lectures, Patient interviewing, acquiring a medical data base, and performing a comprehensive physical examination. University Health Sciences Antigua, School of Medicine, St. John’s, Antigua, 2003
Physical Diagnosis 72 Hours Clinical Internship, Performed triage, history taking, physical examination, rendered diagnoses and created treatment plans for urgent care patients as part of Physical Diagnosis online course, Southland Family Urgent Care, Mission Viejo, CA July – August 2003. University Health Sciences Antigua, School of Medicine, St. John’s, Antigua, 2003
Pathology Online Clinical Lectures, Correlation of the clinical and anatomical manifestations of systemic pathologies. University Health Sciences Antigua, School of Medicine, St. John’s Antigua, California, 2003
Pharmacology Online Clinical Lectures, Pharmacological principles and the therapeutic and toxic actions of important drugs and poisons, principles of drug absorption, metabolism and pharmacodynamics, drug-drug interaction, and drug interactions with diet. University Health Sciences Antigua, School of Medicine, St. John’s, Antigua, 2003
New Era in Whiplash & Spinal Trauma, The Literature with respect to duration of pain, natural history of tissue healing, functional recovery rate and probability of chronic pain syndrome from motor vehicle soft tissue trauma. The literature and principles of hyperextension soft tissue trauma with respect to myofascial pain syndromes, articular dysfunctions, and myofascial pain syndromes, the treatment of chronic and/or disabling spine pain with spinal manipulative therapy. Life College of Chiropractic/ International Chiropractic Association, Irvine, California, 2001
Whiplash & Spinal Trauma II, The literature as to the tissue source of chronic back and neck pain, and how they relate to motor vehicle collisions, the body response to tissue trauma, tissue differentiation, types and quality of tissue healing; principles of healing by regeneration, repair and fibrosis. The role of chiropractic adjustments in accelerating tissue healing, restoration of motion, improved joint mechanics and higher quality scar tissue. The referred pain syndrome of spinal pain and its clinical presentation, the principles of the double crush syndrome as it relates to spinal trauma. Life College of Chiropractic/International Chiropractic Association, Anaheim, California, 1999
Whiplash & Spinal Trauma I, The principles of inertia, acceleration, velocity, mass and friction as they relate to spinal trauma and motor vehicle collisions. Specific aspects of hyperextension injury and the tissue injuries sustained, aspects of rebound flexion injury and the tissue injuries sustained. The neuroanatomy of the intervertebral disc and facet articulations, the effects of osseous adjusting on the pain afferents and mechanoreceptors of the intervertebral disc and facet articulations Life College of Chiropractic/ International Chiropractic Association, Irvine, California, 1999
Medico-Legal Preparation: Auto Injury Mechanics, Comprehensive record keeping and reporting for whiplash, spinal trauma and soft tissue injury cases. Protocols of testing for spinal evaluations and documenting “medical necessity,” including the Mercy Conference Document. Life College of Chiropractic/ International Chiropractic Association, Buena Park, California, 1999
Chiropractic Orthopedic Assessment and Treatment, Physical examination and diagnostic imaging of common spine and extremity bone, joint, muscle, tendon, ligament and disc disorders and injuries. Cleveland Chiropractic College, Riverside, California, 1998
Automobile Accident Reconstruction, Physics involved in the transference of energy from the bullet car to the target car including G’s of force, Newton’s, gravity, skid marks, crumple zones, spring factors, and event data recorders. Determining the clinical correlation of forces and bodily injury. California Chiropractic Association, Irvine, California, 1997
Certification in Industrial Disability Evaluator, Medical/Legal Consultants Association, San Diego, California, 1996
Certification as an Industrial Disability Evaluator, International Chiropractic Association, Irvine, California, 1995
Certification as an Industrial Disability Evaluator, International Chiropractic Association, Irvine, California, 1994
Certification as an Industrial Disability Evaluator, International Chiropractic Association, Irvine, California, 1993
Qualified Medical Evaluator, State of California, Industrial Medical Council, Los Angeles, California, 1992
Board Eligible, Chiropractic Orthopedist, Los Angeles College of Chiropractic Post Graduate School – Department of Orthopedics, Whittier, California, 1986-1989
Certification in Applied Spinal Disability/Spinal Impairment Rating Proficiency, LACC Post Graduate School – Department of Orthopedics, San Diego, California, 1987
Certification in Supervising and Operating Radiology Equipment, State of California, Department of Health Services, Radiological Branch, Sacramento, California, 1986
The CDC recently announced some startling facts about painkillers. Facts that car accident victims, their lawyers and doctors might want to heed.
After a car accident, it’s common practice for medical doctors to prescribe painkillers and muscle relaxers to ease the pain of whiplash. Giving a car accident victim a trinity of an Anti-inflammatory, a Painkiller and a Muscle relaxer is done without an eyebrow being raised. But is this approach effective? Is it safe? If it has risks, are the benefits worth the risk?
Effectiveness of painkillers and muscle relaxers for car accident whiplash injuries has recently been debated. The Cochrane Group found in a 2007 study that little evidence shows that these drugs are effective for the treatment of mechanical neck pain. The topic of Medications for Treatment of Whiplash was earlier covered in this post.
Regarding safety, plenty of evidence suggests that the U.S. has a prescription drug problem. More people are taking more drugs than ever, and many of the drugs prescribed for pain are highly addictive. But abuse is not the only concern regarding these drugs.
The actual safety of these drugs has been called into question. The Centers for Disease Control (CDC) recently reported that more people die from overdosing on painkillers than from heroine and cocaine combined. They also report that 103,000 hospitalizations occur every year due to non-steroidal anti-inflammatory use. An estimated 16,500 deaths occur, that’s more than from AIDS or cervical cancer. So what color ribbon should we wear for the awareness of deaths caused by simple anti-inflammatories? The point is, all drugs, even innocuous drugs like over the counter pain relievers have risks.
Another problem encountered in practice is when patients drive cars, operate machinery and go to work while taking muscle relaxers and painkillers. Doctors prescribe these medications all the time, but obviously do not heed the warnings on the label not to operate machinery while taking them. A dose of either of these medications is similar to having a few drinks. You are intoxicated and liable for DUI if caught driving. Use complicated or dangerous machines at work? How can you safely operate them if you’re intoxicated?
Therefore, the risks of addiction, harmful side effects and being impaired in driving and work must be weighed carefully before taking or dispensing these medications. If a patient has a predilection to substance abuse, narcotics should not be given. If someone has gastric problems, they should not be given anti-inflammatories. If someone is not being taken off of work or admonished not to drive, then painkillers and muscle relaxants should be reserved for at home use only.
Safe and Effective Alternative Car Accident Treatment?
Chiropractic has been shown in many reputable scientific papers to be an effective form of treatment for whiplash injuries.* One of the most important aspects of the success of chiropractic treatment is that it is a mechanical treatment for a mechanical disorder. A car accident whiplash injury involves mechanical, physical damage as well as functional loss. Chiropractic and it’s associated therapies provide mechanical treatments that help heal and rebuild structural damage and provides return of lost function. Learn more about Treatment After a Car Accidenthere
What Personal Injury Lawyers Need to Know About Low Speed Accidents
Low Speed Car Accidents and Bodily Injury
Dr Barry Marks, Chiropractor
The speed at which accident victims may be injured in rear-impact car crashes is amazingly low.
Recent research articles have shown that the human threshold for neck injuries in a rear-impact automobile collision is only 2.5 mph. For years the personal injury field has used 5 mph as a consensus figure for injuries. Brault, et al has shown that the 5 mph figure was indeed double the actual figure. Others have shown that slow speed collisions actually cause more injury than collisions with more vehicle damage.
Plaintiff personal injury attorneys interested in using citable scientific evidence to overcome defense arguments of “no cash, no crash.”
Most people understand that whiplash is a neck injury from trauma such as a car crash accident, but there are many facts about whiplash that might surprise you.
Many people are unaware that you can be injured in a slow speed car crash, especially when there is no vehicle damage. And did you know that your gender makes a huge difference in whether or not you’re going to be injured in a car accident? Other factors like being aware of the impact, the angle of the impact and where you were looking on impact all play a crucial part in determining if and how bad you will be injured in a car crash accident.
When we hear the term headache, we don’t usually think about the neck. Rather, we focus on the head, more specifically, “…what part of the head hurts?” But, upon careful questioning of patients, we usually find some connection or correlation between neck pain and headaches.
Sadly, millions of Americans suffer chronic, sometimes debilitating headaches that re the result of old car accident whiplash injuries. Even more sad is the fact that many of these headache sufferers have no clue why their heads hurt. And because of that they try unsuccessful treatments.
When a person is involved in a car accident, the inevitable question comes up: should I see a doctor? In most cases the answer is yes. But why is this important? And shouldn’t you wait several days to see if the pain will go away?
The short answer is you should see a car accident injury specialist within the first 72 hours (3 days) following a car accident.