Whiplash / Cervical Sprain

The cervical sprain resulting from whiplash is one of the injuries that occurs most frequently in minor or moderate traffic accidents, although other sources of injury such as sports or workplace injuries are known. When the cervical spine makes a sudden motion to the back (hyperextension) and then a sudden motion to the front (hyperflexion), there is great stretching and compression of the muscles, ligaments, and sometimes also the bones and nerves of the cervical spine. This causes acute pain from soft tissue injury including muscles, tendons and ligaments, bringing about neck stiffness, fatigue, and range of motion restriction.

There are four main distinguishing symptoms of whiplash:

1. Cognitive Fatigue: confusion, disorientation, memory loss, low responsiveness to external stimuli, diminished capacity for mental tasks
2. Vestibulo-ocular: altered balance and visual acuity, light sensitivity, symptom provocation with tests, possible cranial nerve affected, vomiting
3. Mood: anxiety, agitation, sadness, depression, irritability, emotional swings, and poor sleep.
4. Headache: head, neck, and shoulder pain and stiffness, restricted motion, TMJ tenderness, local myospasm.

There are correspondingly three grades of concussion which are commonly used in a clinical setting:

Grade 1: no loss of consciousness, other symptoms resolve in less than 15 minutes
Grade 2: no loss of consciousness, other symptoms take more than 15 minutes to resolve
Grade 3: any loss of consciousness (seconds or minutes), other symptoms take more than 15 minutes to resolve

Treatment of cervical strain by a Traditional Korean Medicine practitioner will consist of a personalized treatment plan, including but not limited to the following modalities.

• Acupuncture to relieve muscular tension, release knots, and improve functioning and strength
• Herbal medicine to restore the correct functioning of the body’s balancing and proprioceptive capacity, as well as reducing pain and tension
• Diet and lifestyle modifications to maximize the body’s healing capacity and minimize any stress that results from the recovery process

Treatment Case: 58 years old male

   This patient sought treatment after suffering neck pain, dizziness, stiffness, and limited range of motion after a recent car accident. He was diagnosed as having whiplash-associated disorder (WAD) Grade II (pain and limited movement without neurological symptoms. In terms of history, the patient has a history of mild osteoarthritis in the cervical spine, with no previous whiplash or major neck injuries. Prior to the injury, he maintained an active lifestyle, regularly walking and performing light cardio exercises.
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   The patient reported moderate to severe pain (7/10 on the pain scale) localized around the neck and upper shoulder area. Other than stiffness, there was also limited range of motion, occasional headaches, and tenderness in the trapezius muscles. Treatment was done according to the IMEAST (Intramuscular Electroacupuncture Stimulation Treatment), whereby the muscles responsible for the musculoskeletal dysfunction are targeted and treated. Furthermore, some range-of-motion exercises as well as exercises aimed at resolving dizziness and vertigo-like symptoms were prescribed. Treatments were done biweekly for a total of 5 weeks.
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   After the second week, the patient reported a reduced pain intensity of 5 out of 10, with some improved comfort in doing daily activities. After the 4th week, the patient reported a pain intensity of only 3 out of 10, and noticed that he got less headaches and felt less dizzy as well. After the 5th week, he continued to report his improvement. While his history meant that neck pain would never be completely resolved, he felt well enough to resume most of his previous daily activities. Therefore he was discharged and prescribed maintenance exercises and stretches.