Comprehensive Treatment Approach
Several spinal structures are prone to damage in a whiplash injury. Most commonly the trauma involves the spinal joints, associated ligaments and musculature, and the intervertebral discs. Diagnosis of a spinal joint injury is difficult and sometimes not detected by standard orthopedic testing. Specialized digital x-rays and a detailed hands-on evaluation by an experienced practitioner is the most effective ways to detect spinal joint trauma. Our clinic provides evaluation and treatment that accounts for all of the injured tissues, ensuring patients have the best opportunity to fully recovery.
Injury to the ligamentous structures of the spine are among the most common injuries when someone is in pain following an automobile related trauma. The following information is intended to assist your understanding of how ligament injuries should be treated:
Ligaments consist of fibrous connective tissues and work to connect and hold our bones together. Their job is to provide stability to the joints. Under a microscope, the fibers of a ligament are very organized. These fibers run parallel to one another thereby providing strength in a single direction (Figure 1).
Figure 1: Parallel fibers provide strength primarily in one direction
When a joint is strained in an automobile accident the ligaments are stretched beyond normal anatomical limits causing microscopic (small) tears in the parallel fibers (Figure 2).
Figure 2: The injury causes micro tears in the ligament
When ligaments are not properly addressed with treatment, they heal with unorganized tissue called scar tissue. Scar tissue has fibers running in random directions and is weaker, less elastic and easily torn during normal functional loads (Figure 3). When an injured ligament heals with a large percentage of scar tissue a person is much more susceptible to ongoing and recurring aggravations and pain. A large number of people who suffer a neck injury and opt to not receive treatment never fully heal and continue to have episodes of pain. This pain is due to healing with lots of scar tissue.
Figure 3: Improper healing with a visible fibrous scar tissue matrix
When controlled demands are placed on the ligaments during the healing process, scar formation reduces significantly. This process is known as functional healing. Functional healing reduces scar formation and promotes the regeneration of stronger, more organized ligamentous tissue following an injury (Figure 4). With functional healing, the ligament is more normal in appearance and functions more like a healthy ligament. Risk of ongoing pain and re-injury is reduced.