Does anybody know about the condition I have - Chronic Whiplash Syndrome?

“Whiplash” describes a forward/backward stress on the neck usually associated with low speed motor vehicle accidents. Problems such as neck pain, headache and dizziness persisting after a whiplash type injury are called ”Whiplash Associated Disorders”.
 
The good news for anyone suffering from a whiplash type injury is that over eighty percent of people suffering this type of trauma are better within six weeks. Many others are back to relatively normal after three months. While the acute injured tissues heal in this period, sometimes symptoms persist in a small number of people.
 
The current concept, which may be a bit tricky to understand initially, is that the brain PERCEIVES that the tissues are still injured. Your brain also causes your body to develop “maladaptive postures and movement patterns” to try to avoid pain. These can change. Your past life experiences, previous pain problems and your emotional response to persisting pain all influence how you feel. Your brain can learn how to perceive pain differently.

Recent high quality Australian physiotherapy research has identified some of the factors involved in this persistence of symptoms. While your brain has caused maladaptive postures and movement patterns and is misinterpreting the importance of pain as a sign of injury you can get better.

We know that:

• Every person has a unique story and individual response to what has happened
  
• Multiple factors influence how you perceive pain. These include your age, gender previous neck trauma and your family, work and social circumstances
  
• The brain has a big part to play in the persistence of symptoms
  
• It is never too late to undo brain patterns that have been set
  

•  Residual faults in your posture and movement patterns that are increasing the load on your tissues and adding to your pain.
  
• problems with your ability to know where your head is in space (feeling dizzy) and problems with your brain/tissue circuits (hypersensitivity to touch and movement )
  

Hi, 

I agree with Helen.  I would also like to mention that in a whiplash injury the membranes surrounding the brain and spinal cord are also injured.  Symptoms may persist into a chronic whiplash injury due to strains and stresses on these membranes.

The brain is surrounded by membranes that continue down the spinal column surrounding and supporting the spinal cord with a three layered membrane known as the “meningies” this membrane has attachments in different segments in the upper neck (C2) and the lower back in the sacral/ coccyx area.

When a whiplash injury occurs there can be evidence of strain patterns not only in the neck, but also in the coccyx region as well.  It is really important that the coccyx and lower back is taken into consideration with whiplash injuries as they play a crucial part in the strain pattern of these membrane attachments and can anchor strain patterns in the neck if they are not addressed.

Are you experiencing any lower back pain?  
What symptoms specifically are you experiencing?
When was the accident?
What treatment have you sought?

I also agree with Helen.

The key is that Whiplash Syndrome is really a generic label to describe a method for injuring your neck, and like any syndrome is just a collection of symptoms and not a useful and meaningful diagnosis.

I frequently see patients like you and they have a disc problem from the accident that is not accurately diagnosed. When this disc bulges and compresses the nerve behind this causes the tingling/aching/weakness in the arms. 

I would seek a specific Assessment as your problem may be rapidly amenable to the correct treatment even though it is chronic in nature.

As Allison mentioned your lower back could also be affected and contributing to the neck (the link is hard to understand but lower back problems can frequently affect the neck, and as a McKenzie Physiotherapist I know this as treating the lower back will frequently clear up the seemingly separate neck problem).

I am biased (like all of us health professionals) in my particular field, as I feel a McKenzie practitioner could very likely help you, or at worst see you no more than 3-4 times to determine if you will respond (eg. you will not have to test it for 3-4 weeks to know if it will sort your particular issue out). 

www.mckenziemdt.org.au is the mckenzie website that can help you locate a suitable practitioner near where you live. The McKenzie method is safe, evidence based and in 30 countries in the world. The website is an international one, and has a therapist locator link that is both country and state specific.

Chronic whiplash
Chronic whiplash has many factors which medical professionals need to be aware of - specific restrictions and dysfunctions within the cervical, thoracic (and lumbar) spine, motor control of cervical and thoracic spine as well as how well the individual processes peripheral and central pain sensations (how the brain interprets/ perceives pain). We all have unique experiences that influence how we interpret and respond to pain sensations… this can be a whole topic in itself!!
 
The mechanism of ‘whiplash’ is undoubtedly important in the development of acute and chronic whiplash symptoms – high-velocity hyperflexion then hyperextension, hyper-lateral flexion to one side then the other or combination of all movements of the cervical/ thoracic/ lumbar spine.
 
The person with chronic whiplash often reports neck pain, dizziness, concentration difficulties, headaches and fatigue (amongst other symptoms).  
 
The following is meant to be a guide only. As we are all unique individuals, assessment and management with appropriately trained and skilled health care professionals is advised. Below is a guide as to suggested management approaches for different stages of whiplash.
 
Acute (initial 2-3 weeks) whiplash symptoms can be contributed to by:

• Local joint and muscle restrictions in the cervical, thoracic (and lumbar spine)
  
• Sensitisation of the nervous system (peripheral more so than central –some evidence suggests central sensitisation can start as early as 7 days after the accident!)
  

• Assessment with a general practitioner for appropriate medications (as needed) and referral to a reputable physiotherapist/ osteopath
  
• Provision of a SPECIFIC TO YOU home exercise program by a physiotherapist which promotes increased cervical/ thoracic movement and decreased pain – improvement should be seen within 3-4 sessions!
  
• Local manual therapy to the cervical, thoracic spine and muscles that promotes increased cervical and thoracic movement – techniques must not increase pain! This should be a minor aspect of management.
  

• Persistent local joint and muscle restrictions in the cervical, thoracic and lumbar spine. During the acute stage, if provided with (and performed regularly) the correct SPECIFIC TO YOU exercise program, restrictions should be minimal!
  
• Sensitisation of the nervous system (more so central sensitisation)
  
• Reduced coping with pain strategies (especially if symptoms are not improving)
  

• Continued general practitioner and physiotherapist consultation
  
• Provision of a SPECIFIC TO YOU home exercise program by a physiotherapist which promotes cervical/ thoracic movement control (for stability and endurance) and cardiovascular exercise
  
• Referral to a psychologist specialised in pain management for assistance with development of coping strategies (if needed)
  

• Sensitisation of the nervous system (central sensitisation)
  
• Reduced coping strategies (especially if symptoms are not improving)
  

• Continued general practitioner and physiotherapist consultation
  
• Provision of a SPECIFIC TO YOU home exercise program by a physiotherapist which promotes cervical/ thoracic movement control (for stability and endurance) and cardiovascular exercise
  
• Referral to a psychologist specialised in pain management for assistance with development of coping strategies (if needed)
  

I think Helen's last comment is most important.
See a specialised health professional and if you are not getting anywhere within 3-4 sessions you are not likely being led down the best solution to your problem.
The thing that dissapoints me most about fellow health professionals (and certainly this is not all of them!!) is that many are happy to continue to treat people for months at a time without seeing anything better than a short lived change in the treatment room.
I am amazed when I see people who end up being fixed after 3 sessions with me or my staff that have seen another health professional for months and sometimes years without results.
It is important for practitioners to recognize when they are not making significant change or feel that a particular patient is outside their particular skill-set. These patients are often so happy just to be referred towards a resolution, even if the particular practioner themselves is unable to significantly help them .

Hello

I have the same problem.  Would you mind giving me the contact detials of your neurologist.  I would like to see him.

Thanks

I also have been diagnosed with this. I have found that the best short term results have been from a physio and from a chiropractor. The inflammation does set me back a little, but generally, I will feel really good (like a normal person) for a day or two, but then as it gets inflamed again or I move it too quickly (my head that is) I will end up back where I started. The physio seems to have less impact but lasts longer. I don't take drugs for anything, but am starting to reconsider that as it has been almost three years and I am struggling to run my own business and be a single mum to two very active boys. I know exactly what you mean by people thinking it is just a sore neck. I also have short term memory loss as a result, which people often make jokes about me being forgetful… It isn't that I am forgetful at all… I just don't know what happened thirty minutes ago, it is like it did not happen. I feel sorry for anyone who has this as you look and talk normally, so people think you ate lazy when you are so dizzy you need to lay down in the middle of the day.

I hadn't heard of the term chronic whiplash syndrome before.  I was in a MVA in 1999.  I have  never resolved the constant headaches, pain, dizziness, eye pain, jaw pain etc.  what works for me is an adjustment and trigger point injections from my DO. But the relief is only temporary.  I have had “radio-frequencies” for the neck pain, an ear profusion for the Ménière's disease , which did help for years.  I did all the rehab I was told to do, got a splint for my TMJ…what I'm trying to say is don't let anybody tell you that your pain is not real.   They can put any name on it they want, but we know how we suffer and it's not in our heads. There has to be a way we can manage this pain and live feeling better.  I am going to a psysiatrist later this month hoping to get Botox injected into the spazing muscles… I hope it can give me some long term relief.  Lets keep in touch.  I hope you feel better soon!!!

I have actually recently had great results treating my chronic whiplash syndrome… I am working closely with a physiotherapist who completed his thesis in cws at the university of qld, where amazing study is being done to help overcome this disorder…. I would suggest that you find a physio who is well trained in this exact condition and the best thing for me has been the brain building excercises on lumosity.com it has helped heaps with my concentrarion and memory and i would suggest it strongly to anyne suffering cws. Also, reaffirming that it is real and that i have actually got a serious health condition is so important, because you do feel like you are going crazy!

Bowen Therapy is a very effective way of treating whiplash.  Realignment of muscles and ligaments surrounding the spine is one part of the treatment.  There is also a very specific procedure for whiplash, which I found to have worked extremely well in addressing the most severe symptoms, including migraine.

Hi all, Thank you for your input.

Every professional who has replied to the original post has stressed that what a person is suffering is real.  The therapists have all been empathetic to your problem and not judgemental. 

Overall we have all emphasised the need for people with chronic pain to have quality assessment from an experienced and understanding therapist. You need a diagnosis - not just Whiplash) and a specific individual plan for recovery that you can tackle together with your therapist. Despite the chronicity of your pain and in spite of any underlying damage to structures, you can get better. You will

You need a diagnosis - (not just Whiplash) and a specific individual plan for recovery that you can tackle together with your therapist. Despite the chronicity of your pain and in spite of any underlying damage to structures, you can get better. You will

Despite the chronicity of your pain, and in spite of any underlying damage to structures, you can get better. You will benefit from finding a highly qualified experienced therapist who will help you physical and emotionally to improve. Accurate information will reduce your fears.

Kind Regards

Helen Potter