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  • The Weirdest Whiplash Symptoms

    It doesn’t take much in a car accident to trigger even the smallest whiplash symptoms. Cars are big, powerful objects, and many are built these days to have force go “through” them to avoid damage.

    However, physics says that force is a thing, and that thing must go somewhere, so ultimately, in lower speed accidents that do little damage to your car, the force will most likely go into you, the body strapped to the seat inside the vehicle.

    In an accident resulting in 3 to 10gs of force, (5g’s of force is a car going about 8–10mph at the time of collision), the ligaments holding the vertebrae in your neck together are stretched beyond their normal physiological range of motion. Where we once thought low-speed collisions were safer for the vehicle occupants, MC Robbins found that actually, the less damaged or crushed a car is during a collision, the higher the acceleration of the struck vehicle, therefore the greater risk of injury (7).

    Typical side-effects from a car accident can include neck pain, headaches, shoulder pain, and sometimes lower back pain. Musculoskeletal pain is thought to be the norm, and for many people, it’s the only thing they’ll experience, but there is a slew of other side-effects that can happen due to even a minor car accident, and often, victims don’t even make the correlation.

    Here are a few of the more obscure yet still well-known ones.

    Thoracic Outlet Syndrome

    Thoracic Outlet Syndrome, or TOS for short, is a group of disorders that are complex, confusing, and poorly defined. Some doctors will tell you it’s very common, others will tell you it’s a fairy tale. Not that musculoskeletal pain isn’t confusing enough, already.

    What we’re talking about today, for the sake of simplicity, is Traumatic TOS, or Thoracic Outlet Syndrome that occurs after an accident or a repetitive stress injury. When whiplash happens, scar tissue builds up around the neck, specifically the scalene muscles, causing the brachial plexus and subclavian artery to get compressed.

    Side-effects include pain, tenderness, sensory loss, and weakness, often exacerbated by certain body postures. You may also feel a heaviness in the arms, a “pins and needles” feeling in the forearms, hands, or fingers, or swelling, numbness, or a blue-ish hue in your hands. If you hold your hands above your head for an extended period of time, the side with TOS will get white and numb (13).

    Carpal Tunnel Syndrome

    Carpal Tunnel Syndrome happens when the median nerve in your wrist is compressed. It causes pain, numbness, or tingling in the thumb, index, and middle fingers that gets aggravated when you move your wrist. Sometimes, the pain even radiates into the arm, shoulder, and neck.

    CTS is actually fairly common after whiplash trauma and is likely caused by gripping the steering wheel, bracing your hands on the dashboard during the collision, or an injury to the wrist from airbag deployment. Sometimes people end up with fractures to the wrist which can subsequently cause CTS (10).

    Double Crush Syndrome

    Double Crush Syndrome is when CTS occurs concurrently with Thoracic Outlet Syndrome, which complicates things when it comes to treatment. Both of these symptoms crush your nerves, and it’s suggested that compression of the brachial plexus, or the nerve near your collarbone, can cause the median nerve in the wrist to become more sensitive, making you slightly more susceptible to CTS (11).

    Jaw Pain and TMJ Dysfunction

    During a car accident, sometimes people get what’s called “mandibular whiplash,” or a dramatic opening of the jaw during a collision, which causes damage to the muscles and ligaments around your temporomandibular joint (or TMJ, the joint that moves when you talk).

    TMJ issues resulting from whiplash is well-documented in literature, and studies have found that nearly 40% of whiplash patients end up with some sort of TMJ issues post-accident (8), although it was also found these symptoms were more likely to occur after higher-speed accidents.

    If left untreated, these can go on to become chronic issues and turn into a condition that is called TMJ Dysfunction.

    Difficulty Swallowing, or Dysphagia

    Difficulty swallowing after an accident is estimated to happen in about 10% of whiplash patients. This has a couple of plausible explanations; the most common would be swelling or injury in an area adjacent to the esophagus. In extreme cases, the esophagus or pharynx could be crushed during the “extension” phase of whiplash (9).

    If you end up with this particular symptom after a whiplash accident, it can potentially be one of the more serious injuries and you should see your medical doctor, who may refer you to an ear, nose, and throat specialist.

    Once more serious issues or injuries are ruled out, the other likely explanation is damage to the longus cervicis colli muscle (14), a long muscle that helps with forward and lateral flexion of the neck. A specially trained massage therapist can work on this muscle to relieve damage, although the maneuver involves displacing the windpipe, so it’s a little awkward, but gives you that “brand new neck” feeling after being released.

    Dizziness, Vertigo, and Visual Disturbances

    Studies show that anywhere from 23% to 51% of patients of whiplash will experience dizziness, and somewhere around 35% experience some sort of blurred vision (9). Studies show that patients of whiplash can experience some sort of ocular trauma, and although the symptom itself is well documented, little has been done to study how that trauma actually happens.

    Many whiplash-induced vision issues end up healing themselves with a few exceptions, as vision is susceptible to tension in the musculature around the head. Sometimes the release of tension in the neck and face is all it takes, but severe cases should be referred to an ophthalmologist.

    There are many explanations for dizziness, including mild traumatic brain injury, vascular injuries, direct neurological damage, myofascial damage, inner ear damage, and vertigo. Concussions post-accident can also be fairly common, leading to a slew of other neurological side-effects. If you are experiencing any of these symptoms post-accident, it’s important to see a medical doctor first to rule out anything super serious. If the problem is nerve damage, chiropractic or osteopathic treatment may help.

    Once more serious disorders are ruled out, treatment on the myofascial structures of the neck may be the most effective treatment. Often, damaged muscles in the neck restrict range of motion, and restoring that range of motion and breaking up adhesions in the muscle tissue through treatments like massage therapy can make vertigo and dizziness disappear (1).

    Sleep Problems

    One study showed as many as 70% of whiplash patients reported issues sleeping after an accident, including insomnia and/or waking up consistently throughout the night (9). This can make the healing process even more difficult, as much of the body’s healing occurs during sleep, and lack thereof can cause more pain and more fatigue during the day.

    This issue has multiple plausible explanations. The most common one I see is that people in pain simply can’t sleep. If your shoulder hurts, rolling on to it in the wrong way can cause a sharp pain in that area, causing you to wake up. The adrenaline from that pain is enough to keep you awake thereafter. Emotional distress including PTSD or anxiety from the said accident can result in insomnia and poor sleep, as well.

    So you have whiplash. What do you do now?

    The most widely recognized best approach for treating whiplash injuries is conservative treatment, meaning a program of massage therapy, chiropractic, and/or physical therapy. Although some practitioners have prescribed a “cervical collar” and rest to immobilize the area, studies have found that early mobilization of the neck was actually a more effective treatment (2).

    Teasell and McCain, in their book Painful Cervical Trauma: Diagnosis and Rehabilitative Treatment of Neuromuscular Injuries, say, “Massage therapy is a time-honored treatment for musculoskeletal problems, in particular, myofascial pain and increased muscle tension.” (1)

    In a study on chiropractic treatment for cervical whiplash, 80% had good clinical outcomes, and 77% had not only a good outcome but also showed evidence of reduced or completely resolved disc herniations (4).

    In a separate, smaller study, researchers found 93% of whiplash patients improved with chiropractic care, even when the outcome was measured by an orthopedic surgeon (5).

    Surgery, on the other hand, has not been found very effective. It is sometimes done on patients with chronic pain, but studies have shown that only around 10% of people who opt for surgery to correct chronic neck pain from whiplash end up having “good” results (6).


    1 - Teasell RW, McCain GA. Clinical Spectrum and management of whiplash injuries, in Painful Cervical Trauma: Diagnosis and Rehabilitative Treatment of Neuromuscular Injuries. Ed. Tollison CD, Satterthwaite JR 1992;292–318.
    2 - Mealy K. Brennan H, Fenelon GCC. Early mobilization of acute whiplash injuries. British Medical Journal 1986;292:656–657.
    4 - BenEliyahu DJ. Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. Journal of Manipulative and Physiological Therapeutics 1996:19(9):597–606
    5 - Woodward MN, Cook JCH, Gargan MF, Bannister GC. Chiropractic treatment of chronic ‘whiplash’ injuries. Injury: International Journal of the Care of the Injuried 1996:27(9): 643–645
    6 - Hamer AJ, Gargan MF, Bannister GC, Nelson RJ. Whiplash Injry and surgically treated cervical disc disease. Injury 1993:24:549–550.
    7 - Robbins MC. Lack of relationship between vehicle damage and occupant injury. SAE 970494.
    8 - Frankel VH. Temporomandibular joint pain syndrome following deceleration injury to the vervical spine. Bulletin of Hospital Joint Dis 1969;26:47–51.
    9 - Radanov BP, Di Stefano G, Schnidrig A, Sturzenegger M. Common whiplash: psychosomatic or somatopsychic. Journal of Neurology, Neurosurgery, and Psychiagry 1994; 57:486–490.
    10 - Evans RW. The postconcussion syndrome and the sequelae of mild head injury. Neurology of Trauma 1992; 10:815–847.
    11 - Inbody SB. Myofascial Pain Syndromes, IN Neurology and Trauma, edited by Evans RW, W.B. Saunders Company 1996, p. 464.
    12 - Bogduk N. Post whiplash syndrome. Australian Family PHysician 1994;23:2303–2307.
    13 - Press JM, Young JL. Vague upper-extremity symptoms? Consider thoracic outlet syndrome. Physical and Sports Medicine 1994;22:57–64.
    14 - Pearce JMS. Longus cervicis colli “myositis” (syn: retropharyngeal tendinitis). Journal of Neurology, Neurosurgery, and Psychiatry 1996;61:324.

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