Chiropractors are specialists in treating non-surgical spine injuries and commonly treat whiplash injuries from car accidents. The job of the chiropractor in helping his or her patients overcome the pain and disability associated with whiplash is to:
Diagnose the source of the pain from the whiplash injury
Treat the most important dysfunctions
Teach the patient to return to a more normal lifestyle
The process of rehabilitation from a whiplash injury requires a concerted effort between the chiropractor, the patient and any other professional assisting in the case. The likelihood of success of recovering from whiplash is enhanced by a continued focus on restoring normal function with the help of the chiropractor.
After a whiplash injury, chiropractors take a systematic approach to establishing a diagnosis (1), including:
1. Patient History
2. Chiropractic Examination
3. Working Diagnosis
4. Chiropractic Treatment Plan
Chiropractors’ evaluation of patient history for a whiplash injury
The chiropractor will review specific information regarding the car accident, such as:
• What was the vector of the crash (i.e., rear-end collision, head on collision, side impact collision, etc)?
• Was the patient wearing a seatbelt?
• Did the patient or the vehicle strike any other objects after the crash?
• Was the patient aware of the impending impact?
• How was the patient’s head positioned at time of impact?
• What was the collision speed and damage amount?
The chiropractor will also ask questions about the whiplash injury:
• Where is the exact location of the patient’s pain?
• What is the quality and character of the patient’s neck pain or back pain?
• What movements, positions or activities either increase or decrease the patient’s neck pain or back pain?
Finally, the chiropractor will ask about any other symptoms that may be related to the pain, such as numbness, tingling, weakness, dizziness, or blurred or double vision.
Chiropractor’s examination of a whiplash injury
Next, the chiropractor will examine the patient to assess, in the immediate stage, whether serious whiplash injury is present that may require hospital and/or surgical referral, and to identify specific tissues that have been injured.
• The chiropractor will conduct a neurological examination which involves a cranial nerve examination, sensory, motor and reflex examination of the extremities, and tests for injury in the brain.
• Maneuvers will be carried out by the chiropractor that stresses certain tissues to see if they have been injured by the whiplash.
• The chiropractor will perform motion palpation, designed to assess the mobility and pain reactions in the joints of the spine.
• The muscles of the spine will be examined by the chiropractor for areas of congestion called myofascial trigger points, which are common sources of pain after whiplash.
Chiropractor’s working diagnosis of a whiplash injury
From the history and examination, the chiropractor will establish as a “working diagnosis” — a clinical impression of the most salient features of the whiplash injury.
Based on this diagnosis of the whiplash injury, the chiropractor will then determine whether any additional tests (such as x-rays, MRI, EMG or blood tests) are required. The chiropractor will obtain reports from any tests that were done through the emergency room or at previous consultations with spine specialists to avoid unnecessary duplicate testing at the chiropractic clinic.
Once all the necessary information has been gathered, the chiropractor will make a determination as to the best course of action required to bring about maximum recovery from the whiplash injury in the shortest time possible. This may mean referral by the chiropractor to another spine specialist or a chiropractic treatment plan.