It’s estimated that up to 50% of whiplash associated disorder (WAD) patients will develop chronic symptoms such as neck and upper back pain, headache, dizziness, emotional and cognitive disturbance, referred pain, and physical dysfunctions. Fibromyalgia (FM) is a condition that is also characterized by long-term, persistent symptoms such as chronic widespread musculoskeletal pain, sleep disturbance, cognitive disturbance, fatigue, and physical dysfunctions. Both WAD and FM patients share similar chronic, debilitating signs and symptoms. Why is this so?
In one study, researchers evaluated cognitive loss, central sensitization, and health-related quality of life (QoL) in chronic WAD patients, FM patients, and individuals without any known chronic conditions to serve as a control group. Participants in both the WAD and FM group exhibited significant cognitive impairment, central sensitization, and decreased health-related QoL, suggesting that brain injury plays a significant role in each condition.
In WAD injuries, the mechanism of injury causing cognitive loss (the brain’s inability to process information) appears to arise from the brain slamming into the inside of the skull. In a classic rear-end collision, the brain first hits the back of the brain casing followed by the rebounding into the front of the skull, causing a concussion.
A 2011 study found that among 58 women who had been admitted to the emergency room for a whiplash injury, three met the clinical criteria for FM three years later. Another 2011 study found that among 326 WAD patients with persistent neck pain lasting longer than three months, up to 14% met the criteria for FM. Based on these findings, it’s clear that the whiplash process could be a strong contributing factor for developing FM. Indeed, a 2015 study that looked at the health histories of 939 FM patients identified trauma as a precipitating factor in 27% of cases.
While we typically associated whiplash with motor vehicle collisions, such injuries can also occur in sport collisions, physical assaults, and falling. It’s possible that a greater percentage of FM cases may be due to trauma the participant simply wasn’t able to recall. Emotional trauma and post-traumatic stress disorder have also been associated with an elevated risk for FM. The disease process for FM isn’t entirely understood, and in cases when the cause is not known, it’s possible the condition could be the result of a cumulation of factors, including WAD.
Nonetheless, it’s clear that chronic WAD and FM are potentially debilitating conditions and seeking treatment after a trauma, such as a motor vehicle collision, is important for mitigating the risk for chronic symptoms. The good news is that both FM and WAD patients respond very favorably to chiropractic care! Doctors of chiropractic are trained to examine, diagnose, and treat those presenting with FM and WAD. Studies have reported that the inclusion of spinal manipulation enhances recovery in acute and chronic WAD, as well as FM.