Whiplash and Weakened Neck Muscles

The whiplash process can lead to a number of concurrent symptoms (neck pain, headaches, limited cervical range of motion, etc.) referred to as whiplash associated disorders, or WAD. It’s estimated that about one in five WAD patients will also develop potentially chronic, concussion-like symptoms like brain fog, difficulty concentrating, and other cognitive impairments. A 2020 study shed light on a way to help identify such patients early on so targeted treatment could help keep their WAD from becoming chronic and persistent.

In the study, researchers used resting-state-fMRI (rs-fMRI) to image 23 patients with chronic WAD and compared their findings with assessments used to objectively measure neck disability, traumatic distress, depression, and pain. The research team identified an association between fat infiltration into the cervical muscles and abnormalities in the brain network structure associated with WAD-related neuropsychological issues. That is, the patients with more fatty tissue in their neck muscles were also those with more signs of brain injury or altered brain function.

When deep muscles and associated soft tissue in the neck are injured in a whiplash event, the body may recruit superficial muscles to help stabilize the body and maintain posture. While this can protect the deep muscles from further injury in the short term, it can decondition these muscles over time and allow fatty deposits to infiltrate its tissue.

In another study that followed 141 WAD patients and 40 non-injured subjects for one year, researchers observed that the WAD patients demonstrated a loss in neck muscle strength throughout the year, even if their neck pain resolved and their cervical range of motion returned to normal. Additionally, the patients who had not recovered enough to return to work after a year had an average of 50% loss of strength in their neck muscles.

The findings of these studies suggest that when the whiplash process is forceful enough to  injure the soft tissues of the neck in a manner that leads to abnormal muscle activity that allows important muscles to weaken and for fatty deposits to develop, then the same event can also lead to a potential brain injury, with resulting cognitive symptoms. If so, then identifying WAD patients with cervical muscle weakness early may help doctors uncover which patients may need more substantive care to reduce their risk for ongoing WAD issues. 

Several treatment guidelines indicate that chiropractic care is a great first-choice treatment option for the WAD patient, which may involve a multimodal approach to restore motion in the affected joints and strength in the deep and superficial cervical muscles.

Author
Dr. James Sheehan Dr. James Sheehan is an expert in the treatment of neck and back pain.

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