After evaluating Amy, we wanted to address some of her primary concerns. Amy went to the Emergency Room following the accident and was prescribed pain medication and muscle relaxers. Amy reported that she did not want to continue taking these meds as they were not helping and were interfering with daily activities. Second, Amy wanted to get back to participating in school before falling too far behind.

Following a motor vehicle accident, the following conditions should be ruled out:

• Whiplash: A whiplash injury occurs when the body experiences a quick change of speed or direction. In most motor vehicle accidents the car is moving in one direction when an impact occurs that causes the head to move in hyperflexion quickly followed by hyperextension (or vice versa). This often leads to muscle strain and ligament sprain in the tissues of the neck and mid back. This can range from mild stiffness to debilitating pain. These injuries often resolve after 4-6 weeks with no fracture or disc involvement. Muscle restrictions, joint fixations, and movement alterations can be addressed to get faster improvement.
• Bone Fracture: Motor vehicle accidents are a major cause of bone fractures particularly of the spine. Often fractures will cause severe range of motion restrictions or deep, aching pain. Fractures of the upper spine, compression fractures, and avulsion fractures are not uncommon after a car wreck. Examination and appropriate imaging should be performed as soon as possible.
• Disc Injury: The intervertebral discs serve as the shock absorbers of the spine. The inner material is similar to jelly in a donut protected by outer fibers. With damage to a disc from either chronic damage or an instant excessive compressive force, the disc can become injured causing a disc bulge or herniation. These are some of the most severe spinal cases often accompanied with pain, numbness, and tingling radiating down the arms or legs.
• Cervicogenic Headache: A common cause of headaches in fact stems from tension and inflammation in the tissues of the neck. These headaches can be expected after car wrecks, slip and fall, or other neck injuries. Headache symptoms become worse as neck tension and inflammation increases in cases such as excessive deskwork, long drives, or neck injury. Treatment for this type of headache should be focused on treating the underlying cause in the neck, which requires rest and decreasing inflammation.

In Amy's case we ruled out fracture and disc injuries due to examination findings and imaging. It was determined that a whiplash injury at the time of the accident was causing symptoms of neck pain, back pain, and cervicogenic headache. I discussed with Amy our treatment plan. Our goal was to achieve the results desired with chiropractic adjustments, active release technique, and cervical traction. We also prescribed at home exercises. I explained that we could accomplish these results quickly.

With our treatment plan I expected to see headaches reduce in intensity, duration, and number of headaches per week within 1-2 weeks. The neck and back pain and stiffness I expect to dissipate within 1-2 weeks. I explained that I expected this to allow her to return to daily activities within this time frame. Within the following 2-4 weeks the pain and stiffness and headaches were severely reduced to allow Amy to return to full activities without pain.

Here is a short video showing neck treatment in the office and at-home therapy: