The cooler weather, the kids heading back to school and sun setting earlier and earlier in the evening is proof that the fall is upon us. We hope that everyone is doing well and staying safe. This month we are taking a look at whiplash.

What is Whiplash?

Most people know the term whiplash to mean a neck injury after a quick or strong turning of the head. This is typically from the result of a motor vehicle accident (MVA)

For the healthcare workers who treat whiplash and the insurance adjustors who monitor the claims of whiplash resulting from car accidents, the term is much more specific. In fact the real term is Whiplash Associated Disorder or “WAD”.

Whiplash merely refers to the mechanism of injury-acceleration-deceleration forces to the neck, and the “associated disorder” part of the term refers to the symptoms resulting from those forces.


There are grades of WAD injuries depending on the symptoms the patient presents with. The Quebec Classification of WAD is a clinical classification system which grades symptoms as follows:

  • Grade 0 WAD: refers to no neck complaints and no physical signs (that is, no WAD injury, and thus outside the mandate of the Neck Pain Task Force).
  • Grade I WAD: refers to injuries involving complaints of neck pain, stiffness or tenderness, but no physical signs.
  • Grade II WAD: refers to neck complaints accompanied by decreased range of motion, point tenderness (musculoskeletal signs), and positive orthopaedic test findings.
  • Grad III WAD: refers to neck complaints accompanied by neurologic signs such as decreased or absent deep tendon reflexes, weakness and/or sensory deficits.
  • Grade IV WAD: refers to injuries in which neck complaints are accompanied by fracture or dislocation (and thus outside the mandate of the Neck Pain Task Force), and should be referred for orthopaedic consultation.
  • Other symptoms such as deafness, dizziness, tinnitus (ringing in the ears), headache, memory loss, trouble swallowing, and temporomandibular (jaw) joint pain can be presents in all grades.

The symptoms of WAD are thought to result from cervical sprain or strain, probably from soft tissue damage to ligaments and muscles in the neck.

In more serious cases, there can also be irritation to the nerves in the neck. Although the vertebrae and joints of the neck may also be involved in the less severe cases, serious damage to the bones such as fracture or dislocation, require immediate medical attention and therefore a Grade IV WAD is a medical emergency and usually not referred to as whiplash by the medical community.

Even though traffic collisions are the most common reason for whiplash neck complaints, as mentioned above any acceleration deceleration force can cause a WAD injury. Contact sports like football, hockey, rugby and even soccer have the risk of causing a WAD neck injury. Even everyday activities like walking your dog (if they pull unexpectedly), falling off a bicycle, riding a roller coaster or other amusement park rides, or being hit, kicked or shaken can cause a WAD neck injury.


According to the recommendations made by the Quebec Task Force, treatment for individuals with whiplash associated disorders grade 1-3 should include manipulation (spinal adjustments by a chiropractor), mobilizations, soft tissue therapy and range of motion exercises. A cervical collar should not be used for longer than 72 hours as it may lead to prolonged inactivity. Return to normal activities of daily living should be encouraged as soon as possible to maximize and expedite full recover.


Preventing Another WAD Injury From a Car Accident

Properly adjusting the height of your car seat head restraint (head rest) will prevent whiplash injury in and accident.

In an ideal adjustment, the top of the head should be in line with the top of the head restraint and there should be no more than 2 to 5 cm between the back of the head and the head restraint.

If you experience any neck pain or stiffness after a traffic collision or any neck trauma, your chiropractor can assess your symptoms and provide a treatment plan to put you on the road to recovery.


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