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Whiplash Injuries- The Facts

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Here is a comprehensive report from the Insurance Institute for Highway Safety that not only tells you what happens during a whiplash injury but also how you can prevent it and what factors lessen the severity of a neck injury. This is a must read.

1 What is whiplash?

Whiplash and whiplash-associated disorders describe a range of neck injuries related to sudden distortions of the neck that commonly occur in rear-end crashes. The most common symptom reported by whiplash victims is pain due to mild muscle strain or minor tearing of soft tissue. Other injuries include nerve damage, disc damage, and in the most severe cases ruptures of ligaments in the neck and fractures of the cervical vertebrae. Minor whiplash injuries generally are associated with pain and decreased range of motion in the head and neck. These symptoms usually last only a short time, but occasionally they last longer and include headaches, dizziness, and tingling in the arms. The physical injury to create symptoms of whiplash is uncertain. It is suspected that the biological cause of long-term whiplash symptoms is nerve damage while short-term pain may be a minor strain or sprain.

People can experience severe crashes with no neck injury if there is little or no movement of the head relative to the torso. Consequently, neck distortion resulting from sudden movement of the head relative to the torso probably explains most whiplash injuries. Hyperextension of the neck, or rearward bending beyond its normal range of motion, may explain many whiplash injuries, but experimental and field studies suggest that nerve damage and associated long-term symptoms can occur with milder levels of neck distortion. One hypothesis is that nerve damage is caused by motion of adjacent neck vertebrae during a crash.  Another hypothesis suggests that the nerve damage is caused by fluctuation in spinal fluid pressure arising from neck distortions.

2 How common are neck injuries? Are motorists susceptible to neck injuries in all crash configurations?

Neck sprains and strains are the most frequently reported injuries in US insurance claims. In 2007, an estimated 66 percent of all insurance claimants under bodily injury liability coverage and 57 percent under personal injury protection coverage — two important insurance injury coverages — reported minor neck injuries. For 43 and 34 percent of bodily injury liability and personal injury protection claimants, respectively, neck sprains or strains were the most serious injuries reported. The cost of the claims in which neck pain was the most serious injury was about $8.8 billion, representing approximately 25 percent of the total dollars paid for all crash injuries combined.

Whiplash injuries can be sustained in any type of crash but occur most often in rear-end collisions. Based on National Automotive Sampling System data, the National Highway Traffic Safety Administration (NHTSA) estimated that there were 805,581 whiplash injuries occurring annually between 1988 and 1996. Of these injuries, NHTSA estimated that 272,464 occurred as a result of a rear impact.  A 1999 Institute study found that 26 percent of drivers of rear-struck vehicles reported neck injuries to their insurance company.  This was about the same as the 24 percent neck injury rate reported in a 1972 Institute study. Estimates of neck injury rates in other studies have ranged from 7 to 37 percent, depending on whether police or motorists reported the information.

3 What happens to occupants when their vehicles are struck from the rear?

When a vehicle is struck from the rear it is accelerated forward, causing the seatback to push against the occupant’s torso and propel it forward. The unsupported head lags behind the torso until the neck reaches its limit of distortion. Then the head is suddenly accelerated by the neck much like the tip of a whip; hence the term whiplash. Head restraints limit the neck distortion by pushing the head forward with the torso.

4 Why do vehicles have headrests?

What many motorists refer to as a headrest is actually a head restraint. It is a common misconception that restraints are comfort features. Head restraints are an essential safety feature like lap/shoulder belts. Effective head restraints help move an occupant’s head forward with the body in a rear-end crash and decrease the likelihood of sustaining a whiplash injury. A 2002 Public Attitude Monitor survey asked participants to identify the main purpose of a head restraint; 67 percent correctly identified safety, while 13 percent said comfort and another 15 percent did not know.

5 What factors influence the severity of neck injury?

The majority of studies on whiplash have focused on adult front-seat occupants. Unless otherwise noted, the following facts pertain to persons sitting up front.

Height: According to German research, height is a risk factor for neck injury, particularly among females.  Shorter people often are protected by unadjusted head restraints. Stature may not play as big a role in the severity of injuries among males because many head restraints are too low to protect even shorter males. Taller motorists who do not adjust their head restraints are more likely to sustain whiplash injuries.

Gender: The same German report found females to be 1.8 to 2.2 times more at risk of neck injury in all types of collisions, a finding consistent with research by the Institute and other organizations. A Swedish study found that females with whiplash injuries were more likely to develop long-term symptoms. Fifty-five percent of females who sustained whiplash injuries went on to develop long-term symptoms compared with 38 percent of males.  The risk of disability for drivers has been shown to be three times higher for females than for males; in rear seats, females’ risk is four times higher.  One possible explanation is that males have more neck musculature than females for about the same size head. The Institute studied insurance data and found female drivers in a rear-end crash were more likely than male drivers to report a neck injury.

Seating position: It is uncertain which seating position exposes an occupant to the greatest chance of neck injury. One study concluded that drivers have a higher risk of injury than passengers. It was hypothesized that drivers are prone to move forward and away from the seatback as they reach for the steering wheel and observe traffic around them, whereas passengers usually are more relaxed and lean further back in their seats, with their heads closer to the restraint.

Research studies are inconsistent in their findings of neck injury risk for front and rear seat passengers. One study found that rear seat passengers, are less likely than front seat occupants to sustain neck injuries.  Another study found that the risk of neck injury among females was lowest in the front passenger seat and significantly higher in the rear. The same study found that injury risk for males was higher in the front seat than in the rear seat.

Vehicle size/weight: The size and weight of the struck and striking vehicles may influence neck injury risk. A study of insurance claims found that drivers struck by vehicles heavier than the one they were driving were more likely to claim neck injuries than drivers struck by vehicles of approximately equal or lesser weight.Drivers of rear-struck cars were more likely to claim a neck injury than drivers of rear-struck SUVs.

Seat/head restraint geometry: Restraints can be classified into one of four geometric zones defined by their height and backset (distance from the back of the head to the front of the restraint). Based on these factors, the Institute assigns ratings of good, acceptable, marginal, or poor. Institute research has shown that vehicles with good rated geometric head restraints have 24 percent lower driver neck injury rates than vehicles with poor rated restraints.

6 Do head restraints have to meet government standards?

Yes. Since Jan. 1, 1969, NHTSA under Federal Motor Vehicle Safety Standard (FMVSS) No. 202 has mandated head restraints in the front outboard seats of all new passenger cars. On Sept. 1, 1991, head restraint standards were extended to pickups, vans, and SUVs. Manufacturers may install either of two types of restraints. The first is an integral head restraint with a seatback that is high enough to meet the head restraint height requirement. The second type is an adjustable head restraint consisting of a cushion attached to the seatback by sliding metal shafts. Adjustable restraints must be adjustable to the same height as fixed restraints. Adjustable restraints can be moved and sometimes locked at different heights; some also can be adjusted horizontally to change the distance between the back of the head and restraint.

In December 2004, NHTSA upgraded FMVSS 202 to require head restraints that are higher and closer to the back of people’s heads. The new height requirements for front and rear seat head restraints are similar to the ones mandated in the European Union.

FMVSS 202 establishes a minimum of 29.5 inches from an occupant’s hip to the top of a head restraint. This compares with 27.5 inches under the previous rule. Adjustable restraints in their lowest (down) position must be at least 29.5 inches from an occupant’s hip; the previous rule did not specify a minimum height for adjustable restraints. Another change is that all adjustable restraints must lock once in position. Under the previous rule, the amount of space between the back of an occupant’s head and the head restraint (backset) was not regulated. Now the backset must be 2.2 inches or less. Manufacturer compliance began Sept.1, 2009, under a phase-in schedule that requires all new vehicles to meet the rule by September 2010.

Head restraints will not be required in rear seats, but if they are voluntarily installed they must meet a height requirement. Fixed restraints in rear seats must be at least 29.5 inches from an occupant’s hip, and adjustable restraints cannot be adjusted below 29.5 inches. There will not be a backset requirement for head restraints installed in rear seats. The phase-in schedule for rear head restraints begins Sept. 1, 2010, with all vehicles complying by September 2011.

7 How should my head restraint be positioned?

To reduce the likelihood of sustaining a whiplash injury in a crash, head restraints should be positioned high enough to protect the head so as to minimize neck distortion. A head restraint should be positioned at least as high as the head’s center of gravity, or about 3.5 inches below the top of the head. Because people differ in height, the amount of adjustment varies. For some occupants, no adjustment from the lowest position is required. The distance from the back of the head to the restraint should be as small as possible, preferably less than 4 inches. On seats without horizontally adjusting head restraints, this can be achieved by adjusting the seatback recline angle.

The best exercises to do for neck pain and especially disc bulges,  pinched nerves and whiplash are the McKenzie Neck exercises