The whiplash process can result in a range of symptoms, such as neck pain, headaches, and restricted movement of the cervical spine, which are collectively known as whiplash associated disorders (WAD). Estimates suggest that approximately 20% of individuals with WAD may also experience longer-lasting symptoms similar to those found in concussions, including mental fog, concentration difficulties, and other cognitive challenges. Research conducted in 2020 has provided insights into early identification of these patients so targeted interventions can be implemented, potentially preventing chronic and persistent WAD symptoms.
In this study, researchers utilized resting-state functional MRI (rs-fMRI) to examine 23 individuals with chronic WAD. They compared the imaging results to objective evaluations measuring neck-related disability, trauma-induced psychological distress, depression, and pain levels. The study discovered a connection between fat accumulation in the neck’s cervical muscles and irregularities in the brain’s network structure that are related to neuropsychological complications seen in WAD. Specifically, increased fatty tissue in the neck muscles was associated with greater signs of brain injury or changes in brain function.
Whiplash injuries often damage the deep muscles and connective tissues of the neck. In response, the body may rely more heavily on superficial neck muscles to maintain posture and stabilize the head. While this adaptation may protect deep muscles from further harm temporarily, prolonged reliance on superficial muscles can weaken the deeper structures and lead to fatty infiltration within these muscles.
Supporting these findings, another study followed 141 WAD patients and 40 unharmed control subjects over a one-year period. The researchers noted that WAD patients, even those whose neck pain had resolved and whose neck movement had normalized, continued to experience reduced neck muscle strength throughout the year. Additionally, those unable to resume work after a year exhibited an average reduction of 50% in neck muscle strength.
These research results indicate that a whiplash event severe enough to damage the soft tissues of the neck and cause maladaptive muscle activation—leading to weakening and fat infiltration of key cervical muscles—can also result in potential brain injury, which is reflected in cognitive symptoms. Therefore, promptly identifying WAD patients who show signs of cervical muscle weakness may help clinicians determine which individuals could benefit most from comprehensive care to minimize long-term WAD complications.
Clinical guidelines often recommend chiropractic care as an appropriate initial treatment for WAD. This typically includes a multimodal approach aimed at restoring joint mobility and rebuilding strength in both the deep and superficial muscles of the neck.
