There was minimal damage to Mary’s car, and the other car suffered a dented hood. But what happened to Mary’s body was much worse. Her medical doctor’s initial x-rays noted a slight reversal of the normal curve of the spine. Mary was diagnosed with whiplash and given medications and a soft collar to wear. When, after a few weeks, Mary still experienced neck pain radiating down into her shoulder blades, an MRI was ordered. This was found to be a normal study, and Mary was prescribed physical therapy. This aggravated her condition, however, and so was terminated. Nerve blocks were done, which helped but only temporarily. With nine months of constant pain and no answers, Mary grew increasingly frustrated. Finally, Mary’s insurance company ordered an independent medical examination. The examination labeled her to have malingering pain and no impairments. Now, her insurance benefits were in jeopardy and there was no objective evidence to substantiate her symptoms. Mary had difficulty performing the repetitive arm tasks required at work and had to quit.

Mary’s situation is not uncommon. Whiplash injuries are now considered an epidemic in the United States. The recent outbreak of whiplash claims over the last few decades has lead to the emergence of research institutions to analyze this problem. The many avenues of investigation range from studying the biomechanics of rear-end impact collisions to how insurance companies adjust their claims. More and more people who have suffered whiplash injuries have been coming forward to reveal they are suffering persistent symptoms, but have no medical answers as to why.

For years, whiplash injuries were believed to be disc and nerve root type injuries. Thus, diagnostic studies, such as MRI and CT, have been ordered to evaluate these conditions. Many times, the results show up as negative or normal, but the patient who is still suffering neck pain, headaches, or radiating arm and upper back pain insists the symptoms are real. Many of these people are labeled “malingerers” by insurance companies. Such was the case for Mary. This is why I decided to become a research participant at the Spine Research Institute of San Diego and the Center for Research of Automotive Safety and Health.

At these research facilities, we examine the bio-kinematics (how the auto collisions affect the human occupant) of rear-impact collisions using live human test volunteers and test dummies. The research shows conclusively that rear-impact collisions which result in a change of velocity as little as 5 miles per hour can and do cause injury.

The most common type of whiplash injury is not disc and nerve root compression, as we have been lead to believe, but rather ligament damage resulting in permanent joint instability of the neck. This ligament damage and resultant instability produces neck pain and spasms, radiating upper back pain and spasm, referred arm pain, and headaches. While these injuries are not found with conventional plain film x-ray, MRI, or CT scan, they are found with digital motion x-ray (DMX). I have ordered many DMX studies for my whiplash patients who suffer these symptoms and found the resultant ligament damage when MRI studies of these patients were normal.

When I performed a DMX for Mary, we found ligament damage and resultant painful instability. These findings directed the specialized, appropriate treatment for her and she is doing much better. Without a DMX, people who suffer from whiplash symptoms may not have the correct diagnosis. Unfortunately, this can lead to improper treatment and prolonged suffering.

The combination of research findings and new diagnostic technology with DMX has unraveled the truths and myths of whiplash injuries. They have allowed for accurate diagnoses and directed a new path of appropriate treatment. The research findings have been published, and the DMX protocol is now included in the American Academy of Pain Management’s medical textbook Pain Management: A Practical Guide For Clinicians, sixth edition.

If you or someone you know has suffered neck or back pain from an auto collision, it is crucial to obtain the research information and ask your doctor about ordering a DMX to evaluate for ligament damage and instability as soon as possible prior to implementing a rehabilitation program.