Cervical Spine Injury and Clinical Instability
Whiplash injury is an inertial mechanical injury. Consequently,chiropractors, as a consequence of the mechanical nature of their clinical practice, treat many whiplash-injured patients. Although chiropractors manage a wide range of clinical syndromes and findings, the emphasis of chiropractic clinical practice is to treat, primarily through spinal adjusting, regions of spinal hypomobility (less than normal motion). However, chiropractors are well aware that spinal trauma may also cause regions of hypermobility (excessive motion).
In the evaluation of an injured patient, chiropractors assess the spine for both hypomobility and hypermobility.
Hypomobility is classically managed with spinal adjusting, myotherapy, stretching exercises, and modalities that reduce spasm.
Hypermobility is classically managed by applying spinal adjusting to adjacent hypomobile joints, varying forms of immobilization, and resistive effort exercises.
Chiropractors are aware that trauma, especially whiplash trauma, can result in a risk to the integrity of the nervous system. This type ofhypermobility is referred to as Clinical Instability. Clinical Instabilitymanagement may require prolonged immobilization, or on occasion a surgical stabilization. This paper reviews the historical and contemporary perspectives on Clinical Instability
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