Por qué el latigazo cervical se convierte en dolor crónico
El latigazo cervical es una de las lesiones agudas más comunes que resulta en dolor crónico. Dado que muchos casos no se denuncian, no sabemos exactamente con qué frecuencia ocurre el latigazo cervical. Algunas fuentes estiman que hasta 3 millones de personas sufren de latigazo cervical en los Estados Unidos cada año.
Studies show that at least half of the people who experience whiplash go on to develop chronic neck pain and related symptoms, collectively referred to as “whiplash associated disorders.�� Researchers recognize that one reason why so many people suffer long-term effects is because doctors have “thus far been unable to fully characterize the condition.”
En esta publicación discutiré:
- Las estructuras anatómicas que pueden lesionarse en el latigazo cervical
- Las diversas causas y síntomas del latigazo cervical.
- Investigación sobre la causa de los trastornos asociados al latigazo cervical
- Cómo curarse de los trastornos asociados con el latigazo cervical con ejercicios de somática clínica
¿Qué es el latigazo cervical?
El latigazo cervical ocurre comúnmente en accidentes automovilísticos cuando la cabeza y el cuello se lanzan primero hacia atrás en hiperextensión y luego hacia adelante en hiperflexión por el impacto. Sin embargo, como aprenderá en la siguiente sección, hay otras actividades que también causan latigazo. El latigazo cervical también puede ocurrir cuando la cabeza se lanza repentinamente de lado a lado, como cuando un automóvil tiene huesos en T.
El grado de movimiento repentino y extremo puede dañar muchas estructuras del cuello y partes circundantes del cuerpo:
Muscles in the neck and shoulders can be strained or thrown into spasm
Ligaments that connect the cervical vertebrae and skull can be sprained
Cervical facet joints (the joints in between vertebrae) and the atlanto-axial and atlanto-occipital joints (the junction between the neck and skull) can be damaged
Cervical intervertebral discs can bulge or herniate
Cervical vertebrae can be dislocated or fractured
Joints adjacent to the neck (temporomandibular joint and joints in the thoracic spine, ribs, and shoulders) can be damaged
Nervous system structures including nerve roots, the spinal cord, and brain can be damaged
Vascular system structures including the vertebral artery and internal carotid artery can be stretched and torn
Vestibular system structures of the inner ear can be damaged
Causas del latigazo cervical
El latigazo cervical puede ocurrir en una variedad de actividades que involucran movimientos o impactos repentinos en la cabeza:
- Accidentes automovilísticos
- Abuso o agresión física; ser golpeado o sacudido
- Deportes como fútbol, boxeo, kárate, hockey, hockey sobre césped, voleibol, baloncesto y fútbol
- Accidentes de ciclismo
- Cabalgatas
- Salto de puenting
- Parque de diversiones
- Caídas en las que la cabeza se mueve violentamente hacia atrás.
Los síntomas del latigazo cervical
Los síntomas del latigazo cervical generalmente se desarrollan dentro de 24 horas después de la lesión y pueden incluir:
- Dolor y rigidez de cuello
- Rango de movimiento limitado en el cuello
- Dolores de cabeza, que suelen comenzar en la base del cráneo.
- Sensibilidad o dolor en los hombros, la parte superior de la espalda o los brazos
- Hormigueo o entumecimiento en los brazos
- Mareo
- Concusión
- Tinnitus (zumbido en los oídos)
- Problemas visuales
- Trastornos del sueño
- Fatiga
- Pérdida de memoria y concentración
- Irritabilidad
- Depresión
Por qué el latigazo cervical se convierte en dolor crónico
Some research estimates that 50% of whiplash sufferers go on to develop long-term symptoms. A 20-year prospective study found the number to be higher; of 193 people who had experienced whiplash, 66.9% developed chronic related symptoms. These symptoms included stiff shoulders, neck pain, headache, numbness or pain in the upper limbs, and tinnitus. Unfortunately, as I mentioned earlier, doctors have struggled to determine a consistent cause of these long-term symptoms.
Orthopedic surgeons from London conducted a four-year study of 1025 whiplash sufferers in an effort to understand the cause of long-term whiplash symptoms. They found that the “only totally consistent findings are reduced range of motion and dysfunction of the trapezius muscle.” The researchers suggest that whiplash rehabilitation should target neck stiffness and trapezius dysfunction in particular.
Another study used surface electromyography (EMG) to measure cervical muscle dysfunction in whiplash sufferers. The study found that people with whiplash associated disorders had higher levels of muscle tension than healthy control subjects in their upper trapezius muscle during physical exercise, and a significantly decreased ability to relax the upper trapezius after exercise.
About a second after the head is forcefully thrown or hit, neck muscles reflexively contract in an attempt to stabilize the head. After the injury, the muscles of the neck, and often the shoulders and back as well, remain contracted to splint the injury. Not surprisingly, nearly 9 out of 10 whiplash sufferers have some degree of muscle spasm following the injury.
From my perspective as a somatic educator it seems obvious that like these two studies found, chronic muscle contraction is a likely cause or contributor to many whiplash associated disorders. Chronically contracted muscles feel stiff and painful, and restrict movement of the neck. They limit blood flow, slowing the healing process of injured discs and connective tissues. Tight muscles also compress the spine, potentially causing nerve impingement, inflammation, and disc and joint degeneration.
Reflexive muscle contraction often continues long after a structural injury has healed, because muscle contraction becomes learned by our nervous system. The more often we repeat a muscle contraction, the more deeply learned it becomes; this is what we refer to as muscle memory. So the longer it takes for structural whiplash injuries to heal, the more likely it is that the surrounding muscles will continue to splint the painful area and remain chronically, subconsciously contracted for years.
Another factor that increases the likelihood of developing chronic muscle tension is the emotional trauma of being in a car accident or experiencing any event that causes injury. Strong negative emotions not only trigger muscle tension but also cause that muscle tension to become deeply learned quickly. Instead of requiring many repetitions like practicing your tennis swing, your nervous system immediately learns to keep certain muscles tight, and links that subconscious muscle tension with your emotional state. Researchers have found that an important predictor of whiplash associated disorders 12-14 years later is being in a negative emotional state in the days following the injury. And a study of 6,000 whiplash sufferers found that those who had a positive attitude about their recovery actually recovered more than three times faster than those who didn’t, and those who had low expectations of complete recovery were four times more likely to experience long-term symptoms.
Tratar los trastornos asociados al latigazo cervical con ejercicios de Somática Clínica
Clinical Somatics exercises are an ideal method of recovery for many whiplash associated disorders because pandiculation is the most effective way to release subconsciously held muscle tension. In addition, the exercises are extremely slow and gentle, and can be modified or substituted if the position or movement is painful.
Las personas con dolor crónico y movilidad limitada como resultado de un latigazo cervical deben trabajar para liberar todos los músculos del cuello, los hombros, la parte superior e inferior de la espalda, el pecho y el abdomen. Incluso si no hay dolor o no se siente tensión, la musculatura de toda la parte superior del cuerpo se ha adaptado a la lesión, y se debe abordar el patrón general de tensión y postura para lograr un progreso duradero. Liberar la tensión muscular crónica también evitará la degeneración espinal futura y, a menudo, aliviará el pinzamiento de los nervios al reducir la presión sobre la columna y los nervios espinales.
Following is a list of exercises from the Level One and Level Two Courses that are particularly helpful for whiplash associated disorders. If any of the exercises increase your pain, skip them for now. I’ve made a few notes about modifications.
Curso de Nivel Uno
Arch & Flatten: If this or any exercise in which you lie on your back is uncomfortable for your neck, put a folded towel or thin pillow under your head and neck. Only use as much padding is needed to make your neck comfortable; don’t overdo it. Reduce the padding as you are able to.
Back Lift: If turning your head to the side is not comfortable, you can do this with your neck straight and head facing the floor, with your forehead on the floor so that the back of your neck stays long.
Upper trapezius release: This is at the end of the Bonus Video: “Ultimate Pandiculation.” This exercise can be done standing or sitting upright.
Arch & Curl: Same modification as Arch & Flatten if necessary.
Side Curl: Be sure to support the weight of your head with your hand. If the movement is still not comfortable, then do just the lower body part of this movement—it will still help to release your obliques.
One-sided Arch & Curl: Same modification as Arch & Flatten if necessary.
Diagonal Arch & Curl: Same modification as Arch & Flatten if necessary.
Washcloth: Start by focusing on just the upper body part of this exercise.
Shoulder releases: These are in the Bonus Video: “Carpal Tunnel Exercises.”
Flowering Arch & Curl: Same modification as Arch & Flatten if necessary. Start by focusing on just the upper body part of this exercise.
Curso de Nivel Dos
Head Lifts: Same modification as Arch & Flatten if necessary.
Lower Back Release: Same modification as Arch & Flatten if necessary.
Ejercicio Propioceptivo 1
Scapula Scoops Part 1: Same modification as Arch & Flatten if necessary.
Scapula Scoops Part 2: Same modification as Arch & Flatten if necessary.
Diagonal Curl: Same modification as Arch & Flatten if necessary.
Direcciones del Hombro
Shoulder, Elbow & Wrist Releases: Same modification as Arch & Flatten if necessary.
Giro Sentado
Liberación de Isquiotibiales de Pie
Liberación de Isquiotibiales Sentado
Levantamiento de la Cabeza y las Rodillas
Ejercicios de Cara y Mandíbula
Lectura recomendada:
The Pain Relief Secret: How to Retrain Your Nervous System, Heal Your Body, and Overcome Chronic Pain by Sarah Warren, CSE
Somatics: Reawakening the Mind’s Control of Movement, Flexibility and Health by Thomas Hanna
