Motor Vehicle Accident & Whiplash Associated Disorders

The spine or backbone is made up of a series of bones known as “vertebrae”. The spine is divided into 5 major sections:

  1. Cervical spine (neck): contains 7 vertebrae labeled C1 to C7
  2. Thoracic spine (mid-back): contains 12 vertebrae labeled T1-T12
  3. Lumbar spine (low-back): contains 5 vertebrae labeled L1 to L5
  4. Sacrum (part of the pelvis): contains 5 fused sacral vertebrae
  5. Coccyx (tailbone): a triangular bone that makes up the end of the spinal column

The vertebrae of the lumbar spine are the largest in size. This allows for the low back to function as the major weight-bearer of the spine. In addition to carrying the weight of the torso and head, the structure of the lumbar spine also permit significant range of motion. While low back segments L4 and L5 allow a great deal of spinal rotation, they also take on the largest amount of weight from the body. This places the L4/L5 segment at high risk for damage. 

Located between each set of spinal vertebrae are small cushions known as “intervertebral discs.” These discs function to prevent bone-on-bone contact between the vertebrae and act as shock-absorbers for stresses placed on the spine.


The vertebrae of the spine surround and protect the spinal cord, which is located within the spinal canal. Connecting to the spinal cord and exiting from between each vertebra are the “spinal nerves.” There are both sensory and motor spinal nerves that carry information between the brain and different parts of the body. Sensory nerves, which exit from the left and right side of each vertebra, connect to various patches of skin and provide us with the sense of touch. Motor nerves also exit on the left and right of each spinal segment and carry signals from our brain to specific muscle groups, allowing movement to occur.       

What is Whiplash?

In a motor vehicle accident, forces involved are so great that the neck is often thrown in the opposite direction of the impact. As an accident occurs very quickly and there is no anatomical structure physically stopping the neck from being thrown in one direction or another, injury to soft-tissues such as muscles, ligaments, vertebral joints, discs and nerves may occur.


Commonly Affected Areas

This varies for everyone but some common areas of injury may include: a) the neck, b) the upper back, c) the low back, d) the shoulder and rib cage from seatbelt restraint, or a combination thereof. Some other areas of involvement may include the elbows, the wrists, the hips, and the knees.

Common Signs & Symptoms

Individuals who have been involved in motor vehicle accident may experience either immediate onset of symptoms or delayed gradual onset of symptoms within few days after the accident.  Common symptoms include pain, muscle spasm, loss of functional movement and fatigue due to decreased endurance in injured areas. 

Severity of Accident vs. Injuries

Although there is a common belief that the more severe an accident is, the more injuries there are & vice versa, this may not always be the case.  Individuals may be involved in a serious accident but with minor injuries.  In contrary, some individuals may sustain relatively more injuries based on the amount of damage from the vehicle.

Length of Recovery

Depending on the severity of injuries, time for recovery can vary from weeks to months.  The greatest rate of recovery for soft-tissue injuries is within the first 6 to 8 weeks after the accident.  This is the “Window” period. It is, therefore,  important for patients to receive appropriate treatment and rest during this period and maximize recovery.   Overuse during the window period, on the other hand, can lead to aggravations and possibly delay in recovery.

Treatment


Prognosis

Rest after an accident is probably one of the most important factors in allowing sufficient time for soft-tissue injuries to heal.  As the rate of recovery is the fastest within the first 6 to 8 weeks, repeated aggravation either from excessive work or household chores and lack of rest would slow recovery within this window period. 

As your condition starts to improve, it is never too early to think about returning to work.  Return to work may take place in stages beginning with modified duties and/or hours followed by gradual increase in workload as tolerated until the pre-accident level is reached.  Gradual return to work is important particularly for individuals who have decreased endurance and who fatigue easily for injured body parts such as neck and low back.        

A Note About Your Insurance

Your Application

  1. After your accident, you must report to your auto-insurer that you have sustained physical injuries in addition to damage for your vehicle because there are two adjustors:    1 for your vehicle and 1 for your injuries.
  2. In order to establish claim for your injuries, please ensure that you will have completed application provided  by your auto-insurer. This form is called OCF-1.  Without completion of OCF-1, all subsequent forms submitted by your health care professionals cannot be approved by your auto-     insurer.   If you have questions regarding OCF-1, please feel free to consult our staff or your auto-insurer.

Fees & Coverage

By law in the province of Ontario:

  1. if you have Extended Health Plan (EHP), coverage for physiotherapy fees must be invoiced and be used up with your EHP first before any unpaid balance be reimbursed by your auto-insurer. Extended Health Plans include both your own and your spouse’s if he or she has an independent and separate plan.
  2. even if you or your spouse has coverage with Extended Health Plan, approval of claim by your auto-insurer is required through submission of OCF-1 and other related forms within a reasonable time frame after your accident (i.e. 1 month).
  3. if you do not have any Extended Health Plans, all physiotherapy fees are invoiced directly to your auto insurer through our clinic.
  4. if your injuries are limited to soft-tissue only without any neurological signs/symptoms or fractures/dislocations, you will be enrolled under a program of care called Minor Injury Guideline (MIG). This is a 12 weeks program with flexibility for extension where indicated. The attached is a copy of this program as issued by the Financial Services Commission of Ontario (FSCO).