Approximately 1,500,000 million people are injured in motor vehicle collisions (MVC) each year in the U.S. That is an incidence of about 500/100,000 per year. Anywhere from 12%-86% of individuals injured in MVC never fully recover and suffer with permanent symptoms. Rear-end crashes are generally more severe than front-impact or side-pact collision, accounting for 25% of the crashes but produce 38.7% of the injuries. With the incidence of MVC continuing to rise, likely related to distracted drivers, it’s important to know some key factors that impact the risk of one being injured and recovery from injury.
Risk Factors
Risk factors are factors that increase the likelihood of one being injured in MVC. These can be both human factors (relating to the person themselves) and physical/mechanical factors such as the type of vehicle, weather conditions, speed at which the impact occurred, etc. Some common risk factors include:
- Female Sex: females are twice as likely to be injured in a car crash compared to men. This is because of body mass and anatomy.
- History of prior neck injury: If you’ve been injured in the past, even if you fully recovered, you are more likely to be injured in a subsequent trauma.
- Poor head restrain geometry: Vehicles are designed and tested to protect the 50th percentile male which is 5 ft 9 inches and 175 lbs. Taller individuals have a higher risk of being injured because their head may be higher than a head restraint. Similarly, if the head restraint is in a down position it increases the risk of injury.
- Rear vs other vector impacts: While side impacts are potentially the most dangerous at higher velocity impacts, rear-end impacts have the greatest risk of producing injuries.
- Use of seat belts: While seatbelts should be worn has they can prevent serious illness or death, they increase the risk of injury in a low velocity impact.
- Body mass index/head neck index: Larger people are less likely to be injured because they have more mass and are accelerated less by an impact.
- Having head turned on impact: Having your head turned on impact increased the load on facet joints and ligaments, increase likelihood of injury.
- Non-awareness of impending crash: If you are unaware of an impending crash and are in a relaxed state, it increases your risk of injury.
- Older Age: As we age our strength declines and we have an increase of accumulation of injuries and degeneration over time. This weakens the spine and increases the risk of injury.
- Impact by a vehicle of greater mass: When a larger vehicle hits a smaller vehicle it creates a large speed change or acceleration, increasing injury likelihood.
- Car velocity under 10 mph: This seems counterintuitive however at lower speeds cars do not absorb as much impact, transferring the forces to the vehicle and occupants inside the vehicle. At higher speed vehicle crumple and absorb more of the energy from the impact.
Complicating Factors
Complicating factors are factors that can make the recover from a crash more difficulty, causing the recovery to take longer and also decreasing the likelihood of fully recover. Many of these factors are related to health of the individual injured. Some complicating factors for recovery from an injury include:
- Older age
- Underlying health condition such as diabetes, autoimmune disease, etc.
- Congenital deformity
- Scoliosis
- Cervical kyphosis (reversal of the normal cervical curve)
- Degeneration
- Arthritis
- Anatomical short leg
- Obesity
- Physical demands of occupation
- Prior spine surgery
Prognostic Factor
Prognostic factors help predict the likelihood of recovery from injury. 50% of individuals injured in MVC never fully recover and 25% have permanent disability. Some of the prognostic factors for poor recover from a motor vehicle collision include:
- Initial self-reported pain level greater than 5.5/10
- Initial Neck Disability Index (NDI) greater than 14.5/50
- Initial decrease cervical range of motion
- Poor expectations of recover by the injured individual
- Post-crash emotional factors (ex. post-crash anxiety)
- Hyeragesia or hypersensitive to cold. This indicates hypersensitivity.
- Initial onset of headache
- Initial onset of low back pain
- Initial onset of neck pain
- Female sex
- Prior neck injury
- Symptomatic 3 months post injury. 70% of individuals still symptomatic 3 months post injury never fully recover.
With so many factors that can impact the severity of injury and impact the recovery, frequently overlooked are that factors that increase the likelihood of recovery. There is little that makes a bigger impact on recover that getting the most appropriate treatment early in the recovery process. While there are many possible treatment options, the vast majority of patients injured in MVC will receive the greatest benefits with conservative care from a chiropractor trained in personal injury. Beyond just the physical treatment, it’s important to find a doctor who understands how to properly document all your injuries and recommended treatments and can effectively communicate those to 3rd parties such as insurance companies with good documentation, diagnosis and case management.
Immediately upon injury the body begins the healing process which includes the depositing of scare tissue. The one skill a chiropractor has that no other provider possess is the ability to deliver specific chiropractic adjustments (spinal manipulation) to precise spinal segments. Chiropractic adjustments restore normal motion to the spine. Keeping the spinal joints moving properly combined with proper rehab allows for optimal tissue and joint healing. Additionally, getting fixated joint moving reduces pain signals and inflammation. Additionally, finding a chiropractor that works with other medical professional such as orthopedic specialist, pain management doctors, concussion specialist is important and it frequently takes a team effort to fully recover from a traumatic injury.
About the Author
Chris Gubbels chiropractor Fort Collins specializes in personal injury, scoliosis bracing and treatment and spine biomechanics. He has been published in multiple peer reviewed journals, and holds advanced certifications through American Board of Independent Medical Examiners, Chiropractic BioPhysics, Spine Research Institute of San Diego and International Chiropractic Association.