Whiplash Injury In a Pharmacist

Posted On: June 8, 2017

This is the thirteenth case review from my past practice. I am Dr. David Johnson a chiropractor and physical therapist in Highland Park and Lake Bluff. I am the director of North Shore Spinal and Sports Rehabilitation. I started as a chiropractor in Lake Forest, Il in 1988. I integrated physical therapy into my practice in 1990.

This is case of a 60 year-old male that was involved in a low speed rear impact collision. He was a freelance pharmacist that was hit from behind when he was stopped in traffic. He had been a patient in the past at my clinic for previous episodes of lower back pain and had always responded to physical therapy and chiropractic manipulations in the past. He was an ideal patient, one that would do all the exercises and postural modifications that we would prescribe.

He was bothered this time with neck pain and with some upper extremity referral which started after the motor vehicle accident. He did not go to the ER but rather came to North Shore Spinal and Sports Rehabilitation in Lake Bluff. I examined him. He had very limited cervical ranges of motion with pain on extension and right rotation. When I combined these movements together it referred pain down his right upper extremity. Neurologic testing showed slight loss of sensation of his right hand over the thumb and index finger. His deep tendon reflexes and pathologic reflexes were normal. He also had signs of a left rotator cuff impingement syndrome.

On further questioning he reported he was turned to change the radio station with his left hand on the steering wheel and his head turned to look down at the radio. This positioning helped me understand how he got injured.

I took x-rays and he had a fair amount of degenerative changes in his cervical spine and some osteoarthritis of his shoulder in a joint called the acromioclavicular joint.
I diagnosed him with a cervical acceleration/deceleration injury (whiplash) leading to a right cervical radiculopathy and left rotator cuff impingement syndrome.

I put him into therapy where we performed manual traction to his cervical spine, home traction, progressed him into ranges of motion, cervical strengthening, rotator cuff and scapulothoracic exercises. This was combined with manual therapy to include myofascial release and manipulation. He did not respond as well as hoped but unfortunately that can occur with whiplash cases. He made some gains but never got back to the level of function he once had.

An MRI of his cervical spine showed he had degenerative disc bulging but no distinct herniation. We treated for months and arranged to have epidurals and did everything in our power to get him out of pain. He consulted with neurosurgeons and they did not have an option for him.

I sent him to a chronic pain treatment center but in the end he had to learn to live with his chronic pain. To add insult to injury he lost his court case and ended up paying his own medical expenses. To his honor he paid everyone that tried to help him. I run into him from time to time and he still has the pain but he has accepted it and always is appreciative for the help I provided him and that I did my best in court to present the facts of his case.

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