The efficacy of Craniosacral Therapy in Whiplash

Whiplash is often referred to as a pure soft tissue (ligaments and muscles) injury in the neck. It is caused by a sudden very strong bending and/or hyperextension of the head, causing a painful cervical spine, tension in the neck and shoulders and can also impact the ligaments of the joints in the jaw. In a worst-case scenario, there can also be damage to the intervertebral discs and/or compression of cervical nerve roots.
 
Whiplash is most often caused by a car accident but also can happen through a sporting accident, like boxing, karate, diving and rugby or as a result of a physical trauma. In all cases, the head is violently thrown forward, backward or sideways in two different directions. Pain could be immediate but pain can also happen after a delay of several hours or even days.
 
The diagnosis of Whiplash varies from person to person. Whiplash sufferers often have numerous complaints and can have long periods of pain that may not seem in proportion to the sustained physical injury. It may also not heal in the standard 6-8 weeks that is usually given for soft tissue injuries. However, if we look at the components of whiplash and not only view it as a soft tissue injury, it makes perfect sense why this can be the case. This calls for a treatment model that not only incorporates the soft tissue of the physical body but also the craniosacral system of the physical body plus the mental and emotional body and this is exactly the strength of Craniosacral Therapy.
 
Let me break it down:
Whiplash not only comprises soft tissue injuries that result in headaches, neck pain and stiffness but the lack of control of the head with all the sensory organs and messages to the brain during the impact can also generate neurological complaints that can range from dizziness or vertigo, ringing in the ears, blurred vision, balance difficulties to concentration and memory problems. It can even trigger emotional symptoms like depression, irritability or anxiety as the shock to the nervous system can linger for months. A disturbance in the entire craniosacral system is often possible due to increased tension of the dura matter (the outermost toughest membrane/fascia which envelopes the brain and spinal cord). Disturbances in the Central Nervous System (CNS) – brain and spinal cord – can relay many different symptoms like a chain reaction that cannot be explained by soft tissue injury alone. Pains that occur can also be of a psychosomatic nature and can fluctuate and worsen with life and emotional stress. The force of the injury can also cause minor traumatic brain injury with post-concussion syndrome, which leads to cognitive symptoms as well as balance and often visual complaints.
 
Victims of major accidents and/or trauma that result in whiplash may also experience disassociation or freezing at the time of the incident. This is used as an intelligent defensive self-protective mechanism where the sensory and motor overload in the body and the brain was too great to handle all at once. If these physiological states do not come to a natural end with a successful resolution or discharge, it can lead to PTSD or PTSI where the unconscious survival brain – the brain stem – see my blog our 3 brains – may be tricked into thinking that the threat is still present with all its physiological consequences and storage of the autonomic motor and sensory experiences.

My own Whiplash was caused by a direct physical Trauma where my head was forcibly thrown sideways at a high and quick speed. I experienced all of above symptoms, from the physical to the neurological to the anxiety and the dissociation with a time delay from the original incident. Initially I was put in a neck brace, had all the medical tests but my symptoms did not heal nor could be explained or addressed in the current model alone. When the Neurologist suggested Occipital Nerve block injections, I thought: "hmm let's not".
 
Whiplash is not always straight forward and the road to recovery can be slow and unpredictable, with periods of worsening, particularly if there is Trauma involved. This is because (traumatic) memories can be stored in our body and these memories are linked to the arousal circuitry within the amygdala (Limbic System -pls see my blog on the brain). Any head movement can perpetuate symptoms that is similar to the trauma. I found this out the hard way when on my road to recovery I sledged hard and fast down a long snowy Mountain with the usual bumps only to find that all my symptoms had worsened the next day. Not only did those movements perpetuate my symptoms but my sacrum had transmitted the forces up to my neck and head that was only just recovering. I continued addressing my physical, mental and traumatic part with CST and eventually saw all my complaints completely disappear.
 
The reason why CST works well for Whiplash is because it has a great effect on the autonomics and linked spinal cord segments. After a whiplash the sutures between bones can be compressed, which creates restrictions that impede the motion of the cerebrospinal fluid (CSF). CST will free these cranial immobility’s and enhance fluid exchange throughout the body and brain. CST also addresses myofascial pain and any emotional effects that may serve as contributing factors to chronic neck pain or shoulder pain and CST has a great ability  to reduce stress and anxiety.
 
CST provides a holistic approach, bringing together all elements, reducing physical discomfort as well as emotional shock and trauma, as it truly integrates Mind, Body and Spirit.
 
Case Study
In my own practice I treated a 56 years old lady who had a Quad bike accident and was diagnosed with whiplash. She also suffered from inexplicably fatigue. She has been referred by her doctor for a course of 9 sessions of CST (NB: this was overseas where Craniosacral Therapy is very much part of the medical model). Case history revealed she had another Whiplash injury 4 years ago due to another accident. First examination reveals a weakening in the cranial system rhythm around neck and shoulder area and an increased tension in the whole craniosacral system and attached fascia. Particularly her right shoulder and neck area reveal inertial patterns with big swirling movements around the place of impact where the incoming force of the collision is retained. In the first few sessions the focus is on bringing the central nervous system to rest, working on the general tension around the craniosacral system and the hyper tonus around the cranial base in particular, so fascia can gently unwind, trapped nerves freed and the self-healing capacity of the body stimulated. The client experienced a sharp increase in pain during the session that immediately disappeared when the session was finished. This increase in pain seemed to be related to the old whiplash injury she had sustained and was re-triggered by the new impact. As her system is clearing up the old and new debris she feels very tired, experiences intermittent pain and not capable of doing much but just relaxing. When the immediate fragility of her system has disappeared and she is starting to experience improvement of her symptoms, the focus of the later part of the sessions are more on myofascial release particularly in the muscles of the neck region and the trapezius muscle in the right shoulder.
 
During one of our sessions the clients literally experiences a structural and emotional release at the same time by sensing and hearing a “plop” inside her body – she can’t really describe it but says “it just felt like something disappeared from my neck, like taking the plug out of the bath”. When she gets off the table she feels no pain, no restrictions in head and neck movements and says she actually feels radiant and full of energy. When she comes back for the last couple of prescribed sessions, she indicates she is actually already better but would like to finish her prescribed treatments as she has seen improvements in many “unrelated” areas as well like her digestion, sleep patterns and overall mood.
 
This case study and many more conditions and case studies will be more detailed in my upcoming book: Integrative Healing through Craniosacral Therapy.

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References:
Myofascial Release - SchleuderTrauma - Roland Kastner at Future Health Cranial Institute Zurich Switzerland