Head-on, rear-end, T-bone, sideswipe, rollover, single-car, multi-car… the list goes on. Even with safety precautions and defensive driving, accidents happen!
The World Health Organization (WHO) states that road traffic injuries lead to considerable financial losses for individuals, families, and nations due to treatment costs and productivity loss resulting from time away from work/school1.
Motor Vehicle Accident Injury
Injury during a motor vehicle accident (MVA) can vary greatly depending on the individual and the crash. Some common areas of injury include the skin, head, neck, spine, back, limbs, and bones. The diagnoses of individuals following MVAs is broad due to the large number of potential injuries2.
Due to the force of a crash, common injuries to the skin include lacerations and bruising. The presentation of “seat belt sign” includes the injuries associated with the force applied to the body from the seat belt affecting the musculoskeletal and visceral structures2.
Head injuries, also known as brain injuries or traumatic brain injuries (TBI) vary in type, severity, and symptom presentation. Brain injury can be caused by direct trauma, whiplash (forceful back and forth motion on the neck), damage to internal structures, and more3. Head injuries can result in a large variety of symptoms such as visible external damage, pain, sensitivity to sound/light, nausea, fatigue, imbalance, altered consciousness, speech changes, seizures, and more3. Head injuries may require a comprehensive evaluation including various diagnostic tests such as blood tests and imaging3.
The National Institute of Neurological Disorders and Stroke (NINDS) defines whiplash as a soft tissue injury usually resulting from the sudden extension and flexion of the neck4. Many anatomical structures nearby such as the joints, discs, ligaments, muscles, and nerves may also be injured as well. Neck pain and other symptoms such as stiffness, headache, dizziness and more may be present4.
MVAs can lead to crushing injuries such as fracture of bones within the body, for example car accidents are a common cause of broken feet5. A 2014 analysis of 33,105 front-seat occupants involved in MVAs highlighted that enduring rollovers or multiple collisions/hits during the accident were more associated with vertebral fracture compared to head-on collisions6. A 2020 systematic review and meta-analysis concluded that there was a consistent positive association between motor vehicle collision injury and future low back pain7. As both thoracic and lumbar spinal injuries are greatly caused by motor vehicle collisions a 2014 retrospective study gathered data on over 4500 occupants to investigate patterns. The study concluded that age of occupant, seatbelt, and obesity influenced pattern of fracture and injury severity8.
A 2016 cohort study concluded that chronic widespread pain could develop after a MVA in vulnerable individuals, with a typical presentation of widespread pain developing early after the accident9.
Car accidents, collisions, and trauma can lead to emotional distress and in some cases can last for longer periods of time. Posttraumatic stress disorder (PTSD) can develop, including symptoms of anxiousness, sleep disruption, nightmares, re-living the accident in the mind, and irritability/anger10. A 2022 systematic review concluded that trauma related MVAs were associated with negative psychological consequences. The most frequent pathologies found within the systematic review included PTSD, depression, anxiety, phobia, and emotional distress11.
Treatment
The WHO stresses the importance of timing when providing care, such as the need for timely prehospital response1. As the injuries sustained in a MVA can vary greatly, it is imperative to receive an adequate assessment, which can include a history, physical analysis, and/or laboratory evaluation.
Many treatments exist for the various injuries sustained during an MVA. Some research on alternative treatments is highlighted below:
Head Injuries:
- A 2022 systematic review concluded that a graded return to physical activity, cognitive behavioral therapy, cognitive training, and psychoeducation were effective on persistent post concussion symptoms. This review also detailed the importance of tailored treatment depending on the type and severity of post concussion symptoms12.
- A 2021 clinical focus article in the American Journal of Speech-Language Pathology highlighted the importance of interprofessional collaboration in the management of post concussion symptoms to optimize rehabilitation13.
Whiplash:
- The NINDS mentioned the usage of range of motion exercises and physical therapy in the treatment of whiplash4.
- A 2016 practice guideline suggests multimodal care for whiplash14.
- A 2020 study concluded that acupuncture appeared to be an effective treatment for whiplash-associated disorder following road traffic collision. This study utilized multiple musculoskeletal scales and the return to full-work duties as outcome measures15.
Traumatic Injury:
- Within the interprofessional team managing traumatic injury, physiotherapists play an important role, resulting in improved outcomes in major thoracic and abdominal trauma injuries16.
- A 2018 systematic review with a network meta-analysis concluded that moderate quality evidence exists supporting that half of the patients receiving physiotherapy following a first-time traumatic shoulder dislocation did not experience a recurrence17.
Pain:
- A 2020 systematic review and meta-analysis concluded that acupuncture was an effective treatment for non-specific low back pain18.
- A 2017 systematic review concluded that manual therapy with exercise is better than manual therapy or exercise alone for improving non-specific neck pain19.
- A 2017 systematic review and meta-analysis concluded that massage therapy is effective at improving shoulder pain with larger sample sizes being necessary to support recommendations20.
- A 2016 systematic review and meta-analysis concluded that massage therapy effectively treated pain compared to no treatment21.
Psychological Disorders:
- A 2022 systematic review and meta-analysis concluded that acupuncture therapy for reducing anxiety in patients with generalized anxiety is effective, but more high-quality trials are necessary to support the result22.
- A 2022 systematic review concluded that limited evidence suggests that a combined exercise intervention has the best evidence at improving PTSD symptoms compared to individual forms of exercise23.
- A 2020 systematic review and meta-analysis concluded that cognitive behavioral therapy improved outcomes in generalized anxiety disorder and PTSD24.
After a claim is reported, the Insurance Corporation of British Columbia allows the individual to see various healthcare providers of their choice, these providers may have set up direct billing of treatment costs to ICBC25. Different healthcare providers have various numbers of approved treatment sessions which can be found on the ICBC website. If longer care is needed, an additional treatment plan must be provided to obtain additional coverage. Support and recovery professionals can assist with prolonged injury treatments25.
The Revamp Experience
The Revamp Wellness team includes practitioners who provide massage therapy, physiotherapy, chiropractic therapy, orthotics, shockwave therapy, intravenous therapy (IV Therapy), kinesiology, acupuncture, naturopathic medicine, micro-needling, and more. Revamp Wellness is committed to delivering an integrated approach, to ensure optimal recovery. As every accident is different, a variety of approaches may be necessary, but a general framework for what to expect is as follows:
Step 1: Assessment and planning, the Revamp team will create a targeted treatment plan.
Step 2: Begin treatment with sessions to calm the nervous system and reduce symptom aggravation.
Step 3: Address underlying root cause of discomfort.
Step 4: Active rehabilitation to redevelop strength and mobility.
If looking to book with Revamp Wellness please bring: ICBC claim number, date of birth, care card/ BC service card, adjuster contact details, lawyer contact details, and doctors note (if 12+ weeks since accident).
REFERENCES
[1] https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries
[2] https://www.ncbi.nlm.nih.gov/books/NBK470262/
[3] https://www.hopkinsmedicine.org/health/conditions-and-diseases/head-injury
[4] https://www.ninds.nih.gov/health-information/disorders/whiplash
[6] https://pubmed.ncbi.nlm.nih.gov/24486770/
[7] https://pubmed.ncbi.nlm.nih.gov/32438092/
[8] https://pubmed.ncbi.nlm.nih.gov/24486471/
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4942849/
[11] https://doi.org/10.1016/j.trf.2022.06.017
[12] https://pubmed.ncbi.nlm.nih.gov/36294545/
[13] https://pubmed.ncbi.nlm.nih.gov/34170743/
[14] https://pubmed.ncbi.nlm.nih.gov/27836071/
[15] https://pubmed.ncbi.nlm.nih.gov/32026700/
[16] https://pubmed.ncbi.nlm.nih.gov/32671276/
[17] https://pubmed.ncbi.nlm.nih.gov/29936432/
[18] https://pubmed.ncbi.nlm.nih.gov/32458717/
[19] https://pubmed.ncbi.nlm.nih.gov/28826164/
[20] https://pubmed.ncbi.nlm.nih.gov/28603376/
[21] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925170/
[22] https://pubmed.ncbi.nlm.nih.gov/36626458/
[23] https://pubmed.ncbi.nlm.nih.gov/36033016/
[24] https://pubmed.ncbi.nlm.nih.gov/31758858/
[25] https://www.icbc.com/claims/injury/Pages/medical-care-treatment.aspx