Leading Integrated Healthcare

Whiplash / neck injury

Neck injuries that don’t include a whiplash component are uncommon (though neck pain and associated headaches are very common).

So it is convenient to refer to most if not all neck injuries as variants of whiplash because a) two important groups of muscles are nearly always found to be weak and in need of re-training (upper cervical flexors and lower cervical extensors), and b) there is frequently an element of ‘shock’ involved when the head is moved suddenly on the body and the neck muscles are unable fully to ‘brace’ against the movement.

The most common problem, then, is either strain to muscles that tried in vain to brace the neck against the injurious movement, or the effects of shock on the nervous system that tried to initiate the self-defence mechanisms. Commonly both.

Occasionally, the joints themselves will be injured, together with the ligaments that bind them together, though this only becomes a common finding in high-impact sporting injuries. Injuries that cause fractures in the neck do not necessarily cause worse long term symptoms than muscular strains – as long as the spinal cord itself is not injured.

Proper assessment and management of neck injuries and whiplash, then, must include not only muscles, joints, ligaments, tendons and bony structures, but also the nervous system that controls movement and which may have been shocked and braced, together with the blood supply to all these systems. Attention is also paid to how the neck is used – that is, postural and occupational elements. And last but not least, the patient’s general state of health, including sleep, stress and energy levels.

Whiplash injuries are notorious for taking months if not years to resolve. Unfortunately there has been a common belief that this is often related to legal action taken after road traffic accidents. In fact, there is much good scientific evidence to suggest that the real problem with whiplash is misdiagnosis; most so-called whiplash injuries are not, as is commonly believed, caused by structural damage to nervous tissue or muscular tissue, but are in fact caused by long term bracing – that is, splinting of the neck as a result of a disturbance in the levels of nervous control of neck muscles. This is a ‘shock’ effect, and it is necessary to retrain the levels of power developed by neck muscles in order to resolve the problem.


Dr Kaplan: Provocative Therapy

In December 2012, as result of a stress at work, I suffered from severe anxiety, fear, panic attacks, tachycardia and insomnia.These symptoms became increasingly severe and were associated with low self-esteem and loss of self-confidence. I consulted my GP who prescribed Citalopram and beta blockers for the tachycardia. The antidepressant did not suit me and I felt worse. I was then referred to Dr Brian Kaplan, to be treated with the ‘Provocative Therapy’. This treatment adapted by Dr Kaplan, is based on the principle that the therapist ask questions covering all aspects of the patient’s life, by exaggerating the meanings of it. During the 1 hour session, the patient experiences a strong reaction, triggered by the ‘Provocative’ input of the therapist. Initially, there is an increased fear with regression to the childhood, associated to strong emotions and sorrow, which may precipitate sobbing. Subsequently, this state is followed by a phase of self-analysis which is more constructive. The ‘provocation’ breaks the pattern of the patient’s own feelings of hopelessness and discomfort. In fact, there is an opening of the self-image and a critical strong desire for change, in response to the provocation, which can be at times, outrageous. I underwent 9 weekly sessions during which I progressively became free from fear. The anxiety and panic attacks reduced significantly and I started to know what I want from my life and became more positive and optimistic. At the end of the 9 weeks, I acquired my self-confidence and self – esteem together with a new approach in my life which initially appeared to me broken and rather useless. The 9 sessions – in my opinion – were sufficient to resolve the initial acute state with anxiety and I felt a person full of interest and happier.  It is more than one year since I started the ‘provocative therapy’ with Dr Kaplan and I have not had any relapse to the original symptoms and discomfort. I strongly recommend this this therapy as a novelty; this is medication- free and can produce resolution of the acute psychological/mental conditions, quicker than the conventional therapies. In order to be successful, it is crucial that the patient collaborates and has complete trust in the therapist. The scientific process of such a treatment is not yet known and /or clarified. However, a number of recent studies in Neurophysiology and Psychiatry have shown the importance of hexogen and endogen stimuli, which can triggers and induce changes in the brain in response to the external inputs, acting via the hypothalamic/endocrine axes. It can be suggested that some of these mechanisms may be involved in the therapeutic process of the Provocative Therapy, but a lot of work needs to be in hand.