Ask the Experts: Whiplash Injuries; Vertigo Treatment; GI Diet

Q. Can you recommend any self-help measures that will help ease whiplash syndrome?

A. Whiplash injuries occur when the head is jolted beyond its normal range of motion, resulting in damage to the soft tissue (the muscles, ligaments and tendons) of the neck. Vehicle collisions are a major cause of whiplash injuries, and older adults are at particular risk if they have chronic conditions that affect the neck, such as osteoarthritis.

Symptoms include headaches, dizziness, swelling in the neck area, pain and stiffness that may radiate from the neck to the shoulders, arms and back, and numbness or a tingling sensation in the neck and back. Some people also report tinnitus (ringing in the ears). It typically takes about eight to 12 weeks to recover, but about 25 percent of people who suffer a whiplash injury report discomfort for up to one year afterwards.

A combination of rest, ice packs and painkillers is usually recommended for the first 72 hours after a whiplash injury. It’s likely your doctor will recommend physical therapy after this, to restore flexibility. Gentle stretching exercises that rotate your head from side to side and bend your neck forwards, backwards, and sideways are best. If pain or tight muscles make it difficult for you to perform the exercises, gently massaging the area or applying a heat pack may help. If you’re still having discomfort, your doctor may administer a steroid injection or a local anesthetic before you do the exercises.

Rosanne M. Leipzig, MD, PhD
Geriatric Medicine

Q. A friend who suffers from vertigo said that she found relief from the “Epley maneuver.” What is this, and could it also help to relieve my vertigo?

A. Benign paroxysmal positional vertigo (BPPV) causes a transient spinning sensation to accompany certain movements—for example, rolling over in bed, or looking upwards. While vertigo is not dangerous in itself, it can put older adults at risk for falls, as well as signal serious underlying disorders, including stroke, multiple sclerosis, and tumors of the inner ear. With this in mind, I recommend you mention your vertigo to your doctor, who can rule out these underlying causes.

It’s thought that BPPV is caused by the movement of small naturally occurring crystals called otoconia from one part of the inner ear to another—once relocated, they interfere with tiny hairs in the inner ear that affect balance. The Epley maneuver is an exercise done with the assistance of a doctor or physical therapist, and involves your head being moved into certain positions while you recline in a chair or lie down. The goal is that the crystals will slip back into another area of the inner ear, where they can be reabsorbed, thus relieving BPPV. Some people gain relief after only one treatment, but the procedure may need to be repeated several times over several days. 

Patricia Bloom, MD 
Geriatric Medicine

Q. A friend has managed to control her diabetes by following a “GI diet.” Can you shed light on what she means, since I don’t think she is referring to the “Meals Ready to Eat” used by the military!

A. Your friend is definitely not referring to MREs! It sounds as if the diet she’s following is based on what’s called the “Glycemic Index,” or GI, which is a measure of a food’s ability to raise blood sugar levels compared with a reference food (either glucose or white bread). High GI foods—which are assigned a value of 70 and above—cause blood sugar to spike, which may contribute to poor eating behaviors. Low GI foods (with a value below 55) cause blood sugar to rise more slowly, which helps regulate the appetite.

Studies suggest that following the GI diet may help diabetics better manage their blood sugar, and there also is evidence the diet may help people maintain a healthy weight. This is likely because the diet prioritizes unrefined grains, which are low in calories, and fiber-rich—because fiber takes longer to digest, the GI diet may help you feel fuller for longer, meaning you’ll be less likely to snack between meals. However, the diet can be tricky to manage, since a food’s GI can change depending on how it is cooked or processed, and if it is eaten with other foods. You can find out more about the GI at http://bit.ly/1NlBYLG.

Fran C. Grossman, RD, MS, CDE, CDN 
Nutrition

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