Disclaimer: The following neither contains medical or legal advice but is for Informational Purposes Only. Consult a medical professional or attorney for your unique situation.
What Is Whiplash?
One of the most common neck injuries is whiplash, which is also called neck strain or sprain. But regardless of the name, it is caused by a sudden movement of the head and subsequent sudden neck flexion and extension. The cervical spine has a pretty big range of motion, and it is surrounded by muscles and ligaments which provide stability. 1
In the case of whiplash, the cervical spine will suffer hyperextension and hyperflexion which can cause injuries to different parts of the neck. The most common causes of whiplash are car accidents, fall from a height, and sport injuries, but any injury or force applied to the body which can cause sudden head movement can result in whiplash.2
When it comes to car accidents, especially rear-end hits, the applied force will push the body forward causing the head to go backward and the neck to suddenly extend. When the neck reaches its maximum limit of extension, the head will go forward and the neck will flex until it reaches the maximum of flexion. This motion sequence will repeat several times, causing injury to the tissues located in the neck.
What Are the Symptoms of Whiplash?
In most cases, people who suffer from whiplash won’t have any severe symptoms right after the accident. However, symptoms can start a day after the injury or in some cases even later. Symptoms of whiplash will depend on the amount of force applied to different neck structures. If the applied force is low and the cervical spine is not extremely flexed or extended, symptoms will be less severe. On the other hand, severe flexion and extension will cause severe symptoms. Hyperflexion and extension will cause stretching of neck muscles, ligaments of the cervical spine, cervical spine joints, nerves and nerve roots located in the neck region (most commonly brachial plexus). Stretching of these structures will cause symptoms and signs of whiplash.
The most common symptoms of whiplash are:
- pain located at the back side of the neck followed with neck stiffness
- painful movement of the neck with decreased range of motion
- tingling of neck, head, shoulders, arms, dizziness
- problems with vision
- headache which is usually located at the back of the head
The patient can also have other symptoms such as tinnitus (ringing in ears), memory and concentration issues, and sleeping issues.1,3
How Is Diagnosis of Whiplash Made?
The most important element for diagnosing a whiplash injury is a detailed history of the accident which caused the neck injury. It is very important to get the information regarding the mechanism of injury (rear-end car accident, neck blow, etc.). That information will lead the examiner to screen for whiplash. After assessing the history, the examiner will do an examination of the injured region. If the examination is performed right after the accident, there is a chance that there won’t be any major signs of injury; in some cases, the examination of the cervical spine can be normal. Usually, the examiner will notice muscle spasm of cervical spine muscles, trapezius, etc. Palpation of the neck can be painful and palpation of different areas can indicate the possible level of injury. The individual will have painful and limited range of motion and any attempt to move the head can cause pain in the neck. Also, if the examiner tries to passively move the head, there can be pain in the neck. With more severe injuries, loss of strength in arms and hands can occur. This can be noted when the examiner asks the patient to grip his hands and press them or to attempt to move their arms when he tries to prevent it.
The next step in the diagnosis process is radiographic studies. X-rays are most commonly used as a first radiographic method. They will show the examiner any injuries to the cervical spine, such as fractures or dislocations. Also, a very common finding is straightening of the cervical spine (in normal conditions, the cervical spine has a curve – cervical lordosis).1
CT scan is a radiographic study reserved for more serious injuries, such as when a fracture of the cervical spine is suspected. It has an ability to show bony structures more accurately and to show more details. MRI is a great diagnostic study to show injuries to neck soft tissues. It has an ability to reveal injuries of the intervertebral discs such as disc bulge or disc herniation, muscle injuries, cervical ligaments tear, nerve injures, etc.4
Treatment of Whiplash Injuries
Whiplash injury can be a self-limiting injury and in most cases symptoms will resolve after a few weeks. The main goal of treatment after whiplash should be to restore the normal function of the cervical spine with normal range of motion and without any pain. The exact treatment protocol depends on the severity of injury and symptoms. In the case of less severe symptoms, over the counter medicines can provide great relief. However, there are cases when over the counter medicines don’t suffice and stronger medicines are required. In that case, it is important to be under the surveillance of a medical professional.4
In most cases a combination of different treatment modalities is used. Generally speaking, most patients will recover after a short period of rest, pain killers, NSAIS gels, and/or muscle relaxants. Rest in the early period after a car accident can shorten the painful period and promote pain resolution. Tylenol, aspirin, and ibuprofen are the most commonly used pain killers which provide relief and they can help resolve mild to moderate pain. More severe pain might require other medications such as antidepressants, which can help in this situation. There are also NSAID gels which can be applied to injured areas, in this case the neck, and which allow their active substances (usually ibuprofen or similar substances) to penetrate the skin and get to the injured muscles and help with pain relief. Muscle relaxants are used to reduce muscle spasms which are a consequence of a strong and sudden muscle stretching. They are usually used in the first few days after the accident. Some doctors might recommend injections of local anesthetics into the injured muscles to relieve the pain.4
There is a controversy regarding the need for foam collars. In the past, most patients that suffered whiplash were using foam collars to reduce pain. However, a number of studies show that foam collars might not be beneficial for pain relief when it comes to whiplash. In fact, they might cause more harm than good because they can cause neck muscles to become weak and atrophied.
Physical therapy is another therapeutic modality reserved for more severe injuries. It usually consists of different exercises which have a goal to strengthen the neck muscles, as well as use of electric currents such as TENS, ultrasound waves, etc.4
- Whiplash: Diagnosis, Treatments, And Complications.” Healthline. N. p., 2019. Web. 1 Nov. 2019.
- “Neck Strain And Whiplash.” WebMD. N. p., 2019. Web. 1 Nov. 2019.
- “Whiplash Information Page | National Institute Of Neurological Disorders And Stroke.” Ninds.nih.gov. N. p., 2019. Web. 1 Nov. 2019.
- ” Whiplash – Diagnosis And Treatment – Mayo Clinic.” Mayoclinic.org. N. p., 2019. Web. 1 Nov. 2019.