Whiplash
What is whiplash?
Whiplash is the name given to the hyper-extension or over-stretching of the neck and back region often due to the head being thrown backwards and forwards and/ or to the side in a sudden movement, resulting in possible injury to the ligaments, spinal joints, and soft tissues of the neck area. Spinal nerves can also be irritated by this type of injury. In extreme cases there can be a degree of partial dislocation of a cervical joint. Because of the relationship between the neck and the spinal chord, there are sometimes other symptoms and problems associated with whiplash not just in the neck area.
What causes whiplash?
The most common cause of Whiplash is a car accident and primarily rear-end or side impact collision. In a car accident a driver or passenger is suddenly decelerated in a sudden jerking movement, often without good support to the neck and head due to a mal-adjusted headrest. Other sources of whiplash injuries include:
- Amusement park rides
- Sports injuries, for example during contact sport, mountain climbing, diving, gymnastics or riding
- A blow to the head, for example being punched
- Being shaken violently (as associated with shaken baby syndrome).
Whiplash injury is frequently referred to in the medical arena as cervical strain, or cervical acceleration-deceleration injury. Whiplash is the most common consequence of nonfatal car injuries and is produced by an overload injury to the muscle-tendon unit because of excessive forces on the cervical spine. The cause is thought to be the elongation and tearing of muscles or ligaments in the neck area.
What are the symptoms of whiplash?
Symptoms of whiplash often emerge 24-48 hours following an injury.
Primary symptoms are pain and stiffness of the neck, with varying degrees of decreased range of motion.
There are many possible secondary symptoms that may take affect with varying degrees of severity:
- Neck pain
- Back pain
- Radiating pains to the head, shoulder arms or between thje shoulder blades.
- Headache and dizziness
- Generalised hypersensitivity
- Tingling or burning sensations in the arms and hands
- Weakness and numbness in the arms in the arms and hands
- Symptoms from the jaw (temporomandibular joint) including pain
- Visual disturbances
- Ringing in the ears
- Poor control of head and neck position
- Impaired cognitive function
Symptoms can last from a dew weeks to a few to a few years in sever cases.
What treatment can you have for whiplash?
Things you can do yourself:
- It is advisable to continue normal activities that do not exacerbate the pain. Complete rest could increase stiffness due to inactivity
- Use of non-steroidal anti-inflammatory drugs such as ibuprofen (always seek the advice of a medical professional)
- Cold therapy: Put a cold pack (typically an ice pack applied for 20 minutes) directly on the injury
- Thermotherapy: Apply heat (typically in the form of heated pads, warms packs or lamps) to the areas of the body causing pain. NB. Often Cold therapy and Thermotherapy are alternated, with the cold application happening first
- Home stretching exercises as advised by a medical/health care professional
Rehabilitation Treatment
Rehabilitation treatments provided during the acute stage (0-2 weeks) often include:
- Active exercise through a health professional’s advised home exercise programme
- Education and advice on self-management and return to normal activity as soon as possible
- Pain relief can be sought from your GP and heat therapy may reduce muscle spasm and pain
- Manual mobs
- Soft tissue techniques
- Education about the origin of pain
- Advice about coping strategies
- Relaxation and using a TENS machine can be effective.
Sub-acute stage (2-12 weeks):
- Multimodal approach
- Postural training
- Annual techniques and psychological support
- Acupuncture
- Massage and treatments mentioned in acute stage
Chronic stage (more than twelve weeks):
- exercise therapy
- Multi Disciplinary Team (MDT) psychosocial approach perhaps through referral to rheumatologist
- Orthopaedic surgeon or pain consultant for steroid injections.