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Overview

 



Whiplash is an injury to the soft tissues of the neck. Whiplash injury strains the muscles and ligaments of the neck beyond their normal range of motion. There is often pain and stiffness in the neck for the first few days following a whiplash injury. The pain can also be felt in the surrounding muscle groups in the head, chest, shoulders, and arms.

Common symptoms include head, neck and shoulder pain accompanied by headaches and a feeling of numbness in the extremities. If any of the symptoms are present following any type of accident a doctor should be consulted to perform medical imaging and/or X-rays to check for a whiplash injury.

Considering compensation for a whiplash injury is not frivolous at all, and most of the time is necessary to contact an attorney. The treatment for whiplash will often include anti-inflammatory drugs, pain medications, anti-depressants and very often, a cervical collar. To properly repair damage from a whiplash injury it is also commonplace to perform physical therapy. The act of physical therapy is to repair your range of motion and to heal the injuries caused by whiplash by exercising any of the effected muscles. Physical therapy is often performed one to two times a week for at least one hour.


Whiplash Causes


The most frequent cause of whiplash is a car accident. The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, whether or not they wear seat belts.

Other common causes of whiplash include contact sport injuries and blows to the head from a falling object or being assaulted.

 


Repetitive stress injuries or chronic strain involving the neck (such as using your neck to hold the phone) are a common, non-acute causes.

Child abuse, particularly the shaking of a child, can also result in this injury as well as in more serious injuries to the child's brain or spinal cord.

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Whiplash Symptoms


These signs and symptoms may occur immediately or minutes to hours after the initial injury; the sooner after the injury that symptoms develop, the greater the chance of serious damage.

 


  1. Neck pain
  2. Neck swelling
  3. Tenderness along the back of your neck
  4. Muscle spasms (in the side or back of your neck)
  5. Difficulty moving your neck around
  6. Headache
  7. Pain shooting from your neck into either shoulder or arm

Exams and Tests


If the patient is transported to the emergency department with a cervical collar strapped around the neck, the emergency physician will remove the collar when appropriate.

In most cases, the collar will be removed without the need for x-rays if the patient meets all of the following criteria:


  1. Normal level of consciousness or alertness
  2. No muscle weakness or sensation problems
  3. No evidence of intoxication with alcohol or drugs
  4. No tenderness in the back of the neck
  5. No other painful injury elsewhere on the body

 


Your collar will remain in place if the doctor determines that the patient needs x-rays of the neck.

The doctor will first examine the functioning of the spinal cord in order to determine if any damage is present.
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The following areas will probably be assessed:


  1. Physical strength in both arms and legs
  2. Ability to sense the touching of the skin in different parts of the body
  3. Reflexes at the joints of the arms and legs

 


The doctor will also inspect the patient's head and neck for any external signs of trauma including bruises, cuts, and abrasions. The patient's neck will be pressed in specific areas to be sure the patient does not perceive any pain or tenderness. The patient may be asked to move their neck in a controlled way to the left, right, up, and down. Tell the doctor if neck pain, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers is felt.

X-rays may be taken of the neck bones to make sure there are no fractures or signs of other serious injury. The doctor will review these x-rays and order further imaging with a CT scan or MRI if needed. If the patient's x-rays are normal, then the cervical collar will probably be removed, and should not need any further x-rays.


 


Whiplash Treatment


Self-Care at Home

Home care is intended to relieve the pain and minimize the amount of inflammation in the soft tissues of the neck.

Apply ice to the neck for 20 minutes at a time each hour for the first 24 hours while awake. Do not apply ice directly to the skin. Place a towel between the ice and the neck. Continue to use ice therapy until the pain stops. (After you see the doctor, follow his or her directions for ice therapy.)

Take acetaminophen for pain relief or ibuprofen for anti-inflammatory action. Avoid ibuprofen if you have a past medical history of gastritis, duodenitis, peptic ulcer disease, reflux, or other stomach problems

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Non-surgical recovery from whiplash


During the recovery phase, the goal with any treatment is to help the patient resume normal activities to their pre-whiplash injury level

Any treatment or recommendations set out by your doctor, spinal physician, or physical therapist should be closely followed. A home exercise program customised by the physical therapist is a key to rebuilding strength and increasing range of motion. It may be necessary to continue physical therapy and modalities for a period of time.

 



Surgical recovery from whiplash


Post-operative pain and/or discomfort should be expected. Patient Controlled Analgesia (PCA) enables the patient to control their pain without hospital staff assistance. PCA is eventually replaced by oral medication

The patient may be encouraged to get up and walk the following day. Activity enhances circulation and healing.

 



Medical Treatment


The doctor most likely will recommend a treatment plan including a mixture of the following:


  • Neck massage
  • Neck rest
  • Bed rest
  • Ice therapy
  • Heat therapy
  • Oral pain relievers and muscle relaxers
  • Immobilization of the neck with a soft cervical collar (only a minimal benefit if any at all)
  • Early range of motion exercises combined with heat therapy starting 72 hours after the injury to restore flexibility
  • Avoidance of excessive neck strain for the next week and then increased activity as tolerated in the following weeks

 


Prevention


Prevention is the most effective way to avoid this injury

Always wear your seat belt and adjust your headrest to the proper height when driving. The middle of the headrest should be even with the upper tips of your ears. Seat belts with shoulder harnesses as well as headrests may not reduce the risk of cervical strain but should be used in all motor vehicles because they reduce the risk of death and serious injury.

Child abuse can cause whiplash injuries in children through excessive or violent shaking. Parents need education and counseling. Report suspected child abuse to authorities.

The effect of air bags on whiplash prevention is still being examined.





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