What Is Whiplash?

Whiplash signifies an injury to the cervical, or neck, region of the spine. The cervical region of the spine is made up of seven backbones, or vertebrae. In whiplash, the neck is thrown to and fro by great forces causing it to go well beyond its normal range of motion. During whiplash, the lower part of the cervical spine bends backwards, while the upper part of the cervical spine bends forward. During this process, injuries can occur that may affect vertebrae, muscles, ligaments, discs, joints, nerves, and other soft tissues.

Another name for whiplash is neck strain. The symptoms of whiplash, or neck strain, may occur immediately, several hours, or several days after the causative event.

Symptoms of whiplash may include:

  • Pain in the cervical region of the spine
  • Decreased range of motion
  • Tightness or spasm in muscles of the neck
  • Headaches
  • Shoulder pain and stiffness
  • Difficulty concentrating
  • Dizziness
  • Arm pain and weakness
  • Ringing of the ears (tinnitus)
  • Visual disturbances
  • Memory loss
  • Sleep disturbances
  • Fatigue

Whiplash at times is an enigma, which means the severity of symptoms does not always correspond to the force of the causative agent. Some feel it is this poor understanding of the condition that leads to people being able to fleece the system for financial gain. Since pain is so subjective, the veracity of the pain being felt and reported by whiplash victims oftentimes comes into question. As a result of insurance and legal issues, the economic burden of whiplash and its associated disorders have skyrocketed over the years. These costs include medical care, sick leave, disability, lost productivity, and litigation. Nonetheless, whiplash is a legitimate condition with legitimate symptoms.

Causes Of Whiplash

Whiplash represents a sudden, forceful jolt causing the cervical spine to move outside of its normal range of motion. The most common cause of this condition is motor vehicle collisions in which one automobile rear-ends another automobile. The rear impact causes the neck to be wrenched forward and then backward. Blows to the head from falling objects, or in a sport like boxing, can cause whiplash. Sudden changes in directions in activities like riding roller coasters, falling off a horse, falling off a bicycle, and slips or falls can also cause the condition. Other causes of whiplash include physical assault or abuse and contact sports such as football, basketball, rugby, and hockey.

Whiplash can be diagnosed with imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI). Soft tissues of the neck such as ligaments, discs, tendons, nerves, and muscles are not visible using conventional X-ray techniques. In the majority of cases of whiplash, symptoms are short-lived and resolve quickly. For some, it is complicated by chronic pain in the cervical spine lasting months to years after the causative event. Chronic neck pain can also lead to mood disorders such as depression and anxiety.

Treatments For Whiplash

WhiplashThe treatment of whiplash is varied. No singular treatment has been scientifically proven to be superior. Rest and immobilization with a cervical collar were once routinely recommended for whiplash. Today, the current trend is toward early movement with gentle exercises as opposed to immobilization, which can prolong recovery.

At the outset of injury, pain control is of key importance. Ice is recommended for the initial 24 hours after injury. After that, ice can be replaced by heat. Both should be applied no greater than 20 minutes.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil (ibuprofen), Bayer (aspirin), or Aleve (naproxen sodium) are useful for mild and some moderate neck pain. Narcotic analgesics, or pain relievers, like Percocet (oxycodone/acetaminophen) and Vicodin (hydrocodone/acetaminophen) may be used sparingly for severe neck pain. If muscle spasm is deemed a major constituent of neck pain, muscle relaxants like Soma (carisoprodol), Flexeril (cyclobenzaprine), Zanaflex (tizanidine), or Robaxin (methocarbamol) may be helpful. Oral steroids, which are potent inhibitors of inflammation, may also be helpful in the treatment of neck pain. All the groups of medications mentioned earlier should be used for as short a term as possible due to the increased risk of negative side effects with prolonged use.

Alternative treatments for whiplash include acupuncture, massage, chiropractic care, and electronic stimulation of nerves. Acupuncture is a key component of traditional Chinese medicine and utilizes thin needles placed at strategic points on the body. There are a multitude of massage techniques, but acupressure may be the best for neck pain as a result of whiplash. Cervical spinal manipulation or mobilization are two general approaches utilized by chiropractors for complaints of neck pain. Cervical spinal manipulation is the traditional chiropractic technique, while cervical spinal mobilization is a gentler, less forceful technique. Electronic nerve stimulation utilizes a gentle electric current, which is thought to be helpful with neck pain.

Whiplash treatment also requires that range of motion be restored in the neck. Neck home exercise programs can be established in consultation with an occupational or physical therapist. Passive treatment techniques include electronic nerve stimulation, massage, and traction of the cervical spine. Active treatment techniques include efforts to increase flexibility, strength, and endurance of the neck muscles. It is paramount that neck range of motion be re-established soon after injury to decrease the chances of chronic neck pain and disability.

Unfortunately, an outcome of whiplash can be chronic neck pain. Neck injections with steroids or anesthetics may be helpful. Another option is radiofrequency ablation, which utilizes radio waves to generate heat to destroy nerves that are continually sending pain signals to the brain. If chronic headaches complicate chronic neck pain after whiplash, Botox (botulinum toxin A) injections can be helpful.

Conclusion

Whiplash is a very common condition and happens when a person’s neck is whipped back and forth suddenly and violently. It can be caused by rear-end car collisions, contact in sports, slips or falls, and physical abuse or assault. Symptoms may manifest over the course of hours or several days. The pain of whiplash is usually short-lived and treatment is conservative, which may include alternative means. For those unlucky enough to have chronic neck pain as a result of whiplash, invasive treatments such as steroid or anesthetic injection or radiofrequency ablation may be an option.

References

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