Whiplash is an injury to the neck that most often occurs as a result of a car accident. Not only is whiplash one of the most common types of injuries in the United States, but it is also one of the most common causes of chronic neck pain.

What is whiplash?

Whiplash is an injury to the cervical region of the spine.

When the neck moves rapidly back and forth, like a whip, it forces the neck to move past its normal range of motion. This can cause damage to the muscles, ligaments, and nerves of the neck. Whiplash injuries can even lead to damage of the discs, joints, and vertebrae. For an animation of what occurs during whiplash, watch this video.

Most whiplash injuries are caused by car accidents. In fact, it’s estimated that out of every six million people in cars during low speed rear impacts, approximately three million of those people will sustain a whiplash injury. However, whiplash can occur at other times, too, such as during sports, falls, rollercoaster rides, or other activities.

Despite how common whiplash is, it’s considered quite underreported because whiplash injuries aren’t immediately apparent. If a car accident has occurred, there may be no damage to the car, and the people involved may show no signs or symptoms of injury. Also, whiplash symptoms can take anywhere from a few hours to a couple days to manifest.

Symptoms of whiplash

The symptoms of whiplash can vary widely.

Neck pain and stiffness are very common symptoms of whiplash. The pain may worsen with movement, and there may be some loss of motion in the neck. Headaches are also fairly common, as are pain or tenderness in the shoulders, upper back, or arms. Some people may even experience tingling or numbness in the arms.

Additional potential symptoms of whiplash include:

  • Fatigue
  • Dizziness
  • Blurred vision
  • Ringing in the ears
  • Trouble sleeping
  • Irritability
  • Depression
  • Memory trouble
  • Difficulty concentrating

If any of these symptoms begin to occur after an accident or fall, it’s important to see a physician as soon as possible.

Chronic neck pain and whiplash

Most whiplash injuries heal within a few days or weeks, but some injuries continue to cause chronic pain.

As many as 25% of people with whiplash injuries will experience chronic neck pain as a result of the injury. Until recently, it was unclear why some whiplash injuries continued to cause pain for months or even years. However, new research has shed some light on this.

Scientists at Northwestern University have found that magnetic resonance imaging (MRI) studies of whiplash victims can indicate whether or not an individual will develop chronic pain. As soon as one to two weeks after the initial injury, MRI studies can reveal large amounts of fat infiltrating the neck muscles. This fat has nothing to do with the patients’ weight, size, or shape. Rather, this infiltrating fat indicates that the neck muscles are atrophying.

By using the presence of this fat in neck muscles to predict which patients will likely go on to develop chronic neck pain, physicians can also predict which patients are at a higher risk of develop post-traumatic stress disorder (PTSD) as a result of the injury. Knowing this in advance will allow physicians to personalize treatments and make recommendations accordingly.

Additionally, some researchers have done postmortem (after death) exams of people who suffered from chronic neck pain due to whiplash injuries. These exams have revealed damage to the cervical facet joints of the neck, as noted by Central Physical Fitness & Therapy:

“The results of these studies show that tiny fractures and tears of the joint surface (called articular cartilage) and joint capsule are the main reason for continued neck pain long after the car accident or other injury. And the key finding here is that these lesions don’t show up on X-rays or MRIs.”

It’s thought that up to 50% of people which chronic neck pain from whiplash experience that pain because of damage to the cervical facet joints. By knowing that damage to the cervical facet joints may be to blame for chronic pain, physicians can then design a targeted treatment plan.

Preventing whiplash

When it comes to avoiding pain from whiplash, prevention is the best medicine.

The most important aspect of whiplash prevention is the proper adjustment of the seat and headrest in the car. The seat shouldn’t be tipped back at too much of an angle. The headrest should be high enough and close enough to support the head and prevent the whip-like motion that causes whiplash injuries. An easy way to check the adjustment of the headrest is to set your hand flat atop your head. The headrest should be high enough and close enough that you can touch it.

When playing sports, be sure to use all the right safety equipment. Make certain all safety harnesses or restraints are used correctly when going on rollercoasters.

Also, stronger neck muscles may help reduce the risk of whiplash should an accident occur, so try to work in some easy neck-strengthening exercises with your daily routine. If a whiplash injury does occur, prompt treatment and gentle exercises are the best way to reduce the risk of chronic pain.

Treatments for whiplash

Treatment for whiplash is usually fairly conservative.

The treatment will depend on the severity of the injury. For some people, over-the-counter pain medications, like non-steroidal anti-inflammatory drugs (NSAIDs), are sufficient to control pain. If pain is still significant, a physician might prescribe opioid pain medications, muscle relaxants, or steroids to control discomfort.

Also, while many injuries call for immobilization of the injured area, this isn’t the case with whiplash. A cervical collar to promote immobilization of the neck used to be the norm, but this is now believed to prolong recover. Today most physicians recommend gentle exercise and should be able to suggest a routine of easy moves to achieve this. Alternately, a physical therapist might be of assistance. Regaining full range of motion in the neck as soon as possible after the initial injury can significantly reduce the risk of chronic pain.

Alternative pain therapy methods might also help with whiplash pain. Acupuncture, chiropractic manipulation, or massage can all be effective.

If, despite all efforts, a whiplash injury occurs and leads to chronic neck pain, there are more advanced treatment options that your doctor may try if conservative treatments have failed.

Electric stimulation, such as transcutaneous electrical nervous stimulation (TENS), can provide relief by interrupting pain signals in the nerves. Additionally, nerve block injections to the affected area can block pain signals along the nerves, providing significant relief.

If previous nerve block injections have helped identify precisely which nerves are causing pain, longer-lasting pain management techniques, such as radiofrequency ablation (RFA), could be highly effective. RFA involves the application of focused heat to cause lesions that block pain transmissions along nerves. When chronic neck pain from whiplash also involves headaches, injections of Botox might decrease discomfort.

Have you ever experienced a whiplash injury?

Image by andronicusmax via Flickr


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