As many as three million whiplash injuries occur in the United States every year. Additionally, whiplash is a common source of chronic neck pain, with as much as 45% of people with chronic neck pain attributing their pain to a past whiplash injury. How long does whiplash last, and how do you know if you’re suffering from untreated whiplash symptoms?
What is whiplash?
When the neck is suddenly or violently jolted, first in one direction and then in another, it causes a whip-like motion. This can cause sprains or strains to the structures in the neck by stretching these structures beyond their usual limits. The muscles, tendons, ligaments, and nerves can all be affected. In some cases, the discs in the vertebrae of the neck can be torn, leading to a disc herniation. Among people with osteoporosis, a whiplash injury can even cause fractures to the vertebrae.
Motor vehicle accidents are the most common cause of whiplash injuries. However, it can also occur as a result of sports injuries, work injuries, or falls.
What are untreated whiplash symptoms?
The most common symptoms associated with whiplash are pain and stiffness in the neck. The pain is typically worsened by turning the head. More than two thirds of people with this condition also experience headaches at the base of the skull. It’s also possible for the pain and stiffness to extend into the shoulders, arms, upper back, and upper chest. Irritability, fatigue, or difficulty concentrating can even occur as a result of whiplash.
Whiplash might also be accompanied by some concussion-like symptoms, including:
- Blurred vision
- Difficulty swallowing
- Ringing in the ears
- Jaw pain
How long does whiplash last?
It’s also worth noting that the symptoms of whiplash often take 24-48 hours to appear. Because of this, whiplash injuries sometimes go unreported or untreated. If you ever experience an accident or incident that causes a whip-like movement of your head, stay alert for symptoms a day or two after the incident and see a physician as soon as possible if you begin to experience discomfort.
Once symptoms have developed, they may resolve quickly, but some people continue to experience symptoms of this condition for weeks, months, or years. Unfortunately, chronic whiplash can occur and pain can last years.
The specific structures affected by an injury may play a part in determining how long your symptoms will last. The Whiplash Prevention Campaign notes:
“Some scientists believe that the cause of long-term whiplash symptoms is due to damage of nerves and that the cause of short-term pain may be minor injury to the muscles.”
Recent research has looked into this question even more.
Damage to the neck muscles
A recent study at Northwestern Medicine has found that large amounts of fat in the neck muscles after a whiplash injury suggests that a person will experience chronic pain, disability, and post-traumatic stress disorder (PTSD) as a result of the injury. This fat has nothing to do with the person’s body shape or size. Rather, the fat that infiltrates the neck muscles indicates muscle atrophy. The chronic whiplash victims who have this increased fat in the neck muscles also have an increased amount of muscle fat in the lower legs.
According to the study author, this suggests that an injury to the spinal cord has occurred. The exact type of injury is unknown, but the study does show that whiplash does not always cause a set array of symptoms with a common severity. Instead, injury can vary from the mild to the severe, and each case should be treated as unique. The precise magnetic resonance imaging (MRI) techniques used to screen the muscles of victims can show the increased muscle fat in the neck as soon as one to two weeks after the initial injury.
Chronic whiplash and neck pain
Until relatively recently, it was unclear why whiplash injuries – which are sometimes so subtle that they’re undetectable on imaging studies – can lead to pain that lasts for weeks, months, or even years. However, researchers have been studying chronic pain from whiplash and have come to a few conclusions. First, it’s become clear that a large number of people who suffer from chronic neck pain have also suffered from acute whiplash injuries in the past. This suggests that many people’s chronic neck pain may originate from a past whiplash injury.
As far as why pain persists after a whiplash injury, there are a few possibilities. One of these possibilities is damage to some of the joints in the neck. While severe damage to the joint structures in the neck is visible in traditional imaging studies (such as X-rays), it’s possible that some people experience difficult-to-detect damage to the bones, tendons, cartilage, or other structures.
One study focused on a specific type of joint in the neck, the zygapophysial joint, and noted:
“The cervical zygapophysial joints are particularly relevant. Clinical and experimental studies of whiplash injuries in humans and animals have revealed tears of the joint capsules, hemarthroses, and fractures of the articular cartilage and subchondral bone [of these joints]. Detecting these injuries in vivo is difficult. It has been clearly demonstrated that injuries to the cervical zygapophysial joints frequently are undetectable on conventional x-ray examinations, and there are no known clinical features that permit their identification.”
Another possibility is nerve-related. It is, of course, possible that structural damage to the neck can result in a nerve becoming irritated or pinched, but there may be a deeper connection between whiplash and nerve-related pain. Researchers considered people with chronic neck pain or headaches from a past whiplash injury, and they found that these people had significantly lower pain thresholds as compared to people without whiplash-related chronic pain.
Additionally, this lower pain threshold was observed both in the neck and in the (uninjured) lower limbs. Because the lower pain threshold also extended to body parts that were uninjured by whiplash, it suggests that a whiplash injury can affect the way the central nervous system (which runs throughout the entire body) interprets stimuli. In other words, if a whiplash injury (or other type of trauma) causes the central nervous system to become hypersensitive, it can lead to more pain even in uninjured areas of the body. When this happens, it’s referred to as generalized central hypersensitivity.
How does whiplash occur?
The head’s support system is a complex series of supports. The seven spinal bones, called vertebrae, just below the skull are the cervical spine. There are several types of joints associated with each vertebra, including facet and zygapophysial joints. Between the vertebrae are intervertebral discs, which act as cushions and shock-absorbers for the vertebrae. Ligaments connect the vertebrae to each other. Tendons connect the vertebrae to the surrounding muscles. Nerves also run out from the cervical spine to the body.
All of these parts work together seamlessly most of the time, but injuries to the neck – like whiplash – can cause some serious problems. Whiplash occurs when an impact of some sort forces the head in one direction very quickly and then in the opposite direction very quickly. This motion causes the structures of the neck to be stretched too far.
The specific injuries that can occur with whiplash include:
- Stretching or tearing of the ligaments
- Straining or spraining of the muscles and tendons
- Pinching, straining, or inflammation of the nerves
- Damage to the capsule surrounding the joints
- Fracturing of the vertebrae
A whiplash injury most commonly results in sprains or strains of the various structures of the neck. More extreme whiplash injuries, like vertebral fractures, typically only occur in extreme conditions or in people with osteoporosis.
Getting whiplash treatment
Whiplash treatment is usually quite simple and straightforward.
Unless some sort of serious injury requiring immobilization has occurred, one of the most important parts of whiplash treatment is to stay active. Moving and staying active, within reason, are key to helping the injury heal. It might also be good to ask a physician or therapist to devise a stretching or exercise program to support the best possible long-term outcome.
Use ice or heat to control any pain or muscle spasms that accompany an injury. Electrical stimulation or ultrasound therapies, used in conjunction with an exercise or stretching program, can also provide some relief. In addition to these, a chiropractor might be able to provide some relief from neck pain through spinal manipulation or mobilization. If pain and stiffness from whiplash are still persistent, ask a physician which medications are okay to take.
Reduce your risks
Rather than ask yourself “how long does whiplash last” in the future, take steps now to reduce your risk. There are several steps that can help reduce the risk of a whiplash injury.
Car accidents are the most common cause of injuries, so the best way to prevent it is to take precautions in the car. Wear a seatbelt, and make sure to adjust the seat and headrest (also called a head restraint) properly. Adjusting your seat and head restraint are one of the most effective and easy ways to reduce the risk of whiplash, but a 2002 study in Canada found that 86% of drivers’ head restraints were adjusted incorrectly.
To adjust your seat and head restraint, follow these steps:
- Keep the seat inclined at less than a 20 degree angle. This will help you stay in your seat during a rear-end collision.
- Make sure the head restraint is level with or above the level of your head. You can set your hand flat on your head to check that the restraint is at the correct level. This is a very important step, since a head restraint that’s too low might actually contribute to or worsen a whiplash injury in the event of an accident.
- Keep the head restraint close to the back of your head. About two inches is a good distance.
Following these steps will help to keep your body supported and aligned in case of an accident. This will reduce the risk of whiplash or, at least, reduce the severity of an injury. Also, newer cars have more effective head restraints, so if you’re thinking about trading in your current car, take this into consideration. In 1995, 82% of head restraints were graded as poor, but in 2005, this number had dropped to just 6%.
If you’re suffering from whiplash, or just experienced a traumatic event, it’s important to talk to your doctor. Research continues to find answers for how long whiplash occurs and what you can do to prevent future pain. A diagnosis and examination is the most important first step to preventing chronic whiplash pain.
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