Whiplash is a common injury, affecting about 2 million people in the United States each year. Usually a consequence of an automobile accident, whiplash can also result from falling, engaging in sports, or from other causes, such as being shaken or punched.
Whiplash is the common term for a neck sprain or strain resulting from hyperextension (see image below) and hyperflexion (see image below). It often does not cause immediate symptoms: in fact, it can develop over time. Since whiplash can cause long-lasting effects on the spine, it is important to see your doctor if you have been injured, even if you don’t have pain immediately afterward.
The cervical spine (neck) is a complex structure composed of vertebrae (spinal bones), intervertebral discs (act as shock absorbers), muscles, ligaments, and nerves. The neck is is flexible and can move it different directions (nod, rotate) while supporting the full weight of the head. However, that flexibility can make the neck vulnerable to injury. During a whiplash incident, your neck moves forcefully and rapidly backward and forward. Pain can persist even after the injury itself has healed.
Whiplash can result in temporary disability, reduced productivity, and potentially high medical expenses.
Not just a pain in the neck
The chief complaint of a person with whiplash is neck and/or upper back pain. Other symptoms may include:
- Pain in the arm and/or shoulder that may radiate down into the hand(s).
- Paresthesias (such as numbness or tingling) and/or weakness that may extend into the hand(s).
You may even experience dizziness, nausea, ringing in the ears, fatigue, jaw pain, and/or blurred vision.
A condition with an impact
The most frequent cause of whiplash is an automobile accident in which the person’s vehicle (usually stopped) is rear-ended by another car or truck. As a result of the impact, the cervical spine’s lower vertebrae of the neck are forced into a hyperextended position, while the upper vertebrae are hyperflexed, resulting in an abnormal S-shaped curve. This chain of events often damages the soft tissues (ligaments, tendons, muscles) of the neck.
How do I know I have whiplash?
Your health care provider carefully reviews your medical history and performs a physical and neurological examination. Since x-rays don’t show injuries to soft tissues, a CT (computerized tomography) scan or MRI (magnetic resonance imaging) may be performed.
What does treatment involve?
Treatment depends on the severity and extent of the whiplash, and consideration is given to your age and overall health. Initial treatment may include:
- Short-term rest (a day or two)
- Ice, for the first day or two*; then alternate ice and heat
- Gentle range-of-motion exercises
- Anti-inflammatory medications (over-the-counter or prescription)
- Muscle relaxants
*When using ice, make sure the cold source is wrapped in a towel to protect the skin area. Do not apply ice for longer than 15 minutes at a time.
If your pain does not go away within a reasonable amount of time, or if it is severe, your doctor may recommend trigger point injections, physical therapy, chiropractic, massage, acupuncture, and/or use of a transcutaneous electrical nerve stimulation (TENS) device.
Soft collars, although once widely used for whiplash, are not used so often anymore, since immobilizing the neck for a long time can weaken the muscles and delay recovery.
Whiplash rarely warrants surgery. If your pain persists even after you have undergone nonsurgical treatment, your health care provider may recommend surgery, depending on what structures have been injured and how severe the injury is. It is important to understand that surgery always carries risks. Therefore, you need to have a thorough discussion with your doctor.
Whiplash. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/whiplash/basics/definition/con-20033090. Accessed June 18, 2015.
Whiplash. MedicineNet. http://www.medicinenet.com/whiplash/article.htm Whiplash. Accessed June 18, 2015.
Whiplash Injury. Hopkins Medicine. http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/spine_shoulder_and_pelvis_disorders/whiplash_injury_85,p01388/. Accessed June 18, 2015.