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Whiplash: 5 Things You Should Know

Whiplash, also called neck sprain or neck strain, is an injury to the soft tissues of the neck. Here are five important things you should know about this common injury.

How Whiplash Happens
Whiplash occurs when a person is rear-ended in an automobile. This causes movement of the structures within the neck changing the normal curve of the upper back and neck. The sudden backward movement (extension) and forward movement (flexion) can cause the joints of the neck to be injured and can also cause the muscles and ligaments of the neck and upper back to be over-stretched. The neck is particularly vulnerable to this type of injury because of its ability to move in many directions. If you have ever been in a rear-end car collision, you may have experienced this type of injury.

Symptoms of Whiplash
The primary symptom of whiplash is neck or upper back pain. The pain can start immediately or develop days, weeks, or sometimes even months later. Symptoms can vary widely among individuals. Some may only suffer minor discomfort while others experience one or more of the following:

  • Tightness or spasms of the muscles the neck or upper back.
  • Pain with movement of the neck, headache and dizziness (symptoms of a concussion).
  • Difficulty swallowing and chewing and hoarseness (could indicate injury to the esophagus and larynx).
  • Abnormal sensations such as burning or tingling.
  • Shoulder pain.
  • Upper back pain.

Severe whiplash can also include injury to the intervertebral joints, discs, ligaments, cervical muscles and nerve of the neck or upper back. Fortunately, with time, the vast majority of people who have had a whiplash injury fully recover.

How Whiplash is Diagnosed
Even if your neck pain is only mild, you should be examined by a health professional as soon as possible. X-rays may be done to rule out any bone fractures. A CT scan or MRI may also be done if there is concern you have a herniated disc or significant ligament injury. These tests are better able to identify soft tissue injuries than plain radiographs.

Treatment Options
Most cases of whiplash are treated using conservative methods such as:

  • In most cases patients are encouraged to remain as active as possible.
  • The use of a soft cervical collar (brace) to temporarily immobilize the neck during the healing process only if pain cannot be controlled. A cervical collar (brace) should be used for only a very short period of time (less than a week).
  • Ice or heat can be used to control pain, muscle spasm, and inflammation.
  • Medications to reduce pain, swelling, and muscle spasms are often prescribed and can be very helpful.
  • A short course of spinal manipulation or mobilization can help in restoring normal positioning of the muscles and joints to allow for an active therapy program.
  • Physical therapy helps to increase circulation, restore range of motion, and promote healing. The use of modalities such as ultrasound and electrical stimulation should only be used in the early stages of treatment to reduce pain and assist in getting an active therapy program started.

In more severe cases of whiplash, additional treatments may be necessary. Patients with continued neck pain may find relief from trigger point injections. If symptoms persist for more than 6 weeks, it may be due to a more severe injury involving the facet joints or discs. These can be treated with careful use of injections and other procedures that try to block the area of pain. In patients with evidence of a pinched nerve from a whiplash injury, further evaluation may be needed by a spine surgeon. Surgery is rarely necessary and is usually performed to treated herniated discs that have not improved with more conservative non-surgical measures.

Prevention Tips for Drivers
Since most cases of whiplash occur as a result of rear-end car crashes, the best way to protect yourself on the road is to wear your seat belt correctly and on every ride. Also, make sure the headrest in your vehicle is not too low and avoid driving in an overly reclined position. Although, most current head rests have not be found to properly protect the neck.

Prevention Tips for Athletes
If you participate in sports (especially contact sports), make sure you wear appropriate equipment (like padding) and always use good technique to avoid neck injuries.

While it may be impossible to avoid some injuries, maintaining good overall health can help speed recovery if one occurs. This includes getting regular exercise, eating healthy foods, and not smoking. If you are experiencing neck or upper back pain, see your doctor for a complete evaluation.

Reference:
Whiplash, edited by Gerard A. Malanga, Scott Nadler. Hanley and Belfus, Inc., Philadelphia, PA, 2002.

Updated on: 12/10/09
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