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Whiplash: Neck Trauma and Treatment

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If you have ever been in a car crash and experienced pain in your neck, you have most likely had whiplash. Whiplash, also called neck sprain or neck strain, is an injury to the soft tissues of the neck. It is usually caused by sudden extension (backward movement of the neck) and flexion (forward movement of the neck). This type of injury is often the result of rear-end car crashes. Severe whiplash can also include injury to the intervertebral joints, discs, ligaments, cervical muscles and nerve roots.

Learn whiplash exercises you should do (it's a video, so you can see what you should be doing).

Jump to the whiplash treatments section in this article.

Symptoms of Whiplash
Most people experience neck pain either immediately after the injury or several days later. Other symptoms of whiplash may include the following:

  • Neck stiffness
  • Injuries to the muscles and ligaments (myofascial injuries)
  • 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 prickling (this is called paresthesias)
  • Shoulder pain
  • Back pain

Diagnosis of Whiplash
Although whiplash usually only causes damage to the soft tissues of the neck, the physician will take x-rays of the cervical spine for reference in case of delayed symptoms and to rule out other spinal problems or injuries.

Treatment
Fortunately, whiplash is treatable and most symptoms resolve completely. Initially, whiplash is treated with a soft cervical collar. This collar may need to be worn for 2 to 3 weeks.

Other treatments for individuals with whiplash may include the following:

  • Heat therapy to relieve muscle tension and pain
  • Pain medications such as analgesics and non-steroidal anti-inflammatory drugs (NSAIDs)
  • Muscle relaxants
  • Range of motion exercises and physical therapy

For most patients, the symptoms of whiplash usually subside in 2 to 4 weeks. Patients who continue to have symptoms despite treatment may find temporary relief by keeping the neck immobilized using a halter in the office or at home. This is referred to as cervical traction. Local anesthetic injections may also be helpful.

If symptoms continue or worsen after 6 to 8 weeks, further x-rays and other diagnostic testing may be necessary to see if the patient suffered a more severe injury. Severe extension injuries like whiplash can damage the intervertebral discs. If this occurs, surgical repair of the discs may become necessary.

Updated on: 09/07/12
Harry N. Herkowitz, MD
This snapshot article on cervical whiplash provides an accurate overview of the natural history, symptoms, and treatment of this common disorder. It should be emphasized that the diagnosis of whiplash is one of exclusion, i.e., there are no objective clinical or imaging studies, which confirm this condition. A careful initial assessment of frontal or occipital bruising and/or pain radiating down the arm may signal a more significant problem. X-rays, which show soft tissue swelling, may also indicate a more serious disorder. Initial dynamic films to detect instability may not be possible since muscle spasm may prevent adequate imaging. As pointed out in this article, patients who do not improve or worsen over 2 to 4 weeks should be re-imaged with flexion-extension lateral cervical x-rays and MRI scan to rule out a fracture, ligamentinstability or disc injury.
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Whiplash: A Common Neck Injury

Whiplash commonly results from a car accident causing hyperflexion and hyperextension of the neck tissues.
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