Whiplash: A Common Neck Injury

Written by Todd J Albert, MD
Reviewed by Michael G. Fehlings, MD, PhD, FRCSC, FACS

What Is It?
Whiplash is a collective term used to describe the injuries to the cervical spine (neck). This condition often results from an automobile collision, which suddenly forces the head and neck to whip back and forth (hyperflexion/hyperextension).

Neck Anatomy
The neck consists of 7 cervical vertebrae (C1-C7) held together by muscles and ligaments, intervertebral discs (shock absorbers), joints enabling motion, and a system of nerves. The complexity of the neck's anatomy coupled with its diverse range of motion makes it susceptible to whiplash.

Whiplash Symptoms
The symptoms of whiplash may include neck pain, tenderness and stiffness, headache, dizziness, nausea, shoulder and/or arm pain, paresthesias (numbness/tingling), blurred vision, and in rare cases difficulty swallowing. Symptoms may appear as quickly as two hours following injury.

The symptoms usually result from injury to the neck's soft tissues; the intervertebral discs, muscles, and ligaments. Muscle tears characteristically present with burning pain accompanied by tingling sensations. Ligaments affected by excessive joint movement can cause muscles to defensively tighten limiting motion. 'Wry neck', a condition associated with whiplash, occurs when the neck muscles responsible for head rotation/extension cause the neck to twist involuntarily.

Age and pre-existing health conditions (e.g., arthritis) may increase the severity of whiplash. As people age range of motion declines, muscles lose flexibility and strength, and intervertebral discs and ligaments lose some of their elasticity.

Diagnosis
A physical and neurological examination is performed to evaluate the patient's general condition.

Initially, the physician orders radiographs (x-rays) to determine if fracture exists. Depending on the patient's symptoms, a CT scan, MRI, and/or other imaging tests may be necessary to assess the condition of the cervical spine's soft tissues (intervertebral discs, muscles, ligaments).

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Whiplash: Treatment and Recovery