Whiplash

Symptoms | Tests for Diagnosis | Treatment | Prognosis

During whiplash, the head is first thrown violently forward, which can overstretch the muscles and soft tissues in the neck and may cause a subluxation of the cervical (neck) facet joints of the spine.The neck muscles react to this sudden overstretching by quickly shortening their fibers, creating a powerful muscular contraction that rapidly jerks the head back again.The damage occurring may be from the head being thrown forward, the head snapping back when the neck muscles contract, or both. The term -whiplash" came to be used because the complete forward-back motion resembles that of a whip when it is -cracked".

Whiplash occurs most commonly during a car, diving, boating, or ski accident when violent trauma involving a rapid change in speed occurs (deceleration being more common than acceleration).Injuries range from very mild to serious or life-threatening damage.Although rare, very serious injuries can involve broken neck bones, a herniated disc or head trauma; therefore, patients with neck pain following any trauma should be evaluated by a physician as soon as possible.Severe injuries must receive immediate treatment for optimal recovery.In spite of common use of the special term -whiplash" and its association with high-speed accidents and litigation, whiplash is not a unique type of injury, but a description of a -mechanism of injury", and can resemble neck injury from causes other than motor vehicle accidents.

Symptoms

Whiplash is usually diagnosed as a syndrome, or set of symptoms, which occur together.If you are diagnosed with whiplash injury following a traumatic event, your symptoms might consist of headache, neck stiffness, neck pain, and tenderness over the area of the upper part of the spine and the back part of the skull.You also may experience a certain degree of dizziness, deafness, memory loss, and temporo-mandibular joint pain ÀÀ all symptoms that can be treated if properly evaluated. Patients may, but not always, have a decreased lordosis, or decreased natural curvature of the neck, making the neck appear straighter from the side. Neck pain can occur up to 72 hours after an accident.

back to top

Tests for Diagnosis

If you are involved with any type of trauma and have neck pain, you should see a physician immediately. On examination, your physician will determine whether an X-ray is required to rule out fracture of the neck vertebrae and possible spinal cord damage or disc injury.When serious trauma is ruled out, a more complete physical examination of the neck can be done to determine the extent of soft tissue damage.The doctor may ask you to flex, extend, and rotate your neck, but under his or her guidance to avoid further injury and discomfort.

Important information to give to your physician during the examination is:

  • Were you wearing a seatbelt at the time of the collision?
  • Did you have a head trauma [diagnosed at the time?] which could prolong your recovery?
  • Was the car [you were in moving or] at a standstill?
  • What was the estimated speed of the car when it hit you?

All of this information will help your physician to determine the impact on your neck.

back to top

Treatment

Treatment is similar to neck injury by other causes.Whiplash injuries are usually uncomplicated and the key to treatment is rehabilitation of the muscle and soft tissues that were damaged and the reduction of any pain.If the symptoms are only neck pain and stiffness, the treatment may include analgesics for pain; prolonged use of neck braces and immobilization are generally avoided and most patients will be encouraged to continue with their regular lifestyle. If a person does not recover within a month from a whiplash accident and any initial treatment received, they should seek evaluation from a spine specialist.

While injury to a disc or fracture is rare, treatment for disc injury generally begins with nonoperative treatment. If that fails, surgical intervention may be considered.Any neck fracture is very carefully evaluated for treatment.Depending on the location, type, and severity, nonoperative treatment utilizing a rigid brace or a halo cast may be sufficient.Acute neck instability from a fracture or from subluxation (partial dislocation) generally requires surgical treatment.

back to top

Prognosis

The majority of whiplash injuries are mild and recovery is generally excellent.Fifty percent of patients with whiplash injuries recover within 1 month, 64% within 2 months, 87% within 6 months, and 97% within 1 year.Only a small number of persons have symptoms that linger for more than a year.

back to top