Whiplash

Definition 

Whiplash is an injury to the neck caused by the neck bending forcibly forward and then backward, or vice versa. The injury, which is poorly understood, usually involves the muscles, discs, nerves, and tendons in the neck. Cervical acceleration-deceleration (CAD) describes the the mechanism of the injury, while the term whiplash associated disorders (WAD) is used to refer to the injury and symptoms.

Causes 

Most whiplash injuries are the result of a collision that includes sudden acceleration or deceleration. Many whiplash injuries occur when a person is involved in a rear-end automobile collision, or as a result of a sports injury, particularly during contact sports.

Whiplash-associated disorders can include a brain injury known as a coup-contra-coup injury. In this event the brain is accelerated into the cranium as the head and neck hyperextend, and is then accelerated into the other side as the head and neck rebound.

Symptoms 

The following are the most common symptoms of whiplash. However, each individual may experience symptoms differently. Symptoms may include:

 

  • Neck pain
  • Neck stiffness
  • Dizziness
  • Ringing in ears
  • Blurred vision
  • Concentration or memory problems
  • Irritability
  • Sleeplessness
  • Tiredness

 

The symptoms of whiplash may resemble other conditions and medical problems. Always consult your doctor for a diagnosis.

More severe and chronic cases of whiplash associated disorder may result in symptoms such as:

  • Depression
  • Anger
  • Frustration
  • Anxiety
  • Stress
  • Drug dependency
  • Post-traumatic stress syndrome
  • Sleep disturbance or insomnia

Diagnosis 

In addition to a complete medical history and physical examination, diagnostic procedures for whiplash may include the following (as many whiplash injuries include damage to soft tissue that can't be seen on X-rays):

 

  • Computed tomography (CT) scan. A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Magnetic resonance imaging (MRI). This diagnostic procedure uses a combination of large magnets and a computer to produce detailed images of organs and soft tissue structures within the body.

 

Treatment 

Specific treatment for whiplash will be determined by your doctor based on:

 

  • Your age, overall health, and medical history
  • Extent of the injury
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the injury
  • Your opinion or preference

 

Treatment may include:

 

  • Ice applications for the first 24 hours
  • Cervical collar, with limited use (less than 3 hours at a time) 
  • Gentle, active movement after 24 hours
  • Nonsteroidal anti-inflammatory medications
  • Muscle relaxing medications
  • Physical therapy

 

Recovery 

To help with recovery, you should:

  • Ice your neck to reduce pain and swelling as soon as you can after the injury. Do it for 20-30 minutes every 3-4 hours for 2-3 days. Wrap the ice in a towel or cloth to prevent injury to the skin.
  • Take painkillers or other drugs, if recommended by your doctor. Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil®, Motrin®) or naproxen (Aleve®), will help with pain and swelling. However, these medicines can have side effects. Never use them regularly unless your doctor specifically says you should. Check with your doctor before taking them if you take other medicines or have any medical problems. If over the counter medications do not work, prescription painkillers and muscle relaxants may be necessary.
  • Use a neck brace or collar to add support, if your doctor recommends it. However, they are not recommended for long-term use, because they can actually weaken the muscles in your neck.
  • Apply moist heat to your neck -- but only after 2-3 days of icing it first. Use heat on your neck only after the initial swelling has gone down. You could use warm, wet towels, or take a warm bath.
  • Other treatments, like ultrasound and massage, may also help.