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Whiplash

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  3. Whiplash

Overview of Whiplash

Whiplash (سر کو شدید جھٹکا لگنے سے گردن کو آنے والا زخم) also termed as neck strain. It mostly occurs due to car accidents, in which your head is jerked forward or backward due to any impact or blows, like the cracking of a whip. However, other factors such as physical abuse, trauma, and falls can be the possible reasons. Due to sudden force, the muscles and tendons are stretched and torn. Many professional athletes often experience whiplash. Football players are most likely to have whiplash.

People often confuse whiplash with neck sprains, however, there is a little difference. Whiplash occurs due to the injury of muscles or tissue bands that connect muscles to bones. While neck sprains are the result of ligament tearing, the tissues that join bones to each other.

Most of the time, people recover within a few weeks after taking pain medications and doing proper exercise. But sometimes it can result in other long-lasting complications.

Signs and Symptoms of Whiplash

Symptoms of whiplash often appear within 24 hours after the accident. But in other cases, it can take weeks for the symptoms to appear. Some common symptoms are:

  • Dizziness
  • Headaches, specifically at the base of the skull
  • Neck pain and stiffness
  • Constant weariness
  • Blurred vision

Some less common symptoms associated with whiplash are:

  • Inability to sleep well
  • Ringing in the ears
  • Problems with concentration and memory
  • Irritability
  • Chronic pain in the neck, shoulders, or head

Types of Whiplash

There are four main types of whiplash injury depending on the site of damage such as:

  • Muscle Injury: In a whiplash injury, the muscles of your neck are stretched far away from their original position. Extreme stretch results in tenderness and swelling of the affected area on your neck. 
  • Nerve Injury: Due to muscle stretching your nerves are also stretched. This causes damage to nerves and results in Pinched nerves. Improper positioning of the head during sleep can also cause nerve injury.
  • Joint Injury: Cervical vertebrae joints are responsible for the movement of your neck. Through these joints’ bones move smoothly upon one another. If these joints are injured you will experience stiffness and pain in your neck region. The pain may start in the affected joint but spreads to the shoulders and arms.
  • Disc Injury: Special types of discs are present in between your vertebrae that act as shock absorbers. These discs prevent vertebrae from self-rubbing and wear. Due to whiplash injury, these discs are damaged. The damage results in bulging, herniation, and even rupturing.

Whiplash Headache

  • Approximately, two-thirds of patients having cervical spinal injury experience severe headaches. Some people with whiplash injuries experience pain in the back of their heads. While others feel pain in the forehead and behind the eyes. 
  • Headache often starts in the morning after the day of an accident. The pain spread from the neck over the back of the head. Most people feel the sensation of heat which becomes worse by the cold.
  • Headache becomes severe by repeated neck movements especially if it is repeatedly moved towards extension. Women more often experience whiplash injury as compared to men. The exact reason is unknown, but it is assumed that it might be due to smaller structures of the female neck.

Symptoms of Whiplash Headache

The symptoms of whiplash headaches are similar to other types of headaches. Mostly, people experience pain in the head, neck, and jaw region.

Causes of Whiplash

  • Injured cervical facet joints 
  • Inflammation of the nerves in the brainstem and spinal cord
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Risk Factors of Whiplash

Some risk factors associated with whiplash injury are:

  • Existing low back or neck pain
  • Having had whiplash before
  • A high-speed injury
  • Older age

Health-Related Complications of Whiplash

Most of the time whiplash injury is recovered within a few weeks and you experience no long-term symptoms. However, sometimes it leads to complications such as:

  • More-limited range of motion
  • Pain that spread to the arms
  • Severe neck pain

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Prevention

Preventing a whiplash is not easy but it can be managed by taking a few measures.  So, here are some of them:

  • Whenever you sit in the car make sure that you are sitting up straight.  Wear your seat belt as it helps you to stay in the best position during a crash and prevents you from way worse injury.
  • Practice strengthening your body and especially your neck with specific exercises. Make your neck muscles strong and limber, especially if you had neck strain before.
  • Don't sit in the same posture all day. If you are in the office it’s better to take breaks to stretch and exercise the neck.
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Diagnosis

Your doctor may ask questions about the accident and symptoms before starting treatment. Your doctor may also inquire how well you can perform your daily tasks.

  • Physical Examination

Your doctor will perform a physical examination during which movement of your head, neck, and arm will be checked. You will be asked to move your head and arms to perform simple tasks so that the healthcare can check: 

  • Degree of motion that causes pain or an increase in pain
  • Range of motion in your neck and shoulders
  • Reflexes, strength, and sensation in your limbs
  • Tenderness in your neck, shoulders, or back

  • Imaging Tests

Although whiplash injury can’t be diagnosed by imaging tests. However, your doctor will perform these tests to rule out other possibilities that can cause neck injury. These tests include:

  • X-rays: X-rays help in the identification of fractures, dislocations, and arthritis of the neck area. If these conditions are not present, whiplash injury is confirmed.
  • Computerized Tomography (CT): This is a special form of X-ray that produces three-dimensional images of bone and helps in the identification of bone damage.
  • Magnetic Resonance Imaging (MRI): MRI generates 3D images by using radio waves and a magnetic field. This helps in the detailed study of the injured bones. These tests also detect soft tissue injuries such as injured spinal cords, ligaments, and discs.

 

Treatment of Whiplash | When to Consult a Doctor

Whiplash treatment is required to:

  • Relieve pain
  • Restore your neck’s normal range of movement
  • Get you back to your normal activities

Your doctor will design your treatment plan by considering the extent of your whiplash injury. Some people recover only after taking the over-the-counter medication at home. But others may require prescribed medicines, special pain treatment or physical therapy.

  • Methods to Relieve Pain

Your doctor may recommend some treatment methods to relieve your pain such as:

  • Rest: After the injury, 2-3 days rest is beneficial and helps in the recovery process. But too much rest can delay the process of recovery.
  • Heat or cold: Apply heat or cold for 15 minutes on your neck after 3 hours in a day or more. This will make you feel better.
  • Over-the-Counter Pain Medications: Over-the-counter pain medicines including acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), can help reduce the whiplash pain.
  • Prescription Medications: If you experience severe pain, your physician may prescribe you certain antidepressant drugs to ease the nerve pain.
  • Muscle Relaxants: Muscle relaxants help to lose tense muscles and relieve pain. These medicines also induce sleep. It can be helpful to fall asleep easily which otherwise becomes difficult due to severe pain.
  • Injections: Injections such as lidocaine (Xylocaine) are usually used to make the injured area numb before starting physical therapy.

  • Exercise

Your doctor will recommend you do regular stretching and movement exercises at home.  These exercises will help you to restore neck movements and make you able to perform daily activities. It is recommended by the physician to apply moist heat to the affected area or take a warm bath before exercise. 

  • Exercises may include:
  • Bending your neck toward your chest
  • Rotating your neck in both directions
  • Tilting your head side to side
  • Physical therapy
  • Rolling your shoulders
  • If you experience continuous whiplash pain and need assistance with motion exercises, your doctor may recommend you to book an appointment with a physical therapist.
  • Your physical therapist will help you through exercises and guide you on how to strengthen your muscles, improve posture, and restore normal movement.
  • Sometimes, transcutaneous electrical nerve stimulation (TENS) is used to temporarily ease neck pain and to increase muscle strength.
  • Physical therapy sessions vary from person to person. Your physical therapist will recommend an exercise routine that you can do at home.

  • Foam Collars

  • In the past, soft foam cervical collars were commonly used to treat whiplash injuries to hold the neck and head still. However, as per studies keeping the neck in the same position for long periods can decrease your muscle strength and slow down the recovery process.
  • Still, the use of a foam collar is recommended to reduce pain immediately after injury and help you to sleep at night. However, recommendations for using a collar vary from patient to patient. Some therapists suggest limiting its use to just 72 hours, while others recommend wearing it for 3-4 hours.

You should seek immediate healthcare if you experience the following symptoms:

  • Symptoms spread to shoulders or arms
  • Numbness or weakness in your arms
  • The moving head is painful

In severe cases, you should consult a physiotherapist if your pain is never-ending. 

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