Whiplash injury

Whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip.

This motion can injure the bones in the spine, discs between the bones, ligaments, muscles, nerves and other tissues of the neck.

Whiplash symptoms may present at the time of the whiplash injury, or there could be a delay of up to 24 hours before they appear.

Most people who sustain a whiplash injury will completely recover within 3 months, but some studies show a significant number will have chronic pain or other symptoms that linger longer – sometimes for years.

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What are the causes of whiplash injury?

  • Auto accidents. Rear-end collisions are a major cause of whiplash.

  • Physical abuse or assault. Whiplash can occur if you are punched or shaken. It's one of the injuries seen in shaken baby syndrome.

  • Contact sports. Rugby tackles and other sports-related collisions can sometimes cause whiplash.

Symptoms of whiplash injury

Common symptoms of whiplash include:

  • Neck pain. The pain could range anywhere from mild to severe. It might be located in one spot or general area, or it could also radiate down the shoulder into the arm and/or hand.

  • Neck stiffness or reduced range of motion. Reduced neck mobility could be from pain, tightening of a muscle, or a mechanical problem, such as with a joint.

  • Headache. A neck muscle tightening, or a nerve or joint of the cervical spine becoming irritated could cause headaches.

  • Neck instability. This whiplash symptom commonly results from stretched or torn soft tissues, such as ligaments. Although, it could also be caused by a fracture.

  • Shoulder and/or upper back pain. If the neck’s soft tissues, such as muscles or ligaments, are torn or strained during whiplash, then sometimes that pain can also be referred to other soft tissues in the upper back and shoulders.

  • Radiating tingling, weakness, or numbness. Sometimes whiplash can cause one of the neck’s spinal nerve roots to become compressed or inflamed, which can lead to cervical radiculopathy symptoms of tingling, weakness, and/or numbness radiating down the shoulder, arm, hand, and/or fingers.

When should I seek medical help?

There are circumstances when neck pain might be caused or accompanied by serious issues. If such symptoms are present it is best to seek immediate medical attention to avoid further complications:

  • The pain is severe

  • The pain is disturbing your sleep

  • Painkillers do not work

  • Your pain is caused by a major accident such as a traffic collision or a fall

  • Weakness, numbness, or tingling in your limbs

  • Neck instability

  • Problems with balance or coordination

Diagnosis

When you go to your doctor, your doctor will ask about your pain symptoms and your past medical history. Then they will perform a physical examination, including palpating the area of pain and checking the range of motion of your neck.

They may also test the reflexes in your hands and feet, and check that you have full sensation in all your limbs. Problems with your reflexes or a lack of sense could indicate nerve damage.

If a fracture or neurological problem is suspected, the doctor will probably order diagnostic imaging (X-ray) to learn more.

Treatment

Self-Care for Whiplash

If whiplash symptoms are mild to moderate, some self-care options typically include:

  • Rest. While it’s good to stay active if possible, it’s also good to take things slowly the first few days.

  • Ice and/or heat. In the first couple of days following a whiplash injury, applying ice can reduce pain and swelling in the neck. The ice or cold packs can temporarily close small blood vessels and prevent a worsening of the swelling. Then ice or heat can be applied alternately a few days after the injury has occurred.

  • Over-the-counter medications. Common OTC pain relievers include Panadol and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen. Despite being readily available at the store, it is important to carefully read the OTC label and follow its directions.

Medical Care for Whiplash

If whiplash pain or related symptoms are severe and do not seem to be going away, seek medical attention.

  • Physical therapy. Physiotherapy can help improve neck strength and flexibility, which in some cases can relieve stress on the spine and reduce pain.

  • Prescription pain medications. If over-the-counter drugs have not successfully managed the pain, then prescription-strength medications, such as muscle relaxants and opioids may help

  • Manual manipulation. A chiropractor or other certified medical professional typically uses his or her hands to make manual adjustments to the spine in an effort to increase range of motion and reduce pain.

Prognosis for Whiplash Patients

The majority of whiplash patients recover within 3 months. However, it is also possible for whiplash-related symptoms and disorders to become chronic.

Risk factors that could indicate a longer recovery time from a whiplash injury include:

  • Severe pain at the time of injury. If a person experiences severe pain immediately following the impact, that’s a strong indication of more severe damage.

  • Older age. Older people tend to have more degeneration and pre-existing conditions in the spine, which makes them more vulnerable to whiplash injuries.

  • Female anatomy. Women tend to have smaller structures and muscles in the neck, which could make them more susceptible to whiplash injuries.