WHIPLASH

What is Whiplash?

Whiplash, also known as neck sprain or neck strain, refers to an injury to the neck caused by forceful backward or forward movement of the neck. This neck injury develops commonly as a result of a motor vehicle collision but can also result from contact sports, physical abuse, and other forms of trauma that involve sudden movement of the neck. Whiplash occurs when the muscles and ligaments of the neck extend beyond their normal range of motion and usually affect the muscles, discs, nerves, and tendons in the neck.

What are the Causes of Whiplash?

Whiplash generally occurs due to rapid back and forth movement of the neck. This motion typically happens during automobile collisions that involve the rear end. Other activities that may cause whiplash include horseback riding, contact sports such as football and boxing, cycling collisions, and physical abuse that involves violent shaking.

What are the Symptoms of Whiplash?

The signs and symptoms of whiplash may not occur immediately and a few days might pass after the injury before symptoms begin to show. The most common symptoms of whiplash may include:

  • Neck pain and stiffness that may increase with a slight movement of the neck
  • Headaches, especially at the base of the skull
  • Pain or tenderness in the shoulder or between the shoulder blades
  • Tingling or numbness in the arms or hand
  • Fatigue and dizziness 
  • Muscle spasms

Other symptoms associated with severe whiplash may include blurred vision, irritability, challenges with concentration and memory, ringing in the ears, sleeplessness, and anxiety.

How do Spinal Specialists Diagnose Whiplash?

A spinal specialist will request the patient’s complete medical history and may carry out a thorough physical examination to check for the areas of tenderness and range of motion of the neck. The specialist may also ask questions regarding the cause of the injury and the symptoms experienced by the patient.

Whiplash usually affects the soft tissues of the neck that standard x-rays can’t pick up such as the discs, ligaments, and muscles. The spinal specialist may recommend standard x-rays to rule out any other type of injury or degenerative disease such as arthritis. In most cases, the specialist may order other forms of imaging tests such as MRI or CT scans to assess any damage or inflammation in the soft tissues, spinal cord, or nerves. In some rare cases, a specialist may order an additional scan such as Diffuse Tensor Imaging (DTI) or positron emission tomography (PET scan), to determine the extent of a neck injury to the brain or other areas.

How do Spinal Specialists Treat Whiplash?

The treatment for whiplash depends primarily on the extent and symptoms of the injury. Treatment options for whiplash may include:

Physical therapy

Physical therapy including range-of-motion exercises and safe stretches plays a great role in whiplash recovery. The spinal specialist may recommend a physical therapist to help guide the patient throughout. Physical therapy may help to build strength and flexibility in the neck, improve posture, and restore normal body movement.

Support devices

Support devices such as foam collars can help keep the neck and head stable after a whiplash injury. Although studies have shown that the use of foam collars to keep the neck still for a long period can interfere with whiplash recovery, some specialists may recommend these collars for a limited period to help relieve pain immediately after the injury.

Muscle relaxants

Short-term use of muscle relaxants such as cyclobenzaprine can help to reduce muscle spasms and loosen tight muscles. This medication may also help restore normal sleep patterns in patients who experience difficulty sleeping.

Other treatment options for whiplash may include numbing injections and over-the-counter pain medications such as ibuprofen to help relieve pain and inflammation.

What are the Possible Complications of Whiplash?

While most individuals fully recover from the symptoms within a few weeks, others experience lingering pain some months or even years later. Patients with previous back or neck injuries may experience long-term effects of whiplash after the injury.

References

National Institute of Neurological Disorders and Stroke. Whiplash Information Page. (https://www.ninds.nih.gov/Disorders/All-Disorders/Whiplash-Information-Page)

Yadla S, Ratliff JK, Harrop JS. Whiplash: diagnosis, treatment, and associated injuries. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684148/) Curr Rev Musculoskelet Med. 2008;1:65-8.

Isaac Z, et al. Evaluation of the patient with neck pain and cervical spine disorders. https://www.uptodate.com/home/search.

Wong JJ. Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration. The Spine Journal. 2016;16:1598.

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