Whiplash is a generic term applied to
injuries of the neck caused when the neck is suddenly and/or violently
jolted in one direction and then another, creating a whip-like
movement. Whiplash is most commonly seen in people involved in motor
vehicle accidents, but it can also occur from falls, sports injuries,
work injuries, and other incidents.
What structures are injured in a whiplash?
Whiplash injuries most often result in sprain-strain of the neck. The
ligaments that help support, protect, and restrict excessive movement
of the vertebrae are torn, which is called a sprain. The joints in the
back of the spine, called the facet joints, are covered by ligaments
called facet capsules, which seem to be particularly susceptible to
whiplash injury.
In addition, the muscles and tendons are strained—stretched beyond
their normal limits. The discs between the vertebrae, which are
essentially ligaments, can be torn, potentially causing a disc
herniation. The nerve roots between the vertebrae may also be stretched
and become inflamed. Even though it is very rare, vertebrae can be
fractured and/or dislocated in a whiplash injury.
What are the common signs and symptoms of whiplash?
The most common symptoms of whiplash are pain and stiffness in the
neck. These symptoms are generally found in the areas that are
“whiplashed.” For example, during a whiplash, first the head is lifted
up from the upper-cervical spine. This creates a sprain/strain in the
region just below the skull, where symptoms usually occur. Symptoms may
also commonly be seen in the front and back of the neck. Turning the
head often makes the pain and discomfort worse.
Headache, especially at the base of the skull, is also a common
symptom, seen in more than two thirds of patients. These headaches may
be one-sided (unilateral) or experienced on both sides (bilateral). In
addition, the pain and stiffness may extend down into the shoulders and
arms, upper back, and even the upper chest.
In addition to the musculoskeletal symptoms, some patients also
experience dizziness, difficulty swallowing, nausea, and even blurred
vision after a whiplash injury. While these symptoms are disconcerting,
in most cases, they disappear within a relatively short time. If they
persist, it is very important to inform your doctor that they are not
resolving. Vertigo (the sensation of the room spinning) and ringing in
the ears may also be seen. In addition, some patients may feel pain in
the jaw. Others will even complain of irritability, fatigue, and
difficulty concentrating. These symptoms also resolve quickly in most
cases. In rare cases, symptoms can persist for weeks, months, or even
years.
Another important and interesting aspect of whiplash is that the signs
and symptoms often do not develop until 2 to 48 hours after the injury.
This scenario is relatively common but not completely understood. Some
speculate that it may be due to delayed muscle soreness, a condition
seen in other circumstances.
How is whiplash treated?
Staying active
One of the most important aspects of whiplash management is for the
patient to stay active, unless there is some serious injury that
requires immobilization. Patients should not be afraid to move and be
active, within reason. In addition, your doctor will often prescribe an
exercise or stretching program. It is particularly important to follow
this program as prescribed, so that you can achieve the best long-term
benefits.
Chiropractic manipulation and physical therapy
Ice and/or heat are often used to help control pain and reduce the
muscle spasm that results from whiplash injuries. Other physical
therapy modalities, such as electrical stimulation and/or ultrasound,
may provide some short-term relief. They should not, however, replace
an active-care program of exercise and stretching. Spinal manipulation
and/or mobilization provided by a chiropractor can also give relief in
many cases of neck pain.
Can whiplash be prevented?
Generally speaking, whiplash cannot be “prevented,” but there are some
things that you can do while in a motor vehicle that may reduce the
chances of a more severe injury. Always wear restraints (lap or
shoulder belt), and ensure that the headrest in your vehicle is
adjusted to the appropriate height.
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Thursday, June 21, 2012
Whiplash
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