What is whiplash?
Whiplash is a relatively common injury that is often ignored or mistreated due to lack of understanding of the condition.
- Whiplash is usually the result of a rear impact while in a stationary position.
- Early range of motion and exercises lead to a more rapid recovery than prolonged immobilization or use of a cervical collar.
- Failure to properly educate and treat patients with whiplash can lead to chronic psychosocial symptoms including depression and anxiety.
What is whiplash?
Whiplash is a relatively common injury that occurs to a person's neck following a sudden acceleration-deceleration force that causes unrestrained, rapid forward and backward movement of the head and neck, most commonly from motor vehicle accidents. The term "whiplash" was first used in 1928. The term "railway spine" was used to describe a similar condition that was common in persons involved in train accidents prior to 1928. The term "whiplash injury" describes damage to both the bone structures and soft tissues, while "whiplash associated disorders" describes a more severe and chronic condition.
Fortunately, whiplash is typically not a life threatening injury, but it can lead to a prolonged period of partial disability. There are significant economic expenses related to whiplash that can reach 30 billion dollars a year in the United States, including:
- medical care,
- sick leave,
- lost productivity, and
While most people involved in minor motor vehicle accidents recover quickly without any chronic symptoms, some continue to experience symptoms for years after the injury. This wide variation in symptoms after relatively minor injuries has led some to suggest that, in many cases, whiplash is not so much a real physiologic injury, but that symptoms are more created as a result of potential economic gain. Many clinical studies have investigated this issue. Unfortunately, while there will always be people willing to attempt to mislead the system for personal gain, whiplash is a real condition with real symptoms.
What are the symptoms for whiplash?
Signs and symptoms of whiplash usually — but not always — develop within 24 hours of the injury and may include:
- Neck Pain and stiffness
- Worsening of Pain with neck movement
- Loss of range of motion in the neck
- Headaches, most often starting at the base of the skull
- Tenderness or Pain in the shoulder, upper back or arms
- Tingling or Numbness in the arms
Some people also have:
- Blurred vision
- Ringing in the ears (tinnitus)
- Sleep disturbances
- Difficulty concentrating
- Memory problems
When to see a doctor
See your doctor if you have any neck Pain or other whiplash symptoms after a car accident, sports injury or other traumatic injury. It's important to get a prompt and accurate diagnosis and to rule out broken bones or tissue damage that can cause or worsen symptoms.
What are the causes for whiplash?
Whiplash typically occurs when your head is forcefully and quickly thrown backward and then forward. This motion can injure bones in the spine, disks between the bones, ligaments, muscles, nerves and other tissues of the neck.
A whiplash injury may result from:
- 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. Football tackles and other sports-related collisions can sometimes cause whiplash.
What are the treatments for whiplash?
The goals of whiplash treatment are to:
- Control pain
- Restore normal range of motion in your neck
- Get you back to your normal activities
Your treatment plan will depend on the severity of your whiplash injury. Some people only need over-the-counter medication and at-home care. Others may need prescription medication, specialized pain treatment or physical therapy.
Your doctor may recommend one or more of the following treatments to lessen pain:
- Rest. Rest may be helpful during the first 24 hours after injury, but too much bed rest may delay recovery.
- Heat or cold. Either heat or cold applied to the neck for 15 minutes up to six times a day can help you feel better.
- Over-the-counter pain medications. Over-the-counter pain relievers, such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), often can control mild to moderate whiplash pain.
- Prescription medications. People with more-severe pain may benefit from treatment with certain antidepressant drugs that have been shown to relieve nerve pain.
- Muscle relaxants. Short-term use of these drugs may be recommended to loosen tight muscles and soothe pain. The medicine also can make you feel sleepy. It may be used to help restore normal sleep if pain prevents you from getting a good night's rest.
- Injections. An injection of lidocaine (Xylocaine) — a numbing medicine — into painful muscle areas may be used to decrease pain so that you can do physical therapy.
Your doctor will likely prescribe a series of stretching and movement exercises to help restore range of motion in your neck and get you back to your normal activities. Exercises may include:
- Rotating your neck in both directions
- Tilting your head side to side
- Bending your neck toward your chest
- Rolling your shoulders
Applying moist heat to the achy area or taking a warm shower may be recommended before exercise.
If you have ongoing whiplash pain or need assistance with range-of-motion exercises, your doctor may recommend that you see a physical therapist. Physical therapy (PT) can help you feel better and may prevent further injury.
Your physical therapist will guide you through exercises to strengthen your muscles, improve posture and restore normal movement. In some cases, transcutaneous electrical nerve stimulation (TENS) may be used. TENS applies a mild electric current to the skin. Limited research suggests this treatment may temporarily ease neck pain. More research is needed to determine if it aids long-term recovery.
How many PT sessions are needed vary from person to person. Your physical therapist also can create a personalized exercise routine that you can do at home.
Soft foam cervical collars were once commonly used for whiplash injuries to hold the neck and head still. However, studies have shown that keeping the neck still for long periods of time can decrease muscle strength and interfere with recovery.
Recommendations for using a collar vary. Some suggest limiting use to no more than 72 hours, while others say it may be worn up to three hours a day for a few weeks. Your doctor will instruct you on how to properly use the collar, and for how long. Your doctor may also recommend use of a collar if it helps you sleep at night.
What are the risk factors for whiplash?
physical abuse, such as being struck or shaken
contact sports, such as football, boxing, and some martial arts
cycling collisions or falls
falls in which the head violently jerks backward
blows to the head with a heavy object
Is there a cure/medications for whiplash?
Very few people have any long-term complications from whiplash. Usually, recovery time is anywhere from a few days to several weeks. Most people recover fully within 3 months.