Whiplash

Whiplash is a sudden, moderate-to-severe strain affecting the bones, discs, muscles, nerves, or tendons of the neck.

Description

The neck is composed of seven small bones. Known as the cervical spine, these bones:

• support the head
• help maintain an unobstructed enclosure for the spinal cord
• influence the shape and structure of the spine
• affect posture and balance

About 1,000,000 whiplash injuries occur in the United States every year. Most are the result of motor vehicle accidents or collisions involving contact sports. When unexpected force jerks the head back, then forward the bones of the neck snap out of position and irritated nerves can interfere with flow of blood and transmission of nerve impulses. Pinched nerves can damage or destroy the function of body parts whose actions they govern.

Risk factors

Osteoarthritis of the spine increases the risk of whiplash injury. So do poor driving habits, driving in bad weather, or driving when tired, tense, or under the influence of alcohol or other drugs.

Causes and symptoms

Tension shortens and tightens muscles. Fatigue relaxes them. Either condition increases the likelihood that whiplash will occur and the probability that the injury will be severe.

Sometimes symptoms of whiplash appear right away. Sometimes they do not develop until hours, days, or weeks after the injury occurs. Symptoms of whiplash include:

• pain or stiffness in the neck, jaw, shoulders, or arms
• dizziness
• headache
• loss of feeling in an arm or hand
• nausea and vomiting

Depression and vision problems are rare symptoms of this condition.

Diagnosis

Whiplash is difficult to diagnose because x rays and other imaging studies do not always reveal changes in bone structure. Organs affected by nerve damage or reduced blood supply may generate symptoms not clearly related to whiplash.

Diagnosis is based on observation of the patient's symptoms, medical history, physical examination, and neurological studies to determine whether the spine has been injured.

Treatment

Medication, physical therapy, and supportive measures are used to treat whiplash. Chiropractors gently realign the spine to relax pinched nerves or improve blood flow. A patient whose symptoms are severe may wear a soft, padded collar (Thomas collar or cervical collar) until the pain diminishes.

When pressure on the root of the nerve causes loss of strength or sensation in a hand or arm, a cervical traction apparatus may be recommended.

Self-care

Inflammation and cramping can be alleviated by wrapping ice or an ice pack in a thin towel and applying it to the injured area for 10-20 minutes every hour. After the first 24 hours, painful muscle spasms can be prevented by alternating cold packs with heat treatments. Letting a warm shower run on the neck and shoulders for 10-20 minutes twice a day is recommended. Between showers, warm towels or a heat lamp should be used to warm and soothe the neck for 10-15 minutes several times a day.

Improving posture is important, and gentle massage can be beneficial. Sleeping without a pillow promotes healing, and a cervical collar or small rolled towel pinned under the chin can provide support and prevent muscle fatigue.

Alcohol should be avoided. A chiropractor, primary care physician, or orthopedic specialist should be notified whenever a painful neck injury occurs. Another situation requiring attention is if the face or arm weaken or become painful or numb following a neck injury.

Prognosis

With treatment, whiplash can usually be cured in one week to three months after injury occurs. If nerve roots are damaged, numbness and weakness may last until recovery is complete.

Prevention

Chiropractors can recommend diet and exercise techniques to reduce stress and tension. Careful, defensive driving, wearing seatbelts, and using padded automobile headrests can lessen the likelihood of whiplash.