Whiplash occurs when a person’s head moves backward and then forward suddenly with great force. This injury is most common following a rear-end car collision. It can also result from physical abuse, sports injuries, or amusement park rides. Whiplash results when the soft tissues of the neck extend beyond their typical range of motion. Your symptoms might not appear for a while, so it’s important to pay attention to any physical changes for a few days following any accident. Whiplash is thought of as a relatively mild condition, but it can cause long-term pain and discomfort.
What Are the Symptoms of Whiplash?
The pain of whiplash is often hard to ignore. The symptoms may include:
- Pain, decreased range of motion, and tightness in the neck.
- Pain when rocking your head from side to side or backward and forward.
- Pain or stiffness when moving your head to look over each shoulder.
- Sometimes, the pain of a neck strain is immediate. In other cases, it can take several hours or days before your neck begins to hurt.
What causes whiplash?
Whiplash is most commonly caused by a motor vehicle accident in which the person is in a car that is not moving, and is struck by another vehicle from behind. It is commonly thought the rear impact causes the head and neck to be forced into backward position as the seat pushes the person's torso forward - and the unrestrained head and neck fall backwards. After a short delay the head and neck then recover and are thrown into a forward position.
More recent studies investigating high-speed cameras and sophisticated crash dummies have determined that after the rear impact the lower cervical vertebrae (lower bones in the neck) are forced into a position of hyperextension while the upper cervical vertebrae (upper bones in the neck) are in a hyperflexed position. This leads to an abnormal S-shape in the cervical spine after the rear impact that is different from the normal motion. It is thought that this abnormal motion causes damage to the soft tissues that hold the cervical vertebrae together.
Emergency medical services (EMS) may place the patient in a cervical collar strapped around the neck, and on a backboard to stabilize the neck in order to prevent any further neurologic injury. In the emergency department, the doctor will remove the collar and board when appropriate, following the guidelines set forth in the National Emergency X-Radiography Utilization Study (NEXUS):
- Normal level of consciousness or alertness
- No tenderness in the midline of the back of the neck
- No evidence of intoxication with alcohol or drugs
- No muscle weakness or sensation problems, no focal neurologic deficit
Treatment for whiplash
The treatments for whiplash are relatively simple. Doctors will often prescribe an OTC pain medication like Tylenol or aspirin. Naturally, more severe injuries may require prescription painkillers and muscle relaxants to reduce muscle spasms. In addition to medication, physical therapy plays a crucial role in recovery. You may want to apply ice or heat to the injured area and practice simple exercises to build strength and flexibility in your neck. Practice good posture and learn relaxation techniques to keep your neck muscles from straining and to help with recovery. You might also be given a foam collar to keep your neck stable. Collars should not be worn for more than three hours at a time. They should only be used the first couple of days after your injury, as well.
While it is not always possible to prevent accidents, advances in automobile safety have attempted to reduce the associated risks. Many advances in seat belts and head restraints have been able to reduce the risk of whiplash injury. The proper use of these devices is essential to their success in preventing injury. Head restraints are designed to prevent the head from moving into hyperextension when struck from behind. In order for this to work properly, the head restraint should be optimally positioned directly behind the head. If the head restraint is lowered below the level of the head it could actually force the head into further hyperextension after an impact. Many automobiles have additional safety equipment including air bags and air curtains to further protect drivers and passengers from injury.