Whiplash

An injury to the neck caused by a sudden movement of the head, backward, forward, or sideways, is commonly referred to as "whiplash." While the term "whiplash" is most frequently used to describe auto accident injuries (in which a person is rear-ended, hit head-on, or hit from the side), whiplash can also frequently occur during ski accidents, bike accidents, falls, blows to the head, and other head/neck traumas.

THE MYTH: "If I don't have any symptoms right away, I'm O.K.".

THE TRUTH... After many auto and sport-related traumas, symptoms can be so slight at first, an individual may not realize he/she has been injured. Even if a person feels relatively normal after an accident, he/she should be thoroughly examined. Symptoms can be delayed for days, months, or even years.

Whiplash and whiplash-associated disorders (WAD) represent a range of injuries to the neck caused by or related to a sudden distortion of the neck.

Neck Anatomy

The neck consists of 7 cervical vertebrae held together by muscles and ligaments, intervertebral discs, joints enabling motion, and a system of nerves. The complexity of the neck's anatomy coupled with its diverse range of motion makes it susceptible to whiplash.

Whiplash is commonly associated with motor vehicle accidents, usually when the vehicle has been hit in the rear however the injury can be sustained in many other ways, including falls from bicycles or horses.

Causes of Whiplash
 

The exact injury mechanism that causes whiplash injuries is unknown. A whiplash injury may be the result of impulsive stretching of the spine, mainly the ligament: anterior longitudinal ligament which is stretched or tears, as the head snaps forward and then back again causing a whiplash injury.

Whiplash may be caused by any motion similar to a rear-end collision in a motor vehicle, such as may take place on a roller coaster or other rides at an amusement park, sports injuries such as skiing accidents, other modes of transportation such as airplane travel, or from being hit or shaken. Shaken baby syndrome can result in a whiplash injury.

Whiplash Symptoms

The symptoms of whiplash may include neck pain, tenderness and stiffness, headache, dizziness, nausea, shoulder and/or arm pain, paresthesias (numbness/tingling), blurred vision, and in rare cases difficulty swallowing. Symptoms may appear as quickly as two hours following injury.

The symptoms usually result from injury to the neck's soft tissues; the intervertebral discs, muscles, and ligaments. Muscle tears characteristically present with burning pain accompanied by tingling sensations. Ligaments affected by excessive joint movement can cause muscles to defensively tighten limiting motion. 'Wry neck', a condition associated with whiplash, occurs when the neck muscles responsible for head rotation/extension cause the neck to twist involuntarily.

Age and pre-existing health conditions (e.g., arthritis) may increase the severity of whiplash. As people age range of motion declines, muscles lose flexibility and strength, and intervertebral discs and ligaments lose some of their elasticity.

Symptoms reported by sufferers include: pain and aching to the neck and back, referred pain to the shoulders, sensory disturbance (such as pins and needles) to the arms & legs and headaches. Symptoms can appear directly after the injury, but often are not felt until days afterwards. Whiplash is usually confined to the spinal cord (neck to pubic bone), and the most common areas of the spinal cord affected by whiplash are the neck, and the mid-back (middle of the spine).

The following are symptoms that can occur following a head/neck injury (days to years later):

* Neck pain and/or stiffness
* Blurred or double vision
* Irritability
* Depression
* Fatigue
* Insomnia
* Dizziness / Vertigo
* Pain between the shoulder blades
* Pain in the arms, legs, feet, hands
* Headaches, Migraines
* Low back pain and/or stiffness
* Shoulder pain
* Nausea
* Ringing in the ears (tinnitus), Hearing loss
* Numbness and tingling
* Jaw and/or face pain
* Post-concussion syndrome
* and many more!

In many cases, more severe immune-related, neurological, pain, and disease conditions (Chronic Fatigue Syndrome, Susceptibility to Infection, ADHD, Seizures, Multiple Sclerosis) can result from head/neck injuries, sometimes occurring many years after the accident.

WHIPLASH FACTS

Two million people are exposed to whiplash injury (related to an auto accident) in the U.S. every year.

When the head is suddenly jerked back and forth or side-to-side beyond its normal limits, ligaments supporting the neck vertebrae can be sprained (over-stretched) or torn, forcing vertebrae out of their normal position.

In tests of low speed rear impact collisions, it was reported that the threshold for cervical spine soft tissue injury was 5 mph.

Most rear impact accidents occur at crash speeds of 6 to 12 mph - speeds below the threshold for property damage to the vehicle - but sufficient to cause cervical injury.

Whiplash injuries to the cervical spine can occur in sports (skiing, hockey, football, cycling, ice skating, gymnastics, boxing), during falls (down a flight of stairs, on an icy sidewalk), and many more!

Whiplash Diagnosis
 

Diagnosis occurs through a patient history, head and neck examination, X-rays to rule out bone fractures and may involve the use of medical imaging to determine if there are other injuries.

A physical and neurological examination is performed to evaluate the patient's general condition.

Initially, the physician orders radiographs (x-rays) to determine if fracture exists. Depending on the patient's symptoms, a CT scan, MRI, and/or other imaging tests may be necessary to assess the condition of the cervical spine's soft tissues (intervertebral discs, muscles, ligaments).
 

Whiplash Consequences
 

The consequences of whiplash range from mild pain for a few days (which is the case for most people), to severe disability caused by restricted head movement or of the cervical spine, sometimes with persistent pain.

If a person (infant, child, or adult) experiences an accident, a proper spinal exam is necessary to assess whether a neck injury occurred. An IUCCA upper cervical chiropractic specialist uses a computerized test known as digital infrared imaging and specific x-rays of the upper neck to accurately assess a neck injury. If a neck injury is found, a specific adjustment by hand is used to correct the injured vertebrae. Correction of the neck injury can improve, reverse, and prevent numerous whiplash symptoms.
 

Whiplash protection
 

Protection efforts are hampered by lack of knowledge about the causes of whiplash injuries. The focus of preventive measures to date has been on the design of car seats, primarily through the introduction of headrestraints, often incorrectly called headrests. This approach is potentially problematic given the underlying assumption that purely mechanical factors cause whiplash injuries - an unproven theory. So far the injury reducing effects of head restraints appears to have been low, approximately 5-10%, because car seats have become stiffer in order to increase crash-worthiness of cars in high-speed rear-end collisions which in turn could increase the risk of whiplash injury in low-speed rear impact collisions. Improvements in the geometry of car seats through better design and energy absorption could offer additional benefits. Active devices move the body in a crash in order to shift the loads on the car seat.

Some car manufacturers have begun to implement various whiplash protection devices in their products in order to reduce the risk for and severity of injury, such as whether or not such devices offer a substantial benefit over vehicles without them remains controversial. In a test undertaken by the Swedish National Road Administration and an insurance company (Folksam), one test showed that a whiplash protection device was no guarantee against injury and that the degree of protection varies between vehicles both with and without whiplash protection devices. Yet The Journal of TRAUMA, Volume 51, No 5, November 2001 found that an Active Head Restraint helps reduce the risk of neck injuries by up to 75% in rear-end collisions.

Resources:
Wikipedia | erinelster.com | spineuniverse.com

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