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Whiplash

Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of your neck (specifically ligaments, tendons, and muscles). It is caused by an abnormal motion or force applied to your neck that causes movement beyond the neck's normal range of motion.

  • Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault.
     
  • The term whiplash was first used in 1928, and despite its replacement by synonyms (such as acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury), it continues to be used to describe this common soft tissue neck injury. Your doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury.

Whiplash Causes

The most frequent cause of whiplash is a car accident. The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, whether or not they wear seat belts.

  • Other common causes of whiplash include contact sport injuries and blows to the head from a falling object or being assaulted.
     
  • Repetitive stress injuries or chronic strain involving the neck (such as using your neck to hold the phone) are a common, non-acute causes.
     

  • Child abuse, particularly the shaking of a child, can also result in this injury as well as in more serious injuries to the child's brain or spinal cord.

Whiplash Symptoms

These signs and symptoms may occur immediately or minutes to hours after the initial injury; the sooner after the injury that symptoms develop, the greater the chance of serious damage.

  • Neck pain
     
  • Neck swelling
     
  • Tenderness along the back of your neck
     
  • Muscle spasms (in the side or back of your neck)
     
  • Difficulty moving your neck around
     
  • Headache
     
  • Pain shooting from your neck into either shoulder or arm

When to Seek Medical Care

The best time to call your doctor is immediately after the injury. If the patient cannot determine whether an emergency department visit is needed for the symptoms, then contact the doctor and ask for advice. If the doctor is unavailable at the time of the injury, then call 911 for transport to the emergency department. The risks associated with a possible neck injury are far too great to attempt to diagnose and self-treat. See a doctor and have the patient's neck braced to keep the head from moving during transport.

Depending upon the severity of a car accident, emergency medical personnel may take the patient to an emergency department immediately. In this case, a cervical collar will be placed around the patient's neck, and the body will be strapped to a long, firm board to prevent any movements until a doctor sees the patient.

With less severe car accidents, sports injuries, or other accidental injuries, emergency medical services may or may not be involved in the patient's pre-hospital care. You should call 911 emergency medical services if the patient develops any of the following symptoms shortly after the injury:

Whiplash Treatment

Home care is intended to relieve the pain and minimize the amount of inflammation in the soft tissues of the neck.

  • Apply ice to the neck for 20 minutes at a time each hour for the first 24 hours while awake. Do not apply ice directly to the skin. Place a towel between the ice and the neck. Continue to use ice therapy until the pain stops. (After you see the doctor, follow his or her directions for ice therapy.)

     
  • Pain medications for anti-inflammatory action. Avoid ibuprofen if you have a past medical history of gastritis, duodenitis, peptic ulcer disease, reflux, or other stomach problems

Medical Treatment

The doctor most likely will recommend a treatment plan including a mixture of the following:

  • Neck massage
     
  • Neck rest
     
  • Bed rest
     
  • Ice therapy
     
  • Heat therapy
     
  • Oral pain relievers and muscle relaxers
     
  • Immobilization of the neck with a soft cervical collar (only a minimal benefit if any at all)
     
  • Early range of motion exercises combined with heat therapy starting 72 hours after the injury to restore flexibility
     
  • Avoidance of excessive neck strain for the next week and then increased activity as tolerated in the following weeks

Next Steps

If no serious injury is detected in the emergency room, then the patient will be allowed to return home and will be referred to their doctor for follow-up care.

If you continue to have symptoms from your whiplash injury, contact the doctor. Examine this list of complaints and mention any that the patient may be experiencing:

  • Neck pain
     
  • Headache
     
  • Increased fatigue
     
  • Shoulder or arm pain
     
  • Back pain
     
  • Blurred vision
     
  • Dizziness
     
  • Sleep disturbance or irritability in young children

    Depending on the nature and severity of any continuing symptoms, the doctor may refer the patient to another doctor who specializes in the rehabilitation of these types of injuries. The doctor may also encourage physical therapy and monitor the patient for other injuries that may have been aggravated.

 

     

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