Friday, December 19, 2014

Definition

This is an imprecise term for injury to the cervical vertebrae and adjacent soft tissues. It is produced by a sudden jerking or relative backward or forward acceleration of the head with respect to the vertebral column. People in a vehicle that is suddenly and forcibly struck from the rear may sustain “whiplash” injuries.

Description

Although some believe that whiplash injuries are routinely exaggerated, researchers say they cause real pain, and sometimes enduring problems, for thousands of people every year.

According to the National Safety Council, neck sprains and strains, the most common forms of whiplash, account for almost 10 percent of all motor vehicle accidents in which long-term disability occurs. Only the face, head and knee are more vulnerable to harm in an auto accident.

Causes

The most common whiplash injuries occur when a motor vehicle is struck from behind, causing the occupant's body to thrust forward as the head snaps back and then forward until the chin strikes the chest. This violent motion, which can happen several times in quick succession, inspired the descriptive term "whiplash."

Although front-end and side collisions wrench the head and neck in different ways, they can produce similar neck sprains. Any of these motions can hyperextend the neck beyond its normal range of motion, damaging muscle, ligaments, and connective tissue - and sometimes other structures as well.

Prior to 1969, when automobile headrests became standard equipment, there was nothing to limit back-and-forth head movement in a rear-end collision. Although properly positioned headrests can reduce the incidence of neck pain after rear-end collisions, these injuries still occur.

Symptoms

Researchers have identified a broad spectrum of injuries and symptoms associated with whiplash. In most cases, soft tissues, mainly muscles and ligaments, cause pain because they have been stretched beyond normal limits. On occasion, they may bleed or even tear. In a few instances, violent whiplash motion can squeeze the disks of the cervical spine so hard that they herniate and press on a nerve. Spinal vertebrae can also be knocked painfully out of alignment.

The most common form of whiplash injury is neck strain that manifests as temporary pain and stiffness. One may not feel significant discomfort until several days after the accident. Then the pain may gradually intensify, moving to the back of the head, chest muscles and one or both shoulders and upper arms. The person may complain of hoarseness and have difficulty in swallowing. The neck typically feels tender, swollen and hurts when turned from side to side.

Some people also experience muscle spasms. Those who sustain head injuries may have episodes of blurred vision, ringing or buzzing in the ears and dizziness.

More serious whiplash injuries may involve damage to blood vessels, nerves or the spine.

Treatment

The mildest cases of whiplash injury improve after a few days when treated with rest and aspirin or other over-the-counter anti-inflammatory medications. Other measures may be needed if the neck pain is constant, muscle spasms occur when the head is turned, or pain and spasms have spread to the shoulder and upper arm.

Patients are often advised to wear a soft cervical collar with the low section under the chin so that the high back keeps the neck from bending backward. The collar also takes weight off of the muscles. It should be worn intermittently instead of all the time to reduce dependency. It is especially helpful in settings where pain is most likely to occur, such as driving or riding in moving vehicles that jiggle the neck.

Some doctors recommend taking it easy during the first two weeks after the accident, but staying in bed is not necessary. It is appropriate to take short walks and to go to work for a few hours or more each day, if the job does not put much stress on neck and shoulder muscles. Sports, carrying heavy groceries and other physically demanding activities should be avoided.

When the whiplash injury is not severe, physicians will send patients home with a do-it-yourself set of exercises designed to strengthen and increase the flexibility of the neck muscles. If pain is severe or continuous, however, many specialists recommend working with a physical therapist or similar professional as often as twice a week for several weeks – first to learn to use undamaged muscles and ligaments and then to rehabilitate the injured ones.

Fortunately, most people with severe injury will heal, although it may take time. Some will feel twinges of neck pain or weakness when they are tired. Others may experience periodic flare-ups of pain that will subside with exercise. The likelihood of full recovery is substantially increased by obtaining a comprehensive evaluation from a physician following the accident and adhering to an exercise program designed by your physician to maintain strength and flexibility.

Questions

How serious is the injury to the muscles, ligaments and connective tissue?

Is there any other injury, say to the wrist, ankles or spine?

Should more tests or X-rays be done?

What medications can be prescribed? How will they help? What are the possible side effects?

Would a cervical collar help?

What do you recommend to strengthen and rehabilitate injured muscles?

Should a physical therapist be consulted?