Whiplash

 

Definitions of Whiplash: 

Whiplash>noun  1 the lashing action of a whip.  2 the flexible part of a whip.  3 injury caused by a severe jerk to the head. >verb jerk suddenly. (WordPerfect)

Whiplash, also called neck sprain or neck strain, is injury to the neck. Whiplash is characterized by a collection of symptoms that occur following damage to the neck. In whiplash, the intervertebral joints (located between vertebrae), discs, and ligaments, cervical muscles, and nerve roots may become damaged. (wedmd.com)

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. – (emedicinehealth.com)

Hyperextension (over-extension) injury to the neck, often the result of being struck from behind, as by a fast-moving vehicle in a car accident. (medicine.net)

Symptoms of Whiplash:

Most people experience neck pain either immediately after the injury or several days later. Other symptoms of whiplash may include the following:

  • Neck stiffness
  • Injuries to the muscles and ligaments (myofascial injuries)
  • Headache and dizziness (symptoms of a concussion)
  • Difficulty swallowing and chewing and hoarseness (could indicate injury to the esophagus and larynx)
  • Abnormal sensations such as burning or prickling (this is called paresthesias)
  • Shoulder pain
  • Back pain – (spineuniverse.com)

Diagnosis and Treatment of Whiplash: 

In most cases, injuries are to soft tissues such as the disks, muscles and ligaments, and cannot be seen on standard X-rays. Specialized imaging tests, such as CT scans or MRI (magnetic resonance imaging)may be required to diagnose whiplash. (webmd.com)

If the patient is transported to the emergency department with a cervical collar strapped around the neck, the ER physician will remove the collar when appropriate. In most cases, the collar will be removed without the need for x-rays if the patient meets all of the following criteri:  Normal level of consciousness or alertness; No muscle weakness or sensation problems; No evidence of intoxication with alcohol or drugs; No tenderness in the back of the neck; No other painful injury elsewhere on the body; Your collar will remain in place if the doctor determines that the patient needs x-rays of the neck. The doctor will first examine the functioning of the spinal cord in order to determine if any damage is present. The following areas will probably be assessed: Physical strength in both arms and legs;  Ability to sense the touching of the skin in different parts of the body; Reflexes at the joints of the arms and legs. The doctor will also inspect the patient's head and neck for any external signs of trauma including bruises, cuts, and abrasions. The patient's neck will be pressed in specific areas to be sure the patient does not perceive any pain or tenderness. The patient may be asked to move their neck in a controlled way to the left, right, up, and down. Tell the doctor if neck pain, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers is felt. X-rays may be taken of the neck bones to make sure there are no fractures or signs of other serious injury. The doctor will review these x-rays and order further imaging with a CT Scan or MRI if needed. If the patient's x-rays are normal, then the cervical collar will probably be removed, and should not need any further x-rays." (emedicinehealth.com)

"One of the most frustrating aspects about whiplash is the lack of objective signs that the patient has been injured after a collision.  A study from the Netherlands may change this situation.  Patients with Grade II whiplash-associated disorder were not able to relax the upper trapezius muscles to baseline levels." *

"Although little exists in the literature to recommend it, the standard treatment (rest, use of a soft cervical collar, and gradual self-mobilization) is still commonly prescribed in cases of actue whiplash.  A Swedish study showed that active treatment was more effective than standard treatment in reduction of pain.  The active treatment protocol was more effective when initiated early."*

Dynamics of a Crash and Whiplash:

"The Institute for Highway Safety admitted "the head restrains in most cars are inadequate, neither high enough nor close enough to many people's heads to prevent whiplash injuries or associated neck disorders in crashes." *

"Significantly, the data shows that the peak of shear in the vertebral segments occurs before the head hits the head restraint."*

Rear-end collisions were disproportionately high [59%] in reporting WAD compared to general accident occurrence. The commonest cars involved in WAD outcomes were small. The change of velocity [δV] most common for expressing WAD was between 5-10 km/h [49%], and a further 24% had WAD with 0-5 km/h δV. The medium age of complainants was around 30, with 42% at or under this age; the incidence of WAD in the elderly or frail persons with degenerative neck disorders was disproportionately low, 16% being over age 50. About 20% of WAD claims were involved in collisions of sufficient magnitude to realistically cause physical injury to the neck. About 70% were not. (Journal of Musculoskeletal Pain)

Whiplash is a Permanent Injury:

"43% of patients with cervical whiplash still had symptoms sufficiently severe to interfere with their ability to work two years after their injury"*

"Headaches are, after neck pain, the most common symptom experienced by patients after a whiplash injury.  These headaches can be caused by muscle strain or emotional stress that is common after a car crash.  Also common are cervicogenic headaches, or headaches that originate in trauma to the deep structures of the neck, such as ligament injury."*

Q: Isn't it true that whiplash is essentially "self limiting"? Meaning it will get better with or without treatment. A: While it is true that in many cases the symptoms will calm down some on their own, in the vast majority of cases there will be some level of permanent problems if the whiplash is not treated effectively. You would be amazed at how often a chiropractor hears something like "You know Doc, I had an accident back in 1982 and hurt my neck. I thought I was getting better and didn't see anybody about it, but it never completely got well and after a couple of years started getting worse again. I've had neck problems ever since." A very large percentage of the chronic, hard to treat patients in a chiropractors office can attribute their problems to an auto accident, often many years before. With effective, early treatment these permanent changes can be significantly reduced or eliminated. (thewhiplashsite.com)

References: 1.* Medical Sources for Proving Whiplash by Michael R. Melton. 2. emedicinehealth.com 3. webmd.com 4. spineuniverse.com 5. medicine.net 6. thewhiplashsite.com 7. The Journal of Muculoskeletal Pain 8.

Link to Videos about Whiplash Injuries:

http://www.spineuniverse.com/conditions/whiplash/whiplash-animation

More Questions About Whiplash?

The husband-wife attorney team of Charles Scott and Kathryn Fenderson Scott at The Law Firm of The Law Offices of Charles D. Scott help people who have suffered whiplash injuries in Florida; please call 727-300-4878 or email the attorneys at itslegal@aol.com or fenderlaw@aol.comor visit http://www.yourstpetelawyers.com for more information.

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