What is Whiplash?
Whiplash is the common name for a neck (cervical) sprain and strain injury.
It is caused by the sudden exaggerated thrust of the head backward (hyperextension), forwards (hyperflexion), and sometimes sideways. This results in soft tissue damage (stretching or rupture) to the ligaments and muscles surrounding the cervical spine as they are forced beyond their normal physiological limits.
As a result of the mechanical forces applied to the cervical spine, whiplash injury is also referred to as an acceleration- deceleration injury.
The cervical spine is held together by a complex set of ligaments and these ligaments may be extremely stretched, partially torn or completely ruptured in a whiplash injury. The muscles are also either slightly strained or even torn depending on the force. The common muscles affected are the sternocleidomastoid, scalene, trapezius and levator scapulae muscles of the neck and back.
Causes of Whiplash Injury
Whiplash injuries usually occur in motor vehicle accidents (MVA) especially rear-end collisions. It can however, occur in many other ways like a fall or sports injuries, amusement park rides, airplane turbulence or at any time when a sudden, unguarded movement of the cervical spine takes place.
Signs and Symptoms of Whiplash
After a whiplash incident, the patient may experience pain which may be immediate, shortly after the injury or delayed (24-48 hours later).The pain is usually accompanied by decreased mobility and a decreased range of motion of the neck (flexibility), stiffness and muscle spasm. Local swelling may also be noticed. In more severe cases, there may be damage to the cervical intervertebral discs resulting in referred pain, numbness and parasethias (like tingling) running down into the arms and hands.
Treatment and Management
Diagnosis occurs through a patient history, physical and orthopaedic examination of the cervical spine; x-rays to rule out fractures of the cervical spine and occasionally further medical imaging to rule out other forms of injury.
Treatment will include ice, rest, physiotherapeutic electro-modalities like interferential current (IFC) and therapeutic ultrasound. Physiotherapy or chiropractic joint manipulation may be necessary over a period of time to decrease the severity of the symptoms and assist with healing. A course of non-steroidal anti-inflammatories, pain-killers and muscle relaxants and pain free range of motion exercises may also be required for a period of time. In certain cases, the use of a soft cervical collar (neck collar/brace) may be indicated.
Prognosis is good and can range from anywhere between a few days to weeks to 3 months. It is imperative that help or treatment is sought after a whiplash injury to prevent further damage or degenerative changes from taking place within the cervical spine in the future. These degenerative changes could be a precursor for conditions like osteoarthritis, cervical degenerative joint disease and cervical radiculopathy (pinched nerve).
Whiplash Injury Road Accident Claims
Whiplash injury was among the more common reasons for Road Accident Fund claims. However, with recent changes in legislation, a whiplash injury may not be considered for compensation from the RAF unless the injury sustained will result in long term impairment.