Whiplash

Whiplash is a soft tissue neck injury caused by the neck bending forcibly forward (hyperflexion) and then backward (hyperextension), or vice versa. Although the neck (cervical spine) has a vast range of motion, whiplash causes movement beyond the normal range.

Also known as neck sprain or neck strain, whiplash is most typically associated with automobile accidents. There are other causes as well, like falls, sports injuries and being punched or shaken.

Symptoms of whiplash may not surface for days, weeks or months after the incident. That’s why it’s so important to visit your Wellstar neurologist after an accident. Whiplash can have a serious impact on your future spinal health and can be related to other spine conditions including premature disc degeneration or osteoarthritis.

Symptoms

The most common symptom of whiplash is neck pain. A number of other symptoms associated with "whiplash associated disorder" (WAD) include:

Neck stiffness
Headache
Low back pain
Dizziness
Ringing in the ears
Blurred vision
Concentration or memory problems
Irritability
Sleeplessness
Tiredness
Arm pain and heaviness possibly related to compression from a herniated disk.

Risk Factors

The possibility of getting a whiplash injury is higher for:

Those over age 65.
Those with extreme paraesthesia, a burning sensation in the hands, feet and limbs.
Victims of falls from three feet or higher, bicycle accidents, vehicle collisions at high speed or with rollover or ejection. The risk is less in a simple rear end motor vehicle collision.

Whiplash Prevention

Safety experts say the best way to prevent whiplash is to purchase a vehicle with a good head restraint and adjust it properly. The restraint should be optimally positioned directly behind the head. Also make sure to use seatbelts at all times, wear proper protective gear when playing contact sports and be mindful of fall risks.

Whiplash Diagnosis

If you think you may have suffered a whiplash injury, schedule a visit to your Wellstar neurologist as soon as possible. The doctor will ask questions about your symptoms and how the injury occurred. The visit will include a complete medical history and physical examination. Based on this information follow-up diagnostic tests may be recommended.

Tools and tests

Wellstar physicians use a variety of tests to learn the extent of the injury and what tissues are involved.

X-rays are used directly after an injury if a health care professional believes you may have suffered a fracture or that the spine is not stable. X-rays reveal images of the bone anatomy.
Computed tomography (CT) scan shows images that are more detailed than standard X-rays.
Magnetic resonance imaging (MRI) produces detailed images of organs and soft tissue structures.
Electromyography and nerve conducting velocity study help determine if nerve damage has occurred.

Whiplash Treatment

Treatment for whiplash typically includes medications and other non-surgical treatment. Surgery is rarely required. Your doctor will recommend treatment based on the extent of the injury, your age, overall medical condition and your tolerance for specific medications or therapies.

Non-surgical treatment options

Ice applications for the first 24 hours after the incident.
Supplemental heat application to relieve muscle tension.
Pain medications, starting with over-the-counter and moving to prescription if necessary.
Epidural injections, often in combination with a physical therapy or exercise program. The injections send steroids, which are strong anti-inflammatories, to the inflamed nerve root. Your Wellstar neurologist may suggest other types of injections depending on your injury.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Antidepressant.
Muscle relaxants.
Cervical collar worn for several hours a day for 2-3 weeks. The collar (or brace) provides support to the neck as the soft tissues heal. It limits movement, which takes the load off the neck.

Other treatments include range of motion exercises, cervical (neck) traction and physical therapy. Wellstar physical therapists offer exceptional treatment at several convenient locations. Your doctor will discuss this option with you.

Surgery

Whiplash injuries rarely require surgery. But if shoulder or neck pain persists, your neurosurgeon may recommend a surgical procedure. The type of surgery will depend on what parts of the cervical spine have been injured.

Discectomy is a procedure to remove all or part of a damaged disk. The procedure usually causes an unstable spine, which means the spine moves in abnormal ways that put your at risk for serious neurological injury. For that reason a discectomy is often accompanied by a stabilizing procedure. Options include:

Cervical disk replacement. This is a relatively new surgical option in which the neurosurgeon implants an artificial cevical disk. The technique allows more movement and creates less stress on the remaining vertebrae than traditional spinal fusion surgery.
Fusion and spinal instrumentation. This traditional spine stabilization method creates an environment in which the spine fuses together over time. A bone graft or biological substance is used to stimulate bone growth. Spinal instrumentation (wires, cables, screws, rods or plate) is used to increase stability and help fuse the bones.

Corpectomy may be recommended if the whiplash injury has caused a narrowing of the spinal canal in the neck (spinal stenosis).

Discuss all options in depth with your neurosurgeon to learn about the benefits and risks as they relate to your injury and specific medical condition. Surgical complications can include injury to the spinal cord or other organs, failure to improve, instrument breakage/failure, infection, pain and swilling in the leg, blood clots in the lung and other very rare complications including paralysis or death.

Whiplash Ongoing Care

Generally the head and neck pain associated with whiplash clear within days or weeks. Most patients recover fully within several months of the injury, though some may continue to experience neck pain and headache.

If you have had surgery you will likely be out of bed within 24 hours and on pain medications for 2 to 4 weeks. It’s important to give your body time to heal. That likely means some restriction in activities, especially those that require considerable neck movement. You should avoid contact sports, twisting and heavy lifting during the recovery period.