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The Basics of a Whiplash Injury

Couple involved in a car accident and feeling whiplash

Whiplash is the basic term for pain in the neck (or cervical spine) after sudden back-and-forth head movement. Because the human head can weigh about 10 pounds, the pressure this puts on the neck can make for some very painful injuries. These injuries include muscle strains, and may also involve ligament sprains, disc injury and possible fractures.

What causes whiplash?

Whiplash is commonly caused by car accidents, particularly rear-end accidents. When one car rear-ends another, the driver and or passengers that are hit from the back are pushed forward, and held in place with their seatbelt, making the head/neck the part of the body that takes the brunt of the force. Whiplash can also happen in sports. Injuries in football, snow sports, rugby and skate or ice sports can be related to whiplash. Falls on icy sidewalks, driveways or steps can cause whiplash. Additionally, physical abuse can also cause whiplash. Any instance where the head is whipped forcefully forward and back (or vice versa) is a possible cause of whiplash.

What does whiplash feel like?

During the occurrence of whiplash, when the head is whipped forward and back (like cracking a whip or releasing a bobble head from a backward position) the suddenness of the movement can tear the muscle fibers and/or the ligaments. The movement can also cause shearing motion that can damage vertebral discs. Fractures, dislocations, and artery dissection can also happen, but this is far less common.

Whiplash symptoms often appear hours or days after the injury occurred, or it can be immediate. In some cases, the symptoms don’t appear for weeks after the accident. The symptoms can include:

  • Neck pain
  • Limited neck motion
  • Stiffness and/or muscle spasms in neck, upper back and/or shoulders
  • Headaches (occurrence in the base of the skull is most common)
  • Dizziness or vertigo
  • Pain in the upper back, shoulders and/or arms
  • Tingling and numbness in the arms
  • Trouble sleeping (insomnia; difficulty sleeping because patient is uncomfortable)

How is whiplash diagnosed?

(If you’re asking this question, you should probably be making your appointment with your provider now.) Whiplash can be diagnosed by your chiropractor through an examination of the neck and upper back including palpation (pressing on the surface of the body to feel for any abnormalities), range of motion, neurologic and orthopedic tests. The chiropractor should also take x-rays of the neck (cervical spine). This is done to evaluate for any fracture, pre-existing arthritis, any other boney changes, such as osteoporosis or congenital defects, and to assess the patient’s biomechanics, or: seeing whether the function and motion of the parts of the body are within normal range. The chiropractor may also refer you to have an MRI or CT scan done.

How bad is my whiplash?

There are specific grades of whiplash, using the Croft Grading System. This is used to determine the severity of the case of whiplash and the predictive measure of recovery, or, what it will take for the patient to improve in health.

Croft Grading System  
1 – MinimalNeck pain with no limitation of motion
2 – SlightNeck pain with limitation of motion
3 – ModerateNeck pain with limitation of motion and some ligament injury. Possible neurological symptoms.
4 – Moderate to SevereNeck pain with limitation of motion and ligament instability. Neurological symptoms present. Fracture or disc derangement.
5 – SevereRequires surgical management

What can be done to help my whiplash pain and symptoms?

Depending on the severity, there are a few things you can do at home, but many treatment methods require a visit to a medical professional.

Home care

Use ice and or heat for pain relief. Ice is best during the first few days after a whiplash injury to reduce pain and inflammation. Heat is better for muscle relaxation. Make sure you get plenty of rest. Apply some topical analgesics, such as IcyHot or Bengay. Also consider taking OTC meds such as Advil, Aleve, or Tylenol to help with general pain and swelling.

Therapy

 Seeing someone to manage your pain and solve the root problem is helpful for addressing pain now, and recovering physically over time.

  • Chiropractic:  Restore motion to the joints to increase blood flow and reduce pain. Instrument chiropractic adjustments may be better tolerated at the beginning of treatment after whiplash, because the body is sore and tender.
  • Massage: This is great for muscle relaxation, lymphatic drainage, and pain relief.
  • Physical therapy and/or rehabilitation: This can help strengthen your muscles, and improve your motion and typical bodily function.
  • Cold laser: This is a specialized laser that can help speed your healing up, and reduce pain and inflammation.

Medication

Beyond over-the-counter drugs, using prescription muscle relaxers and anti-inflammatories can be helpful for whiplash. Sometimes painkillers and steroids are prescribed, but those are typically reserved for more severe cases.

Injections

In order to decrease pain and inflammation, providers may inject corticosteroids into facet or trigger points. In some cases, providers may use injections meant to help regenerate healthy tissue in the body by using PRP, prolotherapy and stem cells.

Surgery

Most whiplash cases don’t require surgery, but some are severe enough to require medical intervention. This is usually reserved for whiplash cases that involve disc injury (laminectomy, discectomy or disc replacements) or to bring back stability through fusions or fracture repair.

 

How soon will I recover from whiplash?

For most people, recovery from whiplash takes 3 months or less. There are factors, however, that can slow your recovery:

  • Severity of whiplash: See Croft Grading System above
  • Age of patient: healing goes more slowly as people age. Pre-existing degenerative or arthritic changes can also make symptoms worse.
  • Female: Women tend to have smaller neck muscles and smaller neck structures than men, which can lead to an increase in the risk of whiplash
  • Smoking: Smoking decreases blood flow, increases inflammation and slows healing in general.
 

Whiplash isn’t something you can stop from happening to you, but you can certainly be active in your treatment of it. If you’re involved in a car accident, it’s best to go to your provider right away, regardless of whether you have pain or not. Painful whiplash symptoms could be around the corner.

If you suspect you have whiplash, contact us today to schedule an appointment for examination, and we’ll work with you to help address your painful symptoms of whiplash and get you back in your element.