A B C D E F G H I J K L M N O P R S T U V W

WHIPLASH INJURY

What is a Whiplash Injury ?

This problem occurs in car occupants whose neck is violently thrust forwards and backwards during an accident, usually involving an impact from the rear. The neck of cervical spine is made up of seven bony vertebrae joined together by ligaments and fibrous discs and muscles. They form a flexible tunnel through which the spinal cord runs. Although the neck is normally very flexible, any violent movement can stretch and tear the ligaments between the bones without actually producing any damage to the bones themselves. This violent movement can produce immediate or more often delayed symptoms several hours or even a day or two after the accident. The pain is felt at the back of the neck, spreading sometimes up over the top of the head as a headache which may end up behind the eyes. The pain may spread down between the shoulder blades and across the top of the shoulders. The neck may become very stiff to move, and pain is worse on sitting at a desk or trying to read. It is often difficult to concentrate and affected people become very irritable. Exactly which structures are injured is really not known. It is presumed that the ligaments or muscles are stretched and torn between the vertebrae. There may be some small areas of bruising and swelling within the spinal cord itself which is not sufficient to produce any paralysis but sufficient to produce pain.

How does a Whiplash Injury occur ?

In a car accident, even if the occupants are strapped in, a sudden violent shunting blow from behind will thrust the patient forward in their seat with a reflex backward movement of the head. Even in a front collision, and with the restraint of the seat belt, the head can bend suddenly forwards and then recoil backwards. It is this backward recoil of the neck which seems to be responsible for producing the whiplash injury.

Why does a Whiplash Injury occur ?

There are no particular predisposing factors except in some people where arthritis of the neck may make it stiffer. This makes the effect of a recoil movement even more painful and serious.

Treatment Involved

The usual treatment which will be recommended to you for whiplash injury is a soft sponge collar to support the neck in its most comfortable position. This is usually with the head bent slightly forwards. Painkillers or a muscle relaxant such as Valium are useful additions. It is advisable not to drive a car until the severe pain and spasm has settled. If pain radiates down towards one or other arm, then light traction in the hands of the skilled physiotherapist often eases the pain. In the long term, there is no difference between patients who have physiotherapy and those who have a collar and painkilling tablets.

During Treatment

Recovery may be slow. There are good days and bad days. You may find it difficult concentrating on your work, sitting at a desk or travelling.

After Treatment 

There is a 50% chance that symptoms will get better after 6 weeks. If there are still symptoms at this stage, then these are likely to continue on and off for 6 to 18 months. There is also about a one-in-three chance that there will be a chronic problem with neck pain, stiffness and headaches coming back from time to time.

If a Whiplash Injury is Left Untreated

There is no difference in the long term in those who have not been treated and those who had collar or physiotherapy treatment. The recurrence and persistence rate of symptoms is the same.

Effects on Family

Your family and friends will need to understand that the tension and pain in your neck and the headache, with difficulty in concentration, will make you irritable for some weeks after the injury. If your neck does not get completely better, it is also important for them to realize that you are not putting it on.