By Louis Corpora DPT, PT
Whiplash injury is a neck injury resulting from a forceful back then forward motion of the head/neck, typically due to a force coming from behind. This event is most common in rear end motor vehicle accidents. Although not quite as common, whiplash injuries may occur in sports such as a boxer being struck or a football player being blindsided or tackled from behind.
Depending on the severity of the injury, whiplash can have a variety of symptoms. These include:
-Numbness or tingling in the arms and hands
-Cervicogenic (neck related) headaches
-Pain with neck movement
-Unwillingness to move the neck due to pain
Whiplash can affect and injure a variety of structures depending on the mechanism and location of the blow. Muscles, bones, ligaments, and nerves may be compromised in the neck. Since whiplash injury involves the head and neck rapidly and forcefully thrown from backwards to forward, it can have a multitude of causes. The most common causes are:
– Auto accidents (usually from being rear ended)
- Abuse or assault
- Contact sports (being tackled, hit from behind, or blind sided)
Symptoms of whiplash typically diminish within weeks. In other cases, some have pain that lasts for months or even years. Every whiplash case is different and is hard to forecast their outcome. Outcomes are usually worse if the symptoms were more severe and radiating into the arms and hands as seen with a nerve compromise in the neck. Some risk factors that bode unfavorably are:
- Pre-existing neck pain
- High speed accident
Diagnosing whiplash starts with a series of questions from the doctor. These questions will include the mechanism of injury, symptoms, and ability to perform activities of daily living. The doctor will typically do neurological screen testing reflexes, sensation, and upper extremity strength. He or she will also assess neck motion, checking the ability to move the head in different directions.
Imaging will likely be ordered to rule out any sinister problems that may manifest after whiplash. X-rays are going to identify fractures or dislocations. MRI will reveal harm to the ligaments, discs, or spinal cord.
Since whiplash is usually from a sudden and unexpected event, there is little you can do to avoid it. Incorporating neck strengthening and range of motion exercises in your routine on a weekly basis may help your chances of decreased injury.
The treatment plan depends on the severity of the injury which may vary from over the counter medications to prescription medication. If the condition is mild, the patient may manage it at home. In more serious cases, the patient may be sent to physical therapy or placed in a neck collar.
Usually, if the upper neck vertebrae (C1 & C2) are damaged and emergency surgery is not necessary, the patient will be placed in a neck collar to allow for healing. This is due to the increased risk of spinal cord compromise. A critical ligament attached to C1 is the transverse ligament. This ligament can be ruptured with a rapid forceful motion of the head forward like in whiplash. If this ligament is torn, the spinal cord will be compressed. If not identified or addressed right away, this may result from permanent neurological damage of the arms, trunk, and legs. That’s why it’s important to take extreme precaution if C1 and C2 are involved.
If patients are high risk and have C1 and C2 damage, the patient will likely be in a collar and not start physical therapy until proper healing occurs and cleared from the doctor. Once cleared, the patient will probably have decreased neck motion and strength due to being in the collar.
Even if they were not in a collar, motion and strength will still likely be affected. No case of whiplash or neck pain is the same. The physical therapist will evaluate the patient’s neck motion, reflexes, sensation, and upper extremity strength. The therapist then will create a plan of care based on the unique exam findings of the patient. The patient should expect to get back to activities of daily living after 4-6 weeks of physical therapy.
JOI Physicians are currently offering ASAP fracture and injury care. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care. Make an appointment by calling (904)JOI-2000.
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