HEALTH TALK: Whiplash

Dr. Victor Emmanuel

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Dr. Victor Emanuel

DEFINITION

Whiplash is a common neck injury that often occurs during rear-end vehicle collisions, when your head suddenly moves backward and then forward – similar to the motion of someone cracking a whip. These extreme motions push your neck muscles and ligaments beyond their normal range of motion.

Whiplash injuries can be mild or severe. Treatment typically starts with over-the-counter pain relievers and ice applied to the painful neck muscles. Persistent pain may be relieved by prescription medications or physical therapy (physiotherapy).

Most people recover quickly – usually within four to six weeks – but some people develop chronic symptoms that can be extremely painful and disabling.

SYMPTOMS

Whiplash symptoms can occur immediately after the injury or, as is very common with musculoskeletal injuries, may develop after a few days following the injury. Symptoms may include:

• Neck pain and stiffness
• Headaches
• Dizziness
• Ringing in the ears
• Blurred vision
• Difficulty concentrating
• Pain in the shoulder or between the shoulder blades
• Memory problems
• Irritability
• Fatigue
• Sleep disturbances

CAUSES

When sudden force throws your head backward and then forward, whiplash typically occurs. It is what we call a decceleration injury. The neck muscles and ligaments are usually strained. This type of injury may result from:

• Vehicle accidents, especially for people whose vehicle has been rear-ended (hit from the back).
• Collisions while playing contact sports.
• In places where they exist, amusement park rides, such as roller coasters.
• Incidents of being punched or shaken.

RISK FACTORS

Factors which put you at risk for whiplash include:

• Being female
• Younger age
• Rear-end collision
• Previously having had neck pain

CONSULT YOU DOCTOR PROMPTLY

• If the pain spreads to your shoulders or arms
• If it becomes painful to move your head
• If you experience numbness, tingling or weakness in your arms

TESTS AND DIAGNOSIS

Doctor will want to know how the injury occurred and will measure how far your neck can move in different directions. He or she will also check to see if any parts of your neck are especially tender to pressure. X-Rays may help to rule our other neck pain causes such as fracture of the vertebrae, dislocation or arthritis. CT Scans might be requested to check for soft-tissue damage or pressure on nerves.

COMPLICATIONS

Between 15 percent and 40 percent of people who get whiplash will continue to have pain for months following the injury. In some people, this chronic pain can be traced to damage in the joints, discs and ligaments of the neck.

But in some cases, no abnormality can be found to explain the persistent neck pain.

TREATMENT AND DRUGS

Medications

Over-the-counter pain relievers can sometimes, even often, control mild to moderate whiplash pain. People with more severe pain may need short-term prescription pain relievers. Muscle relaxants may also be prescribed, but these drugs often cause drowsiness, so doctor may advise you to take them only at bedtime.

Ice, heat and exercise

Many whiplash sufferers find it helpful to use ice or heat on their necks and upper backs. Generally, ice should be used early in the recovery period to reduce inflammation, while heat is particularly helpful to relax muscles before range-of-motion exercises.

Once your pain is controlled, doc may want you to regularly perform gentle stretching exercises to help get your neck’s range of motion back. These usually involve rotating your head from side to side, and bending your neck forward, backward and to the sides.

If pain persists for several months, doc may recommend physical therapy to help strengthen the muscles supporting your head.

Injections

A corticosteroid or lidocaine injection into painful muscle areas may relieve the muscle spasms that can be associated with whiplash injuries. This makes it easier for you to perform the stretching exercises crucial to recovery.

Cervical collars

These are actually no longer recommended to be used as commonly as they once were. The thing is that immobilizing the neck for long periods of time can lead to decreased muscle bulk and strength and impair recovery.

During the day, collars should be worn for no longer than three hours at a time and for only the first few weeks after the injury. If you’re continually being awakened at night by whiplash pain, wearing a cervical collar may help you sleep.

ALTERNATIVE MEDICINE

Among the many traditional therapies that have been employed to treat whiplash pain are:
• Acupuncture
• Chiropractic care
• Massage
• Transcutaneous electrical nerve stimulation (TENS)

I mention these only for your interest and will not elaborate from the standpoint that they are essentially “alternative” – non-conventional.

See you next week.

Dr. Emanuel, based in the Commonwealth of Dominica, has been an educator of medical professionals, in training and the public, for over 20 years.  

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