The neck is the start of the spinal column and spinal cord. The spinal column contains about two dozen inter-connected, oddly shaped, and bony segments which are called vertebrae. The neck contains seven of these, known as the cervical vertebrae. They are the smallest and uppermost vertebrae in the body.
Whiplash occurs when the neck and head are suddenly forced backwards and then forwards, putting the cervical spine through rapid motions and extreme stresses. Most cases of whiplash are usually caused by car accidents where the person has been rear-ended. Other rare whiplash causes include; bungee jumping, rollercoaster, football, falls whilst skiing, and other high-impact activities where extreme acceleration-deceleration forces might be applied to the cervical spine.
Causes & Symptoms
The process of a whiplash injury sustained in a car accident can vary depending on a variety of factors, including the angle of the collision. Normally the collision occurs from behind, resulting in a whiplash injury that can be considered to happen in five different phases:
- The car gets impacted from behind, which soon causes the seat to push against the back. The spine then gets loaded with forces that compress the cervical spine upward against the head.
- The torso (in physical contact with the seat) continues to accelerate forward but the head (currently not in contact with the seat) does not.
- The individual’s head slams backwards into the accelerating seat. Soft tissues at the front of the neck are more likely to be injured in this situation as the neck rapidly extends backward.
- The head bounces off the seat and now accelerates forward.
- The seatbelt restrains the body, and the neck rapidly flexes as the head whips forward. Soft tissues at the back of the neck are likely to be injured here.
While the severity of the car crash normally correlates to the severity of the whiplash injury, there are some exceptions. Sometimes, a sturdy car does not crunch up and thus shows no significant outside damage, however, the forces that were not absorbed by the car exterior were instead transferred through the seat and thus caused even worse whiplash. In addition, whiplash injuries have been recorded in incidents whereas the speed at impact was less than 10 miles per hour.
Generally, some of the most common symptoms of whiplash include the following:
- Neck pain – The pain could range anywhere from mild to severe. It might be located in one spot or general area, or it could also radiate down the shoulder into the arm and / or hand. Typically, neck pain from whiplash is caused by ligament sprains or muscle strains, although it can also be caused by injuries to discs, nerves, joints, and / or bones.
- Headache – A neck muscle tightening or a nerve or joints of the cervical spine becoming irritated could cause headaches.
- Stiffness or reduced range of motion – Reduced neck mobility could be from pain, tightening of a muscle, or a mechanical problem, such as with a joint.
- Neck instability – This symptom often results from stretched or torn soft tissues, such as ligaments. But it could also be caused by a fracture.
- Shoulder and / or upper back pain – If the neck’s soft tissues, such as muscles or ligaments, are torn or strained during whiplash, then sometimes that specific pain can also be referred to as other soft tissues in the upper back and shoulders.
- Tingling, weakness, or numbness – Sometimes whiplash can cause one of the neck’s spinal nerve roots to become compressed or inflamed, which can then lead to cervical radiculopathy symptoms of tingling, weakness, and / or numbness radiating down the shoulder, arm, hand, and / or fingers. Typically, cervical radiculopathy is only felt on one side of the body, but in rare cases, it can be felt on both sides if more than one nerve root is affected.
Who Gets Whiplash?
Certain risk factors linked to whiplash include:
- Gender – Although whiplash may occur equally between men and women, some studies have shown that women are twice as likely to experience a whiplash injury when involved in a car crash.
- Age – Whiplash injury may occur at any age, young or old. The likelihood of experiencing whiplash following a motor vehicle collision increases with age. As we reach middle age and beyond, our fitness and strength gradually decline; the degenerative processes of the spine begin, and there is a long history of neck injuries, all of which predispose the body to injury.
- Prior to injury – Some people who have had a prior neck injury may be more likely to experience whiplash in a crash. Prior injuries may have a negative effect on the severity of the new injuries and recovery time.
How Does It Affect You? How Serious Is It?
Other whiplash-associated disorders can include:
- Dizziness – Whiplash-related dizziness could be from neck instability or even a concussion.
- Vision problems – Blurry vision or other visual deficits could result from any number of causes, including concussion or damage to a nerve. A vision problem could also contribute to dizziness.
- Emotional changes – A person might become more irritable, anxious, or even depressed. It can be difficult to understand if these changes are due to a concussion, post-traumatic stress syndrome, pain from the neck injury, or stress from the accident’s aftermath which could include litigation, financial worries, and / or the involvement of loved ones who were also injured.
- A sudden ringing in the ears – Also called ‘tinnitus’, this ringing or buzzing in one or both ears can range from intermittent and minor to constant and highly distracting. Any number of problems from whiplash could lead to tinnitus, such as an injury to the part of the brain that controls hearing, nerve, or vascular damage, jaw injury, or even stress.
- Trouble sleeping – An individual might find it difficult to fall asleep or stay asleep. These problems with sleeping well and waking up refreshed could be due to various whiplash-related factors, such as pain, stress, or concussion.
- Fatigue – Lack of energy could be related to difficulty sleeping, depression, stress, pain, concussion, or stress.
- Challenges with chewing and swallowing – Sometimes trauma to muscles around the jaw can cause chewing or yawning to be painful.
Additionally, it is also possible for someone to develop cognitive symptoms after a whiplash injury. These troubles could involve difficulty with memory or thinking. Sometimes these symptoms begin shortly after the injury, or they might not show until hours or days later. Cognitive problems could be from a brain injury, or perhaps they could be related to various types of stress.
Recommended Treatment & Rehabilitation
Your doctor will usually ask you questions about your recent injury, such as how it occurred, where you feel pain, and whether the pain is dull, shooting, or sharp. They may also perform a physical exam to check your range of motion and look for areas of tenderness. Afterwards, he / she might order an X-ray to ensure your pain isn’t connected to any other type of injury or degenerative disease such as arthritis. Other imaging tests, such as CT scans and MRI, will allow your doctor to assess any damage or inflammation in the soft tissues, spinal cord, or nerves. Certain imaging studies, such as diffuse tensor imaging (DTI), may be helpful especially when there may be a brain injury due to the whiplash injury. This test will help localize and measure the extent of an injury to the brain or other areas.
If anything in the patient’s reported symptoms or initial physical exam suggests the possibility of an irritated nerve, such as pain, tingling, or weakness radiating into the shoulder, arm, or hand, your doctor may further investigate with these following tests:
- Reflexes – A rubber hammer can be used to test whether nerves in the neck are sending correct signals for the biceps, triceps, and forearm.
- Muscle strength – Simple tests to see if the shoulders, arms, or hands exhibit any significant weakness.
- Sensation – Depending on where abnormal sensations are experienced, such as tingling in the thumb instead of the pinky, can help narrow down which cervical spinal segment is likelier to be the primary source of the problem.
If you have ongoing whiplash pain or need additional assistance with a range of motion exercises, your doctor may recommend that you see a physiotherapist. Physiotherapy can help you feel better and may prevent further injury. Your physiotherapist will guide you through exercises to strengthen your muscles, improve posture, and restore normal movement.
In some cases, transcutaneous electrical nerve stimulation (TENS) may be used. TENS apply a mild electric current to the skin. Limited research suggests this treatment may temporarily ease neck pain and improve muscle strength. The number of physiotherapy sessions needed will vary from patient to patient. Your physiotherapist can also create a personalized exercise routine that you can perform at home.
If you have been in a motor vehicle accident and are suffering from whiplash, here are five light exercises you can do at home to help your recovery:
- Isometrics – This type of exercise helps speed up your recovery without damaging muscles. Firstly, place your palm on your forehead. Then, push your head against your palm without bending your neck at all. Lastly, hold for 3-5 seconds and repeat 10 times per day.
- Neck bend – Position yourself in either a standing or sitting position and do a simple neck bend by slowly moving your chin towards your chest. Hold this position for 3-5 seconds before gradually returning to a normal position. Make sure to stretch out your shoulder blades, then repeat 10 times daily.
- Neck turn – To work on your neck mobility, this exercise involves making lateral turns. To do a neck turn, stand straight and slowly turn your neck to the right. When you feel your neck muscles pulling, return your neck back to its normal position. Finally, do the same to the left, then repeat 10 times a day on both sides.
- Upper back twist – If you find yourself suffering from upper backaches after sustaining whiplash, this exercise will support your upper back and reduce the pain. While sitting upright, turn your torso to the right, stopping when you feel your muscles pull. Repeat on the left side while you perform 12 times a day.
- Neck extension – To do a proper neck extension, you will need to sit up straight and bend your neck backward while looking up at the ceiling. Keep this position until you can feel a stretch and hold for 3-5 seconds. Return your neck to its normal position and repeat 10 times a day.
Alternative & Homeopathic Treatment
For most people, whiplash results in mild ligament sprains and / or muscle strains that heal within a few days or weeks. Therefore, here are some alternative treatments that can help you reduce any further symptoms linked to whiplash:
- Rest – While it is good to stay active if possible, it also makes sense to make things easier the first few days. If a certain motion or activity exacerbates the neck pain, then it is recommended to avoid or limit that movement until the neck has more time to heal.
- Ice and heat application – In the first couple of days following a whiplash injury, applying ice can reduce pain and swelling in the neck. After applying ice, heat application can help restore blood flow from where the neck was injured.
- Over-the-counter medications – Some common OTC pain relievers include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), such as Advil, Aleve, and Motrin. Acetaminophen can block pain receptors, and NSAIDs reduce inflammation.