Whiplash: Diagnosis, Treatments & Complications
Whiplash, commonly called neck strain, occurs due to sudden, forceful impact causing the head to move forward and backwards rapidly. This results in the extension of neck muscles, ligaments and joints beyond the normal range of motion, leading to strain injury to the neck. This condition is commonly caused due to accidents but can also result from other types of traumas. The symptoms may not appear immediately, but they can cause long term pain and discomfort.
Causes of whiplash injury
Whiplash injury occurs due to sudden jerks of the head, causing rapid, sudden, forward and backward movements of the neck like a whip. This sudden motion can injure the neck's nerves, muscles, ligaments, and discs.
A whiplash injury can result from the following:
- Car accidents: Rare-end collision
- Physical abuse: Being punched or being shaken violently
- Contact sports: Such as karate, football, boxing which may cause collisions
- Trauma: Falls which cause violent jerking of the head
- Heavy blows to the head
Symptoms of whiplash
Symptoms of whiplash may appear 24 hours after the incident or within a few days of the injury.
Mild symptoms may include:
- Pain and stiffness of the neck
- Headaches, beginning at the base of the skull
- Fatigue and dizziness
- Worsening pain with the movement of the neck
- Decreased range of motion in the neck.
Other severe symptoms may include:
- Blurred vision
- Pain and tenderness of upper back, shoulders and arms
- Ringing in the ears
- Difficulties related to concentration and memory
- Disturbances with sleep
- Irritability and depression.
Symptoms indicating immediate medical care:
- Symptoms spreading to shoulders and arms
- Pain while moving the head
- Numbness, weakness or tingling sensation in the arms.
Diagnosis of whiplash begins with a thorough history and physical examination, followed by other imaging tests as required.
History: Your doctor may ask several questions about the incident, the severity and frequency of symptoms, location of pain, type of pain and ability to perform daily tasks to get a better understanding of the condition.
Physical examination: The doctor may touch and move your head, neck and arms and may ask you to perform simple tasks to assess:
- Range of motion in the neck, arms, shoulders
- Degree of motion causing pain
- Pain and tenderness in neck, shoulder and back
- Strength, sensation and reflexes of the arms and legs.
Although imaging tests may not directly confirm whiplash diagnosis, your doctor may order imaging tests to eliminate other conditions which may be causing neck pain. These imaging tests include:
- X-rays to identify fractures, arthritis, or dislocation of the neck.
- A Computerized tomography (C.T.) scan provides cross-sectional images to assess bone damage.
- Magnetic resonance imaging (M.R.I.) provides detailed 3-dimensional images to assess damage to the spinal cord, discs, ligaments and soft tissue injuries.
Complications of whiplash injury
Most people with whiplash injuries recover within a few days to weeks. However, some people experience chronic pain and headaches even years after their accident. Some complications associated with whiplash include:
- Persistent, severe neck pain and headaches
- Increasing limitation of movement
- Pain spreading to the arms
- Neurological problems.
Some people are at a higher risk of complications:
- Older adults with previous neck/back injuries
- People with a history of whiplash
- People with existing lower back/neck pain
- People who have had a severe injury, affecting multiple parts of the body
- Individuals with damaged neck joints, ligaments and discs.
Treatment for whiplash
Treatment of whiplash depends on the extent and severity of the injury. The main goals of treatment are pain control, restoration of the normal range of motion and return back to normal activities. The longer the restriction of activity, the higher is the impact of de-conditioning on the patient. Various treatment methods include:
- Heat or cold: Application of heat or cold to the neck in the first 24 hours helps to relieve pain.
- Medications: Over-the-counter pain relief medications (ibuprofen) or prescribed medications (muscle relaxants/antidepressants).
- Physical therapy: Includes stretching and strengthening exercises for neck muscles to help restore normal range of motion.
- Rest and support devices: Resting and support devices such as soft foam cervical collars help stabilize the neck, comfort neck muscles, and support recovery.
- Injections: Steroid or local anesthetic injections into the painful muscle and cervical facet joint blocks help to reduce pain.
Whiplash: Frequently Asked Questions (F.A.Q.s)
Whiplash vs Concussion- is it the same thing?
A concussion is a traumatic brain injury, and the most common symptoms include headache, loss of memory, nausea and vomiting, confusion or temporary loss of consciousness. Concussion may occur along with the whiplash injury. Whiplash is neck strain that occurs due to sudden, forceful jerks causing forward and backward movement of the head.
Can whiplash cause neurological problems?
Sometimes, a whiplash injury can affect the brain and cause neurological problems such as memory loss, difficulty in concentrating, sleep disturbances, sudden mood changes, anxiety and depression.
What does whiplash feel like in the neck?
Whiplash may feel like a dull, aching pain in the front and back region of the neck, accompanied by stiffness and difficulty in turning the head from side to side. The severity depends on the type and impact of the injury.
What happens if you leave whiplash untreated?
Untreated whiplash can lead to long-term complications such as chronic, severe neck pain and stiffness, loss of motion, neurological problems and degenerative disc changes.
Dr Phani Kiran S
M.B.B.S, M.S (ORTHO), D.N.B (ORTHO), F.N.B. (SPINE SURGERY)
Senior Consultant - Spine Surgeon
Institute of Advanced Spine Sciences