Cervical Whiplash

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What is it?

A whiplash injury occurs whenever there is a rapid acceleration or deceleration which affects the cervical spine. The head is violently rocked forward, stretching and tearing muscles and ligaments. The soft pulpy discs between the vertebrae can bulge, tear, or rupture. Vertebrae can be forced out of their normal position, reducing range of motion. The spinal cord and nerve roots get stretched, irritated, and compressed.

How does it occur?

This is most common in motor vehicle accidents when the head is suddenly jerked back and forth beyond its normal limits, the muscles and ligaments supporting the spine can be over-stretched or torn. As the vehicle accelerates forward, it pushes the body forward too, but the head remains behind momentarily, rocking up and back, until some of the muscles and ligaments are stretched or torn.

It can also occur in sports when the cervical spine is suddenly extended in contact with the ground or by a direct blow from an opponent.

Symptoms

Pain may not be felt at the time of injury. Depending on the severity of the injury there will be a gradual increase in the intensity of pain over the next 48 hours following the injury.

Symptoms include:

  • Neck pain and/or stiffness
  • Blurred vision
  • Difficulty swallowing
  • Irritability, Fatigue, Dizziness
  • Pain between the shoulder blades
  • Pain in the arms or legs, feet and hands
  • Headache
  • Low back pain and/or stiffness
  • Shoulder pain
  • Nausea
  • Ringing in the ears
  • Vertigo
  • Numbness and tingling
  • Pain in the jaw or face

Complications

The pain generally arises from damage to the cervical discs. It also affects muscles, ligaments, capsular tissue and the dura. This can be a difficult condition to treat as the damaged discs may undergo progressive degeneration. Over time this can lead to altered biomechanics of the joints and thus further joint damage.

The severity of the whiplash trauma often does not correlate with the seriousness of the clinical problems, which can include neck and shoulder pain, temporomandibular joint (TMJ) pain, headache, dizziness, and blurring of vision.

Management and how Physiotherapy can help: 
Initial treatment: 

Sometimes a cervical collar in the first few days after injury can help to control the inflammation, but should be weaned off after 4-6 days to get some gentle movement occurring.

Local pain relieving modalities or an anti-inflammatory may also help in the initial period.

Secondary treatment

Manual therapy, especially mobilisation, and manipulation will gently assist range of motion. The best results often occur when there is a combination of active range of motion exercises such as gentle mobilisation, massage therapy and gentle stretching. What is it?

As the condition improves

Massage and mobilisation will become deeper and more specific to regions of dysfunction.

Once the pain has started to settle and movement has returned to normal some strengthening exercises should be performed to improve neck stability. This treatment can take up to 6-12 weeks and occasionally pain and dysfunction may persist in the years to come depending on the extent of the injury.

Remember

  • Seek treatment at an early stage
  • Ensure you physiotherapist provides you with methods of self treatment.
  • See your doctor if the whiplash in not improving