Whiplash Injury

Also known as acceleration-deceleration cervical injuries, result from sharp hyperextension and flexion of the neck that damages muscles, ligaments, disks, and nerve tissue.

Causes

Any injury that forcibly causes hyperextension and flexion of the neck can result in whiplash. Common causes include motor vehicle crashes, sports accidents, and falls. For example, in a motor vehicle crash, a rear­end collision propels the patient's trunk forward on me pelvis, throwing the head into hyperextension and stretching the anterior structure of the neck; a head on impact initially produces acute flexion and subsequently a reflex hyperextension.

Signs and symptoms

People who experience whiplash may develop one or more of the following symptoms, usually within the first two days after the accident:

• Neck pain and stiffness
• Headaches
• Pain in the shoulder or between the shoulder blades
• Pain or numbness in the arm and/or hand
• Dizziness
• Low back pain

Diagnostic tests

Although whiplash usually only causes damage to the soft tissues of the neck, the physician will take x-rays of the cervical spine for reference in case of delayed symptoms and to rule out other spinal problems or injuries.

Treatment

Until X-rays rule out cervical fracture, treatment focuses on protecting the cervical spine. Initial treatment includes bed rest, the use of a soft cervical collar, and application of ice packs. Oral analgesics provide pain relief, and oral corticosteroids help reduce inflammation and relieve chronic discomfort. To restore flexibility, physical therapy, including mobilization exercises, is started at 72 hours after the injury. It's combined with application of moist heat and a gradually decreased use of the soft cervical collar.

If the patient experiences persistent ligamentous or articular pain, he may benefit from cervical traction and diathermy treatment.

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