Whiplash Definition

Whiplash (or Whiplash Associated Disorder) occurs when your head and neck is suddenly jolted backwards and forwards (or forwards then backwards) in a whip-like movement, or is suddenly forcibly rotated which may occur in a rear-end or side impact car accident. This may cause, neck muscles, ligaments and joints of the neck to stretch more than normal (sprain) and may result in pain. We frequently use the analogy of the sprained ankle to describe what happens in the neck. The nature of injury and the severity of symptoms vary between different people. A relatively minor accident may cause a big impact to an individual whereas for others there may be no symptoms. The recovery time is also variable from one individual to another.

Common Symptoms

  • The main symptoms are pain and stiffness in the neck. It may take several hours after the accident for symptoms to appear. The pain and stiffness often become worse on the day after the accident. You may also feel pain or stiffness in the shoulders or down the arms. There may be pain and stiffness in the upper and lower part of the back.
  • Headache is a common symptom.
  • Dizziness, giddiness, light-headedness, unsteadiness and a feeling of off balance has been reported in 75% of whiplash patients.
  • Blurred vision, pain in the jaw or pain on swallowing, and unusual sensations of the facial skin may occur for a short while, but soon go.
  • Some people feel tired and irritable for a few days and find it difficult to concentrate.
  • Some people may feel distressed after the motor vehicle collision and these feelings usually settle with time and recovery.

Recovery

Many people recover within a few days or weeks. For 20-25% of patients it may take several months to experience substantial improvement in symptoms. Ongoing symptoms may vary in their intensity during the recovery period.

Investigations

There is no definitive test for whiplash. X-Ray, CT, MRI do not demonstrate hard objective evidence of damage following whiplash injury. Neck (cervical spine) x-rays may be taken to rule out injuries such as bone fractures or dislocations.

Self-Management

The Australian Whiplash Injury Recovery – a Self Help Guide is an excellent resource for patients recovering from whiplash giving plenty of practical advice, exercises to optimise recovery. Stay active and do as many of your normal activities as possible. Some more vigorous activities that place undue stresses on your neck may need to be avoided in the early stages of recovery. Plan gradual increases in activity and exercise levels so that you can successfully return to full participation in your regular activities, hobbies or sports. Continue or resume working perhaps in a reduced capacity at first. It may be necessary to change some work routines for a while. Talk to your employer and colleagues so that you can plan your workload effectively. Don’t be afraid to ask for help from family, friends and colleagues. A good posture will help and minimise stress on your neck, change position regularly during the day.

Physiotherapy

If things are not settling we can advise you how best to manage your symptoms. We assess joint movement, neck muscle strength, neck tenderness and sensitivity. Our treatment approach for whiplash injury is evidence based, meaning it is based upon published research that demonstrates their effectiveness in whiplash injury. Hands on treatment including mobilisation and manipulation combined with exercise including neck strengthening, proprioceptive (balance) and oculomotor (eye movement) exercises have been shown to reduce pain and improve ability to perform everyday activities. Taping may also be part of treatment.

Medication

Painkillers are often helpful and may be recommended by your doctor. Paracetamol at full strength is often sufficient. For an adult this is two 500 mg tablets, four times a day. Anti-inflammatory painkillers may be used alone or at the same time as paracetamol. They include ibuprofen which you can buy at pharmacies or get on prescription. Other types such as diclofenac or naproxen need a prescription. Some people with stomach ulcers, asthma, high blood pressure, kidney failure, or heart failure may not be able to take anti-inflammatory painkillers. A stronger painkiller such as codeine is an option if anti-inflammatories do not suit or do not work well. Codeine is often taken in addition to paracetamol. A muscle relaxant such as diazepam is occasionally prescribed for a few days if your neck muscles become very tense and make the pain worse.

If you have any additional questions about Whiplash or to make an appointment, please call 797-9545.

Elaine Maughan MISCP, MSc

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