Definition

Whiplash is a sudden, moderate-to-severe strain
affecting the bones, discs, muscles, nerves, or tendons of
the neck.

Description

The neck is composed of seven small bones. Known
as the cervical spine, these bones:
• support the head
• help maintain an unobstructed enclosure for the spinal
cord
• influence the shape and structure of the spine
• affect posture and balance

About 1,000,000 whiplash injuries occur in the United
States every year. Most are the result of motor vehicle
accidents or collisions involving contact sports. When
unexpected force jerks the head back, then forward the
bones of the neck snap out of position and irritated nerves
can interfere with flow of blood and transmission of nerve
impulses. Pinched nerves can damage or destroy the function
of body parts whose actions they govern.

Risk factors

Osteoarthritis of the spine increases the risk of
whiplash injury. So do poor driving habits, driving in bad
weather, or driving when tired, tense, or under the influence
of alcohol or other drugs.

Causes and symptoms

Tension shortens and tightens muscles. Fatigue
relaxes them. Either condition increases the likelihood
that whiplash will occur and the probability that the
injury will be severe.

Sometimes symptoms of whiplash appear right away.
Sometimes they do not develop until hours, days, or weeks
after the injury occurs. Symptoms of whiplash include:
• pain or stiffness in the neck, jaw, shoulders, or arms
• dizziness
• headache
• loss of feeling in an arm or hand
• nausea and vomiting
Depression and vision problems are rare symptoms
of this condition.

Diagnosis

Whiplash is difficult to diagnose because x rays and
other imaging studies do not always reveal changes in
bone structure. Organs affected by nerve damage or
reduced blood supply may generate symptoms not clearly
related to whiplash.

Diagnosis is based on observation of the patient’s
symptoms, medical history, physical examination, and
neurological studies to determine whether the spine has
been injured.

Treatment

Medication, physical therapy, and supportive measures
are used to treat whiplash. Chiropractors gently
realign the spine to relax pinched nerves or improve
blood flow. A patient whose symptoms are severe may
wear a soft, padded collar (Thomas collar or cervical collar)
until the pain diminishes.

When pressure on the root of the nerve causes loss
of strength or sensation in a hand or arm, a cervical traction
apparatus may be recommended.

Self-care

Inflammation and cramping can be alleviated by
wrapping ice or an ice pack in a thin towel and applying it
to the injured area for 10-20 minutes every hour. After the
first 24 hours, painful muscle spasms can be prevented by
alternating cold packs with heat treatments. Letting a
warm shower run on the neck and shoulders for 10-20
minutes twice a day is recommended. Between showers,
warm towels or a heat lamp should be used to warm and
soothe the neck for 10-15 minutes several times a day.

Improving posture is important, and gentle massage
can be beneficial. Sleeping without a pillow promotes healing,
and a cervical collar or small rolled towel pinned under
the chin can provide support and prevent muscle fatigue.
Alcohol should be avoided. A chiropractor, primary
care physician, or orthopedic specialist should be notified
whenever a painful neck injury occurs. Another situation
requiring attention is if the face or arm weaken or
become painful or numb following a neck injury.

Prognosis

With treatment, whiplash can usually be cured in
one week to three months after injury occurs. If nerve
roots are damaged, numbness and weakness may last
until recovery is complete.

Prevention

Chiropractors can recommend diet and exercise
techniques to reduce stress and tension. Careful, defensive
driving, wearing seatbelts, and using padded automobile
headrests can lessen the likelihood of whiplash.