>> Types of Traffic Accident Injuries >> Whiplash
Imagine yourself driving when a car behind you
rear-ends your vehicle. The impact pushes your car forward.
It takes about 100 milliseconds for your body to catch up
to the forward movement. Your shoulders travel forward until
they are under your head, and your neck extends forward as
your head tilts slightly down toward your steering wheel.
You step on the brakes, bringing the car to an abrupt halt.
The sudden stop throws your head and neck backward, and they
bounce against the headrest. In a matter of seconds, you've
experienced the classic mechanism of injury for whiplash.
About 20 percent of people involved in rear-end
collisions later experience symptoms that center in the neck
region. Although most of these people recover quickly, a small
number develop chronic conditions that result in severe pain
and sometimes disability.
Whiplash is an injury to the soft tissues of
the neck. Whiplash injury strains the muscles and ligaments
of the neck beyond their normal range of motion. There is
often pain and stiffness in the neck for the first few days
following a whiplash injury. The pain can also be felt in
the surrounding muscle groups in the head, chest, shoulders,
Definition of Whiplash: Whiplash
is when the soft tissues of the neck are injured by a sudden
jerking or "whipping" of the head. This type of
motion strains the muscles and ligaments of the neck beyond
their normal range of motion.
Considerations of Whiplash:
When a vehicle stops suddenly in a crash or is struck from
behind, a seat belt will keep a person's body from being thrown
forward. But the head may snap forward, then backward, causing
Causes of Whiplash: In addition
to car accidents, whiplash can be caused
by roller coasters and other amusement park rides, sports
injuries, or being punched or shaken. (Whiplash is one of
the hallmarks of shaken baby syndrome.)
Symptoms of Whiplash: You may
feel pain and stiffness in your neck for the first few days
following a whiplash injury. Then you feel better, but the
pain and stiffness may come back several days later.
The discomfort you feel may involve surrounding
muscle groups in your head, chest, shoulders, and arms.
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
- Pain in the shoulder or between the shoulder
- Low back pain
- Pain or numbness in the arm and/or hand
- Ringing in the ears or blurred vision
- Difficulty concentrating or remembering
- Irritability, sleep disturbances, fatigue
Diagnosis and Treatment of Whiplash:
How whiplash injuries occur is clearly understood,
but the extent and type of injuries varies greatly. The diagnosis
of whiplash is often one of exclusion. Most injuries are to
soft tissues such as the disks, muscles and ligaments, and
cannot be seen on standard X-rays. Your doctor may need to
request specialized tests, such as computed tomography scans
or magnetic resonance imaging (MRI).
In the past, whiplash injuries were often treated
with immobilization in a cervical collar. However, the current
trend is to encourage early movement, rather than immobilization.
The soft collar may be used for a short term and on an intermittent
Ice may be applied for the first 24 hours, followed
by gentle active movement. Your doctor may provide you with
a series of exercises that you can do at home. An early return
to work is encouraged, even if your doctor must prescribe
some temporary modifications in your work situation. No single
treatment has been scientifically proven as effective, but
pain relieving medications, exercises, physical therapy, traction,
massage, heat, ice, injections and ultrasound have all been
beneficial for some patients.
As soon as possible, you should begin aerobic
activities, such as walking. Your doctor may prescribe some
isometric exercises as your condition improves. Symptoms resolve
within several months for about 75 percent of people who have
whiplash. Chronic conditions should be investigated further
and might require surgery.
First Aid of Whiplash: Try
over-the-counter pain relievers like aspirin, acetaminophen,
For at least 2 to 3 weeks, avoid activities that bring on
or worsen your pain and stiffness. Don't lift or carry anything
heavy or participate in sports.
If you have pain when you move your head or
the pain involves your shoulders or arms, your doctor may
recommend a soft neck collar or short-term prescription drug
to relax the muscles.
Call your doctor if:
- Neck pain and stiffness comes back after
it had resolved.
- The pain spreads to your shoulders or arms.
- You have pain when you move your head.
- You have numbness, tingling, or weakness
in your arms.
Prevention of Whiplash: Headrests
in your car can reduce the severity of neck pain from a car
accident. Make sure that the headrest is positioned properly
for your height.
If you do get whiplash, learn proper stretching
exercises once your neck has healed. This reduces the chance
that neck pain or stiffness will come back.
- In a series of recent human volunteer crash
tests of low speed rear impact collisions, it was reported
that the threshold for cervical spine soft tissue injury
was 5 mph (delta V).
- Other reports have shown that crashed cars
can often withstand collision speeds of 10 mph or more without
sustaining damage. Thus: the concept of "no crush,
no cash" is simply not valid.
- Recent epidemiological studies have shown
that most injury rear impact accidents occur at crash speeds
of 6 mph to 12 mph --the majority at speeds below the threshold
for property damage to the vehicle.
- A number of risk factors in rear impact accident
injury have now been verified including: rear (vs. other
vector) impact, loss of cervical lordotic curve, preexisting
degenerative changes, the use of seat belts and shoulder
harness, poor head restraint geometry, non-awareness of
the impending collision, female gender, and head rotation
- The notion of litigation neurosis has been
rather definitively dispelled.
- Once thought to suggest minimal injury, a
delay in onset of symptoms has been shown to be the norm,
rather than the exception.
- Mild traumatic brain injury can result from
whiplash trauma. Often the symptoms are referred as the
postconcussion syndrome. This condition, often maligned
in the past, has now been well-validated in recent medical
- A recent outcome study of whiplash patients
reported in the European Spine Journal found that between
one and two years post injury, 22% of patients' conditions
deteriorated. This second wave of symptoms has been observed
by others as well.
- Radanov et al. followed whiplash patients
through time and reported that 45% remained symptomatic
at 12 weeks, and 25% were symptomatic at 6 months. Other
researchers have reported time to recovery in the most minor
of cases at 8 weeks; time to stabilization in the more severe
cases at 17 weeks; and time to plateau in the most severe
categories as 20.5 weeks. Thus, the notion that whiplash
injuries heal in 6-12 weeks is challenged. (Incidentally,
there never has been any real support for this common myth.)
- Each year, 1.99 million Americans is injured
in whiplash accidents.
- Of the 31 important whiplash outcome studies
published since 1956 (19 published since 1990 pooling patients
from all vectors of collision (i. e., rear, frontal, and
side impacts), a mean of 40% still symptomatic is found.
For rear impact only, a mean of 59% remain symptomatic at
- Although estimates vary, about 10% of all
whiplash victims becomes disabled.
- The Quebec Task Force on Whiplash-Associated
Disorders has been criticized on the basis of potential
bias, study design, the use of ambiguous and misleading
terminology, and for developing conclusions that are not
supported by the literature.
- The chiropractic profession has developed
its own guidelines for management of whiplash patients.
If believe you have whiplash as a result
of a traffic accident, it is important to visit a qualified
doctor to evaluate your injuries. Trying to "heal yourself"
could cause your body more harm.
a Chiropractic Specialist in your area