Whiplash and Car Accidents

Husband helping wife in neck brace
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Whiplash is a term that many people use to describe the pain and other symptoms they feel in their neck, upper back and head following a rear-end car accident. But in truth, it's not a medical term.  When your doctor, physical therapist or chiropractor bills insurance for your "whiplash", generally, it's coded as either a cervical strain or a cervical sprain. These are injuries to soft tissue, i.e., to muscles, ligaments, tendons and/or fascia in your neck area.

Defining Whiplash

If whiplash is not a neck condition, what is it, then?

Whiplash refers to the event that occurs when your upper vertebral column, upper back, neck, and head are thrown suddenly backward then forward upon impact.  

Sounds like a rear-end car accident, doesn't it? 

Technically speaking, with a whiplash, your head and neck are forced first into extension (backward) and then quickly into flexion (forward.) This abrupt experience forces the joints beyond their normal range of movement, which in turn, may result in strain or sprain of the surrounding soft tissue.

In addition to rear-end car accidents, the whiplash event may occur from other types of car accidents, from sports injuries, or by means of shaken baby syndrome (which is child abuse and should be reported to authorities.)

Whiplash Symptoms

Whiplash may lead to pain in various places, especially your neck, back or shoulders.

It may also lead to neurological problems such as dizziness, or pain going down your arm. Here's a complete list; if you have any of these, it's best to speak with your doctor:

  • Neck pain
  • Neck stiffness
  • Headaches
  • Nerve symptoms such as pins and needles
  • Pain in the shoulders
  • Pain between the shoulder blades
  • Pain in one or both arms
  • Fatigue
  • Dizziness
  • Vision problems
  • Ringing in the ears (tinnitus)
  • Poor concentration or memory
  • Neck pain/stiffness
  • Tight and/or sore muscles
  • Tenderness in the muscles
  • Low back pain
  • Sleep disturbance
  • Loss of motion in the neck
  • Depression
  • Other

Symptoms or Not – See a Doctor

It can take up to a few days for pain and other symptoms due to whiplash to make themselves known, so you may not feel anything immediately after the accident or trauma.

And while shrugging it off be easy, especially when you feel fine, keep in mind that a lack of symptoms does not necessarily mean all is well. You should see your doctor anyway; she can help to determine the location and extent of any spinal damage, as well as help you develop an appropriate treatment plan.

It's best to make the appointment as soon after your whiplash event as you can.

Getting Better After a Whiplash Experience

Your doctor may start the treatment process by suggesting an over-the-counter pain reliever, for example, Tylenol or Advil. (Advil is both a pain reliever and an anti-inflammatory but comes with an elevated risk for a heart attack or other cardiovascular event.)

Your doctor may also prescribe a course of physical therapy and/or chiropractic.

The length of treatment typically depends on a number of things from how injured you are, to your preferences and your insurance or ability to self-pay.

Part of treatment success depends on you and may require an attitude shift in order for you to attain. A 2011 study published in Spine confirmed that only about 50% of whiplash patients get fully better. Another study, this one from 2015 and published in PLoS One, says that up to 22% of people who sustain whiplash trauma develop persistent symptoms after, which decreases their quality of life and reduces their ability to work.

What's the secret to maintaining the strides you make in physical therapy for the long term?

A 2017 study published in the journal Pain confirmed that, indeed, there is a relationship between lasting treatment success and going back to work after a whiplash.  

In other words, the study found that being on disability may work against you in the long run.

The PLoS One study mentioned above found that people who took a lot of sick leave prior to their run in with whiplash tended to have more neck pain afterward than those who took the normal amount. The authors speculate that such people may already have had a pain condition, or otherwise have been in poor general health.  The point is that sometimes, people who miss work may tend to rely more on the "system" than on themselves when engaging with whiplash treatment and that this may possibly be a factor in their future functionality, pain levels and the like.

Prevent Whiplash from Happening to You

Then there's prevention — nipping the problem in the bud.

Pre-emptively minimize the damage a whiplash may have on your soft tissues, may come down to which car you buy. A 2009 study published in Clinical Biomechanics suggests that head rests that are positioned too far away may result in more injuries to your lower cervical spine. 

Of course, driving safely and wearing a seat belt are important precautions, as well.

Sources:

Carstensen, T., et. al. Sick Leave Within 5 years of Whiplash Trauma Predicts Recovery: A Prospective Cohort and Register-Based Study. June 2015. 

Ivancic, P., et. al. Whiplash Injury Prevention With Active Head Restraint. Clin Biomech Nov. 2009. 

Stemper, B., PhD., Effect of Head Restraint Backset on Head-neck Kinematics in Whiplash. Accident Analysis and Prevention. 2006. 

Sullivan, M., et. al., Return to Work Helps Maintain Treatment Gains in the Rehabilitation of Whiplash Injury. Pain. May 2017. 

Whiplash Information Page. National Institute of Neurological Disorders and Stroke. September 19, 2012  

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