Whiplash – Cervical Spine Injury

Whiplash or cervical spine injury is the pain in the neck due to an injury to the muscles, tendons, and ligaments when an abnormal force to the neck causes movement beyond the neck’s normal range. Typical cervical spine injury is caused by flexion-extension motion that strains and pulls the ligaments and muscles of the neck. This can happen in falls, motor vehicle accidents, sports activities or in incidents involving personal assault.

“Whiplash” or cervical spine injury really isn’t a medical term. Doctors and nurses use terms such as “cervical hyperextension injury” to describe the injury. It can also be described by words like a cervical strain or cervical sprain. While cervical spine injury is not usually life-threatening, it can lead to prolonged periods of pain and limited activity.

Most individuals who are injured in minor accidents involving motor vehicles quickly recover and don’t have recurring symptoms, but others develop chronic symptoms. This variation in recovery has led some people to believe that whiplash, in many cases, is a symptom victim create as a way to prosper economically from their accident, rather than a real physiologic condition. Much research has studied this theory. It is unfortunate that some people will try to use the system for their own personal gain, but cervical spine injury is a real medical condition and its symptoms are real.

The expression “whiplash” was first utilized as a part of 1928. The expression “railway spine” was utilized to depict a comparative condition that was regular in people engaged with prepare mischances preceding 1928. The expression “whiplash damage” portrays harm to both the bone structures and delicate tissues, while “whiplash related scatters” depicts a more extreme and unending condition.

Luckily, whiplash is commonly not a dangerous damage, but rather it can prompt a drawn-out time of incomplete handicap.

Prevalence

It is estimated that over one million whiplash injuries occur annually in motor vehicle accidents. This number represents an estimate because not all cases are reported. People most likely to suffer cervical spine injury are in their late-forties. Unless cervical strain has also occurred, causing additional spinal cord injury or brain trauma, death is rare.

It is not the speed, but the sudden force, as one object hits another, that causes cervical spine injury. It can occur at speeds less than 15 miles per hour when the head is thrown abruptly back and sideways. The more sudden the force, the more damage occurs to the tendons, muscles, bones, and discs in the upper back and neck. Approximately 6,000 deaths each year in the United States are related to spinal cord injuries and 5,000 cases of quadriplegia per year are caused by whiplash.

One year following whiplash, 4 out of 5 patients no longer have symptoms, but less than 12% of injured people are able to go back to work within a year following their cervical spine injury.

Reasons for Cervical Spine Injury

Motor vehicle accidents are the most frequent cause of whiplash. The speed of the car does not determine the extent of injury to the neck. Even when a person is wearing a seat belt, enough energy can be produced by a vehicle moving at as little as 15 mph to cause whiplash.

Whiplash can also be caused by:

• Injuries sustained during contact sports
• Blows to the head (falling objects or personal assault)
• Neck strains due to sudden direction change can cause whiplash (roller coasters, slips and falls, bicycle accidents)
• Repetitive stress or chronic strain (cradling a telephone in the neck)
• Child abuse (especially shaking a child which often results in injuries more severe than whiplash)

Risk Factors

Risk factors for whiplash include:

• Young adults are more likely to sustain whiplash due to trauma and sports injuries
• Wearing a seat belt with a should restraint increases your risk, but seat belts prevent injuries more serious than whiplash
• Poor posture increases your risk of whiplash
• Wearing a head restraint that does not fit properly increases your risk
• Women are at greater risk for whiplash
• Having a disorder which narrows the spinal canal in the cervical area

Complications

A few people with whiplash do encounter constant pain or migraines for a considerable length of time following their mishaps. Specialists might have the capacity to follow this pain to injured neck joints, plates, and tendons. However, interminable pain following whiplash damage commonly has no therapeutic explanation.

However, not very many individuals have any long-term complications from whiplash. More often than not, recuperation time is anything from a couple of days to a couple of weeks.

Cervical Spine Injury: Symptoms

People who have whiplash usually have cervical spine injury symptoms experience muscle stiffness and pain in their neck. Depending on how severe the injury is, other cervical spine injury symptoms may include:

• Tenderness in the shoulders and the back of the neck
• Swelling in the neck is often present with whiplash
• Muscle spasms in the shoulder, and in the back and front of the neck
• Pain when the head is rotated, or when the neck is flexed or extended
• Tightness in the jaw, trouble chewing is sometimes present with cervical spine injury symptoms
• Headaches, trouble concentrating or thinking, fatigue, insomnia
• In severe cases, whiplash can also cause ringing in the ears, disturbances in vision and other cervical spine injury symptoms of nerve irritation

Normal cervical spine injury symptoms identified with whiplash may include:

• neck pain and firmness
• headaches
• shoulder pain and firmness
• dizziness
• exhaustion
• jaw pain (temporomandibular joint indications)
• arm pain or weakness
• blurred vision
• ringing in the ears (tinnitus)
• back pain

Patients with extreme whiplash injuries may go into depression and social seclusion because of their cervical spine injury symptoms.

Diagnostics Procedures

Following an accident involving the head or neck, a person is often taken for a medical examination. The doctor performs an examination to see if there are any cervical spine injury symptoms other than a whiplash, that needs immediate treatment. Based on the examination and symptoms, a collar may be placed around the neck for support. X-rays of the neck may be taken to evaluate for injuries that are more severe than whiplash. It is important to make certain there are no life-threatening injuries to the head, neck or spine.

If the X-ray findings are normal but the whiplash pain continues, the cervical collar might be kept in place and the patient seen again by the doctor in a few days. X-rays may be repeated to check for any changes. If the doctor thinks there may be injuries in the soft tissues, dynamic X-rays may be obtained, with the head tilted backward and forward. A magnetic resonance imaging (MRI) study may also be recommended to rule out any injuries other than whiplash, that could not be detected on standard X-ray films.

Your specialist will usually get some information about the damage, for example, how it happened, where you feel pain, and whether the pain is dull, shooting, or sharp. They may likewise do a physical exam to check your scope of movement and search for territories of delicacy and your cervical spine injury symptoms.

Your specialist may arrange an X-ray to guarantee your pain isn’t associated with whatever other kinds of damage or degenerative illness, for example, joint pain.

Different tests, for example, CT sweeps and MRI will enable your specialist to evaluate any harm or aggravation in the delicate tissues, spinal string, or nerves. Certain imaging contemplates, for example, diffusion tensor imaging (DTI) or positron emission tomography (PET scan), might be useful, particularly when there might be brain damage. These tests will help limit and measure the degree of damage to the brain or different zones.

Examination

Amid the exam, your specialist should feel and move your head, neck, and arms. He or she will likewise request that you move and perform basic tasks. This examination enables your specialist to decide:

• The scope of movement in your neck and shoulders
• The level of movement that causes pain or an expansion in torment
• Fragility in the neck, shoulders or back
• Reflexes, quality, and sensation in your appendages

Imaging tests

Your specialist will likely arrange at least one imaging tests to decide out different conditions that could be causing or adding to neck pain. These incorporate the accompanying tests:

• X-rays of the neck taken from different points can recognize cracks, disengagements or joint pain.
• Computer Tomography (CT) scan is a specific X-ray innovation that can deliver numerous cross-sectional pictures of bone and uncover points of interest of conceivable bone damage.
• Magnetic Resonance Imaging (MRI) is an innovation that utilizations radio waves and an attractive field to create a point by point 3-D pictures. Notwithstanding bone wounds, MRI sweeps can identify some delicate tissue wounds, for example, harm to the spinal cord, plates or tendons.

Cervical Spine Injury: Treatment

Care at Home

If you have been involved in an accident or have suffered an injury to your head or neck, contact your physician to make sure something more serious than whiplash has not occurred. If there is no evidence of nerve involvement, care at home may be appropriate. The goal of cervical spine injury treatment is to decrease the painful symptoms caused by the strain. Symptoms can be relieved by:

• Cold applications: For the first 48 to 72 hours, use ice or cold pack on your neck to relieve the pain and reduce swelling. Apply for about 20 minutes every 1-2 hours.
• Rest: Limit movement of your neck and head until the muscle tension and pain of whiplash are gone, then start gentle stretches. Avoid any heavy lifting or strenuous activities
• Medications: Take over-the-counter anti-inflammatory analgesics such as ibuprofen or naproxen if tolerated (ask your doctor) or acetaminophen

Medical treatment

Depending on the severity of the injury, medical cervical spine injury treatment varies. If the neck has been severely injured and the spinal cord or vertebrae are involved, surgery may be needed. If the injuries are limited to soft tissues such as tendons, ligaments, and muscles, cervical spine injury treatment is often directed at relieving the symptoms. In this case, cervical spine injury treatment may include:

• Medications for pain: prescription or over-the-counter
• For severe pain, narcotic pain relievers may be needed
• Non-steroidal anti-inflammatory drugs (NSAIDs) will help reduce inflammation and reduce pain
• Muscle relaxants are sometimes prescribed to help relax muscles and relieve the muscle spasms caused by whiplash
• Cervical collars are sometimes worn for a brief time, but these can lead to muscle weakness so their use is limited to a short time
• Ice or cold packs can relieve the pain of whiplash. Apply cold pack/ice to the neck for 20 minutes every 1-2 hours for the first 48-72 hours
• Limit movement of the neck until muscle stiffness and pain subside
• Avoid any lifting or strenuous activity
• Physical therapy may be recommended for cervical spine injury treatment with interventions like ultrasound, electrical stimulation, a range of motion or muscle strengthening exercises

Physical Therapy

The tissue damage and clinical signs and side effects of cervical spine injuries are dealt with during the intense period of therapy and treatment. The objectives of this stage are:

• Lessen overall pain and controlling irritation
• Enhance neuromuscular cervical spine postural control
• Keep the advancement of any solid decay of the cervical spine muscle and postural muscles at bay
• Ensure that essential tissues are mending

Restorative exercises during the intense period of recovery usually include the following:

• Rest
• Non-steroidal calming drugs (NSAIDs)
• Non-intrusive treatment methods
• Surgical treatment methods

In the event that no neurologic history or deficiency is present in a patient with a cervical spine injury, the patient should use ice packs for 15-20 minutes every 1-2 hours or have an ice rub for 5-10 minutes every 1-2 hours during the early treatment of the injury. This treatment helps with muscle spasms, as well as relieving pain and advancing vasoconstriction.

Alternative medicine

Whiplash is sometimes treated with nontraditional cervical spine injury treatment such as:

• Acupuncture: This therapy may be able to relieve the pain of whiplash by inserting a very fine needle at specific locations on your body. Research has been unable to prove that acupuncture as a cervical spine injury treatment definitely relieves chronic pain caused by neck strains.
• Chiropractic: In some cases, chiropractic can work as well as physical therapy for cervical spine injury treatment. Using manipulation of the spine along with exercise is more beneficial.
• Massage: If the pain of whiplash persists for more than a few weeks it may help to knead the muscles in your neck. This is usually performed more easily if the muscles are first relaxed with the heat of a hot bath or shower, or with warm moist towels.
• Transcutaneous electrical nerve stimulation (TENS): This is a device that sends a mild electrical current through the skin to treat the pain of whiplash. It may relieve some kinds of pain by triggering the body to release its natural painkillers, called endorphins, or it may interfere with how the body sends pain signals. TENS works for chronic whiplash pain only when used in combination with exercise.

Prevention

The best way to deal with whiplash is to avoid it:

• When driving or riding in a car, always use your seat belt and make sure your vehicle is equipped with an airbag
• When driving or riding in a car, adjust your headrest to make sure it is positioned to prevent your head from snapping backward and causing whiplash in case of an accident
• Use properly-fitting safety equipment when participating in sporting activities
• When on amusement park rides, follow all safety instructions to avoid whiplash
• Monitor the activities of children to prevent falls and serious injuries