Everything you need to know about whiplash injuries

Everything you need to know about whiplash injuries

Whiplash injuries are those conditions that we associate with the modern lifestyle. It most often occurs during car accidents, falls, but also when skiing or practicing martial arts.

The neck is a complicated structure, composed of 7 vertebrae, cartilage discs, spinal cord, nerves, as well as tissue complexes that provide the entire system with strength, primarily ligaments, and muscles. The problem with the cervical spine is, first and foremost, that it must be firm enough to protect the extremely sensitive structures of the spinal cord, and, on the other hand, sufficiently elastic to allow the great mobility required in everyday life. It is this trade-off that makes the neck structures particularly sensitive to external stimuli, especially shocks or sudden changes in speed, especially in cars.

A typical whiplash injury occurs in cases of a car frontal collision, either with another car or with a fixed obstacle. At that moment, due to the forces at play, the head first strongly goes forward, to “fly” from the position of maximum inclination to the backward position in a split second, and then to the forward at a reduced speed. This whole mix of sudden, intense and uncontrolled movements can cause a series of soft tissue damage to the neck, which can range from mild to extremely severe and life-threatening. The muscles may be stretched to a greater or lesser extent, and partial tearing may occur. The ligaments that surround and secure the vertebrae themselves are most commonly injured, whether in the form of mild stretching or partial or even complete rupture. Cartilage discs are particularly vulnerable, so it is not uncommon for disc herniation as a consequence to occur.

With all the injuries described, the symptoms can be as follows:

  • neck pain,
  • numbness,
  • headaches, either restricted to the parietal region or spreading forward,
  • shoulder pain,
  • arm pain,
  • tingling of the neck, part of the head and/or one or both hands,
  • pain in the interplanetary region,
  • ringing or tinnitus, etc.
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It is important to know that these symptoms do not have to occur immediately after the injury. It is a very common case that the pain, along with a variety of other symptoms, only occurs after 24 to 72 hours of injury.

When suspecting a whiplash injury, it is very important to make detailed diagnostics. An RTG recording is the first step in this direction and will show if there is any damage to the vertebrae of the neck. Later, as long as the symptoms are pronounced, it is possible to do a CT scan or better still MR to see in detail soft tissue damage. The direction of further treatment will greatly depend on the results of these findings, as the length of immobilization, the possible need for surgery, and the assessment of the speed of recovery depend on the extent of the injury itself.

It is also important to treat the patient and make the necessary diagnostics as soon as possible after the accident. But many of these injuries go unnoticed after skiing crashes, or multiple stresses when training or competing in martial arts. In skiing, this occurs because of a larger and more acute injury to the other part of the body, and in martial arts, due to the smaller volume, but multiple repetitive stresses on the neck itself and the soft tissues.

Thus being unrecognized and then inadequately treated, whiplash injuries often end up in a state of chronic pain and symptoms that can disrupt normal everyday life, including recreational or professional sports.

Treatment depends largely on the findings of the diagnostic tests. In severe cases of injury, surgical treatment is necessary. Rehabilitation after such an operation can be long and very tiring. Fortunately, such developments are very rare.

Incomparably more frequent soft tissue damage requires only conservative treatment. However, as in other cases, there are two approaches to such therapy. Specifically, over the past decades, a practice has been established that seeks to keep the neck immobilized for a minimum of three weeks after injury. This means that the patient must wear a collar all the time. The explanation behind such a procedure is that it allows the damaged soft tissues to heal better.

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On the other hand, we have seen in recent years that immobilization itself causes new and unpleasant symptoms with prolonged use. Today, some eminent American neurologists recommend immobilization for only 72 hours continuously, and only occasionally thereafter, preferably at night. Throughout this time, a number of physiotherapy methods have to be implemented, which are focused on reducing muscle spasm, pain, and improving neck mobility. In this sense, we have at our disposal an entire arsenal, from massage and acupressure, through electrotherapy, laser, ultrasound to warm wraps and hydrotherapy.

In cases with high pain intensity, it is also good to use medicines to combat them. After a week or two of injury, it is good to use manipulative therapy. Strength and flexibility exercises are good in the first phase of treatment.

The length of treatment depends again on the level of soft tissue damage, and often on the previous muscle status. Generally, better results are achieved in highly motivated people who are ready to exercise regularly to further stabilize the entire segment.

75% of all patients who have experienced this kind of injury fully recover within less than three months. Of the remaining 25%, only 5% have symptoms so pronounced that they require additional diagnostics and a new interdisciplinary approach to finding other therapeutic options.

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