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Whiplash (Traumatic Neck Injury)

What is it?

Whiplash “Whiplash Associated Disorder (WAD)” occurs when a certain force is transmitted to the neck or “cervical spine”. Motor vehicle accidents, any sudden forceful movements of the neck, a fall causing impact on the head, or sports involving impact to the head can result in injury. Any acceleration and deceleration forces absorbed can cause damage to structures of the neck.[1]

A small amount of force can sometimes cause more significant injury than large amounts of sudden force. Reasons for this is largely due to the fact that the degree of damage depends on the amount of force involved as well as the direction of the force.[1]

Signs and Symptoms

Signs and Symptoms can occur immediately after impact or may take a day or two to develop.

Here is a scale to help you understand how whiplash signs and symptoms can be classified and how to grade its severity:[1]

Grade Signs and Symptoms
0 No complaints about the neck
1 Stiffness, pain or tenderness only
2 Stiffness, pain, increased soreness, loss in mobility
3 Stiffness, pain soreness, loss in mobility, Neurological Signs of weakness in shoulder, arm or hand(s), pain or loss in sensation in shoulder, arm, hand(s)
4 Stiffness, pain soreness, loss in mobility, Neurological Signs of weakness in shoulder, arm or hand(s), pain or loss in sensation in shoulder, arm, hand(s), AND Fracture or dislocation
Note Symptoms and disorders that can occur in all grades, but are not limited to: deafness, dizziness, ringing in ears, memory loss, difficulty with swallowing, and jaw pain (TMJ)
Treatment and Management For Whiplash

*** If you are experiencing symptoms that are similar to either grade 3 or grade 4 whiplash it is highly recommended that you see a doctor immediately. Radiology must confirm grade 4 classifications WAD.[3]

For grades 1-3 whiplash, immediately following your injury apply ice for 10 to 15 minutes every hour for the first 3 days. Early physiotherapy intervention using manual therapy to guide soft tissue and joint movements, therapeutic ultrasound, electrical stimulation, and specific home exercises are very effective.[2,4,5] Dry Needling intramuscular stimulation (IMS) is also effective in controlling pain and reducing muscle spasms and promoting therapeutic increase in mobility.[6] After the first few days and beyond if your function in activities and perhaps even sport participation increases it is important to continue to achieve functional mobility and strength of injured segments.[2,3,4,5] Progressive techniques using manual therapy, massage and specific home exercises and postural education is very effective to achieve this.[2,4] Dry needling (IMS) can also help to progress with your recovery.[6]

Full functional recovery from Whiplash can take anywhere from 6 weeks up to 12 weeks or longer depending on the severity and nature of the injury. As you begin to recover and resume certain activities, and even participation in sports within the first 2- 3 weeks, your joints, ligaments, and muscles are still healing.[1,4] By regaining joint mobility, strengthening muscles and retraining the coordinated movements of injured areas you will get back “InSync” to your active lifestyle.

For more information about neck injuries please contact InSync Physio.

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References
  1. ^ Spitzer WO, Skovron ML, Salmi LR, Cassidy JD, Duranceau J, Suissa S et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine 1995; 20(8 Suppl): 1S-73S.
  2. ^ Gross AR, Hoving JL, Haines T, Goldsmith C, Kay T, Aker P et al. Manipulation and Mobilisation for Mechanical Neck Disorders. The Cochrane Library 2004; 4.
  3. ^ Magee DJ, Oborn-Barret E, Turner S, et al. A systematic overview of the effectiveness of physical therapy intervention on soft tissue neck injury following trauma. Physiotherapy Canada; (Spring): 111-130.
  4. ^ Rosenfeld M, Seferiadis A, Carlsson J, Gunnarsson R. Active intervention in patients with whiplash-associated disorders improves long-term prognosis: a randomized controlled clinical trial. Spine 2003; 28(22): 2491-2498.
  5. ^ Verhagen AP, Scholten-Peeters GGM, de Bie RA, Bierma-Zeinstra SMA. Conservative treatments for whiplash. The Cochrane Library 2004; 4.
  6. ^ Gunn C. The treatment of Chronic Pain: Intramuscular Stimulation for Myofascial Pain of Radicular Origin. 2nd Ed; 1996: 51-60.

What is whiplash?

Whiplash of the cervical spine or neck is common among patients who have been involved in rear-end motor vehicle collisions, and also can also affect those who participate in contact sports such as rugby and football, or those who have experienced other physical trauma affecting the neck.

Biomechanics
The most common cause of whiplash injury happens in response to a rear-end vechicle collision. As such, most studies that have been conducted have simulated a rear-end vehicle collision. During the collision, the spine of the person(s) being hit behave much like a cracking whip in the way that the spine moves in response to the sudden force. At impact, the torso continues to travel forward towards the steering wheel. The chin tucks downward and the skull travels backwards, causing an almost ripple-like motion through the spine, towards the head. That is a lot of different directions for your body to be trying to go all at one time. This movement causes the normal curvature of the cervical spine or neck, which is usually slightly convex to become more concave in shape. The sudden force pushes the spinal vertebrae into a sudden and unnatural alignment. This in turn causes surrounding muscles to tense up to try to stabilize the neck, which can cause muscle strain. The ligaments and discs in the neck can also be affected from the force.

Symptoms
Symptoms of whiplash may be delayed. Generally, you may experience the following as a result of a whiplash injury:

* Neck pain and stiffness
* Headaches
* Pain in and around the shoulder joint or between the shoulder blades
* Low back pain
* Pain or numbness in the arms/hands
* Dizziness
* Difficulty concentrating or remembering or irritability or sleep disturbances (concussion symptoms)

Whiplash injuries are assessed and graded due to the severity of symptoms. Further information regarding severity and the grading scale can be found here on our website.

Treatment
Since whiplash injuries can involve a variety of tissues and can differ greatly from one person to the next based on the exact mechanisms (e.g. amount of force, direction of force, pre-existing conditions, speed of the vehicle or vehicles in question, etc.), there is no single way to treat a whiplash injury. The best thing you can do is visit your doctor or physiotherapist to assess the injury and work with you to build a treatment plan that is specific to you. We treat many whiplash injuries at Insync Physiotherapy and do accept ICBC claims. We would love to meet you and work with you to get you back to feeling your best.

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.