Whiplash

Whiplash is an acceleration–deceleration injury to the neck, most commonly caused by a motor vehicle accident (MVA).

The energy from the impact can result in injury to the muscles, bones, nerves, ligaments and other structures of the neck. A whiplash injury can lead to a variety of clinical presentations known as a Whiplash Associated Disorder (WAD).

Whiplash (WAD) disorders are commonly associated with a high level of disability, decreased quality of life and psychological distress.

What happens to the neck during a whiplash injury?

There are 4 phases in a Whiplash injury:

Phase 1: The impact of the seat against the back of the body forces the spine into an S Shaped curve, compressing the discs, producing painful bone bruises and possible fractures of the spine.

Phase 2: The head and neck then moves backward stretching the structures on the front of the spine and compressing structures on the back of the spine. Ligaments on the front of the spine stretch and tear. The back of the disc is compressed and tears. Joints at the back of the spine are also compressed causing their cartilage to crush predisposing the development of arthritis.

Phase 3: The head then accelerates forward stressing the ligaments and muscles at the back of the upper neck. Compression occurs at the front of the neck often affecting the discs.

Phase 4: The neck follows the head forward forcefully compressing the front structures while the back structures stretch. Discs are forced backwards compressing the spinal cord and the spinal nerves. The forward bending forces stretch ligaments at the back of the spine causing instability to the spine and the joints.

Damage to the ligaments surrounding the joints of the neck cause instability of the spine an injury associated with long-term pain and disability.

This is the sequence of head and neck movements that occur with a whiplash injury. The extent of the injury is based on the size and direction of the force and whether the impact is from the front, rear or side. The rear-end collision as described above is considered to produce the most severe pain

Symptoms:

Whiplash is a complex and varied condition involving diverse physical and psychological symptoms. Some of these symptoms show an association with poor functional recovery.

Neck pain is the predominant symptom often producing limiting neck movement and is capable of producing a severe headache. In addition, neck pain can radiate to the shoulder, arm and between the shoulder blades. Dizziness, loss of balance and visual disturbance are other symptoms that can be experienced.

Changes of neck and shoulder blade muscle activity has been shown to occur very soon after a whiplash injury leading to higher levels of pain and disability lasting for up to 2 years after the recovery of symptoms, increasing vulnerability to re-injury.

Symptoms can occur immediately extending to 12-15 hours after the MVA.

The Role of X-Rays and MRI in diagnosing Whiplash Injury.

X-ray and MRI reveal only limited evidence of injury changes to the neck in patients with whiplash, making a diagnosis controversial. The lack of structural damage identified in whiplash patients makes insurance companies question the injured person’s motives.

Evidence for neck structural injuries is seen in Bioengineering studies and in autopsy cases after MVA studies of non-survivors.

Evaluation of the Whiplash Patient:

Pro-Motion Physical Therapy will perform the most advanced evaluation of your whiplash injury using scientifically recommended evaluation tools. The specific structures involved in your pain presentation will be identified; your prognosis and best course of treatment will be discussed with you in detail.