Whiplash, or WAD (whiplash-associated disorders) refers to a series of neck injuries caused by or related to a sudden distortion of the neck - hyperextension (over-extension) injury to the neck. In many cases whiplash is the result of being struck from behind, for example, by a fast moving vehicle in an automobile accident.
In a typical case the victim's body is initially pushed or accelerated forward while the head remains behind for an instant, making the head rock up and back, stretching and/or tearing some muscles, tendons and ligaments. The muscles react automatically (reflex motion) to bring the heard forward - sometimes this is overdone and the head may rock forward violently, further stretching and/or tearing muscles, tendons and ligaments.
Tendons are tissues by which muscles attach to bone. Tendons are flexible, fibrous and tough. Like ligaments, tendons are tough flexible cords. Ligaments go from bone-to-bone while tendons go from muscle-to-bone. Although tendons and ligaments are tough, they are known as soft tissue (because they are usually compared to bone or cartilage).
Ligaments and tendons in the neck are sprained during a whiplash injury
Most people associate whiplash with one vehicle being hit in the rear by another vehicle - the driver in front sustains the whiplash. However, the impact can come from any direction and the head may move backwards or sideways, not only forwards initially. Whiplash injury may also be sustained in various ways, such as from falling off a bicycle or a horse.
Put simply, the ligaments and tendons in the neck are sprained during a whiplash injury because, for example, the ligament has been overstretched. Even though the neck has not been broken, it may sometimes take several months for everything to heal.
An individual with a whiplash injury will experience stiffness, pain, headaches, muscle spasms, shoulder pain, and temporary loss of movement in the neck. Whiplash may also be caused by a powerful blow to the head, for example during rugby, American football, karate, or boxing.
Women are more susceptible to whiplash injuries than men; experts believe it is because women's neck muscles are usually not as strong as men's.
Symptoms of whiplash
A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.
A whiplash injury typically takes from 12 to 24 hours after the accident or blow to develop. At the time of the incident any swelling or bruising to the neck muscles will not be apparent straight away. In most cases the discomfort, pain and stiffness is much worse on the following day, and may continue to worsen as each day goes by.
A person with whiplash may experience:
- A loss (or reduction) of movement in the neck
- Neck pain
- Neck stiffness
- The back of the neck feels tender
These whiplash signs and symptoms are also possible:
- Lower back pain
- Pain in the arms and hands
- Numbness or pins and needles in the arms and hands
- Muscle spasms
- Swallowing difficulties
- Vision problems (vision may be blurred)
- A feeling that you are moving or spinning (vertigo)
- Ringing in the ears (tinnitus)
- Sleep disturbances
These less common signs and symptoms are also possible:
- Memory loss
- Poor concentration.
Headaches, dizziness, problems swallowing and vision problems should not last long. If they do, tell your doctor.
Causes of whiplash injuries
A whiplash injury may occur if the head is moved violently away from the body because of a sudden and powerful jerk or jolt. The neck moves beyond its normal range of movement, resulting in overstretched ligaments, muscles and tendons. The injury is often exacerbated because the muscles, in order to compensate for the sudden movement, pull the head back into position too hard, causing another overstretching in the opposite direction.
The jolt (or blow to the head) can come from behind, in front, and from the side. A slow-speed collision may also cause a whiplash injury.
Possible causes of whiplash:
- Automobile accidents
- A sudden blow to the head from a contact sport, such as rugby, boxing, karate, or American football.
- A horse riding or cycling accident
- Any fall which causes the head to violently jolt backwards
- Being hit on the head with a heavy object
- Shaking a child/baby violently (possible child abuse)
- Punching a child/baby (possible child abuse).
Diagnosis of whiplash
The GP (general practitioner, primary care physician) will examine the patient and ask them about any recent accidents, sporting events, falls or blows to the head.
The following imaging scans may be ordered, especially if a spinal injury is suspected:
- X-ray - this test may rule out broken bones or other conditions, such as a spinal fracture, arthritis or dislocations.
- A CT (computerized tomography) scan - many X-ray images are taken from different angles and a more detailed picture of the bone and soft tissues may be seen on a monitor.
- An MRI (magnetic resonance imaging) scan - radio waves and a strong magnetic field gradually produce a detailed picture of the affected area on a monitor. The health care professional will be able to detect soft tissue injuries.
On the next page we look at the treatments for whiplash, the possible complications and how whiplash can be prevented.