• Whiplash

    (Cervical Sprain and Neck Muscle Strain)

    Definition

    Whiplash is a neck injury that includes:
    • Spraining the neck ligaments
    • Straining the neck muscles
    • Possible bone and nerve injury
    Process Leading to Whiplash
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    Causes

    Whiplash can occur with any sudden, violent, backward jerk of the head or neck.

    Risk Factors

    Incidents that increase your chance of whiplash include:
    • Motor vehicle accidents
    • Sporting events that include full contact
    • Falls
    • Assaults

    Symptoms

    Symptoms often develop in the hours after the injury. They tend to reach their peak within 24 hours of the injury.
    Symptoms may include:
    • Stiff neck
    • Neck pain
    • Numbness or tingling
    • Shoulder pain and stiffness
    • Decreased range of neck motion
    • Muscle spasms
    • Headache
    • Pain, numbness, or tingling extending down an arm

    Diagnosis

    The doctor will ask about your symptoms. You will be asked how the injury occurred. A physical exam will be done.
    Most whiplash injuries do not show up on imaging tests. Your doctor may order some tests to make sure that no other injuries have occurred.
    Tests that can create detailed picture of the neck and spine include:
    EMG testing may also be done. This will help to assess any nerve damage.

    Treatment

    Treatment may include:
    • Heat or ice packs—Talk with your doctor about using heat or ice to relieve muscle tension and pain. Wrap the heat or ice pack in a towel. Never place it directly on the skin.
    • Medications such as:
      • Pain relievers
      • Anti-inflammatories
      • Muscle relaxants
    Current belief is that a better recovery can result from earlier activity including:
    • Physical therapy—therapy to help strengthen neck muscles and improve neck motion
    • Any movement
    • Joint manipulation of the spine done by a chiropractor or other trained provider
    If you are diagnosed with whiplash, follow your doctor's instructions .

    Prevention

    There are no guidelines for preventing whiplash. It often occurs due to an unexpected event.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org/

    American Academy of Orthopaedic Surgeons http://www.aaos.org/

    CANADIAN RESOURCES

    Healthy Canadians http://www.healthycanadians.gc.ca/

    Physical Therapy Canada http://www.physicaltherapy.ca/

    References

    Cervical sprain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 26, 2012. Accessed November 27, 2012.

    Conlin A. Bhogal S. Sequeira K. Teasell R. Treatment of whiplash-associated disorders--part II: Medical and surgical interventions. Pain Research & Management. 10(1):33-40, 2005.

    Conlin A. Bhogal S. Sequeira K. Teasell R. Treatment of whiplash-associated disorders--part I: Non-invasive interventions. Pain Research & Management. 10(1):21-32, 2005.

    Curatolo M. Arendt-Nielsen L. Petersen-Felix S. Evidence, mechanisms, and clinical implications of central hypersensitivity in chronic pain after whiplash injury. Clinical Journal of Pain. 20(6):469-76, 2004 Nov-Dec.

    Dambro MR. Griffith's 5-Minute Clinical Consult . 2001 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.

    Primary Care Medicine . 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2000.

    Rosen's Emergency Medicine: Concepts and Clinical Practice . 4th ed. Philadelphia, PA: Mosby-Year Book; 1998.

    Verhagen AP. Scholten-Peeters GG. van Wijngaarden S. de Bie RA. Bierma-Zeinstra SM. Conservative treatments for whiplash. Cochrane Database of Systematic Reviews. (2):CD003338, 2007.

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