• Whiplash

    (Cervical Sprain and Neck Muscle Strain)

    Definition

    Whiplash is a soft tissue neck injury that can include:
    • Spraining the neck ligaments
    • Straining the neck muscles
    • Injury to cervical discs
    • Possible 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

    Factors that may 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 although they can also develop in the days after 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
    • Unusual fatigue

    Diagnosis

    You will be asked about your symptoms and medical history. 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.
    Neck images may be taken to look for further damage. Images may be taken with:
    An electromyogram may also be done to test for nerve damage.

    Treatment

    Talk with your doctor about the best treatment plan for you. Options may include:
    • Reducing discomfort with ice and/or heat therapy
    • Taking over-the-counter and prescription medications to reduce pain
    • Moving as you are able to reduce stiffness
    • Physical therapy and exercises
    • Joint manipulation of the spine done by a chiropractor or other trained provider

    Prevention

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

    RESOURCES

    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

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

    References

    Cervical spine injury. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114826/Cervical-spine-injury. Updated January 8, 2015. Accessed January 22, 2015.

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

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

    Curatolo M, Arendt-Nielsen L, et al. 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.

    Ludvigsson ML, Peterson G, O’Leary S, Dedering A, Peolsson A. The effect of neck-specific exercise with, or without a behavioral approach, on pain, disability, and self-efficacy in chronic whiplash-associated disorders: a randomized controlled clinical trial. Clin J Pain. 2015;31(4)294-303.

    Ludvigsson ML, Peterson G, Dedering A, Peolsson A. One and two year follow-up of a randomized trial of neck-specific exercise with or without a behavioral approach compared with prescription of physical activity in chronic whiplash disorder. J Rehabil Med. 2016;48(1):56-64.

    Neck sprain. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.org/topic.cfm?topic=A00410. Updated December 2013. Accessed June 2, 2016.

    NINDS whiplash information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/whiplash/whiplash.htm. Updated November 3, 2015. Accessed June 2, 2016.

    Verhagen AP, Scholten-Peeters GG, et al. Conservative treatments for whiplash. Cochrane Database of Systematic Reviews. (2):CD003338, 2007.

    Walton DM, Macdermid JC, Giorgianni AA, et al. Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013;43(2):31-43.

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