Whiplash “Syndrome”

            The term “whiplash” is a slang term for a neck injury most accurately called a cervical acceleration-deceleration (CAD) injury. Now you know why we call it “whiplash”! It suggests that the head was forced through a range of motion that exceeds the barriers of our normal tissue, resulting in injury to the neck.

            Though a slip and fall, or even a bar-room brawl, can cause whiplash, whiplash is usually associated with injuries that occur from a car accident or “motor vehicle collision” (MVC). The term “syndrome” refers to a cluster of symptoms that can include neck pain, headache, light-headedness, ringing in the ears, visual disturbances, memory loss, nausea/vomiting, noise and/or light sensitivity (usually associated with mild traumatic brain injury or, post-concussive syndrome), TMJ (jaw) pain, radiating pain, numbness, and/or weakness in the arm, limited neck movements, and more. Even the low back can be injured in a whiplash injury!  In other words, a whiplash injury can affect MANY different parts of the body, and the clinical picture can vary widely from case to case.

            Whiplash is diagnosed through a thorough history, paying particular attention to the mechanism of injury – that is, how fast were you and the opposing vehicle traveling, in what direction did you get hit (front, side, rear, angular, or combinations), what size was your vs. the opposing vehicle, was your head turned or pointed straight at the time of impact and did you hit your head? Also, we will ask, what were your immediate symptoms compared to 30 min., 60 min., 3 hrs, 6 hrs later, the next morning, and when did your symptoms peak? What activities (including work) have been affected, and to what degree? What self-management approaches have you tried, and how have they worked? The more we can learn about the accident and your immediate symptoms, or delay in symptom onset, the better we can address your problems. The physical examination is also very important as we will observe your movement quality, posture, pain expression, palpate for muscle guarding, trigger points, and swelling of the injured joints. We will also evaluate your neck and back range of motion, assess your neurological functions, and assess extremity issues that might be present. X-rays will more than likely be done and may include “stress views” where you bend the neck forwards and backwards to assess the stability of your spine. Comparison to older x-rays can be very helpful, if they exist. Depending on the degree and type of the injury, special tests will be considered such as MRI, EMG/NCV, laboratory tests, and perhaps others.

            Treatment will consist of: addressing the acute inflammatory painful symptoms by the use of gentle massage, mobilization and/or manipulation, electrical stim or a different anti-inflammatory modality, review how to apply ice and/or heat, how to bend/lift/pull & push properly to avoid irritation. We’ll teach you exercises, proper sleep positions, and other home applied, self-help techniques. The goals of pain management, functional restoration, and prevention will be applied. If needed, coordinating care between our office and primary care, orthopedic, neurology, or others will be smoothly managed as the need arises.