What is Whiplash?

Whiplash is a term that describes the violent and intense motion of the next flying back-and-forth – like the cracking of a whip.

Whiplash is a very serious injury to the structures of the cervical spine. Whiplash involves damage to the muscles and ligaments and is caused by an extreme range of motion without having any severe bone injury such as a fracture, dislocation or a disc herniation.

Whiplash is most often caused by auto-mobile accidents but sports accidents, physical abuse and other trauma can cause whiplash.

Each year, U.S. motorists are involved in an estimated 4 million rear collisions. With an annual rate of 70 to 329 per 100,000 people, whiplash is the most common injury after a motor vehicle collision in North America.

Symptoms

The most common symptoms of whiplash include neck pain, stiffness and headaches. Most people with whiplash get better within a few weeks by following a treatment plan that includes pain medication and exercise. However, some people have chronic neck pain and other long-lasting complications.  Before we start treatment, it is important that we complete a full assessment of your neck and upper body.

Signs and symptoms, normally develops within 24 hours of the injury:

  • Neck pain and stiffness
  • Worsening of pain with neck movement
  • Loss of range of motion in the neck
  • Headaches, most often starting at the base of the skull
  • Tenderness or pain in the shoulder, upper back or arms
  • Tingling or numbness in the arms
  • Fatigue
  • Dizziness

 

Some people also have:

  • Blurred vision
  • Ringing in the ears (tinnitus)
  • Sleep disturbances
  • Irritability
  • Difficulty concentrating
  • Memory problems
  • Depression

 

Levels of Whiplash

  • 0: No neck pain, stiffness, or any physical signs are noticed.
  • 1: Neck complaints of pain, stiffness or tenderness only but no physical signs are noted by the examining physician.
  • 2: Neck complaints and the examining physician finds decreased range of motion and point tenderness in the neck.
  • 3: Neck complaints plus neurological signs such as decreased deep tendon reflexes, weakness and sensory deficits.
  • 4: Neck complaints and fracture or dislocation, or injury to the spinal cord. Requiring further follow up from a physician prior to physical therapy.

 

Recovery

If physical therapy is applied soon, it’s possible that recovery from whiplash can be limited to a few weeks assuming there is no structural damage. The initial treatment can include a soft-tissue massage and modalities such as therapeutic ultrasound, cold treatments, and electrical stimulation for the pain.

When trying to mobilize the soft tissues with hands-on treatment, we can work to eliminate the trigger points and muscle spasms, restoring normal mobility to muscles, tendons and ligaments affected by the whiplash.

As you start to feel better – please give affected tissues enough time to heal – your physical therapy will progress to light and gentle exercises. Postural correction may be initiated, proceeding to a strengthening and stabilization program for the neck, mid-back and shoulder.

 

A Story About Whiplash

A 42-year-old female was referred to a physical therapist for cervical pain, headaches and vertigo. This woman had a history of concussions and had sustained a whiplash injury in a motor vehicle accident in the past.

She would often complain about increased dizziness when moving her head. She also reported severe headaches; neck pain; intermittent facial numbness; and poor balance when walking, bending forward, lifting and even carrying her baby.  She even had a difficult time ascending and descending stairs.  Clinical X-rays had proved negative for fracture or brain injury.

Furthermore, this woman was presented with poor posture. Her range of motion was very limited, painful and caused dizziness in all directions, especially when rotating to the right.

She was very weak in her cervical spine muscles and poor scapular strength.

How she recovered:

Her treatment included manual techniques, postural education, and various cervical and scapular strengthening; the approach for vestibular dysfunction consisted of oculomotor (eye reflexes) training focused on improving her balance.

Some at-home modifications were addressed, reducing television, phone and computer use and going for a periodic walk with her husband when her symptoms were free.

As she recovered more, functional tasks we added, including lifting and focusing in a stimulating environment.

Finally, her cardiovascular training progressed with a return to running and biking while we monitored for any return of headaches, dizziness or excess fatigue.