Whiplash
Whiplash is a term used to describe a sudden acceleration-deceleration movement of the neck. The head and neck are subjected to a backward and forward motion, also known as a 'whiplash'.
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What is whiplash?
Whiplash is a term used to describe a sudden acceleration-deceleration movement of the neck. The head and neck are then subjected to a backward and forward motion, also known as 'whiplash'.
The term whiplash is therefore a simple word to describe the injury mechanism. However, whiplash can cause various symptoms.
We then speak of a whiplash-associated disorder.
Watch the following video for a moving depiction of whiplash:
What are the symptoms of a whiplash-associated disorder?
The main symptoms of whiplash-associated disorder are the same as those of a cervical sprain, namely:
- Neck pain and stiffness
- Spasms in the neck muscles
- Headaches (caused by the neck problem)
In general, neck movements and certain arm movements trigger the pain.
However, in addition to these symptoms, other symptoms may include:
- Dizziness/vertigo
- Problems controlling eye movement
- Tinnitus
- Loss of balance
- Concentration or memory problems
- Changes in sleep patterns
- Anxiety, depression
Symptoms may appear immediately after the accident or up to 48 hours later. If you also experience pain, numbness, or tingling that radiates into your arms, you likely also have cervicobrachialgia or radiculopathy. See the section on these two conditions.
It is also possible to have suffered a concussion after a whiplash. Be sure to recognize the symptoms of a concussion.
What are the serious symptoms of a whiplash-associated disorder?
The presence of certain signs and symptoms should prompt you to seek immediate medical attention at the emergency room or from a doctor. These include:
- Severe weakness or paralysis in one or both arms
- Significant or even complete loss of sensation in one or both arms
- Recent loss of balance when walking
- New incoordination of the arms or hands
- New difficulties with bladder or bowel control
- Loss of sensation in the genital area or when wiping after a bowel movement
Serious symptoms are only present in less than 1% of cases.
Most of the time, although the pain can be very unpleasant, the condition improves.
What are the causes of whiplash-associated disorder?
It is necessary to have experienced an accident or trauma that causes the neck to move in a whiplash motion. For example:
- A car accident
- A sudden neck movement
- An impact to the head
- A fall
How is whiplash-associated disorder diagnosed?
Diagnosis is made based on a review of your symptoms and a clinical examination. If you have had an accident that caused your neck to move in a whiplash motion and you develop symptoms afterward, the presence of a whiplash-associated disorder can be confirmed.
In some cases, an X-ray of the neck is required to ensure there is no fracture. Here are some criteria that justify taking an X-ray:
- Falling from a height of more than one meter or down five steps
- Receiving a load that crushes the head (for example, diving into a pool)
- A car accident at more than 100 km/h, being ejected from a car, or the car rolling over
- An accident in a motorized recreational vehicle (snowmobile, quad, motocross, Ski-Doo, etc.)
- Being on a bicycle and colliding with a car
When should you consult a physiotherapist for a whiplash-associated disorder?
You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.
You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.
What physiotherapy treatments are available for whiplash-associated disorder?
Physiotherapy treatment for whiplash-associated disorder is divided into three parts:
- Assessment and treatment of the different body systems that may be responsible for the symptoms.
- Planning the return to work or school (cognitive activities)
- Planning your return to sports and other leisure activities
Step 1 – Assessment and treatment of body systems
Your physiotherapist is the only healthcare professional with the expertise to assess the three systems that may have been injured by the whiplash, namely:
- The vestibular system (responsible for balance)
- The oculomotor system (responsible for eye coordination)
- The cervical spine (the vertebrae in the neck)
To assess your neck, your physiotherapist will evaluate the following:
- Your joint mobility
- The gliding of your nerves
- Your postural habits
- The quality of your movements
- Your strength and stability
Based on the assessment results, your physiotherapist will:
- Mobilize the joints, muscles, and nerves in your neck to reduce pain and improve movement
- Give you specific exercises to do at home to address the cause of the problem and relieve pain
- Teach you how to properly manage your daily activities and hobbies to optimize healing
- Give you advice for your postural habits and movements
Step 2 – Planning the return to work or school (cognitive activities)
The physiotherapist will guide you in the gradual return to school or work. They will provide advice to ensure a successful return without recurring symptoms. Follow-up will be maintained until a complete return to work or school is achieved without symptoms.
Step 3 – Planning the return to sports and other leisure activities
The physiotherapist will guide you towards returning to physical activity. They will provide advice to ensure a successful return without recurring symptoms. Follow-up will be maintained until a complete return to physical activities is achieved without symptoms.
What to do at home for a whiplash-associated disorder?
Temporarily stop doing movements that cause too much pain, and then gradually start doing them again.
Here are some other tips that may help at home:
- Move your neck in the movements that don't cause any pain at all
- Support your shoulders and shoulder blades
- With a cushion under your armpit
- With the armrests of a chair or sofa
- By putting your hand in your pants pocket while standing
- Limit the time spent in the same position (computer, television, reading). Get up for a few minutes to move your neck and shoulders a little.
- Make sure your neck is well supported while sleeping at night with a pillow that fills the hollow of your neck. Sleeping on your stomach should be avoided (especially if you have stiffness or pain in the morning or during the night).
If you don't see any improvement after 10 days, you should consult a physiotherapist.
Sources
- Gwilym SE, Stace RM. Whiplash associated disorder: a review of current pain concepts. Bone & Joint 360. 2015 Feb;4(1):37-9.
- Carroll LJ, Holm LW, Hogg-Johnson S, Côté P, Cassidy JD, Haldeman S, Nordin M, Hurwitz EL, Carragee EJ, van der Velde G, Peloso PM. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal of manipulative and physiological therapeutics. 2009 Feb 1;32(2):S97-107.
- Ioppolo F, Rizzo RS. Epidemiology of whiplash-associated disorders. InWhiplash Injuries 2014 (pp. 13-16). Springer, Milano.
Other conditions
Hip osteoarthritis is a normal wear and tear of the hip joint. Osteoarthritis is often described as the wearing away of cartilage between our bones. While this is true, it involves more than just cartilage. Cartilage is a tissue that acts like a cushion between the surfaces of our bones, allowing our joints to glide smoothly and move with ease.
It is a normal wear and tear of the knee joint. Osteoarthritis is often described as the wearing away of cartilage between our bones. While this is true, it involves more than just cartilage. Cartilage is a tissue that acts like a cushion between the surfaces of our bones, allowing our joints to glide smoothly and move with ease.
It is a normal wear and tear of the joints in the lower back vertebrae. Osteoarthritis is often described as the wearing away of cartilage between our vertebrae. While this is true, it involves more than just cartilage. Cartilage is a tissue that acts like a cushion between the surfaces of our vertebrae, allowing them to glide smoothly and move with ease.
A bursa is like a small, very thin, fluid-filled sac found in several joints throughout the body. This small sac acts as a cushion in the joint and lubricates structures that are exposed to more friction.
It is an inflammation of the subacromial bursa in the shoulder joint.
It is a tissue that surrounds the shoulder and allows the shoulder bone to stay in place within the joint. The capsule helps to stabilize the joint.
Cervicalgia is a general term to describe neck pain that does not have a specific cause, such as an accident or sudden movement. Cervicalgia is therefore synonymous with ''I have a pain in my neck and nothing in particular happened''.
In both injuries, there is pain felt in the neck that then radiates into the arm, or vice versa.
It is a significant stretch or tear of the muscle fibers in the groin or inner thigh muscles.
It is a significant stretch or tear of the muscle fibers in the hamstring muscles located at the back of the thigh.
This is a significant stretch or tear of the muscle fibers in the calf muscles (soleus and gastrocnemius).
This is a significant stretch or tear of the muscle fibers in the quadriceps, which is the large muscle at the front of the thigh.
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