Pain in the Neck

Without proper treatment, whiplash can put you out of service.

Imagine yourself driving along the interstate when suddenly a car or truck rear-ends you, propelling you forward. It takes about 100 milliseconds for your body to catch up to the forward movement. Your shoulders travel forward until they are under your head, and your neck extends forward as your head tilts slightly down toward your steering wheel. In a panic, you step on the brakes, bringing the truck to an abrupt halt. The sudden stop throws your head and neck backward, and they bounce against the headrest.

In a matter of seconds, you’ve experienced the classic mechanism of injury for whiplash.
Whiplash is a soft tissue injury to the neck, also called neck sprain or neck strain. The injury is caused by sudden extension and flexion of the neck, usually as a result of an automobile accident. About 20 percent of people involved in rear-end collisions later experience symptoms that center in the neck region. Although most of these people recover quickly, a small number develop chronic conditions that result in severe pain and sometimes disability.

Whiplash may include injury to intervertebral joints, discs and ligaments, cervical muscles and nerve roots. Symptoms such as neck pain may be present directly after the injury or may be delayed for several days. Because most injuries affect soft tissues such as the disks, muscles and ligaments, whiplash cannot be seen on standard X-rays. Your doctor may need to request specialized tests, such as computed tomography scans or magnetic resonance imaging (MRI).

In addition to neck pain, other symptoms may include neck stiffness, headache, dizziness, pain or numbness in the arms/hands, abnormal sensations such as burning or prickling, or shoulder or back pain. In addition, some people experience conditions such as memory loss, ringing in the ears, blurred vision, concentration impairment, nervousness and irritability, sleep disturbances, fatigue or depression. If you have whiplash and experience any of these symptoms, see a doctor right away.

Drug treatment for whiplash may include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants and muscle relaxants. In the past, whiplash injuries were often treated with immobilization in a cervical collar. The current trend, however, is to encourage early movement, rather than immobilization. The soft collar may be used for a short term and on an intermittent basis.

Ice may be applied for the first 24 hours, followed by gentle active movement. Your doctor may provide you with a series of range-of-motion exercises that you can do at home. An early return to work is encouraged, even if your doctor must prescribe some temporary modifications in your work situation. No single treatment has been scientifically proven as effective, but pain medications, exercises, physical therapy, traction, massage, heat, ice, injections and ultrasound have all been beneficial for some patients.

As soon as possible, you should begin aerobic activities, such as walking. Your doctor may prescribe some isometric exercises as your condition improves. Symptoms resolve within several months for about 75 percent of people who have whiplash. Chronic conditions should be investigated further by your doctor and might require surgery.

Because whiplash is usually caused by vehicular accidents, the only prevention is to exercise caution while driving. In particular, avoid rear-end collisions by being careful not to pull out in front of others and not to slam on your brakes suddenly unless in an emergency situation.
–By Kristin Record