(Cervical Strain and Neck Muscle Sprain)
Whiplash is a neck injury]]> that includes:
- Spraining the neck ligaments
- Straining the neck muscles
- Bone and nerve injury may be involved
Process Leading to Whiplash
Whiplash can occur with any sudden, violent, backward jerk of the head or neck that can often occur during:
- Motor vehicle accidents
- Athletic injuries
Risk factors for whiplash include:
- Age: young adults
- Sex: male
- Ankylosing spondylitis]]> (a rheumatic disease that can effect the spine)
Risk factors for poor outcome or longer recovery include being:
- An older woman
- In a truck
- A passenger
- Hit by a moving object
- Hit head-on or perpendicular
- Involved in litigation
- Affected with severe pain or radicular symptoms
The symptoms usually develop over the several hours after the injury. Within 24 hours of the symptoms tend to reach their peak.
- Stiff neck
- Neck pain
- Numbness or tingling
- Shoulder pain and stiffness
- Decreased range of neck motion
- Muscle spasms
- Pain, numbness, or tingling extending down an arm
The doctor will ask about your symptoms. You will be asked how the injury occurred. A physical exam will be done. Although most whiplash injuries do not show up on imaging tests, your doctor may choose to order some tests to make sure that no other injuries.
Tests may include:
- Neck x-rays]]> —a test that uses radiation to take a picture of structures in the neck, especially bones
- ]]>CT scan]]> —a type of x-ray that uses a computer to make pictures of the bony structures inside the neck
- ]]>MRI scan]]> —a test that uses magnetic waves to make pictures of bony and soft tissue structures inside the neck
- CT ]]>myelogram]]> —a test that uses dye to better see structures in the neck
- Electrodiagnostic testing—also known as EMG, test muscles
- Heat or ice packs—Talk with your doctor about using heat or ice to relieve muscle tension and pain. Wrap the heat or ice pack in a towel. Never place it directly on the skin.
Medications—These may include:
- Pain relievers
- Muscle relaxants
- Neck (cervical) collar—This may be given for short-term or occasional use. It will depend upon the extent of injury.
Current belief is that a better recovery can result from earlier activity including:
- Physical therapy—therapy and modalities may help strengthen neck muscles and improve neck motion; exercises may begin within two days of injury
There is some evidence of the effect of the following:
- Chiropractic—manipulation of the spine done by a chiropractor
- Cervical facet injections
- Radiofrequency neurotomy
- Pulsed magnetic field treatment
If you are diagnosed with whiplash, follow your doctor's instructions .
American Academy of Family Physicians
American Academy of Orthopaedic Surgeons
Physical Therapy Canada
Conlin A. Bhogal S. Sequeira K. Teasell R. Treatment of whiplash-associated disorders--part II: Medical and surgical interventions. Pain Research & Management. 10(1):33-40, 2005.
Conlin A. Bhogal S. Sequeira K. Teasell R. Treatment of whiplash-associated disorders--part I: Non-invasive interventions. Pain Research & Management. 10(1):21-32, 2005.
Curatolo M. Arendt-Nielsen L. Petersen-Felix S. 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.
Dambro MR. Griffith's 5-Minute Clinical Consult . 2001 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2001.
Primary Care Medicine . 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2000.
Rosen's Emergency Medicine: Concepts and Clinical Practice . 4th ed. Philadelphia, PA: Mosby-Year Book; 1998.
Verhagen AP. Scholten-Peeters GG. van Wijngaarden S. de Bie RA. Bierma-Zeinstra SM. Conservative treatments for whiplash. Cochrane Database of Systematic Reviews. (2):CD003338, 2007.
Last reviewed February 2009 by ]]>Robert E. Leach, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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