Whiplash

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What is it about ?

The whiplash is due to a sudden shock causing the head to tilt back suddenly and uncontrollably and then violently forward. The injury usually occurs in a rear crash, but can also occur in a side impact or even a poorly executed dive. After a few hours to a few days, neck pain, limited neck movement and headaches appear. Acute whiplash symptoms usually go away within four to six weeks after the accident. If symptoms persist for more than three months, it is referred to as a chronic condition associated with whiplash. They are due to soft tissue damage. If there are also fractures or displacements of the cervical vertebrae, it is not a simple whiplash, and other methods of treatment are used.

What is its frequency?

In half of whiplash traffic crashes, there are acute symptoms of whiplash. Other factors play a role in acute neck pain, for example, disease of the cervical vertebrae (eg, osteoarthritis) or stress. In most cases, symptoms go away within 3 months. In 14-24% of cases, symptoms persist.

In some countries, such as Greece and Singapore, chronic whiplash disorders are rare, despite the equally high number of rear end collisions. It is likely that psychosocial factors (such as fear of permanent pain, stressful insurance procedures, etc.) play a reinforcing role in the onset of chronic complaints.

How to recognize it?

A few hours to several days after a traffic accident, one or more of the following symptoms may appear:

  • neck pain, sometimes radiating to the back of the head, shoulders and arms,
  • neck stiffness / limitation of neck mobility,
  • shoulder pain, pain between the shoulders,
  • headache, especially at the back of the head, sometimes radiating to the forehead,
  • hypersensitivity to light, noise and odors, dizziness, ringing in the ears, nausea,
  • tingling and numbness of the hands,
  • memory impairment,
  • tired.

How is the diagnosis made?

The doctor will ask you questions about the precise circumstances of the accident. They will also ask you questions about your current symptoms and any illnesses and symptoms you may have had before the accident. The doctor will examine your neck and its mobility and detect local pain when applying pressure. He will check if there is no damage to the nerves. He may also request an X-ray examination of the cervical vertebrae to exclude damage to the vertebrae (fractures or displacement). If he suspects other lesions (fractures, nerve damage, etc.) or if you have serious or long-lasting problems, the doctor will refer you to a specialist for a more in-depth examination and treatment.

What can you do ?

Resume your normal daily activities as soon as possible after the accident. Be aware that your symptoms may last for a few weeks. This is normal, and there is no need to worry. Most whiplash-related disorders resolve on their own.

If the doctor prescribes exercises for you, perform them as they have shown you. Resumption of normal activities and active exercise has a beneficial effect on the total duration of symptoms and on recovery. Prolonged rest or wearing a neck brace has not been shown to be helpful; they do not promote recovery and can be harmful.

What can the doctor do?

For the acute pain after the accident, the doctor may prescribe paracetamol or an anti-inflammatory drug. It may help to take a few days off. Staying active speeds up recovery. The doctor may prescribe an exercise program and / or treatment by a physiotherapist.

If the pain lasts more than three months, a rehabilitation program involving different care providers such as doctor, physiotherapist, occupational therapist, psychologist, etc. (multidisciplinary rehabilitation program) can help relieve pain and improve neck function.

Want to know more?

Source

Foreign clinical practice guide ‘Whiplash injury’ (2008), updated on 04.05.2017 and adapted to the Belgian context on 16.06.2018 – ebpracticenet

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