Whiplash is a common injury that occurs in many circumstances, including during a car accident. In America, over two million people are diagnosed with this condition yearly.
You don’t have to be driving at top speeds or be rear-ended to earn a whiplash diagnosis. In fact, you do not have to be going very fast at all. Research has found that even minimal impact can cause severe cases of whiplash. Whiplash symptoms also may take hours and up to a day to be noticed. For these reasons, it is important to seek medical attention after being involved in a car accident, especially if you notice any new pain or discomfort, even if it doesn’t seem serious at the time.
The question is: How do you know if you have whiplash, and who should you see if you have a suspicion that you do? Is it a condition that requires emergency care? Should I wait to see my primary care physician or someone else? Read on to find out answers to these questions and more.
What Is Whiplash?
Whiplash is a neck injury that occurs when the neck moves back and forth forcefully, often due to an impact on the head or trunk of the body. The movement causes strain on the muscles and soft tissues in the neck area, such as the tendons and ligaments.
Causes
There are a few circumstances in which whiplash mainly occurs.
Car Accidents
Most cases occur during car crashes. Rear-end collisions are especially known for causing whiplash, but any kind of impact to your car can cause the back-and-forth movement of your neck muscles, which is what strains the muscles and causes whiplash.
Sports
Athletes are most at risk if they participate in contact sports, but plenty of non-contact sports may cause whiplash too. Any sport which requires your body to move with speed can increase the chance of whiplash injuries: horseback riding, skiing, and bicycling are all examples of such sports.
Falls
Anyone can fall in a position that leads to whiplash, as long as the fall causes the head to move back. However, because aging can cause decreased flexibility and increased fall risk, this is of particular concern for people aged 50 or older.
Head Trauma
If an object hits your head with enough force, the resulting jerking back movement of your head can be enough to cause whiplash.
Physical Assault
Unfortunately, the most frequently observed injuries to survivors of domestic physical abuse are head and neck musculoskeletal injuries, which include whiplash. The condition is also a primary sign of shaken baby syndrome, another form of abuse that often ends in the death of infants.
Symptoms
The main symptom of whiplash is neck stiffness. So common does this symptom accompany cases of whiplash that doctors have begun to use the reactivity in your trapezius muscle – that is, whether or not it is too stiff to react to stimuli – to diagnose whiplash. Neck stiffness will make it difficult for you to turn your head side to side or up and down.
You are also likely to experience neck and shoulder pain, sometimes radiating outwards down the back or arms. Jaw pain and headaches are also frequently experienced. The jaw pain is caused by the location of the temporomandibular joint (TMJ) and its close proximity to the neck. The tension from the pain in the neck, shoulder, and jaw can cause severe headaches, including migraines. Headaches are reported by at least 60% of whiplash patients.
About half of all people diagnosed with whiplash experience dizziness. Rarer but still relatively prevalent is ringing in the ears, or tinnitus. Many people report experiencing tinnitus either during or directly after the impact, but some continue to experience it long after.
Secondary Symptoms
While sleep disturbances and emotional difficulties may not be direct symptoms of concussions, they are certainly a risk. The pain and stiffness can result in insomnia, making it hard for you to fall asleep or causing you to wake up multiple times during the night. Sleep quality, of course, has a significant association with mood. Thus, irritability, difficulty focusing, and increased mood swings may all occur much more frequently. Daytime fatigue is also possible, putting you at risk for another accident.
Complications
In addition to the pain and other symptoms that can disrupt your life for a time, there may be other, more dangerous problems that co-occur with whiplash cases. Up to 50% of people who are diagnosed with whiplash develop whiplash-associated disorders (WADs) and never fully recover.
The brain and nervous system are particularly vulnerable to long-term effects. Those with whiplash-associated disorders may experience hyperarousal of the nervous system, which could lead to chronic pain with frequent flare-ups. People who experience whiplash multiple times could develop lesions along their nerves, causing long-term pain that could last for up to two years after the fact.
Sometimes, a concussion occurs alongside whiplash, especially if the whiplash is due to trauma to the head. Athletes are especially prone to experiencing this kind of double injury. The problem is that the autonomic nervous system (ANS) can be disturbed by both concussions and whiplash. The ANS is in charge of the processes that the body cares out involuntarily, including keeping your heart beating and your blood flowing. The ANS controls your stomach’s ability to digest as well as your ability to eliminate waste. It also responds to stress by letting your endocrine system know to release the chemicals that create the automatic acute stress response. Damage to the autonomic nervous system could disrupt any of these processes as well as make you more sensitive to pain or unable to deal with stress.
Risk Factors
Some people are more at risk for whiplash than others due to individual factors. Gender is one such potential risk factor. For unknown reasons, women are nearly twice as likely as men to develop the condition. Older people, especially those over the age of fifty, have lost some of the flexibility that can protect younger individuals from whiplash and so age is another risk factor. Medical history and athletic participation can also make you more vulnerable to sustaining a whiplash injury. Those with ongoing neck conditions or previous injuries to the neck are associated with significantly higher numbers of whiplash, as are athletes who participate in contact sports like rugby or American football.
Diagnosing and Treating Whiplash
As with any condition, the primary way that medical experts diagnose injuries and illnesses is by listening to patients describe symptoms and then completing a thorough exam that will help them confirm their hypotheses. When you are seeking medical attention, it is important to be as clear, honest, and thorough as possible because you never know what detail may help your doctor determine what is going on with you. Something that seems minor to you may actually help a doctor recognize something that could make a huge impact on your well-being.
Whiplash is a soft tissue injury that affects your muscles, ligaments, and the discs in the top part of your spinal column. It cannot be seen on x-rays, but your doctor may have you do one anyway, just to rule out other options. Your doctor may also need you to undergo magnetic resonance imaging (MRI), which is a helpful imaging tool that allows medical professionals to “see inside” your body. During an MRI, magnets help create images of your organs and some of your soft tissues.
After diagnosis, the medical professionals on your team will come up with a treatment plan. In addition to basics like rest and immobilization for 48 hours and pain management with over-the-counter medications, you may need to visit some specialists to help you with specific needs.
Orthopedic Doctor
While your primary care physician is capable of identifying and treating whiplash, the best doctor for diagnosis and treatment would be an orthopedic physician. These doctors have the same basic medical training all doctors do, with the addition of special training for working with the musculoskeletal system. The musculoskeletal system, made up of your muscles, bones, joints, ligaments, and tendons, is the main body system affected by whiplash.
An orthopedic doctor will know what to look out for and will be able to recognize secondary injuries that may have occurred alongside the whiplash, like a tear in the shoulder. Just like a primary care physician, an orthopedic doctor will discuss your injury with you, asking you about what you noticed at the time of the crash, the degree of pain you have experienced since then, and the kinds of symptoms you are experiencing. They will ask you to demonstrate your range of motion.
Due to the nature of an orthopedic practice, it is likely that if the doctor requires imaging like an x-ray or MRI, it can be completed within the same building. This may not be true for a primary care physician. Also, an orthopedic doctor can help build a more specialized treatment plan than your primary care physician may because the orthopedic doctor retains their license through earning continuing education credits. Oftentimes, through this education, specialty doctors learn about new advances in their field, including the best new treatments.
Physical Therapist
It is probable that your injury limits your ability to complete daily activities and that the pain may seem overwhelming at times. A physical therapist specializes in rehabilitation that will allow you to regain your strength, flexibility, mobility, and range of motion, all of which are necessary for many of the tasks you do each day.
There is no one way that physical therapists address injuries like whiplash. It will depend on what you need: your pre-existing conditions, any other injuries you have, the degree and type of pain you report, and other factors. Some of the things that your physical therapist may do to help you with whiplash include but are not limited to the following:
- Massage and manipulate your neck and shoulders to relieve tension and pain, as well as break up collagen to reduce scarring and help your body flush out inflammatory cells
- Use temperature therapy to manage the blood flow in your body
- Teach you gentle stretches to help you regain the range of motion in your neck, building up to exercises that will rebuild the strength you may lose while recovering in order to prevent a recurring injury
- Use an ultrasound machine to increase blood circulation, reducing muscle spasms, swelling, stiffness, and pain
The benefit to physical therapy is that not only is it minimally invasive and requires no medication, but it is extremely effective – on one condition. When you visit a physical therapist, they most likely will assign “homework.” Usually, this takes the form of exercises, stretches, or other kinds of movement techniques that target your individual issues. It is important to practice these consistently at home, or your recovery period may be significantly longer.
Chiropractor
Last but certainly not least, visiting a chiropractor as part of your treatment plan can make quite a difference in the quality of your experience as you recover. Like orthopedic physicians and physical therapists, chiropractors have specialized training. Through manipulation of your body through different means, chiropractic care can reduce pain and swelling, hasten rehabilitation, and treat holistic issues that may arise in your body as a side effect of your injury.
Some people believe that chiropractic care is limited to spinal manipulation alone, and while spinal manipulation – or chiropractic adjustments – are certainly beneficial for whiplash patients, there are many other techniques a chiropractor may use to treat you.
The main treatment other than chiropractic adjustments is muscle stimulation and relaxation. Through stretching, massage, and targeted pressure, the chiropractor will engage your muscles and cause them to constrict and then relax, which will release tension. They may also use trigger point therapy, identifying places in which your spinal joints are moving abnormally and help restore motion. Direct pressure in these areas is another way of alleviating muscle tension.
These are just a few of the techniques you will see a chiropractor use. What your chiropractor may do will depend on the needs you report and the individualized treatment they provide as a result. To experience relief from your whiplash injury with chiropractic care, call the specialists at AICA Orthopedics of Snellville today to make an appointment.