WHIPLASH

WHIPLASH INJURIES

With more cars on the road than ever before, the chances of a whiplash injury- a sprained neck- have increased. How should a whiplash be treated, and are there any measure we can take to prevent it occurring.

Whiplash injury is a well-known term which conjures up images of a devastating injury to the neck. In fact, whiplash refers to single type of neck injury which is essentially a sprain. Like any sprain, it may vary greatly in severity, ranging from a few days of mold discomfort in the neck to many months of pain and restriction of movements, or even permanent disability. But in the majority of cases, although the condition may be irritating, recovery is complete within about a month.

CAUSES

Whiplash injury is nearly always caused by car accidents, usually when a stationary car is struck from behind by another car. When this happens, the occupations of the stationary car are suddenly accelerated forwards, but their heads are momentarily ‘left behind’. The effect is like suddenly looking upward; the neck is bent backward or ‘extended’. The muscles and ligaments at the front of the neck and throat are placed under a sudden strain. This results in minor haermorrges into these muscles and ligaments which resolve within a short period of time. In more severe cases, there may be momentary dislocation of one or more small joints in the neck, or even fractures of the neck bones.

SYMPTOMS

Often there is little pain immediately after the accident. However the following day there is pain in the neck which is difficult to pinpoint, and this may spread into the shoulders or upper arms. Neck movements may become restricted by muscle spasm. Those with more severe injuries may complain of blurred vision, headaches, dizziness, or difficulty in swallowing because of bruising around the nerves and blood vessels in the neck. X-rays are usually unhelpful since the injuries are located in the soft tissues, which don't show on ordinary X-rays.

In most cases the symptoms settle down within a few days. However, people may develop persistent pain and stiffness which may last for many months. Some of these pains may be due to underlying arthritis in the joints of the neck which is triggered off by the injury. In other cases, there is a vicious circle of pain and stiffness giving rise to muscle spasm which in turn causes more pain and stiffness. It has been observed that people rarely suffer from persistent problems after whiplash injuries suffered in sports, domestic accidents or motor sport competitions, where the question of compensation does not arise.

DANGERS

The main danger is that symptoms will become persistent. Serious injury to the neck is rare: fractures of the neck bones, slipped disc, dislocations of the joints, spinal cord and nerve root injuries are more commonly caused by bending the neck forward, or by direct force applied to the top of the head. Other complications may include pain so acute as to be immobilizing. Constant headaches and dizziness may require medication heavy enough to impair routine activities.

TREATMENT

Initial treatment consists of resting the neck so that the neck muscles can relax and avoid going into spasm. This may be achieved by lying flat in bed so that the neck muscles do not have to work to hold the neck upright. A more convenient method is to apply a collar or neck brace to support the neck; this takes over the function of the muscles and allows the individual to remain fairly active. At this stage, painkillers are useful to prevent sore muscles from going into spasm and worsening the symptoms. If pain persists beyond one or two weeks, physiotherapy may be helpful. Gentle traction to the neck will relieve painful muscle spasm and lessen any pressure on the nerves that go into the shoulders and arms. Exercise to mobilize the neck, often combined with heat treatment, may also help to relax tense muscles. Some patients fail to respond to any form of treatment, and in such cases only time seems to result in any improvement.

The associated symptoms of dizziness, blurred vision and headaches are often very difficult to treat. Again, drug treatment may be of some help, but often the patient simply has to learn to live with these irritating symptoms and wait patiently for them to subside.

In the rare cases where a dislocation or fracture occurs, it may be necessary to stabilize the neck bones by means of an operation which is designed to fuse several of the neck bones together.

OUTLOOK

Most patients recover completely within a month. With those whose symptoms become more persistent, it may take as much as one to two years for these to resolve, although again complete recovery is the rule. In the meantime, the condition is discouraging and irritating, both physically, because of the debilitation, and psychologically.

PREVENTING WHIPLASH INJURIES

Use properly adjusted head restraints: this will prevent the head from jerking back to an extreme degree in rear-end collisions

Apply the hand or foot brake when the car is stationary: if it is hit f from behind, it won't accelerate rapidly, causing sudden jerking of the head and neck, resulting in whiplash

Ensure that rear lights and brake lights are functioning, and the rear fog spotlights are used in conditions of poor visibility. This will reduce chances of rear-end collision.