December 17, 2018
Whiplash is a common neck injury that is usually caused by a road traffic accident (RTA) or in contact sports like rugby. Whiplash is described as acceleration-deceleration injury which may result from rear-end or side-impact motor vehicle collision but can also occur with other situations that involve fast impact. This impact can result in bony or soft tissue injuries which in turn can lead to other symptoms, this variety of clinical presentations is called ‘Whiplash Associated Disorders’ and is graded on a scale from 0-4, from the least to the most severe.This scale is known the Quebec Task Force classification system.
In a Whiplash injury, the lower part of the neck (cervical spine) and the upper part of the mid back (thoracic spine) bend back quickly, while the upper part of the neck quickly moves forward, creating an ‘S’ shape in the neck. Additionally, instead of just moving forward and back normally the neck also may rotate slightly at the small joints along the side of the spine creating compression and irritation in these joints. Since your natural postural reflexes talk about 100 milliseconds to respond the neck is instantly moved forward and back with no ability to protect itself.
The most common symptoms of Whiplash include neck pain, stiffness, reduced neck movement, headache, and muscular tightness, this would fall under WAD Grade I-II. In more severe cases neurological symptoms can be present alongside musculoskeletal symptoms, such as pins and needles, numbness, weakness and reduced reflexes, classified as WAD grade III. Furthermore, the most severe injury that can occur in a Whiplash Associated disorder is a fracture of a spinal vertebrae, this would be classified as WAD Grade IV.
In some cases pain is not felt immediately and may increase over a period of 48 hours after the injury has occurred as the inflammation period begins. Muscles, joints, ligaments and nerves may all be affected. If there was a major RTA many times there will be an X-ray or MRI to rule out a fracture. If it was a smaller accident, they may decide to skip this step and clear the neck by physical examination. Once the neck is cleared of a fracture it is important to keep the neck moving. Many people have the misconception that they should keep the neck completely still and avoid moving it. However, it is important to keep the neck moving gently and try to increase function so that you can return to normal activity as soon as possible.
If you have suffered from Whiplash you may begin a course of Physiotherapy to help reduce your pain and increase your neck movement and strength. Depending on your symptoms and WAD grade your Physio may use manual therapy, dry needling and neck mobilisations to help reduce pain and increase neck movement. They will also give you stretches and exercises to work on at home to help get you back to your normal daily activities as soon as possible. Additionally, your Physio will give you advice on things such as using heat, NSAIDs and ergonomics etc.
If you have suffered from Whiplash or have any questions regarding this topic, please get in touch with one of our Physiotherapists at ReBalance Physiotherapy at 01 441 0100.