Whiplash Injury, Common with Auto Accidents

Causes and Symptoms of Whiplash Injury

Whiplash injury is very common in motor vehicle accidents especially with rear-end collisions but may be present in other types of accidents as well. Front end impact of the vehicle or a fall also may be a culprit. Other causes are a sequela of sport injury, especially high-impact sports, such as showboarding, skiing, boxing, football and others as well as physical assault. Usually it occurs with forceful, rapid back and forth movement of the neck at the moment of the impact. However, it may also occur with low speed auto accidents, at times less than 10 mph.

Injury to facet joint, tiny joint on the back of the neck is believed to be a frequent source of pain in these circumstances, in most studies the prevalence is well over 50%. The main symptom is pain in the neck and shoulders, it may frequently be accompanied by headaches. Other symptoms may come on as well, such as tightening in the neck and shoulders, muscle spasms, blurred vision, dizziness, or difficulty concentrating, sleeping or swallowing. Older people, and those who already have neck problems such as arthritis, may experience more serious whiplash than a younger person.

What To Do If You Have These Symptoms

Interesting phenomenon about whiplash is that it may not even cause symptoms immidiately. Sometimes, the onset is delayed for hours, days or even weeks. However, once you have any symptoms suggestive of whiplash it is best to be evaluated at the doctor's office. This is particularly important if you were involved in auto accident or other experience which may have caused the injury. You need to be examined and your condition may require X-ray or MRI (magnetic resonance imaging). Since the injury frequently occurs to the structures too small to be seen on these tests the results may not show much. The diagnosis is most commonly made based on clinical presentation, which means based on the symptoms you have and their location. Nevertheless, it is important to document all the findings to rule out any potential fractures and allow easier review of your case if legal review is required.

As much as it may be unpleasant to move around after a whiplash injury for fear of making the pain worse it is not a good idea to rest for more than few days. Resting longer can cause the muscles in the neck, shoulders and back to get stiff and weak and actually prolong the pain. To keep the neck muscles flexible it is best to return to normal activity as soon as your doctor says it’s OK.  

What Treatment Options are Available for Whiplash  

You are more likely to need treatment if you have severe pain from the beginning of the accident or you have neurological symptoms such as memory loss or shooting pain in the arms or fingers. Initially, your doctor may prescribe physical therapy to help alleviate symptoms and recondition the muscles. Other options may be gentle heat application, pain medications or neck collar. When these treatments are not completely effective very specific joint injections with steroid medication, nerve blocks and other interventions should be considered. Based on published evidence of high prevalence of cervical facet joint injury in whiplash this approach should be considered if neck pain symptoms persist for more than 2-3 mo after the accident. Commonly, it is a good idea to  combine injections with physical therapy and/or neck adjusments even earlier because this combination can provide better improvement than each of these options used alone. Radiofrequency treatment of the facet joint nerves can be very helpful for treatment of persistent, chronic neck pain resulting from whiplash, the evidence for this treatment is well established and it is capable of delivering consistent and reproducilble results in majority of these cases. There is also an option of treatment with the stem cells ( autologous bone marrow concentrate) or platelet rich plasma. Therapy laser can also be considered and frequently would be most helpful in early stages in combination with other options.

At Advanced Pain Management Center we are able to provide all you need for evaluation and treatment of potential whiplash injury. We have physical therapy services and procedure facilities on site. We can also identify other options available and if necessary refer you to specialists outside of the clinic as needed. The treatments indicated for whiplash are considered to be fairly routine and are covered by most insurance plans. We invite you to call our office for evaluation and discussion of appropriate treatment. 

Author
Vladimir Fiks, MD Medical Director Advanced Pain Management Center and Cedar Hills Surgery Center

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