This article is the second part of a series on whiplash injuries. It discusses whiplash symptoms, possible complications, and common treatments. This will be a discussion on treatment options and the long-term effects of whiplash if not properly treated.
Whiplash, the common term used to describe a hyperflexion/hyperextension injury that usually involves the muscles and joints of the neck, carries with it a variety of symptoms. While each person’s experience may vary, in this article we’ll be discussing the most common complaints associated with whiplash injury.
Range of Motion Loss (Stiffness)
Perhaps the most subtle effect of injury to the neck in an automobile accident is loss of range of motion. The neck is generally very mobile; a healthy neck can fully turn in both directions to line up with the shoulders, bend halfway towards the shoulders on the left and right, flex forward to bring the chin to the chest, and extend to look nearly straight up.
Injury to the muscles of the neck produce a stiffness that can limit range of motion, in some cases preventing motion entirely. This is the result of spasm and comes in two main forms: difficulty moving in the direction of the injured muscles (from weakness in the injured muscle) or difficulty moving in the opposite direction of the injured muscles (from failure of the opposing muscles to relax).
Joint injury may also limit motion, primarily backwards bending and looking up. This is caused by the joints approximating or coming together during those motions; an injured joint may be inflamed or irritated, and when the joint becomes compressed, it may become painful and result in limited range of motion.
Pain
Pain associated with whiplash comes in a variety of forms. Muscle injuries typically are reported as feeling achy, stiff, or even burning. The pain may even be sharp or shooting when attempting to initiate motion if the injured muscle opposing that motion fails to relax. Injured joints also tend to experience sharp pains when compressed but may feel dull or achy otherwise.
Injury to stabilizing ligaments results in a feeling of instability; that instability causes the area to move too much and causes pain during motion. Ligament injuries usually ache but become sharp with motion. If the instability is severe enough, it can result in compression of the nerves in the spine, leading to a shooting, electric like pain.
Because spinal discs are frequently injured in whiplash accidents, the ensuing inflammation or compression (in the case of herniated or bulging discs) may irritate local spinal nerves. This nerve compression produces tingling, numbness, or burning types of pain. If severe enough, it can lead to weakness of the arms or loss of sensation entirely. The same effects can be observed when tight muscles in the neck compress the nerves outside of the spine.
Weakness or loss of sensation are more serious complications and may require higher level intervention from a surgeon. We will discuss those a bit later.
Headaches
Headaches are by far one of the most common symptoms associated with whiplash. Most of these headaches are described as either throbbing (similar to a heartbeat), squeezing, or sharp. They tend to be diffuse, effecting wide areas of the head, but usually originate from singular sources.
Tension headaches, also known as cervicogenic headaches, are the result of injured neck muscles. The scalene muscles on the sides of the neck toward the front produce headaches that tend to feel more one sided, similar to a migraine. Suboccipital injuries (muscles beneath the back of the skull) produce band-like headaches that feel as though the entire head is being squeezed. Suboccipital muscles sometimes produce a stabbing pain that shoots straight to the front and may also have a migraine like presentation.
Instability of the neck due to injured ligaments will also produce headaches that seem to originate from the deeper part of the neck. The nerves that produce sensation to the head are located in the upper portion of the cervical spine; instability in the upper neck increases their activity and contributes to the feeling of head pain when the neck is moved frequently.
Whiplash injuries that result in an impact of the head may lead to more serious headaches that require emergency attention. These headaches are typically described as “thunderclap” headaches or come with the phrase “the worst headache of my life.”
If you experience vomiting because of your headache, loss of motor control, or numbness, seek emergency medical attention, as these may be signs of a life-threatening condition.
Weakness and Numbness
Excessive tension caused by injured muscles in the neck, especially the scalene muscles, may result in nerve compression in the brachial plexus or reduced blood flow of the subclavian artery (both are located by your collar bone, the clavicle).
This results in numbness and tingling in the arm on the side of the compression, usually when the head is turned and the arm is lifted. The arm sometimes becomes weak if held high for too long as a result of limited blood flow or nerve conduction.
Similarly, a herniated or bulging cervical disc may compress the very same nerves at the level of the spine. This produces the same numbness and tingling but is usually made worse by bending the head forward.
The spinal discs have a core that is semi-gelatinous wrapped up in a thick ligamentous material. If that material is damaged, bending the head forward creates negative pressure towards the back, pushing the disc material towards the nerves much like how squeezing a jelly donut pushes its filling towards the fill hole where there is empty space. In turn, this may increase the tingling sensation.
If the compression is severe enough or is left untreated long enough, eventually that numbness progresses to loss of sensation and then finally weakness. While initially reversible, chronic cases may become permanent.
Treatments for Whiplash
Like most injuries, whiplash has several effective treatments available. Proper treatment is paramount to recovering from a whiplash injury. Your chiropractor is likely to recommend a combination of treatments, which may include:
- Spinal adjustments (also called manipulations)
- Traction of the spine
- Electrical muscle stimulation
- Ice/Heat therapy depending on the phase of injury
- Rehabilitative exercises
- Manual therapy
- Supportive braces or athletic taping
On the medical side, medications may be used to mask or reduce symptoms during the recovery process. Even with treatment, it will take time to recover from a whiplash injury; controlling the symptoms may help improve ability to rest, accelerating healing. In rare cases, surgery may be used but is generally not recommended.
Your doctor may also recommend temporary lifestyle changes, including light duty work, time off, and/or increased evening rest. Proper nutrition can also play a key role in recovering efficiently.
If you or someone you know is suffering from a whiplash injury sustained in an auto accident, give our office a call to setup an evaluation. We look forward to helping restore your health!
Stay tuned for our next article, Treatments for Whiplash and the Risks of Not Treating.
About the Author
Dr. Brandon Orsino is a chiropractic physician specializing in treating injuries related to automobile accidents. Along with the other chiropractors at Dynamic Medical & Rehabilitation, he uses chiropractic techniques and physiotherapies to get patients feeling better and back to living their best lives.