If you have been involved in a car accident, whiplash injuries need to be taken very seriously. Because symptoms of a whiplash injury can take weeks or months to manifest, it is easy to be fooled into thinking that you are not as injured as you really are. Too often people don't seek treatment following a car accident because they don't feel hurt. By far, the most common injury to the neck is a whiplash injury.Whiplash is caused by a sudden movement of the head, either backward, forward, or sideways, that results in the damage to the supporting muscles, ligaments and other connective tissues in the neck and upper back.
Unfortunately, by the time more serious complications develop, some of the damage from the injury may have become permanent.Numerous studies have shown that years after whiplash victims settle their insurance claims, roughly half of them state that they still suffer with symptoms from their injuries. If you have been in a motor vehicle or any other kind of accident, don't assume that you escaped injury if you are not currently in pain.
The term "whiplash" was first used in 1928 to define an injury mechanism of sudden hyperextension followed by an immediate hyperflexion of the neck that results in damage to the muscles, ligaments and tendons – especially those that support the head. Today, we know that whiplash injuries frequently do not result from hyperextension or hyperflexion (extension and flexion beyond normal physiological limits), but rather an extremely rapid extension and flexion that causes injuries.
Due to their complicated nature and profound impact on people’s lives, few topics in health care generate as much controversy as whiplash injuries. Unlike a broken bone where a simple x-ray can validate the presence of the fracture and standards of care can direct a health care professional as to the best way in which to handle the injury, whiplash injuries involve an unpredictable combination of nervous system, muscles joints and connective tissue disruption that is not simple to diagnose and can be even more of a challenge to treat.
Injuries Resulting From Whiplash Trauma
As we discussed briefly in the introduction, whiplash injuries can manifest in a wide variety of ways, including neck pain, headaches, fatigue, upper back and shoulder pain, cognitive changes and low back pain. Due to the fact that numerous factors play into the overall whiplash trauma, such as direction of impact, speed of the vehicles involved, as well as sex, age and physical condition, it is impossible to predict the pattern of symptoms that each individual will suffer. Additionally, whiplash symptoms commonly have a delayed onset, often taking weeks or months to present. There are, however, a number of conditions that are very common among those who have suffered from whiplash trauma.
It is the single most common complaint in whiplash trauma, being reported by over 90% of patients. Often this pain radiates across the shoulders, up into the head, and down between the shoulder blades. Whiplash injuries tend to affect all of the tissues in the neck, including the facet joints and discs between the vertebrae, as well as all of the muscles, ligaments and nerves.
Facet joint pain is the most common cause of neck pain following a car accident. Facet joint pain is usually felt on the back of the neck, just to the right or left of center, and is usually tender to the touch. Facet joint pain cannot be visualized on x-rays or MRIs.
In order to assess if it is truly a facet problem that is causing cervical spondylosis two diagnostic medical branch blocks need to be done. This is a tool used by doctors to see if the pain is truly from the facet joint and not due to muscles or ligaments.
Disc injury is also a common cause of neck pain; especially chronic pain. The outer wall of the disc (called the anulus) is made up of bundles of fibers that can be torn during a whiplash trauma. These tears, then, can lead to disc degeneration or herniation, resulting in irritation or compression of the nerves running through the area. This compression or irritation commonly leads to radiating pain into the arms, shoulders and upper back, and may result in muscle weakness.
If there is a herniated disc, our providers can do many things such as prescribe anti-inflammatory medication and muscle relaxants or do procedures such as trigger point injections and epidural spinal injections.
After neck pain, headaches are the most prevalent complaint among those suffering from whiplash injury, affecting more than 80% of all people. While some headaches are actually the result of direct brain injury, most are related to injury of the muscles, ligaments and facet joints of the cervical spine, which refer pain to the head. Our providers will work to assess the true cause of the headaches and work with you to make an individualized plan of care. TMJ Problems
A less common, but very debilitating disorder that results from whiplash is temporomandibular joint dysfunction (TMJ). TMJ usually begins as pain, clicking and popping noises in the jaw during movement. If not properly evaluated and treated, TMJ problems can continue to worsen and lead to headaches, facial pain, ear pain and difficulty eating. Our providers can do nerve blocks on the trigeminal or occipital nerves to treat the pain.
Mild to moderate brain injury is common following a whiplash injury, due to the forces on the brain during the four phases mentioned earlier. The human brain is a very soft structure, suspended in a watery fluid called cerebrospinal fluid. When the brain is forced forward and backward in the skull, the brain bounces off the inside of the skull, leading to bruising or bleeding in the brain itself. In some cases, patients temporarily lose consciousness and have symptoms of a mild concussion. More often, there is no loss of consciousness, but patients complain of mild confusion or disorientation just after the crash. The long-term consequences of a mild brain injury can include mild confusion, difficulty concentrating, sleep disturbances, irritability, forgetfulness, loss of sex drive, depression and emotional instability. Although less common, the nerves responsible for your sense of smell, taste and even your vision may be affected as well, resulting in a muted sense of taste, changes in your sensation of smell and visual disturbances.
Low Back Pain
Although most people consider whiplash to be an injury of the neck, the low back is also commonly injured as well. In fact, low back pain is found in more than half of rear impact-collisions in which injury was reported, and almost three-quarters of all side-impact crashes. This is mostly due to the fact that the low back still experiences a tremendous compression during the time of injury, even though it does not have the degree of flexion-extension injury experienced in the neck.
Recovery from Whiplash
With proper care, many mild whiplash injuries heal within six to nine months. However, more than 20% of those who suffer from whiplash injuries continue to suffer from pain, weakness or restricted movement two years after their accident. Unfortunately, the vast majority of these people will continue to suffer from some level of disability or pain for many years after that, if not for the rest of their lives.