Whiplash

General Information


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Description:

  • Ligamentous injury


Also called:

  • Whiplash


Types:

  • Hyperextension
  • Hyperflexion – often associated, see cervical spine injury


Organs involved:

  • Anterior longitudinal ligament
  • With mild injury – sternocleidomastoid
  • With moderate injury – scalenes, longissimus colli
  • With severe injury – pharynx, esophagus


Incidence/Prevalence:

  • Common
  • Estimated incidence about 4 per 1,000 persons (Am J Med 2001 Jun 1;110(8 ):651)


Causes and Risk Factors

Causes:

  • Motor-vehicle accident – struck from rear or deceleration, injury can occur at speeds as slow as 7 mph


Pathogenesis:

  • Acute hyperextension-hyperflexion of cervical spine, inertia of head and momentum of thorax; edema and microhemorrhage serve as foci for muscle irritability, irritation of occipital and suboccipital nerves


Complications and Associated Conditions

Associated conditions:

  • Paravertebral muscle injury
  • Cervical radicular pain and radiculopathy
  • Cervical cord compression
  • Vertebral fracture
  • Concussion
  • Post-traumatic headache
  • Fibromyalgia (controversial)
  • Depression
  • Chronic pain syndrome
  • Post-traumatic stress disorder (PTSD)
  • Impingement syndrome of rotator cuff reported in 11 of 220 (5%) patients with medicolegal report following whiplash injury of neck, possibly related to direct seatbelt trauma to shoulder (J Orthop Surg 2008 Jun 27;3:25)

 

Imaging Studies

  • x-ray normal
  • review of cervical spine x-rays and decision-making in trauma patients can be found in Am Fam Physician 1999 Jan 15;59(2):331, commentary can be found in Am Fam Physician 1999 Oct 1;60(5):1318 and in Am Fam Physician 2000 Jun 1;61(11):3245

Treatment Overview

Early mobilization improves pain and hastens return to full function compared to rest and prolonged use of cervical collar, based on randomized trials

Activity:
Conservative therapy recommendations often include local heat (or ice in first 48 hours), cold laser, and chiropractic care
neck immobilization not recommended, but may be needed acutely until fracture ruled out
advance activity as tolerated
no evidence of benefit sufficient to recommend rest, immobilization or traction

If you think you may suffer from whiplash injury, please contact our office to schedule an appointment with one of our chiropractors today Call us at 720-515-8002 or 303-927-6181. Proper management is critical in the recovery from whiplash injuries and to prevent future damage. If you live in or around Centennial, Littleton, Highlands Ranch, we will gladly answer any of your questions and provide you with the best treatment options available to you.