What is Whiplash?
Whiplash presents itself in numerous ways, but it is primarily associated with head, neck, and/or upper back pain preceded by an event where a person’s head and neck are jolted back and forth in rapid succession. It most commonly occurs as neck pain after a car accident, but also could be the result of any extreme sport or event where high acceleration and deceleration are possible.
Signs and Symptoms
Symptoms of whiplash can vary based on the event that caused them, but they range from physical pain and stiffness all the way to neurological issues. Some of the potential symptoms are:
- Neck pain
- Neck stiffness
- Neck instability or dizziness
- Shoulder and/or upper back pain
- Tingling, weakness or numbness radiating to the extremities
- Blurred vision
- Behavioral changes such as irritability, anger, or depression
- Ear ringing
- Suddenly poor quality sleep
- Cognitive issues in memory or lacking concentration
Potential Causes of Whiplash
The most common cause of whiplash is a car accident, most often rear-end collisions. However, sports like football, hockey, skiing or snowboarding also have the potential for sudden jolts of the head and neck. Assault or violent shaking can cause whiplash, in infants, this is referred to as shaken baby syndrome. Beyond that, extreme sports and other activities like riding roller coasters can cause whiplash as well.
Whiplash Injury Classifications
The number of symptoms one person can have is numerous after a car accident. Some patients show hardly any symptoms while others may suffer from chronic neck pain and neurological disorders. The Quebec Task Force created a classification system for the levels of whiplash injury.
- Grade 0: no pain or physical signs
- Grade 1: neck pain, stiffness, or tenderness, but has no limits in neck range of motion, strength, or swelling
- Grade 2: Grade 1 + limits in neck range of motion, neck, back, or shoulder strength, and/or swelling of the neck
- Grade 3: Grade 2 + neurological signs such as weaker muscles or sensory issues
- Grade 4: Grade 3 + fracture or dislocation of the cervical vertebrae
Diagnosing whiplash requires patient history, a questionnaire, and evaluation. The questionnaire will consist of what symptoms, the location of the symptoms, how and when the symptoms occurred and the level of pain the patient is in. During the evaluation, postural alignment is observed, the neck is palpated for tenderness, and the neck is tested for strength and mobility. If the pain is mild and neck range of motion is normal, then further evaluation wouldn’t be necessary. If there are limitations in mobility, strength, or anything leading the doctor to believe it could be a Grade 2 injury or higher than diagnostic imaging would need to be performed to check for structural issues to the head, neck, and back.
Chiropractic treatment for whiplash would primarily be done for Grade 2 severity and below, while potentially helping with neck pain management for Grade 3. If there is a fracture of the spine, the patient would need to be referred to a specialist.
If neck range of motion is limited, manual manipulations of the head and neck can relieve neck pain and open back up its range of motion. Also, acupuncture has shown to be an effective technique for neck pain relief as well.
Beyond clinical care, whiplash patients would be best taking a break from highly physical activities and rest until the pain subsides. Icing the neck is also recommended for natural pain management.
Most patients recover within a few months after the injury, however more severe cases – Grades 3 and 4 – may take longer and require further treatment from a licensed specialist.