Flick

Whiplash is a traumatic event that affects the cervical spine. In most cases it occurs as a result of a sudden movement of the head that exceeds the physiological limits of joint excursion.

Causes

The damaging mechanism is typical of motor vehicle accidents, especially those in which the vehicle suffers a violent rear-end collision.

When the car is hit the seat and driver suffer a strong acceleration that projects them forward. The weight of the head tends to retain its initial position by inertia and, while the rest of the body is pushed forward, the head is pressed against the headrest (hyperextension damage).

Then the head is projected forward with a higher speed than the rest of the body (hyperflexion damage).

If the car does not have a headrest, or these are incorrectly adjusted, the hyperextension damage will be greater. In the absence of airbags, hyperflexion injuries will be more serious as the head will not be braked in its stroke and will crash into the steering wheel violently.

Whiplash can also occur for traumatic events related to sports gestures or other types of accidents. In these cases the impact occurs more easily in an oblique direction, projecting the head laterally and causing more consistent vertebral damage.

Consequences

If we imagine the neck as a structure stabilized by a dense network of elastic bands, we can easily understand what the origins and consequences of whiplash are.

When the garment is strongly accelerated, the elastic resistance limit is exceeded and the individual fibers fray more and more until they are completely torn (muscle tear).

Fortunately, in most cases the trauma is not so violent as to cause muscle fibers to break.

In the characteristic whiplash only a simple stretching of the muscles and cervico-nuchal ligaments occurs. Furthermore, our body has the ability to regenerate damaged tissues even if they never reach the level of efficiency of the originals.

Whiplash and its consequences

When examining the possible consequences of whiplash, the extreme complexity of the cervical tract must always be considered both anatomically and physiologically. In fact, many fundamental vessels and nerves for the life of the individual run in it. It is no coincidence that these structures are enveloped by a solid bony, muscular and ligamentous scaffolding that protects them in the event of trauma.

The extent of the injury is directly proportional to the intensity and violence of the impact, which together with the symptoms and the physical examination constitutes the basis for a correct diagnosis.

In less severe whiplash injuries there are only muscle and ligament injuries with marginal involvement of the joint structures. However, these traumas should not be underestimated because their negative consequences can also occur in the following days with the appearance of the classic "protective reflex muscle contracture". It is essentially a defense mechanism that our body adopts by contracting the cervico nuchal musculature. In this way, if on the one hand all those movements capable of worsening the situation are prevented, on the other hand the cellular repair processes can proceed smoothly.

Symptoms Light Injuries

To learn more: Symptoms Bang Shot

The result of all these damaging effects translates into the classic symptoms of whiplash, generally characterized by:

  • cervical pain Icervicalgia),
  • ringing in the ears,
  • stiffness in the muscles of the back and neck,
  • headache
  • movement limitations.

Symptoms Severe Injuries

If the traumas of muscular, bone and ligamentous nature are quite frequent, the same cannot be said for those affecting the nervous structures.

However, as the extent of the trauma increases, the lesions can also affect the intervertebral disc and adjacent structures with the appearance of symptoms such as:

  • paresthesia (tingling),
  • brachialgia
  • sciatica.

In the most serious cases, alterations of the spine, of the physiological balance of the pelvis and even of the temporomandibular joint may also occur.

However, the worst situation appears when whiplash is associated with actual ligamentous breaks, disc herniations and vertebral fractures. In these situations the gravity of the lesion is outside the definition of whiplash that we have seen to be characterized by much more superficial lesions. Suffice it to say that a break in the spinal cord contained in the cervical vertebrae causes paralysis of the limbs and, if it occurs at the level of C1-C2, it is even lethal.

Get well with whiplash

See also: Whiplash treatment drugs

The factors that come into play during an accident are so numerous that they require different therapeutic treatments for each individual case.

A decrease in strength in grasping, coordinative deficits and tendon reflexes are elements that already at first clinical examination suspect an involvement of nervous structures. In these cases, especially if the impact has been rather violent, it is good to report symptoms and dynamics of the accident to the health professionals who will carry out diagnostic tests such as X-rays and CT scans to highlight the actual extent of the lesions.

Since many symptoms appear only several hours after the trauma, it is advisable to contact the nearest emergency room in advance even in the absence of pain. Only a specialist examination will thus be able to diagnose the true extent of whiplash and prescribe the most appropriate therapies.

Rest is initially the most effective means of healing. In this phase the movements of the neck and head will be limited to the maximum. Often the first measure taken by the doctor is to apply the collar, which with its support action protects the cervical tract both from incongruous movements and from other types of stress.

Thanks to immobility, tissue inflammation can regress slowly, especially if it is combined with appropriate drugs.

The most useful medications for treating whiplash are those with anti-inflammatory, pain-relieving and muscle relaxant (NSAID) action. If pain interferes with night rest or anxiety, tranquilizing and sedative medications are also prescribed.

After the acute phase of the trauma, more or less after ten to twenty days, the use of drugs and collar is definitively abandoned. At this point in the rehabilitation process, physical therapies and manipulations are introduced.

To tell the truth, given that the beneficial effect of some treatments is valid also in the acute phase, there are those who advise to undergo these therapies after only a few hours after the trauma. However, these operations are rather risky, especially if performed by a person with little experience; for this reason in most cases it is preferred to wait until the inflammation regresses at least partially.

On the other hand, it is also true that excessive rest tends to delay healing by causing the symptoms to become chronic. Prolonged use of the collar, for example, effectively inactivating the musculature, makes it completely ineffective in dealing with the stresses to which it will be subjected in the absence of artificial support.

Already after a few days, depending on the severity of the whiplash, it is therefore possible to start with the first voluntary isometric contractions which will subsequently be replaced by active manipulations and exercises.

Physical therapies thanks to their analgesic and curative effect are useful to accelerate the healing process. Among the most widespread means we mention ionophoresis, electrotherapy, laser therapy, physiotherapy and decontracting massages. By increasing the blood supply in the region, all these treatments allow you to regain lost health in a very short time.

As for the manual therapies that accompany the intervention of physiotherapists, massophysiotherapists, kinesiologists, agupontors, osteopaths, chiropractors and so on and so forth, you must first know how to choose.

Without going into the matter, we say that all these techniques are supported by more or less recognized scientific studies, which testify to their curative effectiveness in treating whiplash. Rather than wondering which of these therapeutic means is better (considering the extreme variability of the trauma it is not so easy to establish a priori the real effectiveness of the various methods) the patient should make sure in advance of the experience and the degree of professionalism of the therapist.

Only qualified professionals, in possession of specific certificates and a considerable wealth of experience, are in fact able to customize the therapy adapting it to the individual case and taking into account any pre-existing structural alterations.

Following a rehabilitative path after a whiplash is of fundamental importance because it ensures a better recovery from the injury. In the absence of this precaution, the pain could become chronic, worsen or appear even after several months, creating considerable discomfort for the patient.

Prevent whiplash

Since the symptoms of whiplash are very similar to cervicalgia (cervical pain) it is important to take precautions to protect the neck even from the countless daily stresses. It is no coincidence that cervicalgia ranks in second place among the most widespread painful pathologies of skeletal muscle or neuromuscular origin.

Incorrect posture, incorrect positions taken during study, work or sleep, anxiety, stress, cold, excessive and repeated overload on the neck muscles are among the main causes of cervical pain.

In addition to controlling the positions taken during the day, following a regular program of physical activity helps to prevent, but also improve, the symptoms of neck pain.

Let us first say that there is no specific physical activity and that any sport involving upper limbs in movement can be useful. Obviously some targeted exercises such as postural, column mobilization, coordination and stretching exercises have a superior beneficial effect.

Mistakes in the execution or in the choice of the exercises can however worsen the situation (characteristic is the help with the hands pulling on the neck during the training of the abdominals). For this reason it is very important to be followed, at least initially, by an expert trainer who must be informed about any pathological conditions.

In the article "Exercises for the cervical vertebrae", stretching movements that are useful to lengthen the neck muscles and prevent whiplash are amply illustrated.

Our advice

  • Adjust the headrest by positioning it so that the top is about five centimeters above the top edge of the ear
  • While driving keep your back well supported by the seat; bust and head must remain straight since if the back and head are curved forward the distance between the occiput and the headrest will be too high to protect the head from hyperextension; for the same reason, if the headrest can be adjusted forward and back, position it so as not to exceed 6 cm away from the occiput
  • In situations where there is a risk of collision (fog, traffic lights, etc.), take the precautions foreseen by the highway code (lights, rear fog lights, arrows), avoid sudden braking, etc.
  • In the event of whiplash, contact the nearest emergency room immediately, both to verify the absence of bone and ligament lesions, and to have a useful document if insurance compensation is requested
  • Keep yourself healthy by regularly practicing physical activity; in this way the cervical musculature will acquire strength and elasticity protecting this area in case of trauma

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