Whiplash is one of the most common consequences of a motor vehicle collision. It may not always be immediately evident after a car accident. In fact the symptoms usually arise after 24 hours and can last for months but it is not common for whiplash to lead to chronic problems. People with previous neck injuries or musculoskeletal conditions affecting the neck are at a greater risk for chronic neck pain triggered or worsened by whiplash.
Whiplash can affect any person involved in the collision, both the driver and passengers. It is more likely to arise with rear-end collisions. Whiplash can also occur without being involved in a motor vehicle accident. It is known to occur as part of sports injuries (particularly contact sports), falls, assault and other forms of trauma. An estimated 1 million whiplash injuries occur every year in the United States due to motor vehicle collisions.
What happens in whiplash?
Whiplash is a type of neck strain that occurs when the head is forced backward and then forward. This is also known as cervical acceleration-deceleration injury. It arises when the body is in motion and then suddenly stops with the head whipping back and forth at the neck due to this instantaneous change in speed. This causes stretching and even tearing of the ligaments, muscles and tendons.
There can also be intervertebral disc and facet joint injury. In severe cases the bones may also be involved and whiplash can lead to fractures. In addition there is usually some degree of injury to the nerves in the area, such as compression, stretching and so on. Along with the neck injury, whiplash is often accompanied by a concussion. This is a result of the brain striking the inside of the skull with the sudden and forceful head movements.
How to Spot Whiplash
The first symptoms of whiplash may not occur for at least 12 hours but sometimes for as long as 24 hours. Many people who do not sustain any other injuries with a car crash therefore do not realize that they have whiplash immediately after the accident.
There are also usually no significant abnormalities with diagnostic investigations like x-ray, MRI and CT scan. However, these investigations should still be done to rule out other serious injuries that may occur with a motor vehicle accident or related trauma. Some of these serious injuries may also not present with any symptoms initially.
Neck Pain and Stiffness
Neck pain and stiff neck are the most common symptoms of whiplash. It becomes evident anywhere from 12 to 72 hours after the injury. There is also loss of range of motion meaning that the neck is not able to move to the extent that it normally can, which is commonly referred to as a stiff neck. The pain tends to worsen with movement of the neck. Coupled with the stiffness, this pain with motion may result in an inability to move the head in severe cases.
Headaches and Other Pain
Most people will report headaches of varying intensity for days, weeks or even months after the injury. Usually these headaches start at the base of the skull. These headaches are known as cervicogenic headaches. Along with the headaches there is pain and tenderness in the shoulders, arms and upper back. Depending on the extent of the injury there may also be weakness of the muscles of the shoulder, arms and upper back.
A range of sensory disturbances may arise with whiplash. The more common such disturbances includes numbness and tingling of the arms. This is more likely to occur in severe whiplash which results in compression or damage of the nerves arising from the cervical spine. The nerve disturbances may also impact on the motor nerves leading to arm weakness
The disturbances are not limited to the arms. In severe cases of whiplash there may also be blurred vision or double vision. There may also be tinnitus which is a ringing or roaring sound in the ears due to disturbances of the hearing apparatus and nerves. Dizziness may also occur as visual and vestibular (the apparatus responsible for balance) impulses to the brain are confused.
Irritability, difficulty concentrating, poor memory and mood disturbances like depression or anxiety may also arise with whiplash. This may be due to a number of factors. Firstly, these mental symptoms may be part of a concussion. Even after the concussion subsides these symptoms can continue due to post-concussion syndrome. Furthermore the pain and restricted movement can also impact on mental wellbeing.
Many people with moderate to severe whiplash report problems sleeping. It can also occur for a few days with mild whiplash. These sleep symptoms arise for several reasons. Firstly concussion can disturb normal sleep patterns. It may also continue long term in post-concussion syndrome.
Secondly the pain (neck, head, shoulders, arms, upper back) may also affect the ability to sleep. Similarly the stiffness and pain may require a person to lay in awkward positions which therefore affects sleep duration and quality. The psychological impact of the event that resulted in the injury could also play a role in sleep disturbances.
Late Whiplash Syndrome
The following signs and symptoms may be seen with late whiplash syndrome. This is where acute whiplash symptoms are ongoing beyond a period of time where the whiplash should resolved. It is believed to be due to nerve damage but the exact mechanism of late whiplash syndrome is not fully understood.
Memory and concentration problems
Always consult with a medical professional after any trauma that may result in whiplash. Even with minor car accidents it is important to consult with a doctor. If this has not happened, then medical attention should be sought immediately once whiplash symptoms arise.
It is important to note that late whiplash syndrome needs to be diagnosed by a medical professional. There are many serious and even life-threatening conditions, which are not due to trauma, that may give rise to symptoms similar to late whiplash syndrome.