The symptoms of whiplash usually arise in a rear-end collision due to a violent neck flexion to or from the side, followed by a very rapid movement in the opposite direction.
Whiplash is also defined as cervical spine distortion (cervical spine distortion).
The classic whiplash is caused by a rear-end collision, the head is thrown forward and the neck is bent beyond its physiological limits; immediately afterwards there is a violent rebound against the headrest (whiplash phenomenon).
It is important to know the dynamics of the accident so that an appropriate treatment programme can be established.
The problem of whiplash is by no means only in the inflammation of the cervical spine, as is often assumed, but can also cause the following injuries: intervertebral disc damage (discopathies), herniated discs, ligament lesions, muscle tension and joint blockages.
The neck pain and other symptoms can occur even if the rear-end collision occurred at low speed.
Why does the patient still feel pain after performing physical therapies (TENS, ultrasound, etc.), which soon becomes chronic?
Often the patient has complaints of a mechanical nature, i.e. a vertebra has twisted or shifted minimally, perhaps only by one millimeter, which cannot be seen on the X-ray.
Whiplash injury can not only be limited to the cervical spine, many sufferers also complain of pain in the thoracic and lumbar spine, as well as in the lower jaw, in some cases even on the wrist or elbow.
The cervical vertebrae are numbered from top to bottom and are indicated by the letter “C”, followed by the number indicating the position of the vertebra: (C3 is therefore the third vertebra from above).
In a rear-end collision, there is a violent overextension of the cervical spine, which is referred to as a cervical spine distortion.
Whiplash can cause a herniated disc, even in young people; 20-year-olds come into practice with intervertebral disc protrusion or prolapse, which are mainly at the level of C6-C7, C5-C6 and C4-C5.
There can be no herniated discs in the upper cervical region because there is no disc between the occipital bone, C1 and C2.
What is the cause of whiplash?
In most cases, whiplash occurs in a rear-end collision with a car, but it can also be caused by a sporting collision or emergency braking in the car.
If the affected person was strapped in, he only risks whiplash, otherwise he can be thrown forward and hit his head against the windshield.
If the headrest is positioned correctly, i.e. a maximum of 5 cm from the head, and the back is firmly attached to the backrest, the effects of the trauma are smaller.
What are the symptoms of whiplash?
It is important to know that whiplash does not cause immediate pain, often the symptoms do not become noticeable until the next day.
The symptoms vary according to age, state of health of the person concerned, severity of the trauma. The symptoms include: pain and restriction of movement in the cervical spine, stabbing pain in the arm, headache, dizziness, nausea, vomiting, feeling of drowsiness, disorientation, visual disturbances, rarely also difficulty swallowing, tingling in the region between the neck and hand and pain in the lower jaw.
If the affected person’s neck was twisted or tilted to the side at the moment of impact, the pain will be stronger and recovery times will be longer.
In rare cases, the body reacts with fever in the first two days.
As a rule, most of these symptoms disappear on their own over the course of several days.
Most patients come to the practice with a completely blocked neck because the painful stitches are unbearable or because they are afraid to move it.
Only in the case of severe trauma can long-term consequences occur, such as damage to the brain and cranial nerves.
In the post-acute period, behavioral changes may occur, manifested by sleep disorders, depression or increased irritability.
The injured person may have a neck straightened by the trauma, but he may have been straight before; this condition is not a cause for concern, it should not cause any problems.
If the patient has no vertebral fractures, the symptoms may be caused by a herniated disc or the displacement of the cervical vertebrae.
Children can have the same symptoms as adults, although this is much less common, because the child’s spine is better hydrated and a herniated disc is extremely rare before the age of 20.
Whiplash affects not only the neck, but also the lower region of the back; the first trauma occurs at the level of the lumbar eule and pelvis.
Whiplash victims often come to the practice with low back pain (lumbalgia) and accident-related restriction of movement.
Which imaging techniques are used for whiplash?
After whiplash, an imaging diagnostic procedure is not necessarily necessary, but it should be taken into account that the pain may occur the day after the accident and it makes sense to carry out the necessary examinations.
The doctor in charge is an orthopedist who will first perform a physical examination and then prescribe diagnostic imaging procedures.
X-rays are particularly useful here, on which bone fractures, bone changes such as spondylolisthesis and dislocations are (rarely) visible.
An X-ray from the side shows vertebrae C3 to C7, but for a view of the second vertebra and the axis tooth, an open-mouth image must be taken, because the first two vertebrae are at the level of the teeth.
Magnetic resonance is helpful in case of pain radiating into the arm, tingling in the hands, dizziness or mental confusion, because it also indicates the soft tissues.
A herniated disc or protrusion can cause pain radiating into the hand, as well as numbness, loss of strength and sensitivity.
In this case, the doctor may also prescribe electromyography (EMG) to assess the condition of the nerves.