Treating Whiplash

What causes whiplash? Whiplash occurs when the soft tissue in the spine is stretched and strained after the body is thrown in a sudden, forceful jerk. The injury most commonly occurs in car crashes involving sudden deceleration, but the injury can also occur in other strenuous physical activities such as diving.

What does whiplash feel like?

The most frequent complaints are headaches and stiffness in the neck and the back of the head. These symptoms appear within the first couple of days after the accident and usually pass after a few days to a few weeks.

Is whiplash dangerous?

A doctor or hospital should be alerted if the patient experiences memory loss or periods of unconsciousness after a collision. This is especially the case if the patient experiences severe pains in the back of the head, pins and needles in the shoulders and arms or notices a sensation of heaviness in the arms.

Is there anything the patient can do about whiplash injury?

In the first 24 hours after the injury, an ice bag applied to the neck will help to relieve inflammation.

Bags of frozen peas make particularly good ice packs because they mould to the body.

An ice bag should first be wrapped in a towel or cloth to avoid direct contact between the skin and the ice. The patient should lie in bed with their head resting on the ice bag for 20 minutes at a time, with the head also supported by a pillow.

If normal painkillers such as paracetamol (eg Panadol) do not help, consult your GP.

Here's an exercise to relieve pain and stiffness in the neck and back of the head.

• Stand against a door or a wall with your head facing forward and move your eyes so you look towards the two, four, eight, and 10 o'clock positions. Repeat this a few times. This eye movement causes a slight movement in some deep muscles in the back of the head.


• Next, take a step forward and perform the following movements.


• Bend the back of the head carefully forward as if taking a bow. Return to the starting position with your head straight and facing forward.


• Draw the chin in towards your neck and bend the head carefully forward. Return to the starting position. Bend the head backwards far enough to look at the ceiling. Return to the starting position.


• Tilt the head sideways, so the right ear is near the right shoulder. If possible try to maintain the glance at a fixed point at eye level. Return to the starting position. Repeat this action with the head tilted to the other side.


• Turn the head as if trying to look backwards over the shoulder, first to the left and then to the right. Imagine following a horizontal line on the wall at eye level.


• You can also use a beach ball or a soft ball to exercise the head and neck muscles. Place the ball between the wall and the forehead and then try to move it around on the wall in circles or figures of eights. Repeat the exercise, this time placing the ball between the back of the head and the wall.

How does a doctor diagnose whiplash?

Usually the diagnosis is made on the basis of the background of the injury and the patient's description of symptoms. Whiplash cannot be seen on an MRI scan, CT scan or X-ray, although an X-ray is taken if there is a suspicion of fracture or dislocation of the cervical spine.

Exercise

Research has shown that whiplash patients who rest for several weeks and wear a soft collar actually recover more slowly than those who try to follow a normal routine.

Patients with acute pain in the cervical region of the spine are advised to start their neck exercises as soon as possible and to get out of bed within two to three days.

Outlook

The risk of sustained after-effects is very small and the chances for complete recovery are good. However, whiplash is still a strain injury and, as with other strain injuries, it is not unusual for the pain to last for a couple of months.

Whiplash syndrome

A few people develop continuing symptoms after a whiplash trauma and develop what is known as whiplash syndrome. They suffer continual headaches and pain, reduced movement at the back of the neck, tingling in the arms, lumbar pains, fatigue, sleep disruptions and reduced libido.

Whiplash syndrome is difficult to treat. The essence of the treatment is to prevent any further strain and encourage a quick return to normal everyday activities.

Unfortunately, in a very small number of people who have experienced a severe whiplash injury, symptoms can persist for months or even years before settling and even then there can even be residual long-term neck discomfort.

How is whiplash treated?

There is no single treatment for whiplash that is widely accepted among doctors.

If there is no suspicion of a fracture or dislocation, the patient should begin exercising and pursuing normal activities as soon as possible. In some cases it may be necessary to supplement an exercise programme with painkillers.

Further advice on exercise and recovery can be sought from a physiotherapist or chiropractor. For most people the injury will simply pass after a short period.

What medication can be used to treat whiplash?

Paracetamol (eg Panadol) and NSAIDs (non-steroidal anti-inflammatory drugs) can be given for short periods for pain in the back of the neck and headaches. A doctor should be consulted first.