Whiplash (cervical acceleration-deceleration or CAD syndrome)
Whiplash is also known as cervical acceleration-deceleration syndrome. This condition refers to the sudden and rapid backward-forward force on the neck and head – exposing the cervical spine to extreme stress specifically in the facet joints and intervertebral discs. (The cervical spine is the upper portion of the spine located in the neck region. The facet joints and intervertebral discs are responsible to sustain mobility in the spine.) This prevents the muscles from stabilizing and protecting the spinal cord, causing the neck to whip into full flexion. This commonly occurs in motor vehicle accidents. It can also be caused by other physical traumas such as sports, bungee jumping and roller coaster. The result of the sudden blow to the cervical spine can lead to a whiplash injury or whiplash associated disorders. People who suffer from the whiplash injury usually recover in a couple of months, while those who suffer associated disorders are in a more severe and chronic condition where excruciating symptoms can sometimes linger for years.
Whiplash is considered to be a common injury. Unlike degenerating spine conditions that are mostly caused by the natural aging process, the causes for whiplash are not gradual in nature. The following are common causes for a whiplash injury:
As mentioned above, rear end collisions in motor vehicle accidents are the most common cause of this injury. The accelerating seat behind the person pushes against the person’s back which subjects the cervical spine to extreme forces and compressing it against the head. The torso accelerates forward but the head doesn’t because it has not yet hit the head rest. This causes the natural c-shaped lordosis curve of the cervical spine to deform to an s shape. When the head has finally hit the head rest, it causes it to accelerate forward, whipping the head and neck into full flexion. Plenty of excruciating symptoms can result from the whiplash.
Physical abuse or assault
The same mechanism can occur if a person is punched or shaken, causing their neck and head to move in a sudden backward-forward force. This injury is found to be common in shaken baby syndrome.
High-impact sports and activities can cause whiplash as well. Things like tackles and collisions can lead to it.
Symptoms can almost always be immediately felt after twenty-four hours of the whiplash. The following are example of the common symptoms of whiplash:
- Neck pain
The severity of the pain will depend on the severity of the accident. The pain can be in one spot or it could possibly radiate to the shoulders and arms. The neck pain is caused by ligament and muscles strains, but could also be from tears in the discs, nerves, joints and bones.
- Stiffness and Instability
Stiffness in the neck or reduced mobility could be caused by tightening in the muscles or other mechanical problems in the joints of the spine. It could also cause instability due to torn ligaments.
- Tingling, weakness and Numbness
During the whiplash, the sudden force can cause the nearby nerves in the cervical region of the spine to become inflamed. This leads to the tingling, weakness and numbness that can radiate down to the shoulders, arms and hands.
Other symptoms can also include:
When muscles tighten from the whiplash or nearby nerves become irritated, this can cause headache that often starts at the base of the skull.
Dizziness from the whiplash can be caused by the instability in the neck because of torn ligaments, but it can also be caused by a concussion.
- Blurred Vision
This too can also be caused by affected nearby nerves during the whiplash, but it could also be caused by a concussion.
- Memory problems
Difficulty remembering can also be caused by certain brain injury caused during the occurrence of the whiplash.
- Sleep disturbance (Insomnia)
Having a hard time sleeping is also a symptom related to the whiplash associated disorders that may be caused by a concussion or pain and stress from the whiplash.
The following are examples of risk factors for incurring a whiplash condition:
- High-impact sports
Athletes who are involved in high-impact sports have a greater risk of getting a whiplash. For example football tackles can expose your head and neck to rapid backward-forward force and cause the player to have a whiplash.
Although a whiplash can occur with any gender, plenty of studies have evidenced that during accidents, women are far likely to have a whiplash than men.
- History of Neck Injury
Those who have already sustained neck injuries in the past are more likely to have a whiplash on the onset of an accident.
Persons of old age when caught in an accident are more likely to have a whiplash due to a worn out spine. Because of the natural process of aging, the spine will overtime deteriorate – making it brittle and less flexible.
Unlike degenerating spine diseases, there aren’t many life-altering habits in order to prevent a whiplash. Since whiplash is not gradual in nature but is rather caused by sudden exposure of the cervical spine to extreme forces such as motor vehicle and high-impact sports accidents, the best prevention methods can be as simple as wearing protective equipment.
For whiplash that is caused by a car accident, it usually happens because the headrest didn’t offer enough support to prevent it. So in case an accident occurs, it is important that the headrest is adjusted properly such that the top of the headrest lies in the same level as the tips of the ears. It must be located close to the head at least at two inches. Seats must not be reclined too much, specifically not more than twenty degrees. Wearing a seatbelt correctly also helps minimize the chances of getting a whiplash. There are also plenty of cars that are designed to prevent a whiplash in case a rear end collision occurs.
However, whiplash can also happen in other situations other than automobile accidents. It can also happen in sports. While prevention won’t altogether have a patient quit sports, it is important to wear the necessary protective equipment to reduce chances for having a whiplash.
The aim of treatment is to alleviate painful symptoms caused by the whiplash, to restore normal mobility to the neck and to allow the patient back to normal activities. It is important to work with a physician to determine the best treatment for a whiplash case. The doctor’s treatment can vary depending on the severity of the condition. Some may receive instructions for treatment that can be done at home, while others in severe cases may need medical treatment.
The following are examples of conservative treatment for a whiplash:
Rest may be required for the first twenty-four hours however, too much rest can also delay recover. It is important to still stay active, but resting means that one has to take it easy on certain activities for the first few days. Certain motions and activities can aggravate the pain in the neck. Hence, it is important to limit that motion or activity until the neck has healed more.
- Heat and Ice Therapy
Applying ice or cold packs during the first couple of days can reduce pain and inflammation or the swelling in the neck. It can close small blood vessels and prevent further swelling. This also offers relief from neck pain.
These are usually over-the-counter pain relievers such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs). Acetaminophen block pain receptors while NSAIDs can help reduce inflammation. This helps with mild to moderate pain suffered due to the whiplash.
- Prescription Medications
In certain cases, over-the-counter drugs are not able to alleviate the patient from painful symptoms. The physician can prescribe strength medications such as opioids and muscle relaxants. However, it is important to follow the physician’s instructions in these types of medications.
- Physical Therapy
A physical therapy treatment is done by a licensed physical therapist in order to restore mobility in the neck area and alleviate painful symptoms. In certain cases, it can relive the spine of stress and reduce the pain.
It involves exercises that aim to strengthen muscles, improve posture and restore mobility. Sometimes transcutaneous electrical nerve stimulation (TENS) is used – mild electric current is applied to the skin to relieve neck pain. However, plenty of research still needs to be conducted to prove its long-term efficiency. The physical therapist can also advise certain exercises and stretches that can be done at home.
Some patients will also resort to alternative treatments. While there are cases that have successfully treated certain spine conditions, there remains plenty of research to be conducted to prove its safety in the field of medicine.
Acupuncture is a traditional Chinese medicine. It uses the technique of inserting needles in the body that to fuel specific points in the body. It is important to get a licensed acupuncturist to perform the procedure. It is often reported to be safe and has little if no pain at all.
- Chiropractic care
This is a manipulative treatment for the spine for misaligned parts. Hands-on therapy and spinal adjustment is the core of chiropractic care. The main treatment consists of gentle stretches to muscles exposed to excessive tension. Again, it is best to consult a physician for advice on the well-known licensed Chiropractor.
Medical Care Treatment
This refers to professional medical care administered to a patient suffering from a whiplash condition. The following are some of those medical treatments:
It is composed of steroid and anesthetic medications. It is injected near the site of the compressed nerve that is causing painful symptoms. The injection acts as a temporary numbing agent and can help reduce inflammation. It can provide relief from symptoms for weeks and even months. The situation can vary for every patient.
- Radio-frequency neurotomy
This procedure uses heat to target specific nerves using radio waves to prevent the facet joints from sending the brain pain signals. This is done by inserting needles to the skin near the affected area in the cervical region of the spine to deliver the radio waves to the nerves. Imaging scans are used during the procedure to make sure they are placed in the right parts.