Injury Articles

Cervical Whiplash

By December 12, 2016 No Comments

What you might be feeling

Pain in the neck, shoulders, back, head or arms following a high speed incident most commonly in a motor vehicle accident. The pain doesn’t necessarily come on immediately but is often associated with other symptoms such as pins and needles.

What’s really going on inside

This is most common in motor vehicle accidents when the head is suddenly jerked back and forth beyond its normal limits, the muscles and ligaments supporting the spine can be over-stretched or torn. As the vehicle accelerates forward, it pushes the body forward too, but the head remains behind momentarily, rocking up and back, until some of the muscles and ligaments are stretched or torn.

It can also occur in sports when the cervical spine is suddenly extended in contact with the ground or by a direct blow from an opponent.

Symptoms

Symptoms include:

    • Neck pain and/or stiffness
    • Blurred vision
    • Difficulty swallowing
    • Irritability, Fatigue, Dizziness
    • Pain between the shoulder blades
    • Pain in the arms or legs, feet and hands
    • Headache
    • Low back pain and/or stiffness
    • Shoulder pain
    • Nausea
    • Ringing in the ears
    • Vertigo
    • Numbness and tingling
    • Pain in the jaw or face

Complications

The pain generally arises from damage to the cervical discs. It also affects muscles, ligaments, capsular tissue and the dura (covering of the nerves) . This can be a difficult condition to treat as the damaged discs may undergo progressive degeneration. Over time this can lead to altered biomechanics of the joints and thus further joint damage.

How a physio can help

Initial treatment:

Sometimes a cervical collar in the first few days after injury can help to control the inflammation, but should be weaned off after 4-6 days to get some gentle movement occurring.

Local pain relieving modalities or an anti-inflammatory may also help in the initial period.

Secondary treatment

Manual therapy, especially mobilisation, and manipulation will gently assist range of motion. The best results often occur when there is a combination of active range of motion exercises such as gentle mobilisation, massage therapy and gentle stretching.

As the condition improves

Massage and mobilisation will become deeper and more specific to regions of dysfunction.

Once the pain has started to settle and movement has returned to normal some strengthening exercises should be performed to improve neck stability. This treatment can take up to 6-12 weeks and occasionally pain and dysfunction may persist in the years to come depending on the extent of the injury.