What is Whiplash Syndrome?

Whiplash syndrome is the chronic form of whiplash injury, a neck strain that can occur after a nonfatal auto accident. The mechanisms behind whiplash include hyperflexion, hyperextension, and various injuries to the cervical or neck region. Although usually associated with vehicular collisions, whiplash syndrome can also result from falls, horse riding injuries, bicycle accidents, and other sports-related accidents. Most people who have whiplash fully recover, but a few experience whiplash syndrome, which is characterized by continuing symptoms of neck pain, back pain, abnormal sensations in the arms, and headaches.

In medical terms, whiplash injury is called cervical acceleration-deceleration injury, in reference to the mechanism wherein the cervical spine is injured by the initial forward motion of the neck, followed by a backward motion. Damage to structures such as the intervertebral disks, vertebral ligaments, vertebrae, face joints, and joint capsules can be minimal or extensive. When muscular tears occur, muscle spasms immediately follow. Together with edema or swelling, the muscle spasms prevent further injury to the neck by serving as a natural splint, and facilitate the healing process of the damaged connective tissues.

Common symptoms of whiplash injury include neck pain, headache, shoulder pain, visual changes, dizziness, concussion, and numbness or weakness of the arms or legs. Some people complain of these symptoms right after the traumatic event, but others experience these issues a few days post-injury. The areas of affectation are usually limited to the neck and the middle of the back.

The Quebec Task Force (QTF) has developed a grading system for whiplash disorders. Grade 0 means there is no neck pain, stiffness, or any other physical signs noted. If there is a complaint of pain, stiffness, or tenderness of the neck but the examining doctor observes no physical signs, then it is grade 1. Grade 2 means that in addition to neck symptoms the examining physician notes a point of tenderness in the cervical area, together with decreased range of motion; grade 2 symptoms accompanied by neurological symptoms such as weakness, sensory deficits, and decreased deep tendon reflexes is classified as grade 3. Finally, grade 4 means that in addition to the neck complaints the spine is fractured or dislocated, or the spinal cord is injured.

Whiplash disorders falling under grades 1 to 3 can be treated through manipulation, mobilization, and exercises that restore range of motion. Pain relievers, such as nonsteroidal anti-inflammatory drugs, may be used for three weeks. A cervical collar may also be recommended. These measures are important in the prevention of the transformation of whiplash injury into whiplash syndrome.

When whiplash syndrome occurs, the affected person suffers from frequent headaches, reduced range of movement of the neck, back pain, sleep disturbances, fatigue, and diminished libido. This syndrome is difficult to treat and can only be managed through rehabilitation focusing on return of function. Rehabilitation, however, may not be able to completely relieve the long-standing neck discomfort associated with whiplash syndrome.


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