Not Just A Motor Vehicle Accident Injury
Whiplash is a common cause of
neck pain, and one that can be particularly hard to manage effectively. We see a lot of patients for physio for whiplash – often after motor vehicle accidents, but also resulting from contact sports, water sports and falls.
What is whiplash? And why does it occur in car accidents?
Whiplash is a type of neck injury that commonly occurs in
car accidents. It most often occurs in rear-end collisions. It happens when the head is forcefully thrown backward and forward after impact. This sudden and unexpected movement puts strain on the neck’s muscles, ligaments, and other soft tissues. Following this incident, there is often pain and muscle spasm. Thanks to the design of cars and seatbelts, the pain is often not associated with bad structural damage. The pain is part of our body’s warning system to protect us after unexpected force.
It is often the unexpected nature of it that can create much of the ongoing pain and spasm.
What structures are actually involved in whiplash?
It is important to note that nearly all structures of the neck undergo movement, stretch and strain in a whiplash event.
- The cervical muscles: these are stretched and strained in the quick whiplash movement. Also they can spasm and tighten afterwards to try to limit movement of the neck after the fact.
- Facet Joints: These are the parts of either side of the vertebra that articulate one vertebra to the one above and below it. The facet joint is a synovial joint – which means the joint surface is enclosed within a joint capsule. In whiplash, the facet joints can be stretched – resulting in strain in the facet joint capsule.
- Intervertebral Discs: Discs are the soft spacer between the vertebra of our spine. They provide shock-absorption and movement of the vertebra. In whiplash the disc can be strained. In very rare cases this can result in injuries to the disc.
- Nerves: The spinal nerves run through the spinal canal in the centre of the spinal cord. At each level of the spine, nerves exit to the spine to branch out to the body and limbs. In a whiplash event, these nerves can be stretched and irritated – particularly when the hands are held on the steering wheel – limiting the movement available in the nerve tissue. It is uncommon to cause a structural injury to the nerve tissue; but they can certainly become irritated by the abrupt movement of a whiplash event
The symptoms of whiplash can vary from person to person and may not always be immediately apparent after a car accident. They can range from mild to severe, and some symptoms may develop hours or even days after
the injury. This is often because of adrenalin at the time f the incident muting awareness of acute injury. Also, after an accident, in the absence of injury, there can be a delayed onset of protective pain. This can be viewed as the body using pain to prevent us from doing further injury.
Some of the most common symptoms that present for whiplash physio are:
- Neck pain and stiffness: The most prevalent symptom of whiplash is neck pain, often accompanied by a feeling of stiffness and reduced range of motion. This can sometimes manifest as severe movement inhibition where it can be hard and painful to lift the head off the pillow.
- Headaches: Headaches, especially originating from the base of the skull, are a common complaint among people with whiplash. There are many causes for headaches, and can result from concussion. They can also result from strains to the muscles, joints and discs in the upper cervical spine.
- Shoulder and upper back pain: The impact of whiplash can also cause pain in the shoulders and upper back, as the forces involved affect the muscles and ligaments in these areas. Patients can have sensation of spasm and tension in the muscles of the neck and back. There can also be referred pain into the mid back from irritated structures in the cervical spine.
- Arm pain and weakness: Whiplash may irritate or compress nerves in the neck, leading to pain, tingling, or weakness that radiates down the arms.
- Dizziness and vertigo: Some individuals may experience dizziness or a sense of spinning (vertigo) following a whiplash injury.
- Fatigue: Whiplash can cause general fatigue and difficulty concentrating or focusing.
- Jaw pain: In some cases, whiplash may also cause jaw pain due to the impact on the temporomandibular joint (TMJ).
- It’s important to note that these symptoms can overlap with other conditions, and a thorough medical evaluation is necessary to diagnose whiplash accurately. A consult with a physio for whiplash in the days after a car accident can be important in understanding the severity and cause of the symptoms.
- MRI and X-ray imaging can help rule out other potential injuries and confirm whiplash-related damage.
What is the best physio for whiplash treatment?
The treatment for whiplash pain depends on the severity of the injury and the specific symptoms experienced by the individual. It’s important to note that each person may respond differently to treatments, so a personalized approach is often necessary. Here are some common treatments and management strategies used by a physio for whiplash symptoms:
- Reassurance: Often getting movement and structures assessed and being reassured of no major injury is a huge part of the recovery process. This often helps the patient begin to restore normal movement patterns.
- Activity Modification: Physio for whiplash will often look at some activity modifications. This will usually involve trying to keep you as active as possible, while limiting aggravating movements. Often we want to keep muscles of the neck and upper back active with some light strength work, even when a return to the gym or formal exercise doesn’t feel possible.
- Active movement: Restoring active movement is key. These should be small comfortable movements to begin with, but can expand as pain and spasm allows. As mentioned above, a return to strength work is often possible earlier than expected, and can be really helpful as managing muscle pain and spasm.
- Pain Management: Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage mild to moderate pain. However, it’s essential to use these medications as directed and consult a healthcare professional if pain persists.
- Heat and Ice Therapy:Heat and cold can be used for mild pain relief, and to help soothe painful areas. Either heat or cold can be used for these, so take into account personal preference. A heat pack is generally more comforting for aching muscles and neck joints.
- Ergonomic Modifications: Making adjustments to the workplace or driving posture can reduce strain on the neck and promote better comfort, and more regular movement.
- Gradual Return to Activity: As symptoms improve, physio for whiplash aims to reintroduce normal activities and exercises.
- Psychological Support: Whiplash injuries can sometimes lead to emotional distress and anxiety. Counseling or therapy can be beneficial in addressing these psychological aspects of recovery.
- It’s essential to consult a healthcare professional for a thorough evaluation and personalized treatment plan. They can assess the severity of the whiplash injury and tailor the treatment approach to the individual’s needs. Early intervention and a comprehensive, multidisciplinary approach are key to optimizing recovery from whiplash pain.
Physio for whiplash management – summary
Whiplash can be incredibly stressful. The pain and trauma, as well as the psychological stress can have a significant impact across all facets of a patient’s life. If you are experiencing neck pain after a whiplash type incident, a first step can be to speak with your GP or physio to have a thorough assessment and determine a plan for recovery. Our team at Movement Centre in Randwick are experienced at physio for whiplash conditions. We see Compulsory-Third Party (CTP) patients following motor-vehicle accidents, and are happy to discuss this with you and your insurer and medical team.
