Treat Whiplash

Whiplash is a term that describes injury caused to the tendons, ligaments and muscles of the neck and spine as a result of sudden or forceful movement of the head or body. Whiplash gets it’s name because the body stops fast and the head and neck “whip” forward without control. Most cases of whiplash occur as a result of car accidents. If you think you have whiplash, there are some way to assess your situation and treat whiplash.[1][2]

Steps

Assessing Your Condition

  1. Recognize the symptoms. Whiplash is a problem that causes damage to the soft tissue and ligaments surrounding the upper spine. If you are in an accident or undergo trauma, you could have immediate symptoms. You also may have symptoms that start within a day after the incident. Symptoms of whiplash include neck stiffness or pain, headaches that start at the top of the back of the neck, the inability to move your neck around, soreness of the shoulders, arms, and upper back, tingling to the arms from nerve damage, tiredness, dizziness, depression, blurred vision, ringing ears, insomnia, and memory and concentration problems.[3][1]
  2. See a doctor. If you are having neck pain after an accident, injury, or sports injury, it is important to got to the hospital or your doctor right away. You need to make sure you do not have fractures or other damages to your neck. You should also see a doctor right away to check you out if you experience any of the delayed symptoms in the days following the accident or trauma.[1]
    • If you don't have any pain or the doctor sends you home without much treatment, you might have to make another trip to the doctor. Your injuries may not be recognizable until hours after the trauma has happened. Even if you only have minor neck pain, seek treatment the day or so after the accident or trauma.
    • Make a through evaluation of bruising and swelling of your neck. Keep a check on this. If your symptoms worsen and you are unable to move your neck, go immediately to the hospital. If you do not go to the hospital, a prolonged disability may be the result.[4][2]
    • If you notice any head impact or loss of consciousness during your accident, call an ambulance right away or have someone drive you to the hospital.
  3. Do extensive tests. Make sure your doctor takes X-rays to look at your bones. You need to rule out fractures to your neck and spine. If the X-rays come back normal but you still have neck pain, you may need an MRI to look closer at the soft tissue in the neck. If your MRI is normal but the pain persists, the doctor may order a CT scan. This looks at the body even closer with computer technology showing all different angles of imaging.
    • You doctor will use these to assess the extent of the injuries before she advises you of future treatment recommendations.[5][6][7]
  4. Rate your injury with he Croft’s Classification system. To understand how bad your whiplash is, you can compare it to other possible levels of injury. This system was invented by Dr. Croft to grade the whiplash injury from Grade 1 to Grade 5. Grade 1 consists of minimal whiplash with no motion issues, ligament injury, or neurological injury. Treatment can last 10 weeks. Grade 2 means you have slightly limited motion, no ligament injury, and no neurological injury. Treatment can last 29 weeks. Grade 3 patients have moderate motion limitation, some injury to ligaments, and do have neurological symptoms. Treatment can last 56 weeks. Grade 4 is considered moderately severe, which includes motion limitation, injury to ligaments, positive neurological symptoms, and fractured disc or disc misalignment. Grade 4 requires continued treatment with an unspecified end. Grade 5 is severe and requires surgery and rehab for treatment.[8][2]

Handling Whiplash in the Short Term

  1. Limit activities. After your accident, you need to rest the first 24 hours. Try a firm mattress with a neck support pillow for comfort. After this time has passed, you can slowly resume activity instead of sitting in bed. Limit your work and other daily activities for the first few days after the injury occurs, then return to normal activities as pain allows.
    • Avoid lifting anything heavy for 6 weeks to 6b months, depending on the severity of your case.[9][10][10]
    • Spread out your activities throughout the day. If doing household chores, do not lift heavy clothes from the washer to the dryer. Have breaks often to rest your neck. If carrying children, use the stroller or switch arms often.
  2. Use ice to relieve pain. Apply ice to your neck, back, or shoulders for the first 48-72 hours after the injury. This helps reduce swelling and the pain. Ice treatments are most effective if you apply them 10-30 minutes at a time, as often as once an hour. Do not put ice directly on skin. Use a towel to wrap the ice to avoid frostbite.
    • Avoid heat initially because it promotes swelling.[11][10][7]
  3. Switch to heat. Switch to moist heat on the fourth day after the injury. This will help restore flexibility to your muscles. Apply the heat on the neck 10-30 minutes at a time, as often as once every 2-3 hours. You can make your own moist heat pack. Fill a cloth sock with 4 cups of uncooked rice. Tie the sock at the end. Microwave for 1-3 minutes.[12][11][10]
    • If you want you can add essential oils to the rice to make it smell good.
  4. Take over-the-counter pain medication. Your doctor may recommend over-the-counter pain medications. He may also suggest anti-inflammatory medications to decrease the pain and promote healing. Tylenol is used mostly for pain, though it does not help with swelling. NSAIDS like ibuprofen, aspirin, and Aleve will help with the swelling and pain. You can take Tylenol and NSAIDS together because they do not interact with one another and work differently for pain control.[13][14]
  5. Take prescription pain medication. If your injury is severe enough, the doctor may prescribe you medications for the pain. These can include muscle relaxants such as Valium to help the spasms caused by the trauma. Narcotics like Vicodin and Percocet can be used as well for pain in severe cases.
    • If you run out, another follow up is recommended to see if further testing needs to be done.[13]
  6. Get steroid injections. In more severe cases of whiplash, a doctor may use trigger point or epidural spinal injections to treat whiplash. For the epidural steroid injections, the medication is injected to help with pinched nerve pain in your neck. The spinal cord has nerves that branch out to the arms and legs. Injecting the medication in the epidural spaces helps the pain in these nerve areas. The steroid also helps with the swelling directly on the nerve that is swollen. There may be a total of 2-3 injections needed for this pain.
    • Facet joint injections or facet blocks are also used for helping pain. The facet joints help us move, so you may need medication to help them feel better. Though not as common as epidural injections, they are effective. Trigger points are balls of muscle that become inflamed. The doctor can inject a painkiller in this area to help with inflammation as well.[13]
    • The stronger medications and spinal injections reduce your pain so that you can work on healing the soft tissue injuries. You do this through treatments such as physical therapy.

Dealing with Whiplash in the Long-Term

  1. See a physical therapist. Once you have the pain and inflammation under control, you will need to go see a physical therapist. Physical therapy is a variety of techniques used to help recover the movement of your neck and areas affected by the whiplash. It can often be used to help restore a person’s range of movement after a whiplash injury. The physical therapists will help you know what stretches and exercises you can do to increase the strength and range of motion of your neck, back, and arms. Stretching and exercises should not cause pain. If they do, stop them and talk to your doctor or physical therapist.[15]
    • Your physiotherapist will be able to show you neck exercises you can do at home.
    • Applying moist heat before your therapy may help aid in the therapy.
    • Common practices in physical therapy include rotating your neck left to right, tilting your head side to side, moving it up and down, and rolling your shoulders.[9]
  2. Wear a neck brace. Occasionally the doctor may immobilize your neck with a soft cervical collar. This is no longer standard practice with all cases of whiplash because evidence has shown early movement is helpful. If surgery is indicated, immobilization is required.[16]
  3. See a chiropractor. You may need to see a chiropractor for adjustments and spinal manipulations. Most chiropractors are using the modern early movement protocol. This guides the practitioner to help rehab patients affected by whiplash. They have noticed early movement is better and recovery is shorter. This can help restore normal movement to your neck and back.[2]
  4. Consider massage therapy. Massage therapy is great for soft tissue rehabilitation. A massage may be helpful later in the recovery stages of whiplash, but in the beginning, the massage is not indicated. Massage increases the blood flow to the injured muscles and ligaments and speeds the healing process. In the recovery of whiplash, the massage can be helpful in relieving spasms.[17][18]
  5. Consider Transcutaneous electrical nerve stimulation (TENS). TENS is used to give small electrical impulses to your nerves in the affected areas. It distracts the pain sensors in the brain. Though it is expensive, there is no disadvantages to using TENS. However, there is not enough evidence that it helps mild cases to recommend it for every whiplash patient.[19]
  6. Try acupuncture. Acupuncture can be used as a helpful tool for those with whiplash. It breaks up muscle tension similar to a massage. Putting a small needle into the body helps relieve pain by relieving muscle tension and promoting blood flow. This helps after your injury to recover the tissues faster.[20]


Warnings

  • Although many people begin to feel better after a few days, some people suffer from the effects of whiplash for several months, and treatment may be an ongoing process.
  • Although most people view whiplash as a physical injury, psychological symptoms of stress, anxiety and depression can also occur. However, most psychological symptoms tend to appear after the physical symptoms, and in some cases, three months after an injury.[21] If you begin to notice any stress or anxiety, see your doctor right away.
  • Seek medical help if your neck pain comes back after you thought you were healed, pain becomes severe, pain radiates to shoulders and arms, or if numbness, weakness, or tingling occurs in your arms or legs. You should also call a doctor if you cannot hold or cannot have a bowel movement or pee.[10]

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 1.2 http://www.mayoclinic.org/diseases-conditions/whiplash/basics/definition/con-20033090
  2. ↑ 2.0 2.1 2.2 2.3 http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=38153
  3. ↑ http://www.ncbi.nlm.nih.gov/pubmed?term=17108836&holding=ohlakelib
  4. ↑ http://www.medicinenet.com/whiplash/article.htm
  5. ↑ http://www.hopkinsmedicine.org/healthlibrary/conditions/spine_shoulder_and_pelvis_disorders/whiplash_injury_85,P01388/
  6. ↑ http://www.medicinenet.com/whiplash/page3.htm#how_is_whiplash_diagnosed
  7. ↑ 7.0 7.1 http://www.medicalnewstoday.com/articles/174605.php
  8. ↑ http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=18303
  9. ↑ 9.0 9.1 http://www.mayoclinic.org/diseases-conditions/whiplash/basics/treatment/con-20033090
  10. ↑ 10.0 10.1 10.2 10.3 10.4 http://www.nytimes.com/health/guides/injury/whiplash/overview.html
  11. ↑ 11.0 11.1 http://www.spineuniverse.com/blogs/hawkinson/how-can-relieve-neck-pain-caused-whiplash
  12. ↑ http://www.spine-health.com/blog/how-make-your-own-gel-ice-pack-or-moist-heat-pack
  13. ↑ 13.0 13.1 13.2 http://www.spineuniverse.com/conditions/whiplash/drugs-medications-whiplash
  14. ↑ http://www.safemedication.com/safemed/PharmacistsJournal/CanYouDoubleUponPainKillers
  15. ↑ http://www.nhs.uk/Conditions/Whiplash/Pages/Treatment.aspx
  16. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684205/
  17. ↑ http://www.massageenvy.com/benefits-of-massage-therapy/whiplash-massage.aspx
  18. ↑ http://www.themassagesource.com/health-concerns/whiplash
  19. ↑ https://www.som.uq.edu.au/whiplash/whiplash-treatments/treatment-details.aspx?treatmentID=6
  20. ↑ https://www.acupuncturewell.com/2013/01/acupuncture-for-whiplash-injury/
  21. ↑ http://www.injuryresources.com/whiplash-injury/whiplash285.html
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