Whiplash Associated Disorder WAD
Posted on 16th July 2017 at 10:08
What is a whiplash neck sprain?
Whiplash is a non-medical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck. A whiplash neck sprain occurs when your head is suddenly jolted backwards and forwards in a whip-like movement, or is suddenly forcibly rotated. This can cause some neck muscles and ligaments to stretch more than normal (sprain). Whiplash is commonly associated with road traffic accidents, usually when the vehicle has been hit in the rear. Whiplash accounts for more than three quarters of all injury claims after road accidents.
What causes whiplash?
As well as traffic accidents, blows to the head, particularly during sports such as boxing or rugby, or a slip or fall that causes the head to suddenly jolt backwards can also cause whiplash.
Some people are surprised at having symptoms after a minor road traffic accident. Even slow vehicle knocks may cause enough jerking movements of the neck to cause symptoms.
What are the symptoms of whiplash?
After an accident, the symptoms of whiplash may be delayed until around 6-12 hours later and may become worse over the following days.
However, people who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury:
Neck pain and stiffness is the most common symptom. The pain and stiffness often become worse on the day after the accident.
Headaches are the second most common symptom, usually occurring on one side of the head, beginning at the base of the skull (occiput) and often radiating to the top of the head and frontal regions.
Movements of the neck may be difficult, being stiff and painful.
There may be associated pain or stiffness in the shoulders, between the shoulder blades or down the arms.
Pain or numbness in the arm and/or hand. Arm pain can be caused by nerve compression or referred pain from the facet joint or disc.
There may be pain and stiffness in the upper and lower part of the back.
Pain in the jaw or pain on swallowing, unusual sensations in the skin on the face may occur for a short while, but soon go. Tell a doctor if any of these persist.
Ringing in the ears
Difficulty concentrating or remembering
Irritability, sleep disturbances, tiredness
How is whiplash diagnosed?
In most cases, injuries are to soft tissues such as the discs, muscles and ligaments, and these cannot be seen on standard X-rays.
The diagnosis is usually made from a detailed description of the accident and the symptoms and by examination.
If a problem such as spinal injury is suspected then specialised tests, such as CT scans or magnetic resonance imaging (MRI) can be carried.
What is the treatment for whiplash?
To help with recovery:
Ice your neck to reduce pain and swelling as soon as you can after the injury. Do it for 10-20 minutes every 3-4 hours for 2-3 days, or as recommended by your doctor or physiotherapist.
Take painkillers or other medications, if recommended by your doctor. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen will help with pain and swelling. However, these medicines can have side effects. Always follow the dosing instructions. Prescription painkillers and muscle relaxants are sometimes necessary.
Apply moist heat to your neck - but only after 2-3 days of icing it first. Use heat on your neck only after the initial swelling has gone down.
Exercise your neck and keep active:
At first the pain may be bad, and you may need to rest the neck for a day or so. You must not allow your neck to stiffen up. However, gently exercise the neck as soon as you can. Gradually try to increase the range of neck movements. Every few hours gently move the neck in each direction. Do this several times a day. As far as possible, continue with normal activities. You will not cause damage to your neck by moving it.
Although treatment is tailored to individual needs general aims of physiotherapy treatment should be to:
Return the person to normal activity /work
Advise on pain relief
Once the acute symptoms have gone, you may benefit from exercises ideally under the supervision of a physiotherapist. This will make your neck muscles stronger and more flexible. It will help you recover and reduce the odds of straining your neck again in the future. Various treatments may be advised by a physiotherapist. These may include:
Joint mobilisations to increase neck range of movement
Soft tissue massage to alleviate pain
Active exercises to alleviate pain and to restore normal movement
A detailed home exercise plan
Postural re-education. A good posture may help. Check that your sitting position at work or at the computer is not poor. (That is, not with your head flexed forward with a stooped back.) You may need to get your employer to assess your work station set up.
Treatment may vary and you should go back to see a doctor:
If the pain becomes worse.
If the pain persists beyond 4-6 weeks.
If other symptoms develop such as loss of feeling (numbness), weakness, or persistent pins and needles in part of an arm or hand. These may indicate irritation to or pressure on a nerve emerging from the spinal cord.
What is the outlook (prognosis) after a whiplash neck sprain?
This will depend on the severity of the sprain, but the outlook is good in most cases. Symptoms often begin to improve after a few days. Most people make a full recovery within a few weeks. However, in a small number of people, some symptoms persist long-term.
Whatever you do, do not rush things. People who play contact sports need to be especially careful that they are fully healed before playing again. Do not try to return to your previous level of physical activity until you can:
Look over both shoulders without pain or stiffness.
Move your head all the way forward and all the way back without pain or stiffness.
Move your head from side to side without pain or stiffness.
If you start pushing yourself before your neck strain is healed, you could end up with chronic neck pain. Other pain-relieving techniques may be tried if the pain becomes chronic (persistent). Chronic neck pain is also sometimes associated with anxiety and depression which may also need to be treated.
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