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Whiplash-Associated Disorder - Causes, Symptoms, and Treatment

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Whiplash-Associated Disorder - Causes, Symptoms, and Treatment

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A whiplash-associated disorder refers to neck injuries mainly caused by motor vehicle accidents. To know more, continue reading this article.

Written by

Dr. Lochana .k

Medically reviewed by

Dr. Prakashkumar P Bhatt

Published At March 27, 2020
Reviewed AtApril 18, 2023

What Is a Whiplash-Associated Disorder?

Whiplash-associated disorder (WAD) is the term given for a group of symptoms affecting the neck after a motor vehicle accident. A sudden accident causes the tendons and ligaments of the neck to stretch and tear. The incidence of whiplash injury occurs differently in various parts of the world. Different parts of the head, neck, and spine may be affected. However, depending on the force and direction of impact, the symptoms and complications may vary.

What Are the Causes of Whiplash- Associated Disorder?

  • Accidents - This mostly includes car accidents.

  • Physical abuse with objects or violent force.

  • Shaken Baby Syndrome - People tend to play with their children by tossing and catching them in the air. This might lead to serious complications in the future.

  • Minor injuries to intervertebral discs and cartilage.

  • Sports activities that cause a collision with other players are the most important contributing factors for whiplash injuries. This might include sumo wrestling, karate, football, basketball, etc.

  • Paraspinal muscle spasms or contusions of the intra-articular meniscus.

What Are the Symptoms?

After the initial injury, it might take up to 48 hours for the symptoms to arise.

  • Sensory dysfunction:

  • Post-traumatic stress.

  • Psychological depression.

  • Cognitive dysfunctions.

  • Sleeping patterns get altered.

  • Motor dysfunction:

  • Restricted spinal motions.

  • Muscular movements get altered.

  • Sensorimotor dysfunction

  • Eye movements get disturbed.

  • Balance is lost while walking.

  • Temporomandibular joint pain.

  • Tinnitus (continuous ringing sound in ears).

  • Thoracic pain.

  • Facial pain.

  • Vision problems.

  • Dizziness.

  • Fatigue.

  • Nausea.

  • Painful musculoskeletal system.

  • Body pain.

  • Loss of lordosis. Lordosis is the normal curvature of the spine, inwardly. Due to whiplash injuries, the normal curvature of the spine may be disturbed.

  • Post-traumatic stress disorder (PTSD).

  • Severe pain and certain disabilities.

  • Neck pain and stiffness. Minor neck movements tend to increase pain.

  • Numbness sensation in the arms.

  • Severe headache and migraines.

  • General body weakness and fatigue.

It mostly involves soft tissue injuries. The bones may not be affected all the time.

Grades of Whiplash-Associated Disorder:

Grade 0: No problems in the neck and no physical signs.

Grade 1: Stiffness, tenderness, and pain in the neck. No physical signs.

Grade 2: Problems of the neck and musculoskeletal signs.

Grade 3: Problems of the neck and neurological signs.

Grade 4: Problems of the neck along with fracture or dislocation.

What Is Chronic Whiplash-Associated Disorder?

A whiplash injury along with psychological problems constitutes a chronic whiplash-associated disorder. So, this disorder requires cognitive-behavioral therapy (CBT). Cognitive-behavioral therapy is a talk therapy that improves emotional regulation and provides different coping strategies for an individual. Through this therapy, many cognitive irregularities can be corrected. It helps to change the attitude of the patient by helping them focus on their thoughts, images, and beliefs. This may require the help of a psychotherapist.

Some whiplash injuries get resolved in a few weeks if properly treated. If ignored, it can cause some chronic effects.

What Are the Risk Factors of Whiplash-Associated Disorder?

  • Old age.

  • Pre-existing back and neck pain.

How Is Whiplash-Associated Disorder Diagnosed?

Predominantly, it is a soft tissue injury and will not be visible in x-rays. Whiplash can be diagnosed clinically by a thorough history and physical examination by a doctor.

During the medical history, the physician will ask the patient about the details of the accident, including the direction and force of impact, as well as any symptoms that have developed since the accident. They will also ask about any pre-existing medical conditions that may complicate the diagnosis or treatment of WAD.

The physical examination typically includes a thorough evaluation of the neck and upper back, checking for any signs of tenderness, swelling, or range of motion limitations. The physician may also check for neurological symptoms, such as numbness or weakness in the arms or hands.

CT (computed tomography) scans and MRI (magnetic resonance imaging) scans are required for an accurate diagnosis. They can provide more detailed images of the soft tissues, such as the muscles, ligaments, and discs in the neck.

What Are the Treatment Options of Whiplash- Associated Disorder?

Deep muscle therapy is of high benefit for neck and back pain.

  • Massaging the trigger point (the point where more pain is initiated) can give good relief.

  • Ultrasonic waves are known to relieve pain.

  • Traction procedures to reduce head protrusion.

  • Biofeedback therapy.

  • Muscle-strengthening exercises.

  • Motor control exercises.

  • ROM exercises.

  • McKenzie exercises.

  • Motor control exercises.

  • Exercises that strengthen the posture.

  • Applying heat and cold packs every three hours would provide instant relief.

  • A chiropractor will perform spinal manipulation techniques to restore the normal functioning of the neck.

  • Cervical foam collars can be used to keep the neck still and restrict the movements of the neck.

  • Acupuncture - It involves the insertion of fine needles in specific areas to relieve pain.

ROM Exercises.

A goniometer is an instrument used to determine the range of motion (ROM) in joints. It can be measured by the flexion and extension of the muscles, tendons, and muscles. It is measured in degrees of a circle. There are three types of ROM exercises.

  • Active: The patient can independently perform the exercise.

  • Passive: The patient completely requires help from a therapist.

  • Active assisted ROM exercises: The patient can partially perform the exercise but needs the help of a therapist to complete it.

McKenzie Exercises.

Back pain will be present in most cases of whiplash and McKenzie exercises will be of high benefit when coordinated with a fitness therapist. It is contraindicated in patients with spinal fractures and a previous history of spinal surgery. It includes

  • Lying on the stomach.

  • Prone press-up.

  • Prone on elbows.

  • Lying flexion.

  • Sitting flexion.

  • Standing extension.

Motor Control Exercises:

The main purpose of motor control exercise is the coordinated and effective use of muscles supporting the spine. It is the best treatment for chronic non-specific back pain.

Medications:

Painkillers such as Acetaminophen and Ibuprofen can be used to control mild to moderate pain.

Muscle relaxants can be used to reduce pain.

Intramuscular injections of Lidocaine greatly relieve pain.

What Is the Prognosis of Whiplash- Associated Disorder?

Patients suffering from WAD usually have a good prognosis. Sometimes, patients may face prolonged difficulty and pain. Some patients have a completely pain-free period and some patients are known to have good mental well-being.

What Is the Prevention of Whiplash-Associated Disorder?

  • Sit upright and always use a seat belt while driving.

  • Buying a car with a good rear crash rating will help.

  • Airbags can help to reduce the impact on the spine.

  • Head restraint (head rest) is designed in a way to restrict head movements during a collision. The top of a head restraint should reach as high as the top of your head.

What Is the Differential Diagnosis of Whiplash-Associated Disorder?

  • Cervical spine fracture.

  • A herniated disc.

  • Spinal cord injury.

  • Muscle strain.

  • Ligamentous injury.

  • Subluxation of the cervical spine.

Conclusion:

To summarize, whiplash-associated disorder is a frequent injury caused by a sudden, rapid movement of the head and neck. Whiplash-associated disorder symptoms can vary from mild to serious and include neck pain, stiffness, headaches, and dizziness. In some instances, symptoms can last for weeks or months, resulting in chronic pain and disability. Rest, pain management, physical therapy, and, in severe instances, surgery may be used to treat the whiplash-associated disorder. To avoid long-term complications and ensure appropriate treatment, one should seek medical attention if experiencing any symptoms of the whiplash-associated disorder.

Frequently Asked Questions

1.

How Long Does Whiplash Treatment Take?

Depending on the severity of the condition, the whiplash recovery time may vary. Most whiplash patients, especially those with mild symptoms , can recover in a few days or weeks. The healing process for more severe whiplash may take many weeks or even months. For severe, whiplash lasts longer.

2.

Can Whiplash Cause Major Issues?

Whiplash is a minor concern because it only results in temporary pain, soreness, or stiffness. Whiplash may result in long-term pain and consequences if it is more severe. In the most severe situations, whiplash can result in serious spinal damage that can be fatal or permanently disabling.

3.

Which Portion of the Brain Is Affected by Whiplash?

Whiplash is commonly affected in specific areas of the brain such as prefrontal, frontal and cortex. Brain injury can happen without or with a direct blow to the head. There is local and extensive injury as well as electrochemical disruption when the brain is crushed, twisted, and distorted inside the skull. More than 40% of mild traumatic brain injuries are the result of vehicle accidents.

4.

How Do Doctors Diagnose Whiplash?

The doctor may able to diagnosis whiplash by asking patients signs and symptoms along with other digital imaging tests, they are:
- X-rays - X-rays of the neck taken from various angles can be used to detect fractures, dislocations, or arthritis.
- Computed Tomography (CT) – This specialized form of X-ray is capable of creating cross-sectional images of bone and displaying bone damage.
- Magnetic Resonance Imaging (MRI) - A magnetic field and radio waves are used in magnetic resonance imaging (MRI), which creates accurate 3D (three dimensional) images. These scans can find various soft tissue injuries in addition to bone injuries, such as damage to the ligaments, discs, or spinal cord.

5.

What Is Whiplash?

Whiplash is a neck injury that is also referred to as a neck sprain or neck strain. Whiplash is characterized by a number of symptoms that appear after neck injury. Whiplash may cause injury to the cervical muscles, nerve roots, discs, and intervertebral joints (found between the vertebrae).

6.

What Can Happen If Whiplash is not Treated?

Serious adverse effects can occur if the whiplash is not treated; they are:
- Loss of Mobility and Stiffness - Untreated whiplash can result in degenerative disc degeneration and misaligned vertebrae.
- Having Difficulty in Sleeping - Neck pain can make it difficult to sleep.
- Migraines and Chronic Headaches - Headaches can start at the base of the skull and spread to the forehead, back, or sides of the head. The shoulders and back may experience soreness.
- Spinal Fracture - In certain cases, a spinal fracture can go unnoticed since the symptoms of whiplash becomes more severe injury.

7.

How to Treat Whiplash Naturally?

The natural measurements to be taken for the prevention of whiplash are:
- Rest - After an injury, a day or two of rest may be beneficial, but staying in bed too long can delay recovery.
- Heat or cold - By applying heat or cold to the neck for 15 minutes approximately every three hours may relieve the symptoms.
- Painkillers - It is frequently possible to manage mild to moderate whiplash pain with over-the-counter analgesics such Acetaminophen (Tylenol, among others) and Ibuprofen (Advil, Motrin IB, among others).

8.

Can Whiplash Be Treated?

Although no single treatment for whiplash has been scientifically proven to be effective. Some patients have found relief from pain with the help of painkillers like Ibuprofen (Motrin, Advil) or Naproxen (Aleve, Naprosyn), gentle exercises, physical therapy, traction, massage, heat, ice, injections, and ultrasound. In the past, immobilization in a cervical collar was commonly used to treat whiplash injuries.

9.

Does a CT Scan Show Whiplash?

No, the whiplash is a challenging condition for diagnosing because it does not produce accurate findings in X-rays, computed tomography (CT scans), or Magnetic resonance imaging(MRI scans). Typically, the diagnosis is determined by asking the patient how they feel, and then proceeding forward from there. Most people experience back pain in their necks, which they often findworse when they move.

10.

Can Whiplash Result in Neurological Issues?

Yes, whiplash may result in neurological issues, they are:
- Headaches - Headache is a common sign of whiplash. Patients could experience dull, throbbing headaches along the base of the skull.
- Referred Pain - Whiplash can also result in referred pain that feels a pain everywhere in the body.
- Pinched Nerve - Pinched nerves in the neck and upper back may develop as a result of whiplash. Whiplash can cause a bulging or herniated disc because of the strain and pressure that puts on the neck's spine.
- Dizziness - Car accidents can damage or exacerbate the spine in the neck, which can cause dizziness.

11.

Do Whiplash Patients Usually Recover?

The majority of whiplash patients heal within a few days or weeks, while some may need several months. As they grow better, the majority of people will be able to continue with their regular activities.Whiplash patients are normally recovered.

12.

What Are the Signs and Symptoms of Whiplash?

The signs and symptoms of whiplash are:
- Neck Pain
- Muscle Stiffness
- Reduced Range of Motion
- Back and Shoulder Pain
- Tingling & Numbness

13.

Can an MRI Detect Whiplash?

Magnetic resonance imaging are helpful for diagnosis whiplash, but it does produce a clear appearance of the condition. Magnetic resonance imaging can help to rule out conditions like fractures, slipped discs, or other severe injuries that may cause pain, enabling medical professionals to identify whiplash as the primary issue that needs to be treated.

14.

Does Whiplash Results in Memory Loss?

Yes, whiplash injuries cause memory problems, but many individuals are not even aware of this and are left wondering whether they're okay or not. Most medical professionals who treat these patients are constantly bombarded with questions to determine whether or not the patient's memory was impacted by the accident.

15.

What Nerves Are Damaged by Whiplash?

Whiplash can result in the compression or inflammation of spinal nerve roots in the neck, which can cause cervical radiculopathy, which manifests as tingling, weakness, and/or numbness radiating down the shoulder, arm, hand, and/or fingers. Cervical radiculopathy often affects only one side of the body, while it is rare to affect more than one nerve root to be affected at the same time.
Dr. Prakashkumar P Bhatt
Dr. Prakashkumar P Bhatt

Neurology

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tinnituspost traumatic stress disorderwhiplash associated disorder
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