Whiplash-Associated Disorder - Causes, Symptoms, and Treatment

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.