Neck pain and reduced mobility in the neck are typical symptoms of the so-called “whiplash”. Here’s how to diagnose and treat it.
Although common and well known, especially as a result of many car accidents, the so-called “whiplash” still represents a real challenge from the point of view of both diagnosis and treatment: on the one hand because in most cases with the usual diagnostic investigations it is not possible to detect lesions on the bone components, affected muscular, ligamentous or nervous; on the other hand because, despite the absence of obvious organic damage, often the associated symptoms tend to become chronic.
What are the causes
The traumatic mechanism most frequently at the origin of whiplash is the sequence of a sudden hyperextension movement and an equally abrupt hyperflexion of the neck that occur in rapid succession.
It is believed that these sudden movements can immediately cause stretching or micro-lesions of the joints or intervertebral discs and in the long term microscopic degenerative changes in the deep cervical muscles.
In addition, it is thought that functional alterations that affect the mechanisms of transmission and perception of pain support the persistence of symptoms over time.
How to diagnose it
Since the hypothesized lesions are not actually demonstrable with normal instrumental examinations (X-ray, CT, magnetic resonance imaging, electromyography), the most recent guidelines recommend the execution of these examinations only in cases where the severity of the trauma and the clinical picture suggest damage to the skeletal or nervous structures of the cervical spine (fractures / vertebral dislocations, lesions of the marrow, compression of spinal roots).
In all other cases, an accurate examination of the joint and muscle function of the neck is indicated, to be repeated after some time to evaluate the evolution of the symptoms.
What are the symptoms?
The symptoms that most commonly follow whiplash are neck pain and reduced cervical mobility, but changes in sensitivity at the site of the trauma or, even at a distance, headache, dizziness and hearing alterations can also be added.
On the basis of the most used classification, whiplash is defined:
- grade I or II in the absence of skeletal or nerve injury
- grade III or IV when bone or neurological damage occurs.
The most suitable therapies to prevent the disorder from becoming chronic
The therapeutic approach recommended by the current guidelines includes pharmacological treatment with painkillers in the acute phase, early mobilization and specific physiotherapy.
On the other hand, in light of the latest studies, immobilization by collar (which is still often prescribed in the first weeks) is not recommended as it can delay healing.
The resumption of normal activities and movement are therefore also recommended in case of positioning of the collar, which can be kept in place, if soft, or temporarily removed, if rigid, during the execution of the exercises.
Physiotherapy should be continued until the symptoms regress, which depending on the case can take from a few weeks up to three months.
The persistence of disorders beyond this limit must be carefully considered as it may represent their evolution towards the chronic form.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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