Flick
Whiplash is a traumatic event that affects the cervical spine. In most cases it arises following a sudden head movement that exceeds the physiological limits of articular excursion.
Causes
The damaging mechanism is typical of car accidents, especially those in which the vehicle suffers a violent rear-end collision.
The head is then thrown forward at a faster rate than the rest of the body (hyperflexion damage).
If the car does not have head restraints, or they are incorrectly adjusted, the damage from hyperextension will be greater. In the absence of an airbag, on the other hand, hyperflexion trauma will be more serious since the head will not be braked in its travel and will crash violently against the steering wheel.
Whiplash can also appear due to traumatic events related to sporting gestures or other accidents. In these cases the impact occurs more easily in an oblique direction, projecting the head laterally and causing more substantial vertebral damage.
Aftermath
If we imagine the neck as a structure stabilized by a dense network of rubber bands, we can easily understand the origins and consequences of whiplash.
When the garment undergoes a strong acceleration, the resistance limit of the elastics is exceeded and the single fibers fray more and more until they are completely torn (muscle tearing).
Fortunately, in most cases the trauma is not so violent as to cause the muscle fibers to break.
In the characteristic whiplash, only a simple stretching of the cervico-nuchal muscles and ligaments occurs. Furthermore, our body has the ability to regenerate injured tissues even if these will never reach the level of efficiency of the originals.
Whiplash and its consequences
When examining the possible consequences of whiplash, it is always necessary to consider the extreme complexity of the cervical tract both from an anatomical and physiological point of view. In fact, many vessels and nerves which are fundamental for the life of the individual run through it. It is no coincidence that these structures are surrounded by a solid bone, muscle and ligamentous scaffold that protects them in case of trauma.
In less severe whiplash there are only muscular and ligamentous injuries with a marginal involvement of the joint structures. However, these traumas should not be underestimated since their negative consequences can also manifest themselves in the following days with the appearance of the classic "muscular contracture from protective reflex". It is essentially a defense mechanism that our body adopts by contracting the neck and neck muscles. In this way, if on the one hand all those movements capable of worsening the situation are prevented, on the other hand the cellular repair processes can proceed smoothly.
Slight Injury Symptoms
For further information: Whiplash Symptoms
The result of all these harmful effects translates into the classic symptoms of whiplash, generally characterized by:
- neck pain Icervicalgia),
- ringing in the ears,
- stiffness of the back and neck muscles,
- headache
- movement restrictions.
Symptoms Serious Injury
If the traumas of a muscular, bone and ligamentous nature are quite frequent, the same cannot be said for those affecting the nervous structures.
However, as the extent of the trauma increases, the lesions can also affect the intervertebral disc and adjacent structures with the appearance of symptoms such as:
- paraesthesia (pins and needles),
- brachialgia
- sciatica.
In the most serious cases, alterations of the spine, of the physiological equilibrium of the pelvis and even of the temporomandibular joint may also occur.
However, the worst situation appears when whiplash is associated with real ligamentous ruptures, disc herniations and vertebral fractures. In these situations, the severity of the injury goes beyond the definition of whiplash that we have seen to be characterized by much more superficial injuries. Suffice it to say that a rupture of the spinal cord contained in the cervical vertebrae causes paralysis of the limbs and, if it occurs at the level of C1-C2, it is even lethal.
Heal from whiplash
See also: Whiplash Treatment Medications
The factors that come into play during an accident are so numerous that different therapeutic treatments are required for each individual case.
A decrease in the strength in the grip, coordination deficits and tendon reflexes are elements that already at a first clinical examination lead to suspect an involvement of the nervous structures. In these cases, especially if the impact was rather violent, it is advisable to report the symptoms and dynamics of the accident to the health professionals who will carry out diagnostic tests such as radiographs and CT scans to highlight the actual extent of the injuries.
Since many symptoms appear only several hours after the trauma, it is advisable to go to the nearest emergency room in advance even in the absence of pain. Only a specialist visit will thus be able to diagnose the real extent of whiplash and prescribe the most appropriate therapies.
Rest is initially the most effective means of healing. In this phase the movements of the neck and head will be limited to the maximum. Often the first measure taken by the doctor is precisely to apply the collar, which with its supporting action protects the cervical tract both from incongruous movements and from other types of stress.
The most useful medicines to treat whiplash are those with anti-inflammatory, pain relieving and muscle relaxant (NSAID) action. In case the pain interferes with the night's rest or creates anxiety, tranquilizers and sedatives are also prescribed.
After the acute phase of the trauma, more or less after ten to twenty days, the use of drugs and collar is definitively abandoned. At this point of the rehabilitation process, physical therapies and manipulations are introduced.
To tell the truth, given that the beneficial effect of some treatments is also valid in the acute phase, there are those who recommend undergoing these therapies just a few hours after the trauma. However, these are rather risky operations, especially if performed by a person with little experience; for this reason in most cases it is preferred to wait for the inflammation to regress at least partially.
On the other hand, it is also true that excessive rest tends to delay healing by making symptoms chronic. Prolonged use of the collar, for example, effectively inactivating the action of the musculature makes it completely ineffective to cope with the stresses it will be subjected to. in the absence of artificial support.
Already after a few days, depending on the severity of the whiplash, it is therefore possible to start with the first voluntary isometric contractions which will subsequently be replaced by manipulations and active exercises.
Physical therapies thanks to their analgesic and healing effect are useful for accelerating the healing process. Among the most common means are iontophoresis, electrotherapy, laser therapy, kinesitherapy and decontracting massages. By increasing the blood flow in the region, all these treatments allow you to regain lost health in a very short time.
As for the manual therapies that accompany the intervention of physiotherapists, massage therapists, kinesiologists, agupontori, osteopaths, chiropractors and so on and so forth, it is first of all necessary to know how to choose.
Without going into the merits, let's say that all these techniques are supported by more or less recognized scientific studies, which testify to their curative efficacy in the treatment of whiplash. Rather than asking which of these therapeutic means is better (considering the extreme variability of the trauma is not so easy to establish a priori the real effectiveness of the various methods) the patient should make sure in advance of the experience and degree of professionalism of the therapist.
Only qualified professionals, in possession of specific certificates and a considerable wealth of experience, are in fact able to customize the therapy by adapting it to the individual case and taking into account any pre-existing structural alterations.
Following a rehabilitation process after a whiplash is of fundamental importance because it ensures a better recovery from the injury. In the absence of this precaution, the pain could become chronic, worsen or appear even after several months, creating considerable inconvenience to the patient.
Prevent whiplash
Since the symptoms of whiplash are very similar to neck pain (neck pain) it is important to take precautions that protect the neck even from the countless daily stresses. It is no coincidence that neck pain ranks second among the most common painful pathologies of musculoskeletal or neuromuscular origin.
Incorrect posture, incorrect positions taken during study, work or sleep, anxiety, stress, cold strokes, excessive and repeated overloads on the neck muscles are among the main causes of cervical pain.
In addition to controlling the positions taken during the day, following a regular program of physical activity helps to prevent, but also to improve, the symptoms of neck pain.
Let's say first of all that there is no specific physical activity and that any sport that involves the upper limbs in movement can be useful. Obviously some targeted exercises such as postural, spinal mobilization, coordination and stretching exercises have a superior beneficial effect.
Mistakes in the execution or in the choice of the exercises can however worsen the situation (characteristic is the help with the hands by pulling on the neck during the abdominal training). For this reason it is very important to be followed, at least initially, by an expert trainer who must be informed of any pathological conditions.
In the article "Exercises for the cervical vertebrae" stretching movements useful for stretching the neck muscles and preventing whiplash are extensively illustrated.
Our advice
- Adjust the headrest by positioning it so that the top is about five centimeters above the top of the ear
- While driving, keep your back well supported on the seat; torso and head must remain straight because if the back and head are curved forward the distance between the occiput and the headrest will be too great to protect the head from hyperextension; for the same reason, if the headrest can be adjusted forwards and backwards, place it in such a way as not to exceed 6 cm from the occiput
- In situations at risk of a rear-end collision (fog, traffic lights, etc.), take the precautions required by the Highway Code (headlights, rear fog lights, arrows), avoid sudden braking, etc.
- In the event of whiplash, contact the nearest emergency room promptly, both to verify the absence of bone and ligamentous lesions, and to have a useful document if an insurance compensation is required.
- Staying healthy by exercising regularly in this way the cervical muscles will acquire strength and elasticity protecting this area in case of trauma
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