Definition
Typical of road accidents, whiplash represents an acute and sudden trauma involving the cervical tract, with all the attached structures - fascicular, articular, nervous and visceral -. Whiplash is one of the so-called "indirect" traumas, since the lesion is transmitted to the contiguous anatomical sites in the absence of direct contact.
Causes
In most cases, whiplash is the immediate consequence of a car accident: following a rear-end collision, the person sitting in the car undergoes a violent acceleration, such as to violently push the head towards the headrest, and then fall back into forward, just as abruptly. Whiplash can also result from violent injuries related to sports or accidents of a different nature.
Symptoms
The symptoms accompanying whiplash can be defined as "dizzying", always accompanied by an unpleasant sensation of rigidity that radiates from the point of trauma. Neck pain is a symptom that characterizes whiplash, although its intensity is different according to the severity and violence of the trauma suffered.
- Whiplash is considered a dangerous and violent strain involving the muscles and ligaments of the neck and neck. In severe cases, whiplash causes complete tearing of the muscles (muscle tear).
The information on Whiplash - Whiplash Treatment Medications is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Whiplash - Whiplash Treatment Medications.
Medicines
Whiplash treatment therapy is purely symptomatic and makes use of the aid of painkilling drugs and orthopedic collars useful for keeping the neck in a static position, supporting the cervical tract and protecting it from possible stresses. Immobilizing the neck, the pain it tends to regress, albeit slowly, following a gradual removal of the inflammation.
In some patients, the pain in the neck caused by whiplash is such as to create serious difficulties in falling asleep: in this case, it is possible to take drugs that promote sleep, such as sedatives and anxiolytics.
Treatment with pain relievers, anti-inflammatory drugs and muscle relaxants generally lasts 2-4 weeks, depending on the severity of the lesions; during this period of time - let us remember again - the patient must rest, never subjecting the neck to exercises taken on their own initiative, which could aggravate the injury. Only after having calmed pain and inflammation, the patient is invited to follow a targeted physiotherapy path: physical therapies, with their curative, beneficial and analgesic effect, accelerate healing times.
In addition to classical physiotherapy, patients can choose between alternative therapy methods, including: electrotherapy, iontophoresis, laser therapy, decontracting massages, massophysiotherapy, kinesiology, acupuncture, etc.
In particularly sensitive patients, or in severe traumatic events, whiplash can create serious psychological and emotional disturbances, which can even induce depression. In others, a traumatic event of this magnitude can cause shock, such as to favor the onset of fear of getting back into the car.
The possible involvement of the nerve structures must be checked soon: the decrease in tendon reflexes and the marked uncoordination are alarm signals, which must be considered in order to understand the severity of the injury.
The following are the classes of drugs most used in whiplash therapy, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Pain control therapy for whiplash: This therapeutic approach uses non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants:
- Ibuprofen (eg. Brufen, Moment, Subitene): for medium-moderate pain resulting from whiplash, it is recommended to take a dose of active by mouth equal to 200-400 mg (tablets, effervescent sachets) every 4-6 hours after meals, as needed. Do not take more than 2.4 grams per day.
- Naproxene (eg Aleve, Naprosyn, Prexan, Naprius): it is recommended to take the drug at a dosage of 550 mg, orally, once a day, followed by 550 mg of active ingredient every 12 hours; alternatively, take 275 mg of naproxen every 6-8 hours, as needed. Do not exceed 1100 mg per day.
- Diclofenac (eg. Fastum, Dicloreum): for the control of mild pain associated with whiplash, it is recommended to take 25 mg of active, 4 times a day. Follow the instructions given by the doctor.
- Ketoprofen (eg Fastum, Ketoprofen ALM, Steofen): available in the form of creams or ointments to be applied directly to the area affected by whiplash (topical drug), or as tablets to be taken by mouth (systemic action). In the form of a cream or gel, it is recommended to apply a thin layer of the product directly on the injured area, twice a day. The dosage of taking the drug orally in the control of pain associated with whiplash suggests taking 25-50 mg every 6-8 hours. Do not exceed 75 mg per dose.
- Thiocolchicoside (eg. Thiocolchicoside PLIVA, Muscoril): this is a muscle relaxant drug with anti-inflammatory and analgesic effect. The active ingredient is available as a solution for injection (4mg / 2ml). The doctor will inject the drug twice a day in the first 24 hours after the injury.
- Ciclobenzaprine (eg. Flexiban): the muscle relaxant drug is indicated to reduce muscle spasms resulting from whiplash. Start taking the drug at a dose of 5 mg orally, three times a day. Depending on the patient's response, the dosage may be increased to 7.5-10 mg, three times a day. Alternatively, take the drug in the form of slow-release tablets, at a dose of 15 mg or 30 mg, orally, once a day. Intake of excessive doses of Ciclobenzaprine can promote dizziness and sedation.
Anxiolytic and depressive therapy: the administration of antidepressant and anxiolytic drugs in the context of whiplash is not useful, in itself, for the purposes of the disease; rather, it is indispensable to alleviate the collateral symptoms: when a severe trauma to the cervical spine, such as whiplash, is such as to create problems with falling asleep, anxiety and mood depression, it is recommended to take drugs to relax the body and stave off anxiety. Here are some of the most used drugs for this purpose:
- Zaleplon (eg Zerene, Sonata): it is a hypnotic / sedative drug, indicated to treat insomnia, anxiety and stress particularly accentuated in the context of whiplash. The product, available in capsules of 5 and 10 mg, is indicated for those who complain of obvious difficulty in falling asleep and, subject to medical prescription, can only be taken when the disorder is severe. Take 5-10 mg of active just before bedtime; the duration of therapy should not extend beyond two weeks. Do not take in case of liver and kidney diseases.
- Amitriptyline (eg. Laroxyl, Triptizol, Adepril): tricyclic antidepressant used for the treatment of depression and to treat insomnia in the context of stress and depression disorders, also (and not only) following a particularly violent whiplash. The dose should be determined by the doctor based on the severity of the condition.
- Melatonin (eg Circadin, Sublingual Melatonin 3): Melatonin is available as capsules, slow-release tablets or drops. In case of difficulty falling asleep, following pain associated with whiplash, it is possible to take the drug in the form of slow-release tablets: it is recommended to take 2 grams of active, a couple of hours before bedtime, preferably on a full stomach. Repeat the treatment for three weeks. Do not use in case of renal and hepatic dysfunction. In the form of drops, it is recommended to take 4 drops, before bedtime (each drop contains about 0.25 mg of active).
For further information, read the following articles:
- Medicines for the Treatment of Anxiety
- Medicines for the treatment of insomnia
- Drugs for the treatment of depression
When the painful symptoms caused by whiplash become bearable, it is recommended to contact physiotherapy specialists to follow a specific program of physical activity; since the exercises must be performed with precision (in order not to aggravate the problem), it is strongly not recommended to carry out exercises on your own initiative, without an expert trainer.
Exercises for the cervical vertebrae and stretching exercises are very useful not only for strengthening the cervical muscles, but also for preventing whiplash.
