What is a whiplash injury?
A whiplash injury is a non-medical term to describe a range of neck injuries that occur with a sudden distortion of the neck. A whiplash injury is commonly the result of a motor vehicle accident. The most common scenario is that the victim is seated in a vehicle that is rear ended or hit from the rear quarter. A whiplash injury can occur at speeds less than 15 miles per hour.
What are the symptoms of whiplash?
Patients will typically experience pain along the neck, corresponding to the level of where the pain is being generated from. Neck pain due to whiplash injury can be immediate or can progress over several weeks. Neck pain may be referred to the shoulders, upper back or may even sometimes cause headache. A whiplash injury may result in stretching or pinching of the spinal nerves. With involvement of the nerves, radiating pain may be present to the shoulder, arm or fingers.
What causes a whiplash injury?
The biomechanics of whiplash injury are well studied. At impact there is a violent and complex multi- stage movement of the neck. First, the lower spine extends while the rest of the spine flexes, resulting in an S shaped configuration of the spine. Then, the upper spine starts to extend, as the lower spine already has. This causes an extreme rotational torque at the lower spine. This torque causes the joints of the lower spine to impact on one another, injuring the spinal joints, called facet joints. Spinal ligaments and discs can also be injured due to whiplash. Neck pain can become chronic in 10% to 40% of sufferers.
How is whiplash pain evaluated?
The diagnosis of a whiplash injury can be made by a careful history. The mechanism of injury and pain symptoms are the leading clues. MRI will often fail to show acute injury to the facets joints, although MRI is effective in detecting disc herniation or ligament injury due to whiplash. In chronic injury, x-rays and MRI can show neck joint degeneration.
How is whiplash pain treated?
Medications and therapy are the first line in the treatment of a whiplash injury. In patients that don’t respond a spinal pain management evaluation can be performed. In this highly specialized evaluation, we determine which of the structures in the neck the pain is emanating from. Spinal injections can bring relief and confirm the source of pain. Minimally invasive surgery is reserved only for cases that do not improve with spinal injections.
The following spinal injections can be used to treat whiplash:
- Cervical Epidural Injection
- Endoscopic Facet Debridement
The following minimally invasive surgical procedures can be used to treat whiplash: