Whiplash occurs when the neck is suddenly and forcefully jerked, and is typically associated with car crashes. The speed at which the neck is forced upon impact is faster than we can contract our muscles in attempt to stop such movement. This results in muscle, tendon, and/or ligament over-stretching, even tearing. Symptoms can include stiff and painful neck movements, weakness, the head feeling “heavy” (making it challenging to “hold up”), headaches, dizziness, ear noises, TMJ or jaw pain, and “mental fog.” What should be done if a whiplash injury occurs?
The amount or degree of damage to the soft tissues – that is, the muscles, tendons, ligaments, and disks of the neck — will be the deciding factors as to how much rest vs. activity should be initially performed. If there are no fractures, dislocations, or other injuries resulting in an unstable cervical spine (neck), studies have shown rest and a soft collar are actually harmful when compared to early return to activity and exercises. A handy way to classify the injury includes four categories: 1) Pain with no significant abnormal clinical findings; 2) Pain with mild clinical findings and range of motion loss; 3) Pain with neurological injury (resulting in radiating arm pain); and 4) Pain associated with fracture and/or dislocation. Those suffering with category 1 or 2 injuries should minimize rest, collar use, proceed with life’s activities, and not be afraid to do desired activities. Chiropractic treatment, which essentially exercises the joints of the neck, has been shown to speed recovery when performed sooner rather than later after a whiplash injury. Category 4 (fractures and dislocations) injuries require the use of a rigid collar usually for 4-6 weeks as rest/protection is imperative. Category 3 demands careful monitoring by your chiropractor as neurological problems like arm pain and numbness and muscle strength weakness must be watched during the healing process. The use of ice is helpful with all four categories of injury and exercise training is important and can be started sooner in the first two categories of injury.
What can you do if you sustain a whiplash injury? The first order of self-help is the use of ice. This is a much better choice over the use of heat as ice reduces swelling and pain while heat can increase swelling because it brings in more blood flow into an already swollen area. The heat may feel good during its use but most patients report the pain either returns shortly thereafter or feels worse. Ice and heat can be alternated but ice should be emphasized by using ice for 10 minutes, heat 5 minutes, and repeat the ice / heat / ice approach starting and ending with ice. One session usually equals 40 minutes (ice/heat/ice/heat/ice for 10+5+10+5+10, respectively, = 40 min.), and several sessions can be repeated each day. The old adage of “ice for 24 hours followed by heat” does NOT apply here as ice or “contrast therapy” of ice/heat/ice/heat/ice can be performed for as long as there is pain or for several weeks or longer. The next (very important) recommendation is to utilize exercises to stretch and strengthen the neck and upper back region. The “general rule” of exercise is slow repetitions staying within “reasonable” boundaries of pain. That is, a good, stretch type of pain is encouraged while avoiding sharp pain. We have discussed several very practical neck stretches and strengthening exercises previously and we will again address this in the future. Posture correction involving chin tucks and keeping your head back over your shoulders is very helpful as well.