Back in the days when pirates roamed the seven seas anyone suffering a whiplash injury would quite likely have previously been tied to the mast and lashed with the cat o’ nine tails but today the word “whiplash” has a very different meaning. Although commonly used, this is a colloquial, non-medical, term describing a neck injury caused by a sudden violent movement of the head. The most commonly encountered cause of whiplash injuries is that of car accidents but there are many other situations giving rise to this condition including sporting activities or even leisure pursuits such as bungee jumping or fairground rides.
What is Whiplash
The word “whiplash” is used so freely that few people ever feel the need to ask, “What is whiplash?” as it is universally known to be a neck injury due to an accident but the actual mechanics of this type of traumatic injury are less understood. The word “whiplash” has been adopted because of the perceived analogy between this type of injury and the cracking of a whip where the flexing of the body of the whip (spine) results in the high speed flicking over of the tip (head and neck). In fact this is a very poor analogy and, having established that it has nothing to do with whips or lashes, we are still left with the question, “What is whiplash?” A trauma specialist would probably give a more formal description of it being a cervical acceleration-deceleration injury but in order to understand it better it is necessary to consider the chain of events during an accident.
How Whiplash Occurs
Whiplash can result from many different types of accident with head and neck movement being in any direction but the most common is that seen from a car accident involving a rear-end impact. In such an accident, the car occupant begins by being at rest (in an inertial frame). An impact to the rear of the car causes the car seat to propel the body forward usually to then be restrained by the seat belt but the head is affected by inertia meaning that, relative to the body, it is left behind and so the neck bends backwards. It should be remembered that the human head weighs between 4.5 and 5 kg which is well within the normal weights of a ten-pin bowling ball and overcoming this inertia would require immense forces, certainly many times the capabilities of the body tendons. When the head has moved back as far as it can go, or is restrained by a suitable head restraint, it then rapidly accelerates forward following the body but just as this happens, the force of the initial impact is subsiding and the body returning back to its original position leaving the inertia-sensitive head to continue on its way resulting in further bending of the neck. The actual damage-causing mechanisms are not fully understood but are generally considered to be due to the stretching and compression of the soft tissues resulting in damage or inflammation of the tendons and ligaments. Rear end vehicle collisions are one of the most common types of road accident and as result whiplash claims for compensation are common.
Whiplash symptoms can vary in intensity from being very slight to severe and in most cases will appear some time after the accident, typically after about 6-12 hours. In many cases the symptoms will be worse the following day but will improve over the following days or weeks. Occasionally, long-term symptoms persist and where these last for over 6 months this is referred to as chronic whiplash syndrome. The most commonly reported symptoms are as follows:
Other related whiplash symptoms include shoulder pain, anxiety and depression.
The type of whiplash treatment chosen depends mainly on the severity of the condition. X-rays and MRI scans are not routinely carried out as this is normally considered to be a condition affecting soft tissue but obviously, where fractures or severe spinal injury is suspected, such tests and hospitalisation will be required. In most cases, the assessment will be made on the basis of information forwarded by the patient along with a simple examination. Whiplash treatment normally involves maintaining mobility along with the use of painkilling medication.