Whiplash

Neck trauma is characterized by damage to the cervical spine from a direct insult such as a blow to the neck or from a whiplash-type injury.  The most common whiplash scenario occurs in rear-end automobile accidents but, may also be a result of sport injuries, fall accidents, and head shaking.  Trauma of this nature may cause hearing loss, balance disorders, and ringing in the ears (tinnitus) amongst other symptoms.  According to Wikipedia, one million whiplash injuries occur in the U.S. annually from automobile accidents with 5000 neck injuries resulting in quadriplegia at a total cost of $40.5 billion.  For most cases, the symptoms of neck trauma may be transient and resolve in a few weeks to months, but for some they can develop into ongoing quality of life issues that can last for years.

How Does It Happen?

Whiplash injury is a result of rapid acceleration and deceleration of the head; first being extended backwards and then being whipped forwards.  Just think of the head as a bowling ball on the end of a big spring and the brain inside the skull as an egg being bruised as it is bounced around.   Even at 5 mph, i.e. bumper car speed, the positive acceleration of the head can be as high as 8.2 G’s.  This is dramatic when taking into consideration that according to Wikipedia the reentry of Apollo 16 was 7.19 G’s.  Even though the head motion may not appear to be excessive, the action of the head and strain on the neck may be more serious than initially considered.  Whiplash can result in damage to a variety of cervical structures such as ligaments, vertebral joints, discs, muscles, and nerves.  Although other mechanisms are involved, the sudden changes in blood flow that occur from the whipping action may result in concussion to the inner ears or brain making a whiplash injury very serious business.

What Are the Warning Signs?

Symptoms of injury include complaints of neck and shoulder blade pain, a heavy head, and headaches, hearing loss, tinnitus, instability or vertigo, TMJ pain, reduced sound and light tolerance, auditory processing difficulty, and psychological consequences such as memory loss, sleep deprivation, anxiety and depression, and post-traumatic stress in the most severe cases.

Whiplash Associated Disorder (WAD) is the medical term used to classify the results of this type of injury.  WAD is broken into 5 categories ranging from no neck pain or physical signs to significant neck injury with fracture or dislocation, severe chronic pain, and psychological consequences.  Risk factors for long term impairment include, pre-existing conditions such as degenerative disc disease, aging, female gender, and head position at the time of the accident, and pre-existing psychological stress.  When combined with head trauma a more significant issue arises such as traumatic brain injury.

What Should I Do?

The most important action to take after being involved in a rear-end automobile accident is to go to the emergency room to be evaluated by a physician, especially if there is any degree of head injury or neck pain.  Frequently, patients will complain of hitting their head on the steering wheel, sun visor, or side window and not take action.  The early symptoms may be judged as minor; however, in many cases, symptoms may not become serious immediately, but within hours to days after the accident, the extent of injury will be revealed as inflammation and nerve damage sets in.

Fortunately, most patients resolve with no treatment or minimal treatment, but for those with significant injury (approximately 10%), early assessment and careful planning can make a world of difference.  Getting an evaluation of the head and neck followed by necessary medical treatment, physical therapy, hearing and tinnitus management, and cognitive training can take advantage of the body’s spontaneous recovery period and reduce the over-all effects.  People frequently wait to see if the condition will pass.  Eventually, when the symptoms worsen they realize the connection between the whiplash they sustained in the motor vehicle or other accident and their changes in hearing, onset of tinnitus, memory and cognitive processing, and problems with sound sensitivity issues.  Taking action is important at the onset to make sure that all possible bases are covered when a whiplash occurs.