Symptoms of whiplash result from sprains and strains at muscles and ligaments located in the cervical region. During a collision, the driver receives an acceleration forward, following which, by inertia, the head goes into hyperextension; in the next step, the neck flexes, making chin impact on chest. The hyperextension phase can cause injuries at the anterior longitudinal ligament of the cervical spine and damage other soft tissue of the front of the neck, including tears and muscle bleeding. In the most acute cases may occur, also, esophageal haemorrhage or rupture of an intervertebral disc. Sometimes they even bring visual and auditory symptoms related to vessel injury or the cervical sympathetic chain. The most common symptoms are
- Pain, usually at the base of the neck
- Local stiffness
- Restriction of movement
- Feeling weak and fragile muscle
The diagnosis must be based on clinical history, the trauma’s dynamics, on symptoms and examination of the patient. Physical examination may however be negative if executed within a few hours after the accident; over time, come out pain at palpation of the cervical area, restrictions on movement and muscle spasms.
Clinical examination includes a neurological examination of the upper extremities with evaluation of motor and sensory function, deep tendon reflexes and grip strength. There’s also the need to perform an X-ray examination of the spine.
We can talk about whiplash or cervical distortion only when there are no radiological signs of injury to the cervical vertebrae, or clinical signs of root lesion. In the case in which the symptoms are felt over a long time, it can be useful to perform an MRI, as the bone scan is particularly sensitive to the detection of occult lesions. However, it is important to remember that any of these surveys can detect soft tissue injury.
Doctors offer different types of treatments for the symptoms of whiplash: use of cervical collar, NSAIDs, muscle relaxants, skin injections with local anesthetics, local application of heat or ice, ultrasound and physiotherapy sessions, while in chronic cases are suggested electromagnetic therapies and sometimes even surgery.
For what it concerns immobilisation as an aid to disorders affecting the cervical area, various studies agree on the usefulness of this practice in helping the recovery of patients. We must pay attention to the type of collar used for this purpose: it must be soft, of the right size relative to patient’s anatomy, with a higher back part to ensure a slight neck flexion. During the day, it is advisable to wear it alternating 1-2 hours wearing with exercises of gradual muscles’ mobilization.