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Pain after whiplash injury

Copy of Schleudertrauma

Emmanuel Coradi

27. Oct 2024

Whiplash is an injury to the cervical spine. It is caused by sudden, jerky bending and hyperextension of the head as a result of an unexpected force. Whiplash is also known as a whiplash phenomenon or acceleration trauma to the cervical spine.

Schmerzprobleme

How does whiplash occur?

Whiplash is usually caused by a car accident with a rear-end collision (rear-end collision). However, whiplash can also be caused by sports accidents, falls or other violent impacts on the cervical spine.
The majority of those affected can be successfully treated with specific exercises and medication. After a few weeks, they often show hardly any symptoms. However, some patients experience a less pleasant course and develop chronic neck pain that can accompany them for years.

Typical symptoms

The typical signs and symptoms of a whiplash injury often develop within days of the neck injury. Patients often complain of the following symptoms:

  • Pain and stiffness in the neck
  • Increase in neck pain during movement
  • Range of movement in the neck is significantly restricted
  • Headaches in the back of the head
  • Pain also in the area of the shoulders and upper back
  • Tingling and/or numbness in the arms
  • Tiredness and difficulty concentrating
  • Feelings of dizziness
     

Some patients also report other symptoms:

  • Blurred vision
  • Tinnitus complaints
  • Sleep disorders
  • Increased irritability
  • Memory disorders

Influencing factors for pain chronification

Most whiplash sufferers can be successfully treated with specific exercises and medication so that they hardly have any symptoms after a few weeks. However, some patients experience a less pleasant course and develop chronic neck pain, which can then accompany them for years.

It is difficult to predict how an affected patient will recover from a whiplash injury. In general, however, it seems to be the case that patients with rapidly occurring, severe symptoms often have a less favorable course and later suffer more frequently from chronic pain.

Unfavorable signs for later pain chronification can be

  • Rapidly occurring, severe neck pain
  • Significant restriction of the range of motion of the cervical spine
  • Pain radiating into the arms

In addition, the following risk factors are associated with a worse course of a whiplash injury:

  • A previous, survived whiplash injury
  • Increased age
  • Pre-existing back pain
  • High-speed accident

Diagnosis

The focus is on a detailed medical history and a systematic physical examination. Imaging/radiological methods can sometimes play a role in the diagnostic process. However, it is important to understand that X-ray examinations, CT scans and MRI examinations do not usually provide any direct evidence of the possible presence of a whiplash injury.

Conservative treatment

Most patients who suffer a whiplash injury experience an improvement in their symptoms in the first weeks and months after the triggering event. During the first days and weeks after a whiplash injury, pain management and the restoration of normal mobility are the focus of all therapeutic efforts. The aim is to ensure that affected patients are able to resume their usual activities as soon as possible. The healing process is positively influenced by the targeted use of medication and suitable neck exercises. Physical measures, such as heat or cold applications, as well as electrical treatment with TENS can also be helpful.

What to do in case of chronic progression?

Unfortunately, some patients with whiplash injuries suffer from a chronic course. These patients often suffer from persistent severe neck pain and have a poor quality of life. After six months at the latest, it should be specifically clarified whether irritation of the facet joints of the cervical spine (small vertebral joints) is the cause of the persistent whiplash symptoms. For this purpose, ultrasound or X-ray controlled test injections are recommended as part of a standardized procedure. If the typical neck pain disappears as a result of a test injection, treatment with radiofrequency can often provide lasting relief or even freedom from pain.

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