A whiplash injury can occur when the body is suddenly subjected to an external force that throws the head from one outer position to another. The injury can be described as a puncture of the neck that can cause everything from mild to more severe symptoms.

A common cause of whiplash injury in traffic accidents, but also for example tackles, strokes and fall accidents in sports such as hockey and riding can cause injury.

Symptoms of whiplash injury

If you have a whiplash injury, it is common for the symptoms to appear within a few days.

Symptoms of whiplash injury that may occur are

  • sore throat and stiffness
  • pain in the head, arms, shoulders or between the shoulder blades
  • teasing, sticking, numbness or other impacts on the face and one or both arms
  • low back pain, sometimes with radiating pain in the hips and legs
  • dizziness
  • tinnitus or hearing impairment.

Over time, you can also become more sensitive to sound, light, smell, taste, and touch.

You may also get memory difficulties and symptoms from other body parts and organs.

When should I seek care?

If you suspect that you have had a whiplash injury, contact a health care center. If you are in a lot of pain, contact an emergency department.

Seek care as early as possible to find out if your symptoms are due to a whiplash injury. The earlier you are examined, the easier it is for the physician to link the symptoms to the injury.

What can I do for myself?

Regardless of which treatments of whiplash injury you try, it is good if you from the beginning draw a full-body image where you shade areas with trouble. The picture is usually called pain drawing, pain drawing or trouble drawing. You can then update the image if the symptoms of whiplash injury change over time or after different treatments.

It is good if you avoid stress and make fewer demands on yourself during the time after the injury has occurred. A doctor may need to assess how active you can be, for example, how much you can work.

All healing in the body is dependent on blood circulation, which is activated as you move. Small head movements and quiet forest walks can be good for healing and relaxation.

It is also important to try to sleep well. It allows you to cope better with pain. Otherwise, sleep problems can affect memory.

Relieve pain

It is important to reduce the pain so that you can get started early on moving and sleeping well. You can try taking anti-inflammatory painkillers, NSAIDs, for a few days. Examples of such drugs are Ipren or Naproxen. It may sometimes be good to take medicines containing omeprazole to protect the lining of the stomach.

You can also take pain-relieving drugs such as Alvedon or Paracetamol, individually or in combination with anti-inflammatory painkillers, NSAIDs.

If you are over 75, have cardiovascular disease or have had a stomach ulcer, use paracetamol instead of anti-inflammatory painkillers.

Cooling or heat can relieve

For example, you can put an ice bag where it hurts to relieve the pain. A warm scarf or heat pad can make your muscles relax.

Relaxation

It is good for the healing process to do relaxation exercises. You can get help from a physical therapist if you have difficulty doing the exercises. Physical therapists are sometimes also called physiotherapists.

Read more: Stress management and sleep

How can I prevent a whiplash injury?

Whiplash injuries are most common in traffic and in some sports.

In traffic, you can prevent whiplash injury by keeping a distance from other cars and following the exposed speed, so that the traffic flows without rapid changes in speed. It is important that you stay focused on driving and not on any calls, SMS or the like. You should be aware of what is happening, not least through the rearview mirror.

The head restraint should be set as high and close to the head as possible. You should also avoid having a towbar on the car if it is not necessary, as it increases the risk of head injury when driving from behind.

Some sports involve an increased risk of whiplash injuries, such as American football, ice hockey, and martial arts. Unfortunately, head protection does not protect the fragile structures found in the neck and spine.

There are other situations where you are also at risk of a whiplash injury. Such situations are, for example, riding a roller coaster or jumping Bungy jump.

A child can also suffer the same injury if it is shaken vigorously.

Treatment of whiplash injury

If you have a whiplash injury, you may be treated. The treatment of whiplash injury you receive depends on what problems you have received and how they develop. The cause of the inconvenience can vary from person to person depending on how the injury occurred and, for example, physique. It is important that the treatment you receive is based on a specific diagnosis as possible. Then advice and measures can be adapted to your situation. Treatment can change over time, depending on how your symptoms change. Examples of professional groups that you can meet are doctors, physiotherapists, naprapathy, and chiropractors.

Different treatments work differently well for different people. If one treatment does not work for you, you may want to try another. It can sometimes also be good to take your work and leisure activities into account when deciding on treatment.

Other tips that are usually given are:

  • Exercise posture, as good posture in rest and movement is good for the joints.
  • Exercise is good, as it provides increased circulation in the body. Increased circulation provides better oxygenation and nutrition for damaged tissue.
  • Avoid so-called manipulative measures of the neck, as they can aggravate the injury.

Physiotherapy

At the physiotherapist, you can get advice on training and posture that can improve healing. There you can also get knowledge on how you can vary your position in everyday life to avoid extreme situations. You can do balance exercises if you have dizziness.

Acupuncture

You can also try acupuncture to relieve pain. The goal is to release the body’s own pain-relieving substances, called endorphins, through thin, sterile needles that are inserted at certain points on the body.

Tens

Another treatment method that can be tested is tens, which stands for transcutaneous electrical nerve stimulation. With the help of a tensor, selected muscles, tendons, and leads get weak electrical impulses. You can sometimes borrow a tens device to treat yourself at home.

Treatment with drugs

In addition to counseling, the treatment of whiplash injury you can get can also consist of drugs. For example, you may meet specialists in general medicine, pain doctors, orthopedics or rehabilitation doctors. They can prescribe painkillers to help you move and sleep comfortably. Some drugs are sedative, while others, for example, can affect the nervous system and raise your pain threshold.

Therapy

You may need to get a referral to a curator, occupational therapist or psychotherapist to try for example cognitive behavioral therapy, KBT, or acceptance decision therapy, ACT. It can help you deal with difficult situations.

It is good to get treatment early for, for example, sleep problems, anxiety, concentration difficulties, memory difficulties or signs of depression. You can get help with such symptoms at a rehabilitation clinic, pain clinic or a clinic that specializes in whiplash injuries.

Operation

You may have surgery if you are unstable in the spine, or if your nerve tissues are affected. An operation is done only when other possible treatments have been tried and there are clear signs of a serious injury.

What is a whiplash injury?

The word whiplash injury only gives a picture of how an injury has come about. In the body, it is mainly the head and spine that can be subjected to a rapid movement similar to a whip. The head weighs several kilos and sits together with the spine with thin ligaments, muscles, and tendons. This means that even small changes in direction and speed can lead to damage. The injuries can occur mainly in the spinal cord’s ligaments, discs, nerve tissue, tendon tissue, and muscle tissue. A vehicle speed as low as 6-8 kilometers per hour can, if you are unprepared, cause the head and neck back to be subjected to forces of up to 4.5 G, which is considered the limit for the occurrence of a lighter whiplash injury.

What happens in the body during a whiplash injury is very individual. If you have been able to tighten muscles and prepare yourself before the whiplash movement occurs, you can avoid injuries at best. If injuries occur, they can range from mild to more severe.

Spinal cord joints – joint capsule, ligaments, ligaments, and discs

The joints in the back receive so-called passive stability of ligaments and ligaments, which have a certain stretchability but can burst if the tensile forces are sufficiently large. Muscles in the back can partially compensate for some instability in the back while the ligaments and ligaments get a chance to heal. Nevertheless, there is a risk that, over time, you may develop osteoarthritis in a damaged joint, as a result of continued instability and inflammation

In the midline of the spine are longitudinal ligaments and ligaments. Damage to ligaments that hold discs and vertebrae together is called discoligamentary injury. They can lead to instability in the back, but also disc curvature or leakage of the contents of the disc. In both cases, radiating discomfort can occur in different body parts and organs, depending on the levels of the spine that have been damaged.

Following such an injury, an X-ray examination can show the following:

  • Changed the shape of the spine.
  • Vertebrae that slide apart.
  • Discs that have become darker and thinner over time.
  • Disk bending of various degrees.
  • A bone tuber.
  • Scars in the casing of the counter.
  • Change of the end pieces of the motor.

The bone tuber can take a long time to grow and can in itself cause it to become too tight for the spinal cord and nerves. In the long term, vertebrae can also grow together.

muscles

There are many superficial and deep muscles in the neck that stabilize the spine and cooperate as you move. In a whiplash injury, these muscles are subjected to so-called eccentric load, which means that the muscle is stretched while trying to contract. It can cause parts of the muscle to break.

Disorders of the balance organs

The balance is largely regulated in the upper neck. In the upper neck joints, deep muscles and ligaments, there are many sensory bodies that give signals about the posture of the head in relation to the back. The sensory bodies are important for balance ability. The balance sense also includes the vision and the inner ear’s balance organ. If the signal from the neck joints is disturbed, it can cause problems with balance, as well as dizziness and nausea.

Other possible inconveniences

If you get bleeding in the soft parts of the throat it can lead to a lumpy feeling and you will have difficulty swallowing for a few days.

Having pain for a longer period of time can cause you to become more sensitive and react more strongly to pain. This is due to changes in nerve pathways. For example, you may become more sore than usual and you may react more strongly to pain after a lighter load of a muscle. You can also react more strongly to, for example, smells and flavors. This increased sensitivity of the nervous system is usually called sensitivity.

WAD degree and clinical significance

Internationally, whiplash injuries are divided into five groups. The division is usually called WAD, which stands for Whiplash Associated Disorder, and has been made to be able to adapt the treatment to various whiplash injuries.

The gradation of whiplash injury depends on the symptoms and findings noted:

  • 0: No neck problems, no clinical findings.
  • I: Neck problems in the form of only pain, stiffness or tenderness, no clinical findings.
  • II: Neck problems and clinical findings from muscle and/or skeleton.
  • III: Neck disorders and clinical neurological findings.
  • IV: Neck and leg fractures or misalignment.

Investigations

At the doctor’s, you first have to go through a body examination and answer questions. You may be asked to fill in so-called trouble drawing. There you can describe your symptoms yourself. You can also answer questions about how and when the injury occurred, what your social situation looks like and any other injuries, illnesses, and medication.

With the help of a body examination, the doctor or physiotherapist will check how your reflexes and feelings work and if there are any signs of spinal instability. The diagnosis is also made using various so-called imaging examinations, such as x-rays and sometimes magnetic cameras. You may need to go through examinations several times if your symptoms change.

Based on the assessment made, you will be given advice on which treatment is right for you.

Various surveys

X-rays are made on suspicion of an injury classified as WAD grade II, III or IV. X-rays are then taken on the cervical spine and possibly other parts of the spine. The pictures should be taken as you bend forward, backward and sideways. In this way, any instability in the back is better seen.

One type of X-ray used is magnetic resonance imaging, abbreviated MRI. It is used in cases of suspected whiplash injury that can be classified as WAD grade III or IV. MRI can show if the spinal cord or nerve roots are damaged, such as during acute disk bulging or displacement of the vertebrae. You lie down during the investigation. In some situations, computed tomography may be needed instead.

Other possible investigations

If, after what has happened, you have problems with dizziness or balance, you may need to go through an examination for it. Such inquiries are made at special receptions.

You may be able to do an examination of the jaw joint if you have problems with the jaw and have difficulty gapping. The jaw and neck joints mutually affect each other. You can get a referral to a dentist to determine if the bite is skewed. Sometimes a bait rail can help.

Complications

Instability of the spine joints can basically cause you to get symptoms of whiplash injury from all organs in the body. It may be due to changes in the spine that have arisen urgently or over time.

Many people who have suffered a severe whiplash injury continue to have symptoms, especially if nerves are damaged or if you have an unstable spine. In addition to neck and headache, you may have the following symptoms:

  • Poor balance and vision.
  • Tinnitus.
  • Lumpy feeling in the throat.
  • Discomfort from the jaw.
  • Pain in the chest.
  • Stomach ache.
  • Work in large parts of the body.

You may also feel depressed, anxious, and more difficult to sleep.

The instability of the spinal joints can cause them to become movable in these joints and with time develop osteoarthritis. The osteoarthritis can, in turn, make it too narrow for nerve signals to pass and cause nerve impingement in different parts of the back. For example, a severe form of nerve impaction can occur in the transition between the head and the spine, where all the nerve strands of the brain should pass. If an injury has occurred to the thin ligaments that hold the head in place relative to the spine, it can also lead to instability and to the nerve trunk being affected.

The risk of long-term problems is greater among women, the elderly and people who already had problems from the spinal cord injury before the whiplash injury. If you are too afraid to move after the injury, it is also considered to increase the risk of long-term complaints.

If you have long-term problems

If you are still in pain and hard to work and manage everyday life a month after the whiplash injury, it may be advisable to have the complaints assessed by more than one healthcare provider. You can get a referral to a physiotherapist via a doctor at a health center. You should get a comprehensive investigation of your entire life situation if you have been suffering for a long time. This includes, in addition to an assessment of the actual injury, your mental and social situation.

Such assessments are usually made at a rehabilitation clinic, pain clinic or a clinic that specializes in whiplash injuries. If there are clear signs of instability and nerve impingement in the spine, you may be referred to a neurosurgeon or orthopedic surgeon. You may only undergo an operation of the cervical spine if there is clear evidence of instability, nerve damage, or both.

If the inconvenience results in you not being able to work for an extended period of time, you may need to undergo rehabilitation aimed at being able to start working again. The employer shall cooperate with health care and the insurance fund. It is important that you find a form of rehabilitation that works and helps you get back to working life. It is almost always best to start working in some form, rather than being full-time sick.

Living with long-term problems

For example, if you suffer from long-term problems after a whiplash injury, you may find it difficult to sleep, concentrate and remember. You can lose the spark of life and feel dejected and worried about the future. It may be due to the accident itself, but also because you are in pain and that life has changed after the injury. Sometimes it can be difficult to handle even simple tasks in everyday life, such as doing the laundry, lifting objects, working at a computer or spending time with family and friends. You can also find it difficult to plan your life from one day to the next because the pain can come and go and prevent you from doing what you want and need to do. Therefore, it is good if you can find different ways to deal with the pain and try to get the best quality of life possible. 

Patient organizations can provide support

It is important that you get the help you need to improve your situation and be able to handle the grief that life has changed. In addition to public and private care providers, there are several patient organizations that are open to anyone who wants help and to those who want to increase their knowledge of whiplash injuries.

  • Neck Injury Association
  • Personal Injury Association RTP
  • The right of neck, spine, and brain was investigated and diagnosed after trauma

These organizations can be valuable to you if you want to share other people’s knowledge or provide support and support from others. There, there are often voluntarily engaged people who can contribute information. Maybe something that interests you, or that you know more about, is discussed.

New medical assessment

You can get a new medical assessment from another doctor, a so-called second opinion. Obtaining another doctor’s assessment can help you, for example, if you are unsure which treatment is best for you.

Wanting to get a new medical assessment does not mean that you are dissatisfied with your doctor’s assessment. If you want to know more about how to get a new medical assessment, ask your doctor.

Advice to related parties

As a relative, you may be worried about the hassles and reactions that may come after a whiplash injury. Many thoughts and questions can emerge, such as how the person who was involved in the accident will feel if you as a relative will be able to be a support and how to do something to help. Uncertainty can cause fear. A good way to handle a new situation is to obtain information. Important sources of information can be doctors, nurses, other care providers, and patient organizations.

You can make an important contribution by following us when you visit the health care. Then you get support from each other and can often understand the information better and ask questions.

A related child needs information on how it can best help. The child may, for example, be allowed to visit a doctor.

Ehtisham Nadeem

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