WHIPLASH

If you have ever been in a car crash and experienced pain in your neck, you have most likely had whiplash. Whiplash, also called neck sprain/strain, is an injury to the structures of the neck. This type of injury is often the result of rear-end car crashes. Whiplash can include injury to the intervertebral joints, discs, ligaments, cervical muscles and nerve roots. The most common structure injured is the cervical facet joint.

Whiplash, although not technically a medical term, is very real and can be very painful. It is called whiplash because your neck really can whip back and forth—first backward (hyperextension) and then forward (hyperflexion). In reality, the specific biomechanics of this injury are far more complex than this, but these details are beyond the scope of this discussion.

Each year, over 2 million North Americans are injured and suffer from whiplash. It can be caused by:

  • Motor vehicle accident. The most frequent cause of whiplash is a motor vehicle accident (MVA). The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 8 miles per hour can produce enough energy to cause whiplash in occupants.
  • Sports injury
  • Fall
  • Being struck by a falling object
  • An assault

SYMPTOMS


The key symptom of whiplash is neck or upper back pain. If you have whiplash you might feel:

Neck pain

Shoulder pain

Upper back pain

Burning or tingling

Tightness or spasms of the neck or upper back muscles

You may also experience other symptoms, such as:

Numbness and/or tingling

Headaches

Dizziness

Nausea

Blurred vision

Ringing in the ears or blurred vision

Difficulty concentrating or remembering

Irritability, sleep disturbances, fatigue

Pain can start immediately, or it can develop days, weeks, and sometimes even months after the accident. Some people only have a little pain, but some experience a lot. Traditionally, it was believed that most people with whiplash recover fully. We now know that a significant number of whiplash injuries fail to improve without further intervention.

INTERVENTIONAL PAIN TREATMENT OPTIONS


Although whiplash pain and symptoms usually resolve in 6 to 8 weeks, if pain persists or worsens, interventional pain treatments are considered. Cervical medial branch nerve block steroid injection treats facet joint-related pain. Cervical facet joints may be sprained or damaged in much the same way other joints are injured in a high velocity “stop and go” movement.

Cervical epidural steroid injections treat pain secondary to a disc disorder / pinched nerve.

Your physician may perform electromyography (EMG), nerve conduction study (NCT), and MRI to confirm the cause of pain. Electromyography measures electrical activity in muscles. A nerve conduction test (NCT) to studies nerve function.

If pain returns after a cervical medial branch block, then a radiofrequency ablation of these nerves can be considered for longer term relief.