What is whiplash? |

Causes and Symptoms

When a moving car

collides with an obstacle, the driver and passengers suddenly feel themselves thrown forward. If an occupant’s head hits the dashboard or windshield, then serious injury can result. Seat belts, a padded dashboard, and air bags can reduce the severity of the impact. Conversely, when a car is hit by another vehicle from behind, the occupants will feel an extra forward push against the trunk of their body while the head snaps backward. This so-called whiplash effect is like the crack of a whip made by the driver of a team of horses, in which the whip handle is rapidly moved forward while the end of the rope snaps backward. In a rear-end automobile collision, if a person’s head flies backward beyond its normal range of motion, then the muscles and ligaments of the neck can be damaged. The person may not feel pain
right away, but it can
show up after a delay of some days. In severe cases, vertebrae of the spine can be knocked out of alignment or fractured. Most commonly, injury occurs at the junction of the fourth and fifth vertebrae. The upper four vertebrae are flexible and act as the lash, while the lower ones act as the handle of the whip.

Treatment and Therapy

Various treatments for whiplash are available, depending on the severity of the injury. Physically demanding activities such as sports or heavy lifting should be avoided. For pain control, aspirin or other anti-inflammatory drugs can be taken. If muscle spasms occur, then a physician may prescribe physical therapy, which includes heat treatment, massage, and stretching exercises. Wearing a neck collar can be useful to limit the motion of the head so that the muscles and ligaments can heal.

Perspective and Prospects

Most automobiles have a headrest attached to the top of each seatback. Its purpose is to prevent an occupant’s head from snapping backward in a rear-end collision. Whiplash injuries happen frequently in cases such as a multiple-car pileup on an interstate highway. Slower speeds and a greater distance between cars are especially important during foggy driving conditions or on an icy road.

Whiplash injury is not limited to car accidents. In football, a quarterback sometimes is tackled from behind, causing the same effect as a car collision from the rear. On the ski slope, a skier may lose control and crash into someone who has stopped to rest. During the snow season, some mountain towns have a tubing hill where people can slide down on inflated inner tubes, with frequent collisions resulting. Any activity that causes excessive flexion of the neck muscles and ligaments can result in whiplash injury.

Bibliography

American Medical Association. American Medical Association Family Medical Guide. 4th rev. ed. Hoboken, N.J.: John Wiley & Sons, 2004.

Carson-DeWitt, Rosalyn. "Whiplash." Health Library, June 24, 2013.

Foreman, Stephen M., and Arthur C. Croft. Whiplash Injuries: The Cervical Acceleration/Deceleration Syndrome. 3d ed. Philadelphia: Lippincott Williams & Wilkins, 2002.

Kasper, Dennis L., et al., eds. Harrison’s Principles of Internal Medicine. 16th ed. New York: McGraw-Hill, 2005.

Komaroff, Anthony, ed. Harvard Medical School Family Health Guide. New York: Free Press, 2005.

"Neck Pain." American Academy of Orthopaedic Surgeons, November 2009.

Rook, Jack L. Whiplash Injuries. Philadelphia: Butterworth-Heinemann, 2003.

"Whiplash." MedlinePlus, June 4, 2011.