by Richard Hollis
Whiplash is a term used to describe injury caused by a sudden quick movement of the head forwards, backwards or sideways. This usually affects the neck and upper back and the acceleration/deceleration of the neck causes stretching and compressive forces on the joints, muscles, ligaments and nerves primarily at the front and back of the neck and upper back.
Road accidents are the main cause of whiplash, but it can also occur following any sudden blow to the head or a slip or fall where the head is suddenly and violently jolted backwards.
Following an accident, if there is any pain in the neck or upper back or pain that radiates from these areas, then assessment by a health professional is important, even if symptoms take a few days to develop.
The most widely accepted scale of whiplash injury was devised by the Quebec Task Force in 1998 and is as follows:
- Grade 0: no neck pain, stiffness, or any physical signs are noticed.
- Grade 1: neck complaints of pain, stiffness or tenderness only but no physical signs are noted by the examining physician.
- Grade 2: neck complaints and the examining physician finds decreased range of motion and point tenderness in the neck.
- Grade 3: neck complaints plus neurological signs such as decreased deep tendon reflexes, weakness and sensory deficits.
- Grade 4: neck complaints and fracture or dislocation, or injury to the spinal cord.
Treatment of whiplash grades 1-3 at the Broadgate Spine and Joint Clinic is done with a team approach. A chiropractor can perform treatment to speed muscular healing, mobilise stiff joints and a physiotherapist can advise on exercises to stretch and strengthen the injury.
Treatment of grades 3-4 usually follows assessment by our spinal surgeon. MRI scanning will determine if fracture, dislocation or nerve compression require surgical intervention.
Whiplash injuries have a reputation of being slow healers. Even grade 2 whiplash injuries can take up to 3 months to fully recover, but a combination of the correct treatment, a diligently followed exercise plan and time resolve the vast majority of cases at this severity. Grade 3 and 4 injuries often leave some unresolved pain, which may need ongoing management.