Whiplash, also known as a cervical spine distortion or an acceleration injury, is caused by a sudden and forceful acceleration of the head, which leads to a hyperextension of the cervical spine. Whiplash typically occurs after car accidents, especially rear-end collisions. The symptoms usually develop within 72 hours and can vary. The following provides a comprehensive overview of the causes, symptoms, diagnosis, treatment and prevention of whiplash injuries.

Mann hält sich vor Schmerz den Nacken und Kopf fest

Overview of whiplash

Whiplash is commonly caused by accidents in which the head is suddenly thrown back and then whipped forward, as is often the case in rear-end collisions. This movement leads to the overextension of the cervical spine without there necessarily being any visible injury. Those affected typically complain of headaches, neck pain and dizziness, which occur within three days of the accident. Treatment depends on the individual symptoms and can range from pain medication to physiotherapy.

Causes and risk factors

The most common causes of whiplash injuries are

Car accidents

Car accidents, especially rear-end collisions, are the most common cause of cervical spine distortions.

Falls or sports accidents

Whiplash can also occur during contact sports or falls, especially if there is a sudden  impact on the head or neck.

Risk factors that can increase the likelihood of a whiplash injury include:

  • High impact speed in case of accidents.
  • Poor seating position or incorrectly adjusted headrests in the car.
  • Pre-existing neck problems or injuries.

Disease progression

After a whiplash injury, the symptoms usually appear within 72 hours and can last for several weeks to months. In most cases, the symptoms resolve completely within six months. In rare cases, however, the symptoms become chronic, which can lead to long-term complications. The causes of the development of chronic symptoms are not yet fully understood. If a whiplash injury is left untreated, there is a risk that the symptoms will worsen and possibly develop into chronic conditions.

Symptoms

A whiplash injury causes a variety of symptoms. Those affected frequently complain of

  • Headaches: the most common complaint.
  • Neck pain: often accompanied by stiffness.
  • Dizziness: balance disorders.
  • Vision problems: blurred vision.
  • Ringing in the ears: tinnitus.
  • Speech disorders: difficulty speaking.
  • Sensory disturbances: numbness in arms or shoulders.

These symptoms can have a significant impact on everyday life and should be taken seriously.

Diagnosis

The diagnosis of a whiplash injury is made by a neurologist based on the circumstances of the accident and the typical symptoms. Imaging techniques such as X-rays or magnetic resonance tomography are generally used to rule out cervical spine injuries. These examinations help to identify serious injuries and initiate targeted treatment. 

Differences between whiplash injuries and concussions

A whiplash injury affects the cervical spine as a result of a sudden hyperextension of the neck, while a concussion is caused by a direct or indirect head injury and affects the brain itself.

Treatment

Treatment of a whiplash injury depends on the specific symptoms and may include the following measures:

Pain medication

Pain medication is often used to relieve the acute pain that is caused by a whiplash injury.

Muscle relaxants

Muscle relaxants can be used as part of whiplash treatment to relieve muscle tension and spasms.

Physiotherapy

Following a whiplash injury, exercises are recommended to improve mobility and relieve pain.

Avoid neck braces

Neck braces should only be used in the short term to relieve acute pain. Long-term use can weaken the muscles and impede the healing process.

In most cases, a combination of drug therapy and physiotherapy is successful and patients make a full recovery within six months. During the acute phase of the symptoms, sick leave of a few days to weeks is usually required, depending on how severe the symptoms are. In the case of acute whiplash injury, driving is not recommended until the acute symptoms have subsided. Activities that strain the neck or require a relaxed posture should be avoided so as not to impede the healing process.

Prevention

The following measures can be taken to prevent whiplash:

Correct positioning of headrests

Car headrests should be positioned in such a way that the upper edge reaches at least as far as the top of the head and the distance between the back of the head and the headrest is less than 5 cm. This minimises the backward movement of the head in the event of an impact and reduces the strain on the cervical spine.

Fastening seat belts correctly

Seat belts should go over the shoulder and across the chest without touching the neck, and the lap belt should be low across the pelvis. Both belts should fit snugly in order to secure the body in an optimal manner in the event of an accident and minimise forces on the neck.

Defensive driving

Always drive carefully and look ahead, maintain a sufficient distance from other vehicles, choose a speed that is suited to the traffic conditions and avoid risky manoeuvres. 

Protective measures during sport

Suitable protective equipment such as helmets and neck supports should be used when participating in sports that involve a high risk of injury. It is also important to learn and apply the correct techniques and follow the safety rules in order to avoid injuries and reduce the risk of whiplash.

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