Whiplash

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Diagnosis

Whenever a neck injury is suspected, the neck should be braced to prevent movement of the head. A cervical collar and back board may be used to achieve this until the patient can be seen by a physician.

Diagnosis of whiplash involves taking a medical history and performing a physical examination, including a neurological examination. Imaging tests (e.g., x-rays, CT scan, MRI scan) and blood tests (e.g., complete blood count [CBC], arthritis profile) may be performed to rule out other conditions, such as fracture, infection, tumor, or arthritis.

During physical examination, the head and neck are carefully examined. The physician evaluates the patient's level of consciousness, pain level, and ability to feel sensations, and looks for signs of traumatic brain injury (TBI) or spinal cord injury. The patient's mental state (e.g., alertness, confusion), motor function (e.g., muscle strength, coordination), and reflexes also are evaluated.

Although x-rays cannot detect cervical sprain or strain, they often are used to rule out or diagnose other conditions (e.g., fractured vertebra, damaged disc). Computed tomography (CT scan) and magnetic resonance imaging (MRI scan) also may be used to evaluate neck injuries

Treatment

Treatment for whiplash injury may include rest, ice and/or heat, a cervical collar (usually for about 2 weeks), and medications. Over-the-counter medications, such as pain relievers (e.g., acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen) often are recommended to reduce symptoms. Because of the risk for side effects, including liver and stomach problems, patients should be sure to follow package directions or the advice of a physician for taking these medications.

Pain that does not respond to conservative treatment may require prescription muscle relaxants (e.g., Flexeril®, Soma®, Zanaflex®), anti-inflammatory drugs (e.g., Celebrex®), non-narcotic pain relievers (e.g., Tramadol®), or narcotic pain relievers.

Physical therapy and occupational therapy are helpful in some cases of whiplash injury. Therapy may include range of motion exercises, massage, electrical stimulation, and cervical (neck) traction.

Prognosis

In most cases, complete recovery from a whiplash injury takes about 3 months. Symptoms that develop immediately can indicate a more severe injury that may result in long-term complications (e.g., chronic neck pain) and a poor prognosis.

Prevention

To help prevent whiplash injury in a car accident, headrests should be adjusted to the proper height for each person in the car, and seatbelts with shoulder straps should be worn.

Parents should be instructed in the dangers of shaking infants and young children. Appropriate equipment (e.g., pads, helmets) should be worn when participating in recreational activities and proper body mechanics should be used when lifting heavy objects.

Whiplash, Diagnosis, Treatment, Prognosis & Prevention reprinted with permission from pain.healthcommunities.com
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