Whiplash
Learn more about common pain disorders, their development, and the pain mechanism.
Overview
Whiplash, also known as cervical acceleration-deceleration (CAD) trauma, refers to an injury in the cervical spine caused by sudden, jerking flexion and hyperextension of the head due to an unexpected force impact.
Causes
Whiplash is most commonly caused by a rear-end car collision. It can also result from sports accidents, falls, and other impacts on the cervical spine.
Symptoms
Typical signs and symptoms of whiplash develop within days after the neck injury and include:
- Pain and stiffness in the neck
- Pain that worsens with neck movement, extending to the shoulders and upper back
- Reduced range of motion in the neck
- Headaches, especially at the base of the skull
- Occasionally, tingling and/or numbness in the arms
- Fatigue and concentration difficulties
- Memory issues
- Dizziness
- Blurred vision
- Tinnitus
- Sleep disturbances
- Increased irritability
Pain Chronification
Most people with whiplash can be successfully treated with specific exercises and medications, resulting in symptom relief within a few weeks. However, some patients may experience a less favorable outcome, developing chronic neck pain that can persist for years. Predicting the recovery trajectory is difficult. Risk factors for poor outcomes and pain chronification include rapidly occurring severe neck pain, significant restriction in cervical spine mobility, and pain radiating to the arms. Previous whiplash injuries, older age, pre-existing back pain, and high-speed accidents are associated with a worse prognosis.
Diagnosis
History-taking and physical examination are the foundation of whiplash diagnosis. Imaging may play a role but is often not definitive. X-rays, CT scans, and MRIs typically do not provide direct evidence of whiplash.
Treatment
The recovery from cervical acceleration-deceleration trauma is generally positive, with symptom improvement occurring within the first few weeks and months post-incident. In the initial days and weeks after a whiplash injury, the focus is on pain management and restoring normal mobility. The healing process is supported by targeted medication use and specific neck exercises. Additionally, physical measures such as heat or cold applications and electrical treatment with TENS can be beneficial.
Chronic Course
Patients who do not experience significant improvement within a few weeks often suffer from persistent severe neck pain and reduced quality of life. By six months, it is essential to determine whether irritation of the cervical facet joints (small spinal joints) is causing persistent whiplash symptoms. This involves standardized procedures with ultrasound- or X-ray-guided test injections. If the typical neck pain disappears following a test injection, radiofrequency treatment can often provide lasting relief or even pain freedom.
