A whiplash injury is essentially an externally invisible injury to the soft tissue in the area of the cervical sp ine. This is often the result of acceleration, as can occur, for example, in a rear-end collision or during games and sports. Because it is usually not noticeable from the outside, consequential damage may have occurred in the area of the cervical vertebrae that requires rapid treatment. Therefore, if whiplash is suspected, it is essential to seek medical advice!
The majority of whiplash injuries affect the soft tissue in the cervical and neck area, especially the ligaments, without involving the bones. In severe cases, the spinal cord in the area of the cervical vertebrae can be damaged, especially if bone structures are involved. Secondary damage usually occurs due to edema, circulatory disorders or delayed bleeding.
Depending on the degree of severity, doctors divide whiplash injuries into the following 5 classes:
0: without symptoms, usually asymptomatic
1: neck pain occurs, stiff neck
2: Muscle tension and neck pain, onset of movement restrictions
3: Neck problems with nerve involvement (neurological findings)
4: Neck pain, fractures and dislocations in the neck area
The symptoms of whiplash depend on the severity of the injuries and the involvement of bones and nerves. As a rule, symptoms can also occur hours to days after the trauma, as bleeding and edema in particular take a certain amount of time.
The most common symptoms after a whiplash injury are
occur. Neck stiffness is also described. Depending on whether neurological damage has occurred, there may be
- difficulty swallowing,
- sleep problems,
- impaired vision and hearing and
- sensory disturbances in the area of the face and arms.
can occur. In severe cases, disorientation and gait instability may occur.
Important: If whiplash is suspected - especially if disorientation, dizziness or neurological deficits occur at the same time - please always consult a doctor immediately!
Whiplash is caused by sudden, jerky overextension of the head @ highwaystarz /AdobeStock
If whiplash is suspected, an X-ray is usually taken to rule out vertebral damage. Magnetic resonance imaging (MRI) is used to detect possible more severe soft tissue damage, for example to blood vessels, nerves or muscles. However, such additional examinations must be planned according to the current S1 guideline of the German Society of Neurology (DGN) depending on the findings. It is particularly important to avoid overdiagnosis.
As a rule, whiplash is treated conservatively depending on its severity. The white neck brace, which used to be so common, is used less and less today. This is mainly due to the fact that the neck brace immobilizes the neck area for too long, resulting in additional weakening of the muscles. This ultimately results in further functional restrictions in the neck area. Instead, the guideline recommends more physiotherapeutic measures and special movement exercises.
The current S2 guideline from the DGN suggests the following therapeutic measures, among others:
- conservative approach with a few days of immobilization, followed by activation of the patient,
- Depending on the pain symptoms, painkillers are administered for a short period of time,
- if necessary, muscle relaxants can be used for a few hours to relax the muscles in the neck area and thus reduce the pain,
- targeted physiotherapy,
- consistent psychoeducation combined with re-presentation,
- short-term sick leave of around three weeks with the possibility of extending it.
The primary goal of whiplash therapy today is to get patients back to work as quickly as possible.
Only in the case of serious injuries with neurological or orthopaedic symptoms is interdisciplinary treatment with surgery planned.
In the majority of cases, whiplash only results in soft tissue damage, which has a good prognosis. However, it is important that doctors also communicate this good prognosis, allay fears and encourage patients to take action. Without this intensive information and advice, those affected often develop avoidance behavior, which ultimately makes the symptoms chronic and hinders healing.
As whiplash is usually the result of an accident or sports injury, the emergency room will be the first point of contact for patients. Depending on the severity, however, the family doctor or neurology specialists may also be involved.
