Whiplash

When the cervical spine is subjected to a very rapid flexion-extension or lateralization movement due to an external contusion, an injury known as whiplash occurs.

How is it produced?

Whiplash usually occurs when people who travel in a vehicle suffer a lateral or more frequently posterior contusion. When suffering it, the neck is subjected to a movement of acceleration or flexion followed by a second opposite movement of deceleration or extension. When these two movements occur abruptly and at high speed, the cervical muscles, which are not prepared for them, contract sharply and drag the cervical spine with it, which can cause damage of different degrees of severity.

Symptoms

The main symptoms of whiplash are neck pain and muscle tightness. Cervical pain in general does not radiate, it is localized in the neck, but sometimes it can do so towards the jaw, shoulders or thorax, due to compression of the nerve roots that come out of the cervical spinal cord caused by the contracture of the musculature surrounding the cervical spine. The pain usually increases within two to three days of the trauma.

Occasionally, depending on the force of the impact and whether or not there has been an associated head injury, confusion, temporary time-space disorientation, or headaches of greater or lesser intensity may appear. Likewise, there may be an associated dizzying picture.

The contracture of the paravertebral muscles causes that the movement of the neck is limited, both in flexion and extension and in rotation, and the pain can increase when trying to do these movements, especially during the first days after the whiplash.

In whiplash due to very strong impacts, a cervical disc herniation can occur which, after solving the acute problem, will require follow-up and probable treatment by the orthopedic surgeon or neurosurgeon.

Depending on the affectation that occurs, whiplash can be classified into:

• Grade I: symptoms related to the contusion are seen without contracture or neurological involvement.
• Grade II: limitation of mobility of the cervical spine without neurological involvement.
• Grade III: associated neurological involvement is observed.

Diagnosis

The diagnosis will be based on the patient's explanation of the trauma and on the physical examination. A more or less contracted cervical musculature will be appreciated, with limitation of mobilization and pain when pressing on the muscle groups and the spinous processes (extensions of the vertebrae backwards) of the cervical vertebrae. A complete neurologic examination should be performed to rule out nerve root involvement or brain contusion.

In the, a cervical rectification will be appreciated, that is, it will be seen that the cervical spine is straight, it will have lost its lordosis (curvature) due to the traction produced by the adjacent contractured muscle groups.

In case of acute neurological involvement or for the subsequent control of grade II and III whiplash, one and one can be performed if necessary.

Treatment

Treatment will depend on the degree of whiplash. Initially, regardless of the case, cervical pain and contracture will be treated with non-steroidal anti-inflammatory drugs and muscle relaxants.

Immobilization and rest are necessary initially, but only during the first 72 hours, because if the muscles are lengthened further, they suffer a certain degree of atrophy and recovery is more difficult. The collar should only be placed on grade II and III lashes and never for more than three days, as well as relative rest.

From the third day it is necessary to start a series of cervical exercises combined with rest and postural measures to mobilize the muscles and prevent them from atrophying. Local dry heat using an electric mat or hot water bottle can also help.

Rehabilitation may be necessary for grade II and III whiplash to restore muscle tone and strength after limited mobility. With it you can have quality specialized assistance both in consultation and in diagnosis and therapy, as well as in surgical interventions. In addition, if you wish, you can add other optional benefits to your policy with all the guarantees and experience of the professionals that make up MAPFRE.

PRECAUTIONARY MEASURES

There are no preventive measures to avoid whiplash, you can only try to drive carefully, at a moderate speed and always wear your seat belt to avoid greater damage in the event of a side or rear collision with another vehicle.