WHIPLASH

What is it?
Whiplash is a neck injury which occurs when the head and neck are abruptly thrust in alternating directions. This commonly occurs after a motor vehicle accident.

How does it occur?
The head and neck are moved unexpectedly in different directions. The classic example of a whiplash injury is a motor vehicle accident. The neck and head are quickly moved in one direction then another. This will open and close the disc spaces and the small facet joints, stretch ligaments and muscles. This can result in injuries to these structures.

What are the symptoms?
Whiplash can produce neck pain, muscle pain, radicular pain, decreased and painful neck movement. If a disc is involved and is irritating or putting pressure on a nerve, this can result in arm pain, weakness and numbness.

How is it evaluated?
Whiplash is evaluated with a history and physical examination. X-rays of the neck are often performed to be sure no bones are broken or dislocated. If symptoms persist, an MRI of the cervical spine may be ordered. In chronic whiplash, facet joint injections and evaluation is performed.

How is it treated?
Medications such as non-steroidal anti-inflammatories and muscle relaxers are uses. Physical therapy is important to help keep and improve neck range of motion and strength and to decrease pain and disability. If there is a significant component of muscle or myofascial pain, trigger point injections may be helpful. If the symptoms persist, evaluation of the facet joint with facet joint injections or medial branch blocks will help determine if these structures are causing the pain. If needed, medial branch radiofrequency ablation may be helpful to reduce the ongoing pain and symptoms.

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