Whiplash Associated Disorder
What is Whiplash Associated Disorder?
Whiplash is a general termed injury that usually take place in a motor vehicle crash where the head is subject to sudden acceleration and deceleration, causing forceful bending in neck region. Since the movement is unlikely to occur in normal human range of motion, the muscles that control your neck movement do not have time to respond to the force, causing damage to the neck region.
The Quebec Task Force classifies Whiplash into five gradings, based on severity:
- Grade 0: No complaint about pain, tenderness, or stiffness of the neck. No physical signs.
- Grade I: Complaint of pain, tenderness, or stiffness of the neck without physical signs.
- Grade II: Complaint of pain, tenderness, or stiffness of the neck with musculoskeletal signs such as decrease range of motion and point tenderness.
- Grade III: Complaint of pain, tenderness, or stiffness of the neck with neurological signs such as sensory deficits.
- Grade IV: Complaint of pain, tenderness, or stiffness of the neck with signs of fracture and dislocation.
During a rear-end crush, the torso the carried forward, forcing the cervical spine, located in our neck, into an abnormal “S-shaped” position. Then, the head and neck were forced backwards since the torso was pulled forward during the collision. This may cause injuries to anterior cervical ligaments. The head and neck will swing forward as the driver stop the vehicle immediately.
Signs and symptoms
Whiplash Associated Disorder comprised range of symptoms including neck pain and stiffness, headache, memory loss, dizziness, dysphagia, and temporomandibular joint pain.
Patients with history of sudden or excessive neck extension, flexion, or rotation are in the risk of whiplash injury. During initial assessment, patient may report having reduced cervical spine range of motion, loss of muscle control in both cervical spine and shoulder gridle, loss or decrease in balance and deficits in neck-influenced eye movement control. For more serious cases, some patient may experience muscle degeneration in the cervical extensor muscles, lead to long lasting pain and disability.
In the first 96 hours after injured, mobilization such as active and passive range of motion exercises can result in reduced pain levels and improve function. Active rest, such as continue daily activity with brief rest period, can help blood flowing and muscle recover. Immobilization of long period of time can delay recovery time as muscle and ligament fibers are not aligned properly which can reduce strength and energy absorption capacity. Moreover, some patients will take NSAIDs to reduce inflammation, and neck rang of motion had reported improved after two weeks with medicine. Other physical treatments that practitioners will used are heat and cold packs, ultrasound therapy, and head traction. Theses can reduce pain and enhance recovery during the acute phase of whiplash injury.
During subacute phase, the goal for the patient is to return cervical muscle function as normal as possible. Light isometric and isotonic strengthening exercises that target the neck and scapular can help restore neck active range of motion. Light stretching also play a crucial role to improve tissue healing by increasing blood flow to the injured area. Vestibular and motor control exercises can improve neuro deficits and retraining muscle activation. Manual joint manipulation provided by chiropractors can reduce pain and initiate body’s natural healing processes. For ongoing management, continue with all the treatments stated above as well as increase the intensity of strengthen exercises.
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