Wednesday, January 9, 2008

Whiplash


The Following is an Overview of Whiplash type Injuries.
Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of your neck (specifically ligaments, tendons, and muscles). It is caused when an abnormal motion or force is applied to your neck that causes movement beyond the neck's normal range of motion.
Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault.
The term whiplash was first used in 1928, and despite its replacement by synonyms (such as acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury), it continues to be used to describe this common soft tissue neck injury. Your doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury.
Whiplash Causes
The most frequent cause of whiplash is a car accident. The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, whether or not they wear seat belts.
Other common causes of whiplash include contact sport injuries and blows to the head from a falling object or being assaulted.
Child abuse, particularly the shaking of a child, can also result in this injury as well as in more serious injuries to the child's brain or spinal cord.
Whiplash Symptoms
These signs and symptoms may occur immediately or minutes to hours after the initial injury; the sooner after the injury that symptoms develop, the greater the chance of serious damage.
Neck pain
Neck swelling
Tenderness along the back of your neck
Muscle spasms (in the side or back of your neck)
Difficulty moving your neck around
Headache
Pain shooting from your neck into either shoulder or arm
When to Seek Medical Care
The best time to call your doctor is immediately after the injury. If the patient cannot determine whether an emergency department visit is needed for the symptoms, then contact the doctor and ask for advice. If the doctor is unavailable at the time of the injury, then call 911 for transport to the emergency department. The risks associated with a possible neck injury are far too great to attempt to diagnose and self-treat. See a doctor and have the patient's neck braced to keep the head from moving during transport.
Depending upon the severity of a car accident, emergency medical personnel may take the patient to an emergency department immediately. In this case, a cervical collar will be placed around the patient's neck, and the body will be strapped to a long, firm board to prevent any movements until a doctor sees the patient.
With less severe car accidents, sports injuries, or other accidental injuries, emergency medical services may or may not be involved in the patient's pre-hospital care. You should call the Doctor immediately if the patient develops any of the following symptoms shortly after the injury:
Neck pain
Pain in either or both arms
Shoulder pain
Headache
Dizziness
Weakness, tingling, or loss of function in the arms or legs
Exams and Tests
If the patient is transported to the emergency department with a cervical collar strapped around the neck, the emergency physician will remove the collar when appropriate.
In most cases, the collar will be removed without the need for x-rays if the patient meets all of the following criteria:
Normal level of consciousness or alertness
No muscle weakness or sensation problems
No evidence of intoxication with alcohol or drugs
No tenderness in the back of the neck
No other painful injury elsewhere on the body

Your collar will remain in place if the doctor determines that the patient needs x-rays of the neck.
The doctor will first examine the functioning of the spinal cord in order to determine if any damage is present. The following areas will probably be assessed:
Physical strength in both arms and legs
Ability to sense the touching of the skin in different parts of the body
Reflexes at the joints of the arms and legs

The doctor will also inspect the patient's head and neck for any external signs of trauma including bruises, cuts, and abrasions. The patient's neck will be pressed in specific areas to be sure the patient does not perceive any pain or tenderness. The patient may be asked to move their neck in a controlled way to the left, right, up, and down. Tell the doctor if neck pain, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers is felt.
X-rays may be taken of the neck bones to make sure there are no fractures or signs of other serious injury. The doctor will review these x-rays and order further imaging with a CT scan or MRI if needed. If the patient's x-rays are normal, then the cervical collar will probably be removed, and should not need any further x-rays.
Follow-up
If no serious injury is detected in the emergency department, then the patient will be allowed to return home and will be referred to their doctor for follow-up care.
If you continue to have symptoms from your whiplash injury, contact the doctor. Examine this list of complaints and mention any that the patient may be experiencing:
Neck pain
Headache
Increased fatigue
Shoulder or arm pain
Back pain
Blurred vision
Dizziness
Sleep disturbance or irritability in young children

Depending on the nature and severity of any continuing symptoms, the doctor may refer the patient to another doctor who specializes in the rehabilitation of these types of injuries. The doctor may also encourage physical therapy and monitor the patient for other injuries that may have been aggravated.
Outlook
Most people never recover completely from a whiplash injury. However for a majority, the symptoms will dissapate in the first six weeks. Others' symptoms continue to improve over the course of a year. There is a 40% chance of experiencing some symptoms after three months, and an 18% chance after two years. No reliable way exists to predict the prognosis.
A worse outcome has been reported in people with a more rotated or inclined head position at the time of impact injury.
The amount of time that elapses between injury and the onset of neck symptoms can predict the severity of injury and prognosis. A shorter time signifies a potentially severe injury with more frequent long-term complications.

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