Acute Whiplash Explained

Aagh, you have just had the misfortune of your car being hit from behind!

It sounds obvious, but unless you hear and feel bony damage happen immediately with the force of impact, it is fair to assume that you have not sustained any serious, permanent damage.

If you suspect bony damage you should stay in the car and await the arrival of the paramedical services.

However the body has naturally strong protective reactions to limit damage. So apart from shock, the vast majority of whiplash injuries involve strain to soft tissues of the neck region, mainly muscles and ligaments.

So what exactly happens? From timed laboratory studies we know that the impact of being hit from behind causes the relatively heavy head and neck to bob forward very rapidly, then flick or 'whip' backwards.

In classic whiplash, as the head travels forward, skin and long muscles at the back of the neck from the skull down into the upper back area are rapidly stretched. The backward lash stretches skin and muscles at the front of the neck.

Skin is very elastic and often shows no outward sign of damage.

Just under the skin, large superficial muscles are designed to withstand stretching to a large extent. However the speed of the stretch in whiplash can cause overstretch. This leads to microscopic tears or bruising developing throughout the muscle fibres.

Where muscle bruising occurs in whiplash, it may feel fine immediately after the collision but gets worse over the following few days.

In this case pain is often accompanied by discomfort over the area, with a feeling of muscle stiffness, just as if you had done some extra physical activity a few days before.

In fact, this is exactly what has occurred, as the superficial muscles have worked extra hard trying to contract strongly to prevent over stretch.

These muscles have an excellent blood supply and appear to be designed to self heal. This process can be helped along with rest, ice initially, heat after 48 hours, over-the-counter painkillers or anti-inflammatories and gentle neck stretching movements after the first three days.

Rest implies simply reducing excessive physical activities for some 2-3 weeks. Within 14-21 days, as you feel the discomfort melting away, you can gradually resume activities one by one. Research proves that 80% of all whiplash symptoms fully recover in about one month without any medical intervention.

However if more damage is sustained, recovery may not be so smooth. Of the 15-20% of people who experience a more severe whiplash, damage is usually more complex, affecting many different tissues.

Spinal ligaments holding the neck bones together may tear to some extent, along with small muscles right on the front of the neck bones. With the force of impact, as the head pushes backwards the small joints at the back of the neck can compress or bang off each other. This causes joint stiffness that can restrict neck movement. The jaw joints can also be damaged.

Sometimes delicate nerves emerging from the neck are also overstretched and hurt. This can lead to pain over a wide area of the face, head, neck, upper back, shoulders and arms.

In terms of seeking treatment, a good rule of thumb is that if the pain is settling well during the first week, it is safe to wait and see, using the simple self help approach outlined above.