Whiplash is the collective term for complaints that can occur after the head has made a sudden violent movement. This may have been a movement forward, backward and / or to the side.

A so-called 'classic whiplash' occurs when someone is hit from behind. The head of the occupant of the car that has been hit will first be pushed back vigorously. The moment the stopped car comes to a halt again, the head is strikingly forward. The neck then made a movement of a 'whiplash': the literal translation of whiplash.

With a whiplash, the head has always made a violent movement with respect to the rest of the body. To more accurately indicate which movement has made head, some doctors also call the whiplash acceleration injury (head struck forward) or deceleration injury (head struck backwards). The term Cervical Acceleration Injury (CAL), also referred to as acceleration injury in the neck vertebra region, is used.

These movements are accompanied by a lot of speed and power. As a result, stretching, compression and shift (micro) injuries can result in various structures such as vertebral bodies, vertebral joints, intervertebral discs, ligaments, muscles, neural pathways and brain tissue. If the head was turned at the moment of the accident, the risk of injury is greater.

Symptoms

The whiplash condition is divided into different stages related to the severity of the complaints. The elapsed time can also be divided into phases.

The clinical symptoms (WAD = 'whiplash associated disorders') can be divided into five degrees.

0 - no complaints, no subjective and objective deviations

1 - pain, stiffness and sensitivity in the neck, but no objective deviations

2 - neck complaints and other complaints of the postural and musculoskeletal system (eg reduced mobility, pressure point sensitivity)

3 - neck complaints and neurological deficits (for example decreased or disappeared tendon reflexes, muscle weakness and sensory disorders)

4 - neck complaints and fractures or dislocations * Symptoms such as deafness, dizziness, ringing in the ears, headaches, loss of memory, swallowing disorders and pain in the temporomandibular joint can occur at any level of severity.

The elapsed time since the accident can be divided into six phases:

up to four days;

four days to three weeks;

three to six weeks;

six weeks to three months;

three to six months

and longer than six months.

Symptoms of whiplash

The most common whiplash complaint is a painful, often stiff neck. Many whiplash patients also suffer from headaches, low back pain and radiating pain to the arms and face. However, there are many more complaints that can be part of a whiplash trauma, such as loss of strength in the arms, dizziness, balance disorders, nausea, tinnitus, poor vision or staining of the eyes and sleep and concentration problems. Not only the nature, but also the seriousness of the complaints is very different. Half of the patients were recovered within a month, but sometimes the consequences are so serious that it leads to incapacity for work.

Diagnosis

Because the whiplash trauma is often associated with a head-to-tail collision, the diagnosis is often made much less quickly or not in patients with a different accident. What exactly is being damaged at that moment is still not properly demonstrated. However, there are different theories about it. The most plausible of these is that (as with a sports injury) ligaments are stretched and / or muscle fibers are damaged. Most abnormalities are difficult to visualize with current medical techniques such as X-ray photography, CT scan, EEG and MRI, which makes some people tend to see the symptoms as psychological. The diagnosis is made on the basis of the known complaints of the patient.

Causes

The main cause of the whiplash trauma is the rear-end collision, where the head, which usually weighs 5 kilos, swings back and forth at great speed.

The whiplash trauma is regarded as a typical disorder of the twentieth century, because the increasing number of patients is mainly due to the fast-growing motorized traffic. If you look at the rear-end collision, the following happens: There is a car waiting for the traffic light. And the driver of the car coming back does not pay attention and crashes with great speed on the waiting car.

If you now assume that the moving car is traveling at 50 km / h, this causes a rearward acceleration of the head of 250 km / h when the vehicle is stationary. The muscles do not get the chance to prepare for the blow and therefore the head swings backwards and pulls the vertebrae. Then an acceleration emerges, after which the neck vertebrae again shift with the surrounding bands. All this gives the whiplash trauma.

Causes that cause the symptoms to become chronic.

Whiplash related factors:

decreased mobility of the neck (just after accident)

rather head trauma

higher age

the way of dealing with complaints

psychosocial factors: eg passive coping, anxiety, less satisfied with work situation

Course

In 70% of the victims the symptoms disappear within 3-6 months. At 30%, however, chronic complaints develop with limitations in daily activities. At 10% there are serious pain complaints indefinitely.

The main problem is that, for unclear reasons, the symptoms do not disappear but become chronic, despite the fact that no physical abnormalities can be found. In this phase of chronic becoming, all kinds of behavioral factors occur, so that the course is even more unfavorably influenced, sometimes even in such a way that these factors are caused by the injury itself predominating.

Epidemiology

Epidemiological data with regard to the occurrence of whiplash are usually derived from the number of insurance claims submitted. Partly because of this, the annual incidence rates of whiplash vary greatly from country to country. For the Netherlands, the number of new patients with a whiplash is estimated at 94 to 188 per 100,000 inhabitants per year. These figures are much higher than the international figures because they are derived

accident statistics. No Dutch data are available on the prevalence of certain symptoms after whiplash.

Therapy

A whiplash is treated in different ways. The treatment prescribed by the doctor depends on the severity of the injury, the complaints you have and your medical history (for example, head-and-neck injury). It goes too far here to discuss all forms of treatment.

Many people with whiplash injuries are prescribed a collar and / or physiotherapy. The neck collar is meant to temporarily relieve the neck. The effect of a neck collar over time has not been clearly demonstrated. In some cases this can actually maintain the complaints. Your doctor or physiotherapist can advise you best about the use and use of the neck collar. Wearing a neck collar may in any case not last longer than six weeks. This is because keeping the neck joints more or less immobile can lead to a permanent restriction of movement.

If you come to the doctor or general practitioner shortly after the accident, he or she may be referred to you to have x-rays taken. This is done to exclude other injuries. It can also refer you to a specialist or physiotherapist for further treatment.

Physiotherapy

For more than 25 years we have been treating whiplash patients with good results. Special courses have been followed for this.

We work with treatment protocols that have been developed in collaboration with the whiplash institute PELS and other organizations. The physiotherapeutic treatment is mainly concerned with movement therapy. We also check whether no vertebral movements have occurred as a result of the accident. These are corrected with very gentle techniques if necessary. After this, the muscles of your shoulders, back and neck are strengthened so that you can do more. This is because after a whiplash accident, you often do not use the muscles because it is painful. As a result, the muscles relax and you get complaints more quickly if you have to use the muscles again. By strengthening the muscles under good supervision of the physiotherapist you can do more without getting complaints

The general aim of physiotherapy is to let the patient return to a full (or desired) level of activities and to prevent chronic complaints with whiplash. In the first three weeks after a whiplash the physical therapist observes and supports the natural course of the consequences of whiplash. From 3 to 6 weeks, the physical therapist will respond to the patient's handling of the complaint if necessary. The physical therapist makes use of behavior-oriented principles, in which the moving functioning is central. Paying too much attention to pain symptoms and low stimulation of activities can adversely affect the recovery.

For more detailed information, please refer to: www.whiplash.nl