Causes, Symptoms, and Treatment
Whiplash is one of the most debilitating injuries you can suffer, often lingering for weeks or even months. Also referred to as neck sprain or strain, whiplash may involve damage to nerves, muscles, ligaments, and even discs in your upper back.
What Causes Whiplash?
As the name suggests, whiplash involves a violent snapping of your head back and forth, much like the crack of a whip. Most often the result of a motor vehicle accident, whiplash can occur any time the forward movement of your torso is impeded, but your head keeps moving. When your neck fully stretches forward, the elasticity in your muscles and ligaments then cause it to jerk backward, compounding your injury.
How Do You Know If You Have Whiplash?
Don't be surprised if it takes a few days for the symptoms of whiplash to appear; however, it's common for symptoms such as these to occur within 24 to 48 hours after an accident:
- Persistent headaches, often at the base of your skull or radiating into your neck
- Difficulty turning your head left or right, or soreness when you lift your head up or down
- Tenderness or pain in your shoulders or between your shoulder blades
- Dizziness, lightheadedness, or vertigo
- Pain, numbness, or tingling in your upper extremities, including arms, hands, or fingers
- Cognitive dysfunction, including difficulties with short-term or long-term memory, loss of focus or concentration, or challenges putting thoughts together
- Uncommon irritability or mood swings
- Sleep changes, including either insomnia or excessive fatigue
- Lower-back pain
Your doctor cannot use X-ray technology to diagnose whiplash; however, other imaging tests, such as MRI or CT scan technology, can show damage to muscles, ligaments, and discs.
Treating a Whiplash Injury
A significant part of the pain caused by whiplash stems from inflammation. Ibuprofen or naproxen can minimize inflammation and provide some temporary relief. Heat and ice also can help alleviate inflammation and discomfort, and gentle massage or ultrasound can be helpful in the early days after a whiplash injury. As you move forward, a gentle, graduated exercise program can strengthen muscles and reduce pain. In cases of severe whiplash, you may need to immobilize your neck while everything heals.
Alleviating Back Pain with Total-Disc-Replacement Surgery
Back pain is among the most common and excruciating conditions suffered by Americans. Ideally, you want to relieve your discomfort with non-invasive or minimally-invasive procedures. When those efforts are ineffective, though, you may need back surgery. One option proven to be highly effective is the total replacement of a damaged or herniated disc.
Total disc replacement is a surgical procedure in which diseased or damaged discs of your spinal column are replaced with artificial discs, restoring the normal function and movement of the spine. Total disc replacement is a relatively new procedure, developed as an alternative to spinal fusion for the treatment of diseased or damaged discs.
When Total Disc Replacement Is Appropriate
Total-disc-replacement surgery may be recommended for patients with back pain from degenerative disc disease, a condition of gradual degeneration of discs caused by the natural aging process. The procedure is customarily prescribed for patients whose disc problems have not responded to non-surgical treatment options.
Total-disc-replacement surgery is generally not advised for patients with spinal infection, osteoporosis, allergy or sensitivity to implant materials, spondylolisthesis, or spinal tumors. The surgery also is not recommended for anyone who is pregnant or morbidly obese or who has used steroids for a lengthy period of time or had prior spinal surgery.
The Total-Disc-Replacement Procedure
Total-disc-replacement surgery is performed under general anesthesia. During the surgery, the patient is positioned on their back on an operating table. The surgeon makes an incision near the belly button. The internal organs and the blood vessels are carefully moved aside to gain access to the spine. An X-ray is then taken to see a well-defined image of the disc to be replaced.
The surgeon then removes the diseased disc and prepares the disc space to receive the new artificial disc. The metal endplates of the implant are inserted and tapped into the correct position. Finally, the sliding polyethylene core is placed between the endplates. As the vertebrae are returned to normal posture, the pressure of the spinal column places the endplates into the vertebral bones and secures the sliding core in position. After the procedure, another X-ray is taken to verify the position and fit of the new disc.
Disc-replacement surgery typically requires a hospital stay of 2 to 4 days, depending on your progress. You should be able to walk and stand by the first day after surgery. A brace or corset may be prescribed for support, and basic exercises, such as walking and stretching, are usually part of the rehab during the first weeks after surgery.
Risks and Complications
Total disc replacement surgery does carry certain risks, including:
- Blood vessel injury
- Wear and tear of device materials
- Dislocation of the disc
- Nerve damage
- Damage to adjacent structures
The Importance of Seeking Medical Attention After a Motor Vehicle Collision
When you get in a fender-bender—or even slam on the brakes without making impact—it's just a minor bump, right? You can't suffer any serious injuries, can you? Think again.
It's generally true that the severity of injuries in a car wreck increases when the vehicle is traveling at a higher speed at the time of impact. But a study by the AAA Foundation for Traffic Safety concluded that even small increases in speed can produce dramatically different results, particularly when a motorist collides with a pedestrian. Another study, conducted by the National Center for Biotechnology Information, found that drivers and passengers are still at significant risk of whiplash even when traveling between five and ten miles per hour at the time of the crash. Researchers say that, regardless of vehicle speed at the time of impact, there's still a significant amount of force caused by two colliding automobiles, and much of that force is absorbed by passengers in the vehicles. Furthermore, data indicates that in rear-end crashes, the most common source of whiplash injuries, the force from the other vehicle can actually increase in magnitude by the time it reaches the front seat of the car.
Whiplash occurs when your head suddenly and violently snaps back and forth, straining or tearing connective tissue, such as ligaments, tendons, and muscles. Upon impact, the torso is thrown forward, with the head lagging just behind. When the torso returns to its original position, the head then jerks forward, leading to hyperextension of the neck and the connective tissue in the upper back and shoulders. Like a rubber band, the neck then snaps backward, leading to hyperextension in the other direction.
Don't be surprised, though, if you seem fine immediately after a minor collision, only to experience excruciating pain a day or two later. Many of the symptoms of whiplash can take up to 24 hours to manifest. Even with low-speed collisions, you can have micro-tears in muscle, ligament, or tendon fibers that can take hours to become inflamed. Once the inflammation sets in, it typically impinges on nerves and nerve endings, causing discomfort.
Regardless of the type of job you have—whether heavy construction, manufacturing, retail, or office—the most common workplace maladies are those that affect your back. It's estimated that every year over a million workers suffer a back injury on the job, making it the primary cause of work-related disability in the United States. Studies show that back injuries account for one in every five work injuries, leading to more than 250 million lost work days annually.
The Most Common Types of Job-Related Back Injuries
Work-related back injuries include a broad range of events:
- Strains, sprains, and pulled or torn connective tissue—These types of injuries are frequently found in occupations that involve lifting, bending, pushing, or pulling, including warehouse work, manufacturing, and construction. These injuries can affect muscles, tendons, and ligaments, leading to significant pain and loss of mobility.
- Repetitive strain, stress, or motion—These injuries can occur in almost any occupation and can involve repeated use of hands, shoulders, hips, knees, or other joints, causing inflammation, swelling, or aggravation of nerves.
- Bulging, herniated, or slipped discs—The vertebrae in your spinal cord are protected and cushioned by soft discs that act like a shock absorber, minimizing rubbing and friction. Repetitive stress or motion, as well as traumatic accidents, can cause the disc to rupture or move out of place, impinging on nerves. When that happens, you can experience substantial pain and a compromised range of motion.
- Pinched nerves—Your spinal cord is the nerve center of your body. When one of the discs in your back slips out of place and puts pressure on a nerve, it can radiate out to your neck, arms, and legs, causing pain and loss of sensation.
- Broken back—Fractured vertebrae in your back typically result from a serious accident, such as a fall or a motor vehicle crash.
Whether you work in an office, in construction, in a warehouse, or in retail, you can be at significant risk of suffering a workplace injury. In fact, workplace accidents are among the leading causes of non-fatal injuries every year. Here are the most frequent types of injuries suffered on the job:
- Repetitive motion or stress injury— When you do the same thing over and over again for eight hours a day, five days a week, you can be susceptible to motion or stress injury. Such injuries typically involve joints or connective tissue like tendons, ligaments, muscles, or cartilage. As a consequence, repetitive stress or motion injuries often occur in the knees, elbow, shoulder, hips, hands, and feet. You also can incur injury by remaining in the same position for too many hours. As a general rule, when connective tissue is subjected to repetitive stress or motion, you can experience inflammation and swelling, as well as strains and tears.
- Over extension— Over extension typically involves pushing, pulling, carrying, moving, lifting, or squatting. It typically leads to back injuries hyperextension of knees, elbows, shoulders, and other joints; and sprained, strained, or torn muscles. In addition, overextension can lead to herniated, bulging, or ruptured discs.
- Traumatic brain injury (TBI)— The most common types of accidents at work are slip-and-falls, falls from heights, and being struck by falling objects. These types of accidents are a common cause of head injuries, including concussions.
- Motor vehicle accident injuries— Some of the most severe work-related injuries are caused by vehicles in motion, whether forklifts, delivery trucks, heavy equipment, or company cars. The injuries most often associated with vehicle crashes include spinal cord trauma, whiplash, soft tissue injury, disc trauma, and broken bones. Your spine houses your central nervous system, and even slight bruising can cause swelling that impinges nerves, leading to pain and even loss of sensation. Soft-tissue injury, which involves muscles and other connective tissue, can make it difficult to perform basic tasks, such as walking, sitting, or standing.
Understanding the Typical Back Trauma Suffered in a Car Crash
According to data collected by the Mayo Clinic, about four of every ten spinal cord injuries suffered by Americans every year are caused by motor vehicle accidents. Back injuries are one of the most common consequences of a collision and can be extremely debilitating, even when impact was at a relatively low speed. Furthermore, many back injuries are internal in nature, making them difficult to observe initially. Here are the most common types of back injuries suffered in car, truck, and motorcycle accidents:
- Whiplash—Though whiplash involves the snapping of the head and neck, it almost always causes pain, discomfort, and trauma to your back. After all, theneck and back work in tandem. When your head ricochets back and forth, it stretches muscles in your back and can have an impact on your upper spine, vertebrae, and discs. While whiplash can take hours or days to fully manifest, it typically includes persistent pain, dizziness, stiffness, and/or fatigue.
- Soft tissue injury—Virtually any level of impact can cause trauma to muscles, tendons, and ligaments in and around your back. Symptoms of soft-tissue injury include stiffness, headache, muscle tenderness, nausea, vertigo, tingling, and numbness.
- Herniated disc—The vertebrae in your spinal column are separated and cushioned by discs that absorb shock and protect sensitive nerve endings. The blunt force of a motor vehicle accident can cause a disc to slip, bulge, or rupture, leading to friction between vertebrae and/or impingement of nerves. Some of the indications of a herniated disc include pain that extends to your legs or arms, pain that gets worse when you stand or sit, pain that increases at night, or unexplained muscle weakness.
- Spinal cord injury—Though your spinal cord is an amazing and resilient body part, even a minor accident can lead to bruising or swelling, and a serious crash can cause spinal fractures or severing of the spinal cord. The most common type of spinal fracture is a compression fracture, where the impact of a crash causes cracks in or along your vertebrae. One of the first symptoms of a compression fracture is localized pain at or near one of your vertebrae. Typically, the pain will increase with any type of movement. A compression fracture, however, can have more serious consequences, including bladder issues, loss of muscle tone, numbness, and loss of sensation. The severing of the spinal cord generally results in some level of paralysis.
Torn Ligaments | Torn Meniscus | Fractured Kneecap
When you're traveling in a motor vehicle, whether as driver or passenger, and you collide with another car or truck, it's not unusual for your legs to catch much of the impact. Even at relatively low speeds, that impact can twist or hyperextend your need, causing significant injury to connective tissue such as ligaments, tendons, and muscles. In fact, knee injuries are one of the more common types of trauma associated with motor vehicle accidents.
Ligaments are short bands of tough, fibrous tissue that either hold a joint together or connect bones or cartilage. There are four different ligaments associated with the knee—the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), the posterior cruciate ligament (PCL), and the lateral collateral ligament (LCL).
- PCL injury—PCL ligament injury is the one most commonly associated with a motor vehicle accident, earning it the nickname "dashboard knee." It's commonly caused when a driver or front seat passenger hits their knee on the dashboard after impact with another car. The PCL is located at the back of the knee and connects the shinbone (tibia) to the thighbone (femur).
- ACL tear, sprain or strain—The ACL is in the middle of your knee and prevents your shinbone from sliding out in front of your thighbone. It can often be torn or bruised by a sudden stop or deceleration, or as a result of violent twisting.
- MCL injury—The MCL connects the shinbone to the thighbone. Impact with any solid object inside or outside a car can cause trauma to the MCL.
Your meniscus is a disc-shaped section of cartilage that serves as a cushion in your knee joint. Each knee has both a medial and a lateral meniscus. The impact of a car accident can cause the meniscus to tear, either completely or with a small section hanging off the rest of the meniscus.
The impact associated with a motor vehicle accident can result in a fracture of the kneecap, but the impact must typically be by a direct blow. The telltale signs of fracture include swelling, bruising, and an inability to put weight on the knee or walk or straighten the leg.
Treating the Loss of Motion in Your Shoulder Joint
Have you lost motion or flexibility in one of your shoulders, unable to extend the joint very far vertically or laterally? Do you experience pain in your shoulder, even when you're not using it? It's possible that you have a condition known as "frozen shoulder," or by the medical term "adhesive capsulitis." It's far more prevalent in individuals 40 years of age and older, and is more commonly diagnosed in women.
What Are the Risk Factors for Developing Frozen Shoulder?
Frozen shoulder is customarily tied to an inflammation of the ligaments in and around your shoulder. Your ligaments hold your bones together. If your shoulder capsule gets tight or thickens, you can develop stiff bands of tissue that reduce flexibility—those bands are known as adhesions. Frozen shoulder is more likely to occur in those who have suffered a shoulder injury or had a shoulder immobilized for some period of time. It's also more common with people who suffer from Parkinson's, heart disease, or hypothyroidism/hyperthyroidism.
To diagnose frozen shoulder, a doctor typically starts with a physical exam. Based on what the doctor observes, an X-ray and/or MRI may be required.
Treatment Options for Frozen Shoulder
There are both surgical (invasive) and non-surgical (non-invasive) approaches to address a frozen shoulder. Non-invasive options include the following:
- Physical therapy to strengthen muscles and improve flexibility and range of motion;
- Steroid injections to relieve pain;
- Anti-inflammatory drugs, either over-the-counter or by prescription; and
- Heat, ice, and gentle massage to ease pain and improve range of motion.
Surgical options may be done arthroscopically or through other surgical procedures. The objective of a surgical procedure is usually to remove scar tissue (which can inhibit motion) or dissect any ligaments that have become stiff or inflexible. Regardless of the type of surgical procedure, it's customary to have some level of physical therapy post-surgery to help reestablish strength and flexibility.