What is Cervical Sprain (Neck Sprain)?
The term “whiplash” was first used by Harold Crowe in 1928 to describe injuries related to sudden acceleration or deceleration in the neck area. This term was later expanded to whiplash-associated disorders (WAD), which now includes any neck-related symptoms a person might have after a car accident. One challenging aspect of identifying these injuries is that, by definition, no structural damage can be found even after thorough medical examination. Thus, WADs are typically diagnosed only after other possibilities have been ruled out.
Treatment options for WADs include rest, pain relief medication, soft neck braces, and early start of physical therapy. The impact of this injury can vary: some people may recover fully in a short time period, while others may experience long term pain and disability, requiring ongoing healthcare support. In some cases, individuals with WAD report high levels of depression, bodily complaints, and obsessive-compulsive behavior, which is known as the “whiplash profile”.
What Causes Cervical Sprain (Neck Sprain)?
Whiplash-associated disorders are a collection of neck-related symptoms that show up after a car accident or similar incident. The exact process of how they occur isn’t fully understood. Many believe that they could be caused by a mix of minor injuries which might not be significant individually but could cause pain when combined.
These injuries could potentially happen to different parts of the neck including the joints of the spine, spinal ligaments, nerve roots, discs between the vertebrae, cartilage, and the muscles on the sides of the spine. Even bruising or swelling in the joints can produce symptoms that are associated with whiplash injuries.
Risk Factors and Frequency for Cervical Sprain (Neck Sprain)
Whiplash injuries, often happening because of sports injuries, falls, or more commonly, car accidents, affect about 0.3% of people in the US every year. It’s estimated that around 1 million people a year suffer from a whiplash-related condition due to a motorcycle accident. The frequency of these types of injuries used to be much higher – before seat belts were introduced in the UK in 1990, 42.5% of the patients seen after car crashes had neck injuries. Also, in 1995, British Columbia reported that 61% of the claims made to insurance companies were for neck injuries.
These injuries tend to affect women more than men, with females making up nearly two-thirds of the affected population. However, it can be quite difficult to get exact numbers on this problem. This is because there are many factors at play including personal factors, legal issues, and socioeconomic circumstances, and these can all affect the outcomes.
Signs and Symptoms of Cervical Sprain (Neck Sprain)
Whiplash-associated disorders typically originate from injuries that cause rapid movements of the neck, similar to car accidents or sports collisions. People who experience these types of injuries may be immobilized with a neck brace by emergency personnel to avoid further harm. People with whiplash can experience a variety of symptoms such as:
- Neck pain and stiffness
- Pain between the shoulder blades
- Pain and tingling sensations in the upper limbs
- Jaw dysfunction
- Headaches at the back of the head
- Visual disturbances
- Psychological distress
- Problems with memory and concentration
In addition to these symptoms, individuals with whiplash may also experience psychological symptoms like anxiety, depression, and hypochondria. Doctors will perform a thorough exam and evaluation, checking the spine and adjacent muscles while the patient’s neck is in a neutral position. If there are any pain-indicating areas along the spine or signs of offset (step off), further imaging, will be recommended and they will keep the brace or collar in place.
People with other injuries or who are under the influence of substances, will not have the neck brace removed until it is clear they do not have cervical spine injuries. Patients will need follow-up exams once they are conscious and alert enough to participate in comprehensive physical exams.
In situations with a low likelihood of injury and when the patient doesn’t have any spinal pain or other remarkable symptoms, the neck brace can be removed. They will also perform neurological exams of the upper limbs to ensure there are no deficits. Existing guidelines, such as NEXUS or the Canadian Cervical Spine Rule, assist in determining if more imaging is necessary.
Testing for Cervical Sprain (Neck Sprain)
The Canadian guidelines (also known as NEXUS criteria) are helpful for assessing neck injuries in the emergency department. These guidelines decide when neck imaging is needed, based on the cause of the injury, how the person presents at the time of the accident, symptoms shown in the emergency department, and physical examination findings.
The NEXUS criteria state an image is needed if there is pain in the middle of neck at the back, specific areas of weakness, confusion, intoxication or injuries that distract from the neck pain. As per the Canadian guidelines, neck imaging is necessary for patients over 65 years old, after severe trauma, if ‘pins and needles’ sensation (paresthesia) is felt in the body, neck pain straight after the accident, mid-neck tenderness, and limited neck motion.
If initial tests show abnormal results, further imaging like an MRI might be needed to check for spinal cord injury. Specific films aimed at checking the bending and straightening movements of the neck can help rule out injuries to the ligaments in the neck.
Treatment Options for Cervical Sprain (Neck Sprain)
If you have a whiplash-associated disorder, which is commonly caused by sudden neck movement, various treatment methods are available. Typically, doctors recommend wearing a soft neck collar for support, trying to return to your normal activities, and doing exercises that promote movement. However, studies indicate that keeping the neck immobilized does not always improve the condition as much as might be expected.
Some people find relief from whiplash pain with ultrasound therapy. First-line treatments for whiplash generally include pain relievers, nonsteroidal anti-inflammatory drugs, and the application of cold or heat to the area.
Even though it’s somewhat debated, muscle relaxants could help with pain, as shown by a few studies. Another treatment method showing promise is biofeedback, which can be especially effective when used alongside other treatments for acute whiplash. One study also found that injecting the muscle relaxant, lidocaine, can help reduce pain symptoms.
In addressing whiplash, it seems most treatments are moderately effective on their own. However, combining different treatments can improve results, with early movement being consistently the most effective approach.
What else can Cervical Sprain (Neck Sprain) be?
When a doctor is trying to diagnose an injury to the neck, they might consider a number of conditions that might be the cause. These could include:
- A break in one of the bones in the neck (cervical spine fracture)
- Damage to the main blood vessels in the neck (carotid artery dissection)
- A condition where a disc in the spine bulges out and presses on a nerve (herniated disc)
- Injury to the spinal cord itself
- A situation where the bones in the neck have moved out of place (subluxation of the cervical spine)
- An injury to the muscles or other soft tissues in the neck (muscle strain, facet injury, ligamentous injury).
Sometimes, these injuries can be caused by a type of neck injury often caused by car accidents, known as whiplash. If the injury happened awhile ago, the doctor will consider other causes, like a mass, tumor, or infection.
What to expect with Cervical Sprain (Neck Sprain)
The prognosis, or expected outcome, of whiplash associated disorders (WAD), can vary widely. This depends on several factors: the patient’s existing health conditions before the injury, the severity of the whiplash, their age, and their socioeconomic environment.
Individuals may fully recover from whiplash in a few days to several weeks. However, some people can experience long-term effects, such as chronic pain and impaired physical function, potentially making the disability permanent.
Current studies have not adequately considered factors such as socioeconomic status or legal considerations, which can affect an accurate assessment of recovery. Interestingly, in regions where there’s little or no litigation around whiplash injuries, the prognosis tends to be more favorable. This suggests economic gain from disability could affect a patient’s report of full recovery.
Possible Complications When Diagnosed with Cervical Sprain (Neck Sprain)
While neck pain is usually the main complaint, long-term conditions like dizziness and headaches can also frequently be reported. Chronic pain can not only interfere with your ability to work and go about your everyday activities, but it could also mean losing money and having to adjust your way of life.
Preventing Cervical Sprain (Neck Sprain)
Studies have shown that using seatbelts can help decrease the occurrences of neck injuries or Whiplash Associated Disorders (WAD), especially in car accidents. In fact, low-speed car accidents are one of the major causes of neck strain or WAD. By maintaining safe and alert driving practices and avoiding distractions like texting, we can cut down on the number of car accidents and cases of WAD resulting from careless driving.
It’s also important to mention that starting to move as soon as possible is the best approach as long as other serious injuries have been ruled out through a medical check-up and imaging tests. This is effective in promoting healing and preventing further complications.