Whiplash

Traumatic injury to the cervical spine has been labelled “whiplash” due to the common mechanism of injury being thought to represent a “whipping” motion. Often this injury is sustained during a “rear-ended” motor-vehicle accident, however, it is also common to suffer neck-related injury during contact-sports or other trauma. 

The mechanism of whiplash is generally due to an accelerating motion of the head, causing either a flexion and/or extension motion in a harmful manner.  Mechanical injury to muscles, joints, discs and ligaments may cause neck pain and referred symptoms into the arms.  For 50% of people, their injuries will resolve within 6 months, but like concussion, there is a proportion of people who will continue to have problems for many months, or even years, after the injury (1).  There is evidence that those with pre-existing neck problems, and those over the age of 35 are more likely to suffer a prolonged recovery.

Symptoms of dizziness, neck pain, and headaches can often be overlapping in both concussion and whiplash, making it important for careful differentiation. Whereas neck and arm pain can be related to mechanical injury, “non-mechanical” symptoms such as dizziness, brain-fog and blurry vision are more commonly referred to as brain-related.  

The brain is affected in whiplash because it relies on sensory information from the neck. Hence, when the neck is damaged, the brain can find it difficult to interpret important information about head position, which makes it hard for the brain to coordinate movement of the body, neck and eyes.

For treatment of brain-related symptoms after whiplash, it may be necessary to re-calibrate the integration of the neck and head position (neck proprioception), with the eyes and the balance centres of the inner ear. 

Neuro-rehabilitation techniques that are used for whiplash may include manual therapy, isometric resistance exercises, oculomotor exercises, laser-targeted head movements, improving muscle control of the neck, eye-head coordination and balance exercises.