Whiplash
A neck injury that can occur during rear-end automobile collisions, when your head suddenly moves backward and then forward - similar to the motion of someone cracking a whip is called Whiplash. These extreme motions push your neck muscles and ligaments beyond their normal range of motion. The non-medical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck associated with extension. although the exact injury mechanisms remain unknown. The term "whiplash" is a colloquialism. "Cervical acceleration-deceleration" (CAD) describes the mechanism of the injury, while the term "whiplash associated disorders" (WAD) describes the injury sequelae and symptoms.
Whiplash injuries can be mild or severe. Treatment typically begins with over-the-counter pain relievers and ice applied to the painful neck muscles. If pain persists, prescription medications and physical therapy may be helpful.
Most people recover from whiplash in just a few weeks, but some people may develop chronic pain after a whiplash injury.
Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of the neck (specifically ligaments, tendons, and muscles). It is caused by an abnormal motion or force applied to the neck that causes movement beyond the neck's normal range of motion. It is usually caused by a flexion-extension motion of the neck that pulls and strains the neck muscles and ligaments.
Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault.
Synonyms for whiplash include acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury. A doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury.
Whiplash is commonly associated with motor vehicle accidents, usually when the vehicle has been hit in the rear; however, the injury can be sustained in many other ways, including headbanging,medical citation needed bungee jumping and falls.4 It is one of the main injuries covered by insurance.citation needed In the United Kingdom, 430,000 people made an insurance claim for whiplash in 2007, accounting for 14% of every driver's premium.
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Before the invention of the car, whiplash injuries were called "railroad spine" as they were noted mostly in connection with train collisions. The first case of severe neck pain arising from a train collision was documented around 1919.6 The number of whiplash injuries has since risen sharply due to rear-end motor vehicle collisions. Given the wide variety of symptoms associated with whiplash injuries, the Quebec Task Force on Whiplash-Associated Disorders coined the phrase 'Whiplash-Associated Disorders'.6 Whiplash is the term commonly used to describe hyperflexion and hyperextension,7 and is one of the most common nonfatal car crash injuries. More than one million whiplash injuries occur each year due to car crashes. This is an estimate because not all cases of whiplash are reported. In a given year, an estimated 3.8 people per 1000 experience whiplash symptoms.8 "Freeman and co-investigators estimated that 6.2% of the US population have late whiplash syndrome".9 The majority of cases occur in patients in their late fourth decade. Unless a cervical strain has occurred with additional brain or spinal cord trauma mortality is rare.8
Whiplash can occur at speeds of fifteen miles per hour or less; it is the sudden jolt, as one car hits another, that causes ones head to be abruptly thrown back and sideways. The more sudden the motion, the more bones, discs, muscles and tendons in ones neck and upper back will be damaged. Spinal cord injuries are responsible for about 6,000 deaths in the U.S. each year and 5,000 whiplash injuries per year result in quadriplegia.7
After 12 months, only 1 in 5 patients remain symptomatic, only 11.5% of individuals were able to return to work a year after the injury, and only 35.4% were able to get back to work at a similar level of performance after 20 years. Estimated indirect costs to industry are $66,626 per year, depending on the level and severity. Lastly, the total cost per year was $40.5 billion in 2008, a 317% increase over 1998.7
Whiplash can be described as a sudden strain to the muscles, bones and nerves in the neck. The neck is made up of seven vertebrae, referred to as the cervical vertebrae. The first two cervical vertebrae, the axis and atlas, are shaped differently from the remaining five. The atlas and axis are responsible for movement of the skull from side to side (cervical rotation to the right and left); also moving forward and backward (cervical flexion and extension). Excessive extension and flexion can disrupt the vertebrae.
There are four phases that occur during "whiplash": Initial position (before the collision), retraction, extension and rebound. In the initial position there is no force on the neck it is stable due to inertia.10 Anterior longitudinal ligament injuries in whiplash may lead to cervical instability.11 They explain that during the retraction phase that is when the actual "whiplash" occurs, since there is an unusual loading of soft tissues. The next phase is the extension, the whole neck and head switches to extension, and it is stopped or limited by the head restraint. The rebound phase transpires as result of the phases that are mentioned.
Symptoms reported by sufferers include: pain and aching to the neck and back, referred pain to the shoulders, sensory disturbance (such as pins and needles) to the arms and legs, and headaches. Symptoms can appear directly after the injury, but often are not felt until days afterwards.3 Whiplash is usually confined to the spine. The most common areas of the spine affected by whiplash are the neck and middle of the spine. "Neck" pain is very common between the shoulder and the neck. The "missing link" of whiplash may be towards or inside the shoulder and this would explain why neck therapy alone frequently does not give lasting relief.1314151617
Cognitive symptoms following whiplash trauma, such as being easily distracted or irritated, seems to be common and possibly linked to a poorer prognosis.
The exact injury mechanism that causes whiplash injuries is unknown. A whiplash injury may be the result of impulsive stretching of the spine, mainly the ligament: anterior longitudinal ligament which is stretched or tears, as the head snaps forward and then back again causing a whiplash injury.
A whiplash injury from an automobile accident is called a cervical acceleration-deceleration injury. Cadaver studies have shown that as an automobile occupant is hit from behind, the forces from the seat back compress the kyphosis of the thoracic spine, which provides an axial load on the lumbar spine and cervical spine. This forces the cervical spine to deform into an S-shape where the lower cervical spine is forced into a kyphosis while the upper cervical spine maintains its lordosis. As the injury progresses, the whole cervical spine is finally hyper-extended.
Whiplash may be caused by any motion similar to a rear-end collision in a motor vehicle, such as may take place on a roller coaster20 or other rides at an amusement park, sports injuries such as skiing accidents, other modes of transportation such as airplane travel, or from being hit, kicked or shaken.21citation needed Shaken baby syndrome can result in a whiplash injury.
Whiplash associated disorders sometimes include injury to the cerebrum. In a severe cervical acceleration-deceleration syndrome, a brain injury known as a coup-contra-coup injury occurs. A coup-contra-coup injury occurs as the brain is accelerated into the cranium as the head and neck hyperextend, and is then accelerated into the other side as the head and neck rebound to hyper-flexion or neutral position.
position. "Volunteer studies of experimental, low-velocity rear-end collisions have shown a percentage of subjects to report short-lived symptoms."
Diagnosis occurs through a patient history, head and neck examination, X-rays to rule out bone fractures and may involve the use of medical imaging to determine if there are other injuries.
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A large number of people have a positive result from surgery but like other surgeries, spinal surgery also carries some risks. Potential complications can be relatively minor, such as an infection at the operation site, to the more serious like permanent damage to the spinal nerves. Before choosing a spinal surgery, the surgeon will discuss the possible risks and benefits. It is important to choose the right surgeon. Spine and Neurosurgery Hospitals in India, especially in metropolitan cities like Delhi and Nagpur, provide promising treatment for whiplash problems. Also the major boost factor is the lesser price. The overall expenses of treatment in India may cost as low as 25 % of what one may have to incur in the western countries, with the same excellence and efficiency in treatment.
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