What is Whiplash? How do I recover?
What is Whiplash?
When involved in a car accident, whether if you see it coming or not, there will be forces involved that will make your body move suddenly in a specific way due to the sudden acceleration caused by the force applied by the other vehicle against your or even by the different ways your vehicle can be spinning. Not to mention if you’re a motorcyclist.
We should also consider the fact that the head is the heaviest part of our body (for its size) and is stabilised on top of the neck which, despite being a resilient structure, offers only so much support in these situations. Therefore, even when we see it coming, the head will move a fast way in one direction, against which the neck muscles won’t be fast enough to react and prevent.
Which structures are affected in Whiplash?
This leads to joints moving too far in their range, reaching the end of range too fast forcing the structures that usually determine this end of range. So, generally, we have joint surfaces getting irritated, spine ligaments being overstretched, vertebral discs being pulled and/or pinched and sometimes also nerves being pulled and/or compressed. To this mechanism we call Whiplash, in which the head tends to move firstly towards the direction from which impact comes from until the ligaments loose the slack and pulled it then in other directions.
Even though, there is no evidence that all accidents lead to damage in the structures above, these may get sore and bruised for some time. We also need to add to the equation, the psychological and emotional impact a, sometimes, near-life changing experience has on us, as this may also lead to anxiety which has a direct impact in recovery.
What are the common symptoms?
Whiplash-related symptoms tend to be mainly present in the neck but can extend to headaches (generally with their source on neck structures), upper back, shoulder and arm pain and, even though this doesn’t necessarily mean there is more damage, it will certainly impact more on our daily activities and lead to the wrong perception that something bad has happened to us. Understanding the mechanisms and reasons why we have pain and their very likely temporary nature is very important in the management of our feelings and anxiety towards this condition.
What do these symptoms mean?
When whiplash occurs, it may take up to 12-15 hours for symptoms onset, as our bodies may go in the flight or fight mode, as a response to a situation perceived as life-threatening, leading to a rush of adrenaline and inhibiting initial pain, while we make sure we are safe.
Why does the pain take a while to kick in?
As said above, not all car accidents lead to structural damage, but the body will be in alert mode and over-protective mode which means:
- The pain threshold is going to decrease and we become more sensitive;
- The muscle baseline tension is going to increase, making our neck movements feel stiff and restricted, especially in the morning;
- This increased tightness of the muscles means they are working harder, leading to early fatigue and ache onset, during the day.
How to recover?
After the “all clear” from paramedics or Accidents and Emergencies department at the hospital, we know no major injuries have occurred in our bodies and our recovery begins!
The great news is that the human body has all the tools needed to recover from an injury. With some guidance, you can make this process faster and also manage your feelings and anxiety towards your symptoms and recovery time frame in a more efficient way, which will also potentiate recover.
Inflammation After Whiplash
On the first days after whiplash, our organism will look after the bruised and sore structures and will do so by using a very important mechanism called inflammation. You see, inflammation is a good thing, it is the first step towards recovery and we should encourage it and facilitate its resolution which should take no longer than the first week. This means we’ll be achy and sore, for a while, but Painkillers can be used to help this. You can see why Anti-inflammatory medication may be inappropriate at this stage, as it will prevent an efficient inflammation from occurring, affecting and delaying the recovery of the tissues.
Motion is Lotion
Even though the Neck/Upper Back/Shoulders are sore, early gentle movements of the affected areas are encouraged from an initial stage, as long as they are maintained within ranges that offer no sharp pain or great aggravation of symptoms: remember that “Motion is Lotion”.
Is Physiotherapy appropriate after Whiplash?
A physiotherapist we’ll look at you as an individual and inform you about all the things mentioned above and, after understanding the full depth of the impact this condition is taking in the different aspects of your life, will help you establish a plan to assist your recovery, of which you must be the main actor.
What are the stages of recovery?
Whereas in the initial stages of recovery your body will be over-sensitive and protective towards external stimuli and manual therapy may not be appropriate, education on movement and pacing strategies can be used, sometimes along with Acupuncture that will help the pain intensity and anxiety, sometimes allowing you to sleep better earlier on.
Later, when you feel less sore as a result of your body healing processes, more hands-on and Manual therapy (joint mobilisations, stretches, active exercises, soft tissue techniques) are often used to help you achieve normal range of movement, strength and function.
If you commit to these ideas and plan, you’ll come out of this experience strong and confident.
- Jull, et al. 2008. Whiplash headache and neck pain: research-based directions for physical therapies. Edinburgh: Churchill Livingston.
- Provinciali L, Baroni M, Illuminati L, Ceravolo M. G. Multimodal treatment to prevent the late whiplash syndrome. Scand J Rehabil Med. 1996;28(2):105–111