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Diseases » Whiplash » Wikipedia
 

Whiplash in Wikipedia

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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Whiplash (medicine)". (Source - Retrieved 2006-09-07 14:18:29 from https://en.wikipedia.org/wiki/Whiplash_%28medicine%29)

Introduction

Whiplash is defined as a medical condition where the soft tissues of the neck have been injured after a sudden jerking (whipping) of the head, which results in a strain on the muscles and ligaments of the neck when it is moved beyond the normal range of motion, causing a sprain-type injury.$[1]$ Whiplash is a description of the movement which causes injury, but has become synonymous with the soft tissue injury which occurs.$[2]$

Cause

A whiplash injury can be the result of impulsive stretching of the spine, often the result of a rear-end collision between cars or trucks. When a vehicle stops suddenly or is hit from behind and the occupants are wearing seatbelts their bodies are prevented from being thrown forward, but their heads can snap forward and then back again causing a whiplash injury.$[1]$ The Insurance Institute for Highway Safety defines whiplash as: "a range of neck injuries that are related to sudden distortions of the neck." It takes about 100 milliseconds for an occupant's body to catch up to the car when it is hit, and it is during this time that the damage occurs. Whiplash injury can result from a rear-impact collision, front-impact collision, lateral (side) impact or rollover.$[2]$

Whiplash can be caused by any motion similar to a rear-end collision in a motor vehicle, such as may take place on a roller coaster 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 or shaken.$[3]$ Shaken baby syndrome can result in a whiplash injury.$[1]$

Symptoms

Symptoms reported by sufferers include: ringing or whistling in the ear, headache, deafness, memory loss, dizziness, depression, jaw joint pain and difficulty in swallowing. Symptoms can appear directly after the crash or hours or days afterwards.$[2]$

Diagnosis

Reliably diagnosing a whiplash injury or disorder is not difficult for a trained doctor. If a patient cannot achieve the full motion, or has excessive range of motion, the probable ultimate cause is the whiplash motion.

Québec Task Force

The Québec Task Force (QTF) was a task force sponsored by Société d'assurance automobile du Québec (SAAQ), the public auto insurer in the province of Quebec, Canada. The QTF submitted a report on Whiplash-associated disorders (WAD) in 1995, which made specific recommendations on prevention, diagnosis and treatment of WAD. The recommendations have become the base for Guideline on the Management of Claims Involving Whiplash-Associated, a guide to classifying WAD and guidelines on managing the disorder. The full report titled Redefining "Whiplash" was published in the April 15, 1995 issue of Spine.$[4]$

Québec Task Force grades of disorder

Four grades of Whiplash-Associated Disorder were defined by the Quebec Task Force on Whiplash-associated disorders (WADs):

  • Grade 1: complaints of neck pain, stiffness or tenderness only but no physical signs are noted by the examining physician.
  • Grade 2: neck complaints and the examining physician finds decreased range of motion and point tenderness in the neck.
  • Grade 3: decreased range of motion plus neurological signs such as decreased deep tendon reflexes, weakness, insomnia and sensory deficits.
  • Grade 4: neck complaints and fracture or dislocation, or injury to the spinal cord.$[4]$

Consequences

The consequences of whiplash range from mild pain for a few days, to severe disability caused by restricted head movement or of the cervical spine, sometimes with persistent pain.

Prevention

When travelling in an automobile a properly adjusted headrest can reduce the severity of the injury.$[1]$ The top of the headrest should be in line with the top of the occupants head. Maintaining an adequate separation from the vehicle in front while driving and pressing your back against the seat while facing forward if a collision appears imminent might also be advisable.$[5]$

Whiplash protection

The mechanism which causes injury is not fully known, but several hypotheses exist which influence attempts to prevent or reduce the possibility of injury. The focus of preventive measures has been on the design of car seats, primarily through the introduction of headrests. So far the injury reducing effects of head restraints has been relatively low, approximately 5-10 %, because car seats have become stiffer in order to increase crash-worthiness of cars in high-speed rear-end collisions which in turn increases the risk of whiplash injury in low-speed rear impact collisions. Improvements in the geometry of car seats through better design and energy absorption could offer additional benefits. Active devices move the body in a crash in order to shift the loads on the car seat.$[2]$

Some car manufacturers have begun to implement various whiplash protection devices in their products in order to reduce the risk for and severity of injury, such as

  • Mercedes-Benz A-Class Active Head Restraint (AHR)$[6]$ $[2]$,
  • Ford, Nissan, Opel, Peugeot and Saab - Active Head restraint (SAHR)$[7]$ $[2]$,
  • Volvo and Jaguar - Whiplash Protection System/Whiplash Prevention System (WHiPS)$[8]$, and
  • Toyota - Whiplash Injury Lessening (WIL).$[2]$

Whether or not such devices offer any substantial benefit over vehicles without them remains controversial. In a test undertaken by the Swedish National Road Administration and a insurance company (Folksam), one test showed that a whiplash protection device was no guarantee against injury and that the degree of protection varies between vehicles both with and without whiplash protection devices.$[9]$

References

  1. Whiplash, MedlinePlus, August 22, 2006 (English)
  2. Assessment of Whiplash Protection in Rear Impacts (PDF), Swedish National Road Administration and Folksam, April 2005 (English)
  3. Whiplash injury, August 23, 2006 (English)
  4. Guideline on the Management of Claims Involving Whiplash-Associated Disorders, August 23, 2006 (English)
  5. Bilars skydd mot pisksnärtskada (Protection against whiplash injury in cars) PDF, Swedish National Road Administration and Folksam, August 22, 2006 (Swedish)
  6. Long Fibre-Reinforced Polyamide for Crash-Active Car Headrests, August 22, 2006 (English)
  7. Top Safety Ratings For Saab Active Head Restraints, UK Motor Search Engine, August 22, 2006 (English)
  8. Volvo Seat Is Benchmark For Whiplash Protection, Volvo Owners Club, August 22, 2006 (English)
  9. Whiplashskydd inte alltid säkrare (Whiplash protection not always safer), NTF, August 22, 2006 (Swedish)

Further reading

 

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