Whiplash / Neck Injury
At the Trauma Clinic we will formally assess your neck injury and develop a tailored care plan for your rehabilitation.
What is a neck injury?
Neck injuries can happen in a variety of ways. Common causes of neck injuries are car accidents and sports injuries where the head and neck are suddenly jerked forwards and backwards. This is termed a whiplash type of injury. Common symptoms after such an injury include the following:
- Muscle tightness or spasm
- Being unable to move your neck or turn your head
- A headache, especially in the back of the head
Sometimes it takes some time for pain and stiffness to develop (i.e. some hours or days). This is referred to as “delayed onset of neck pain” and is quite commonly seen.
Your neck is a very complex structure. It is composed of the following structures:
- Ligaments – Ligaments are tough bands of tissue that connect bones to other bones.
- Bones – The neck has 7 bones (called “vertebrae”) that are stacked on top of each other.
- Discs – Discs are cushions that sit between the bones.
- Nerves – A bundle of nerves (called the spinal cord) travels down the middle of the spine. Nerves branch off from the spinal cord to all parts of the body.
- Muscles – Muscles hold the head up and make the neck move.
- Tendons – Attach muscles to the bones of your neck.
In cases of a whiplash type injury, we will usually have determined that the muscles and ligaments are not broken and that your nerves are not damaged. The ligaments and muscles can however become ‘stretched’ or sprained.
Our consultants at the Trauma Clinic have significant experience in caring for patients who have suffered whiplash injuries in order to support and augment your recovery. We aim to provide a comprehensive care package with rapid access to dedicated therapists and specialised care.
Common symptoms of neck injury after a car crash
These can last several weeks or months after a neck injury. Usually they are not serious in overall medical terms, but do represent a significant nuisance and disruption to your normal life.
- Headache and dizziness
- Cracking noises from the neck
- Flashbacks and upsetting memories
- Insomnia, anxiety (general anxiety and/or travel anxiety when in a car) or depression.
- Symptoms may be severe, but investigations often do not demonstrate any abnormality.
Will I need tests?
Our specialist consultants should be able to tell if you have whiplash by inquiring about your symptoms and physically examining you. Some people may need an x-ray of their neck and occasionally advanced imaging such as an MRI scan will be required. Working with Affidea Ireland, the Trauma Clinic has on-site access to expedient high fidelity imaging such as MRI to help get the right diagnosis of your injury in a timely fashion.
We can also arrange other imaging as necessary such as CT scans, ultrasound and x-rays. These scans will be reported by a Consultant Radiologist and fully discussed with you to tailor your recovery.
How is whiplash treated?
Whiplash can take 6-12 months to recover. This can be variable and depends on things like age and previous neck problems. Some people have symptoms for longer. We recommend the following for whiplash type of neck pain.
Painkillers such as Paracetamol are really effective if taken regularly,
Medication like Ibuprofen and Diclofenac (anti-inflammatories) can help in some people.
However in those with a past history of ulcers in the stomach, those with kidney failure or heart failure, and elderly patients (with potential kidney problems), we usually recommend avoiding medication like Ibuprofen or Diclofenac.
A stronger painkiller such as codeine is sometimes an option if anti-inflammatories do not suit or do not work well. Codeine is often taken in a combination preparation with Paracetamol.
A muscle relaxant such as diazepam is occasionally prescribed for a few days in a tapering dose if your neck muscles become very tense and stiff (so much so that no movement is possible). This is generally used if your neck is in spasm (i.e. twisted) or to help with sleep for a couple of days. It is not prescribed on a long term basis – because the medical evidence doesn’t support its use in the longer term and because of the side-effects if this is taken on a long term basis.
Do as many of your normal activities as possible. Better recovery has been found in individuals who maintain a healthy active routine after a whiplash injury. Plan gradual increases in activity and exercise levels so that you can successfully return to full participation in your regular activities, hobbies or sports.
Neck stretches and exercise
Mobility aids recovery. Our multidisciplinary team of physiotherapists at the Trauma Clinic is best placed to guide you on a supervised rehabilitation programme.
Ice pack and heat pads
Applying an ice pack over the sore area for 5-10 minutes for the first couple of days can provide pain relief and relax muscle spasm.
Heat can help to reduce pain in the neck muscles. Moist heat can be applied for 10 to 15 minutes in a shower, hot bath, with a moist towel warmed in a microwave or a medicated heat pad.
It is important to avoid overheating the towel or using heat pad etc. for too long The skin can become red in a blotchy pattern in people who use heat too frequently.
Various treatments may be advised by our physiotherapist if the pain is not settling. These include heat, manipulation and perhaps, most importantly exercises to do at home.
Depending on the severity of your symptoms, our consultant team may initially advise on painkillers and gentle neck exercises. If symptoms do not begin to settle over a week or so, you may then be referred to our physiotherapist to help with pain relief and for advice on specific neck exercises.
Sitting in one position for prolonged periods of time is not good for anyone, certainly not someone with neck pain. Keep your neck healthy.
It is essential that you change your position before your neck becomes stiff or sore. Perform the postural correction exercise regularly.
The following are simple common-sense pointers on good posture post a neck injury.
- When sitting, use a supportive chair where the back is stable and steady.
- Avoid prolonged sitting in the same position for prolonged periods of time.
- Sleeping on your back or your side provides a better position for your neck.
- You might have less pain if you sleep on your back with pillows under your thighs.
- Yoga, Pilates, and the Alexander Technique all improve neck posture, but their value in treating neck pain is uncertain. Many people do find these techniques beneficial however.
Acupuncture involves inserting hair-thin, metal needles into the skin at specific points on the body. It causes little to no pain. Biofeedback involves learning to control certain bodily functions, such as muscle tension, which can help to decrease pain.
Acupuncture has been used in patients with persistent neck pain with cervical muscle strain. The quality of many of the studies in this area is insufficient to draw firm conclusions regarding their efficacy. One review found that acupuncture may help to relieve chronic neck pain
What treatments are NOT helpful?
Most doctors do not recommend that people wear soft neck collars. Wearing a neck collar for too long can make your neck muscles get too weak.
Other treatments that are NOT helpful include surgery or a treatment that pulls on the head to lengthen the neck (called “cervical traction”).