Whiplash pain is a term used to describe the soft tissue injuries of the neck that can occur when the neck moves in an abnormal way. It typically occurs following a motor vehicle accident, but it also may occur following any activity that causes forceful movement of the neck, including falls, trauma, and sports-related injuries. During this type of injury, the neck is forced to extremes of range of motion, which can cause significant injury to the muscles, ligaments, discs, and facet joints. This injury can lead to pain for many months, or even years following the original accident. Following a motor vehicle accident, it is important to seek medical care as soon as possible.
Common symptoms associated with whiplash include neck pain, swelling along the back of the neck, muscle spasms, and difficulty turning the head from side-to-side or up and down. During this acute phase, X-ray and MRI can help to determine the extent of damage that has occurred.
Common treatment following a whiplash injury includes anti-inflammatory medication (ibuprofen, naproxen), muscle relaxers, ice, heat, and rest.
Chiropractic therapies, decompression, and massage therapy can also be very useful during this acute phase. Sometimes people experience symptoms following a whiplash injury that require immediate medical care. If you are experiencing severe neck pain, dizziness, headaches, or weakness of the upper or lower extremities, go to the emergency room immediately.
Treatment
Most whiplash pain is a term to describe the soft tissue injuries of the neck that can occur when the neck moves in an abnormal way. Injuries resolve within six weeks of the initial injury. However, about 40% of people continue to have pain three months following the accident, and about 18% of people will continue to have pain after two years. Common treatment for chronic neck pain related to whiplash injury includes chiropractic treatment, medication management, physical therapy, and injection therapy.
Chiropractic adjustments and decompression therapies can help to relieve pain associated with whiplash pain. Common types of medications used to treat whiplash pain include anti-inflammatories (ibuprofen, naproxen), antidepressants (Cymbalta, amitriptyline), neuropathic medications (gabapentin, Lyrica), and occasionally short-term opioid use (hydrocodone, oxycodone). Physical therapy can help to strengthen core muscles in the neck, thus reducing pain. Some injections used to treat whiplash pain injuries include trigger point injections (for muscle spasms), cervical epidural steroid injections (for discogenic pain with radicular symptoms), and medial branch blocks, for pain related to the cervical facet joints.
In a study by Manchicanti, Boswell, and Singh, et al (2004), it was estimated that 55% of all neck pain originates from the facet joints. For these patients, diagnostic and therapeutic facet injections or medial branch blocks have been found to be very helpful. Facet injections involve injection of an anesthetic agent (lidocaine or bupivicaine) along the medial branch nerves of the facet joint. A positive response to this block is a 50% reduction in pain for the first several hours following injection. Sometimes a second block will be performed to confirm the diagnosis. If a person has a positive response to the medial branch block, they are considered candidates for radiofrequency ablation of the medial branch nerves.
Radiofrequency is a procedure in which destruction of a nerve occurs by percutaneously inserting a catheter, and heating it to 50-80° Celsius. A study by Lord, Barnsley, and Wallace, et al (1996) showed that radiofrequency ablation can provide significant, long-term relief for facetogenic neck pain. For people who are experiencing chronic neck pain related to a whiplash pain injury, there are many treatments available.
