Whiplash, also called “whiplash”, is a trauma to the cervical spine most often resulting from a sudden change in speed followed by a rapid deceleration in the head, frequently observed in the event of accidents. even light car. The main symptoms associated with whiplash are pain and stiffness in the neck. Other symptoms, such as headache, pain in the arms, or feeling dizzy, are not unusual. Many people recover in a matter of days or weeks. For others, it may take several months before you see significant improvements. After a whiplash, it is important to see a doctor in order to make a diagnosis. In the event of neck pain, the doctor can prescribe medication and possibly rehabilitation, in addition to practical recommendations concerning his lifestyle.

The term “whiplash” – a pictorial description derived from the method used to kill a rabbit by breaking its neck – also called “whiplash” or “whiplash” in English, is used to describe a very rapid mechanism of acceleration and deceleration that the neck can undergo.

More common in women than in men, whiplash is due to a car accident in the majority of cases. In fact, in the event of a rear-end collision, the occupant of the car is first pushed violently into his seat and then thrown forward. And it is this “whiplash” movement that causes the trauma. Even at reduced speed, in the event of an impact, the acceleration is such that, when the head “goes forward” then is thrown backwards, the weight of the skull represents up to several tens of kilos. The neck lengthens, the cervical vertebrae and the muscles hardly resist this traction. Such stretching, often associated with micro-tears, can then cause sensations of stiffness and the characteristic pains of whiplash.

Can also be at the origin of a whiplash:

• the falls ;
• accidents during the practice of a contact sport such as rugby or boxing;
• a road accident (pedestrian hit);
• emotional trauma, etc.

The mechanism of onset is different depending on the cause or severity of the shock.

In a car accident with a rear impact at low speed, the movement of the shock wave is transmitted from the rear to the front. The cervical spine will therefore undergo in a very short time an exaggerated and uncontrolled movement of flexion / extension. This back-to-front movement, in most cases, blocks the upper cervicals in flexion and the lower cervicals in extension. Depending on the severity of the shock, the discs may be touched or moved.

As the back of the neck is unable to absorb shock, the cervical muscles also undergo rapid stretching. Having failed to anticipate the shock wave, these muscles will contract reflexively. This contracture can sometimes affect all of the erector muscles of the spine and result in the sudden onset of lumbago.

The nature of the lesion and the number and severity of symptoms vary from person to person.

In the case of a so-called “mild” whiplash, symptoms appear slowly after the accident:

• between 3 and 5 hours after the accident, soreness and nausea may occur;
• then the following days, headaches (headaches) and dizziness.

On the contrary, in the event of a “severe” whiplash, the symptoms appear immediately:

• severe and chronic neck pain, accompanied by stiffness of the neck;
• torticollis;
• dizziness;
• numbness and tingling along the upper limbs, especially in the hands;
• nausea;
• vomiting;
• headache;
• pain at the base of the skull;
• difficulty standing;
• neck pain;
• tinnitus (ringing or ringing in the ears);
• speech difficulties;
• tired ;
• eye disorders;
• jaw pain;
• decrease in general condition and vitality, etc.

A cervical fracture with section of the spinal cord is an extremely serious case which causes the immediate death or definitive quadriplegia of the victim. Fortunately, this case is exceptional. In fact, 90% of whiplash cases only result in light and transient cervical lesions, 10% resulting in prolonged discomfort ranging from headaches, stiffness, contractures, dizziness, reduced mobility, up to disability. permed.

Many people recover within days or even weeks. For others, it may take several months before you see significant improvements. Persistent symptoms may vary in intensity during the healing period.

Most people recover well after a whiplash.

In the event of neck pain, that is to say pain in the neck, the doctor can prescribe medication and possibly rehabilitation, in addition to practical recommendations concerning his lifestyle.

Medicines to relieve neck pain

Here are the medications that can be prescribed:

• in first intention, it is most often paracetamol or a non-steroidal anti-inflammatory drug (NSAID);
• if the relief is insufficient, the doctor may prescribe an analgesic intended to treat more intense pain: the paracetamol / codeine combination, tramadol and the paracetamol / tramadol combination can in particular be used;
• In case of painful muscle contractures, muscle relaxants may also be prescribed.

A cervical collar worn for a very short time

If the pain is very severe, a foam cervical collar may be helpful. But it is recommended not to keep it for more than 2 to 3 days because of the risk of habituation, weakening of the neck muscles and increased stiffness in case of prolonged wear.

Re-education

A few physiotherapy sessions may be necessary. Different techniques can be used:

• electrotherapy, ultrasound and infrared applied to the neck;
• spinal traction performed by a competent professional, in the absence of contraindications, may be beneficial in the short term;
• neck massage;
• active or passive mobilization techniques and contract-release techniques are recommended.

Repetitive activities with heavy lifting, especially overhead, should be avoided so as not to aggravate neck pain and prevent recurrence.

In the event of sedentary work, special attention must be paid to the correct positioning of the workstation, in particular the chair, desk, keyboard, computer screen and lighting. If necessary, an ergonomic adaptation of the workstation can be considered to accelerate healing and prevent recurrence of neck pain.