Whiplash Psychosocial and Physical Symptoms

Whiplash symptoms may be so mild for some people that they disappear in a few days. Others may experience a wide range of chronic symptoms, from excruciating pain to emotional and cognitive issues.

Typical whiplash symptoms include neck pain and stiffness, shoulder pain, headaches, insomnia, and upper or lower back pain. However, some people may not experience any symptoms, and symptoms themselves may not develop for 24 hours or even days after the accident.

Whiplash

Whiplash results when your head is abruptly jolted backwards and forwards in a whip-like motion. Some of the ligaments and muscles in your neck may stretch. The following are the primary causes of whiplash:

1. Experiencing a road traffic accident
2. Falling down the stairs or from a height
3. An accident in sports (contact sports)

It is imperative to seek medical attention immediately if you have been in an accident to ascertain the severity of any injuries and receive the right care.

Whiplash Psychosocial and Physical Symptoms

Timing is a crucial component of whiplash symptoms. While some whiplash symptoms may develop immediately following a collision, others won’t show up for at least 12 hours. A whole day or even a few days may occasionally pass before all the symptoms manifest.

Signs and symptoms of whiplash can be divided into two categories: Psychosocial and physical. Let’s take a quick look at psychosocial symptoms, then move on to physical ones:

Whiplash Psychosocial Symptoms

Whiplash injury is linked to several psychosocial/ psychological symptoms that typically manifest weeks or months after the initial injury.

The common psychological injuries that people who have undergone whiplash injury suffer include:

1. Feeling down, despairing and depressed
2. Mental anguish, frustration and rage
3. Anxiety and irritability (generalized anxiety disorder)
4. Might experience stress at work or in your family
5. Hypochondriasis (excessive concern for one’s health)
6. Memory, focus, balance and concentration problems
7. Drug addiction (due to taking several medications and relying on them)
8. Chronic post-traumatic stress disorder leads to nightmares, flashbacks, and avoidance behaviours linked to the injury.
9. Insomnia (this refers to a problem getting to sleep or staying asleep)
10. Social isolation (the act of withdrawing from family or friend activities)

 

Please read Whiplash Injury: 3 Major Mental Health Concerns for more information.

Whiplash Physical Symptoms

There is a wide range of whiplash symptoms; researchers developed a grading system for the severity of illnesses or injuries linked to whiplash. This grading scheme is called the Quebec Classification of Whiplash-Associated Disorders (WAD). The severity of signs and symptoms of whiplash, following this grading system, is as follows:

• Grade 0: There are no neck-related problems. No outward indication(s).
• Grade I: The only complaints are neck discomfort, stiffness, or tenderness. No outward indication(s).
• Grade II: Musculoskeletal symptoms and neck complaint(s). Point soreness and a reduction in range of motion are musculoskeletal symptoms.
• Grade III: Neurological symptom and neck problem(s). Decreased range of motion and point discomfort are neurological symptoms.
• Grade IV: A fracture or dislocation and neck discomfort.

Whiplash Symptoms: Grade 0

The grade 0 for whiplash symptoms indicates that the person with the whiplash injury has no musculoskeletal issues or neck strain. It also identifies that the person who has undergone an injury does not feel any pain or show any signs of physical injury. This grading system does not apply to psychological injuries caused due to whiplash.

Whiplash Symptoms: Grade I

Grade 1 identifies that the person who has undergone a whiplash injury feels pain and tenderness around the injury. The person is not at risk of developing chronic pain, and there is no outward indication post-whiplash. The common whiplash symptoms under Grade I include:

1. Sensation of pain
2. Neck stiffness and discomfort
3. Tenderness when being touched

Whiplash Symptoms: Grade II

This is the first level at which a person exhibits pain, other Grade I symptoms, as well as physical signs of an injury. Compared to Grade I, the effects of the pain can vary. At this Grade, this person will exhibit musculoskeletal issues, soreness, and immobility to some extent. The following are the whiplash symptoms for Grade II:

1. Musculoskeletal issues and neck complaints
2. A reduction in range of motion due to muscle spasms
3. Soreness and radiating nearby pain face, head, shoulders and back
4. Bruising, swelling, and sensitivity to touch in the area of the injury
5. Inflammation may also occur when touched in the area of the injury

Whiplash Symptoms: Grade III

Grade III whiplash symptoms include reduced mobility, other Grade II symptoms, as well as neurological symptoms such as discomfort or decreased mobility. These symptoms occur because nerve signals travelling through the injured area on their way to or from your brain are disrupted by swelling or hyperinflammation. The following are the signs of Grade III whiplash symptoms:

1. Muscle weakness and sluggishness
2. Numbness in your neck, upper back, shoulders, or upper arms
3. Loss of ability to feel the pain, heat, or cold sensations
4. Paresthesia, a burning, tingling, or “pins and needles” sensation
5. Headaches, usually starting from the skull
6. Vision issues due to disruption in reflexes
7. Trouble swallowing and hoarseness or loss of voice (dysphonia/ dysphagia)
8. Nausea or vertigo (also known as cervical vertigo)

Whiplash Symptoms: Grade IV

The most severe whiplash injury is the one whose symptoms reach (or surpass) Grade IV. In most cases, these include all of the whiplash symptoms mentioned above, particularly the neurological ones, but they are more severe.

Grade IV also includes a fracture, misalignment, or displacement of at least one neck vertebra, which would put pressure on your spinal cord or nearby nerves, and could be the cause of more severe neurological symptoms.

In general, if your initial symptoms post-whiplash were severe and intense, you may be at high risk of developing Grade IV symptoms. Grade IV (or Long-term or chronic) symptoms of a whiplash injury can include the following:

1. Persistent neck pain, muscle weakness and stiffness
2. Chronic radiating headaches starting from the frontal skull
3. Pain or numbness in the neck, upper back, shoulders, or upper arms
4. Dizziness and balance problems (chronic, mostly due to damaged inner ears)
5. Tinnitus (ringing in the ears) and vision issues due to disruption in reflexes
6. Jaw pain, difficulty swallowing and hoarseness or loss of voice
7. Loss of ability to feel the pain, heat, or cold sensations
8. Nausea or vertigo (also known as cervical vertigo)
9. Bone or nerve fracture/ dislocation/ misalignment
10. Paraesthesia (“pins and needles” sensation)

The duration of headaches, vertigo, swallowing issues, and vision issues should be a short run. However, you must tell your doctor immediately if these last for days or weeks. Early diagnosis and treatment can aid in preventing the emergence of more severe or chronic conditions.

Whiplash Complications

Serious whiplash injuries may result in neck fractures or dislocations, as well as nerve damage and a range of psychological issues. Whiplash injuries usually result in complete recovery. A small percentage of people may experience chronic pain and disability as a result of whiplash.

Depression or post-traumatic stress disorder symptoms can appear in some people. Your attitude may also impact your recovery. Nevertheless, you have a better chance of recovering from whiplash if you believe you will recover than if you are distressed and pessimistic about your injury.

How quickly you recover also depends on your age and how bad your initial injury was. Nevertheless, a range of therapies and treatments for whiplash rehabilitation can help you recover.

Whiplash Treatments

If you have experienced a whiplash injury, you will likely undergo a physical examination. Your general practitioner may inquire about recent mishaps, such as sports injuries, falls, or head blows.

If a musculoskeletal injury is thought to have occurred, the following imaging tests might be prescribed:

1. X-rays can rule out fractured bones and other skeletal conditions
2. CT scan for a more detailed image of the bone and soft tissues
3. MRI scan as soft tissue injuries will be easy to spot for the doctor

Once diagnosed, your GP will prescribe definitive treatments for whiplash according to your case. The goal of treatment is to reduce neck stiffness and pain while also repairing damaged tendons, muscles, and ligaments. After a few days, most patients will notice a significant improvement in their symptoms.

Approximately 60% of the time, symptoms go away within 2-3 months, according to the NHS (National Health Service), United Kingdom. However, some people experience symptoms months after the injury; in rare cases, issues may last even longer. The following are the whiplash treatment options commonly recommended by doctors:

1. Applying an icepack immediately after a whiplash injury
2. Regular exercising helps strengthen nerves and muscles
3. Maintaining a good posture prevents the stiffness from getting worse
4. Physiotherapy, massage and manipulation can help reduce the pain
5. Osteopaths can help treat back and spinal injuries caused by the whiplash
6. Orthopaedic treatments are also helpful in the reduction of stiffness and sensitivity
7. Over-the-counter (OTC) medications can also help reduce pain and swelling
8. lidocaine or Corticosteroid injections are effective for muscle spasm relief
9. Cervical Collars (C-Collars) are also used for whiplash injury rehabilitation
10. In severe cases, psychological therapies like CBT and EMDR help in pain relief

Conclusion

After a whiplash injury, it’s critical to seek medical care as soon as possible. Even if you don’t experience any whiplash symptoms right away, it’s still important to see a doctor to rule out the possibility of broken bones and other serious injuries.

You should visit a doctor if you have experienced neck pain and stiffness due to a car accident or other injury. This could be your general practitioner or a nurse in the emergency room of a hospital.