The part of the spinal column in the neck (cervical spine) has seven bones called cervical vertebrae. Thick fibrous bands called ligaments hold these bones together. Disks between the bones are cushions and act like shock absorbers during normal daily activities. Neck muscles support and move the neck. Whiplash is a neck injury in which the neck is forced to extend too far back and then quickly go forward. Ligaments, muscles, bone, and disks are injured. Whiplash can be uncomfortable and make people miss work. More than 1 million people a year have whiplash.
The cause is usually a motor vehicle accident, trauma from falling, contact sport injury, or physical abuse. Rear-end vehicle collisions account for more than 40% of cases.
Neck pain is the most common complaint. Pain usually starts hours to days after the accident. Neck tightness, stiffness, and headaches over the back of the head occur. Pain over the shoulder and arms, numbness, reduced range of motion, numbness of arms, and trouble swallowing can also be noted in severe cases with extensive injury.
The health care provider makes a diagnosis from the medical history and physical exam. Sometimes x-rays and magnetic resonance imaging (MRI) may be done to check for nerve injury and to rule out other causes. Your health care provider may suggest seeing a neurologist (specialist in nervous system diseases) or orthopedic surgeon (specialist in bone diseases).
The goals of treatment are to reduce pain and allow time for the injury to heal. Conservative treatment is usual. Ice packs are applied to the area first, and then heat (heating pad, hot shower) or cold. A soft cervical collar is usually suggested.
For sleeping, a small rolled towel that is 2 inches in diameter or cervical pillow (neck support pillow) can be used. Ultrasound may also help symptoms.
Medicines for pain include antiinflammatory drugs and acetaminophen (alone or with antiinflammatory drugs). Muscle relaxants can also be tried for muscle spasms.
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