Whiplash is a specific type of neck injury which is suffered due to the rapid acceleration or deceleration of the body, while the head is unsupported. The anatomy of the cervical spine and head are complex, but most of us understand that the cranium is extremely heavy and taxing on the neck. Since the cervical spine is light in structure; the head is much like a lollipop placed on this skinny stick. However, being that this stick is flexible, the head will move when the body is thrown forward or back. Since the weight of the head multiplies the already significant force suffered exponentially, the result is often injurious.
This article topic examines the occurrence of neck injury due to the head being whipped forward and/or backwards suddenly.
What is Whiplash?
The actual reason for pain upon this injurious event is due to hyperextension and hyperflexion of the cervical spine and attaching soft tissues. Flexion describes the normal movement of looking downwards, chin to chest. Meanwhile, extension describes the opposite movement, which is looking upwards.
When hyperflexion occurs, the weight of the head is thrown forwards with such force as to extend the range of movement past its normal limits. This can injure both the spinal and soft tissue structures which regulate typical neck movement. In much the same manner, when hyperextension occurs, the head is thrown backwards past its normal range of motion, also potentially traumatizing the spinal and soft tissues of the local anatomy.
Whip-type injuries typically involve both movements occurring in rapid succession, as the initial force will throw the head forwards, then snap it back as the force dissipates, causing first hyperflexion, then immediate hyperextension within fractions of a second. This is a double dose of injury and pain that can happen in the blink of an eye.
Most cases of traumatic hyperflexion or hyperextension injury result in temporary soft tissue damage. Small tears occur in the muscles, ligaments or tendons in the region, causing inflammation and pain. In some cases, and particularly in the most severe traumas, the actual spine can also be damaged. This can result in vertebral fracture, intervertebral herniation, the loss or exaggeration of typical spinal curvature, or the acceleration of the already existent degenerative processes.
Since many hyperflexion/hyperextension injuries occur due to terrible trauma, civil litigation often results. The most common causes of these varieties of neck injuries include slip and fall events, automobile accidents, sports injuries and other sudden and acute traumas.
Whiplash Injury Scenarios
Not all patients suffer immediate pain due to these neck injuries. In fact, time delayed pain is commonplace, both due to purely physical and psychoemotional factors, including secondary gain. Pain may not occur until inflammation sets in and this may take hours, or even up to 2 days, in rare scenarios. The adrenaline dump common to traumatic occurrences can fight off pain and regulate injury while the chemical remains in high concentration in the body immediately following trauma. If litigation is discussed within hours to days of the injury, there is a statistical correlation with escalating symptoms.
Time delayed pain is certainly a possible psychological overlay which can occur due to the opportunity for financial gain stemming from the trauma. This is a fascinating aspect of whip-type injury which has always intrigued me as a former trial preparation investigator and perpetual student of mindbody medicine.