Whiplash Associated Disorders, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Whiplash Associated Disorders, Diagnosis and Treatment and Related Diseases

A whiplash is a frequent medical disorder that happens during a motor car accident due to the sudden jerking of the neck after a high impact collision.

Whiplash Associated Disorders (WAD) is a variety of injuries to the soft tissues of the neck from a sudden jerking or "whipping" of the head linked with extension of the neck.

This type of movement strains the muscles and ligaments of the neck beyond their normal range of motion.

When a vehicle halts suddenly in a crash or is hit from behind, the seat belt will stop the person's body from being thrown forward.

But the head may still snap forward, then backward, producing a whiplash injury.

Cervical acceleration-deceleration (CAD) depicts the mechanism of the injury while the term whiplash associated disorders (WAD) depicts the injury sequel and symptoms.

The term "whiplash" injury was first used to define acceleration-deceleration injuries happening to the cervical spine or neck region.

This term was altered to an all-encompassing term called whiplash-associated disorders (WAD) that have been refined to depict any compilation of neck-related symptoms after a motor vehicle accident (MVA).

The difficulty that seems in depicting these injuries is due to the fact that there is, by definition, no structural pathology diagnosed after a comprehensive diagnostic workup.

WADs are a diagnosis of exclusion.

The injury may be:

1. Acute with full recovery or
2. Chronic with residual long term pain, disability, and medical resource utilization

Causes

1. Car accidents,
2. Roller coasters and other amusement park rides,
3. Sports injuries or being punched or shaken.
   A sudden blow to the head or neck during contact sports such as boxing or rugby
4. A slip or fall where the head is suddenly and violently jolted backwards
5. Being struck on the head by a heavy or solid object
6. Whiplash is one of the hallmarks of shaken baby syndrome.

The suspected underlying mechanisms of pathophysiology had blamed multi-factorial elements such as vertebral distraction to the facet joint capsule region of the cervical spine causing pain.

Other plausible explanations can be any combination of minor injuries to:

1. The facet joint,
2. Spinal ligaments,
3. Dorsal root ganglia/nerve roots,
4. Intervertebral discs, cartilage, and
5. Paraspinal muscle spasms

Contusions of the intra-articular meniscus hemarthrosis may produce symptoms consistent with WADs.

The injury happens in three stages with a rapid loss of lordosis.

Both the upper and lower spines have flexion in stage one.

In stage two the spine takes on an S-shape while it starts to extend and ultimately straighten to make the neck lordotic again.

The final phase shows the complete spine in extension with an intense sheering force that produces compression of the facet joint capsules.

The whiplash injury forms the S-shaped curvature of the cervical spine which induced hyperextension on the lower end of the spine and flexion of the upper levels, which surpasses the physiologic limits of spinal mobility.

The Quebec task force suggested a classification to depict the severity of the whiplash injury.

1. In Grade 1 the patient has complaints of neck pain, stiffness, or tenderness with no positive findings on physical exam.

2. In Grade 2 the patient shows musculoskeletal signs such as decreased range of motion and point tenderness.

3. In Grade 3 the patient also reveals neurological signs that may involve sensory deficits, decreased deep tendon reflexes, muscle weakness.

4. In Grade 4 the patient reveals a fracture.

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