UNDERSTANDING WHIPLASH INJURIES
By: Dr. John A. Papa
Whiplash is a common injury that can be experienced following a motor vehicle
collision (MVC). There are more than 100,000 whiplash cases in Canada each year.
The unique forces generated during these collisions can stress biological tissues and
result in pain, decreased functioning and disability for those affected. This article
provides a review of the current scientific understanding of whiplash associated
symptoms, along with guidelines on assessment and best management strategies.
Although rear-end collisions are the most commonly reported mechanism of
whiplash injury, an injury may also occur following side and head-on collisions. The
forces generated from these types of impacts thrust the head
(and to a lesser extent the entire body) back and forth, much like
a snapping whip. Injury results because the body is unable to
compensate adequately for the speed of head and torso
movement from the acceleration forces generated at the time of
impact. This will put stretch, compressive and shear stresses on
biological tissues such as muscles, ligaments, joints and nerves.
As a result, this can generate pain symptoms, and affect range
of motion, strength, coordination, and balance. The onset of whiplash symptoms may
immediately follow a MVC or may gradually develop over the first 24-72 hours. A later
onset of symptoms does not necessarily indicate a more serious injury.
Neck pain is traditionally associated with whiplash injuries. However, the
whiplash mechanism may also cause injury and symptoms that include: whole body
muscle pain/ache, jaw pain, shoulder pain, referred arm pain, mid back pain, low back
pain, headaches, dizziness, vertigo, tinnitus, difficulties with swallowing, hearing and
memory acuity, depression and anxiety. The term WAD (Whiplash Associated Disorder)
encompasses all of these potential symptoms and is commonly used to grade the
degree of injury present. WAD Grades 1 and 2 represent the