Whiplash injuries have the reputation of being among some of the most difficult injuries to correctly diagnose and treat. In some cases the type of injury is obvious from the history and physical examination while in other cases a severe whiplash injury can be missed, even with modern diagnostic imaging technology.
Q: Does whiplash occur right away at the accident?
A: The answer depends on what is meant by “whiplash.” If you mean the actual whiplash injury that is caused by the violent back and forth motion of the head and neck caused by the force of a collision, then the answer would be yes. A whiplash injury is present within seconds after the accident occurred. If you mean the symptoms of a whiplash injury, the answer is no. The symptoms of a whiplash injury can occur at any time from seconds after the accident until days, weeks, and even months after the accident that was responsible for the injury.
Q: How can symptoms of an injury not appear until some time later, often months later?
A: it isn’t uncommon for an injury to cause delayed symptoms. One of the most often used examples is that of a long distance runner who subjects his ankles to repetitive stress each time that he trains and when he competes. This repetitive trauma causes no problems early on, but emerges as arthritis years after the runner retires.
Whiplash injuries produce an unnatural strain on the muscles of the neck, including the muscles that help keep the spine in its normal position. When these muscles are first damaged, they usually go into a spasm that pulls the spine out of its normal position but later, as the muscles heal, they do not return to their original strength, This allows the vertebrae to again move out of position. This abnormal movement can eventually result in changes similar to arthritis. Once these arthritis-like changes occur they can restrict neck movement and can even cause the channels where nerves attached to the spinal cord emerge from the neck to become narrowed. This narrowing, which can occur years after the original injury, can lead to pain and weakness in the arms and shoulders.
Q: Is there any way to tell which whiplash injuries will go on to cause problems later?
A: No. Whiplash injuries that cause significant discomfort early after an accident can heal completely after only a few days, while those that cause only minor aches and pains early on can require spinal surgery at a later date. Doctors that specialize in spinal trauma that occurs in whiplash injuries have a slightly better record at predicting what injuries will be the most problematic later on, but even these specialists are unable to maintain a very high rate of accuracy.
Q: Are whiplash injuries hard to diagnose?
A: Whiplash injuries are notoriously hard to diagnose, even immediately after an accident, because the damage done may be too small to see on x-rays or even MRI scans. Treatment decisions are often made on the basis of the patient’s symptoms and the physical exam in the days and weeks after an injury. After that time a clearer clinical picture usually emerges and a better estimate of the long term prognosis can be made.
Q: What treatments seem the most effective in whiplash injuries?
A: Since whiplash injuries can be so unpredictable there are no hard and fast rules for their treatment.
Most spinal injury specialists will suggest a period of immobilization using a hard or soft cervical collar, with a non-steroidal ant-inflammatory medication such as ibuprofen for pain control and a muscle relaxation drug such as Flexaril to combat muscle spasms. After the acute phase of the injury has passed, most will recommend a course of physical therapy to strengthen the neck muscles. Beyond that point, treatment is guided by the patient’s symptoms.
Q: How can a personal injury lawyer help someone with a whiplash injury?
A. As in any accidental injury, working with a personal injury attorney is the best way to protect your legal right to be treated fairly after an injury. Personal injury attorneys understand how unpredictable whiplash injuries can be and will work with insurance companies to insure that you are treated fairly and not pushed into accepting an early settlement that is favorable to the company rather than to you.
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