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Whiplash
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Imagine yourself driving when a car behind
you rear-ends your vehicle. The impact
pushes your car forward. It takes about
100 milliseconds for your body to catch
up to the forward movement. Your shoulders
travel forward until they are under your
head, and your neck extends forward as
your head tilts slightly down toward your
steering wheel. You step on the brakes,
bringing the car to an abrupt halt. The
sudden stop throws your head and neck
backward, and they bounce against the
headrest. In a matter of seconds, you
experienced the classic mechanism of injury
for whiplash.
The acceleration-deceleration forces which
cause whiplash injury are sufficient to
permanently disable you. Even in a low speed
rear impact collision of 8 mph, your head
moves roughly 18 inches, at a force as great
as 7 G's in less than a quarter of a second.
The Discovery space shuttle is only built
to withstand a maximum of 3 G's.
About 20 percent of people involved in rear-end
collisions later experience symptoms that
center in the neck region. Although most
of these people recover quickly, a small
number develop chronic conditions that result
in severe pain and sometimes disability.
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| Signs and symptoms |
People who experience whiplash may develop
one or more of the following symptoms,
usually within the frist two days after
the accident¡G
- Neck pain and stiffness.
- Headaches.
- Pain in the shoulder or between the
shoulder blades.
- Low back pain.
- Pain or numbness in the arm and/or
hand.
- Dizziness.
- Ringing in the ears or blurred vision.
- Difficulty concentrating or remembering.
- Irritability, sleep disturbances, fatigue.
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| Diagnosis and Treatment |
How whiplash injuries occur is
clearly understood, but the extent and type
of injuries varies greatly. The diagnosis
of whiplash is often one of exclusion. Most
injuries are to soft tissues such as the
disks, muscles and ligaments, and cannot
be seen on standard X-rays. Your doctor
may need to request specialized test, such
as computed tomography scans or magnetic
resonance imaging (MRI).
In the past, whiplash injuries were often
treated with immobilization in a cervical
collar. However, the current trend is to
encourage early movement, rather than immobilization.
The soft collar may be used for a short
term and on an intermittent basis.
Ice may be applied for the first 24 hours,
followed by gentile active movement. Your
doctor may provide you with a series of
exercises that you can do at home. An early
return to work is encouraged, even if your
doctor must prescribe some temporary modifications
in your work situation. No single treatment
has been scientifically proven as effective,
but pain relieving medications, exercises,
physical therapy, traction, massage, heat,
ice, injections and ultrasound have all
been beneficial for some patients.
As soon as possible, you should begin aerobic
activities, such as walking. Your doctor
may prescribe some isometric exercises as
your condition improves. Symptoms resolve
within several months for about 75 percent
of people who have whiplash. Chronic conditions
should be investigated further and might
require surgery.
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TAIWAN SPINE CENTER
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