Whiplash occurs when the muscles in your neck suffer a strain because of a rapid movement backward and then forward. The sudden motion causes your neck’s tendons and ligaments to stretch and tear, resulting in whiplash associated injuries.
Neck injuries, aka cervical spine injuries, vary in severity and type. An injury to your neck may be preceded by accident, trauma to the area, falls, degenerative changes that take place in the spine or a combination.
An overview of the most common types plus information on their symptoms and treatment can be seen below.
Neck Injuries Affecting Soft Tissue
Damage to one anatomical part in your neck often means damage to others. This is because the parts of your neck are connected.
Bones, joints, soft tissue, and nerves in the cervical spine all work together to hold up and move your head. As an example, whiplash may result in one or several diagnosis, including muscle strain, ligament sprain, and/or disc injury.
The good news is that most of the time, neck injuries mainly affect soft tissue, muscles, tendons, ligaments, and/or fascia. But every type of cervical spine injury, including those that involve the bones, joints, and discs, will also affect your muscles at least to some extent.
Neck Injuries That May Affect Nerves and/or the Spinal Cord
Some neck injuries affect or damage the nervous system, and these can get pretty serious. Nerve involvement generally occurs when one or more spinal structure comes into contact or puts pressure on either a spinal nerve root, the spinal cord, or both.
The remaining injury descriptions in this article talk about those that in some way, whether mild or serious, affect some aspect of the nervous system.
Muscle Strain
A neck strain is an injury to the muscles that attach to and move the head and upper part of the spine. Symptoms include muscle spasm, reduced flexibility, and pain.
Strains are graded, meaning that they range from mild to severe.
Grade I strains are mild and are often treated by modifying activity to a level where the pain is tolerated, without giving into complete bed rest. Also, taking an over-the-counter pain medication is a common way to get past the pain of a mild strain. As with a neck crick, if the pain lasts longer than a week, or if it disrupts your usual activities, see your doctor.
With a Grade II neck strain, the injury is limited to the muscle only. Like a Grade 1 strain, your neck pain is likely not indicative of other types of structural damage.
But when it comes to Grades III and IV, it is. According to the Quebec Task Force on Whiplash-Associated Disorders, Grade III neck strain is associated with nerve damage. In this case, you may, among other things, get weak and/or feel electrical sensations down one arm. With these injuries, making an appointment with your doctor as soon as possible will likely give you the best chance of a full recovery.
Needless to say, Grade IV neck strains or whiplash are the most serious of all. The Quebec Task Force says these are related to fracture or vertebral dislocation. This injury requires immediate medical attention.
Neck Sprain
Sprains are injuries to ligaments. (Ligaments are strong bands of connective tissue that hold bones together.)
Neck sprains can be caused by falls or sudden twists that overload or overstretch one or more joints in your cervical spine. Another cause is repeated stress to the joint.
According to the American Academy of Orthopaedic surgeons, symptoms of a neck sprain can be very varied but may include pain at the back of your neck that gets worse when you move, pain that comes on slowly and peaks after about 24 hour hours, headache at the back of the neck, muscles spasms and pain in your upper shoulder, neck stiffness, and/or numbness, weakness, or tingling in your arm.
Neck sprains can also bring on less structural type symptoms, including a sore throat, mood changes, difficulty concentrating or sleeping and more, the AAOS says. Similar to neck strains, neck sprains can be mild, moderate, or severe and are graded. This may mean, for example, that if you have tingling down one arm, your sprain is a Grade III. Always check with your doctor to be sure.
For minor and moderate sprains, generally resting and icing the area is recommended, as is taking anti-inflammatory medication. Generally an over the counter will do. Getting it checked by a doctor is important, as well.
Whiplash-Associated Disorders (WAD)
Whiplash (WAD) is a set of symptoms following a movement event in which the head is thrown first into hyperextension and then quickly forward into flexion. It’s most often due to car accidents, but may be caused by sports injuries, falls, or trauma.
Like a neck crick, WAD is not a medical diagnosis. It’s an episode that can lead to any number of diagnoses from strain to herniated disc and sometimes more. Whiplash may damage joints or discs, which in turn may irritate spinal nerve roots or, more rarely, the spinal cord, causing nerve symptoms.
Depending on the exact nature of the injury, symptoms can include pain, weakness, numbness, tingling, or other electric-type sensations that go down one arm. Stiffness, dizziness, or disturbed sleep are also possible. Note that symptoms may be delayed a day or two following the whiplash event.
There are different levels of severity of whiplash injuries with some causing inconsiderable pain and restriction of movement of the neck while others resolve within a few weeks with no further disabilities.
The Quebec Task Force (QTF) contains a classification of the various grades of whiplash- associated disorders in terms of severity. The awards under each grade will carry different awards of damages. The classification is generally classified as follows.
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- Grade 0 – No neck pain or stiffness
- Grade 1 – Neck Complaints of pain stiffness or tenderness only but no physical signs are noted
- Grade 2 – Neck complaints and the doctor finds decreased range of motion and point tenderness in the neck
- Grade 3 – Neck complaints and neurological signs including decreased or absent deep tendon reflexes, weakness or sensory deficits
- Grade 4 – Neck complaints with fracture or dislocation or injury to the spinal cord
Herniated Disc
A herniated disc occurs when the soft substance that is normally contained to the inside of the disc (called the nucleus pulposus) escapes.
Should this jelly-like substance land on a nerve root, which it often does, you’ll likely feel pain and/or have nerve-related symptoms. Nerve-related symptoms generally includes weakness, numbness, a burning sensation, or electrical shock sensation that go down one arm.
Tears in the tough outer fibers of the disc (called annular tears) may lead to a herniation. Annular tears may be brought on by either repeated or a sudden, forceful stress to the spinal joint. Treatment generally starts with medication and physical therapy, but may proceed to surgery as needed.
Herniated discs can happen anywhere along the spine where one of the shock-absorbing cushions are located, including of course, in the cervical spine, or neck, area.
Neck Fracture
A neck fracture is a break in a cervical bone. It may be caused by trauma, a fall, or degenerative changes in the spine. The angle of force at impact often determines the type and severity of the break.
Football players who block with their head are at high risk for cervical fractures. Elderly people with osteoporosis are also at risk, because of their fragile bones. The most serious neck fractures are generally accompanied by a dislocation.
Treatment depends on a lot of things, including your age, other medical conditions and extent of damage to your spine. If a fracture destabilizes your neck, you may need to wear a halo brace.
Spinal Cord Injury
A spinal cord injury (SCI) occurs when a fracture, dislocation, or other neck injury damages the spinal cord. If the spinal cord is damaged at the third cervical vertebra or above, the person may die or need a respirator to stay alive.
People living with SCI often endure a lifelong disability with complete or incomplete paralysis below the level of injury.
The timeliness of emergency care and the type of first aid and medical treatment immediately given are especially critical to survival and subsequent quality of life following any serious neck injury.
The awards made for each of the type of injury will depend on the severity and disability and suffering one experiences.