Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine
Cervical sprain usually happens after an accident, and causes several ailments. Those who suffer from it are desperately looking for solutions to get better.
What is whiplash, and what are the consequences? Can you work with a cervical sprain? What are the treatments for resuming activities without pain?
This popularized article explains everything you need to know about whiplash, with an emphasis on the various natural and medical solutions to remedy it.
Definition and anatomy
Before talking about whiplash, it is worth discussing the anatomy of the cervical region.
La cervical spine is a structure composed of bones, nerves, muscles, ligaments and tendons. The cervical spine is delicate – it houses the spinal cord – but it is also remarkably strong and flexible, allowing movement of the neck in all directions.
The cervical spine is made up of 7 superimposed bones (called vertebrae), numbered C1 to C7. The upper part of the cervical spine is connected to the skull, while the lower part is connected to the dorsal vertebrae.
Etymologically, whiplash is defined as overstretching or injury to the ligaments of the cervical region. It is an evil that occurs mainly during various shocks or when the head is suddenly thrown backwards or forwards for example.
Whiplash Symptoms
Obviously, the main symptoms of a whiplash are pain felt in the neck. These pains can radiate to the head and cause headaches, or to the arm to reproduce symptoms of cervico brachial neuralgia.
These symptoms can appear immediately after an injury, but sometimes they occur a few days later. Indeed, adrenaline and shock can cause you to feel almost no symptoms after a trauma.
It is only after the shock has passed that you begin to feel the pain, and the stiffness gradually sets in as you go. Symptoms vary depending on the severity of the injury.
How do you know if whiplash is serious? In general, these symptoms indicate a serious condition that requires immediate medical attention:
- Significant trauma or neck surgery.
- Systemic disorders (weight loss, night sweats, fevers).
- Severe pain that is not relieved by rest.
- Night pain.
- Signs of spinal cord compression (pain in all 4 limbs, tingling and numbness).
- History of cervical surgery, tuberculosis, HIV, cancer or inflammatory arthritis.
- Speech disorders
- Syncope
Causes of whiplash
As mentioned, the main cause of whiplash is of traumatic origin. They are usually caused by car accidents, especially when the impact is from behind. This can also be reproduced by a contact sport (football, rugby, hockey, etc.)
In short, any shock causing hyperextension or torsional stress on the neck (also called whiplash) can irritate the ligaments in the cervical region.
Repetitive shocks can also cause irritation of the cervical ligaments. This is the case of athletes who suffer one of the major micro-traumas (such as boxers).
Indirectly, certain factors can aggravate the symptoms of whiplash:
- Sedentary lifestyle
- Age
- Weak neck musculature
Diagnosis: How do you know if you have a whiplash?
To arrive at a diagnosis, the doctor will first make a physical assessment of his patient.
Several elements will be evaluated, such as:
- The mechanism of injury
- Symptoms
- Functional impairment
- Neurological tests (Clonus, Babinsky, reflexes, dermatomes, myotomes)
- Evaluation of cervical movements
- Evaluation of the strength of the stabilizers of the neck, shoulders, etc.
In addition to the physical exam, it is not uncommon for the doctor to order X-rays or a CT scan. This will allow the integrity of the vertebrae and joints to be seen.
If symptoms radiate down the arms (especially if they cause numbness or tingling), further testing may be recommended. An MRI could reveal soft tissue integrity, and an EMG could provide information about nerve integrity in the upper limbs.
Cervical sprain and sick leave
It is not uncommon that following a whiplash, a work stoppage is prescribed for people exercising a professional activity. However, this is not always necessary, especially if the job is sedentary. The duration of the stop is adapted to the type of the profession as well as to the importance of the symptoms.
More specifically, the doctor will consider the following elements to determine the relevance and duration of the work stoppage:
- the nature of the work
- patient's age
- the physical condition of the person concerned
- pain intensity
- response to treatment
- duration and conditions of transport
The doctor proposes a duration of work stoppage ranging from 3 to 15 days on average when the work of the person concerned is physical with carrying heavy loads on the head or with performing repeated movements of flexion-extension of the neck.
Once this rest period has passed, the doctor will generally suggest a gradual return. For example, he may restrict the carrying of heavy loads and working hours. An occupational therapist can also treat the affected patient during the return to work.
How to sleep with a whiplash?
When you have a whiplash, you should know that there are positions that will allow you to sleep while minimizing the symptoms. In general, the position on the back or the side is recommended.
The supine position allows you to reduce spinal twisting. However, it should be noted that this is not a recommended position for people with snoring or sleep apnea problems.
It is more recommended for these to sleep on the side. Sleeping on your side is also one of the positions to adopt to sleep with a sprain.
In addition to positions, choosing the right pillow will optimize your nights' sleep. An orthopedic memory foam pillow is an excellent choice (for a full review, read this article).
Finally, the mattress can also act on pain. Although subjective, a semi-firm mattress has been shown to be effective in minimizing back pain.
What is the healing time for a whiplash?
In reality, the healing time of a whiplash depends on its severity. A sprain can be relieved after about ten days if all the prescriptions have been respected. When it is more severe, it may take several weeks or months to improve.
Here are some factors that can influence healing time:
- Duration of symptoms
- Presence of irradiation, numbness, tingling, etc.
- Psychosocial factors
It should be noted, however, that regardless of the type of sprain, rehabilitation by a physiotherapist (physiotherapist) will accelerate the healing process, and allow optimal resumption of activities as well as prevention of recurrences.
Treatment of a cervical sprain
If you suffer from a whiplash, it should be mentioned that there are a large number of treatments to apply in order to cure and relieve the whiplash. Here are the treatment options generally offered:
Cervical collar (neck brace)
This option is not unanimous among health professionals. On the one hand, it supports the neck and relieves pain, which can be beneficial immediately after an accident.
On the other hand, it limits the cervical mobility, and limits the muscular activity of the muscles of the neck. In the long run, this can be harmful and cause a certain form of addiction.
It is therefore recommended to use the neck brace as little as possible. For example, it can be used in the presence of acute pain, when preparing to do a more physically demanding activity.
Repos
The first reflex after an accident, or in the presence of pain, is to rest until the pain disappears. Although this solution may seem intuitive, it causes harmful consequences and most often delays healing.
Indeed, it has been shown that prolonged rest worsens pain over the long term. This is because the muscles lose their inhibitions and become stiff from inactivity.
Thus, early muscle reactivation is recommended to optimize the healing process. Obviously, it is advisable to go there gradually, and to use the rest intelligently - in the event of acute pain, and as short as possible.
heat and ice
Immediately after an accident, it is best to use ice to calm inflammation and muscle spasms.
In the subacute phase (a few days to a week after the accident), heat can be used to reduce muscle tension and provide a feeling of relaxation.
To learn more about using heat and ice, see the following article.
Medical treatment
Drug treatments are often used upfront to control pain and calm inflammation. It is not uncommon to be prescribed anti-inflammatories, painkillers and/or muscle relaxants after a whiplash.
As some medications come with side effects (such as drowsiness), it is important to follow the doctor's instructions. It is also important to tell your doctor if you are taking any other medications, in order to avoid drug interactions.
When the pain becomes too severe, the attending physician can sometimes prescribe other stronger medications aimed at relieving you (morphine, oxycodone, anti-epileptics, anti-depressants, etc.).
Treatment in kinesitherapy (physiotherapy)
- Electrotherapy
- Massages and passive stretching
- Mobilization, tractions and manipulations
- Therapeutic exercises
- Postural advice
Besides the physiotherapist, an osteopath or a chiropractor can also help following a whiplash.
orthopedic treatment
When conventional treatments do not bring results, we refer to a specialist. This will first have the role of clarifying the diagnosis, in the event that any damage is responsible for the absence of progression.
Thus, more advanced medical imaging tests could be considered.
Then, invasive treatments will be considered for refractory cases, or if a serious impairment has been identified. We speak then of infiltration cortisone, or even surgery.
Natural treatment
Even if they are not supported by scientific research, several natural treatments are considered after a whiplash:
- Acupuncture
- Cupping (suction cups)
- Natural products
- Hypnotherapy
- Sophrology
- Reiki
Conclusion
Cervical sprain usually occurs after a traumatic accident, and is caused by overstretching of the ligaments of the cervical spine.
Whiplash is likely to heal on its own, but to aid healing you can use various means and seek the help of a medical professional.
Thus, it is important to consult after a cervical sprain to eliminate any serious damage, and to optimize the healing process.
Good recovery !