Serious cervical sprain: How to heal without sequelae? (physio advice)

In the presence of a serious cervical sprain, it is essential to benefit from adequate care and optimal treatment. This will ensure that no important structures are affected (such as the spinal cord), and avoid long-term sequelae.

What is a cervical sprain serious, and what are its particularities? How to heal without sequelae and resume daily activities? We talk about it in this article.

Short anatomical reminder 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 overlapping bones (called vertebrae), numbered from 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. In the presence of severe whiplash, the particularity is that the trauma is generally more severe, which causes more serious lesions.

Causes of serious whiplash injuries

Being essentially the consequence of a cervical trauma, the main causes of severe whiplash are dominated by accidents having an impact on the neck. Notably :

  • Un traffic accident with a shock impacting the rear or the lateral side of the car thus generating a rapid and brutal movement of flexion extension. This will stiffen the upper cervical in flexion and the lower cervical in extension associated in some cases with a sprain or a vertebral fracture.
  • The fall-type accidents particularly observed during the practice of certain contact sports, such as boxing or rugby, skiing, rallying, etc.
  • Following blows and violence worn on the neck and face.

The mechanism of onset may differ depending on the cause and intensity of the shock causing the neck pain. Indeed, the shock will transmit a sound wave according to its origin (if it comes from the rear, the most frequent case, it will be transmitted from rear to front) and the cervical spine will have to undergo it in a fairly short period of time.

In addition to achieving cervical vertebrae (which will be blocked in flexion for the highs and in extension for the lows), the intervertebral discs can also be moved or damaged.

Since the cervical and intervertebral discs alone are not always able to absorb the shock, the cervical muscles can contract by reflex in response to a rapid stretch and cause stiffness in the neck.

Finally, the dura mater, a rigid fibrous membrane surrounding and protecting the central nervous system can also be affected and cause multiple symptoms.

This is explained by the fact that it is inserted at the base of the skull on, among others, the first two cervical vertebrae (atlas and axis) which are the first and most frequently affected during a whiplash. Consequently, the shock wave can reach this membrane and cause tensions at its level.

What are the possible symptoms?

Obviously, the main symptoms of a severe whiplash injury are severe neck pain. These pains can radiate to the head and cause headaches, or to the arm to reproduce symptoms of cervico brachial neuralgia.

Other symptoms sometimes associated with rare whiplash can include:

  • Loss of consciousness ;
  • Chest tightness with respiratory distress;
  • Vision disorders;
  • Severe dizziness with uncontrollable vomiting;
  • dizziness
  • Paraesthesias in the upper and lower limbs

When to worry

How do you know if whiplash requires urgent intervention? In general, these symptoms indicate a serious condition that deserves 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

How to establish the diagnosis of severe cervical sprain?

To arrive at a diagnosis, the doctor may decide to start with 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 the presence of serious cervical sprain, the doctor will certainly prescribe examinations ofmedical imaging (such as an X-ray, CT scan, MRI, etc.). This will allow the integrity of the vertebrae and joints to be seen.

How to recover from a serious cervical sprain? (Treatment)

If you suffer from a serious cervical sprain, it is essential to obtain the green light from your doctor before applying the following methods. Indeed, it is first necessary to ensure the integrity of the structures surrounding the cervical spine before starting treatment:

Cervical collar (neck brace)

In the presence of incapacitating pain and/or cervical instability caused by severe whiplash, a cervical collar (neck brace) will limit cervical mobility, and limit muscle activity of the neck muscles. This will support the neck and relieve pain, which can be beneficial immediately after an accident.

On the other hand, in the long run, this can be harmful and cause a certain form of addiction. Be sure to follow your healthcare professional's recommendations for the use of a neck brace.


Following a severe whiplash injury, rest is often recommended to provide an optimal environment for healing. This most often includes time off work and stressful activities.

However, it should be noted that prolonged and excessive rest has been shown to aggravate 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.

Be sure to follow the advice of your treating professional.

heat and ice

Immediately after an accident causing a severe sprain, it is essential to clarify the diagnosis and eliminate any serious damage.

Then 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 right away to control pain and calm the inflammation caused by severe whiplash. It is not uncommon to be prescribed anti-inflammatories, painkillers and/or muscle relaxants.

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)

The physio (or physio) is a professional of choice to help recover from a severe whiplash. These treatments will be prescribed once we have eliminated nerve and spinal cord damage, or even cervical instability.

Here are some modalities used that could greatly help you:

  • Electrotherapy
  • Massages and passive stretching and progressive
  • Mobilization and other cervical manipulations
  • Therapeutic exercises
  • Postural advice

In addition to physiotherapist, an osteopath can also help following a severe cervical sprain.

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 severe whiplash:

It is crucial to start with medical treatment and not to use natural products right away. Also notify your doctor of any product consumed or therapy started.

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