Whiplash injury is an intriguing injury not just for the way it is injured, but also for the vague symptoms. The appearance of the symptoms after hours to days from the traumatic incident, frequently confuses the physician and delays the diagnosis. It is only the vigilance and knowledge of the affected person, that can make the diagnosis easy and early. However, there is frequent negligence on this part from an ignorant patient, which leads to further progression of the disease.
Whiplash Injury Symptoms
The earliest symptom to occur in a whiplash injury is neck spasm. The spasm is not only because of violent stretching of muscles, but also because of the injury to the nerve cells and ligaments. This is a protective response of the body to allow healing of the torn muscle fibers and ligaments. This is a very crucial period for this injury. If the neck is properly immobilized, healing occurs without any further problems. However, ignorance and neglect in this phase is what gives rise to the “whiplash associated disorders” or “whiplash syndrome”, which are delayed manifestations of the injury.
Other symptoms seen in whiplash injuries are headache, tingling numbness in the hands, and shooting pain in the arms, and so on. These are due to nerve cell stretching and inflammation. Normally, if the neck is stable these symptoms rapidly recover. If there is instability of the neck bones (dislocation), then these changes persist for weeks and may even progress to full blown paralysis of the entire body below the neck !
Whiplash Injury Investigations
Whiplash injury is primarily an injury of soft tissues, like nerves, ligaments, and so on. Hence, MRI is the investigation of choice for establishing an accurate diagnosis. Though its high cost is prohibitive in using it for screening of each patient. If cost is not a concern, then MRI should be the first and last thing to do for diagnosis of a whiplash injury.
Investigations like X-ray, CT Scan, and so on, help us to know if the soft tissue injury is severe enough to cause any bony disturbance. Since, bones are clearly seen in these films, any disturbance in the normal arrangement of bones of the neck can be easily detected. They are commonly used for screening of patients of whiplash injury and if positive are followed up with an MRI for confirmation.
Grading of Whiplash Injury
A whiplash injury is graded as per severity of the symptoms. These grades were decided by Qubec Task Force.
- Grade 0: no neck pain, stiffness, or any physical signs are noticed
- Grade 1: neck complaints of pain, stiffness or tenderness only but no physical signs are noted by the examining physician.
- Grade 2: neck complaints and the examining physician finds decreased range of motion and point tenderness in the neck.
- Grade 3: neck complaints plus neurological signs such as decreased deep tendon reflexes, weakness and sensory deficits.
- Grade 4: neck instability with secondary spinal cord damage.
The grade of a whiplash injury is important from the perspective of a whiplash injury claims, as it clearly segregates the victims on the basis of severity.