Initially there may be no evidence of whiplash injury on X-rays, unless the accident was very severe. Symptoms can take months or even years to appear. The problem may be in the muscles and ligaments, which do not appear on an X-ray, which is understandably frustrating.

Research shows that during a road traffic accident involving a rear-end shunt, the neck curves in an abnormal S-shape which grossly alters normal neck movement. Normally, the joints at the back of your neck glide over each other and are self-lubricated, but a whiplash injury forces them together, damaging the surrounding area of nerves, muscles, ligaments and discs. There are tiny receptors in the ligaments around the neck called proprioceptors. These relay information to your brain about the position of the joints.

If these ligaments have been damaged, you may experience dizziness or light headedness as well as:

• Neck pain
• Headaches
• Arm pain
• Fatigue
• Poor concentration

Not just car accidents
Whiplash injuries are also known as ‘acceleration/deceleration’ injuries and need not be the result of car accidents. A slip or fall can give you a whiplash type injury. Even a sudden movement, especially if it is repetitive, may cause injury. Welders, for example, may suffer whiplash – type symptoms as a result of ‘nodding down’ their masks more than 50 times in a day.
There was no pain straight after the accident – why has it started hurting now?
Pain from a whiplash doesn’t have to happen immediately after a trauma; your body can compensate temporarily for injuries and it’s not until weeks or months later that the pain develops.
I was involved in a high speed accident, and I seem to be fine, but my friend had an accident at 10mph and had severe pain. Why?
Tiny receptors in your neck ensure that when it is stretched quickly, an immediate muscle spasm will sometimes protect it from harm. But if the neck is stretched more slowly, the receptors don’t recognise that there is a problem, and the protective mechanism fails, leaving you open to injury.
Rest doesn’t seem to have made it any better. Why not?
It is important to rest for a short period whilst tissues are inflamed. It then becomes equally important that you move your neck, to ensure that, if scar tissue develops, it remains flexible. Early treatment helps restore appropriate movement in your neck as quickly as possible.

We can help
After taking a medical history, your practitioner will carefully examine you to assess whether your neck is moving properly. This involves examining the muscles, nerves, joints, ligaments and tendons. Your treatment will begin with gentle, specific adjustments to your neck, combined with soft tissue massage. This will decrease pain and restore normal movement to the area, aiming to ensure that each joint is working. As well as manipulative treatment and massage we also use rehabilitation exercises to improve muscle flexibility, joint mobility and retrain nerve receptors.
How you can help
Initially: First 7-10 days
1. In the crucial first 7 – 10 days following a whiplash injury we recommend 2 – 3 treatments to speed up inflammation and prevent the healing process from slowing down.
2. Rest from ‘pain producing activities’.
3. Support the head (and arms if helpful) when resting. If sitting, sit tall, a small rolled towel supporting the low back may also be beneficial.
4. Ice, i.e. gel pack, wrapped in a damp towel, or heat (hot water bottle / heat pack) may settle the pain and improve circulation. Ice is generally more effective during the day as the tissues have become inflamed and hot, whereas heat helps to warm up the body when the circulation is slower, for example at night and first thing in the morning. It is recommended that you use the ice pack for about 10 minutes, every 2-3 hours. When using heat make sure the temperature is tolerable so as not to burn your skin, and leave it on for no longer than 15 minutes.
5. Pain free movement is very important, as it helps to improve the circulation, and reduce the formation of adhesions, which may restrict movement later on. It is recommended the following exercises are done, pain free, 3-5 repetitions SLOWLY, hourly.

• Keeping your shoulders relaxed turn the head to the right and left.
• Keeping your shoulders relaxed take your left ear down towards your left shoulder and then repeat to the right.
• Keeping your shoulders relaxed look up and down.

The movement exercises are progressed:

Remodeling Stage: 3-4 weeks to 12 months: Monthly treatments are aimed at ensuring the scar is refining itself along the lines of stress, and that neck joint mobility is returning to pre-injury levels. The exercises progress to reflect this, 10 repetitions, 3 times daily into mild pain with the aim to restore full movement. If it feels tight but NOT particularly painful, firm pressure by pushing the head with your hand may help release the tightness. You are unlikely to need ice or heat.

Finally: 12-24 months: The remodeling phase lasts about 12-24 months after the injury. Treatment every 1 – 2 months and continuing the stretches will ensure correct spinal alignment and prevent the scar tissue from tightening, causing problems later. The suggestion is to stretch 1-2 times daily for about 2-3 months, then 3 times a week until 12-18 months.
Remember Don’t Wait to Get Examined
Even if you feel normal after an accident you should be thoroughly examined ASAP by your practitioner at Back Pain Centre Sunderland. Symptoms can be delayed for days, months or years. Worse, whiplash can cause secondary problems such as osteoarthritis and premature disc degeneration. This delay in symptoms and the long-term consequences make it very important to get examined after any accident.

The information provided is for general guidance only and must not be used for diagnosis or treatment of a health problem. This information is not intended to be a substitute for professional medical advice.