Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of your neck (specifically ligaments, tendons, and muscles). It is caused by an abnormal motion or force applied to your neck that causes movement beyond the neck's normal range of motion.

• Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault.
  
• The term whiplash was first used in 1928, and despite its replacement by synonyms (such as acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury), it continues to be used to describe this common soft tissue neck injury. Your doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury.

The most frequent cause of whiplash is a car accident. The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, whether or not they wear seat belts.  

• Other common causes of whiplash include contact sport injuries and blows to the head from a falling object or being assaulted.
  

• Repetitive stress injuries or chronic strain involving the neck (such as using your neck to hold the phone) are a common, non-acute causes.
  

• Child abuse, particularly the shaking of a child, can also result in this injury as well as in more serious injuries to the child's brain or spinal cord.

Whiplash Symptoms

These signs and symptoms may occur immediately or minutes to hours after the initial injury; the sooner after the injury that symptoms develop, the greater the chance of serious damage.

• Neck pain
  
  
• Neck swelling
  
  
• Tenderness along the back of your neck
  
  
• Muscle spasms (in the side or back of your neck)
  
  
• Difficulty moving your neck around
  
  
• Headache
  
  
• Pain shooting from your neck into either shoulder or arm

The best time to call your doctor is immediately after the injury. If the patient cannot determine whether an emergency department visit is needed for the symptoms, then contact the doctor and ask for advice. If the doctor is unavailable at the time of the injury, then call 911 for transport to the emergency department. The risks associated with a possible neck injury are far too great to attempt to diagnose and self-treat. See a doctor and have the patient's neck braced to keep the head from moving during transport.

Depending upon the severity of a car accident, emergency medical personnel may take the patient to an emergency department immediately. In this case, a cervical collar will be placed around the patient's neck, and the body will be strapped to a long, firm board to prevent any movements until a doctor sees the patient.

With less severe car accidents, sports injuries, or other accidental injuries, emergency medical services may or may not be involved in the patient's pre-hospital care. You should call 911 emergency medical services if the patient develops any of the following symptoms shortly after the injury:

• Neck pain
  
  
• Pain in either or both arms
  
  
• Shoulder pain
  
  
• Headache
  
  
• Dizziness
  
  
• Weakness, tingling, or loss of function in the arms or legs

Exams and Tests

• If the patient is transported to the emergency department with a cervical collar strapped around the neck, the emergency physician will remove the collar when appropriate.
  
  
• In most cases, the collar will be removed without the need for x-rays if the patient meets all of the following criteria:
  
  
  • Normal level of consciousness or alertness
    
    
  • No muscle weakness or sensation problems
    
    
  • No evidence of intoxication with alcohol or drugs
    
    
  • No tenderness in the back of the neck
    
    
  • No other painful injury elsewhere on the body
  
  
• Your collar will remain in place if the doctor determines that the patient needs x-rays of the neck.
  
  
• The doctor will first examine the functioning of the spinal cord in order to determine if any damage is present. The following areas will probably be assessed:
  
  
  • Physical strength in both arms and legs
    
    
  • Ability to sense the touching of the skin in different parts of the body
    
    
  • Reflexes at the joints of the arms and legs
  
  
• The doctor will also inspect the patient's head and neck for any external signs of trauma including bruises, cuts, and abrasions. The patient's neck will be pressed in specific areas to be sure the patient does not perceive any pain or tenderness. The patient may be asked to move their neck in a controlled way to the left, right, up, and down. Tell the doctor if neck pain, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers is felt.
  
  
• X-rays may be taken of the neck bones to make sure there are no fractures or signs of other serious injury. The doctor will review these x-rays and order further imaging with a CT scan or MRI if needed. If the patient's x-rays are normal, then the cervical collar will probably be removed, and should not need any further x-rays.

Medical Treatment

The doctor most likely will recommend a treatment plan including a mixture of the following:

• Neck massage
  
  
• Neck rest
  
  
• Bed rest
  
  
• Ice therapy
  
  
• Heat therapy
  
  
• Oral pain relievers and muscle relaxers
  
  
• Immobilization of the neck with a soft cervical collar (only a minimal benefit if any at all)
  
  
• Early range of motion exercises combined with heat therapystarting 72 hours after the injury to restore flexibility
  
  
• Avoidance of excessive neck strain for the next week and then increased activity as tolerated in the following weeks

Most people recover completely from a whiplash injury in the first six weeks. Others' symptoms continue to improve over the course of a year. There is a 40% chance of experiencing some symptoms after three months, and an 18% chance after two years. No reliable way exists to predict the prognosis.

• A worse outcome has been reported in people with a more rotated or inclined head position at the time of impact injury.
  
  
• The amount of time that elapses between injury and the onset of neck symptoms can predict the severity of injury and prognosis. A shorter time signifies a potentially severe injury with more frequent long-term complications.

What Should You Tell Your Doctor About Your Personal Injury Insurance Claim?

What should you say if your doctor wants to ask questions about whether or not you are going to pursue a personal injury claim? Often a doctor may ask whether you have a lawsuit or an insurance claim pending or whether you have an attorney. A good way to respond is to ask your doctor what he thinks you should do about making a personal injury insurance claim. That way you will find out the extent to which he is willing to support you by making positive, thorough chiropractic records and reports.

Another tactic if he asks about making an insurance claim for your whiplash and soft tissue injuries is you can always just tell him that you are considering a claim, but that your primary emphasis is on healing. That is always the patriotic thing to do as far as medical doctors are concerned. It will earn you points and maybe buy you some cooperation from them. No doctor wants to write reports in support of a personal injury insurance claim if they feel they are being manipulated or used as a tool primarily to obtain a settlement award.

Should you bring up the topic of your personal injury insurance claim? If your doctor does not bring up the question of whether or not you will be making an insurance claim, just leave the topic alone. You do not want him to get the feeling that you are doctor-shopping and trying to find some doctor who will go overboard to support your claim. That will make him suspicious that you are always going to try to manipulate him and his reports.

In fact, with a good chiropractor, you do not have to get into the business of worrying what he is writing so long as you follow his recommendations, stay on his course of treatment, and you are a good, thorough, honest historian as to all the problems you are having due to the whiplash and soft tissue injuries you suffered.

Proper chiropractic or medical care, AND SUPERIOR HISTORY AND DOCUMENTATION are the keys to your physical recovery and your monetary recovery in your personal injury insurance claim. There are three aspects to maximizing your chances for a prompt physical recovery and satisfactory monetary recovery.

1. The first is to select a doctor who is competent to treat your injuries, and who will support your efforts to recover in a personal injury insurance claim;
   
2. The second key is to follow the doctor's advice and to treat as suggested-don't be a cowboy and go it alone, ignoring his instructions, because failure to follow your doctor's orders is ammunition for the insurance defense and the IME doctor;
   
3. The third is to ensure that your doctor properly documents your injuries and continued pain and suffering during your injury recovery: on the members' side we teach how to do this accurately without appearing manipulative.
   

As discussed here, the car accident victim has a number of choices in managing his/her medical care. This is true even if you only have one insurance company to pay your chiropractor and medical bills. Even with no insurance available, there are means of obtaining medical care, especially with chiropractors inasmuch as they are more willing to take a lien on the claim to secure payment for services.

Moreover, your choice is not just whether to obtain medical or chiropractic care or not, it is also a choice as to the type of doctor you want to see. For the majority of whiplash and soft tissue car accident injuries, it has been our members' experience that chiropractic care, massage therapy and physical therapy provide a better physical recovery rate than the conservative treatment by an orthopedic surgeon or a general medical practitioner, who will just have you popping pills and perhaps trying physical therapy. 

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