FAQ’s on Whiplash Treatment in Philadelphia

Whiplash affects the cervical (neck) region of the body. This condition occurs from an injury to the structures of the spine, as well as the soft tissues. A whiplash injury is the result of a severe jerking motion of the neck.

Who is at risk for whiplash?

Whiplash is most likely to affect someone who has suffered a motor vehicle accident (MVA). This occurs from occupational injuries and falls as well.

How common is whiplash?

Whiplash affects over one million people each year. This is mostly the result of high-velocity injuries.

What causes whiplash?

Cervical strain of neck muscles and ligaments is the cause of whiplash. This happens due to excessive extension and flexion of the neck, and it is the result of a serious accident. The neck is moved in a whip-like fashion, which stretches and strains neck structures.

What symptoms are associated with whiplash?

Most people do not experience any symptoms immediately after the accident. However, within 12-36 hours, neck pain, muscle soreness, muscle spasms, and inability to move the neck occurs. The pain of whiplash is often so debilitating that it interferes with normal daily functioning.

How is whiplash diagnosed?

The doctor will ask questions about the nature of your injury or accident and take a medical history. To assess the problem, the doctor will do a physical examination and order some routine diagnostic imaging tests. These include magnetic resonance imaging (MRI), x-rays, and computed tomography (CT) scans.

How is whiplash treated?

The treatment of whiplash depends on the extent of the injury and the patient’s symptoms. Therapy options include:

  • Medications – The medications prescribed include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and opioid pain killers (short-term).

 

  • Cervical collar – Immediately after the accident, the doctor will order a soft collar support device to maintain the spinal alignment, allow tissues to heal, and prevent further injury.

 

  • Botox – Botulinum toxin A is injected into the muscles of the neck and shoulders to temporarily paralyze the region and prevent pain.

 

  • Trigger point injections (TPIs) – Trigger points are painful areas of the muscles that contract. To deactivate the points, the doctor injects the muscle tissue with a local anesthetic. A recent study found that TPIs are superior to no intervention for the relief of neck pain.

 

  • Epidural steroid injection (ESI) – The doctor may inject the epidural space with a powerful corticosteroid agent. This space lies right outside the spinal cord. The medication will reduce swelling and inflammation. According to clinical studies, ESI is between 80 and 90% effective.

 

  • Medial branch block (MBB) – With this procedure, the doctor injects a long-acting anesthetic into the cervical facet joints, which are at the posterior region of the spine. Using x-ray guidance, the doctor inserts tiny needles to instill the medication. According to a randomized controlled study, patients report greater than 50% pain relief with this procedure, which lasts for up to one year.

 

  • Radiofrequency ablation (RFA) – If MBB is effective, the doctor can destroy a portion of the nerve root with radiofrequency energy. This prevents the nerves from transmitting pain signals.

 

  • Electrical spinal neuromodulation – Spinal cord stimulation involves insertion of a small device near the cervical spine. This device emits mild electrical impulses that interfere with pain signal transmission. A recent study found this to have a 70-90% efficacy rate.

Resources

Lee JW, Park KW, Chung SK, Yeom JS et al. (2009). Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: a comparative study of particulate versus non-particulate steroids. Skeletal Radiology, 38(11):1077-82.

Manchikanti L, Damron K, Cash K, Manchukonda R, & Pampati V (2006). Therapeutic cervical medial branch blocks in managing chronic neck pain: a preliminary report of a randomized, double-blind, controlled trial: clinical trial NCT0033272. Pain Physician, 9(4):333-46

Tough EA, White AR, Cummings TM, Richards SH, & Campbell JL (2009). Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials. Eur J Pain, 13(1):3-10

Vallejo R, Kramer J, & Benyamin R (2007). Neuromodulation of the cervical spinal cord in the treatment of chronic intractable neck and upper extremity pain: a case series and review of the literature. Pain Physician, 10(2):305-11.