Vertebroneurological manifestations of whiplash injury

August 24, 2012

What is whiplash? Why is a herniated disc dangerous? Why should a stiff neck in the morning be a concern?

Neck pain is a common consequence not only of sports injuries, but also of a sedentary lifestyle. Most often, neck injuries are limited to soft tissue and muscle injuries. But the bones, joints, soft tissues and nerves in the neck work closely together to support and move the head. Therefore, any damage in this area can lead to loss of mobility and severe pain.

"Tight" neck

Neck exercises: video tutorial

Especially for readers of the portal, we have prepared a video course of exercises for the neck. Be sure to complete the entire complex: parts one, two and three.

This non-medical term is often used to describe the discomfort in the neck that a person experiences when standing up after sleeping in an awkward position. Similar symptoms also occur in those who have sat at the computer without a break for a long time or suddenly jerked their head sharply. A “tight” neck is not a diagnosis, and this problem can have completely different causes. Typically, the feeling of stiffness is caused by muscle spasm or nerve compression as a result of a displaced intervertebral disc. Unpleasant sensations usually go away after resting in a comfortable position and doing physical therapy. Attention: if symptoms persist for more than a week, do not delay visiting your doctor.

Diagnostics

MRI or magnetic resonance imaging. This will help your doctor figure out exactly where the sprain occurred and for what reasons.

1. Radiography. With its help, the specialist will examine not only the neck, but also the spine. This will help determine if additional deformation has occurred in these areas.
2. Ultrasound or ultrasound. This will allow the doctor to take heart disease for diagnosis because when the neck muscles are stretched, the pain sometimes radiates into the chest.
3. CT scan.
4. Based on these examination methods, only a qualified specialist will be able to make the correct diagnosis and recommend appropriate treatment that will ensure the patient’s recovery as soon as possible.

At the first symptoms, it is best to apply a cold compress. This will help limit further development of muscle tension and reduce pain. After this, be sure to take painkillers.

Neck sprain

Ligaments are bands of connective tissue that hold bones together, including the bones of the spine. Sprains of these ligaments can occur as a result of a fall or sudden sharp turns of the head, which unnecessarily stretch and overload the ligaments. Another reason is chronic tension due to prolonged exposure to an incorrect position. If there is sharp pain, limited mobility and swelling in the neck - especially after a fall - place the person on their back on a hard surface and immediately call an ambulance
.

Measures to restore all functions of the neck

Massage. It soothes muscle spasms and aims to strengthen them.

1. Physiotherapy. It helps restore metabolic processes and ensures proper blood circulation in the injured area.
2. Physiotherapy. It eliminates remaining pain and generally revitalizes the body.
3. Acupuncture. Relaxes neck muscles, relieves inflammation.
4. Manual therapy. It aims to improve health and the entire body, as well as relieve pain in the injured area.
5. If you follow all the doctor’s recommendations and instructions, he will be able to guarantee the patient a quick recovery and avoid the development of negative consequences. With proper treatment, a person very quickly returns to a full life.

Anyone can get a neck strain. This happens for various reasons. Some of them do not even depend on humans. In them she becomes an accidental victim. The main thing is to prevent ligaments and muscles from rupturing in this case. However, in all other cases, if you follow basic safety rules, this can be avoided. For example, before training it is better to warm up all the muscles, avoid being in drafts, and do not use air conditioning.

Intervertebral disc herniation

A herniated disc develops when, as a result of injury, the nucleus pulposus, located under the hard fibrous membrane of the disc, protrudes into the space between the vertebrae. This leads to pinched nerve roots and even damage to the spinal cord. When the roots in the cervical spine are pinched, severe pain, weakness and numbness in the arm, as well as dizziness and headaches appear. The appearance of intervertebral hernias is provoked by injuries, as well as severe overexertion - for example, lifting a heavy load with a curved spine. Remember:
treating intervertebral hernias at home is impossible!
If the symptoms described above appear, you should immediately consult a doctor
. Keep in mind that in some cases surgery may be required.

Treatment for Whiplash

Treatment for whiplash injury includes:

• Immobilization is wearing an orthopedic collar for several days, which allows, in the acute period, to reduce the load on the muscles and other structures of the neck.
• Drug treatment. Taking anti-inflammatory drugs both internally and externally for several weeks helps reduce the inflammatory process and relieve pain. In addition, for prolonged pain, it is possible to prescribe antidepressants and muscle relaxants.
• Physiotherapy (electrophoresis, cryotherapy, ultrasound) can speed up regeneration and relieve the inflammatory process.
• Exercise therapy is prescribed after minimizing pain and allows you to restore normal biomechanics of the spine.
• Manual therapy and massage can relieve muscle blocks and muscle spasms.
• Blockades can also be used, but it must be taken into account that their effect is quite short-lived. It is also possible to use minimally invasive procedures, such as radiofrequency neurotomy, if the pain syndrome is persistent.

Surgical treatment is prescribed only if there is a violation of the integrity of the structures of the cervical spine and persistent symptoms resistant to treatment.

Neck injuries leading to spinal cord damage

Charging in the office

Neck pain can occur even at work. But several effective exercises - for example, exercises in the office - can be performed right at your desk.

Spinal cord injury can occur for a number of reasons.
As a result of road accidents or sports injuries, a so-called whiplash injury
, which is caused by a sudden movement of the neck back and then forward.
This injury causes damage to the ligaments and intervertebral discs, which in turn irritates the nerve roots and spinal cord. Attention!
Neurological symptoms of whiplash may not appear immediately, so it requires immediate medical attention.
A fracture of the bones of the spine in the cervical region is a consequence of injury or a consequence of osteoporosis. The bones of the spine in people with this disease are very fragile. If such a fracture damages the spinal cord, the person may die from respiratory failure or remain disabled for life. Timely assistance in this case is especially important for survival. Therefore, a person with suspected spinal cord injury should be placed on a hard surface and an ambulance should be urgently called
.

First aid

The person should be in a horizontal position and should be completely rested. It is best to use any hard surface. You should place a cushion under your head that can be rolled out of a towel. This helps minimize stress on the neck and spine. The patient should not turn his head or make sudden movements.

• Apply a cold compress. This could be a damp towel or other item. However, doctors do not recommend applying clean ice to the bruise site. Better to wrap it up with something early. This will help relieve the first symptoms of injury: pain and swelling. Cold causes blood vessels to constrict.
• Give the victim anti-inflammatory drugs. They will also help reduce pain. These can be any drugs. Pharmaceuticals that you buy at a pharmacy or have at home. For example, ketones or paracetamol.
• These are first aid measures if a neck muscle strain occurs at home or after playing sports. However, if your injury was the result of an accident or collision, the first thing to do is call an ambulance.

Before making a diagnosis, the doctor must carefully examine the damaged area and conduct a palpation examination. This is done in order to determine the specific location of the injury. After an initial examination and interview with the patient, the specialist prescribes research methods such as:

Symptoms

Identifying cervical myositis in children sometimes turns out to be quite difficult, since the child himself does not say anything about his health, and the parent can only guess what is bothering his child. Often in such a situation, even older children cannot really explain what exactly hurts and where. In general, the clinical picture of the disease is as follows:

• pain in the neck, which can spread lower;
• increase in skin temperature;
• weakness of the child, some symptoms of intoxication.

But, in addition, treatment of myositis in children may be necessary after the manifestation of some particular symptoms, which do not occur in every situation and may depend on which muscles are affected. These symptoms include:

1. Limitation of the child’s body mobility due to pain.
2. Uncontrolled muscle contractions.
3. Redness of the skin and swelling of the tissues directly above the site of inflammation.

Often the first signs of myositis of the neck muscles in a 3-year-old child appear at the moment of awakening; often the baby begins to be capricious, and parents note his lethargy, and attempts to change body position are accompanied by bouts of crying. When a parent tries to examine the baby, he may notice muscle tightness and tenderness to palpation.

Treatment[edit | edit code]

Conservative treatment[edit | edit code]

Conservative methods form the basis of treatment. Initially, immobilization with a collar splint is necessary until the muscle spasm disappears, which usually takes 7-10 days, after which a lateral X-ray can be taken in flexion and extension to rule out instability. Anti-inflammatory drugs can be prescribed during immobilization. If x-rays do not reveal serious associated injuries, then as soon as the muscle spasm has disappeared, remove the splint and begin exercise therapy: first passive movements, then isometric exercises. Prolonged immobilization leads to muscle atrophy and detraining of healthy muscle fibers. Exercise therapy prevents detraining and post-traumatic spasticity (rigidity) of muscles. As clinical improvement progresses, muscle activity can be increased.

Surgical treatment[edit | edit code]

Surgery is only necessary after a severe injury causing instability. Ligament rupture may initially be hidden by muscle spasms. Surgical treatment in most cases comes down to arthrodesis of the segment that has lost stability, but this is required quite rarely.

Degree of damage

There are several stages of pathology:

1. Microtraumas. They provoke pain of moderate intensity. However, edema does not always develop. There may be a slight decrease in mobility or discomfort when trying to move the head. Recovery from microtrauma of soft tissue occurs in 5–7 days.
2. Significant muscle tearing that accompanies severe stretching. In this case, recovery may take 1.5–2 weeks. Symptoms of this condition: intense pain, obvious limitation of movements.
3. Tissue rupture. This pathology is treated under the supervision of a doctor; recovery may take several months. Symptoms: unbearable pain, severe swelling, change in skin color: redness, cyanosis, inability to move the head.

Causes of the disease

A lot of factors can provoke the disease. Your child may have developed myositis:

• infectious due to the penetration of infection into the child’s body in the form of a harmful virus or bacteria;
• parasitic infectious - myositis is provoked in this case by echinococci, trichinella, etc.;
• traumatic - if the baby falls or hits himself, inflammation can occur in response to the damage;
• static-dynamic – when the child is in an uncomfortable position for a long time;
• due to hypothermia - too cold clothes, fans, air conditioners, prolonged swimming in a pond and other factors;
• due to too much physical strain on the neck muscles.

According to many doctors, cervical myositis in children can also occur due to the fact that the baby’s neck muscles are hypertonic. Inflammation can also be caused by severe and frequent stress, which can lead to spasms of the neck muscles. Over time, this phenomenon can cause constant, persistent spasms and pain.

How to diagnose?

To determine myositis in a child, it is not enough to feel the sore spot yourself. You need to consult a doctor to identify the causes of the baby’s pain, since they may lie in something completely different. To establish a diagnosis, you will need to take tests and undergo diagnostic procedures.

What tests are needed?

In general, the doctor may prescribe for the child:

1. General blood analysis.
2. Detection of alkaline phosphatase.
3. Serum creatinine and total creatine kinase, its MB fractions.

As a result, it will be possible to determine the cause of pain and deterioration in the child’s well-being, confirm or refute the presence of myositis of the neck muscles in a small child.