The Top 7 Whiplash Injury Symptoms and Why they Cause Permanent Damage

Whiplash is a potentially incredibly devastating type of injury that can change your life. Far too often it is taken for granted. People assume “no damage = no injury” meaning that if their vehicle survived intact then they couldn’t have been injured.

Nothing could be further from reality!

How could that be true? First, modern vehicle bumpers are engineered to withstand significant impact without damage. It’s largely an effort to save money on auto repairs. 

Many impact test studies have shown that even when the impact exceeds 17 mph, the collision did not cause any observable bumper damage. But, at speeds of 17 mph or greater, the occupants can suffer injury even if the bumper looks fine.

Other research from Yale University found that

“Research with a human volunteer found that with a pre-impact automobile speed of 8.2 mph, forces applied to the head were 2.5 times greater than the forces applied to the vehicle.”

If the Vehicle isn’t Damaged How Can the Occupant be Injured?

It’s natural to assume that if you get rear-ended and there’s barely a scratch on your vehicle that you shouldn’t have gotten injured. But, that couldn’t be further from what happens. 

Whiplash injuries are called “Acceleration – Deceleration” injuries and the biggest factor in whether you get injured is whether your vehicle is suddenly moved forward when hit from behind or abruptly slows down or comes to a stop when striking something in front of you. 

I will sometimes offer this example to explain this. Let’s say your car is anchored to the ground so that it can’t possibly move and it is struck from behind. On impact the vehicle from behind comes to an abrupt stop but you don’t move. 

You don’t get hurt because damage to soft tissues like muscles, ligaments, joints, nerves, brain, discs require rapid and extreme movement for damage or injury to occur. That’s why they call whiplash “Acceleration – Deceleration” injuries. 

The injuries occur when you are moving forward and experience a rapid slowing down or come to a stop when impacting something in front of you. Or, you get whiplash injuries when sitting at a stop or moving slowly and then move rapidly forward when struck from behind. 

This rapid acceleration or deceleration is what causes the whipping movement of the body. 

The Head and Neck are Especially Vulnerable

It is common for there to be brain injury due to acceleration-deceleration forces where there is no direct impact to the head. An example would be a restrained passenger coming to a sudden stop when the vehicle strikes a stopped vehicle in front of them. 

The brain can experience a range of significant injury in these accidents including bruising (contusion), hematoma (bleeding), edema (swelling), as well as nerve damage (diffuse axonal injury), and more. 

The average human head weighs about 11 lbs. It sits on top of and is balanced by the relatively small and fragile neck. When that 11 lb weight gets “whipped” suddenly back and forth a number of things can happen:

  • The brain strikes the front and/or back of the head sustaining injury
  • Muscles of the neck sustain tears
  • The cervical spine joints are overstretched or violently compressed
  • The discs of the cervical spine are injured
  • The nerves going into the head are injured
  • The nerves that go into the arms are injured
  • Concussion
  • Loss of consciousness

Top 7 Whiplash Injury Symptoms

There is an incredibly wide range of symptoms that result from whiplash injuries. Many factors contribute to the nature of the injuries and the symptoms that show up post-injury. For example:

  • Driver or passenger
  • Strike something in front of you (deceleration-acceleration)
  • Struck from behind by another vehicle (acceleration-deceleration)
  • Head looking straight ahead or turned to the side
  • Head strikes something – airbag, steering wheel, windshield, door window
  • Seat belt 
  • Many, many more…

The top 7 Whiplash Symptoms according to Johns Hopkins Medical School are:

  1. Neck Pain
  2. Neck Stiffness
  3. Shoulder Pain 
  4. Low Back Pain
  5. Dizziness
  6. Pain or Numbness in Arm or Hand
  7. Ringing in the ears

Why stop at 7 when there is so much more to these devastating injuries like:

  • Blurred Vision
  • Concentration and Memory Problems
  • Insomnia
  • Fatigue

Why Do These Injury Symptoms Often Cause Permanent Damage?

Hopefully you understand a bit more about the mechanism of these injuries and how that 11 lb weight on top of the neck getting whipped around can cause injury. But, why are these injuries so devastating and result commonly in permanent damage?

  • Brain and Nerve Injuries: there is no more delicate tissue in the body than the brain and the rest of the nervous system. These are so sensitive that they are encased in bone (skull and spine).

Both compression and stretching can easily damage this tissue resulting in significant and permanent damage. We’ve witnessed the amount of TBI (Traumatic Brain Injury) in football players wearing a helmet to protect them. Whiplash injuries are even more traumatic and result in permanent changes.

  • Cervical Discs: the discs are the cushions between the vertebrae that allow motion and create space for the nerves that exit the spine. Whiplash can cause tearing and herniations that do not heal fully. 

The bulging or herniated discs can put pressure on the delicate nerves that control the arms, causing numbness, tingling, pain, and weakness.

  • Soft Tissues: muscles, ligaments, tendons, and joint capsules are all easily damaged in whiplash injuries. When these tissues are torn the body heals them with the formation of scar tissue. The problem is that scar tissue is not healthy tissue.

Scar tissue is weaker and less elastic than healthy uninjured soft tissue. This sets the stage for permanent problems that restrict proper motion, cause pain, and result in degenerative changes. 

  • Improper, Insufficient, or Delayed Treatment: in order to avoid or minimize permanent damage the treatment must be appropriate to the injuries and the damaged tissues. 

There is an attitude that if you are not bleeding that these injuries heal on their own and only if you continue to experience problems should you seek treatment. While these injuries do “heal”, they do so by forming scar tissue that creates many long term problems. If you wait to get treated you have much less ability to influence how the injuries heal. 

The critical issue is less whether you might experience permanent damage as a result of whiplash and much more about how severe that damage might be, the degree of long term pain and symptoms, and the limitations these injuries impose on your life. 

The use of medications as well as ice and heat and rest will not get these injuries to heal properly. The treatment must match the injured tissue and start as soon as possible since the healing process starts immediately.

If you’ve been injured in a whiplash do not take a wait and see attitude to determine if you seek treatment. Treat your injuries early and often through the healing process. 

Not a week goes by when someone presents to my office with chronic issues like neck and shoulder pain, headaches, or back pain without any recent trauma. When we do a deep dive into their history there is always some trauma, often decades before. And, when x-rays are taken they more often than not reveal degenerative arthritis far more advanced then one would expect given their age and lifestyle. 

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