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Whiplash is the term used to describe the acceleration-deceleration forces on the neck which may occur in rear-end or side impact motor vehicle collisions.

These forces may result in painful injuries to the muscles, ligaments and joints of the neck and other spinal areas. However, sometimes they result in no injury or pain at all. The joints and ligaments of the neck are covered by muscles. So the injury cannot be seen from the surface.

This can be frustrating when your neck is painful. Imagine a sprained ankle. Immediately following a sprain, the ankle becomes bruised, swollen and painful to move. A similar reaction can be expected from an injury to the small joints of the neck, it is just that you cannot see it.

Whiplash associated disorders (WAD)

It’s important to know that Whiplash is an injury from which most individuals recover well. Recent studies have shown that people who are positive about recovery and resume their normal daily activities as tolerated may recover faster than those who markedly alter or markedly reduce their activity level for a period.

The main symptoms of a whiplash associated disorder are neck pain and stiffness. Other symptoms such as headaches, aching in the arms or feelings of being lightheaded are not uncommon. It is also understandable that some people may feel distressed after the motor vehicle collision and these feelings usually settle with time and recovery. Symptoms may appear immediately after the incident or have a delayed onset of a few hours or days.

The nature of injury and the number and severity of symptoms vary between different people. Remember the sprained ankle. Some people can resume walking immediately after going over on their ankle; others cannot put the full weight on their foot for many days. Neck x-rays may be taken to rule out injuries such as bone fractures or dislocations. X-ray reports often state that no abnormality has been found. However, x-rays do not reveal injuries to the soft tissues of the neck and x-rays do not provide information about pain levels. Normal x-rays only provide assurance that there are no major bone injuries.
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    Grades of WAD

    In 1995 the Quebec Taskforce developed a classification system that was designed to improve the management of WAD by providing a guide to the signs and symptoms of whiplash indicative of the seriousness of the injury sustained. This system has helped guide assessment and diagnosis over the past decade. The clinical classification provided by the Quebec Taskforce is as follows:

    Quebec Taskforce Classification of Grades of WAD

    Grade Classification

    0 No complaint about the neck No physical sign(s)
    I Neck complaint of pain, stiffness or tenderness only No physical sign(s)
    II Neck complaint AND musculoskeletal sign(s) Musculoskeletal signs include decreased range of motion and point tenderness
    III Neck complaint AND neurological sign(s) Neurological signs include decreased or absent tendon reflexes, weakness and sensory deficits IV Neck complaint AND fracture or dislocation Recovery

    Following a whiplash injury, you may have a few questions.
    1. Will I make a full recovery?
    Most people recover from a whiplash injury although at different rates. No injury is the same as another. A small percentage of people who have a whiplash injury may develop long-term neck pain. Research is being conducted worldwide to understand why there are different recovery rates between different people. Some reasons have been identified such as age and initial severity of the pain or injury. However, there is still more to be learnt.
    2. How long will it take to get better?
    Many people recover within a few days or weeks. For others it may take several months to experience substantial improvement in symptoms. Ongoing symptoms may vary in their intensity during the recovery period. This is normal.
    3. What can I do to help my recovery?
    Research has shown that it is better to try to keep doing normal daily activities as much as possible to aid recovery. You need to take care of your neck and not expose it to unnecessary strain during the healing phase. It’s also important to regularly exercise your neck muscles.
    4. Can I do the same activities as before? Are there any limitations?
    In the early stages of recovery, you may need to adapt some activities to care for your neck. However you should gradually resume normal activity as your neck improves (work, recreation and social). It may be necessary to limit some of your usual work and recreational activities in the early to mid-stage of recovery. Be adaptable - find new ways to do tasks to avoid unnecessary strain on your neck.