John Murtagh, Patient Education, Third edition, McGraw-Hill Book Company

Neck: postaccident neck pain

What is the cause of the probIem?
In a rear-end collision, your head is thrown back into
overextension and then bends sharply forwards on the
rebound. This is commonly called a whiplash injury, but it is
an overextension injury.
If your car collides with a stationary object, your head bends
sharply forwards at first and then rebounds backwards. This
results in a similar injury to the neck.
What happens?
1. The ligaments binding the vertebrae together are stretched
and torn, rather like a sprained ankle. Some bleeding
occurs in the ligaments.
2. The many small joints in the neck are jarred and bruised.
X-rays do not usually show up this injury to ligaments and
joints.
What are the symptoms?
At first the neck may feel okay, but later (maybe 2 or 3 days
later) becomes painful and stiff (like a sprained ankle). Pain in
the arms and headache may follow. Some people have
difficulty swallowing. Apart from a sore neck, there is a
tendency to feel depressed for about 2 weeks. Talk to your
doctor about this feeling if it persists.
What is the outIook?
The outlook is invariably very good with a normal recovery,
but it may take some months. It will not be speeded up by
repeated X-rays or wearing a cervical collar.
What is the treatment?
Like a sprained ankle, the neck needs time to heal, taking at
least 3 weeks.
SeIf-heIp
Apply icepacks for the first 3 days, then warmth and gentle
massage.
Exercise: The best treatment is exercising your neck as soon
as possible, even though it feels stiff and tender.
Mobilisation therapy can certainly help, but manipulation is
not recommended in the first 8 weeks. Your therapist will
advise on the best exercises, but any slow, deliberate
stretching of the neck is good.
Pain-killers: Paracetamol taken every 4 hours for pain is
advisable.
Cervical collar: Support for the neck from a 'collar' with the
back higher than the front can help for the first 10 days.
However, only 2 or 3 days in a collar is preferred. The less
time in it the better. Keep the neck in a slightly bent forward
non-painful position in the collar. Discard the collar as soon
as possible and start moving your neck.
Medication
Your doctor may prescribe a short course of muscle
relaxants or anti-inflammatory tablets to make your neck more
comfortable.
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