Жағаның шайқалуы және оның зардаптары

Informal term for injuries to the neck
the medical condition

Whiplash is a non clinical term describing a range of injuries to the neck caused by or related to a sudden distortion of the neck associated with extension, although the exact injury mechanisms remain unknown. The term "whiplash" is a colloquialism. "Cervical acceleration–deceleration" (CAD) describes the mechanism of the injury, while the term "whiplash associated disorders" (WAD) describes the subsequent injuries and symptoms. Whiplash is commonly associated with motor vehicle accidents, usually when the vehicle has been hit in the rear; however, the injury can be sustained in many other ways, including headbanging, bungee jumping and falls. It is one of the most frequently claimed injuries on vehicle insurance policies in certain countries; for example, in the United Kingdom 430,000 people made an insurance claim for whiplash in 2007, accounting for 14% of every driver's premium. In the United States, it is estimated that more than 65% of all bodily injury claims are whiplash related, translating to around $8 billion in economic costs per year. Before the invention of the car, whiplash injuries were called "railway spine" as they were noted mostly in connection with train collisions. The first case of severe neck pain arising from a train collision was documented around 1919. The number of whiplash injuries has since risen sharply due to rear end motor vehicle collisions. Given the wide variety of symptoms associated with whiplash injuries, the Quebec Task Force on Whiplash Associated Disorders coined the phrase 'Whiplash Associated Disorders'.

Symptoms reported by affected people include: pain and aching to the neck and back, referred pain to the shoulders, sensory disturbance (such as pins and needles) to the arms and legs, and headaches. Symptoms can appear directly after the injury, but often are not felt until days afterwards. Cognitive symptoms following whiplash trauma, such as being easily distracted or irritated, seems to be common and possibly linked to a poorer prognosis.

Whiplash can be described as a sudden strain to the muscles, bones and nerves in the neck. The neck is made up of seven vertebrae, referred to as the cervical vertebrae. The first two cervical vertebrae, the axis and atlas, are shaped differently from the remaining five. The atlas and axis are responsible for movement of the skull from side to side (cervical rotation to the right and left); also moving forward and backward (cervical flexion and extension). Excessive extension and flexion can disrupt the vertebrae. There are four phases that occur during "whiplash": Initial position (before the collision), retraction, extension and rebound. In the initial position there is no force on the neck it is stable due to inertia. Anterior longitudinal ligament injuries in whiplash may lead to cervical instability. They explain that during the retraction phase that is when the actual "whiplash" occurs, since there is an unusual loading of soft tissues. The next phase is the extension, the whole neck and head switches to extension, and it is stopped or limited by the head restraint. The rebound phase transpires as result of the phases that are mentioned. During the retraction phase, the spine forms an S Shaped curve, and this caused by the flexion in the upper planes and hyperextension at the lower planes and this exceed their physiological limits this phase the injuries occur to the lower cervical vertebrae. At the extension phase, all cervical vertebrae and the head are fully extended, but do not surpass their physiological limits. Most of the injuries happen in C 5 and C 6.

Diagnosis occurs through a patient history, head and neck examination, X rays to rule out bone fractures and may involve the use of medical imaging to determine if there are other injuries.

According to the recommendations made by the Quebec Task Force, treatment for individuals with whiplash associated disorders grade 1–3 may include non narcotic analgesics. Non steroidal anti inflammatory drugs may also be prescribed in the case of WAD 2 and WAD 3, but their use should be limited to a maximum of three weeks. Botulinum toxin A is used to treat involuntary muscle contraction and spasms. Botulinum toxin type A is only temporary and repeated injections need to take place in order to feel the effects. According to a year long follow up study in 2008 on 186 patients, the WAD classification and Quebec Task Force regimen were not linked to better clinical outcomes.

The consequences of whiplash range from mild pain for a few days (which is the case for most people), to severe disability. It seems that around 50% will have some remaining symptoms. Alterations in resting state cerebral blood flow have been demonstrated in patients with chronic pain after whiplash injury. There is evidence for persistent inflammation in the neck in patients with chronic pain after whiplash injury. There has long been a proposed link between whiplash injuries and the development of temporomandibular joint dysfunction (TMD). A recent review concluded that although there are contradictions in the literature, overall there is moderate evidence that TMD can occasionally follow whiplash injury, and that the incidence of this occurrence is low to moderate.

Whiplash is the term commonly used to describe hyperflexion and hyperextension, and is one of the most common nonfatal car crash injuries. More than one million whiplash injuries occur each year due to car crashes. This is an estimate because not all cases of whiplash are reported. In a given year, an estimated 3.8 people per 1000 experience whiplash symptoms. "Freeman and co investigators estimated that 6.2% of the US population have late whiplash syndrome". The majority of cases occur in patients in their late fourth decade. Unless a cervical strain has occurred with additional brain or spinal cord trauma mortality is rare. as the worldwide incidence of such injuries varies enormously, from 16 to 2000 per 100,000 population, and the late whiplash syndrome in these cases varies between 18% and 40%. Thus, important work by Schrader et al. in The Lancet showed that late whiplash syndrome after a motor vehicle collision is rare or uncommon in Lithuania, and Cassidy et al. 's conclusion in the New England Journal of Medicine is that "the elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury". Moreover, an experimental study in 2001 places participants in a stationary vehicle with a curtain blocking their rear view, and exposed them to a simulated rear end collision. Twenty percent of patients had symptoms at 3 days, despite the fact that no collision actually occurred. From the evolving viewpoint of naturalistic Internet search engine analytics in has been shown in 2017 that the expectations for receiving compensation may influence Internet search behavior in relation to whiplash injury.