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self-study / Torts

Jun. 5, 2024

Whiplash and Whiplash-Associated Disorder is no joke

Reza Torkzadeh

Founder and CEO, The Torkzadeh Law Firm

18650 MacArthur Blvd. Suite 300
Irvine , CA 92612

Phone: (888) 222-8286

Email: reza@torklaw.com

Thomas Jefferson SOL; San Diego CA

Reza's latest book is "The Lawyer as CEO."

Allen P. Wilkinson

Email: allenpwilkinson1955@gmail.com

Allen is a retired lawyer, with many years of experience involving personal injury and medical malpractice cases

Over the years, whiplash victims – and the lawyers who represent them – have been the butt of many jokes and parodies. We have all seen television comedy sketches where a driver whose car has been bumped slightly from the rear, opens the door of his vehicle and falls out, with his hand behind his neck yelling “whiplash.” This is promptly followed by the arrival of an “ambulance chaser” lawyer, John T. Pettifogger, smoking a big fat cigar and waving a handful of papers, saying something like, “Oh, my poor man. Don’t worry; we’ll sue for millions! Just sign here.”

Although whiplash can be a mild to moderate injury, the truth is that whiplash is a real injury that can be a serious, painful, and disabling condition that lasts many months, even years. Whiplash is a neck injury caused by the violent, rapid back-and-forth movement of the neck, like the cracking of a whip. This commonly occurs in motor vehicle crashes, especially rear-end collisions and side-swipe accidents or when a car suddenly pulls out from the curb into a passing car, causing a collision. Whiplash is sometimes referred to as neck sprain or strain, but those terms also include other types of neck injury.

Whiplash injuries may not show up right away. A person may awaken several days or even a week or two after the accident with classic signs of whiplash, such as neck pain, stiff shoulder, and a headache. However, the sooner the symptoms of whiplash appear, the more serious the injuries tend to be.

Many people with whiplash get better in one to three months by following a treatment plan that includes pain medication, physical therapy, exercise, and wearing a foam cervical collar for a short period of time. However, some people have long-lasting pain, persistent range of motion issues, and other lasting complications. Up to 40% of whiplash patients develop chronic symptoms that can last for more than three months, and in some cases years.

Whiplash-Associated Disorder

Whiplash-Associated Disorder (WAD) is the term given for the collection of symptoms affecting the neck that are triggered by an accident with an acceleration-deceleration mechanism of energy transfer to the neck. Although WAD is usually thought of as arising from motor vehicle accidents, it can be caused anytime the head is violently thrown back and forth, such as in sporting activities, diving mishaps, even slip-and-falls. The impact may result in bony or soft-tissue injuries (whiplash injuries), which in turn may lead to a variety of clinical manifestations called WAD.

Whiplash-Associated Disorder can involve much more than just a sore neck. Symptoms of WAD can include:

• Neck pain and stiffness

• Pain that gets worse with neck movement

• Loss of range of motion in the neck

• Headaches, most often starting at the base of the skull

• Tenderness or pain in the shoulder, upper back, or arms

• Tingling or numbness in the arms

• Tiredness

• Dizziness

Some people with WAD may also experience:

• Blurred vision

• Ringing in the ears (tinnitus)

• Trouble sleeping

• Crankiness

• Trouble focusing

• Memory problems

In the more severe and chronic cases of WAD, the person may experience depression, anger, frustration, anxiety, stress, drug dependency, alcoholism, substance abuse, posttraumatic stress disorder (PTSD), insomnia, and social isolation.

If the person has neck pain or other WAD symptoms after an automobile accident, it is important to get a quick diagnosis to rule out broken bones or other damage that can cause or worsen symptoms. A person is more likely to have ongoing pain if the first symptoms were intense, started quickly, and included severe neck pain, more limited range of motion, or pain that spreads to the arms. Risk factors linked to a worse outcome include having had whiplash before, older age, or the person already has low back or neck pain.

A whiplash injury does not show on imaging tests, but imaging tests can rule out other conditions that could be making the neck pain worse. Such tests include:

• X-rays – X-rays can show broken bones, arthritis, and other conditions;

• CT scan – a CT scan can make detailed images of bone and show damage;

• MRI – in addition to showing injuries to the bones, MRI scans can show some soft-tissue injuries such as damage to the spinal cord, disks, and ligaments.

WAD that involves injuries to bones or soft tissue in the neck can cause neck pain, stiffness, disequilibrium, sensimotor dysfunction, psychological disturbance, cognitive issues, sleep disturbance, and pain in other parts of the body.

Chronic WAD is commonly defined as symptoms that persist for three months or longer. Up to 50% of car-accident victims with whiplash-associated disorder have pain and movement restriction for more than three months, some even years after the injury, and 30% of this group have persistent pain and distress that significantly affects their lives.

WAD is divided into five grades:

Grade 0 – No complaint about the neck; no physical sign(s)

Grade 1 – Neck complaints of pain, stiffness, and tenderness only; no physical sign(s)

Grade 2 – Neck complaints and neuroskeletal sign(s); decreased range of function and point tenderness complaint

Grade 3 – Neck and neurological sign(s); decreased range of motion and point tenderness

Grade 4 – Neck complaint and fracture or dislocation

In more serious cases, whiplash can cause traumatic brain injury (TBI). TBI can vary from mild to severe and can have lasting effects on cognitive function, motor skills, and emotional well-being. Potential effects of TBI from whiplash include cognitive impairment, emotional and behavioral changes, sensory disturbances, motor and coordination challenges, and sleep disturbances

WAD may also involve a concussion, as when the head snaps back violently and strikes the head restraint at the top of the seat.

Treatment of whiplash

The goals of whiplash treatment are to control pain, restore range of motion in the neck, and get the person back to his regular activities. Depending on the severity of the injuries, the doctor may have the patient wear a foam cervical (neck) collar, although there is some debate among medical professionals on this. Some doctors will prescribe rest and have the patient wear the cervical collar for 72 hours, while other doctors will have the patient wear the collar three hours a day for two to three weeks. Still other doctors will not prescribe the wearing of a cervical collar, believing exercise is the best treatment.

If the patient is in low to moderate pain, the doctor may prescribe over-the-counter anti-inflammatory pain killers, such as ibuprofen (e.g., Advil or Motrin) or naproxen (Aleve). For patients in severe pain, the physician may prescribe heavy duty opioid painkillers such as hydrocodone. The doctor may also prescribe a muscle relaxant. Some antidepressants are also used in the management of pain. The doctor may also instruct the patient to apply heat or cold to the painful area.

In addition to medication, and depending on the severity of the patient’s condition, the doctor may order a course of physical therapy for several weeks or more, depending on how well the patient is recovering.

#1471

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