Whiplash Neck Injury

Whiplash Neck Injury Commonly Happens In Rear End Car Crashes

Common symptoms of whiplash injury are neck pain from mild muscle strain or minor tearing of muscles and/or ligaments. In more severe cases, this type of neck injury may include nerve damage, disc damage, and in the most severe cases ruptures of ligaments in the neck and fractures of the neck bones.

Minor whiplash injury is usually associated with pain and limited motion of the head and neck. These symptoms are usually temporary, but occasionally they may persist and include headaches, dizziness, and tingling in the arms indicating pain may be more than a minor neck strain or sprain.

whiplash neck injury

When a car is struck from the rear it is accelerated forward which causes the seatback to push against the body and propel it forward while the head lags behind until the neck reaches its structural limit. The head is then suddenly accelerated by the neck like the tip of a whip which is where the term “whiplash” injury originates. Properly constructed and adjusted head rests (restraints) limit the damage to the neck before the head starts to follow the body.

whiplash injury motionThe neck being thrown back and forth beyond its normal range of motion (distortion) results from sudden movement of the head relative to the body probably explains most whiplash injuries, but experimental and field studies suggest that nerve damage and associated long term whiplash injury symptoms can occur with even mild levels of neck distortion. It is possible that damage to the nerves and the joints is caused by motion of neck bones during a crash or that the nerve damage is caused by sudden changes in spinal fluid pressure from neck distortions. Neck sprains and strains are the most frequently reported injuries in insurance claims.

Risk of having a whiplash injury in a car accident?

Females are about 2 times more at risk of whiplash neck injury in all types of collisions and are more likely to develop long term symptoms. Fifty five percent of females with whiplash injuries develop long term symptoms compared with about 40 percent of males. Possible reasons are that males have stronger neck muscles than females for about the same size head and females tend to sit farther away from their seats than males which means the head must travel more before reaching the head restraint. This is seen generally as women suffer neck pain more than men

  • A 2018 study in Traffic Injury Prevention found that women are more susceptible to neck injury during whiplash because of variations in shape of the cervical spine. The authors noted that women have straighter cervical spines, which undergo greater facet joint compression, higher segmental rotation, and more stretching of the ligament in the front of the spine (anterior longitudinal ligament).

reclining and whiplashDrivers have a higher risk of whiplash injury than passengers possibly because they tend to move forward and away from the seat as they reach for the steering wheel and observe traffic, while passengers are more relaxed and lean further back in their seats, putting the head closer to the restraint. Persons in the rear seats are less likely to sustain neck injuries. This is assuming sitting correctly.

  • A 2022 study in Sensors indicates the optimal seating angle is 117 degrees for reduce cervical spine injury. However, passengers who a reclined seating configuration are at greater risk for injury. The found, “The more reclined the seat, the higher deceleration and, therefore, the higher the overall acceleration of the head.”

How can the headrest influence whiplash injury?

whiplash head restThe head restraint is commonly called a head rest, indicating it is for comfort rather than a safety feature, but, installation of these are similar to seat belts – for protection. A proper head restraint reduces forceful backward trajectory of the head in a rear-end collision, reducing the odds of suffering a whiplash injury to the neck. The necessity of a good head rest is just as important as other safety devices in a vehicle, perhaps more so, as rear-end collisions are very common.

Head restraints that are adjusted at or above the center of gravity of the head decrease reporting of neck pain in a whiplash neck injury. In fact, the drivers with properly adjusted restraints indicate 40% less occurrence of neck pain compared to those that use improperly adjusted head restraints.

Having a poorly adjusted head restraint or one that cannot be adjusted properly to the height of your head in your vehicle is a major risk factor for increasing the severity of whiplash neck injury during a rear end collision. View the Insurance Institute for Highway Safety Head Restraint Rating to get an idea of how your car’s head restraint rates.

Taking time to properly position your head restraint, or using a crash tested car seat head support may help to prevent a chronic whiplash neck injury and possible life with a chronic, disabling condition.

How To Adjust Your Head Rest To Protect From Whiplash Injury

protect from whiplash injuryAdjusting the height level: A head rest positioned too low may result in a neck injury due to the head pivoting over the head rest in a whiplash injury. So, the initial adjustment is making sure height is correct. Maneuver the head restraint upward or downward so the mid point of the head restraint at meets the central point at the back of your head and even somewhat higher.

For every inch your head moves forward in relation to the restraint (away from the headrest), the force of injury to your neck is magnified. A crash test by the Center for Research into Automotive Safety and Health indicates the forward positioning of the head by two inches greatly increases the whiplash force to your neck.

The term “backset” refers to the distance between the head and the restraint. This backset should not be more than 4 finger widths.

If your head restraint fails to meet the minimum required backset, it can not help to prevent whiplash injury. The geometry of head restraints are evaluated by institute researchers at regular intervals in vehicles using the height and backset compared with an average sized person. A head restraint needs to be, at the minimum, at the height of the center of gravity of the head, which is approximately 3 and a half inches or 9 centimeters below the top of the head. The backset, which is the distance in back of the head, needs to be as short as possible. A backset greater than 4 inches or 10 centimeters is associated with more symptoms of whiplash injury to the neck in rear-end collisions. For more see the National Highway Traffic Safety Administration Review

The National Highway Traffic Safety Administration (NHTSA) told auto makers the head restraints in their passenger vehicles will have to extend higher and fit closer to the backs of people’s heads. For the first time, the new standard addresses the backset. Head restraints will have to be within about 2 inches behind the head. It has been in effect since 2009. However, this has created a new problem – headrests that are very uncomfortable and leave a space between the head, neck and headrest. Fortunately, there are some products which can help this now like the car neck pillow.

What Else Can Be Done To Reduce Whiplash?

While at a stop, having your head or body turned during a collision can increase your chances of a significant injury. Keep your eyes on the road and your head straight. If you know you’re going to get hit, then reduce the distance between your head and the head restraint (backset) by moving your head back. The car neck pillow reduces the backset distance and increases your level of safety.

Crashes involving a whiplash injury happen at lightning-fast speeds, but if you have time to prepare: Put your head and your neck all the way back so that you’re in contact with the seat back and the properly adjusted head restraint. Straight-arm the steering wheel and get a good grip. If you are stopped, put your foot on the brake as hard as you can. Look straight ahead, not in the rear-view mirror – don’t have your head turned at all. Put your neck back slightly so your eyes are looking level up at about the top of the windshield. Scrunch your shoulders up toward your ears and then brace.

  • A 2021 study in Traffic Injury Prevention found increasing levels of obesity introduces slack in the seat belt system by placing the belt further away from the skeleton. The belt is designed to engage the pelvis during a crash and belt placements that are higher and further forward may increase injury risk by allowing excursions or submarining.

managing neck pain at amazon

Benefits Of Reducing Effects Of Whiplash

  • In 2010 study published in the European Spine Journal. The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study. It was found that “… a history of neck injury in a motor vehicle collision is a risk factor for developing future troublesome neck pain. The consequences of a neck injury in a motor vehicle collision can have long lasting effects and predispose individuals to experience recurrent episodes of neck pain.”
  • A 2016 study in the journal Pain indicates that whiplash can trigger chronic condition with widespread pain in vulnerable individuals who experience widespread pain early after a motor vehicle accident, which does not improve.

Studies show 11 to 13% of adults suffer from (CWP) chronic widespread pain, which is pain on the right and left sides of the body, below and above the waist, including the spinal region. They experience significant disability along with reduced quality of life.

  • A 2021 review in the journal Neuro-Chirurgie indicates neck joint dysfunction, upper cervical pain, decreased endurance of the flexor muscles, and an increase in neck stiffness can cause tension headaches. This could explain neck pain and headache in whiplash as related to mild traumatic brain injury.

Are People Faking Whiplash Injuries?

  • Some would suggest that being involved in a personal injury case related to whiplash leads to greater reporting of ongoing neck pain, however; as indicated in a 2014 study from the journal Pain, persistent pain after an auto accident is common among those not engaged in litigation, relating initial neck pain severity to be the most predictive factor of ongoing neck pain related to whiplash.
  • A 2022 study in Frontiers in Neurology found that minor whiplash trauma with no signs of a tissue injury can present with central neuromotor dysfunction, such as hyperactive and abnormal activation patterns associated with the involved and related muscle groups. This places the cause within the central nervous system and can lead to chronic symptoms due to dysfunctional nerve and muscle control.

More Information About Whiplash, Neck Pain & Help With Recovery

More about whiplash injury as it relates to specific neck problems in the article; whiplash and neck pain, helping yourself in whiplash recovery and managing whiplash.

Author Bio

Stephen Ornstein, D.C. has treated thousands of neck, shoulder and back conditions since graduating Sherman Chiropractic College in 1987 and during his involvement in Martial Arts. He holds certifications as a Peer Review Consultant from New York Chiropractic College, Physiological Therapeutics from National Chiropractic College, Modic Antibiotic Spinal Therapy from Dr. Hanne Albert, PT., MPH., Ph.D., Myofascial Release Techniques from Logan Chiropractic College, and learned Active Release Technique from the founder, P. Michael Leahy, DC, ART, CCSP.