My 22 year-old daughter had a car accident a month ago, which left her with slight whiplash. She didn't need to take any of the painkillers provided by the hospital and seemed to make a quick recovery. Now she says the whiplash has returned (after a karate session) and it is almost bad enough for her to consider missing work. Is it normal for whiplash symptoms to recur so long after an accident? She has made a chiropractor appointment for this weekend. Is this likely to help?

answer

Whiplash is an injury to the neck, commonly caused when sitting in a car that is either shunted in the rear, or which hits an object in front. Although the body is strapped in, the head is not restrained, so sudden acceleration or deceleration will jerk the head backwards and then forwards (or vice versa), overstretching tissues in the neck. This leads to sprained or even torn ligaments, strained muscles and, sometimes, a partial dislocation of one or more of the small joints between cervical vertebrae.

Typically, pain and stiffness increase over 24 hours following the original injury. Whiplash can also injure nerve fibres, leading to numbness, burning and tingling in the fingers and, in severe cases, may cause weakness or even paralysis of arm muscles. Other symptoms include headache and tinnitus (ringing in the ears). The fact that the symptoms returned after your daughter recovered, suggests that the karate session caused her to strain her neck again, because a weakness remained.

Easing the pain

It will help if she sleeps on her back and uses a flat pillow so her head is not raised above her neck. Some people prefer lying curled on their side, but she should avoid lying on her stomach. A variety of treatments are available, including non-steroidal anti-inflammatory painkillers (like ibuprofen), muscle-relaxant drugs to reduce spasms, if necessary, and physiotherapy. Supplements containing glucosamine sulphate help to repair damaged ligaments, antioxidants (for example vitamin C and E) help to reduce inflammation, while St John's Wort is helpful for relaxing tense muscles (seek advice if taking any other medication, including the Pill).

Chiropractor help

A chiropractor is likely to be very helpful in identifying the site of the injury and helping to correct any misalignments. Whiplash sufferers usually recover fully, but it may be several weeks before full pain-free neck movements return.

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