Cervical Sprain

A cervical sprain, also known as whiplash or cervical hyperextension, is a tear in the ligaments of the cervical vertebrae caused by a sudden and excessive flexion-extension movement of the neck. Generally, a cervical sprain occurs during the flexion phase, followed by a lesion or overload in the facet joints of the cervical spine during the extension phase.

There are three types or degrees of cervical sprain, depending on severity:

• Type 1 cervical sprain: A mild sprain caused by a slight stretching of the soft tissues and bones in the neck without compromising the structural integrity of the joint.
• Type 2 cervical sprain: A moderate stretching of the tissues, leading to partial tears without complete separation.
• Type 3 cervical sprain: A severe stretching of the tissues, causing their rupture and separation. This is the most serious type, and recovery may take several months, potentially leaving long-term aftereffects.

Symptoms

Whiplash symptoms usually appear hours or even days after the incident and vary depending on the severity of the sprain. The most common symptoms include:

• Neck pain that worsens with movement.
• Muscle contracture.
• Stiffness and reduced range of motion in the neck.
• Headache, often originating at the base of the skull.
• Pain or tenderness in the back, shoulders, and arms.
• Tingling or numbness in the arms.
• Fatigue.
• Dizziness or vertigo.
• Blurred vision or ringing in the ears may also occur.

Causes

Cervical sprains result from a sudden and strong rear impact. The injury mechanism occurs in three phases:

1. The rear impact pushes the torso forward in relation to the neck and head.
2. Inertia causes the neck to move backward, leading to hyperextension.
3. Once the displacement stops, inertia forces the neck into hyperflexion forward.

This injury is commonly caused by a rear-end car accident involving a strong collision. It is also frequent in contact sports such as rugby or football, where falls or direct impacts occur. Additionally, it can result from physical assault.

Risk Factors

The likelihood of suffering a cervical sprain increases in the following cases:

• Age: More common in teenagers and young adults.
• Sex: More frequent in women.
• History of neck pain or injury.
• Driving at high speeds.

Complications

Cervical sprains generally do not lead to complications, but in some cases, the injury may not fully heal, resulting in persistent pain and stiffness for months or even years. Additionally, the impact causing the sprain can have serious consequences, such as:

• Cerebral contusion: A blow to the head during the accident can affect brain function, leading to symptoms such as headaches, confusion, loss of consciousness, difficulty concentrating, and memory or behavioral changes.
• Cervical disc herniation: The impact may cause an intervertebral disc to shift and compress the spinal cord or a nerve root. This condition can lead to permanent motor or sensory impairments, even resulting in tetraplegia or paraplegia if the spinal cord injury is severe.

Prevention

To prevent a cervical sprain or minimize damage, the following measures can be taken:

• Drive carefully, frequently checking rearview mirrors.
• Always wear seat belts in the vehicle.
• Properly adjust the car headrest: aligned with the top of the head, with its center at ear level.
• Adjust the seatback correctly: keep it completely vertical with the back fully supported.
• Tense the body before a possible collision.
• Use protective gear when playing contact sports.

Which Doctor Treats Cervical Sprains?

Cervical sprains are diagnosed and treated in traumatology and orthopedic surgery consultations, as well as in rehabilitation medicine consultations and traffic accident units.