What causes neck pain after fainting

Whiplash

Whiplash (Acceleration injury, cervical spine distortion, whiplash injury): pulled muscles and ligaments in the cervical spine, combined with painful tension in the neck and throat muscles. The cause is an unforeseen acceleration, usually from behind, which causes a sudden head movement in relation to the fixed trunk, e.g. B. in rear-end collisions. In addition to pain and restricted movement of the neck, some sufferers also experience vegetative complaints such as nausea, tremors and increased sweating, and rarely tinnitus or visual disturbances. The symptoms usually last a few weeks, but become chronic in 2–3% of cases.

If the pain is severe, the doctor will prescribe pain medication. On the other hand, immobilizing the cervical spine with a neck tie and taking it easy on the body is in most cases not only unnecessary, but even harmful.

Leading complaints

  • Painful restriction of movement of the cervical spine immediately after the event or on the following day
  • Radiation of complaints in shoulder and arm possible
  • Possibly headache, dizziness, sleep disorders, nausea, sweating and / or tremors
  • Possibly visual disturbances, ringing in the ears or feelings of numbness in the arms, face or shoulders.

When to the doctor

Within a few days at

  • persistent painful restriction of movement of the cervical spine
  • persistent dizziness or headache after an accident.

Within a day at

  • Paralysis or visual disturbances or after an accident.

See a doctor immediately

  • Unconsciousness and amnesia to rule out traumatic brain injury.

The illness

Causes and Risk Factors

Acceleration trauma usually occurs as a result of sudden acceleration or an impact from behind, for example in a car accident, bumper car driving or even during martial arts. The jerky and unexpected flexion and hyperextension of the cervical spine strains the ligaments and muscles there. Almost at the same moment you can feel the neck and throat muscles tense up like a lightning bolt. This painful process is triggered by a reflex that serves the vital protection of the cervical spine; it ensures that injuries to the intervertebral discs or even the spinal cord rarely occur and up to 95% of whiplash injuries can be classified as mild to moderate (see classification below).

Most of the time, the symptoms subside - with or without treatment - within a few days. Occasionally, however, they turn into protracted neck pain, often radiating to the head and arms. Such complaints are difficult to grasp and prove, as they usually contain a strong psychological component.

Clinic and course

The symptoms of whiplash injuries usually develop immediately after the accident. In milder cases, however, neck pain and nausea can only appear on the following day. Depending on the severity, the symptoms last for different lengths of time.

  • Severity 1 is primarily characterized by neck pain, which usually lasts a few days to weeks.
  • In severity level 2, muscle tension occurs, and it usually takes several weeks for healing to occur.
  • Severity 3 is characterized by nerve damage, in severity 4 the bones (e.g. with fractures) are involved. In these very rare cases, healing can take years.

On average, the symptoms disappear after about a month. Longer courses are also possible with a slight degree of severity, risk factors for this are, for example

  • Female gender
  • High age
  • Strong pain at the beginning
  • Psychogenic factors such as depression, anxiety, stress and conflict situations.

Complications

An important complication of whiplash is the psychogenic fixation of the symptoms. The term "whiplash" alone gives some patients the impression that the injury to the cervical spine is far greater than in reality. Out of fear and tension, head and neck pain then persist for a long time, even if there is no physical reason for it. The fact that whiplash is mostly caused by third-party negligence also strengthens the feeling of being at the mercy of some people and the incorrect processing of what happened.

Diagnostic assurance

Depending on the cause and extent of the symptoms, the physical examination shows reduced or (rarely) increased mobility of the cervical spine. To rule out a concussion, the doctor checks the patient's neurological status and eye mobility, and an X-ray is used to rule out a vertebral fracture.

The doctor will only order further special examinations if there is justified suspicion. For example, a nuclear spin is required to rule out a ligament injury to the spine. If a nerve or balance organ is suspected of being injured, the doctor will arrange for the necessary examinations such as B. the measurement of nerve conduction velocity, otoscopy and the testing of the equilibrium organ using the thermal labyrinth test.

Differential diagnoses. The most important differential diagnoses are vertebral body fracture, concussion, traumatic brain injury and other injuries to the skull.

treatment

In the vast majority of cases, the consequences of whiplash can be treated conservatively. Surgical therapy is only required very rarely, especially when nerve damage or vertebral fractures have occurred.

Note: wearing special neck bandages (Cervical brace, Cervical brace, "neck brace") is not recommended. Fixing the neck in one position weakens the neck muscles and stiffens the muscles and ligaments, which delays the healing process.

Treatment of normal whiplash consists of the following components:

  • enlightenment of the patient about the harmlessness of the whiplash and its good prognosis.
  • Pain management. Severe pain often initially requires treatment with pain relievers, e.g. B. Paracetamol or NSAIDs, possibly also with muscle relaxing drugs, z. B. tetrazepam. If neck pain persists, the doctor may inject anesthetic or muscle relaxant medicine near the painful area.
  • Physiotherapy and warmth. Physiotherapeutic stretching grips as well as cold or heat applications (e.g. fango) help with muscle tension. Massage of the tense muscles and possible trigger points is also used to treat pain and tension after whiplash. In some cases, the doctor also recommends transcutaneous electrical nerve stimulation (TENS).
  • Psychotherapy. Occasionally, the doctor advises psychotherapeutic treatment, especially if he suspects that the accident will lead to long-term psychological stress in the person concerned.

If the symptoms do not subside within 1–2 weeks after an accident, the doctor repeats the initial examinations or, in cases of doubt, supplements them in order to identify accompanying injuries that have not yet been diagnosed.

forecast

Whiplash symptoms usually go away in a period of up to 4 weeks. In every tenth patient, however, it takes up to six months for symptoms such as neck or shoulder pain to completely subside. Up to 3% of those affected still suffer so severely from long-term effects after 2 years that they are disabled in the exercise of their profession.

Your pharmacy recommends

What you can do yourself

Warmth to the neck.

Many whiplash patients benefit from warmth because it makes tense muscles easier to relax. The painful neck can be z. B. keep warm with scarves, turtlenecks, heated cherry stone pillows or potato wraps.

Exercises.

Let the doctor or physical therapist show you exercises that gently loosen and strengthen the muscles of the neck and shoulders and improve the mobility of the cervical spine. In any case, consult before you damage your cervical spine with incorrect or excessive training.

Complementary medicine

Further information

  • Comprehensive textbook on whiplash with an interdisciplinary approach: Michael Graf et al., Acceleration injury of the cervical spine: Cervical whiplash, Steinkopff Verlag 2009

Authors

Dr. med. Sonja Kempinski using text excerpts from: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 17:20


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.