Notes from an emergency room doctor: “I’ve got whiplash!” patients will cry, arriving in an E.R. by ambulance or by foot after a car accident. Emergency rooms across the country see more than a million people each year complaining of “whiplash,” a severe hyperextension injury to the neck muscles. There are more than 12 million motor vehicle accidents in the United States each year. And about one-third of them are rear end collisions, the most common cause of “whiplash” injuries.

The origin of the term is not certain. It may have started with World War I navy pilots who suffered neck strain when their planes were “whipped” off the decks of ships by catapult. Fortunately, the navy recognized the problem quickly and provided shoulder harnesses and protective headrests for their pilots. It wasn’t until fifty years later that auto manufacturers adopted this same remedy.

Proper headrests can also reduce the likelihood of neck strain in rear-end motor vehicle collisions. Unfortunately, many people do not have their car headrests properly positioned. A headrest in a down position does not protect a person of average height. In fact, if adjustable headrests are too low, they can act as a fulcrum and cause a more severe injury.

A whiplash injury, also called cervical muscle strain, not only causes neck pain but is frequently associated with other symptoms like muscle tension headaches, dizziness, and “paresthesias,” a tingling and numbness in the upper limbs.

Routine treatment consists of anti-inflammatory pain medications, muscle relaxants, ice for 24 hours followed by local heat applications, and the wearing of a soft cervical collar for 2 or 3 weeks. If pain persists, physical therapy and cervical traction are sometimes prescribed.

Nearly 50% of victims are better just a few weeks after injury. But ten years after, as many as one-third of whiplash victims still complain of symptoms.

The rate of litigation after whiplash injuries is exceedingly high. Because there is generally no radiologic or diagnostic test that can confirm a cervical strain, those suffering from whiplash often fall suspect to having an emotional problem or a compensation neurosis, especially if symptoms persist and become a jumping board to litigation. E.R. physicians become particularly suspicious when a patient arrives complaining of neck pain several days after an accident and comments, “my attorney told me to come.” In one retrospective study of emergency room patients complaining of whiplash, 81% were found to be seeking some form of compensation.

Although we live in a terribly litigious world, one that leads us to suspect malingerers, most whiplash patients are sincere as evidenced by the fact that very few who have persistent symptoms get cured by favorable verdicts.

In the course of your life the odds are good that you’ll be the cause of, or the victim of, this ailment. The best cure is the best prevention. Keep an adequate distance between cars, properly position your headrest, and for god sake watch the road instead of yakking on the car phone or switching stations.