Concussion education / Tampa Bay / For providers

Whiplash or Concussion? Tampa Bay Rear-End Crash Patients

Whiplash and concussion share symptoms after rear-end crashes. History clues and testing options for Tampa Bay chiropractors and physicians.

Stop-and-go traffic produces a steady stream of rear-end crashes across Tampa Bay: I-275 through Westshore and downtown, Dale Mabry Highway, Bruce B. Downs Boulevard in New Tampa, State Road 60 in Brandon and US-19 in Pasco. Many of those patients arrive at a chiropractic or medical office with neck pain, headache, dizziness and trouble concentrating. Every one of those complaints fits whiplash-associated disorder. Every one also fits concussion.

This article is for Tampa Bay chiropractors and physicians who want a practical way to think about the overlap and decide when objective testing adds value.

The overlap is biomechanical, not just coincidental

A 2016 analysis in the Journal of Orthopaedic & Sports Physical Therapy (Elkin, Elliott and Siegmund) modeled the head motion in rear-end collisions. Under some conditions, including a poorly positioned head restraint, the estimated brain tissue strains approached those seen in concussive football impacts, even without the head striking anything hard. The authors concluded that concussion-like symptoms after a rear-end crash may come from the neck, the brain or both.

A concussion does not require a head strike or loss of consciousness. NINDS notes that a forceful jolt to the head or body can cause a TBI, and that concussion can result from rapid movement of the brain inside the skull.

Symptoms that belong to both

Headache, dizziness, visual disturbance, poor concentration, sleep disruption and irritability show up in both conditions. Marshall and colleagues (The Physician and Sportsmedicine, 2015) described how cervical spine dysfunction can drive or prolong post-concussion symptoms, which is one reason neck care and concussion care often need to run in parallel.

Headache classification reflects the same split. The International Classification of Headache Disorders (ICHD-3) lists headache attributed to traumatic injury to the head separately from headache attributed to whiplash. Getting the history right is what lets the record reflect which one, or both, is present.

History clues worth documenting

No single question separates whiplash from concussion, but these details help:

Whether the head struck the restraint, window or steering wheel, and where the head restraint sat.
Any moment of confusion, a gap in memory around the crash or feeling dazed at the scene.
Whether headaches worsen with neck movement and posture, or with screens, reading and concentration.
Light or noise sensitivity, balance complaints and trouble tracking moving objects.
Changes in sleep, mood or work performance reported by the patient or family.
Prior concussions, migraine history and when each symptom first appeared.

Writing these answers down at the first visit, in the patient's own words, gives everyone a reliable starting point. It makes later comparisons easier if symptoms change, and it helps the next clinician understand why a referral was made.

When objective testing adds value

Consider concussion testing when cognitive or visual complaints persist after neck symptoms improve, when symptoms are out of proportion to the cervical findings, or when recovery stalls. Testing does not replace your exam. It adds an objective measure of how the brain is functioning, which can support what your history suggests or point toward another explanation. Braintree's mobile team brings concussion and TBI testing to your office in Hillsborough, Pasco, Hernando and Citrus counties, with scheduling coordinated around your clinic. You receive a physician-reviewed diagnostic report, and the patient stays in your care. We diagnose. You treat.

See how concussion and TBI testing works, view our Tampa Bay service area or send a referral. Patients can read our For Patients page before their visit. Recent local crash reports appear on the Tampa Bay Crash Map.

Red flags that need emergency care

Send the patient to the emergency department or call 911 for the CDC danger signs: a headache that gets worse and does not go away, repeated vomiting, weakness or numbness, slurred speech, seizures, one pupil larger than the other, or increasing confusion or drowsiness. Tampa General Hospital is the area's Level I trauma center, and St. Joseph's Hospital in Tampa and HCA Florida Bayonet Point Hospital in Hudson are Level II trauma centers.

If a patient shows danger signs, call 911.

Frequently asked questions

Can whiplash cause a concussion if the head never hit anything?

It can. Rapid acceleration of the head can injure the brain without a head strike, and biomechanical research on rear-end collisions supports that some crashes reach concussion-level brain strain.

How can I tell a cervicogenic headache from a post-traumatic headache?

There is no single test. History helps: headaches tied to neck movement point toward the neck, while headaches worsened by concentration, light or noise raise concern for concussion. Both can exist together.

Can chiropractors refer patients for concussion testing?

Yes. Braintree accepts referrals from treating providers, including chiropractors, and returns a physician-reviewed diagnostic report to the referring office.

Does Braintree treat patients?

No. Braintree performs mobile testing and reporting. The referring provider keeps the patient and decides on care.

Where in Tampa Bay does the mobile team test?

At referring offices across Hillsborough, Pasco, Hernando and Citrus counties, as part of statewide mobile service.

Sources

This article is educational and is not medical or legal advice. If this is a medical emergency, call 911.

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