[Spectrum of sequelae after whiplash injury. Localization and development in relation to the clinical picture]

Neck sprain, a common sequela of motor vehicle trauma, is characterised by soft tissue lesions in the facet joints (the capsule), cervical discs (the annulus), ligaments, muscles, and sometimes in the nerve roots or the central nervous system. The cardinal manifestation of whiplash injury is neck pain, which may arise from any innervated part of the injured joints or muscles except the disc nucleus, the articular surface of facet joints, or the flaval ligaments. Pain may be referred to the skin or muscles via the respective sensory nerves. The tissue lesions, together with post-traumatic nerve root degeneration or medullary compression, may give rise to the complex neck sprain syndrome. Localisation of the source of symptoms by means of meticulous physical examination, MRI (magnetic resonance imaging), or accurately sited local anaesthetic injections is described in the article, and operative and multimodal rehabilitation procedures are discussed.