A whiplash injury occurs when the head is suddenly moved in one direction, forcing the cervical spine past its normal mobility limits. This sudden movement can damage discs, ligaments, neck muscles, or even the bones, but the damage is usually so minor that it is not detectable. Car accidents are the most common cause of whiplash, particularly rear-end collisions. Contact sports, roller coaster rides, falls, and blows to the head are other possible causes. Though the damage is usually minor, whiplash can cause symptoms. When there are symptoms, they are diagnosed as whiplash-associated disorders (WAD), cervical sprain, neck sprain, or neck strain. Symptoms usually appear a few hours after the injury and may resolve quickly or linger for weeks, months, or longer. The most common symptoms are neck pain and neck stiffness. Some people might also have headaches, shoulder pain, upper back pain, blurred vision, and dizziness. The range of symptoms often grows the longer they last. For long-lasting WAD, the cluster of symptoms may include psychiatric problems like depression, anxiety, and sleep problems.
Whiplash is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity.
Early signs of whiplash include neck pain, neck stiffness, and a limited range of motion in the neck.
Get immediate medical attention when whiplash symptoms develop after a neck injury.
Whiplash is trauma caused by motor vehicle collisions, contact sports injuries, roller coaster neck injuries, falls, and blows to the head. Increased risk of developing whiplash symptoms occurs if you are older than 65, female, or have had previous neck injuries.
Whiplash usually requires a medical diagnosis.
Whiplash generally does not require treatment other than rest, heat, and gentle neck exercises to speed up recovery. Whiplash symptoms typically resolve without treatment within a few days or weeks.
Treatment of whiplash may include short rest, an immediate return to normal activities, neck exercises, over-the-counter painkillers, or more aggressive medical interventions for chronic or severe symptoms.
Untreated whiplash could result in complications like chronic pain, psychological issues, and diminished social functioning.
Use coupons for whiplash treatments like aspirin, ibuprofen, and acetaminophen to save up to 80%.
The early signs of whiplash usually start within a few hours after the injury but sometimes don’t appear until the next day or even later. These early symptoms include:
Neck pain
Neck stiffness
Limited range of neck motion
Depending on the severity of the injury, other early signs of whiplash might include:
Pain between the shoulder blades
Upper arm pain
Headache
Jaw problems
Muscle spasms
Tingling or numbness in the hands or arms
The most common symptoms of whiplash injury include:
Neck pain
Neck stiffness
Limited range of neck motion
Headaches
Dizziness
Shoulder pain, tenderness, and stiffness
Pain between the shoulder blades
Arm pain
Tingling or numbness in the hands or arms
Tiredness
Other physical symptoms include:
Weakness
Ringing in the ears
Vertigo
Visual disturbances
Memory problems
Difficulty concentrating
Problems speaking
Several psychological symptoms are also common in people with whiplash symptoms. They are more likely when whiplash symptoms have lasted for months or longer. The injury may not directly cause them but are usually secondary symptoms due to disability, pain, and frustration. Whatever the cause, they are common symptoms in people with chronic WAD and are taken seriously. These symptoms include:
Depression
Anxiety
Post-traumatic stress disorder (PTSD)
Anger
Sleep disturbances
Both whiplash and concussions share many of the same symptoms and causes. Someone can even have both whiplash and a concussion from the same injury. The difference is that whiplash is an injury to the neck's musculature and soft tissues, and concussion is a brain injury. The primary complaints people have after a whiplash injury are pain, stiffness, and limited movement specific to the neck and upper back. Other symptoms may be possible, but they are usually physical, like muscle spasms. The chief complaints people have with concussions are neurological: headache, vision problems, memory or concentration issues, or ringing in the ears. These are possible whiplash symptoms, but they are usually the only symptoms concussed people experience.
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RELATED: Concussion treatments and medications
Whiplash-associated disorders are ranked by the severity of the symptoms:
Grade 0 whiplash has no symptoms.
Grade 1 whiplash is characterized only by neck pain, neck stiffness, and neck tenderness.
Grade 2 whiplash not only includes neck symptoms but other muscle or skeletal symptoms.
Grade 3 whiplash includes neurological symptoms like numbness and tingling.
Grade 4 whiplash is characterized by severe pain and other symptoms as well as a diagnosable neck injury: bone fracture or a dislocated cervical spine disc.
A whiplash injury with symptoms requires immediate or emergency medical care. There is a possibility that the symptoms are due to a broken neck bone or other serious problem. Once whiplash has been diagnosed, further visits to the doctor may be unnecessary.
The goal of diagnosis is to make sure there isn’t a serious medical problem that needs immediate treatment. To do so, the clinician will ask detailed questions about how the injury happened and your current symptoms. The clinician will examine the neck carefully and test for range of motion, tenderness, and any neurological issues. A thorough neurological exam may be necessary if there are signs of nerve or spinal cord damage.An X-ray, CT scan, or MRI may be ordered if more information is needed.
The most common complications of whiplash are:
Long-lasting symptoms (chronic whiplash-associated disorders)
Psychological complications such as depression, anxiety, PTSD, drug abuse, and sleep problems
Social complications such as social isolation, family problems, and job loss
Healthcare professionals believe that the most effective treatment for whiplash involves resuming a normal life within bearable levels and actively exercising the neck. The recommended exercises are mobility exercises and stabilization exercises.
Immobilization is often a standard treatment for whiplash, but research suggests that it prolongs symptoms.
Over-the-counter pain medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen may be enough to manage pain and stiffness. Icing (in the first few days after the injury) and heat (10 days after the injury) also help with pain and stiffness. Prescription medications such as muscle relaxants or lidocaine injections may be used for severe symptoms.
Chronic whiplash symptoms are harder to treat. An estimated 40% of people with a whiplash injury report symptoms 15 years after the injury. Research suggests neck exercises and cognitive behavioral therapy are the most effective treatments for chronic whiplash symptoms.
Healthcare professionals may use more dramatic interventions for chronic whiplash-associated disorders such as:
Biofeedback
Neck manipulation
Ultrasound therapy to reduce pain
Nerve stimulation
Nerve ablation (destruction)
Alternative therapies such as melatonin supplements
RELATED: 8 non-narcotic pain meds and other pain management tips
Although whiplash symptoms usually resolve in a few weeks, sometimes symptoms may last for months or years. Healthcare professionals don’t know why whiplash symptoms last so long since there is no detectable damage to the neck. This doesn’t mean there isn’t pain or suffering, but the causes of the pain may be manageable in a way that an injury is not.
If whiplash symptoms are a long-term problem, there are several options to help manage the symptoms:
Find the right healthcare provider who will address the symptoms and help find treatments that work
Keep exercising the neck to increase range of motion and stability—this is the only treatment shown to improve chronic WAD
Look for a cognitive behavioral therapist—acceptance cognitive behavioral therapy has also been shown to reduce disability due to chronic whiplash symptoms
Use a biofeedback machine at home
Avoid poor posture
Avoid cervical collars
A whiplash injury can be very frightening. The accident itself is scary, and sometimes the whole process of being treated by an EMT at the scene, put in a collar, and being transported to a hospital in an ambulance can be terrifying. When being treated, healthcare professionals may say alarming things about the injury. However, when the problem is finally diagnosed as a whiplash, remember that there is no detectable problem with the neck. As a diagnosis, whiplash is a minor injury. To avoid chronic pain and disability, take charge of your recovery. You can rest for a day or two but then return to normal daily activities as tolerated, take off the cervical collar, do neck exercises, and expect the symptoms to improve.
The most effective treatments for whiplash symptoms are neck exercises and a return to normal activities after limited rest. Most whiplash injury symptoms will resolve in a few weeks without medical intervention.
Whiplash is a type of injury. If a neck bone breaks or there are problems with a cervical disc, those issues will be detectable on an X-ray, CT scan, or MRI. Otherwise, if there are no detectable problems, the diagnosis is “whiplash” or “whiplash-associated disorder.”
Whiplash symptoms are highly variable. Some people report greater pain or stiffness in the morning or at night, but this increased pain may be related to sleep position.
Acute whiplash associated disorders (WAD), Open Access Emergency Medicine (OAEM)
Cervical sprain, StatPearls
Clinical and other symptoms related to whiplash injury, American Family Physician
Cervical sprain, StatPearls
Prevention of chronic pain after whiplash, Emergency Medicine Journal
Whiplash diagnosis and treatment, Mayo Clinic
A research synthesis of therapeutic interventions for whiplash-associated disorder: part 1—overview and summary, Pain Research and Management
Psychiatric sequelae following whiplash injury: a systematic review, Frontiers in Psychiatry
Risk factors for ‘whiplash’ in drivers: a cohort study of rear-end traffic crashes, Injury
Degenerative disc disease treatments and medications, SingleCare
Neuropathy treatments and medications, SingleCare
Spinal stenosis treatments and medications, SingleCare
Leslie Greenberg, MD, is a board-certified practicing family physician with more than 25 years of doctoring experience. She was a psychology major at Northwestern University near Chicago, then graduated with an MD from the University of Nevada School of Medicine. She completed her family medicine residency at St. Joseph Hospital in Wichita, Kansas. She has trained more than 350 family medicine resident-physicians, been in private practice, and delivered babies for 22 years.
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