Whiplash

Whiplash usually occurs when a person is rear-ended in an automobile. This causes movement of the structures within the neck changing the normal curve of the upper back and neck. The sudden backward movement (extension) and forward movement (flexion) can cause the joints of the neck to be injured and can also cause the muscles and ligaments of the neck and upper back to be over-stretched. The neck is particularly vulnerable to this type of injury because of its ability to move in many directions. If you have ever been in a rear-end car collision, you may have experienced this type of injury.

The best time to call your doctor is immediately after the injury. If you cannot determine whether an emergency department visit is needed for your symptoms, then contact your doctor and ask for advice. If your doctor is unavailable at the time of your injury, then you should call 911 for transport to the emergency department. The risks associated with a possible neck injury are far too great to attempt to diagnose and treat yourself. You should see a doctor and have your neck braced to keep your head from moving during transport.

Depending on the severity of your car accident, emergency medical personnel may take you to an emergency department immediately. In this case, a cervical collar will be placed around your neck, and your body will be strapped to a long, firm board to prevent any movements until a doctor sees you.

With less severe car accidents, sports injuries, or other accidental injuries, emergency medical services may or may not be involved in your prehospital care. You should call 911 emergency medical services if you develop any of the symptoms above shortly after your injury.

Even if your neck pain is only mild, you should be examined by a health professional as soon as possible. X-rays may be done to rule out any bone fractures. A CT scan or MRI may also be done if there is concern you have a herniated disc or significant ligament injury. These tests are better able to identify soft tissue injuries than plain radiographs.

Most cases of whiplash are treated using conservative methods such as:

In most cases patients are encouraged to remain as active as possible.

The use of a soft cervical collar (brace) to temporarily immobilize the neck during the healing process only if pain cannot be controlled. A cervical collar (brace) should be used for only a very short period of time (less than a week).

Ice or heat can be used to control pain, muscle spasm, and inflammation.

Medications to reduce pain, swelling, and muscle spasms are often prescribed and can be very helpful.

A short course of spinal manipulation or mobilization can help in restoring normal positioning of the muscles and joints to allow for an active therapy program.

Physical therapy helps to increase circulation, restore range of motion, and promote healing. The use of modalities such as ultrasound and electrical stimulation should only be used in the early stages of treatment to reduce pain and assist in getting an active therapy program started.

In more severe cases of whiplash, additional treatments may be necessary. Patients with continued neck pain may find relief from trigger point injections. If symptoms persist for more than 6 weeks, it may be due to a more severe injury involving the facet joints or discs. These can be treated with careful use of injections and other procedures that try to block the area of pain. In patients with evidence of a pinched nerve from a whiplash injury, further evaluation may be needed by a spine surgeon. Surgery is rarely necessary and is usually performed to treated herniated discs that have not improved with more conservative non-surgical measures.