Whiplash, also called neck sprain or neck strain, is a soft tissue injury to the neck. It is characterized by a collection of symptoms that occur following damage to the neck, usually because of sudden extension and flexion (bending).

The disorder commonly occurs as the result of an automobile accident and may include injury to intervertebral joints, discs, and ligaments, cervical muscles, and nerve roots. Symptoms such as neck pain may be present directly after the injury or may be delayed for several days. In addition to neck pain, other symptoms may include:

• Neck stiffness
• Injuries to the muscles and ligaments (myofascial injuries)
• Headache
• Dizziness
• Abnormal sensations such as burning or prickling (paresthesias)
• Shoulder or back pain

In addition, some people experience memory loss, impaired concentration, nervousness/irritability, sleep disturbances, fatigue, or depression.

Treatment may include pain medications, nonsteroidal anti-inflammatory drugs, antidepressants, muscle relaxants, and a cervical collar (usually worn for 2 to 3 weeks). Range of motion exercises, physical therapy, and cervical traction also may be prescribed. Supplemental heat application may relieve muscle tension.

Generally, the outlook for individuals with whiplash is good. Most people recover within 3 months after the injury, however, some may have residual neck pain and headaches.

Whiplash is an injury to your muscles, tendons or other soft tissues of your neck. It is caused by a sudden and vigorous movement of the head in one direction, then back again quickly, most commonly during a car accident.

When your neck is forced beyond its usual range of movement, the soft tissues (tendons, muscles and ligaments) may be overstretched or sprained. This causes pain and discomfort in your neck and shoulders and may also cause back pain.

Whiplash injuries are commonly caused by motor vehicle accidents. For example if your neck is quickly accelerated and decelerated in a rear-end or side impact.

You can also get a whiplash injury from a sudden blow to the head during contact sports, such as rugby or boxing. Other examples of causes of whiplash include being are hit on the head by a heavy object, slipping, falling, jolting or jarring your head.

Sometimes you can have no symptoms after a whiplash injury, but sometimes your symptoms can be severe.

Pain from a whiplash injury often begins 6 to 12 hours after the injury. You may just feel uncomfortable on the day of the injury or accident and find that your pain, swelling and bruising increase over the following days.

Common symptoms of whiplash include:

• neck problems: pain, stiffness, swelling or tenderness
• difficulty moving your neck
• headaches, difficulty concentrating
• muscle spasms or weakness
• ‘pins and needles’, numbness or pain in your arms and hands or shoulders
• dizziness, vertigo, (a feeling you are moving or spinning) or tinnitus (ringing in your ears)
• difficulties swallowing or blurred vision

Your symptoms are likely to greatly improve or disappear within a few days to weeks. It may take longer for your symptoms to resolve completely and you might even experience some pain and neck stiffness for months after a whiplash injury.

Your doctor will examine you, feel your neck and see how well your neck moves in different directions. They may order a neck x-ray to rule out a bone fracture or dislocation. Whiplash is caused by injury to soft tissue, so it won’t show up on an x-ray.

Stay active

While you are recovering from whiplash, try to stay active. Continue your normal activities as much as you can. Avoiding activity after a whiplash injury might mean it takes you longer to recover.

Adapt your activities

At first, you may need to adapt how you move to take care of your neck. Then gradually build up to your normal activities as your neck improves.

You might need to adapt some of your work or recreational activities for a while to avoid unnecessary strain on your neck. For example, you could make more trips so you don’t have to carry too much shopping at once, cut down on housework or gardening, or lift the handlebars on your bike so you can change your posture.

Try an ice pack

An ice pack can relieve your swelling and pain. Apply this as soon as possible after the injury, for 15 to 20 minutes at a time. You can make an ice pack from a bag of frozen peas wrapped in a tea towel to prevent cold burns.

Consider your posture

Correct posture is important after a whiplash injury. Keep your back straight when you are sitting, standing or walking to help prevent stiffness and pain developing. If you spend a lot of time sitting at a desk, take regular breaks to stand up and move around so that your neck and back do not become stiff. Adding a back support to your chair may provide relief while you are recovering from an injury, especially if you work at a desk.

Physiotherapy

Physiotherapy may help you to regain movement in your neck. Physiotherapists use gentle exercises, manipulation and massage to help restore your body’s maximum range of movements after an injury or illness. A physiotherapist can also teach you how to exercise, without causing further damage to your neck.

See your doctor or pharmacist

If you are in pain, get advice from your doctor or pharmacist on suitable pain relief medicines.

Avoid heavy lifting, punching or pulling, or contact sports like rugby and boxing, until your symptoms improve. Check with your doctor or healthcare professional before you to start these activities again.

Take care when lifting, bending or carrying out repetitive twisting movements. Make sure that you take regular breaks.

Resting, taking time off work or wearing a collar are not likely to help you recover from whiplash. Don’t do these without first speaking with your doctor or physiotherapist.

In serious whiplash injuries, there may be damage to your nerves, fracture or dislocation of your neck.

Most people fully recover from a whiplash injury. For a small percentage of people, whiplash can lead to ongoing pain and disability. Some people may develop depression or post-traumatic stress symptoms.

Your attitude can also affect your recovery. Research has shown that if you believe you’re going to recover after whiplash you have a better chance of full recovery than if you feel distressed and negative about your injury. Your age and the severity of the initial injury also play in a role in how quickly you will recover.

Car design has improved to reduce the chance of whiplash. It’s important to adjust your car seat and headrest correctly to minimise your chances of whiplash.

For correct posture when driving, adjust your steering wheel so it’s level with your chest, not your face. Keep your arms bent and your thumbs on the rim of the steering wheel. Have the seat upright so your back and shoulders have support and sit deep in the seat, bracing your body with your left foot.