Aptly named, whiplash describes a neck injury that occurs when the head suddenly whips forward and then backward. Motor vehicle accidents, especially when a car is hit from behind, are the most common cause of whiplash. The abrupt flexion and extension of the cervical spine can cause pain, spasms and impaired range of motion.
Whiplash, also called neck sprain or neck strain, is defined as a soft-tissue injury to the neck. Injury to the neck's facet joint is thought to be the leading cause of whiplash pain. However, bones, ligaments, disks, nerves and muscles in the neck can all be affected by a whiplash injury. Whiplash injury may be apparent immediately after an accident or a few days later.
The hallmark symptoms of whiplash are neck pain, neck stiffness, muscle spasm or tightness, difficulty turning your head and headache. Other symptoms of whiplash can include:
- Pain in the shoulders, lower back or between the shoulder blades
- Arm pain or heaviness
- Difficulty with concentration or memory
- Sleep disturbances
Head and neck pain usually go away on their own in two to three weeks, and most people fully recover from whiplash within three months. But for certain people, neck pain or disability persists longer, sometimes for years.
In a February 2013 study, published online by The Clinical Journal of Pain, Canadian researchers found that the different strategies people use when coping with a whiplash injury can influence their recovery time. Researchers were able to predict a slow recovery from neck pain and disability among people who had passive coping styles, such as withdrawing from physical and social activities, relying on others for pain management and wishing for better pain medication.
Whiplash is a poorly understood condition, and evidence is limited as to the best ways to treat whiplash injuries. A 2005 study in the Archives of Internal Medicine found that early, aggressive care of a whiplash injury doesn't lead to a faster recovery.
To help relieve pain and symptoms, your doctor may suggest one or more of the following strategies based on several factors, including your age, your overall health, the severity of your injury and your tolerance for certain drugs:
- Apply ice to the painful area for the first 24 hours immediately after your injury to reduce inflammation.
- Take over-the-counter pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) to ease symptoms temporarily. If your symptoms a re severe or don't improve, your doctor may prescribe a muscle relaxant or a mild opioid analgesic.
- Practice proper posture by keeping your head, neck, upper body and lower back aligned during movement and at rest, which relieves stress on the neck. Avoid carrying shoulder bags and sitting for long periods. Also, try sleeping on your back with a pillow underneath your thighs to relieve pain.
- Do neck stretches and exercises to improve muscle strength and range of motion. A doctor or physical therapist can show you exercises and stretches to practice at home.
Treatments to avoid
Wearing a soft foam cervical collar is no longer routinely recommended for treating whiplashthe collar limits movement, allowing muscles to weaken. However, doctors may sometimes suggest wearing a collar when pain is acute but for only one or two weeks and no longer than three hours daily. A collar may also help at night if pain is preventing you from sleeping.
Spinal manipulation therapy may offer relief for pain that persists for 12 weeks or longer, especially when combined with exercise. However, it's generally not recommended for older adults with neck pain because of the risk of adverse affects, such as a herniated disk and even death.
Another treatment called cervical traction, which involves pulling on the head to lengthen the neck, has shown no benefit in studies and should never be tried.
Finally, surgery should be avoided; no conclusive evidence has shown that it's effective in treating whiplash.
If symptoms persist
See your doctor if your symptoms worsen or you have numbness or weakness in your arms or legs. If you don't recover fully after six weeks, your doctor may prescribe additional strategies ranging from physical therapy to antidepressants.
Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50