Whiplash is a neck injury caused by a strain, sprain, or tear in the soft tissues (muscles and ligaments). It is caused by a sudden and severe neck movement.

The most common form of injury is a rear-end motor vehicle accident, where the head and neck rapidly bend a long way forward before stopping suddenly or even being thrown backwards.

Approximately 20% of people involved in rear-end motor vehicle accidents experience neck symptoms later. It is common to find that these symptoms are worse a day after the injury. Although most recover quickly, some develop chronic severe pain that may result in significant disability.

The term “whiplash” is best used to describe the way the injury occurred, although some use it as a diagnosis. The actual cause of symptoms can be either a stretch or tear of the ligaments or muscles, or even compression of the spinal nerves.

SYMPTOMS

The symptoms of whiplash may include neck stiffness or reduced range of movement, neck pain, headaches, and even arm pain.

Pain at the back of the neck is often worse with movement, and frequently peaks one or two days after the injury before improving. Muscle spasms and pain between the shoulder blades or over the trapezius muscles (between the shoulders and the neck) may also occur.

Headaches, especially at the back of the head (‘cervicogenic headaches’) are common.

Arm or hand pain, fatigue, numbness, tingling or weakness may be a result of nerve or spinal cord injury or compression. These symptoms usually warrant a more extensive investigation.

TREATMENT

Like sprains in other parts of the body, neck sprains usually heal gradually, with time and appropriate treatment.

• Collars

  A soft cervical collar may be worn for comfort. In cases where there is severe disc and/or ligamentous disruption, a hard collar (such as an Aspen Collar) may be prescribed.

• Medication

  Analgesics and anti-inflammatory medications are often used to reduce pain and swelling. Muscle relaxants can be used to help ease muscle spasms. An ice pack may be applied for 15-30 minutes, several times a day for the first two or three days after the injury. Heat can help relax cramped muscles, but should not be applied for the first few days. Other treatment options include massaging the tender area, ultrasound, and physiotherapy.

• Modifying activities

  Early return to work is encouraged, usually with modifications in your workplace activities, which can be eased with time and recovery. Aerobic activities, such as walking or swimming, should be started early.

  Whilst most symptoms resolve in one or two months, severe injuries may take several months to heal completely. Symptoms of arm weakness, numbness, or shooting pains should be investigated further.

• Surgery

  Neck sprains or strains rarely require surgery. Indications for surgery include spinal cord compression, prolonged arm pain and/or weakness, and severe persistent headaches. Surgery may be recommended if other conditions such as verterbral fracture or disc herniation are present.