FAQs on Whiplash

The lay term whiplash is used to describe a neck injury that occurs after a rear-end motor vehicle accident. Also called cervical strain, whiplash is the result of forceful movement of the head backwards and then forwards from sudden force, considered similar to cracking a whip. With whiplash, the force pushes the neck ligaments and muscles beyond their normal range of motion.

What are the symptoms of whiplash?

There are several signs and symptoms associated with whiplash. The pain of whiplash typically develops within 24 hours of the initial trauma. Symptoms include:

  • Neck pain
  • Neck stiffness
  • Decreased cervical mobility
  • Fatigue
  • Dizziness
  • Memory problems
  • Difficulty concentrating
  • Sleep problems

How common is whiplash?

According to a recent study of patients who suffered injuries, the incidence of acute whiplash was around 4 per 1,000 individuals. However, around 32% of study participants reported long-term pain and disability. The factors associated with chronic whiplash were pretraumatic neck pain and female gender.

How does whiplash occur?

Several events lead to cervical strain, and whiplash generally occurs as the result of unnatural head motion. The cause of whiplash is strain to the muscles and ligaments of the neck. This occurs in:

  • Auto accidents, particularly rear-end collisions
  • Contact sports, such as football tackles and direct blows to the body
  • Physical abuse, when a person is shaken, punched, or hit

What are the treatment options for whiplash?

The treatment of whiplash depends on the severity of the injury and the patient’s current health status. Options are:

  • Medications – For mild cases of whiplash, the pain management doctor will prescribe nonsteroidal anti-inflammatory drugs, such as naproxen or ibuprofen. If muscles spasms occur along with the pain, a muscle relaxant is prescribed short-term, such as Flexiril or Robaxin. Mild analgesics are used for severe pain.
  • Cervical collar – A support collar is prescribed short-term to support the cervical spine and prevent further injury.
  • Trigger point injection (TPI) – These injections are used to alleviate painful myofascial pain of the neck and shoulders. The doctor will inject a local anesthetic into the trigger point. Recent clinical studies found TPIs to be superior to placebo or no intervention.
  • Botox – Botulinum toxin (Botox) can be injected into muscle tissue to temporarily paralyze it. This prevents painful contractions associated with whiplash pain. Botox improves range of motion of the cervical spine and reduces pain, according to a recent clinical study.
  • Facet Blocks/Medial Branch Blocks – These minimally invasive procedures involve the Nashville pain doctor injecting a numbing and steroid agent into the facet joint or around it. These treatments offer substantial pain relief when pain is emanating from the facet joints. With whiplash, the severe motion may cause facet related pain which achieves significant relief with the procedure.

Resources

Brin MF, Lew MF, Adler CH, Comella CL, Factor SA, et al. (1999). Safety and efficacy of NeuroBloc (botulinum toxin type B) in type A-resistant cervical dystonia. Neurology, 22;53(7):1431-8.

Lee JW, Park KW, Chung SK, Yeom JS et al. (2009). Cervical transforaminal epidural steroid injection for the management of cervical radiculopathy: a comparative study of particulate versus non-particulate steroids. Skeletal Radiology, 38(11):1077-82.

Sterner, Y, Toolanen, G, Gerdle, B, & Hildingsson, C (2003).The incidence of whiplash trauma and the effects of different factors on recovery. Journal of Spinal Disorders, 16(2), 195-199.

Tough EA, White AR, Cummings TM, Richards SH, & Campbell JL (2009). Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials. Eur J Pain, 13(1):3-10.