FAQs on Whiplash

Whiplash is a lay term used to describe a neck injury that often occurs during a rear-end car collision. Also called cervical strain, this injury is the result of the head moving backward and then forward from a sudden force, which is similar to the motion of a cracking whip.

The extreme motion of whiplash pushes the neck muscles and ligaments beyond their usual range of motion. While most people recover from whiplash in a few weeks, others may develop chronic pain after this injury.

How common is whiplash?

In a recent study of patients who had whiplash trauma to the cervical spine, disability related to whiplash was used as a variable to assess prognosis. The incidence of acute whiplash was 4.2 per 1,000 people.

However, approximately 32% of study participants reported persisting pain and disability at the follow-up. Factors associated with chronic neck pain and long-standing whiplash were female gender, pretraumatic neck pain, and lower educational level.

What are the symptoms associated with whiplash?

The symptoms associated with whiplash typically develop within 24 hours of the initial trauma. These include:

  • Neck pain
  • Neck stiffness
  • Headaches
  • Dizziness
  • Fatigue
  • Blurred vision
  • Ringing in the ears
  • Memory and concentration problems
  • Sleep disturbances

What can cause whiplash?

Many events can lead to a cervical strain. Whiplash usually occurs when the head is thrown backward then forward, which strains the neck ligaments and muscles. This injury may result from:

  • Auto accidents – Rear-end collisions are the number one cause of whiplash.
  • Contact sports – Whiplash can occur due to football tackles and other sports-related impact collisions.
  • Physical abuse – Being punched, shaken, or hit can cause strain the cervical spine and associated structures.

How is whiplash treated?

  • Medications – Certain medicines are used to relieve the pain associated with cervical strain, such as muscle relaxers, anti-inflammatory agents, and mild painkillers.
  • Cervical collar – This soft structure supports and immobilizes the cervical spine, to prevent further injury and maintain proper alignment of the neck.
  • Botox – Botulinum toxin (Botox) is injected into the neck muscles and shoulders to temporarily paralyze them. This agent prevents the painful contractions associated with whiplash pain. In a study where Botox was used to treat the pain associated with whiplash injury, participants reported improved neck range of motion as well as significant pain reduction.
  • Trigger point injections (TPIs) – The doctor can inject a local anesthetic into painful “trigger points” of the neck and upper back. In a review of several clinical studies, TPIs were found to be superior to no intervention.
  • Epidural steroid injection (ESI) – The doctor injects a steroidal agent into the epidural space, which lies between the cervical epidural layer and the spinal cord of the neck. In a recent study, this procedure had an 80-90% efficacy rate.
  • Medial branch block (MBB) – With this procedure, the doctor injects and anesthetic agent into the cervical facet joints, which “block” nerves that cause persistent chronic neck pain. In a recent randomized, double-blind controlled study, patients reported significant relief of pain (greater than 50%) and improved functional status following the MBB at 3, 6, and 12 months.
  • Radiofrequency ablation (RFA) – Targeting the medial branch nerves, the doctor uses electrical energy to burn (cauterize) a portion of the nerve in the cervical spine region. This prevents pain signals from reaching the brain.
  • Electrical spinal neuromodulation – A from of spinal cord stimulation, this procedure involves the surgical implantation of a small device. In a recent study where SCSs were placed in the cervical epidural space through thoracic needle placement, patients reported 70-90% of pain reduction, which included upper extremity pain, as well as neck pain.