Whiplash injury is a type of neck injury caused by sudden movement of the head forwards, backwards or sideways. It occurs when the soft tissues in the neck become stretched and damaged (sprained). Whiplash will often get better within a few weeks or months, but for some people it can last longer and severely limit their activities.
Symptoms of whiplash
Common symptoms of whiplash include:
- neck pain and tenderness
- neck stiffness and difficulty moving your head
- headaches
- muscle spasms
- pain in the shoulders and arms
Less common symptoms include pins and needles in your arms and hands, dizziness, tiredness, memory loss, poor concentration and irritability. It can take several hours for the symptoms to develop after you injure your neck. The symptoms are often worse the day after the injury, and may continue to get worse for several days.
When to get medical advice
Visit your GP if you've recently been involved in a road accident, or you've had a sudden impact to your head and you have pain and stiffness in your neck. They'll ask how the injury happened and about your symptoms. They may also examine your neck for muscle spasms and tenderness, and may assess the range of movement in your neck. Scans and tests such as X-rays will usually only be carried out if a broken bone or other problem is suspected.
Table showing the possible factors in the prognosis of whiplash-associated injuries
Causes of whiplash
Whiplash can occur if the head is thrown forwards, backwards or sideways violently. Common causes of whiplash include:
- road traffic accidents and collisions
- a sudden blow to the head – for example, during sports such as boxing or rugby
- a slip or fall where the head is suddenly jolted backwards
- being struck on the head by a heavy or solid object
Treatments for whiplash
Whiplash will usually get better on its own or after some basic treatment. Treatments for whiplash include:
- keeping your neck mobile and continuing with your normal activities – using a neck brace or collar isn't recommended
- painkillers such as paracetamol or ibuprofen – stronger painkillers are available on prescription if these don't help
- physiotherapy, exercises and stretches
If your pain lasts a long time, you may be referred for specialist treatment and support at an NHS pain clinic. Painkilling injections and surgery aren't normally used for whiplash.
Outlook for whiplash
The length of time it takes to recover from whiplash can vary and is very hard to predict. Many people will feel better within a few weeks or months, but sometimes it can last up to a year or more.
Severe or prolonged pain can make it difficult to carry out daily activities and enjoy your leisure time. It may also cause problems at work and could lead to anxiety or depression. Try to remain positive and focus on your treatment objectives. But if you do feel depressed, speak to your GP about appropriate treatment and support.
Diagram showing the main symptoms of whiplash injury
Treatment - Whiplash
Whiplash will often get better on its own or after some simple treatment in a few weeks or months. But sometimes it can cause severe and troublesome symptoms that last a long time. The main treatments for whiplash are outlined below.
Keep your neck mobile
It's important not to rest your neck for prolonged periods if you have whiplash. Your neck may be painful at first, but keeping it mobile will improve its movement and speed up your recovery. Any pain you experience when moving your neck is normal and won't cause further damage.
It's best to try to carry on with your normal activities and not use a neck brace or collar. Try to avoid staying in the same position, such as sitting or lying down, for long periods. Doing some controlled neck exercises may also help reduce stiffness. Read an NHS leaflet on whiplash (PDF, 259kb) for some simple exercises you can try.
Self-care adviceThe following measures can also help reduce your pain and aid your recovery:
- Ice packs – for the first few days, holding an ice pack (a bag of frozen peas wrapped in a towel will also work) to your neck for up to 10 minutes several
- times a day may help reduce pain and swelling.
- Warm compress – after a few days, holding a warm hot water bottle to your neck for up 15 minutes several times a day may be better at soothing your pain.
- Good posture – always maintain a good, upright posture by keeping your back straight while sitting, standing and walking. If you spend a lot of time using a computer, adjust your chair and computer screen correctly.
- Supportive pillow – some people find a firm, supportive pillow helps when sleeping. Avoid using more than one pillow and don't sleep on your front.
Schematic Diagram showing the mechanism of whiplash injury
Painkillers
Painkillers can help relieve the pain of a whiplash injury. Over-the-counter painkillers are usually recommended first, such as paracetamol or ibuprofen. These should be used regularly rather than only when the pain is most severe.
Always read the leaflet that comes with your medication to check whether it's suitable for you. For example, ibuprofen shouldn't be taken by anyone with a history of stomach ulcers. If one of these medicines doesn't relieve your pain, you can try taking both together. If your neck pain is more severe, your GP can recommend a stronger painkiller, such as codeine. This can be used on its own or in combination with other painkillers.
Physiotherapy
Physiotherapy may be recommended if your symptoms continue for several weeks. A physiotherapist may use a range of physical techniques to help improve your symptoms, such as:neck exercises
- massage
- gentle manipulation of your neck
You may be able to get a referral for NHS physiotherapy through your GP, or you can choose to pay for private treatment.
Long-term whiplash
Whiplash that lasts for six months or more is known as chronic whiplash or late whiplash syndrome. There's little in the way of scientific evidence to suggest which treatments are most effective for long-term whiplash. Continuing with the treatments above is often recommended.
If you have long-term pain, ask your GP about a referral to a specialist NHS pain clinic for further treatment and support. If you're struggling to cope with your symptoms, talk to your GP about medication and psychological support – such as cognitive behavioural therapy (CBT) – that may help.
