Whiplash: Definition, Causes, Symptoms, Diagnosis, and Treatment

Whiplash is a type of neck injury that occurs when the neck is rapidly and forcibly thrown back and forth. It is most commonly caused by car accidents, but it can also be caused by sports injuries, physical abuse, or other types of trauma. Symptoms of whiplash may include neck pain and stiffness, headaches, dizziness, and difficulty concentrating. Treatment for whiplash typically includes a combination of medications, physical therapy, and rest. In severe cases, surgery may be necessary. 

Whiplash Injury

What is Whiplash?

Whiplash is a type of neck injury that occurs when the head is suddenly and violently thrown forward and backward or from side to side. It is often caused by a car accident, but it can also be caused by other types of trauma, such as sports injuries or falls.

The rapid movement of the head can cause the neck to stretch and strain the muscles, tendons, and ligaments in the neck. This can lead to a variety of injuries, including:

  • Strains and sprains: These are injuries to the muscles and ligaments in the neck. Strains occur when the muscles are stretched or torn, while sprains occur when the ligaments are stretched or torn.
  • Disc injuries: The neck contains discs that help to cushion the spine. Whiplash can cause the discs to become damaged or herniated, which can cause pain and other symptoms.
  • Fractures: Whiplash can also cause fractures (breaks) in the bones of the neck, such as the vertebrae. These fractures can be serious and may require surgical treatment.
  • Nerve damage: Whiplash can also cause damage to the nerves in the neck, which can lead to numbness, tingling, and other sensory symptoms.

The severity of the injury will depend on the force of the impact and the position of the head and neck at the time of the injury.

Causes of Whiplash

Whiplash is typically caused by a sudden and forceful movement of the head and neck, such as those that can occur during a car accident. When a car is struck from behind, the head can be thrown violently forward and then snapped back, which can cause the neck to stretch and strain the muscles, tendons, and ligaments.

Whiplash can also be caused by other types of trauma, such as sports injuries, falls, or physical abuse. For example, a football player who is tackled from behind or a person who falls and hits their head on the ground may be at risk for developing whiplash.

Symptoms of Whiplash

The symptoms of whiplash may vary depending on the severity of the injury, but they may include:

  • Neck pain: Pain is the most common symptom of whiplash and may be felt in the front, back, or sides of the neck. The pain may be severe or mild, and it may be constant or intermittent.
  • Neck stiffness: Some people may find it difficult to move their neck freely or may feel pain when they try to turn their head.
  • Headaches: Whiplash can cause headaches that may be felt at the base of the skull or across the forehead.
  • Numbness or tingling: Whiplash can cause numbness or tingling in the arms and hands.
  • Dizziness: Some people with whiplash may feel dizzy or lightheaded, which can affect their balance and coordination.
  • Fatigue: Whiplash can cause fatigue and a feeling of being tired all the time.
  • Difficulty concentrating: Some people with whiplash may have difficulty focusing or remembering things.

It is important to see a doctor if you think you may have sustained a whiplash injury, as prompt treatment can help to speed recovery and prevent long-term problems.

Diagnosis of Whiplash

Whiplash can typically be diagnosed through a history and physical examination alone.

During the history portion of the exam, the doctor will ask you about your symptoms and how the injury occurred. The physical exam is a more hands-on evaluation of your neck and any related injuries. 

Based on the results of the history and physical exam, the doctor may order imaging studies to evaluate for fracture, disc herniations, torn ligaments, or damage to the spinal cord. 

Some common imaging tests used to evaluate whiplash injury include:

  • X-rays: X-rays use radiation to create images of the bones in the neck. They can help to identify fractures or other bone injuries, but they do not show soft tissues like muscles and ligaments.
  • CT scans (computed tomography): CT scans use a series of X-rays to create detailed, cross-sectional images of the neck. They can show both bones and soft tissues, and they can be helpful in identifying fractures or vascular injuries. 
  • MRIs (magnetic resonance imaging): MRIs use a strong magnetic field and radio waves to create detailed images of the neck. They do a great job of evaluating soft tissues, and are often used to evaluate injuries to the discs, spinal cord, muscles, ligaments, and tendons in the neck.

Treatments for Whiplash

The treatment for a whiplash injury will depend on the severity of the injury and the specific symptoms that the patient is experiencing. Some common treatments for whiplash include:

  • Medications: Pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants, can help to reduce pain and inflammation in the neck.
  • Physical therapy: Physical therapy can help to improve range of motion and strength in the neck, and can also help to reduce pain and other symptoms.
  • Cold and heat therapy: Cold packs can help to reduce inflammation and numb pain, while heat therapy can help to relax muscles and improve circulation.
  • Massage: Massage can help to reduce muscle tension and improve circulation in the neck.
  • Stretching and strengthening exercises: Stretching and strengthening exercises can help to improve flexibility and strength in the neck muscles, which can help to reduce pain and improve function.

In rare cases, surgery may be necessary if the injury is severe. Some reasons why surgery may be necessary for a whiplash injury include:

  • Fractures: If a whiplash injury has caused a fracture (break) in the bones of the neck, surgery may be necessary to repair the fracture and stabilize the spine.
  • Herniated discs: If a whiplash injury has caused a herniated disc (a condition in which the disc bulges out of its normal position), surgery may be necessary to remove the herniated portion of the disc and relieve pressure on the spinal cord or nerves.
  • Nerve impingement: If a whiplash injury has caused pressure on a nerve in the neck, surgery may be necessary to relieve the pressure and restore normal function.

It is important to note that surgery is usually only recommended in severe cases of whiplash and is not commonly needed. The doctor will carefully evaluate the patient’s condition and will recommend the most appropriate treatment based on the specific circumstances of the injury.

Sources

Yadla, Sanjay et al. “Whiplash: diagnosis, treatment, and associated injuries.” Current reviews in musculoskeletal medicine vol. 1,1 (2008): 65-8. doi:10.1007/s12178-007-9008-x

Rodriquez, Arthur A et al. “Whiplash: pathophysiology, diagnosis, treatment, and prognosis.” Muscle & nerve vol. 29,6 (2004): 768-81. doi:10.1002/mus.20060

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for SpineInfo.com.