Mr James Langdon

BSc (Hons) MB BS MRCS (Eng) FRCS (Orth) Consultant Orthopaedic Spinal Surgeon

Whiplash

Whiplash is the term used to describe a neck injury that is caused by a sudden movement of the head forwards, backwards or sideways. Whiplash most commonly occurs following motor vehicle accidents in which the force of the collision has jolted the head violently forwards, backwards or sideways causing the ligaments in the neck to be overloaded and sprained. Whiplash can also occur following a violent blow to the head.

Following an accident it may take 6 to 12 hours for the symptoms of whiplash to develop. Symptoms are not usually obvious at the time of the accident. Typically patients gradually develop pain and stiffness, and this is usually worse the day after the injury. The pain may then get worse over the next few days before the starting to improve. Patients may also experience neck swelling, muscle tenderness, a reduced range of movement, and headaches. Some patients develop pain, numbness or pins and needles in the arms and hands.

If you have recently been involved in a road traffic accident and are experiencing pain and stiffness in your neck, then you should make an appointment to see your GP. A diagnosis can normally be made from the history and physical examination. X-rays and scans are not usually required.

Treatment of whiplash

There are a number of things that you can do to ease the symptoms of whiplash:

Apply an ice pack to the neck. This will help to reduce any inflammation. Ideally this should be done as soon as possible after the injury. Be careful not to apply ice directly onto the skin. A bag of frozen peas wrapped in a tea towel is ideal. Apply the ice for 10 to 30 minutes at a time.

Try to move your neck normally. If you have had whiplash injury then it is important that you try to move your neck normally. Even if the pain is severe it is important that you exercise your neck gently so that it does not become stiff.  You should try to move the neck slowly in each direction, gradually increasing the range of movement. It is important that you continue with your normal daily activities.

Maintain good posture. Following a whiplash injury it is important that you try to maintain a good posture. This can help prevent the pain and stiffness in your neck from getting worse. Using a firm, supportive pillow will help you to maintain a good neck posture whilst you are asleep.

Take regular painkillers. Painkillers such as paracetamol will help to ease the pain caused by whiplash. For the first few days following an accident it is better to take painkillers regularly, rather than only take them when the pain is severe. Non-steroidal anti-inflammatories, such as ibuprofen, will also help.

When taking any medication always follow the instructions on the leaflet, and do not exceed the recommended dose. Anti-inflammatories are not be suitable for everyone, especially if you have a history of asthma, high blood pressure, kidney or heart failure, or heartburn or stomach ulcers. You should check with your GP or pharmacist if you have one of these conditions or if you are taking any other form of medication.

If paracetamol and anti-inflammatories do not relieve your pain, then you may require a prescription for something stronger from your GP.

Physical therapy

If you have experienced a whiplash injury and are experiencing neck pain, then you are likely to benefit from seeing a physiotherapist, osteopath, or chiropractor. They will be able to help by using treatments such as manipulation and massage. Additionally, they will be able to give you advice on neck exercises and other things that you can do to help relieve the pain and stiffness in your neck. Some people find acupuncture helpful following this type of injury.

Recovery period

After a few days the symptoms of whiplash should begin to improve. In the majority of cases, the symptoms improve significantly or completely disappear within six weeks. However, as with any sprain, it can sometimes take a few months for the symptoms of whiplash to disappear completely. If you have an underlying problem with your neck, or established wear and tear then it can take a bit longer for your symptoms to settle down. You should not drive whilst you have neck pain and stiffness that prevents you from turning your head quickly.

In a small number of cases the pain caused by whiplash can become chronic. In severe whiplash cases, the pain can persist for six months before it disappears. Prolonged pain may make it difficult for you to carry out normal daily activities or to enjoy your normal recreational activities. It can also cause problems at work. Sometimes chronic pain can result in anxiety and depression. If your pain is not settling down and is interfering with your ability to undertake your normal everyday activities, then you should seek further advice from your doctor.