1. Slideshow: Surprising Reasons You're in Pain
2. Take the Pain Quiz!
3. Slideshow: Good and Bad Exercises for Low Back Pain

Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

View Full Profile

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

View Full Profile

Emergency medical services (EMS) may place the patient in a cervical collar strapped around the neck, and on a backboard to stabilize the neck to prevent any further neurologic injury. In the emergency department, the doctor will remove the collar and board when appropriate, following the guidelines set forth in the National Emergency X-Radiography Utilization Study (NEXUS):

• Normal level of consciousness or alertness
• No tenderness in the midline of the back of the neck
• No evidence of intoxication with alcohol or drugs
• No muscle weakness or sensation problems, no focal neurologic deficit
  • Physical strength in both arms and legs
  • Ability to sense the touching of the skin in different parts of the body
  • Reflexes in the joints of the arms and legs
• No other painful injury elsewhere on the body (distracting injury)

The doctor will inspect the patient's head and neck for external signs of trauma including bruises, cuts, and abrasions. The patient's neck will be pressed in specific areas to be sure the patient does not perceive any pain or tenderness. The patient may be asked to move their neck in a controlled way to the left, right, up, and down. The patient should tell the doctor if they feel pain in the neck, numbness, or tingling in any of the arms or legs, or any other abnormal feelings during these maneuvers.

If the patient needs X-rays of the neck to make sure there are no fractures or signs of other serious injury, the collar will remain in place to stabilize the neck. If the patient's X-rays are normal, then the cervical collar will probably be removed, and the patient should not need any further X-rays. If the X-rays appear abnormal, further imaging with a CT scan or MRI may be ordered.

Must Read Articles Related to Whiplash

Muscle Strain Muscle strain or muscle pull or even a muscle tear implies damage to a muscle or its attaching tendons. Symptoms and signs include swelling, bruising, pain, and...learn more >>

Neck Strain The portion of the spine contained within the neck is referred to as the cervical spine. That's the site for injuries known as neck strain. Symptoms include pai...learn more >>

Shoulder and Neck Pain Shoulder and neck pain may be caused by bursitis, a pinched nerve, whiplash, tendinitis, a herniated disc, or a rotator cuff injury. Symptoms also include weakn...learn more >>

See the Entire Whiplash Topic Guide »