Whiplash Facts

  • Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of the neck (specifically ligaments, tendons, and muscles).
  • It is caused by an abnormal motion or force applied to the neck that causes movement beyond the neck's normal range of motion. It is usually caused by a flexion-extension motion of the neck that pulls and strains the neck muscles and ligaments.
    • Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault.
    • Synonyms for whiplash include acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury. A doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury.

Whiplash Causes

The most frequent cause of whiplash is a car accident. The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury; speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, even when they wear seat belts.

  • Other common causes of whiplash include contact sport injuries and blows to the head from a falling object or being assaulted.
  • Strains of the neck from sudden changes in direction, for example, roller coasters, minor bicycle accidents, or slips and falls can all cause whiplash.
  • Repetitive stress injuries or chronic strain involving the neck (such as using the neck to hold the telephone) are common, non-acute causes.
  • Child abuse, particularly the shaking of a child, can also result in this injury as well as in more serious injuries to the child's brain or spinal cord.
Pain Management: Surprising Causes of Pain

Whiplash Symptoms

The symptoms of whiplash generally include some degree of neck pain and muscle stiffness. Depending on the severity of the injury, signs and symptoms may also include:

  • Tenderness along the back of the neck and shoulders
  • Neck swelling
  • Muscle spasms in the posterior cervical spine (back of the neck), anterior cervical spine (front of the neck), or in the trapezius muscles (back of the shoulders)
  • Difficulty flexing, extending, or rotating the head
  • Headache, difficulty concentrating, sleep disturbances, and/or fatigue
  • Jaw tightness or difficulty chewing
  • Severe cases of whiplash may also cause vision disturbance, tinnitus (ringing in the ears), and other signs of nerve irritation

Migraine Headache Treatment

Migraine headaches are common and usually more intense than most other headaches. They often are recurrent and have associated symptoms such as nausea, vomiting, sensitivity to light, and in some people, warning symptoms, termed auras, that a migraine headache is going to develop. Some people may have throbbing pain on one side of the head.

Whiplash Diagnosis

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.

Pain Management: Surprising Causes of Pain

Whiplash Self-Care at Home

See a doctor to diagnose whiplash. For minor injures or strains of the neck, without serious signs and symptoms as listed above, or without evidence of any neurologic problems, home care may be appropriate. If there is any question about the severity or treatment of a neck injury, see a doctor.

Home care for whiplash includes decreasing the painful symptoms of the strain. The symptoms of whiplash can be treated with the following home remedies:

  • Cold packs or ice can be applied to the neck to minimize swelling and pain. Apply ice/cold to the neck area for 15-20 minutes. Repeat every hour, as needed, for the first 48-72 hours after the injury.
  • If there is no pre-existing condition or contraindication to their use, over-the-counter pain medications can be used (consult a doctor):
  • Limit motion of the head and neck until pain and muscle tightness are gone.
  • Limit strenuous activities such as sports or heavy lifting.

Whiplash Treatment

The medical treatment for whiplash depends on the severity of the injury. Severe neck injuries associated with bone or spinal cord damage may require surgical intervention. Less severe injuries are often limited to soft tissue injuries (muscles, ligaments, tendons) and treatment is directed at symptom relief.

Your doctor may prescribe a treatment plan including:

  • Pain medications (over-the-counter or prescription)
    • Narcotic pain medication may be necessary with severe whiplash
      • Nonsteroidal anti-inflammatory medications (NSAIDs) should be part of the treatment if the patient is able to take them
      • Muscle relaxers
      • Benzodiazapine medications such as diazepam (Valium) may help muscle tightness and spasm
      • Other muscle relaxer drugs may also be used
  • A cervical collar may be used for the first few days, but use should be limited to the time period prescribed
  • Cold packs or ice can be applied to the neck to minimize swelling and pain. Apply ice/cold to the neck area for 15-20 minutes. Repeat every hour, as needed, for the first 48-72 hours after the injury.
  • Limit motion of the head and neck until pain and muscle tightness are gone.
  • Limit strenuous activities such as sports or heavy lifting.
  • Physical therapy with range of motion exercises, muscle strengthening, ultrasound, or electrical stimulation may be prescribed.
  • Non-traditional medical treatments such as chiropractic, massage, or acupuncture may be helpful for some patients in the treatment of whiplash. Consult your doctor.
Pain Management: Surprising Causes of Pain

Whiplash Follow-up

Depending on the severity of the whiplash injury and the patient's response to treatment, follow-up care will recommended by the doctor as necessary.

Follow-up care may include physical therapy, home exercises, or a visit to a specialist.

Whiplash Prevention

Prevention is the most effective way to avoid whiplash.

  • Always using seatbelts and drive motor vehicles with airbags. Proper adjustment of the car seat headrest can also help keep the neck from snapping backwards.
  • Always use the proper safety equipment when participating in sports.
  • Follow amusement park or carnival safety instructions on high-velocity rides, such as roller coasters.
  • Report suspected child abuse to authorities.
  • Monitor children's activities to prevent falls or serious injuries.

Whiplash Prognosis

The prognosis (outlook) for recovery from whiplash depends on the severity of the injury.

  • Minor whiplash injuries usually resolve within 1-2 weeks.
  • Moderate whiplash injuries with muscle spasm or ligament strains may take up to 4-8 weeks to resolve.
  • Severe whiplash injuries, or those that involve nerve damage or ligament or disc injury to the spine, may result in chronic or permanent disability. These injuries may require future surgical intervention.
Reviewed on 11/17/2017

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery


KnowYourBack.org. Whiplash and Whiplash Associated Disorder (WAS).

Hoffman JR, Wolfson AB, Todd K, Mower WR. Selective cervical spine radiography in blunt trauma: methodology of the National Emergency X-Radiography Utilization Study (NEXUS). Ann Emerg Med. 1998 Oct;32(4):461-9. PubMed PMID: 9774931.

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