Whiplash (Neck Sprain)
The term “whiplash” is a non-medical term applied to the injury that occurs when the natural range of motion of the neck is exceeded, such as occurs in a car accident or a fall.
The bones of the cervical spine are connected by soft tissues, discs and ligaments, and these structures can be injured in these types of accidents.
The symptoms can include:
- Pain, especially in the back of the neck, that worsens with movement
- Pain that peaks a day or so after the injury, instead of immediately
- Muscle spasms and pain in the upper shoulder
- Neck stiffness or decreased range of motion
- Headache in the back of the head
- Increased irritability, fatigue, difficulty sleeping, and difficulty concentrating
- Sore throat
- Tingling or weakness in the arms and/or hands
The diagnosis is made by:
- Careful history of how the injury occurred
- Physical examination
- X-rays to be sure there is no fracture, dislocation, or underlying arthritic condition.
Certainly there can be more serious causes of continued pain, such as a herniated disc, as illustrated here. However, in most cases, it is wise to try a period of conservative treatment to see how symptoms resolve prior to ordering an MRI.
For treatment recommendations:
Keep in mind that all sprains and strains gradually heal, with the usual time course of about 4-6 weeks. Treatment is generally symptomatic, or designed to minimize symptoms while time is passing. Non-operative treatments include soft collar, muscle relaxants, pain relievers such as aspirin, anti-inflammatory medicines, and judicious use of narcotic pain meds (which can be addictive).
For further details, see the section on non-surgical treatments.