Whiplash (Neck Strain)

Medically Reviewed by Shruthi N, MD on August 29, 2024
Written by WebMD Editorial Contributor, Marijke Vroomen Durning, RN
9 min read

Whiplash is a common neck injury, affecting almost 3 million people in the U.S. every year. You may have heard it called neck sprain or neck strain.

Whiplash is caused by an abrupt backward and/or forward jerking motion of the head. The intervertebral joints (found between vertebrae), disks, ligaments, cervical muscles, and nerve roots all can be damaged when your head moves suddenly from front to back or side to side. This results in pain and stiffness. Most often the pain goes away with treatment and time, but some people experience long-term effects for months or years.

 

Whiplash-associated disorders, or WAD, is the term used to describe the collection of symptoms that result from whiplash. Whiplash is the actual injury. WAD is the term used to describe the symptoms that affect the neck after the injury. There are five grades of WAD:

Grade 0

  • No physical signs of injury
  • No complaints of pain

Grade 1

  • No physical signs of injury
  • Neck pain, stiffness, or tenderness if the neck is touched

Grade 2

  • Complaints of pain that moves (radiate) to the head, face, shoulder, or back
  • Muscle spasms in the neck, making movement painful and difficult
  • Signs of injury (bruising and swelling)
  • Pain if the neck is touched

Grade 3

  • Muscle weakness
  • Neurological symptoms — numbness or tingling in the neck, upper back, shoulders, or upper arms
  • Headaches
  • Changes in vision
  • Difficult swallowing
  • Hoarse voice
  • Dizziness, vertigo

Grade 4

  • Symptoms of Grade 3 injury but more severe. There also may be a fracture or displaced bone in the neck.

Typically, whiplash is caused by an abrupt forward-to-backward jerking motion of the head, often as a result of a car accident, especially when the vehicle is hit from behind. When you are hit from behind, your head tilts forward sharply and then pitches backward with force. These movements can damage the tissue in your neck and if severe enough, break or displace a bone.

Whiplash can also occur in other situations, ranging from shaking a person so hard their head moves back and forth. Shaken baby syndrome is one example of this. Falling, doing contact sports, or other forms of trauma or physical abuse can also cause whiplash.

Symptoms of whiplash may be delayed for 24 hours or more after the initial trauma. However, people who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury:

  • Neck pain and stiffness
  • Pain that worsens when you move your neck
  • Headaches
  • Pain or tenderness in the shoulder or between the shoulder blades
  • Low back pain
  • Tingling or numbness in the arm and/or hand
  • Dizziness
  • Difficulty concentrating or remembering
  • Irritability, sleep disturbances
  • Fatigue
  • Blurry vision
  • Tinnitus, ringing in your ears
  • Memory problems
  • Depression

When you see your doctor or a doctor in the emergency room or urgent care clinic, the first thing they will want to know is what happened. Be as specific as possible because they need to know when the accident happened, how your head moved, and what caused the accident.

You’ll also be asked about what symptoms you have, if any. If you’re not seen right after the injury, your doctor will want to know how often the symptoms occur, if anything makes them worse or better, and if they interfere with your daily activities. 

The physical exam and tests will be not so much to diagnose whiplash but to rule out something more serious that could be causing the symptoms. This is because whiplash is a diagnosis of exclusion — if nothing else is causing the symptoms, then it’s likely whiplash.

Physical examination

A physical exam is important because it allows your doctor to look for any obvious injury and to touch your neck to see if touching it causes pain. During the exam, your doctor will be looking to see where the pain is and if you can move your head and turn your neck. They’ll likely check your reflexes as well.

Imaging scans can help rule out fractures or bone displacement. You might have:

  • X-rays
  • CT scan — a more advanced type of X-ray
  • MRI — imaging that uses magnets instead of radiation

How your doctor treats whiplash depends on how severe it is. If the pain is severe, your doctor might recommend using a collar to immobilize your neck. Aside from standard treatments for mild whiplash, such as ice, rest, and over-the-counter (OTC) pain relievers, your doctor might recommend:

Medications

  • Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) or other pain relievers. These are stronger than what you can buy OTC.
  • Muscle relaxants. These can help prevent your neck muscles from being too tight
  • Topical medications. These are creams or gel pain relievers that are rubbed on the skin.
  • Injections. Lidocaine or steroid injections into the neck can help relieve pain.

Therapy

  • Physical therapy. A physical therapist can assess how well you can move your neck and give you exercises to help you recover.
  • Osteopathic manipulation. This technique is a hands-on manipulation of the muscles and other tissues in the neck.
  • Transcutaneous electrical nerve stimulation (TENS). It uses electrical currents that go through your skin to stimulate the muscles. It helps relieve pain.
  • Acupuncture. An ancient Chinese medical practice, acupuncture may help relieve pain and muscle tension.
  • Chiropractic care. Chiropractors focus on the spine and its alignment.
  • Massage. Massage therapy can help relax neck muscles, decreasing pain.
  • Relaxation therapies. Also called mind-body therapy, activities such as tai chi and qi gong can help. Yoga is another option but must be done gently at first as your neck heals.

Exercises for whiplash

Some gentle exercises for your neck may help lessen the pain and tightness from stiff muscles. If you have more pain when doing them, stop. Don’t push through. If this happens, speak to your doctor who might refer you to a physical therapist.

If you have mild whiplash, you might want to try these gentle exercises to see if they help. If it doesn’t hurt to do them, repeat each one five times:

  1. Sit on a hard-backed chair, trying to sit up straight.
  2. Slowly turn your head to one side and look over your shoulder. Don’t force the turn. Slowly turn your head to the other side. 
  3. Facing forward, tilt your head slowly to one side, ear towards your shoulder. Don’t force it. Lift your head back up and then tilt to the other side. 
  4. Face forward, and slowly bring your chin to your chest. Don’t force it. Count to 3 and then lift your head back up. 
  5. Facing forward, shrug your shoulders. Lift them up, move them back, and then around. Relax. 
  6. Facing forward, cross your arms so your right hand is on your left shoulder and your left hand on your right shoulder. Slowly turn at the waist to the right and count to five. Return to facing front and then turn to the left. 
  7. Stand up. Gently stretch both arms up over your head. Don’t force it. You may want to use a stick (such as a broom handle) so both arms move up at the same time.

If you have neck pain and stiffness after an accident or a fall, it’s best to get checked by a doctor to make sure you don’t have a serious injury. If you have minor whiplash (Grade 1 or 2) that doesn't get worse, it’s possible to take care of it at home. 

Don’t try to manage this at home if you have any of the following, as you may have a more severe injury than whiplash:

  • Loss of consciousness (passing out) at the time of neck injury
  • Passing out later
  • Dizziness
  • Tingling or numbness in your limbs
  • Weakness in your limbs
  • Trouble swallowing
  • Trouble speaking

Here are some tips to take care of yourself if you have mild to moderate whiplash:

  • Apply ice, especially in the first 24 hours after the injury. When using ice, don’t let it sit right next to your skin. Make sure there’s a towel or some type of fabric between the ice and your skin. Keep the ice in place for about 15 minutes and repeat every 3 hours.
  • Apply heat. After the first 72 hours, some people prefer heat on their sore neck, while some alternate between using heat and ice. Be sure the heating pad or heat bag is not too hot to avoid burns.
  • Rest. Try not to do activities that cause you to jar your neck, but it’s not necessary to stay in bed. That could slow down the healing.
  • Take OTC pain relief medications such as ibuprofen (Motrin, Advil) or naproxen (Aleve, Naprosyn). 

It may be tempting to wear a cervical collar, or C-collar, to support your neck, but this could cause more harm than good because you aren’t using your muscles to support your head. It might take longer for you to recover from the whiplash. Check with your doctor what is best for you.

Recovery from whiplash depends on how severe it is. If it’s mild, recovery can be as short as a few days or weeks. More severe whiplash can take longer.

The risk of having long-lasting pain and stiffness increases if you:

  • Have had whiplash before
  • Are older
  • Already have problems with your back or neck, including chronic pain
  • Were hurt by a high-speed impact

Can you get a concussion from whiplash?

Whiplash doesn’t cause concussions, but some of the symptoms you may have can be the same as concussion symptoms. These include:

  • Passing out
  • Dizziness, vertigo
  • Tingling or numbness
  • Weakness
  • Trouble swallowing
  • Trouble speaking

Shaken baby syndrome and whiplash

A baby’s neck is not strong enough to hold their head securely; the younger the baby, the more fragile the neck. If someone shakes a baby, it could cause a condition called shaken baby syndrome. You may have heard it called shaken infant syndrome. When a baby is shaken, their head may flop forward and backward. This can cause whiplash as well as brain damage.

Whiplash is a common neck injury. The most common cause is a motor vehicle accident, but you can get whiplash from any type of injury that forces your head to move forward and back quickly. Mild whiplash can likely be managed at home with rest, ice, and pain relievers. However, mild or moderate whiplash should be checked by a doctor to make sure there is no other damage to the neck and to give you the right treatment to prevent long-term pain and stiffness.

Is whiplash a serious injury?

For most people, whiplash is a painful injury but not a serious one. However, if you have whiplash and experience symptoms such as passing out, dizziness, numbness or tingling headaches, and others, this is serious and you should be checked by a doctor as soon as possible.

How long does a whiplash injury last?

Most mild to moderate whiplash injuries last only a few days or weeks. More serious whiplash can cause pain and stiffness for a longer period.

Will whiplash heal on its own?

Mild and moderate whiplash typically can heal on its own, with rest, ice, and pain relief. If you have more severe whiplash, your doctor will help you manage your treatment.

What can be mistaken for whiplash?

Doctors seeing a patient for possible whiplash would need to rule out other injuries, such as spinal cord suppression, fracture, or bone displacement in the neck.

What happens if whiplash goes untreated?

Untreated whiplash could leave you with chronic pain and stiffness. This can lead to difficulty sleeping and performing everyday activities.

Print
View privacy policy, copyright and trust info
View privacy policy, copyright and trust info