Whiplash & Pain

Robert Hamel, PA-C and Julie Roth, MPT, explain the relationship between whiplash and pain.

What is whiplash?

A common type of injury resulting from motor vehicle accidents and frequently triggering head and neck pain is whiplash. Whiplash is defined as muscle or ligament strain due to hyperflexion and hyperextension. Hyperflexion is the sudden, extreme forward motion of the head. Hyperextension is the sudden, extreme backward motion of the head. Whiplash can also be complicated by rapid movement of the head from side to side.

Do people recover from whiplash?

About 50% of all people sustaining a whiplash injury are fully recovered within three months, with 75% being fully recovered within one year. If symptoms such as neck and shoulder pain or headache last longer than one year, full recovery is often much more difficult to obtain. In addition, recovery can be prolonged if the neck was rotated at the time of the accident. People experiencing prolonged symptoms are often older, have higher levels of initial neck pain and/or headache, and may have pain which radiates down the arm.

What is cervical facet syndrome and how does it relate to whiplash?

Cervical facet syndrome is a treatable condition that may follow whiplash and is characterized by neck pain and a decrease in range of motion of the neck. Cervical facet syndrome is due to trauma to the facet joints in the cervical spine. (Note: MRIs and x-rays usually do not demonstrate this abnormality.)

How is whiplash treated?

The treatment of whiplash is determined by the symptoms resulting from the injury. For example, if migraine headaches are triggered by whiplash, treatment may include medications and behavioral therapies. Nerve pain as a result of whiplash may respond to medications such as Lioresal, tricyclic antidepressants, or Tegretol. Nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxers can also be effective. Physical therapy is usually an important aspect of the treatment plan for whiplash injuries.

Physical therapy is directed at restoring normal movement of the joints, relaxing muscles, and increasing full flexibility and strength in the affected area.

Research indicates that once more serious injuries are ruled out, recovery is improved when patients return to normal activities as soon as possible. Early mobilization of the injured area, along with regular icing, may reduce the need for more aggressive treatment.