Patient information from BMJ

Whiplash

Last published:Jan 07, 2021

Whiplash is a neck injury that causes pain and stiffness. It usually gets better on its own after a few days or weeks. But there are things you can do to help with the pain and speed up your recovery.

We’ve looked at the best and most up-to-date research to produce this information. You can use it to talk to your doctor and decide which treatments are right for you.

What is whiplash?

Whiplash is a type of neck injury that can happen if your head is suddenly jolted backwards and forwards in a whip-like movement. The most common cause of whiplash is a vehicle crash. When this happens your neck muscles and ligaments (the strands of tissue that hold your bones together) stretch more than normal and may be sprained.

You can also get whiplash from a sport injury or if you jolt your neck if you trip or fall.

What are the symptoms?

If you have whiplash your neck will be sore, especially when you try to move it. The pain will probably feel worse the day after the injury. You may have some other symptoms within the first two days after your injury, or they might start a day or two afterwards. These could include:

• A stiff neck

• Headaches

• Pain in your shoulder or between your shoulder blades

• Pain in your lower back

• Trouble concentrating

• Dizziness, ringing in your ears, or blurred vision. This should go away quickly. Tell your doctor if it doesn't.

Tell your doctor if these symptoms don't start to get better after about a week, or if they get worse.

A severe whiplash injury can cause more serious problems that need hospital treatment. The spine or spinal cord (the nerves that run through the spine) can get damaged. You should go back to see your doctor if:

• The pain from your injury gets worse after a day or two, or

• You get any numbness, weakness, or pins and needles in your arm or hand at any time.

What treatments work?

Your pain and stiffness should start to get better within a few days. There are some things you can do to help your recovery.

Things you can do for yourself

You might feel as though you should rest and move as little as possible after whiplash.

Your doctor might refer you to a physiotherapist. The physiotherapist can give you advice about how to move your neck and what exercises can help with your neck pain.

Although doing these exercises can be a big help, don't push yourself too much. Don't do the exercises so much that they hurt.

Neck collars can help with more serious neck injuries. But they don't help with whiplash and can actually make things worse. This is because they stop you moving your neck normally.

Medicines

Painkillers can help with neck pain, especially in the first few days after your injury when the pain is likely to be at its worst.

You can buy some painkillers, such as paracetamol and ibuprofen, without a prescription. But be careful not to take more than the recommended dose.

Ibuprofen is what's called a non-steroidal anti-inflammatory drug (NSAID). These drugs reduce pain and also help reduce inflammation (swelling).

Taking NSAIDs can cause side effects such as heart problems and bleeding in the stomach. But this usually only happens if you take them at a high dose over a long period. So this shouldn't be a problem if you're only taking them for a few days for whiplash.

People who have heart problems shouldn't take an NSAID called diclofenac.

If your pain is severe your doctor might suggest a short course of stronger painkillers called opioids. But most people don't need them. Opioids are usually only recommended for short periods, as people can become dependent on them.

What will happen to me?

The pain and stiffness from whiplash usually go away in a few days or weeks. But the symptoms can sometimes last a lot longer. For example, some people still have some pain and stiffness many years after the accident that caused their whiplash.

Your doctor should follow up with you soon after your injury. If your pain persists you might need further tests to see why it hasn't stopped.