What is whiplash?

Whiplash is an injury to the muscles, tendons and other soft tissues of the neck. It is caused by a sudden and vigorous movement of the head, sideways, backwards or forwards.

When the neck is moved beyond its usual range of movement, the soft tissues of the neck (tendons, muscles and ligaments) may be overstretched or sprained. This causes pain and discomfort in the neck and shoulders and may also cause back pain.

What symptoms relate to whiplash?

Sometimes there are no symptoms of whiplash, but sometimes the symptoms can be severe.

Pain from a whiplash injury often begins 6 to 12 hours after the injury. Many people feel uncomfortable on the day of the injury or accident and find that pain, swelling and bruising increase over the following days.

Common symptoms of whiplash include:

• neck pain and stiffness
• swelling and tenderness in the neck
• temporary loss of movement, or reduced movement, in the neck
• headaches
• muscle spasms
• pain in the shoulders or arms
• dizziness
• weakness
• pins and needles, numbness or pain in the arms and hands
• difficulty concentrating
• difficulties swallowing
• blurred vision
• vertigo (a feeling you are moving or spinning) and dizziness
• tinnitus (ringing in the ears)

The symptoms often greatly improve or disappear within a few days to weeks. It may take longer for symptoms to completely disappear and some people experience some pain and neck stiffness for months after a whiplash injury.

What causes whiplash?

Whiplash injuries are commonly caused by motor vehicle accidents. The neck is quickly accelerated and decelerated due to rear-end or side impact.

It can also be caused by a sudden blow to the head from contact sports such as rugby or boxing, being hit on the head by a heavy object, or a slip or fall where the head is jolted or jarred.

When should I see my doctor?

You should see a doctor if you have had a motor vehicle accident or an injury that’s causing pain and stiffness in your neck.

If there is any suspicion that the injury was not the result of an accident, and that it was deliberately inflicted, you should seek help from a healthcare professional as soon as possible. This could be a nurse or doctor at a hospital emergency department or doctor’s surgery, or a health visitor or school nurse. If you are unsure who to speak to, call healthdirect Australia on 1800 022 222 (known as NURSE-ON-CALL in Victoria) to discuss your concerns.

How is whiplash diagnosed?

Your doctor will examine you, feel your neck and see how well your neck moves in different directions. They may order a neck x-ray to rule out a bone fracture or dislocation. However, whiplash symptoms are caused by injury to the soft tissue, which won’t show up on an x-ray.

How is whiplash treated?

The best thing you can do to recover from whiplash is to stay active and do some gentle neck exercises. People who drastically change or reduce their activity level after a whiplash injury tend to take longer to recover.

At first you may need to adapt how you move to take care of your neck. Then gradually build up to your normal activities as your neck improves.

It may be necessary to adapt some work or recreational activities for a while to avoid unnecessary strain on your neck. For example, you could make more trips so you don’t have to carry too much shopping at once, cut down on housework or gardening, or lift the handlebars on your bike so you can change your posture.

An ice pack can relieve swelling and pain. You should apply this as soon as possible after the injury, for 15 to 20 minutes at a time. You can make an ice pack from a bag of frozen peas wrapped in a tea towel to prevent cold burns, which you can re-freeze time and again. If you are in pain, get advice from your healthcare professional on suitable pain relief medicines.

Correct posture is important after a whiplash injury. Keep your back straight when you are sitting, standing or walking to help prevent stiffness and pain developing. If you spend a lot of time sitting at a desk, take regular breaks to stand up and move your body so that your neck and back do not become stiff. You may need to ask for a special back support for your chair while you are recovering from an injury. You should speak to your HR department for more information about ways they may be able to help you if you have neck or back pain.

Avoid heavy lifting, punching or pulling, or contact sports like rugby and boxing, until your symptoms improve and your doctor or healthcare professional is happy for you to start these activities again. Take care when lifting, bending or carrying out repetitive twisting movements. Make sure that you take regular breaks and move your body position.

You may find it helpful to sleep using a firm support pillow and to only use one pillow when you sleep.

Physiotherapy may help you to regain movement in your neck. Physiotherapists use gentle exercises, manipulation and massage to help restore the body’s maximum range of movements after an injury or illness.

Resting, taking time off work or wearing a collar are not likely to help you recover from whiplash.

Can whiplash be prevented?

Cars these days are designed to reduce the chance of whiplash. It’s important to adjust your seat and headrest correctly when driving to minimise the chances of whiplash.

To ensure correct posture when driving, the steering wheel should be adjusted so it’s level with your chest, not your face. Keep your arms bent and your thumbs on the rim of the steering wheel. Have the seat fairly upright so your back and shoulders are supported and sit deep in the seat, bracing your body with your left foot.

Complications of whiplash

In serious whiplash injuries, there may damage to the nerves or fracture or dislocation of the neck.

Most people fully recover from a whiplash injury. But in a small percentage of people, whiplash can lead to ongoing pain and disability. Some people may develop depression or post-traumatic stress symptoms.

Research has shown that people who believe they are going to recover after whiplash have a better chance of full recovery than people who feel distressed and negative about their injury. Your age and how bad the initial injury was also play in a role in how quickly you will recover.

Resources and support

You can read about how to look after yourself, including exercises for whiplash, in the Whiplash Injury Recovery, A Self Help Guide published by the RECOVER Injury Research Centre.