Limited evidence exists in current medical literature to support certain whiplash treatment methods over others. Aside from a general consensus on staying active (if possible), many treatment options appear to come down to the patient’s unique situation and symptoms, as well as preference.
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For most people, whiplash results in mild ligament sprains and/or muscle strains that heal within a few days or weeks. However, sometimes whiplash symptoms can last months or longer. The long-term prognosis for whiplash patients can vary widely and usually correlates to the severity of initial symptoms.
Self-Care for Whiplash
If whiplash symptoms are mild to moderate, some self-care options typically include:
- Rest. While it is good to stay active if possible, it also makes sense to take things easier the first few days. If a certain motion or activity exacerbates the neck pain, then avoid or limit that movement until the neck has more time to heal.
- Ice and/or heat. In the first couple days following a whiplash injury, applying ice can reduce pain and swelling in the neck. During this time window, the ice or cold packs can temporarily close small blood vessels and prevent a worsening of the swelling. Then ice or heat can be applied alternately a few days after the injury has occurred.
- Over-the-counter (OTC) medications. Some common OTC pain relievers include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil, Aleve, and Motrin. Acetaminophen can block pain receptors, and NSAIDs reduce inflammation. Despite being readily available at the store, it is important to carefully read the OTC label and follow its directions.
In the past, some doctors advised whiplash patients to wear a cervical collar to immobilize the neck in the beginning, but this advice oftentimes made the problem worse. Immobilization allowed the neck muscles to weaken and become more problematic for the cervical spine.
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Medical Care for Whiplash
If whiplash pain or related symptoms are severe and/or do not seem to be going away, medical care should be sought. Some combination of the following treatments could be used:
- Physical therapy. A treatment program run by a trained physical therapist or qualified health professional can help improve the neck’s strength and flexibility, which in some cases can relieve stress on the spine and reduce pain.
- Prescription pain medications. If over-the-counter drugs have not successfully managed the pain, then prescription-strength medications, such as muscle relaxants and opioids, could be prescribed under the careful supervision of a physician.
- Injections. In some cases, an injection is used to target a specific area. Some examples could be cervical epidural steroid injection (to reduce nerve and tissue inflammation from a disc herniation), cervical facet joint injection (to provide relief within the joint), and trigger point injection (to help an irritated muscle bundle).
- Psychotherapy. If for any reason a person develops a psychological condition in the aftermath of a whiplash injury, such as depression or post-traumatic stress disorder, a mental health professional can provide counseling to help work through, understand, and manage the issues. Medications could also be prescribed.
- Manual manipulation. A chiropractor or other certified medical professional typically uses his or her hands to make manual adjustments to the spine in an effort to increase range of motion and reduce pain.
- Acupuncture. Some people report benefits from acupuncture, which involves placing thin needles in various strategic parts of the body depending on the condition being treated. When done by a licensed acupuncturist, the treatment is safe and has little to no pain.
- Massage therapy. This treatment can be combined with others, such as physical therapy or manual manipulation. A massage can reduce pain by soothing muscle tension and spasms, as well as increasing blood flow.
- Radiofrequency neurotomy. This procedure targets specific nerves with heat to create a lesion that prevents the facet joint from sending pain signals to the brain.
The above does not cover every possible treatment available for whiplash.
In addition to the above treatments, anything a person can do to lead a healthy lifestyle will generally be beneficial for neck pain. Some ideas can include healthy eating, getting enough rest (with an ergonomic pillow), good posture, not smoking, and staying active without causing further neck pain.
Prognosis for Whiplash Patients
The majority of whiplash patients recover within 3 months. However, it is also possible for whiplash-related symptoms and disorders to become chronic.
Risk factors that could indicate a longer recovery time from a whiplash injury include:
- Severe pain at time of injury. If a person experiences severe pain immediately following the impact, that’s a strong indication of more severe damage.
- Post-traumatic stress disorder. This condition could involve constantly thinking about or trying to forget the accident, avoiding situations such as driving or going anywhere near the accident site, becoming more easily startled or anxious, developing depression, and/or trouble sleeping.
- Older age. People who are older tend to have more degeneration and pre-existing conditions in the spine, which makes them more vulnerable to whiplash injuries.
- Female sex. Women tend to have smaller structures and muscles in the neck, which could make them more susceptible to whiplash injuries.
Progress has been made in being able to better predict who will have longer recovery times for whiplash. In addition to the risk factors noted above, clinical tests can help estimate the severity of the injury. For example, some research indicates that cold hyperalgesia, or sensitivity to cold, can help estimate the likelihood that a person will have long-term pain and disability from the whiplash injury.3 The more sensitivity to cold at the neck’s injury site in the aftermath of a whiplash injury would indicate a stronger likelihood for delayed recovery.
- Goldsmith R, Wright C, Bell S, Rushton A. Cold hyperalgesia as a prognostic factor in whiplash associated disorders: A systematic review. Man Ther. 2012; 17: 402-10.