Think You Might Have Whiplash? Know the Symptoms

This injury won’t show up on tests such as MRIs
elderly man with neck pain

If you feel a tightening in your neck and shoulders after a car accident or another incident that snaps your head forward or backward, you may wonder about whiplash. How do you know if you have it? And if you do, how long will the pain last?

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Pain management specialist Robert Bolash, MD, answers our questions about what causes whiplash, who is more at risk and how long it may last.

Q: What causes whiplash?

A: People associate whiplash with a motor vehicle collision, and that often is the cause. But it can also happen with a sports injury, physical abuse (such as being violently shaken by the shoulders) or by being punched. These all can cause an intense flexing and extension of the neck — a movement similar to when you nod your head to say yes.

Whiplash happens when structures in your neck, including discs, ligaments, nerves or muscles, are damaged.

Sometimes a small vessel tears after an accident and releases inflammatory substances in the neck, causing swelling and pain.

Q: What are the signs of whiplash?

A: You might feel symptoms of whiplash immediately after the injury, or they can show up several days later. Common signs of whiplash include:

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  • Pain.
  • Muscle spasms.
  • Decreased range of motion.
  • Headache.
  • Stiff neck.
  • Fatigue.
  • Anxiety.
  • Memory disturbances.

Q: How do you know whether you have whiplash?

A: Your assessment will start with a physical exam. Depending on the results, a doctor might order a magnetic resonance imaging (MRI), computed tomography (CT) scan or X-ray if they suspect whiplash. But for most people, the injury occurs within structures too small to be seen in these tests. This is true even if you are experiencing pain. As a result, symptoms remain the primary way to tell if you have whiplash.

Q: Are some people more likely to get whiplash?

A: Yes. Some people are more prone to having whiplash after an accident. Risk factors identified through research include:

  • Being hit from behind by another car.
  • Being a woman.
  • Being younger.
  • Having a history of neck pain.
  • Being hit when your car is stopped.
  • Not being at fault in the accident.
  • Having a job with lots of monotonous work, meaning you probably had tight muscles before the accident.

Q: How long does whiplash last?

A: A vast majority of neck pain goes away within a few days, and even more within three months. But studies show that between 12% and 50% of people still have persistent neck pain after a year. You are more likely to have this lingering pain if:

  • You have severe pain from the beginning.
  • Pain develops right after the accident.
  • You have neurological symptoms such as memory loss.
  • Your pain shoots into your arm or fingers.

The more severe your pain is after the initial injury, and the higher your anxiety level, the more likely it is that your acute short-term neck pain will develop into a chronic problem.

Q: How is whiplash treated?

A: Your doctor may prescribe anti-inflammatories and/or muscle relaxers. Applying heat (rather than cold) to the area might also help loosen tight muscles.

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The purpose of treatment is to regain your range of motion as quickly as possible. We start physical therapy early and focus on stretching, rotating and moving the neck back and forth. We very rarely advise patients to wear a soft neck collar, as we’d rather keep the joints and muscles moving than immobilize them.

You can do exercises at home to help alleviate the pain. Do these three to four times a day for a few minutes:

  1. Rotate your neck side to side gradually, far enough to stretch your muscles, but avoid causing pain.
  2. Tilt your head side to side, as if you are holding your phone between your ear and shoulder.
  3. Move the neck forward toward the chest and backward.
  4. Roll your shoulders in circles.

If you are still feeling significant pain after three months, it’s a good idea to ask your doctor to evaluate your condition. They may then recommend further treatment, if needed.

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