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Whiplash – head on into diagnosis and early management


Whiplash is commonly associated with rapid acceleration and deceleration of the neck and head in a forward and backward direction. This results in trauma to the neck ligaments and muscles mainly but can also result in damage to the discs in the neck.

The common cause is when you are in a car that is hit from behind by another car. Being in a car hit from the side or front can also cause whiplash sprains. Commonly different muscles are affected and so a thorough case history is a necessary part of your initial assessment at a Perfect Balance Clinic by the Osteopath or Physiotherapist that sees you.

In one of the worst-case scenarios whiplash can result in damage to the spine or spinal cord or nerves, this occurs in a severe whiplash accident. This is uncommon and would need a referral to the hospital for assessment. This news article deals only with the common whiplash sprain to neck muscles and ligaments although if you are suspecting it is more severe and you are concerned then please feel free to contact us for a consultation and initial assessment at a Perfect Balance Clinic with a qualified Osteopath or Physiotherapist.

Who gets whiplash neck sprains?
Although these injuries are common after car accidents they can also occur with other sudden forces placed on the neck such as motorcycle accidents and contact sports. Women are more prone to whiplash injuries than men as their neck muscles are often less strong.  Don’t be fooled by having a small car accident, many people we see at Perfect Balance Clinics have suffered from neck injuries from what seems like quite minor car accidents.

What are the symptoms of a whiplash neck sprain?

  • Pain and stiffness in the neck. It may take several hours after the accident for symptoms to appear. The pain and stiffness often become worse on the day after the accident. In about half of cases, the pain first develops the day after the accident.
  • Turning or bending the neck may be difficult.
  • You may also feel pain or stiffness in the shoulders or down the arms.
  • There may be pain and stiffness in the upper and lower part of the back.
  • Headache is a common symptom.
  • Dizziness, blurred vision, pain in the jaw or pain on swallowing, unusual sensations of the facial skin may occur for a short while but soon go. Tell a doctor if any of these persist.
  • Some people feel tired and irritable for a few days and find it difficult to concentrate. How do we diagnose the whiplash injury?
    At Perfect Balance Clinic, we make sure every clinician who works with us carries out a full medical history to help isolate the cause of the problem and any other problems. This will help in the diagnosis of whiplash and whiplash-associated disorder. Reflexes and another nerve testing will help isolate a nerve problem if it is present. Carrying out movements and muscle testing will help find any muscles and ligaments that are damaged. What are the treatments for a whiplash neck sprain? Exercise your neck and keep active
    Aim to keep your neck moving as normally as possible. At first, the pain may be bad, and you may need to rest the neck for a day or so. However, gently exercise the neck as soon as you are able, as you should not let it ‘stiffen up’. Gradually try to increase the range of neck movements. Every few hours gently move the neck in each direction. Do this several times a day. As far as possible, continue with normal activities. You will not cause damage to your neck by moving it, but make sure you have been assessed before you start to do this.


Painkillers are often helpful and may be recommended by your doctor.

  • Paracetamol is often sufficient. For an adult, this is two 500 mg tablets, four times a day.
  • Anti-inflammatory painkillers. These may be used alone or at the same time as paracetamol. Other types such as diclofenac or naproxen need a prescription. Some people with stomach ulcers, asthma, high blood pressure, kidney failure, or heart failure may not be able to take anti-inflammatory painkillers.
  • A stronger painkiller such as codeine is an option if anti-inflammatories do not suit or do not work well. Codeine is often taken in addition to paracetamol.
  • A muscle relaxant such as diazepam is occasionally prescribed by a GP for a few days if your neck muscles become very tense and make the pain worse.

Other treatments

Some other treatments which may be advised include:

      • A good posture may help. Check that your sitting position at work or at the computer is not poor (that is, not with your head flexed forward with a stooped back). Sit upright. Yoga, pilates, and the Alexander technique all improve neck posture, but their value in treating neck pain is uncertain.
      • A firm supporting pillow seems to help some people when sleeping. Try not to use more than one pillow unless sleeping on your side and you have broad shoulders.
      • Physiotherapy and Osteopathy. Various treatments may be advised by a physiotherapist or osteopath if the pain is not settling. These include traction, heat, manipulation, etc. However, what is often most helpful is the advice that can be given on exercises to do at home. A common situation is for a doctor to advise on painkillers and gentle neck exercises. If symptoms do not begin to settle over a week or so, you may then be referred to a physiotherapist or osteopath to help with pain relief and for advice on specific neck exercises.

This will depend on the severity of the sprain, but the outlook is good in most cases. Symptoms often begin to improve after a few days. Most people make a full recovery within a few weeks. However, in a small number of people, some symptoms persist long-term.

Can whiplash neck sprains be prevented?

    • Modern cars are increasingly designed to minimise the impact of collisions on the neck. However, all cars include head restraints on car seats which may prevent some whiplash sprains. The head restraint should be as high as the top of the head. This may stop the head from jolting backward in a car crash. However, up to 3 in 4 head restraints are not correctly adjusted. Head restraints may make a journey less comfortable when they are correctly adjusted as they will not allow your head to lie back. However, if you have had a whiplash neck sprain, you may be more particular about correctly adjusting the head restraint for yourself and for other passengers.
    • In the event of an imminent car crash – if you see a car coming up behind you then, if possible, push your head back against the head restraint and your back into the seat. This may minimise the jolting effect on your neck.


Treatment may vary and you should go back to see a doctor😕

  • If the pain becomes worse.
  • If the pain persists beyond 4-6 weeks.
  • If other symptoms develop such as loss of feeling (numbness), weakness, or pins and needles in part of an arm or hand, which may indicate irritation to or pressure on the nerves emerging from the spinal cord.


For more information about Whiplash

If you would like additional information about Whiplash or discuss how we may be able to help with your queries, please contact us using the form below and we will get back to you as soon as possible.

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