Kim Burns DPT, OCS Physical Therapy and Sports Rehabilitation

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All About Whiplash

You were in an accident and you’re in pain. Now what?

Whiplash is basically a sprain of the ligaments and strain of the muscles of the spine from a sudden acceleration (movement from a stop) or deceleration (stop from movement). It most commonly occurs in the neck but can also occur in the low back as well.

The nerves in the joints of the neck sense a forced forward bend or backward bend from a neutral position. Then they create a protective response by increasing the muscle tension surrounding the injury.

In this drawing, the white parts represent the ligaments that hold the bones together and help the brain sense where the neck is in space. The spine is surrounded on all sides by muscles. Only one of the muscles in the neck is shown in this picture.

Dizziness and vertigo can also happen alongside the neck stiffness and pain in 25-50% of whiplash injuries. This is thought to be the result of ligament sprains in the neck, making it difficult for the brain to accurately align the head on top of the neck joints.

Here is a great video from the John Hopkins Hospital that explains what whiplash looks like in the neck: Video Link

Most of the time, imaging is not a necessary part of treatment for whiplash. Based on the best evidence available to medical practitioners right now, reasons you may need imaging include:

  • You are 65 years old or more

  • The accident was at 60mph or more, a roll over, or you were thrown from the vehicle

  • You have numbness, tingling or radiating pain in your arms or legs after the accident

  • You can’t rotate your head more than 45 degrees to either side

According to the best available evidence, once the physical therapist does their examination and clears any “red flags,” beginning movement as prescribed by a PT is the quickest way to recover after a whiplash injury.

This exercise is also helpful for other neck pain conditions like headaches or general neck tension that can be painful at times. Here’s how to do it: