What happens if you leave whiplash symptoms untreated?

Has your head recently been jolted backwards and forwards in a whip-like movement? It might have been in the classic rear-ender car accident, falling down the stairs or in a forceful rugby tackle, but all cause similar stress to the neck joints, ligaments, muscles and discs.

Whiplash is effectively a sprain of the joints in the neck and occurs when an acceleration-deceleration event causes sudden extension and flexion of the neck. Whiplash injuries are also commonly referred to as cervical strains or sprains.

Whiplash neck sprains are common, with about 2 in 3 people involved in car accidents developing neck pain. But the good news is that physiotherapy treatment is very effective in the treatment of whiplash.

How do I know if I have whiplash?

Whiplash symptoms can vary between individuals, but the most common symptoms include:

  • Neck pain
  • Muscle tightness or spasm
  • Being unable to move your neck or turn your head
  • A headache, especially in the back of the head
  • Shoulder pain
  • Dizziness

Whiplash injuries are classified according to the associated signs and symptoms[1]

The extension-flexion mechanism may have injured intervertebral joints, discs, and ligaments; cervical muscles; and nerve roots. Injury to the zygapophyseal joint, commonly referred to as the facet joint, is likely the most common cause of whiplash-related upper neck pain and headaches.[2]

  • Grade 1 – Complaint of neck pain or stiffness only; no physical signs
  • Grade 2 – Complaint of neck pain or stiffness with associated musculoskeletal signs (eg, decreased range of motion, point tenderness)
  • Grade 3 – Complaint of neck pain or stiffness with associated neurologic signs (eg, decreased or absent deep tendon reflexes, weakness, sensory deficits)
  • Grade 4 – Complaint of neck pain or stiffness with associated fracture or dislocation

Physiotherapy treatment of whiplash

Research shows the most effective way to treat your injury is with a combination of treatment options which are tailored to your individual needs. Physiotherapy management of whiplash is extremely effective when started rapidly after the injury occurs.

Early treatment consists of reducing pain and inflammation and stabilizing your neck to prevent further damage.  Ice is the best natural anti-inflammatory and it is also very soothing when your neck is painful.

Most whiplash patients will start to feel better within a few weeks of the injury. Your physiotherapy treatment will aim to:

  • Reduce neck pain, headaches and inflammation.
  • Normalise joint range of motion.
  • Strengthen your neck muscles.
  • Strengthen your upper back muscles.
  • Improve your neck posture.
  • Normalise your muscle lengths and resting muscle tension.
  • Minimise your chance of future neck pain or disability.

If you are able to support your head and neck, it is important to keep your neck mobile rather than immobilizing it in a soft cervical collar.   Studies have shown that you are more likely to make a quicker recovery if you do regular neck exercises, and keep your neck active rather than resting it for long periods in a collar.

Red Flags

Due to traumatic nature of a whiplash injury; there is a risk of more sinister injuries which need to be ruled out before undergoing treatment. Please notify a health professional if you have (or develop) any of the following:

  • Bilateral pins and needles
  • Gait disturbances
  • Progressively worsening weakness or sensation problems
  • Pins and needles or numbness in the face
  • Difficulty speaking or swallowing
  • Drop attacks/fainting
  • Bladder or bowel problems

Because whiplash injuries are complex and require time to heal and rehab, don’t waste time before you seek treatment. Whiplash is one of those injuries that can hang around for years if not treated properly.

[1] Spitzer WO, Skovron ML, Salmi LR, et al. Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining “whiplash” and its management. Spine (Phila Pa 1976) 1995; 20:1S.

[2] Lord SM, Barnsley L, Wallis BJ, Bogduk N. Chronic cervical zygapophysial joint pain after whiplash. A placebo-controlled prevalence study. Spine (Phila Pa 1976). 1996 Aug 1;21(15):1737-44; discussion 1744-5. doi: 10.1097/00007632-199608010-00005. PMID: 8855458.

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