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Whiplash: Symptoms, diagnosis and treatment

Whiplash is an injury to the ligaments and tendons in the neck when it is moved forwards, backwards or sideways, often as the result of a car crash.

After an accident, the symptoms of whiplash may not be felt until around 6-12 hours later and may become worse over the following days.

Whiplash symptoms include neck pain, stiffness, tenderness, reduced neck movement and headache.

Women are more likely to experience whiplash than men.

Whiplash accounts for more than three quarters of all injury claims after road accidents.

What causes whiplash?

As well as traffic accidents, blows to the head, particularly during sports such as boxing or rugby, or a slip or fall that causes the head to suddenly jolt backwards can also cause whiplash.

What are the symptoms of whiplash?

Symptoms of whiplash may be delayed for 24 hours or more after the initial trauma. However, people who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury:

  • Neck pain and stiffness
  • Headaches
  • Pain in the shoulder or between the shoulder blades
  • Lower back pain
  • Pain or numbness in the arm and/or hand
  • Dizziness
  • Ringing in the ears or blurred vision
  • Difficulty concentrating or remembering
  • Irritability, sleep disturbances, fatigue

How is whiplash diagnosed?

In most cases, injuries are to soft tissues such as the disks, muscles and ligaments, and cannot be seen on standard X-rays. The diagnosis is usually made from a detailed description of the circumstances and the symptoms. Specialised imaging tests, such as CT scans or magnetic resonance imaging (MRI) are not carried out routinely, but may be performed if a problem such as spinal injury is suspected.

What's the treatment for whiplash?

To help with recovery:

  • Ice your neck to reduce pain and swelling as soon as you can after the injury. Do it for 20-30 minutes every 3-4 hours for 2-3 days, or as recommended by your doctor.
  • Take painkillers or other medications, if recommended by your doctor. Non-steroidal anti-inflammatory drugs ( NSAIDs) like ibuprofen will help with pain and swelling. However, these medicines can have side effects. Always follow the dosing instructions. Prescription painkillers and muscle relaxants are sometimes necessary.
  • Apply moist heat to your neck - but only after 2-3 days of icing it first. Use heat on your neck only after the initial swelling has gone down. You could use a hot, wet flannel or enjoy a soak in a warm bath.
  • Other treatments, like physiotherapy and massage, may also help.

When will my whiplash feel better?

Recovery time depends on how serious your whiplash is.

Given time, most whiplash should heal on its own.

There's some evidence the average recovery time for a whiplash injury is 32 days. However, in around 12% of cases of chronic whiplash patients do not recovered within six months.

Remember that everyone heals at a different rate.

Once the acute symptoms of neck strain are gone, you may benefit from exercises ideally under the supervision of a physiotherapist. This will make your neck muscles stronger and more flexible. It will help you recover and reduce the odds of straining your neck again in the future.

You might start with gentle stretching exercises that become more vigorous as you get better.

Whatever you do, don't rush things. People who play contact sports need to be especially careful that they are fully healed before playing again. Do not try to return to your previous level of physical activity until you can:

  • Look over both shoulders without pain or stiffness.
  • Rock your head all the way forward and all the way back without pain or stiffness.
  • Rock your head from side to side without pain or stiffness.

If you start pushing yourself before your neck strain is healed, you could end up with chronic neck pain and permanent injury.

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