What is whiplash?

A whiplash injury is an injury to the joints of the vertebrae in the neck caused by trauma. In general, one or more ligaments in the vertebrae of the neck are stretched. It is a common injury that can occur during an accident or sudden movement.

To better understand the anatomy of your neck and how the vertebrae work together, check out our guide to cervical anatomy.

What are the symptoms of whiplash?

The main symptoms of whiplash are:

• Pain and stiffness in the neck following a specific event
• Spasms in the neck muscles
• Headaches (caused by neck problems)

In general, neck movements and certain arm movements trigger the pain. You may also feel that your neck is locked or that you cannot turn your head normally.

If you experience pain that radiates down your arm, accompanied by numbness or tingling, you may also have cervicobrachialgia or cervical radiculopathy. This occurs when a nerve is irritated.

What are the serious symptoms of whiplash to watch out for?

Severe symptoms are rare. They occur in less than 1% of cases. However, you should seek immediate emergency care or see a doctor if you have:

• Severe weakness or paralysis of one or both arms
• Significant or even complete loss of sensation in one or both arms
• Recent loss of balance when walking
• New incoordination of the arms or hands
• New difficulties in controlling your urine or stool
• Loss of sensation in the genital area or when wiping after a bowel movement

Rest assured, most of the time, although the pain can be very unpleasant, the condition progresses well.

What causes whiplash?

A whiplash injury can be caused by a specific event such as:

• A car accident
• A sudden neck movement
• An impact to the head
• A fall
• A greater effort than usual (for example: straining to lift a load)

It should be noted that whiplash very often leads to cervical sprain. Whiplash is an acceleration-deceleration movement of the neck that often occurs in car accidents.

To learn more about neck pain in general and how it develops, see our comprehensive guide to neck pain.

How is a cervical sprain diagnosed?

The diagnosis is made based on the history of symptoms and a clinical examination. If you suffered the injury in a traumatic context, your doctor may request an X-ray of your neck. This is to ensure that there are no fractures.

Here are some criteria that justify having an X-ray of the neck:

• Falling more than one meter or five steps
• Having received a blow to the head (for example: diving into a swimming pool)
• A car accident at over 100 km/h, being thrown from a car, rolling over with the car
• Being involved in an accident while operating a motorized recreational vehicle (snowmobile, ATV, motocross bike, mountain bike, etc.)
• Being on a bicycle and colliding with a car

When should you consult a physiotherapist for a cervical sprain?

You should consult a physiotherapist if you have symptoms as described above, or if your doctor has already ruled out any other cause that may explain your pain.

You do not need to see a doctor before consulting a physical therapist. If your condition requires you to see a doctor, your physical therapist will be able to tell you.

To learn more about how physical therapy can help with your neck pain, check out our guide to physical therapy for neck pain.

What are the physiotherapy treatments for a cervical sprain?

As with all traumatic injuries, we must allow the body to perform its natural healing process.

Inflammation is a normal and necessary process for proper healing. There is therefore no miracle cure to speed up healing. However, it is very important to ensure that all factors that could slow down healing are eliminated.

Here are some examples of factors that could slow down healing:

• Improper dosage of exercises and daily activities
• Poor biomechanics of your movements
• Stiffness in the joints, muscles, and nerves
• Worries or fears related to the injury or pain

That's why your physical therapist can help you optimize the healing process. He or she will guide and coach you in the best possible direction to ensure that the injury heals effectively.

Healing from a traumatic injury should be viewed like caring for a plant. You won't make the plant grow faster by pulling on it. However, you can make sure it gets enough water, sunlight, and fertilizer. You want to put the plant in a good environment so it can heal. The same goes for a traumatic injury.

Your physical therapist will perform an assessment to determine the type and severity of the injury. To do this, he or she will evaluate the following:

• Your joint mobility
• The gliding of your nerves
• Your postural habits
• The quality of your movements
• Your strength and stability

Based on the results of the assessment, your physical therapist will:

• Mobilize the joints, muscles, and nerves in your neck to reduce pain and improve movement
• Give you specific exercises to do at home to address the cause of the problem and relieve pain
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your postural habits and movements

What to do at home for a cervical sprain?

Stop doing movements that cause temporary pain and gradually start doing them again afterwards. It is important to stay active, but without forcing yourself.

Here are some other tips that can help at home:

• Move your neck in movements that do not hurt at all.
• Perform gentle movements several times a day.

• With a cushion under the armpit
• With the armrests of a chair or sofa
• By putting your hand in your pants pocket

• Limit the time spent in the same position (computer, television, reading). Get up for a few minutes to move your neck and shoulders a little.
• Ensure your neck is well supported when sleeping at night with a pillow that fills the hollow of your neck. Sleeping on your stomach should be avoided if you experience stiffness or pain in the morning or during the night.

• Engage in cardio activities such as walking, stationary cycling, or swimming if they do not cause any pain. Cardio activity improves blood circulation and speeds up healing.

If you don't see any improvement after 10 days, you should consult a physiotherapist.

Sources

• Delfini R, Dorizzi A, Facchinetti G, Faccioli F, Galzio R, Vangelista T. Delayed post-traumatic cervical instability. Surgical neurology. 1999 Jun 1;51(6):588-95.
• Stiell IG, Wells GA, Vandemheen KL, Clement CM, Lesiuk H, De Maio VJ, Laupacis A, Schull M, McKnight RD, Verbeek R, Brison R. The Canadian C-spine rule for radiography in alert and stable trauma patients. Jama. 2001 Oct 17;286(15):1841-8.
• Stiell IG, Clement CM, McKnight RD, Brison R, Schull MJ, Rowe BH, Worthington JR, Eisenhauer MA, Cass D, Greenberg G, MacPhail I. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. New England Journal of Medicine. 2003 Dec 25;349(26):2510-8.