What is whiplash?

Whiplash is a term used to describe a sudden acceleration-deceleration movement of the neck. The head and neck are thrown backward and then forward in a motion also known as "whiplash."

The term whiplash is therefore simply a word used to describe the mechanism of injury. However, whiplash can cause various symptoms. These are referred to as whiplash-associated disorders.

To better understand why this movement can hurt your neck, check out our guide to cervical anatomy. It explains how the structures of the neck normally function.

What are the symptoms of a whiplash-related disorder?

The main symptoms of whiplash-associated disorder are identical to those ofcervical sprain, namely:

• Neck pain and stiffness
• Spasms in the neck muscles
• Headaches (caused by neck problems)

In general, neck movements and certain arm movements trigger the pain.

However, in addition to these symptoms, other symptoms may also occur, such as:

• Dizziness or lightheadedness
• Problems controlling eye movement
• Tinnitus (ringing in the ears)
• Loss of balance
• Concentration or memory problems
• Changes in sleep patterns
• Anxiety or depression

Symptoms may occur immediately after the accident or up to 48 hours later. If you also experience pain, numbness, or tingling down your arms, you probably also have cervicobrachialgia or cervical radiculopathy. This is when a nerve is irritated.

It is also possible to have suffered a concussion after whiplash. If you have symptoms such as confusion, nausea, or vision problems, talk to your physical therapist or doctor.

To learn more about neck pain in general and all its possible causes, check out our comprehensive guide to neck pain.

What are the serious symptoms of a whiplash-related disorder?

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-related disorders?

You must have had an accident or some kind of trauma that causes whiplash. For example:

• A car accident (the most common cause)
• A sudden neck movement
• An impact to the head
• A fall

Whiplash often occurs during a rear-end collision. When a car hits you from behind, your body is thrown forward, but your head remains in place for a moment. Then your head is thrown back quickly, then forward. This rapid movement can injure the ligaments, muscles, and even the discs in your neck.

How is whiplash-associated disorder diagnosed?

The diagnosis is made based on the history of symptoms and clinical examination. If you have had an accident that caused whiplash and you develop symptoms afterwards, we can confirm the presence of a whiplash-related disorder.

In some cases, an X-ray of the neck must be taken to ensure that there are no fractures. Here are some criteria that justify taking an X-ray:

• 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 whiplash-associated disorder?

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.

Physical therapy is particularly effective for whiplash-related disorders. Your physical therapist has the expertise to assess all the systems that may have been affected by whiplash. To learn more, see our guide to physical therapy for neck pain.

What physiotherapy treatments are available for whiplash-associated disorder?

Physiotherapy treatment for whiplash-associated disorder is divided into three parts:

• Assessment and treatment of the different body systems that may be responsible for the symptoms.
• Planning for return to work or school (cognitive activities)
• Planning your return to sports and other leisure activities

Step 1 - Assessment and treatment of body systems

Your physical therapist is the only healthcare professional with the expertise to assess the three systems that may have been injured by whiplash, namely:

• The vestibular system (responsible for balance)
• The oculomotor system (responsible for eye coordination)
• The cervical spine (the vertebrae of the neck)

To assess your neck, your physical therapist 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

Step 2 - Planning for return to work or school (cognitive activities)

Your physical therapist will guide you through the process of returning to school or work. He or she will give you advice on how to make this transition in the right way without your symptoms returning. Follow-up will continue until you are able to return to work or school without any symptoms.

Step 3 - Planning your return to sports and other leisure activities

Your physical therapist will guide you back to physical activity. He or she will give you advice on how to do this safely without causing your symptoms to return. Follow-up care will continue until you are able to resume all physical activities without symptoms.

What to do at home for a whiplash-associated disorder?

Stop doing movements that cause too much pain temporarily and gradually start doing them again afterwards. It is important to stay active, but without pushing yourself too hard.

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 while standing

• 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 (especially if you experience stiffness or pain in the morning or during the night).

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

Sources

• Gwilym SE, Stace RM. Whiplash associated disorder: a review of current pain concepts. Bone & Joint 360. 2015 Feb;4(1):37-9.
• Carroll LJ, Holm LW, Hogg-Johnson S, Côté P, Cassidy JD, Haldeman S, Nordin M, Hurwitz EL, Carragee EJ, van der Velde G, Peloso PM. Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal of manipulative and physiological therapeutics. 2009 Feb 1;32(2):S97-107.
• Ioppolo F, Rizzo RS. Epidemiology of whiplash-associated disorders. InWhiplash Injuries 2014 (pp. 13-16). Springer, Milano.