Introduction

Whiplash is a term that describes a neck injury caused by a sudden movement of the head forwards, backwards or sideways.

It often occurs after a sudden impact such as a road traffic accident (see below). The vigorous movement of the head overstretches and damages the tendons and ligaments in the neck.

Tendons are tough, fibrous bands that connect muscles to bone. Ligaments are fibrous connective tissues that link two bones together at a joint.

Common symptoms of whiplash include:

  • neck pain and stiffness
  • tenderness over the neck muscles
  • reduced and painful neck movements
  • headaches 

After an accident, it can take a while (six to 12 hours) for the symptoms of whiplash to develop.

The neck pain and stiffness is often worse on the day after the injury and may get worse for several days afterwards.

Causes of whiplash

Road traffic accidents are the main cause of whiplash.

Car and motorcycle accidents often result in whiplash because the sudden stopping force of the collision makes your head move violently.

As whiplash can occur when the head is thrown forwards, backwards or sideways, it can develop after collisions from the front, back or side. Low speed collisions can also cause whiplash.

As well as road traffic accidents, whiplash can also be caused by a sudden blow to the head – for example, during contact sports, such as boxing or rugby.

A slip or fall where the head is suddenly and violently jolted backwards can also cause whiplash, as can being struck on the head by a heavy or solid object.

Diagnosing whiplash

Whiplash can usually be diagnosed from a description of your symptoms. Tests and scans aren't usually required.

Visit your GP if you've recently been involved in a road accident, or you've had a sudden impact to your head and you have pain and stiffness in your neck.

They'll ask about how the injury happened and details of your symptoms. They may also examine your neck for signs of muscle spasms and tenderness and assess the range of movement in your neck.

Scans, such as X-rayscomputerised tomography (CT) or magnetic resonance imaging (MRI) will usually only be carried out if a fracture or other problem is suspected.

Treating whiplash

Whiplash will usually get better on its own or after some basic treatment.

If you have whiplash, it's better to move your neck rather than keep it still using a neck brace or collar.

Your neck may be painful but keeping it mobile from an early stage will improve its functionality and speed up your recovery.

Painkillers, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be used to help relieve the pain. 

Whiplash that lasts for six months or more is sometimes known as chronic whiplash or late whiplash syndrome.

Your treatment plan should be based on your symptoms. For example, if you have severe pain, your GP can prescribe a stronger painkiller, such as codeine, or they may recommend physiotherapy.

Read more about how whiplash is treated.

Complications

In most cases, whiplash eventually gets better without causing any lasting damage. However, in a small number of cases, the pain can last for six months or longer (chronic whiplash).

Prolonged neck pain may make it difficult for you to carry out daily activities and enjoy your leisure time. It may also cause problems at work and could lead to anxiety and depression.

See your GP if you have chronic neck pain that's causing problems with work and preventing you from carrying out normal, everyday activities.

Read more about the complications of whiplash.

Symptoms

Whiplash causes pain, tenderness, stiffness and loss of movement in the neck.

You may also experience headaches, muscle spasms and pain in your arms or shoulders.

If you have whiplash, the ligaments in your neck will be overstretched. This is known as a sprain.

Hyperextension and hyperflexion are where the tendons and ligaments of the neck are forcefully extended or flexed beyond their normal limits.

Although the ligament isn't broken, a sprain can often take a long time (sometimes several months) to heal.

After an accident, the symptoms of whiplash often take a while (six to 12 hours) to develop. Any inflammation and bruising in neck muscles won't usually be evident at the time of the accident.

Neck pain and stiffness is often worse on the day after the injury and may continue to get worse for several days afterwards.

Whiplash is usually short lived and self-limiting (it gets better on its own), but in a small number of people the symptoms persist beyond six months. This is known as chronic whiplash or late whiplash syndrome (see below).

Less common symptoms of whiplash

Less common symptoms of whiplash can include:

  • lower back pain
  • pain, numbness or pins and needles (paraesthesia) in your arms and hands
  • muscle spasms
  • dizziness 
  • tiredness
  • vertigo – the sensation that you're moving or spinning while standing still

Following a whiplash injury, symptoms of headaches and dizziness should only last for a short time. See your GP if they persist.

Whiplash can also sometimes cause memory loss (amnesia), poor concentration and irritability.

Long-term whiplash

Symptoms associated with long-term (chronic) whiplash are:

  • neck pain and stiffness
  • persistent headache
  • dizziness
  • pins and needles in the arms and hands
  • psychological and emotional symptoms, such as anxiety and depression

Read more about how chronic whiplash is treated.

Treatment

In many cases, whiplash will eventually get better on its own or after some basic treatment.

However, sometimes whiplash can cause a number of severe and troublesome symptoms that last for a long time.

Whiplash that lasts for six months or more is known as chronic whiplash or late whiplash syndrome (see below).

Neck movement

If you have whiplash, it's important to keep your neck mobile by doing some gentle neck exercises.

Your neck may be painful, but keeping it mobile from an early stage will improve its movement and speed up your recovery. Any pain you experience when moving your neck is normal and won't cause further damage.

If you rest your neck and keep it still it's likely to prolong your symptoms and delay your recovery. Therefore, wearing a neck brace or collar isn't recommended.

Painkillers and anti-inflammatories

Analgesics (painkillers) can be used to help relieve the pain of a whiplash injury.

Paracetamol is recommended to treat mild neck pain. You should use it regularly rather than only when the pain is most severe.

If your neck pain is severe, your GP will be able to prescribe a stronger painkiller, such as codeine. This can be used on its own or in combination with paracetamol to provide increased pain relief.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also be used to help ease the pain and reduce inflammation.

Always follow the manufacturer’s recommended dosage instructions when taking painkillers and NSAIDs.

Avoid taking ibuprofen if you have a stomach ulcer, or if you've had one in the past. You should also avoid taking ibuprofen if you have severe heart failure or liver disease.

Physiotherapy

Physiotherapy may be recommended if your whiplash symptoms continue for several weeks.

Physiotherapy uses a range of physical techniques to help restore movement to areas of the body following illness or injury.

It can often be used to help restore a person’s range of movement after a whiplash injury.

Your physiotherapist will be able to show you neck exercises you can do at home.

Long-term whiplash

The symptoms of whiplash can sometimes last six months or more. There's little in the way of scientific evidence to suggest which treatments are most effective for treating long-term whiplash.

However, keeping your neck mobile and using painkillers for pain relief are recommended. Your treatment plan should be based on your specific symptoms and focus on dealing with the cause of your pain.

If you have severe neck pain, a stronger painkiller, such as codeine, can be prescribed either to use on its own or with paracetamol or ibuprofen. Again, always follow the manufacturer's dosage instructions when using painkillers and anti-inflammatories.

Self care

As well as keeping your neck mobile and using painkillers, the self care measures below may also help you manage the pain and stiffness in your neck and prevent them getting worse.

  • Good posture – always maintain a good, upright posture by keeping your back straight while sitting, standing and walking. If you spend a lot of time using a computer, adjust your chair and computer screen correctly.
  • Supportive pillow – some people find a firm, supportive pillow helps when sleeping. Avoid using more than one pillow.
  • Exercises and stretches – controlled exercises, such as those used in yoga, will help improve your strength and posture. However, there's no evidence that they help reduce neck pain.

Complications

Most cases of whiplash eventually get better without any lasting damage, but sometimes the pain can be prolonged and severe.

Whiplash that lasts for several months or longer can sometimes cause anxiety and depression.

If the injury was the result of a motor vehicle accident, sorting out the damage to your vehicle and dealing with compensation claims can often be stressful and time-consuming.

Severe or prolonged pain can make it difficult to carry out daily activities and enjoy your leisure time. It can also affect your work. Visit your GP if your neck pain is causing problems with work or everyday activities.

Try to remain positive and focus on your treatment objectives. However, if you do feel depressed, your GP will be able to recommend appropriate treatment. They may refer you to a specialist pain clinic for further assessment and treatment or they may recommend counselling.

Recovering from whiplash

The length of time it will take to recover from whiplash will depend on how severely your neck has been sprained.

If the ligaments and tendons in your neck are only slightly damaged it may take a few weeks to recover. However, in severe cases, whiplash and whiplash-associated injuries can last for several months or for more than a year.

One study found the average recovery time for a whiplash injury without other associated symptoms was 32 days, and that 315 out of 2,627 participants hadn't recovered six months later (chronic whiplash).