Patient leaflets from the BMJ Group
Whiplash
If you have whiplash, your neck will be painful and stiff.Whiplash should get better
on its own after a few days.There are also some things you can do to reduce your
pain and speed up your recovery.
What is whiplash?
You can get whiplash if your head is suddenly jolted backwards and forwards in a whip-like
movement. This type of neck injury often happens in car crashes.Your neck muscles
and ligaments (the strands of tissue that hold your bones together) stretch more than
normal and may be sprained.
You can also get whiplash from a sports injury. Or you might jolt your neck when you trip
or fall, but this is less common.
What are the symptoms?
If you have whiplash, your neck will be sore and painful, especially when you try to move
it. The pain will probably feel worse the day after the injury.You may have some of the
following symptoms within the first two days after your injury, or they might start a day
or two afterwards:
• A stiff neck
• Headaches
• Pain in your shoulder or between your shoulder blades
• Pain in your lower back
• Difficulty concentrating and feeling irritable
• Dizziness, ringing in your ears or blurred vision. This should go away quickly. Tell
your doctor if it doesn't.
Tell your doctor if these symptoms don't start to get better after about a week or if they
get worse.
A severe whiplash injury can cause more serious problems that need hospital treatment.
People's spines or spinal cords sometimes get damaged, but it is not very common.You
should go back to see your doctor if:
• The pain becomes worse
• The pain lasts more than four to six weeks
• You get any numbness, weakness or pins and needles in your arm or hand.
© BMJ Publishing Group Limited 2007. All rights reserved.
page 1 of 3
What treatments work?
Your pain and stiffness should start to get better within a few days.There are some things
you can do to help your recovery.
Things you can do for yourself
• Keeping your neck moving as normally as possible helps to stop it becoming stiff.
Keeping your neck moving also helps you to be able to move it further. A
physiotherapist can give you advice about how to move your neck or what exercises
can help with your neck pain. Research shows you're less likely to have long-term
neck problems if you follow advice from a trained physiotherapist. Neck exercises
to keep your neck moving are more likely to work if you start doing them straight
away after the injury. This is called early mobilisation.
• Try to get back to your normal routine as soon as possible after a whiplash injury.
This can also help to reduce long term pain and stiffness in your neck.
• Doctors think that using a firm, supportive pillow at night might help. But there's
no research evidence to support this.
• Resting your neck in a soft collar probably won't help. Research has found that
people who rested their neck in a collar and took two weeks off work were more
likely to have continuing pain, stiffness and headaches than people who got back
to their normal activities.
Medicines
Painkillers haven't been studied in people with whiplash, but they will probably help your
neck pain, especially in the first few days after your injury when the pain is likely to be
worse. Several different kinds of medicines can be used to treat pain. Here is some
information about the most common ones.
• You can buy some painkillers, such as paracetamol or codeine (in combination
with other painkillers), in a pharmacy. But you'll need a prescription from your doctor
to get any stronger painkillers. Paracetamol is safe if you follow the directions on
the package. Codeine is a stronger type of drug, called an opioid. Opioids can cause
nausea, vomiting, drowsiness and constipation. If you take opioids like codeine,
regularly, you're likely to begin needing them in order to feel well (you get addicted
to them). This means that if you stop taking them, you get withdrawal symptoms.
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, reduce pain
and inflammation in sore body tissue.You can get some mild side effects from
NSAIDs, such as stomach pains and diarrhoea. People who take NSAIDs for a long
time (usually for conditions such as arthritis) are also at risk of getting stomach ulcers
and bleeding. Some NSAIDs have been linked to a higher risk of getting a heart
attack or a stroke. But this risk happens when people take very high doses of NSAIDs
for a long time.
Muscle relaxants relax your muscles and also make you calm and sleepy.They include
benzodiazepines, such as diazepam (brand name Valium). Muscle relaxants are
© BMJ Publishing Group Limited 2007. All rights reserved.
page 2 of 3
Whiplash
sometimes used for people in severe pain from muscle spasms, but they are used for
only a short period. They can make you feel sick, dizzy or drowsy. It's also possible to
become dependent on these drugs if you take them for too long. This means you have
withdrawal symptoms if you stop taking them.There is no good research to show whether
these drugs help whiplash.
What will happen to me?
The pain and stiffness from whiplash usually go away in a few days or weeks. But they
can sometimes last longer.
Up to 2 in 5 people still have some symptoms 15 years after their injury.We don't know
why some people get more problems than others. Whiplash is more likely to cause
disability than neck pain from other causes.
© BMJ Publishing Group Limited 2007. All rights reserved.
This information is aimed at a UK patient audience. This information however does not replace medical advice.
If you have a medical problem please see your doctor. Please see our full Conditions of Use for this content
http://besttreatments.bmj.com/btuk/about/12.html.
© BMJ Publishing Group Limited 2007. All rights reserved.
page 3 of 3
Whiplash
http://clinicalevidence.bmj.com/ceweb/conditions/msd/1103/neck-pain--whip-lash-standard-ce_patient_leaflet.pdf
